Hump Day Hustling – Weekly Research Summary – February 21, 2024

New clinical practice guidelines released, a first (to our knowledge) publication on running mechanics during pregnancy, and much much more in this episode of Hump Day Hustling! Enjoy, and if you want to dive deeper with ICE content make sure to check out our Upcoming Course Dates and Locations.

Exercise and Depression

Systematic review & network meta-analysis

Love to see it, particularly at the SR/MA level. This open access publication from BMJ has some amazing things to say, but make sure you at least open the PDF to capture and share the image at the top of page 2 which shows the different modes of exercise and their impact on depression.

The paper is open access, so we’ll let you dive into the details, but two quick key things:

  • The biggest wins seems to come from walking, jogging, strength training
  • Lots of ways work, but adding higher intensity/vigor does seem to level up benefits

New Clinical Practice Guidelines

Heel pain – plantar fasciitis

Before we get to the parts we like, let’s start with the BIAS CHECK: Low level laser therapy is now B level evidence

More in line with our bias; AN UPTICK IN EVIDENCE FOR exercise and DN directly to the FOOT (now ‘B’ level)

A few notables:

“Clinicians should use dry needling to MTrP in the gastrocnemius, soles, and plantar muscles of the foot for short- and long-term pain reduction, as well as long-term improvements in function and disability”

“Clinicians should prescribe therapeutic exercise that includes resistance training for the musculature of the foot and ankle”-

‘A’ level evidence continues to support: manual therapy to lower leg, stretching of gastroc and soleus, foot orthoses, taping, and night splints for those with 1-3 months of pain,

SHOULD NOT USE: ultrasound

As always this CPG is open access

Pregnancy and Running

Well this is a first!

An IRB actually approved a study on running during pregnancy? To the best of our knowledge this is the first study of its’ kind comparing running mechanics during the 2nd and 3rd trimesters and 4-6 months postpartum as compared to healthy controls.

Summary of findings: Not surprisingly, running velocity was slower in the 3rd trimester and trunk rotation was less in the 2nd and 3rd trimester as well as in the postpartum period as compared to the controls. Postpartum runners exhibited less trunk flexion, more trunk extension, less hip flexion, greater hip adduction, and greater knee abduction compared to controls, but it’s interesting that these variables were not found to be significantly different in the pregnant trials. Researchers did not see differences in EMG activity after controlling for gait speed with the exception of greater peak glute med and erector spinae activation in the pregnant trials.

These are some of the mechanical changes we would expect given the anatomical changes we see during pregnancy and it’s nice to see some confirmation of what we think we see!

Older Adults, Plyometrics, & Resistance

When the student becomes the teacher

Let’s give it up for PT student Troy Merchel preaching the good news of resistance training and ploymetrics for our older adults in this recent JOSPT blog! 

“Safety concerns may be a barrier for both clinicians and older adults to utilize these modes of exercise. These fears are often grounded in assumptions about the aging body rather than evidence.”

PREACH IT TROY

Trail Runners

Fueling concerns galore

Yikes.

This open access survey study of >1900 self-reported trail runners that included questionnaires on energy availability, disordered eating and exercise dependence found that 43% of trail runners were at risk for LEA, 43% were at risk for DE, 62% reported insufficient fueling during long runs, and a whopping 87% were symptomatic for exercise dependency. For all categories, females were at a higher risk than males, and runners <25 years old were at a higher risk than runners >26.

The study has some obvious flaws as the results are based on a survey but an important takeaway is that we need to be extra vigilant when identifying potential energy-related risk factors for injury in trail runners, especially the young and female, to educate on energy availability and fueling during long bouts of exercise and to refer to an appropriate practitioner for nutrition consult when necessary.

PTonICE Rewind

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

Monday: “Breaking down the brace” (Rachel Moore)
Tuesday: “Using palpation for differential diagnosis” (Cody Gingerich)
Wednesday: “The fitness forward discharge” (Dustin Jones)
Thursday: “Deathbed regrets” (Jeff Moore)
Friday: “Protein: Is 25 grams the limit?” (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!

📢 Next week on Virtual ICE we’ve got ICE faculty Rachel Selina presenting “The Ultra Marathoner”. Not in our virtual mentorship group yet?? Head over to this link and change that! $29.99 a month for 24 annual CEUs, live meetings every week with ICE faculty and special guests!​