Hump Day Hustling – Weekly Research Summary – November 29, 2023

Hypertrophy, BFR, 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

Patient Perspective

“Smallest worthwhile effect”

This is a really cool open access paper that evaluates “The minimum benefit of an intervention that patients consider worthwhile given the costs, risks and inconveniences” e.g. “The Smallest Worthwhile Effect”.

Basically this is asking “How much more better would you need to get beyond what you can expect with time/natural history to make it ‘worth it’ to take NSAIDS or do Physio?”. Answers were interesting at 30% additional pain reduction for NSAIDS and 20% for CLBP. This is really great to hear as those are very reasonable results to expect with rehab.

    Hypertrophy Protocols

    A narrative review

    Warning: Not peer reviewed yet, but very reliable author group!

    “This review aims to synthesize the evidence on what constitutes an optimal approach to training technique for maximizing hypertrophy and provide recommendations for future research on the effect of RT technique on muscle hypertrophy”

    Nice to finally read a summary that synthesizes the endless trials we’ve seen on this topic over the past couple years. The authors breakdown key variables and discuss each of these individually:

    • Repetition Tempo
    • Range of Motion
    • Exercise specific kinematics

    And then close with practical recommendations. Great stuff!

    Article Link

    Blood Flow Restriction

    For BONE health??

    Not open access unfortunately, but we believe this publication is worth sharing anyhow considering the novel angle. When you think BFR you tend to think lots of opportunities for creating a favorable metabolic environment for tissue growth even in the absence of heavy external loads. What you likely DON’T think as much about is the possible utility of this modality for BONE development.

    From the paper: “First evidence indicates that low load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise.”

    Intriguing to say the least!

    Achilles Tendinopathy

    In search of the best protocol

    This open access SR & MA looked at 12 RCTs and had 2 aims:

    1. Compare exercise loading protocols with passive treatment modalities for the management of midportion achilles tendinopathy
    2. Compare different exercise loading protocols (and the intervention (isometric or isotonic or eccentric)

    “Passive interventions resulted in greater pain reduction in the short term compared with eccentric loading protocols (n = 4 studies; n = 212 participants; pooled MD, 10.22 [95% CI, 2.18 to 18.25]; P= .01). For function, there was a nonsignificant trend in favor of eccentric loading in the short-) and midterm follow-up.”

    Conclusion in a nutshell: Loading wins out #OnlyAlways for midportion achilles tendinopathy compared to passive treatment , and it does not seem to matter which loading strategy (heavy slow resistance, eccentric, concentric, or isometric). Consider passive treatment early in care for a modulating window of opportunity TO LOAD.

    One clinical implication recommendation we don’t agree with was recommending heel lifts for (passive treatment) pain relief. This was based off one study in the 12 RCTs. Our most recent clinical practice guideline says we do not have conclusive evidence to determine this, and this SR & MR sure does not give us enough to give this rec***

    Partner Corner

    Mayhem: Fitness programming for everyone

    ICE physio proudly partners with Mayhem Athlete and we recommend them for all your online fitness and programming needs!​

    The Mayhem Family has options for you whether you workout at home, in your garage or at the gym! You and your clients will find programs for beginners, those getting back into fitness, and seasoned competitors.

    Join the Mayhem Family and experience a community that helps you reach your fitness goals like no other!

    PTonICE Rewind

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

    Monday: “Breathing, voicing, and the pelvic floor” (April Dominick)
    Tuesday: “Patellofemoral pain syndrome: Studs & Duds” (Mark Gallant)
    Wednesday: “Give a sh*t, don’t be full of sh*t” (Jeff Musgraves)
    Thursday: “The golden triangle: Money, time, autonomy” (Alan Fredendall)
    Friday: “Rowing 101” (Alan Fredendall)

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    📢 Did you know we have two other free email subscriptions just like Hump Day Hustling but geared towards Pelvic and Older Adult demographics? Simply click those links, drop your email, and sit back to receive the bi-weekly goods!

    📢 On Virtual ICE next week we’ll be chatting “When it’s the back AND the hip” with ICE faculty Cody Gingerich! Not in our virtual mentorship program? Find out how to enroll and learn more HERE