Tibial Stress Fractures in Runners: It’s All the Same Problem

Distinct hip and rearfoot kinematics in female runners with a history of tibial stress fracture. Journal of Orthopaedic & Sports Physical Therapy. 2010 Feb;40(2):59-66. Milner CE1, Hamill J, Davis IS. STUDY DESIGN: Cross-sectional controlled laboratory study. OBJECTIVES: To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female … Read more

Kinesio Tape Smells Like Placebo

Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014 Mar;60(1):31-9. Parreira Pdo C, Costa Lda C, Hespanhol Junior LC, Lopes AD, Costa LO. AbstractQuestions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition … Read more

Strength Better than Stretch for Plantar Fasciitis

High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2014 Aug 21. Rathleff MS1, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. AbstractThe aim of this study was to investigate the effectiveness of shoe inserts and … Read more

Plantar Fasciitis: One Cortisone Shot = 19X Risk of Rupture

Risk factors affecting chronic rupture of the plantar fascia. Foot Ankle Int. 2014 Mar;35(3):258-63. Lee HS1, Choi YR, Kim SW, Lee JY, Seo JH, Jeong JJ. AbstractBACKGROUND:Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar … Read more

Foot Muscle Fatigue Causes Loss of Foot Arch

Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5.  Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. AbstractOur purpose was to assess the effect of foot intrinsic muscle fatigue on pronation, as assessed with navicular drop, during static stance. Twenty-one healthy young adults participated. Navicular drop was … Read more

Foot Intrinsic Muscles Important for Foot Arch

Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Abstract Much of the work describing support of the medial longitudinal arch has focused on the plantar fascia and the extrinsic muscles. There is little research concerning … Read more

Runners with Patellofemoral Pain, Have Altered Hip and Knee Rotational Stress

Patellofemoral joint stress during running in females with and without patellofemoral pain. Knee. 2012 Oct;19(5):703-8. Wirtz AD1, Willson JD, Kernozek TW, Hong DA. AbstractPatellofemoral pain (PFP) is a common complaint among female runners. The etiology for PFP is frequently associated with increased patellofemoral joint stress (PFJS) and altered hip and knee joint kinematics during running. … Read more

Cervicogenic Headaches Reduced Most with Strength Training

Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med. 2010 Apr;42(4):344-9. Ylinen J1, Nikander R, Nykänen M, Kautiainen H, Häkkinen A. AbstractOBJECTIVE:To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain. METHODS:A total of 180 female office workers, with … Read more

Foot Orthotics Help Some with Patellofemoral Pain

Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med. 2009 Mar;43(3):169-71. Collins N1, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. AbstractOBJECTIVE:To compare the clinical efficacy of foot orthoses in the management of patellofemoral pain syndrome with flat inserts or physiotherapy, and to investigate … Read more

Total Knee Functional Outcome Measure Doesn’t Measure Function

Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM&R. 2011 Jun;3(6):541-9 Stevens-Lapsley JE1, Schenkman ML, Dayton MR. AbstractOBJECTIVE:To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures over the … Read more

Low Back Pain, Hip Strength, and IT Band Tightness

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & Osteopathy. 2010 Jan 13;18:1. Arab AM, Nourbakhsh MR. Abstract BACKGROUND: Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with … Read more

Decreasing Low Back Pain While Driving

Seat inclination, use of lumbar support and low-back pain of taxi drivers. Scand J Work Environ Health. 2005 Aug;31(4):258-65. Chen JC, Dennerlein JT, Chang CC, Chang WR, Christiani DC. AbstractOBJECTIVES:Epidemiologic evidence supporting optimal seating is limited and inconsistent. This cross-sectional study was conducted to examine the association between seat inclination, use of lumbar support, and … Read more

Running Volume Increase Effects on Injury

Can GPS be used to detect deleterious progression in training volume among runners? J Strength Cond Res. 2013 Jun;27(6):1471-8. Nielsen RO1, Cederholm P, Buist I, Sørensen H, Lind M, Rasmussen S. AbstractThere is a need to ascertain if an association exists between excessive progression in weekly volume and development of running-related injuries (RRI). The purpose … Read more

Marathon Runners, Running >30 Km/Wk Decreases Risk of Injury

Weekly running volume and risk of running-related injuries among marathon runners. International Journal of Sports Physical Therapy. 2013 Apr;8(2):111-20. Rasmussen CH, Nielsen RO, Juul MS, Rasmussen S. AbstractPURPOSEBACKGROUND: The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race.METHODS:The study was a retrospective … Read more

Reversing Disc Protrusions, McKenzie Mostly Correct in Theory

Disc prolapse: evidence of reversal with repeated extension. Scannell JP, McGill SM. Spine (Phila Pa 1976). 2009 Feb 15;34(4):344-50. AbstractSTUDY DESIGN:A basic science study that used a porcine cervical spine model to produce disc prolapse subsequently exposed to an extension protocol.OBJECTIVE:This study investigated whether extension or combined extension and side flexion could move the displaced portion … Read more

