Cervical manipulation risk, injections vs PT, a bias check, and more coming at you in the first Hump Day Hustling of the new year! Enjoy, and if you want to dive deeper with ICE Physio we’ve got over 200 courses slated for 2023, check out our Upcoming Dates and Locations to reserve your spot!
Cervical Vascular Risk Mitigation
New IFOMPT position statement
Hopefully many of you have read the IFOMPT 2020 framework on examination of the cervical spine in light of vascular concerns. This recent open access position statement does an amazing job integrating the data from that 2020 paper into a clinically applicable roadmap. A few highlights:
- Clearest contrast between dissection vs nondissection presentation that we have seen to date
- Extremely important table highlighting risk of manual therapy compared to other interventions such as NSAIDS
- Concise breakdown of physical exam items that do and don’t have utility and with a thorough explanation of why
If you regularly treat the cervical spine, and/or teach others how to do so, this article deserves your time this week.
Shoulder Impingement
PT or injection?
We’ve all had patients ask, heck many of us treating a lot of shoulder issues struggle to go a month without the question getting flung our way: “What do you think about an injection?”. Lots of factors have to be considered for an appropriate answer to each individual patient, but the findings from this recent open access systematic review can certainly help guide the conversation. It’s a small scale review with only three RCTs ultimately included, but the results suggest no difference in function, pain, or ROM at long term follow up. Admittedly there was a difference in function at short term in favor of injection so depending on patient priorities that may be relevant.
Fake Meat for Real Gains?
The “SWAP-MEAT” trial
Here were the different dietary conditions in this recent open access RCT from Nutrition Journal:
1) Whole-food, plant-based diet
2) Plant-based diet with meat alternatives
3) Omnivorous diet with animal protein
Key findings:
1) Whole-food, plant-based diet had the highest levels of carbohydrate & fiber intake but lowest protein
2) Plant-based diet with meat alternatives led to higher levels of protein intake with less levels of carbohydrate & fiber consumptions
3) Omnivorous diet with animal protein had the highest levels of protein intake but lowest levels of carbohydrate & fiber intake
4) All 3 diets had a similar daily caloric intake (~1900 cal/day)
5) Performance measurements did not differ to a statistically significant degree in any of the endurance or strength outcome measures
Perhaps a bit of a #BiasCheck for those meat lovers among us!
Bias Check
Coffee: Is there too much of a good thing?
Perhaps for some populations, yes. Coffee has had a long series of wins recently and our crew is loving every one of those, BUT we need to interrupt this hot streak with some bad news from JAHA for those with severe hypertension. This open access article concludes: “Heavy coffee consumption was associated with an increased risk of CVD mortality among people with severe hypertension, but not people without hypertension and with grade 1 hypertension.” For those with grade 2 hypertension (160-179 systolic) this may be something to seriously consider.
A Word From Our Sponsor
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PTonICE Rewind
Did you miss any of our ICE Physio podcasts last week? Well here you go!
Monday: “Let’s talk breech babies” (Jessica Gingerich)
Tuesday: “Labels limit in ITB care” (Lindsey Hughey)
Wednesday: “Dependence to independence: A transitional state” (Alex Germano)
Thursday: “Meet them at their story” (Lindsey Hughey)
Friday: “Programming accessory work for CrossFit” (Zach Long)
Thank You! – ICE Faculty
Upcoming In-Person Courses
- January 14-15: Extremity Management (Paoli, PA)
- January 14-15: Extremity Management (Maplewood, MN)
- January 14-15: Total Spine Thrust (Glencoe, MD)
- January 14-15: Fitness Athlete: LIVE (Decatur, GA)
- January 14-15: Older Adult: LIVE (National City, CA)
- January 14-15: Older Adult: LIVE (Hendersonville, TN)
- January 14-15: Lumbar Spine (Marshfiled, MA)
Upcoming Online Courses
- January 3rd: Rehab of the Injured Runner
- January 4th: Older Adult: Essential Foundations
- January 9th: Primary Care Physical Therapy
- January 9th: Persistent Pain Comprehensive Management
- January 9th: Fitness Athlete: Pregnancy and Postpartum
- January 12th: Older Adult: Advanced Concepts
📢 On Virtual ICE next week we’ve got “Migraine Headache” with special guest Dr. Amy Pakula! Not in our virtual mentorship program? Find out how to enroll and learn more HERE
