Wrist straps for deadlifts? Single versus multiple PT sessions for maximum benefit? Answers to these questions and more in this episode of Hump Day Hustling! Enjoy, and if you want to dive deeper with ICE content make sure to check out Upcoming Course Dates and Locations!
The magic is in the variations
This study used muscle EMG to analyze the muscle activation effects in the body of various plank variations. 21 subjects performed low planks, low planks with shoulders in ER, low planks with front reaches, low planks with bird dogs, high planks, high plank “plus”, bear crawl planks, high plank shoulder taps, high planks with toe touches, and high side planks.
Findings: high plank exercises increase lower trapezius & triceps activation. Serratus anterior was highest in the low plank bird dog. Activation ratios were lowest in the traditional low plank exercise.
Take away: Planks are a great way to begin loading the shoulder girdle early in rehab, and increasing the challenge beyond the traditional low plank on elbows with these different variations significantly increases the demand of the scapular muscles. Planks appear to load the shoulder girdle in such a manner that no particular muscle is overloaded, making them safe for early post-op loading. The authors made a particular note that biceps appears to be minimally involved in the plank, making these variations a great option to begin loading the shoulder in closed chain flexion/external rotation without concern for the integrity of the biceps tendon in the case of a biceps repair, SLAP tear, etc.
Respiratory health concerns?
When pondering a trail marathon or ultra marathon, we’re certain patients encounter plenty of mental barriers, but respiratory issues probably isn’t high on the list. Perhaps it should be? This is a really interesting article from Trail Runner that explores both athlete and environment respiratory health considerations. The authors lay out various conditions athletes encounter and how their genetic make up along with where they do their training can combine to bring them about. Please don’t let this stop you from getting out on the trails, just great info to have when treating runners in your community!
One and Done
Is a single PT treatment all you need?
We want to think more is better, that patients will get additional benefit from visiting a PT 8-10 times compared to going only once. But does the data support this assumption?
This new systematic review and meta analysis of six randomized controlled trials certainly challenges the belief showing no difference in function or quality of life at 3, 6, 12 months between a single physio session versus multiple.
Some thoughts: First, it is important to appreciate the issue wasn’t that NO ONE got better, but instead that MOST PEOPLE got better. This is great, but still presents an uncomfortable challenge about the lack of discrepancy between groups. At the risk of sounding defensive, it is important to note that the only outcomes were subjective pain, sf-36 and function, so there is no measurement of important factors that could be improved with multiple visits: For example strength and how much medical care patients seek after rehab (imaging, opioids etc) which we know improve after PT care. What if our profession leveled up and started coaching everyone on lifestyle behaviors, fitness, strength etc and actually tracked changes in more meaningful metrics, could we / would we see more promising changes? Maybe, either way this paper is a tough pill to swallow!
Wrist straps: Yay or nay?
Always love when the research shines a bit of light on an age old controversy!
This publication in October’s JSCR took a look at total number of repetitions, mean and peak barbell velocity, and grip strength during the deadlift exercise in women.
Findings: “The wrist strap condition allowed participants to perform significantly more reps while resulting in no statistically significant differences in mean or peak barbell velocity.”
Our 2 cents: If your goal with the deadlift is to provide max stimulus to the posterior chain use lifting straps to get more volume or load!
Barriers & enablers of return to sport
With so many mamas out there crushing it more questions about timeline/expectations for return to sport are coming up in the clinic. This recent piece in BMJ does a great job of providing guidance for clinicians during these challenging conversations.
Five key factors were found to significantly influence female athlete RTS postpartum including (1) postpartum recovery time; (2) time to manage motherhood and sport demands; (3) sport organization policies; (4) stereotypes; and (5) social support.
Did you miss any of our ICE Physio podcasts last week? Well here you go!
Monday: “Postpartum depression part 2: Screening and what to say to a client” (April Dominick)
Tuesday: “Shoulder instability: The plan” (Mark Gallant)
Wednesday: “Medication issue. Now what?” (Alex Germano)
Thursday: “Evidence-based medicine: Are you doing it right?” (Alan Fredendall)
Friday: “Hip shifting in the squat” (Zach Long)
Upcoming ICE Physio Courses
- October 21-22: Lumbar Spine (Frederick, MD)
- October 21-22: Rehab of the Injured Runner (Bellingham, WA)
- October 21-22: Older Adult LIVE (Matawan, NJ)
- October 21-22: Dry Needling: Lower Body (Anchorage, AK)
- October 21-22: Pregnancy and Postpartum LIVE (Corvalis, OR)
- November 3-5: Dry Needling: Upper Body (Seattle, WA)
- November 4-5: Lumbar Spine (Fort Worth, TX)
- November 4-5: Total Spine Thrust (Simi Valley, CA)
- November 4-5: Pelvic LIVE (Bozeman, MT)
- November 4-5: Fitness Athlete LIVE (Hoover, AL)
- November 4-5: Older Adult LIVE (Annapolis, MD)
- November 4-5: Older Adult LIVE (Easley, SC)
- November 4-5: Fitness Athlete LIVE (San Antonio, TX)
- October 23rd: Persistent Pain Management
- November 6th: Fitness Athlete: Essential Foundations
- January 2nd: Rehab of the Injured Runner
- January 9th: Fitness Athlete: Pregnancy and Postpartum
- January 9th: Brick by Brick
- January 10th: Older Adult: Essential Foundations
- January 11th: Older Adult: Advanced Concepts
- January 22nd: Primary Care PT
- February 4th: Fitness Athlete: Advanced Concepts
📢 On Virtual ICE next week we’ll be chatting “Decoding headaches” with ICE faculty Jessi Witherington! Not in our virtual mentorship program? Find out how to enroll and learn more HERE