How to Herniate a Disc, and How Not to

Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech (Bristol, Avon). 2001 Jan;16(1):28-37. Callaghan JP, McGill SM. AbstractOBJECTIVE:To determine whether repeated motion with low magnitude joint forces, and flexion/extension moments consistently produce herniation in a non-degenerated, controlled porcine spine motion segment.DESIGN:Combined loading (flexion/extension motions and … Read more

Patellofemoral Pain Most Associated with Hip Weakness

Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011 Sep;3(5):455-65. Meira EP, Brumitt J. AbstractCONTEXT:Patellofemoral pain syndrome (PFPS) is one of the most common conditions limiting athletes. There is a growing body of evidence suggesting that dysfunction at the hip may be a contributing factor in PFPS.DATA SOURCES:MEDLINE … Read more

Runners with Plantar Fasciitis Have Weak, Tight Calf Muscles

Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med. 1991 Jan-Feb;19(1):66-71. Kibler WB1, Goldberg C, Chandler TJ. Abstract Plantar fasciitis is a relatively common injury that occurs in running athletes. The disease entity is a good example of an overloaded process of the plantar fascia at its calcaneal insertion. This study … Read more

Plantar Fasciitis Sufferers Have Weaker Foot Muscles

Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Physical Therapy. 2003 Aug;33(8):468-78. Allen RH, Gross MT. Abstract STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine if a difference exists in toe flexors strength and passive extension range of motion of the first … Read more

Plantar Fasciitis Associated with Foot Muscle Atrophy

Use of MRI for volume estimation of tibialis posterior and plantar intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Chang R, Kent-Braun JA, Hamill J. Clin Biomech (Bristol, Avon). 2012 Jun;27(5):500-5. Abstract BACKGROUND: Due to complexity of the plantar intrinsic foot muscles, little is known about their muscle architecture in vivo. Chronic plantar fasciitis … Read more

Plantar Fasciitis: Orthotics Don’t Help Much

Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med. 2006 Jun 26;166(12):1305-10. Landorf KB, Keenan AM, Herbert RD. AbstractBACKGROUND:Plantar fasciitis is one of the most common foot complaints. It is often treated with foot orthoses; however, studies of the effects of orthoses are generally of poor quality, and to our … Read more

Tennis Elbow: Both Concentric and Eccentric Exercise Helps

A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy). Clin Rehabil. 2014 Mar 14. [Epub ahead of print] Peterson M, Butler S, Eriksson M, Svärdsudd K. Abstract Objective:To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.Design:Randomized controlled trial.Setting:Primary care in Uppsala County, … Read more

Electric Muscle Stimulation for Athletes

Electromyostimulation–a systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. J Strength Cond Res. 2012 Sep;26(9):2600-14. Filipovic A1, Kleinöder H, Dörmann U, Mester J. AbstractThis is the first part of 2 studies that systematically review the current state of research and structure the results of selected … Read more

Fibromyalgia Pain Decreased 30% with TENS and Exercise

Effectiveness of high-frequency transcutaneous electrical nerve stimulation at tender points as adjuvant therapy for patients with fibromyalgia. Eur J Phys Rehabil Med. 2013 Apr;49(2):197-204. Carbonario F, Matsutani LA, Yuan SL, Marques AP. AbstractBACKGROUND:Fibromyalgia is a chronic pain syndrome associated with sleep disorders, fatigue and psychological symptoms. Combinations therapies, such as electrotherapy and therapeutic exercises have … Read more

Total Knee Replacement: More than 85% Last at Least 20 Years

What is the evidence for total knee arthroplasty in young patients?: a systematic review of the literature. Clin Orthop Relat Res. 2011 Feb;469(2):574-83. Keeney JA1, Eunice S, Pashos G, Wright RW, Clohisy JC. AbstractBACKGROUND:TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to … Read more

Fibromyalgia Improved Immediatley with TENS

Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain. 2013 Nov;154(11):2554-62. Dailey DL, Rakel BA, Vance CG, Liebano RE, Amrit AS, Bush HM, Lee KS, Lee JE, Sluka KA. AbstractBecause transcutaneous electrical nerve stimulation (TENS) works by reducing central excitability and activating central inhibition pathways, we tested … Read more

Central Sensitization and Chronic Pain

Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. Woolf CJ. [FREE FULL TEXT] AbstractNociceptor inputs can trigger a prolonged but reversible increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways, the phenomenon of central sensitization. Central sensitization manifests as pain hypersensitivity, particularly dynamic tactile allodynia, secondary … Read more

