Hump Day Hustling – Weekly Research Summary – April 3, 2024

Nordic hamstring nuances, protein supplementation, new anatomical discoveries, 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 our Upcoming Course Dates and Locations.

Pregnancy

Does pelvic pain effect balance?

Sixty-three pregnant women between 12 and 38 weeks of gestation and complaints of PPGP (VAS) were included in this open access paper published last month. Balance was assessed using force plates on compliant and non-compliant surfaces with eyes open and eyes closed.

Center of pressure velocity and sway was greater (p<0.05) in pregnant women with PPGP compared to women without, especially in the 3rd trimester. Regardless of PPGP, pregnant women in the 3rd trimester had greater center of pressure velocity and postural sway compared to women in their 2nd trimester. Decreased static stability was noted in pregnant women with PPGP compared with pregnant women without.

Clinical application or rant? You decide…

We need to exercise the pregnant population in varying positions. This includes static balance, dynamic balance, power, and overall strength. We CANNOT exclude the core or the fact that they may need to go up and down stairs, get on and off the floor, lift a wiggly first-born, OR go to the gym and jump, squat, hinge, lift overhead, do all of this for time, etc.

The answer is no longer, “exercise pregnant people in side lying, quadruped, or sitting positions.” Get your women on their feet and challenge their systems to match their life. Even better, make it harder than their typically ADLs.

Nordic Hamstring

The role of knee flexion angle

This paper supports the importance of doing whatever you can to regress and modify if your not strong enough to get into a low knee flexion angle. Simple EMG study of N=13 males around the age of 25, they looked at varying hip and knee angles finding that the highest hamstring EMG was when you got all the way down to 30 degrees of knee flexion compared to the higher angles of 45 and 60 degrees. They achieved that lower flexion angle by elevating the bench, similar to all the new nordic machines that have entered the market recently.

We tend to argue that hamstring strains occur at the lower flexion angle so its important to train people in that low angle, but its also important to maximize the volitional contraction and training effect.

Protein

A confusing take on supplementation

This open access article was published a few months ago and has been featured in a few social media discussions as an argument against protein supplementation. We’re featuring it this week as a good example of why you have to read the full text….

N = 122 (99 men // 23 women) subjects were all British Army recruits completing basic training. Individuals consumed 20g (low protein), 60g (high protein), carbohydrate placebo, or no beverage prior to bed each night for 12 weeks. Basic summary of findings: No difference between groups was found for mid-thigh pull, medicine ball power throw, 2k run time, max push-ups, max vertical jump, or body composition.

The issues:

1) Despite varying degrees of protein intake, this study did not adjust for the large amount of caloric deficits that most recruits were placed in. Take a look at paragraph 1 describing energy expenditure and compare it to table 1 describing caloric intake. The average caloric deficit in this study was around 1500 cal/day which is enormous. In this energy imbalance environment we would expect any person to demonstrate average or below-average performance during re-testing.

2) Recommendations for protein intake in individuals eating in a caloric deficit are often recommended at 2.2-3.1 g/kg/day. The highest amount of consumption in subjects was 2.15 g/kg/day.

We would argue this paper is more of a take on how folks who are under fueled in general perform upon retesting versus a serious take on effect of protein supplementation.

Obturator & Pelvic Floor

New anatomical findings

This is a fascinating open access study published in the Journal of Anatomy with NEW findings. (Always amazing to me that we’re still learning even about ANATOMY…. much less physiology… of the pelvic floor)

Findings: the obturator internus and levator ani (largest pelvic floor ‘sling’ muscles) have a closer relationship to one another than we previously thought… they actually share a broad planar contact with one another. We used to believe they just interacted linearly.

This broad contact relationship has several potential implications: by strengthening the hip (external rotation + abduction, OI’s main functions), we can potentially influence the pelvic floor muscles. This study is based on both male and female cadaver pelvises. They include great photos to really appreciate the relationships here.

Sponsor Corner

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PTonICE Rewind

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

Monday: “Call to action: Pelvic PREhab in the community” (April Dominick)
Tuesday: “Multi-planar approach to loading the lumbar spine” (Brian Melrose)
Wednesday: “Cognitive screening” (Alex Germano)
Thursday: “Mentorship: Optimizing via degrees of separation” (Jeff Moore)
Friday: “The state of kipping in 2024” (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 Brian Melrose presenting “Growing wellness: Harnessing houseplants”. 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!​