Research Articles

This simple study has huge implications for managing tibial stress fractures in young running athletes. The authors performed a cross-sectional study comparing differences in size, shape, and strength of the tibia, fibula, and second metatarsal shaft in 16 collegiate level cross-country runners and 16 collegiate soccer players. The authors incorporated high-resolution computed tomography and determined that compared to runners, the tibia in young soccer players was 7.5% larger and 29.4% more...

The authors begin this paper by pointing out that by the year 2050, there will be 2.1 billion people over the age of 60. Unfortunately, as many as 27% of older adults will be classified as having sarcopenia, which greatly increases the risk of falls, hospitalizations, and reduces the overall quality of life. While the authors note that regular resistance training can prevent the development of sarcopenia, compliance with resistance training among older adults is low, and worse, resistance...

This is an excellent review of the literature where the authors evaluated the natural decline in muscle mass associated with aging. The authors reviewed 47 studies in which CTs, MRIs, and/or ultrasound devices were used to measure muscle volume in an accumulated total of 982 younger adults (average age 25) and 1003 older adults (average age 75). What made this paper interesting is that the authors compared nine different muscle groups to determine if some muscles atrophy at quicker rates than...

In this simple study, the authors applied five minutes of focal muscle vibration to the shoulder external rotators and evaluated the range of motion pre-and post-vibration. In just five minutes, shoulder internal rotation using the behind the back reach test increased by 4.1°, while shoulder internal rotation when the arm was abducted 90° increased by a surprising 11.4°. The authors also measured muscle strength, and unlike stretching protocols used to increase range of motion, focal muscle...

The purpose of this study was to evaluate age and gender effects on lower limb biomechanics while running. Despite the growing popularity of distance running among middle-aged and older adults, there has been little research studying biomechanical running differences between men and women as they age. The authors hypothesized that regardless of age, women would generate less force with their ankles and quads, but more force with their hips compared to men while running. Based on prior...

The authors begin this article by pointing out that even though physical activity has been proven to improve cardiovascular health and decrease all-cause mortality, women typically lag behind men when it comes to the frequency and intensity in which they exercise. They cite a recent meta-analysis from 406 countries that showed that young girls were 7% less active than boys and were less likely to participate in vigorous-intensity exercises and/or strength training. This paper is unique as it...

This is the first paper to look at what happens to muscles that are not exercised during resistance training. These authors had 21 participants perform resistance training for 10 weeks in which they performed specific exercises to target their biceps, hamstring, and quads. No other muscles were exercised. At the start and end of the study, the authors performed MRI imaging to measure three-dimensional volume of 28 muscles in the body, including all of the muscles that were targeted and a range...

Athletes have been using foam rollers to warm up before exercising for the past 20 years, and recently, foam rollers that vibrate at specific frequencies are being used to relax muscles and potentially improve performance (Fig. 1). While prior research shows that focal muscle vibration can improve athletic performance and muscle strength, relatively few studies have evaluated if vibration foam rollers can actually reduce delayed onset muscle soreness and accelerate recovery. These authors took...

This interesting paper evaluated the best ways to produce hypertrophy in the gastrocnemius and soleus muscles. The authors emphasize that these important muscles are notoriously unresponsive to strength training and they list several studies showing that while the hamstrings and triceps typically gain between 10% to 20% muscle mass in 12 weeks of strength training, gastrocnemius and soleus tend to gain only 2 to 6% more muscle mass during the same time. They also note that compared to other...

It’s been over 25 years since Alfredson et al. developed the heavy load eccentric protocol for managing Achilles tendinopathy and despite its continued popularity, outcomes with this protocol have never been that good. In fact, nearly 60% of people who perform this exercise routine continue to be symptomatic 5 years later. The authors of this current study suggest that in order for tendon rehab to be successful, the applied weight should be heavy enough to cause the tendon to lengthen between...

Hypermobility of the first ray has been correlated with a wide range of forefoot conditions, including hallux abductovalgus and second metatarsal head capsulitis. Because hypermobility of the first ray undermines the stability of the entire foot, especially during the propulsive period, quantifying the degree of first ray mobility is extremely important. To date, the only accurate way to quantify first ray mobility is with expensive machinery, which is not available to the typical practitioner...

This is an interesting paper that looked at gender and age-related differences in running biomechanics. Specifically, the authors evaluated running kinematics in middle-aged men and women (average age 57 years old) and compared them to young men and women (average age 28 for men and 30 for women). The authors emphasize that it is important to understand how gender and age-related differences in running biomechanics affect function, as it could allow for the development of improved training...

The relationship between arch height and intrinsic muscles/plantar fascial injury is controversial. Some authors suggest that height of the medial longitudinal arch does not affect function, while others claim it plays an important role in a wide range of injuries. In this paper, researchers from Japan measured cross-sectional area and stiffness of the extrinsic and intrinsic muscles of the feet and planter fascia while people with low or neutral arches loaded their feet at 10%, 50%, and 90%...

These researchers measured tomato consumption and followed more than 7000 high-risk participants in a 3-year longitudinal study to evaluate whether or not tomato consumption had any effect on hypertension. Tomatoes were evaluated because they are high in calcium, magnesium, phosphorus, zinc, manganese, pantothenic acid, niacin, and phenolic compounds. Tomatoes are also the highest source of lycopene, which is a powerful antioxidant with 10 times greater antioxidant capabilities than vitamin E....

I previously published a paper called “Novel Exercises and Stretches for Managing High Blood Pressure” that showed diaphragm exercises, holding prolonged static stretches, and performing a few minutes of isometric contractions a few times a week could lower systolic and diastolic blood pressures by 10.4 mmHg and 6.7 mmHg, respectively. In this recent paper Edwards et al. (1) analyzed 270 randomized controlled trials that included nearly 16,000 participants to evaluate the effect different...

Over the past few years there’s been a lot of press suggesting that regular exercise protects not just against a range of cardiovascular and metabolic diseases, but it can also keep our brains healthy by slowing down the overall rate of cognitive decline. The authors of this study tested this theory by using MRIs to measure various markers of brain age to evaluate differences in a group of 225 older adults who went through an exercise intervention and compared these findings to a group 260...

This is an interesting paper for anyone who treats tendon injuries. Most practitioners are aware of the strong connection between fluoroquinolone antibiotics and tendon ruptures, and the connection between type II diabetes and tendon injuries, but more often than not patients presenting for treatment and evaluation of tendon tears do not have their vitamin D levels checked. This is unfortunate because this paper confirms that hypovitaminosis D plays a significant role in the development of...

The authors of this study point out that nearly 1 million Americans get their knees replaced every year, and this number is going to jump to 3.5 million knee replacements annually by 2030. The authors state “the morbidity and mortality due to disuse associated with this is profound.” The authors took 5 severe osteoarthritis patients who were about to get their knees replaced and had them perform blood flow restriction training 3 times a week for 4 weeks and followed each workout by ingesting...

I like this article because it shows that downloading the Anglemeter app onto your iPhone allows you to take photographs of your patients’ bunions and measure their hallux valgus angle. This is important as it allows you to monitor progress for specific interventions when attempting to reduce the size of bunions. The authors evaluated reliability of 2 specific smart phone measurements and determined that they had excellent inter- and intrarater reliability, with ICC values over .9. The only...

These researchers measured plantar pressure distribution through the midfoot, metatarsals and toes as recreational runners ran in 3 different footwear conditions: a control group wearing the flexible Nike Free Run and two experimental conditions in which carbon fiber plates of different thickness were embedded into the control shoe. The running shoes were classified as control, stiff, and stiffest, depending upon which carbon plates were added. Plantar pressure data was collected with 233...