Neck Pain/Tender Points Reduced Most by Strength Exercise

Effect of long-term neck muscle training on pressure pain threshold: a randomized controlled trial. Eur J Pain. 2005 Dec;9(6):673-81. Ylinen J, Takala EP, Kautiainen H, Nykänen M, Häkkinen A, Pohjolainen T, Karppi SL, Airaksinen O. AbstractMuscle tenderness has been measured in several studies to evaluate effectiveness of treatment methods, but only short-term results have been reported … Read more

Neck Pain Immediately Reduced After Strength and Posture Exercise

Specific therapeutic exercise of the neck induces immediate local hypoalgesia. J Pain. 2007 Nov;8(11):832-9. Epub 2007 Jul 19. O’Leary S, Falla D, Hodges PW, Jull G, Vicenzino B. AbstractThis study compared the effect of 2 specific cervical flexor muscle exercise protocols on immediate pain relief in the cervical spine of people with chronic neck pain. … Read more

Strength Training with Chronic Neck Pain Improves Quality of Life

Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study. Health Qual Life Outcomes. 2010 May 14;8:48. Salo PK, Häkkinen AH, Kautiainen H, Ylinen JJ. Abstract BACKGROUND: Chronic neck pain is a common condition associated not only with a decrease in neck muscle … Read more

Greater EMS Rate Causes Greater Blood Flow with Peripheral Artery Disease

Calf muscle stimulation with the Veinoplus device results in a significant increase in lower limb inflow without generating limb ischemia or pain in patients with peripheral artery disease. J Vasc Surg. 2013 Mar;57(3):714-9. Abraham P1, Mateus V, Bieuzen F, Ouedraogo N, Cisse F, Leftheriotis G. AbstractOBJECTIVE:Increase in arterial inflow to the lower limbs is important … Read more

Electric Stimulation and Peripheral Vascular Disease

Chronic muscle stimulation improves ischaemic muscle performance in patients with peripheral vascular disease. Eur J Vasc Surg. 1994 Jul;8(4):419-22. Tsang GM1, Green MA, Crow AJ, Smith FC, Beck S, Hudlicka O, Shearman CP. AbstractThere is currently no established treatment for intermittent claudication with proven long term benefit. Exercise classes have been shown to improve walking … Read more

Electric Muscle Stimulation Helps Rheumatoid Arthritis

Neuromuscular electrical stimulation and volitional exercise for individuals with rheumatoid arthritis: a multiple-patient case report. Physical Therapy. 2007 Aug;87(8):1064-77. Piva SR1, Goodnite EA, Azuma K, Woollard JD, Goodpaster BH, Wasko MC, Fitzgerald GK. AbstractBACKGROUND AND PURPOSE:Muscle atrophy is common in patients with rheumatoid arthritis (RA). Although neuromuscular electrical stimulation (NMES) is a viable treatment for … Read more

EMS Increases Circulation and Function with Severe PVD

The influence of electrostimulation on the circulation of the remaining leg in patients with one-sided amputation. Angiology. 2002 May-Jun;53(3):329-35. Presern-Strukelj M1, Poredos P. AbstractThe aim of the authors’ study was to investigate, in patients with one leg amputated, the influence of electrostimulation on the arterial circulation of the other lower limb and on the ability of a … Read more

Electric Stimulation Increases Capillary Number and Oxygenation in Peripheral Vascular Disease

Noninvasive augmentation of microvessel number in patients with peripheral vascular disease. J Vasc Surg. 2003 Dec;38(6):1309-12. Clover AJ, McCarthy MJ, Hodgkinson K, Bell PR, Brindle NP. AbstractOBJECTIVE:Therapeutic angiogenesis has great potential for the treatment of ischemic diseases. One possible route for noninvasive induction of microvessels has recently been suggested by the finding that subcontractile electrical … Read more

Electric Stimulation for Intermittent Claudication

Chronic transcutaneous electrical stimulation of calf muscles improves functional capacity without inducing systemic inflammation in claudicants. Eur J Vasc Endovasc Surg. 2004 Feb;27(2):201-9. Anderson SI, Whatling P, Hudlicka O, Gosling P, Simms M, Brown MD. Abstract OBJECTIVES: To assess whether electrical stimulation of ischaemic calf muscles in claudicants causes a systemic inflammatory response and to … Read more

Low-Intensity Pain-Free Treadmill Exercise for Intermittent Claudication

Benefits of low-intensity pain-free treadmill exercise on functional capacity of individuals presenting with intermittent claudication due to peripheral arterial disease.  Angiology. 2009 Aug-Sep;60(4):477-86. Barak S, Stopka CB, Archer Martinez C, Carmeli E. AbstractPatients with intermittent claudication due to peripheral arterial disease (PAD) experience muscle aching during walking secondary to ischemia.  The purpose of this study … Read more

Pain Free Treadmill Training for Intermittent Claudication?

