Hump Day Hustling – Weekly Research Summary – June 12, 2024

Bone stress injuries, combining HIIT with comorbidities, and more in this week’s hump day hustling! If you want to dive deeper with ICE content check out our Upcoming Courses and Specialty Certifications!


Sacral bone stress injuries

This 2024 AJSM article sheds a little light on the under reported condition of sacral bone stress injury (BSI). Sacral BSI account for only ~2% of all BSI and female long distance runners have a higher incidence than other sex/sport combination. The authors looked at variables of 34 athletes with a diagnosis of sacral BSI and found SLR <60 deg in 71%, + neural tension in 18%, 26% had tenderness at the PSIS, and no evidence of decreased LE muscle strength. Most athletes had difficulty continuing their sport due to severity of symptoms. Case study evidence cited a primary complaint of low back pain and/or buttock pain exacerbated with weight bearing and physical activity. Especially important to sacral BSI is the consideration of energy availability and hormone balance as the sacrum is primarily trabecular bone and highly influenced by metabolism. Prognosis for RTS was good for athletes with sacral BSI, however athletes did require at least 1 month refraining from exercise & impact.

Take aways from this study: If you are evaluating a young athlete with a primary complaint of non-traumatic low back or buttock pain who also describes a high volume of activity, consider it a sacral BSI until determined otherwise.

High Intensity Interval Training

Navigating in the presence of comorbidities

This is a super practical clinical commentary on high-intensity interval training in the presence of complex comorbidities.

Two things really jumped out at us:

1) HIGH-INTENSITY / LOW – VOLUME: The author’s acknowledge that much of the research out uses programs that aren’t very practical in session. Many of them are ~30 min not including warm up/cool down which is tough to get in a session and tough for many patients to tolerate (especially settings like HH, SNF, etc).

They highlight the research that shows the effectiveness, adherence, and safety with High-Intensity, Low-Volume (~15 min) in individuals with complex comorbidities which will be more applicable across settings/populations.

2) TESTING: Most clinicians are typically prescribing exercise programs without any formal cardiopulm exsc testing or stress testing. So it can feel like you’re going in blind and you’re just waiting for problems to arise as you push intensity. They give practical tips on how clinicians can perform their own testing in a safe manner. 6MWT, 2MWT, etc combined with vital sign monitoring can ensure safety as well as helpful info to then prescribe at appropriate intensities.


The NEW fitness athlete

Cool instagram post highlighting some key differences metabolically between hydrox and CrossFit. Hydrox events have seen a big increase in popularity over the past year and while many want to say “OR”, this post may highlight why “AND” might be useful here in the fitness athlete space!

Bias Check

Exploring hydration and weight loss

Water Intake and Adiposity Outcomes among Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

N = 1,038 (8 RCTs)

What are the effects of increasing water intake, replacing sugar-sweetened beverages with water, and replacing artificially-sweetened beverages with water?

Surprising no one, individuals replacing sugar-sweetened beverages with more water do tend to see a reduction in waist circumference & fat adiposity, but individuals not already consuming these drinks did not see a weight loss effect from simply consuming more water.

Individuals replacing artificially-sweetened (“diet”) drinks with water saw a statistically significant increase in fat adiposity. Traditionally, the myth around diet drinks has been that your brain will be “tricked” by the fake sugar but empty stomach and increase your craving for actual sugar. Results of some of the studies in this systematic review & meta-analysis suggests the contrary.

Takeaways: humans need to drink water, 3-5 L, everyday. While replacing soda, juice, etc. with water does result in increase weight loss, it is a behavior change that is easier said than done. Conversely, we should probably be less concerned about people who meet their daily hydration goals with a mixture of “diet” drinks & water.

Sponsor Corner

Maximize joy in your practice: 3 tips from fellow practitioners

Hump Day Hustling - Weekly Research Summary - June 12, 2024

As a health and wellness practitioner, it’s important to take care of yourself before you can help others. But finding a strategy that works for you isn’t always easy.

Here’s how 3 practitioners stay energized throughout their day and get the most enjoyment out of their jobs:

  • “Power hours”: “I dedicate the first hour of my morning to activities aligning with my personal and professional goals: meditation, visualization, journaling, reading, and physical activity.” – Josh Wagner
  • Take a nap: “Every day, I set aside at least 20 minutes for an afternoon snooze.” – Lisa Simone Richards
  • Putting fun first: “The biggest difference for me is scheduling my fun and free time first. It’s too easy to get caught up in daily work and neglect our personal lives because we’re ‘tired’ or ‘don’t have time’.” – Lex Lancaster

For more self-care strategies from practitioners in the Jane community, check out the full blog post here.

PTonICE Rewind

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

Monday: “Deltoid Week: Pelvic floor edition” (Jessica Gingerich)
Tuesday: “The deltoid: Form, function, and clinical application” (Ellison Melrose)
Wednesday: “Permission to succeed” (Jeff Musgrave)
Thursday: “Myofascial decompression: Deltoid” (Lindsey Hughey)
Friday: “The role of the deltoid in functional fitness” (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 Dr. Jeff Moore delivering “The Art of Presentation”. 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!​