Hump Day Hustling – Weekly Research Summary – August 9, 2023

New research on posture, cold immersion, and much more in this hump day hustling episode! Enjoy, and if you want to dive deeper with ICE Physio content make sure to check out our Upcoming Course Dates and Locations!

Is Good Posture Overrated?

Spoiler: yes

This is a nice article from The Guardian written for the general public on posture and back pain. Quick take home: Evidence simply does not support posture as a cause of back pain or its’ persistence. Wise words from Dr. Peter O’Sullivan: “Often, this is a distractor from the big game. Our spinal health is linked to our general health. Keeping fit and strong. Moving. Eating well. Sleeping well. They’re the things we should be targeting, rather than this idea of targeting body posture. The interventions that have targeted posture haven’t worked. We have to look beyond that.”

Low Energy Availability

Effects are quick and profound

This June 2023 paper from the Journal of Physiology found that just 10 days of low energy availability (defined here as less than 25 kcal/kg of fat-free mass per day) resulted in a large loss in muscle protein synthesis & loss of fat-free mass, including bone mass, even while consuming 2.2 g of protein per kg fat-free mass. Not only was the loss of fat-free mass drastic, but the metabolism loss from losing metabolically active tissue reduced resting energy expenditure by approximately 100 calories/day.

It’s easy to see how people can get trapped in a weight loss diet/obesity doom loop where crash dieting causes them to lose muscle & bone mass, reducing their basal metabolism, which then requires more exercise or less food (or both) to create a caloric deficit, causing more extreme crash dieting, which causes the further loss of metabolically active tissue. Rinse & repeat.

Notably, subjects in the study were eating 1,185 – 1,513 calories per day compared to control eating 2,093 – 2,713 calories per day. We’ve met a lot of people eating less than 1,185 calories per day while trying to exercise a lot which definitely makes us pause & think about the true nature of MSK injury in the context of active individuals.

Spinal Manipulation

Does specificity matter?

It’s an age old question, and for the first time to our knowledge a systematic review (10 RCTs N=931) has taken it on and come to a fairly straight forwardd conclusion: “Targeting a specific vertebral level when administering SMT for patients with non-specific low back pain did not result in improved outcomes on pain intensity and patient-reported disability compared to a non-targeted approach.”

This isn’t to say spinal manipulation doesn’t work, but perhaps that we should develop a healthy humility regarding the need (or even the ability) to be segmentally specific.

Cold Water Immersion

Another chilly reception in the research

More evidence to stay away from cold water immersion after exercise published in this month’s JSCR

N = 18 “subelite” volleyball players

Subjects performed the same resistance training program and then were allocated to 15 minutes of passive control (sitting at room temperature), contrast immersion, cold water immersion, or hot water immersion.

Those athletes exposed to hot water immersion reported reduced levels of fatigue, improved sleep quality, and an increase in circulating testosterone levels.​

“Podcast health gurus are cool, research data is cooler.”

Inspiration Corner

Be like Joan!

Not sure what we love more, the inspirational #OldNotWeak vibes or the savage dig to her husband “brittle bones.” Either way this IG post from @trainwithjoan is worth a quick read and smile.

PTonICE Rewind

Did you miss any of our ICE Physio podcasts last week? Well here you go!

Monday: “Virtual pelvic floor PT, Part 1: The subjective exam” (Alexis Morgan)
Tuesday: “Offensive meniscal care: Another call to #StopTheScope” (Lindsey Hughey)
Wednesday: “5 things I’ve changed my mind about in geriatric rehab” (Juie Brauer)
Thursday: “Do more better: A case for high dosage” (Jeff Moore)
Friday: “Mobility: How much can we really move the needle” (Alan Fredendall)

Upcoming ICE Physio Courses

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📢 On Virtual ICE next week we’ll be chatting “Exercise prescription for spine pain” with ICE faculty Britt Lademann! Not in our virtual mentorship program? Find out how to enroll and learn more HERE