Experimental model of pain-free treadmill training in patients with claudication. Am J Phys Med Rehabil. 2005 Oct;84(10):756-62. Mika P, Spodaryk K, Cencora A, Unnithan VB, Mika A. AbstractOBJECTIVE:Treadmill training in claudication is often based on walking exercise to a pain threshold or longer to the maximum muscle pain of the lower limbs.  This kind of … Read more

Intermittent Claudication and the Importance of Supervision

The Effect of Supervision on Walking Distance in Patients with Intermittent Claudication: A Meta-analysis. Eur J Vasc Endovasc Surg. 2014 Jun 10. pii: S1078-5884(14)00206-8. doi: 10.1016/j.ejvs.2014.04.019. [Epub ahead of print]  Gommans LN, Saarloos R, Scheltinga MR, Houterman S, de Bie RA, Fokkenrood HJ, Teijink JA. AbstractBACKGROUND:A number of reviews have reported the influence of exercise therapy … Read more

McKenzie Method, Diagnosis No Better Than Treatment

McKenzie lumbar classification: inter-rater agreement by physical therapists with different levels of formal McKenzie postgraduate training. Spine (Phila Pa 1976). 2014 Feb 1;39(3):E182-90.  Werneke MW, Deutscher D, Hart DL, Stratford P, Ladin J, Weinberg J, Herbowy S, Resnik L. Abstract STUDY DESIGN: Inter-rater chance-corrected agreement study. OBJECTIVE: The aim was to examine the association between … Read more

Strength Training and Intermittent Claudication

Strength training increases walking tolerance in intermittent claudication patients: randomized trial. J Vasc Surg. 2010 Jan;51(1):89-95.  Ritti-Dias RM, Wolosker N, de Moraes Forjaz CL, Carvalho CR, Cucato GG, Leão PP, de Fátima Nunes Marucci M. Abstract OBJECTIVE: To analyze the effects of strength training (ST) in walking capacity in patients with intermittent claudication (IC) compared … Read more

Intermittent Claudication: More Workouts Equals More Improvement

High-intensity interval training for intermittent claudication in a vascular rehabilitation program. J Vasc Nurs. 2006 Jun;24(2):46-9. Adams J, Ogola G, Stafford P, Koutras P, Hartman J. Abstract: This article reports an observational study investigating the safety and effectiveness of a high-intensity interval exercise program for patients with peripheral arterial disease. Patients were asked to walk … Read more

Supervised Treadmill Walking, Calf Muscle Capillarization and Walking Distance

Effects of supervised treadmill walking training on calf muscle capillarization in patients with intermittent claudication. Angiology. 2009 Feb-Mar;60(1):36-41. Wang J, Zhou S, Bronks R, Graham J, Myers S. Abstract The aim of this study was to evaluate the effects of supervised treadmill walking training on the calf muscle capillarization in patients with intermittent claudication. The … Read more

Intervals with Active Rest for Intermittent Claudication

New rehabilitation program for intermittent claudication: Interval training with active recovery: pilot study. Ann Phys Rehabil Med. 2011 Jul;54(5):275-81. Villemur B, Marquer A, Gailledrat E, Benetreau C, Bucci B, Evra V, Rabeau V, De Angelis MP, Bouchet JY, Carpentier P, Pérennou D. AbstractBACKGROUND:Peripheral arterial disease (PAD) is one of the complications of atherosclerosis. Intermittent claudication … Read more

Exercise for Intermittent Claudication

Exercise for intermittent claudication. Physical Therapy. 2011 Jul;91(7):997-1002 Brunelle CL, Mulgrew JA. My Comments This was short review paper but I liked it because it gave consensus recommendations from both the TASC II (Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease) as well as the program from the American Heart Association.  The TASC … Read more

Physical Therapy for Peripheral Artery Disease and Intermittent Claudication

Functional impairment in peripheral artery disease and how to improve it in 2013. Curr Cardiol Rep. 2013 Apr;15(4):347. McDermott MM. AbstractLower extremity peripheral artery disease (PAD) affects 8 million men and women in the United States and will be increasingly common as the U.S. population lives longer with chronic disease. People with PAD have poorer … Read more

Electrical Stimulation to Treat Cluster Headaches

Nociception specific supraorbital nerve stimulation may prevent cluster headache attacks: Serendipity in a blink reflex study. Cephalalgia. 2014 Mar 10. [Epub ahead of print] Haane DY1, Koehler PJ. AbstractBACKGROUND:In cluster headache, neuromodulation is offered when patients are refractory to pharmacological prophylaxis. Non-invasive peripheral neuromodulatory approaches are of interest. We will focus on these and particularly … Read more

Migraine Headache Prevention with TENS (Cefaly Effectiveness Study)

