Corticosteroids, RED-S, “potentiapenia”, and more in this edition 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!
International Olympic Committee consensus
In August 2023, the International Olympic Committee published their updated (from 2018) consensus statement on Relative Energy Deficiency in Sport (REDs).This paper is open access and packed with updates including: Health and Performance Conceptual models, Physiological model, which reiterates the impact of low energy availability (LEA) and associated modifiable factors and provides a new version of a Clinical assessment tool for detection, diagnosis and severity/risk assessment of REDs.
Don’t miss the gorgeous graphics worth saving for patient education purposes that highlight how REDs infiltrates and bleeds into all body systems!
A couple key highlights from the publication:
- The unique bidirectional relationship between mental health and REDs: mental health issues can exist prior to the athlete experiencing REDs or REDs can contribute to poor mental health.
- Though the need for males to be included in LEA studies has been highlighted, there is continued scarcity in that only 20% of studies on REDs from 2018-2022 have included male subjects
- Para athletes may be at an even greater risk for LEA compared to their able bodied fellow athletes.
Same story, different day
Corticosteroid injection has an improvement in function over PT for the first 6 weeks and then shows no benefit compared to PT after that 6 weeks. With more and more data about immune system implications, articular cartilage toxicity, and harm to tendons with CSI, is the 6 weeks really worth it?
Conclusion from the paper: “No evidence was found for the superiority of CSI compared to physiotherapy for pain and ROM in the short term besides an improvement in shoulder function in favor of CSI at 6–7 weeks”
Have we failed to name the enemy?
Has our focus on muscle mass and even strength resulted in a neglect of power training? This is a really interesting commentary from a 20+ year ortho surgeon & avid PTonICE listener -Dr. Michalak
Dr. Michalak argues that while we’ve been so focused on naming & attacking the issue of age-related muscle mass (old definition of sarcopenia) & strength (dynapenia) which has resulted in a neglect of a potentially more important variable in function/independence – power. So he has a call to action to name the enemy – Potentiapenia – a term he made up to encapsulate the age-related loss of muscular power.
What’s interesting is that sarcopenia originally just encompassed age-related loss of muscle mass. Then in the late 2000s the push for dynapenia really forced a critical eye on that definition which has resulted in loss of strength now being included in defining sarcopenia (still debated). We can see this conversation regarding power to continue to shape how we think of sarcopenia.
If this is an area of particular interest for you check out Dustin Jones’ podcast on the topic from last week!
Does Manual Therapy Work?
Great blog post from CEMMT
On a topic as polarizing as this one, finding quality information to guide your understanding can feel like an insurmountable obstacle. Thankfully Duke’s Center for Excellence in Manual and Manipulative Therapy serves as a trusted source of information and science regarding the evolving role of manual therapy in rehab. This recent blog is a wonderful example of their thoughtful and well referenced content!
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To be your best you need to squat your best, and VersaLifts heel lift inserts can help! Designed to be worn in your existing training shoes, VersaLifts provide an additional 1/2″ of heel-to-toe drop, assisting athletes to squat deeper with improved form. Simply place them in any training shoe, either above or beneath the insole, and immediately experience deeper depth & improved mechanics.
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Did you miss any of our ICE Physio podcasts last week? Well here you go!
Monday: “Prolapse intervention” (Jess Gingerich)
Tuesday: “Why the reverse hyper is king” (Jordan Berry)
Wednesday: “Name the enemy: Poteniapenia” (Dustin Jones)
Thursday: “Breaking up with deliverables” (Jeff Moore)
Friday: “Refining double-unders” (Alan Fredendall)
Upcoming ICE Physio Courses
- November 11-12: Cervical Spine (Bridgewater, MA)
- November 11-12: Older Adult LIVE (Wappinger Falls, NY)
- November 11-12: Extremity Management (Woodstock, GA)
- November 18-19: Dry Needling: Upper Body (Rochester, MN)
- November 18-19: Pelvic LIVE (Bear, DE)
- November 18-19: Total Spine Thrust (Santa Rosa, CA)
- November 18-19: Older Adult LIVE (Westmont, IL)
- November 18-19: Total Spine Thrust (Albuquerque, NM)
- November 6th: Fitness Athlete: Essential Foundations
- January 2nd: Rehab of the Injured Runner
- January 8th: Persistent Pain Comprehensive Management
- 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 “Sex, drugs, and rock and roll for older adults” with ICE faculty Jeff Musgraves! Not in our virtual mentorship program? Find out how to enroll and learn more HERE