Hump Day Hustling – Weekly Research Summary – September 20, 2023

New book recommendation, pelvic floor, mental health, and more in this episode of Hump Day Hustling! Enjoy, and if you want to dive deeper with ICE Physio content make sure to check out our Upcoming Course Dates and Locations!

Mental Health

Exploring lifestyle and depression connection

We’re preaching to the choir here, but ya gotta love seeing the MEDS (Mindfulness, Exercise, Diet, Sleep) approach being showcased in research when it comes to combatting mental health conditions such as depression.

From a Gallup poll survey in February 2023, a startling 29% of U.S. adults reported having been diagnosed with depression at some point in their lifetime. This has grown by 10 percentage points since data collection began in 2015. This recent study published in Sept 2023 aimed to determine the association between 7 lifestyle factors, brain structure, immune function, metabolic pathways and genetics and their impact on depression. They studied data from approximately 290,000 individuals across 9 years, with about 13% who developed depression (love that length of time for data collection!). The following are 7 healthy lifestyle factors that were associated with a lower risk of depression (% reduced risk for depression listed to the right of factor):

  1. Healthy sleep—(7-9 hrs of sleep) (reduced risk of depression by 22%)
  2. Frequent social connection- (18%) —most protective against RECURRENT depressive disorder
  3. Never smoking (20%)
  4. Regular physical activity (14%)
  5. Low to moderate sedentary behavior, (13%)
  6. Moderate alcohol consumption (11%)
  7. Healthy diet (6%)

Let’s hone in on these lifestyle factors with our clients, good news they are all modifiable!

Limitations: only a small set of the sample size had depression.

Ten Naked Truths

…about the pelvic floor in athletes

In a space that is remarkably fertile with misinformation, this recent Instagram post from BMJ is a welcome find. The post breaks down in both image and caption text “10 evidence based truths about the athletes pelvic floor”. Such a great post to share out to your communities and following!

For those stuck on a device without IG access here they are:

  1. Physical activity can be protective against PFD, yet its specific effects vary from one athlete to another.
  2. Stress urinary incontinence? It’s just one of the many PFD symptoms athletes face.
  3. Both internal and external factors, like training intensity, can play into PFD risk in athletes.
  4. Male athletes are at risk too.
  5. Young and childless athletes aren’t exempt from PFD.
  6. Comprehensive training should include pelvic floor exercises.
  7. PFD can impact an athlete’s mental well-being and performance, even pushing some to quit.
  8. All health professionals working with athletes: routinely screen for PFD, regardless of age or gender. Tools like the PFD-SENTINEL can be used to help.
  9. An athletes’ post-pregnancy phase is critical. We must ensure a seamless transition, complete with pelvic health checks and a solid return-to-sport plan.
  10. Every athlete is unique. PFD care should be, too, involving experts from multiple disciplines.

Athletic Performance

The role of sleep interventions

ARTICLE: Open access systematic review of 25 publications 


Sleep extension of 46-113 minutes in athletes that sleep ~7 per night OR

Sleep supplement 20-90 min nap after a night of partial sleep restriction

CONCLUSION: “Sleep extension and naps were the most representative and most effective strategies to improve sleep and performance. Mindfulness and light manipulation demonstrated promising results, but more studies are needed to confirm these findings. Sleep hygiene, removing electronic devices at night, and cold water immersion had no effects on sleep and subsequent performance/recovery, but these results are based on a few studies only.”

*Authors acknowledge low quality of summarized research with not a single paper being identified as low risk of bias*

Stress Urinary Incontinence

Remarkably common, but still not normal

This open access 19-question, cross-sectional survey paper includes data from 425 subjects with the goal of assessing prevalence, normalization, rate of treatment, and sources used to obtain information regarding stress urinary incontinence (SUI) in female strength athletes.

For variable control in this study, CrossFitters were excluded on the survey unless they also performed powerlifting, Olympic weightlifting, or strongman training in addition to CrossFit.

Survey responses revealed that 43.5% of female strength athletes experience SUI during the day outside of training, 59.1% experienced SUI during regular training and 50.2% experienced SUI during competition. Of those reporting SUI, 61.4% did not have SUI before beginning strength training. Only 9.4% reported ever seeking treatment while 67.9% reported the belief that SUI was a normal part of participating in strength training/strength-based sport.


Book Recommendation

Finally a motivational interviewing page turner

Hands down the best book we’ve come across on Motivational Interviewing to date. Admittedly, the competition is quite soft as everything else out there seems to be equal parts boring and non-actionable. This one from Rollnick et al is precisely the opposite on both accounts. The specific description of motivational interviewing and formulaic guide to implementation makes this a must read for anyone coaching anyone anything including patients! Big thanks to Dr. Christopher Johnson for getting this one on our radar recently!

PTonICE Rewind

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

Monday: “Postpartum depression part 1: Definition, prevalence, and risk factors” (April Dominick)
Tuesday: “ITB pain: The plan” (Mark Gallant)
Wednesday: “Radically candid patient care” (Jeff Musgraves)
Thursday: “You have to choose” (Jeff Moore)
Friday: “Ground reaction forces and running” (Megan Peach)

Upcoming ICE Physio Courses

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📢 On Virtual ICE next week we’ll be chatting “Dynamometers and white boards: The must-haves of the #Geri clinician” with ICE faculty Sam Chamberlain! Not in our virtual mentorship program? Find out how to enroll and learn more HERE