Migraine prevention with a supraorbital transcutaneous stimulator: a randomized controlled trial. Neurology. 2013 Feb 19;80(8):697-704. Schoenen J, Vandersmissen B, Jeangette S, Herroelen L, Vandenheede M, Gérard P, Magis D. Abstract OBJECTIVE: To assess efficacy and safety of trigeminal neurostimulation with a supraorbital transcutaneous stimulator (Cefaly, STX-Med., Herstal, Belgium) in migraine prevention. METHODS: This was a … Read more

Safety and Satisfaction of Cefaly (Headband TENS) for Headaches

Safety and patients’ satisfaction of transcutaneous supraorbital neurostimulation (tSNS) with the Cefaly® device in headache treatment: a survey of 2,313 headache sufferers in the general population. J Headache Pain. 2013 Dec 1;14:95. doi: 10.1186/1129-2377-14-95. Magis D, Sava S, d’Elia TS, Baschi R, Schoenen J. AbstractBACKGROUND:Transcutaneous supraorbital nerve stimulation (tSNS) with the Cefaly® device was recently … Read more

Migraine Headaches, Electric Stimulation and Paresthesia Concordancy

Peripheral neuromodulation and headaches: history, clinical approach, and considerations on underlying mechanisms. Reed KL. Curr Pain Headache Rep. 2013 Jan;17(1):305.< From the Review: “With the publication of their “Gate Control Theory” of pain modulation in 1965, Wall and Melzack provided a conceptual mechanistic foundation for considering direct electrical stimulation of the spinal cord and peripheral … Read more

Shooter’s Elbow (aka Tennis Elbow / Golfer’s Elbow)

Shooter’s elbow is a bit of a made up term. If it hurts on the outside of your elbow, then it’s the same as tennis elbow (lateral epicondylitis) and if it hurts on the inside of your elbow it’s golfers elbow (medial epicondylitis). I don’t know if any of my friends play tennis, and only … Read more

EMS Decreases Pain, Numbness, Burning, and Improves Sleep with Neuropathy

External electric muscle stimulation improves burning sensations and sleeping disturbances in patients with type 2 diabetes and symptomatic neuropathy.  Pain Med. 2009 Mar;10(2):413-9.  Humpert PM, Morcos M, Oikonomou D, Schaefer K, Hamann A, Bierhaus A, Schilling T, Nawroth PP. OBJECTIVE: External muscle stimulation (EMS) of the thighs was previously shown to have beneficial effects in … Read more

Electric Muscle Stimulation Better than TENS for Neuropathy

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia. 2005 May;48(5):824-8.  Reichstein L, Labrenz S, Ziegler D, Martin S. Abstract AIMS/HYPOTHESIS: Diabetic distal symmetrical sensory polyneuropathy (DSP) affects 20-30% of diabetic patients. Transcutaneous electrical nerve stimulation (TENS) and electrical spinal cord stimulation have been proposed as physical therapies. We performed a controlled, … Read more

Electric Stimulation Complementary with Drug Treatment for Neuropathy

Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief. Diabetes Care. 1998 Aug;21(8):1322-5. Kumar D, Alvaro MS, Julka IS, Marshall HJ. From the study: Abstract OBJECTIVE:To evaluate the efficacy of combining electrotherapy with amitriptyline for the management of chronic painful peripheral neuropathy in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS:Patients (n = … Read more

Electric Stimulation Decreases/Eliminates Painful Neuropathy

Diabetic peripheral neuropathy: amelioration of pain with transcutaneous electrostimulation. Diabetes Care. 1997 Nov;20(11):1702-5. Kumar D, Marshall HJ. Abstract OBJECTIVE: To evaluate the efficacy of transcutaneous electrotherapy for chronic painful peripheral neuropathy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Thirty-one patients with symptoms and signs of peripheral neuropathy were randomized to the electrotherapy … Read more

Muscle Spasms and Low Back Pain

This was a pair of studies by the same authors that have some great, real world implications with regards to prevention and physical therapy treatment of low back pain and neck pain. Short rest periods after static lumbar flexion are a risk factor for cumulative low back disorder. J Electromyogr Kinesiol. 2005 Feb;15(1):37-52. Courville A, … Read more

Post Total Knee Replacement; If You Can Walk Fast for 6 Minutes, You Can Walk Fast for 30.

The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013 Apr 24;14:145. Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. Abstract BACKGROUND: The Six-minute walk (6 MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty … Read more

Abdominal Hollowing, Core / Spine Stabilization, and Low Back Pain

This study explains a lot with regards to differential, and failure to differentiate exercise outcomes in people with low back pain. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 2007 Oct;17(5):556-67. Vera-Garcia FJ1, Elvira JL, Brown SH, McGill SM. Abstract Much discussion exists … Read more

Not Just Strength but Also Neuromuscular Exercise and Counseling Decreases Low Back Pain.

Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study.   Spine (Phila Pa 1976). 2013 Mar 1;38(5):375-84.   Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki H, Parkkari J.   Abstract STUDY DESIGN: Controlled intervention with group randomization. OBJECTIVE: To investigate … Read more

Preventing Low Back Pain on Airline Flights

Lessons from this study make up what I think is about a third of the solution to effectively treating low back pain preventing future episodes of back pain.  That is, to avoid prolonged damaging posture particularly in spine flexion. Using a pneumatic support to correct sitting posture for prolonged periods: a study using airline seats. Ergonomics. … Read more

Strength Better than Stretch for Neck Pain AND Range of Motion

This was one of the earlier cervical strength training studies on neck pain that influenced my physical therapy treatments for neck pain. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA. 2003 May 21;289(19):2509-16. Ylinen J1, Takala EP, Nykänen M, Häkkinen A, Mälkiä E, Pohjolainen T, Karppi … Read more

Periodized Resistance Training Works Better than Aerobic Training for Chronic Low Back Pain

A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res. 2009 Mar;23(2):513-23. Kell RT, Asmundson GJ. From the study: Abstract The purpose of this study was to determine the influence of 2 different periodized exercise rehabilitation programs (resistance training [RT] and aerobic training … Read more

Strength Training, Function and Low Back Pain.

The influence of periodized resistance training on recreationally active males with chronic nonspecific low back pain. J Strength Cond Res. 2011 Jan;25(1):242-51. Jackson JK, Shepherd TR, Kell RT. From the study: Abstract The most common musculoskeletal health issue is chronic nonspecific low back pain (CLBP). CLBP increases pain and disability, which reduces quality of life … Read more

Hard Times for McKenzie Method, Low Back Pain

The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach. Spine. 2006 Apr 20;31(9) Machado LA, de Souza Mv, Ferreira PH, Ferreira ML. From the study: “Eleven trials of mostly high quality were included. McKenzie reduced pain (weighted mean difference [WMD] on a 0- to 100-point scale, -4.16 … Read more

ACL Repair: Abnormal Gait, Future Arthritis Due to Low Strength

The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon). 2002 Jan;17(1):56-63. Lewek M1, Rudolph K, Axe M, Snyder-Mackler L. From the study: BACKGROUND:Individuals following anterior cruciate ligament rupture often demonstrate reduced knee angles and moments during the early stance phase of gait. Alterations in gait can neither … Read more

After ACL Repair: Lunges Appear Particularly Safe

Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics. Biomed Res Int. 2013;2013 Norouzi S1, Esfandiarpour F, Shakourirad A, Salehi R, Akbar M, Farahmand F. From the study: AbstractA safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the … Read more

Rehabilitation after ACL Reconstruction: Leg Extensions, Knee Laxity, and Training Load (Not What You Would Expect)

Is knee laxity change after ACL injury and surgery related to open kinetic chain knee extensor training load? Am J Phys Med Rehabil. 2009 May;88(5):369-75. Morrissey MC, Perry MC, King JB.From the study: OBJECTIVE:The purpose of this study was to evaluate whether knee anterior laxity changes after anterior cruciate ligament injury and surgery are related … Read more

Wall Squats Not so Good after ACL Reconstruction

Tibial displacement and rotation during seated knee extension and wall squatting: a comparative study of tibiofemoral kinematics between chronic unilateral anterior cruciate ligament deficient and healthy knees. Knee. 2013 Oct;20(5):346-53. Keays SL1, Sayers M, Mellifont DB, Richardson C. From the study: “Following anterior cruciate ligament (ACL) rupture, the knee becomes unstable with alterations in joint … Read more

ACL Reconstruction, Leg Extensions Safe but Timing is Everything

Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):402-14. Epub 2007 Jan 12. Heijne A, Werner S. From the study: AbstractThe purpose of the present investigation was to evaluate physical outcome after anterior … Read more

After ACL Repair, Closed Kinetic Chain Exercises Not Enough to Restore Quadriceps Strength

Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. 2000;8(6):337-42.  Mikkelsen C1, Werner S, Eriksson E. From the study: AbstractRehabilitation after anterior cruciate ligament (ACL) reconstruction has … Read more

Hip Pain: Trochanteric Bursitis Isn’t Bursitis

Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome. Arthritis Rheum. 2001 Sep;44(9):2138-45. Bird PA1, Oakley SP, Shnier R, Kirkham BW. From the Study “All subjects were women (median age 58 years, range 36-75 years). The median duration of symptoms was 12 months (range 12-60 months). MRI … Read more

Low Back Pain: Use of Biopsychosocial Model Does Not Improve Outcomes

Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2118-23. From the review: “The biopsychosocial model of back pain has become a dominant model in the conceptualization of the … Read more

Rotation Stretch Increases Low Back Pain and Decreases Spine Stability

Low back pain development response to sustained trunk axial twisting. Eur Spine J. 2013 Sep;22(9):1972-8. From the study:METHODS:Sixteen male pain-free university students volunteered for this study. The trunk axial twisting was created by a torsion moment of 50 Nm for 10-min duration. The axial rotational creep was estimated by the transverse camera view directly on … Read more

Low Back Pain: Cyclic and Static Spine Flexion Both Bad for the Back

Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Ann Biomed Eng. 2005 Mar;33(3):391-401. From the study: Abstract There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic … Read more

Without Aggressive Rehabilitation Function Usually Diminished 1 Year Post-Op after Total Knee Replacement

Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Physical Therapy. 1998 Mar;78(3):248-58. From the study: SUBJECTS:Twenty-nine individuals 1 year following TKA (13 women, 16 men) and 40 age- and gender-matched control subjects (18 women, 22 men) were assessed.METHODS:Walking speed, stair-climbing ability, knee torque (in newton-meters), … Read more

EMS Better than TENS for Pain

Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation for treatment of chronic back pain: a double-blind, repeated measures comparison. Arch Phys Med Rehabil. 1997 Jan;78(1):55-60. Moore SR1, Shurman J. INTERVENTIONS:Subjects self-administered NMES, combined NMES/TENS, TENS, and placebo treatments. Each treatment had a duration of 5 consecutive hours per day over 2 consecutive days, with … Read more

Electric Stimulation Increases Strength and Decreases Pain in Patients with Osteoarthritis

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013 Apr;31(4):511-6. From the study: “OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee … Read more

Electric Muscle Stimulation Prevents Atrophy after Total Knee Replacement

Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Physical Therapy. 2012 Feb;92(2):210-26. Stevens-Lapsley JE1, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. From the study: “Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation … Read more

Physical Therapy after Total Knee Arthoplasty: Neuromuscular Electrical Stimulation Causes a Significant Boost in Quadriceps Strength

Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2004 Jan;34(1):21-9. AbstractSTUDY DESIGN:A case series. OBJECTIVES:The purpose of this case series was to assess the effect of high-intensity neuromuscular electrical stimulation (NMES) on quadriceps strength and voluntary activation following total knee arthroplasty … Read more

Physical Therapy and EMS after Total Knee Arthoplasty: More Current = More Muscle

Relationship between intensity of quadriceps muscle neuromuscular electrical stimulation and strength recovery after total knee arthroplasty. Physical Therapy. 2012 Sep;92(9):1187-96. AbstractBACKGROUND:Neuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet to be … Read more

Electric Muscle Stimulation Well Tolerated by Patients at Sufficient Intensities to Strengthen Muscle after Total Knee Replacement

Response of male and female subjects after total knee arthroplasty to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2010 Jun;89(6):464-72. AbstractOBJECTIVES:To examine responses to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle in male and female subjects after total knee arthroplasty. DESIGN:Sixty-four subjects who underwent total knee … Read more

Alfredson’s exercise program in Achilles tendinopathy 5 years later

A 5-year follow-up study of Alfredson’s heel-drop exercise programme in chronic midportion Achilles tendinopathy. van der Plas A, de Jonge S, de Vos RJ, van der Heide HJ, Verhaar JA, Weir A, Tol JL. Br J Sports Med. 2011 Nov 10. [Epub ahead of print] AbstractBACKGROUND: Eccentric exercises have the most evidence in conservative treatment … Read more

Tennis Elbow: Improved with Isometric Exercise

Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3. AbstractBACKGROUND: The aim of this prospective randomized clinical trial was to investigate the efficacy of a home-based … Read more

Cortisone, Eccentric vs Heavy Slow Resistance for Patellar Tendinopathy

Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Kongsgaard M, Kovanen V, Aagaard P, Doessing S, Hansen P, Laursen AH, Kaldau NC, Kjaer M, Magnusson SP. Scand J Med Sci Sports. 2009 Dec;19(6):790-802. Epub 2009 May 28. Abstract A randomized-controlled single-blind trial was conducted to investigate the clinical, structural … Read more

Cluster Headaches and Migraines, What I Am Learning from the Surgically Implanted Electrical Stimulation Studies.

Greater occipital nerve stimulation via the Bion microstimulator: implantation technique and stimulation parameters. Clinical trial: NCT00205894. Pain Physician. 2009 May-Jun;12(3):621-8. Abstract BACKGROUND: Millions of patients suffer from medically refractory and disabling primary headache disorders. This problem has led to a search for new and innovative treatment modalities, including neuromodulation of the occipital nerves. OBJECTIVES: The … Read more

Eccentric vs Eccentric Plus Shock-Wave Treatment for Achilles Tendinopathy

Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. Rompe JD, Furia J, Maffulli N. Am J Sports Med. 2009 Mar;37(3):463-70. Epub 2008 Dec 15. AbstractBACKGROUND: Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave … Read more

Eccentric Exercise and Heel Brace for Achilles Tendinopathy

Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the AirHeel Brace. A randomized controlled trial. A: effects on pain and microcirculation. Knobloch K, Schreibmueller L, Longo UG, Vogt PM. Disabil Rehabil. 2008;30(20-22):1685-91. AbstractPURPOSE: To compare eccentric training and the combination of eccentric training with the … Read more

Electric Stimulation for Headaches, Migraines (My Results)

This treatment is serendipitous, so I’ll add some background information on how I came to it.  As shown by my other blogs, in the last year I’ve been especially interested in electric muscle stimulation (EMS) to help recovery by accelerating strength gains better than exercise alone.  A number of my knee and back pain patients … Read more

Eccentric Exercise vs. Ultrasound for Achilles Tendo Pain

Eccentric calf muscle training compared with therapeutic ultrasound for chronic Achilles tendon pain–a pilot study. Chester R, Costa ML, Shepstone L, Cooper A, Donell ST. Man Ther. 2008 Dec;13(6):484-91. Epub 2007 Jul 26. Abstract A number of studies have indicated that eccentric calf muscle training has beneficial effects in the management of Achilles tendon pain … Read more

Electric Muscle Stimulation BEFORE Total Knee Replacement Improves Outcomes

“Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study. BMC Musculoskelet Disord. 2010 Jun 14;11:119. ” <br) BACKGROUND: Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve … Read more

Eccentric calf muscle training in athletic patients with Achilles tendinopathy

Eccentric calf muscle training in athletic patients with Achilles tendinopathy. Maffulli N, Walley G, Sayana MK, Longo UG, Denaro V. Disabil Rehabil. 2008;30(20-22):1677-84.  AbstractPURPOSE: To evaluate the effects of eccentric strengthening exercises (ESE) in athletic patients with Achilles tendinopathy.METHODS: Forty-five athletic patients (29 men, average age 26 years +/- 12.8, range 18 – 42; 16 … Read more

Electric Muscle Stimulation for Strength, How to Make It Work.

”Electromyostimulation–a systematic review of the influence of training regimens and stimulation parameters on effectiveness in electromyostimulation training of selected strength parameters. J Strength Cond Res. 2011 Nov;25(11):3218-38. ” Since I plan to discuss a number of studies on electric stimulation, I figured I should get this one out there. It gives some background as to which … Read more

Physical Therapy and EMS: Restores Activation, Strength 1 Year Post TKA

”The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2006 Sep;36(9):678-85.” This was a single-patient case study of a patient who had high level function but persistent quadriceps weakness and activation deficits 13.5 months post op. … Read more

No Rest Necessary for Achilles Tendinopathy

Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Am J Sports Med. 2007 Jun;35(6):897-906. AbstractBACKGROUND: Achilles tendinopathy is a common overuse injury, especially among athletes involved in activities that include running and jumping. Often an initial period … Read more

Anatomic factors related to the cause of tennis elbow

Anatomic factors related to the cause of tennis elbow. Bunata RE, Brown DS, Capelo R. J Bone Joint Surg Am. 2007 Sep;89(9):1955-63. AbstractBACKGROUND: The pathogenesis of lateral epicondylitis remains unclear. Our purpose was to study the anatomy of the lateral aspect of the elbow under static and dynamic conditions in order to identify bone-to-tendon and … Read more

Muscle Deficits Usually Persist Long after Total Knee Replacement

“Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation. Physical Therapy. 2009 Oct;89(10):1072-9.” From the study: “Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and … Read more

Eccentric exercise in treatment of Achilles tendinopathy

Eccentric exercise in treatment of Achilles tendinopathy. Nørregaard J, Larsen CC, Bieler T, Langberg H. Scand J Med Sci Sports. 2007 Apr;17(2):133-8. AbstractAIM: Prognosis and treatment of Achilles tendon pain (achillodynia) has been insufficiently studied. The purpose of the present study was to examine the long-term effect of eccentric exercises compared with stretching exercises on … Read more

How Soon is Too Soon to Lift Weights after Total Knee Arthroplasty?

Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible? Disabil Rehabil. 2012;34(12):1034-40. From the study: “Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition … Read more

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achilles: a randomized controlled trial. Rompe JD, Nafe B, Furia JP, Maffulli N. Am J Sports Med. 2007 Mar;35(3):374-83. Epub 2007 Jan 23. AbstractBACKGROUND: Few randomized controlled trials compare different methods of management in chronic tendinopathy of the main … Read more

Achilles Tendinopathy, Symptom Recovery Does Not Ensure Functional Recovery

Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Br J Sports Med. 2007 Apr;41(4):276-80; discussion 280. Epub 2007 Jan 29. AbstractOBJECTIVE: To assess the relationship between muscle-tendon function and symptoms in patients with Achilles tendinopathy using a validated test … Read more