Predicting Running Related Injuries in Male and Female Novice Runners

February 3, 2010

In a study of 532 novice runners (226 men, 306 women) preparing for a recreational 4-mile (6.7-km) running event. After completing a baseline questionnaire and undergoing an orthopaedic examination, they were followed during the training period of 13 weeks. Running Related Injuries (RRI) was defined as any self-reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least 1 week.

Twenty-one percent of the novice runners had at least one RRI during follow-up. Male and female novice runners have different risk profiles

The model for male participants showed that body mass index (BMI) , previous injury in the past year , and previous participation in sports without axial load were associated with RRI.

In female participants, only navicular drop remained a significant predictor for RRI. Type A behavior and range of motion (ROM) of the hip and ankle did not affect risk.

Source: Am J Sports Med February 2010 38:273-280; doi:10.1177/0363546509347985

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Who needs bone-building drugs?

January 20, 2010

Osteoporosis is a common debilitating condition that contributes to increase risk of fractures. To prevent possible risk of fractures, bone building drugs are available to improve bone density. However, they can have side effects and are only 50 percent effective in preventing fractures. Therefore, World Health Organisation has come up with a tool to find out who will benefit from bone building drugs.

FRAX is an online risk calculator which helps the doctors and patients to determine the possibility of potential fracture and determine whether the drug therapy might prevent fractures. The list consists of questions looking at risk factors of osteoporosis. The factors analyze the lifestyle, conditions, diseases and medications that can contribute to the risk of osteoporosis and fractures.

The formula is applicable to both men and women. It can be used independently without a person’s bone density score but having a bone density score can further enhance the accuracy of the prediction.

References

www.shef.ac.uk/FRAX/index.htm

http://mobile.nytimes.com/2009/12/29/health/29brod.xml

Written by lenia.teo · Filed Under Latest Research Findings | Comments

TENS – Not effective for Chronic Low Back Pain according to latest guidelines

January 2, 2010

The American Academy of Neurology (AAN) recently published an evidence-based guidelines on the use of TENS ( transcutaneous electric nerve stimulation) is not recommended for the treatment of chronic low-back pain due to lack of proven efficacy. This supports our views at Core Concepts as a large number of chronic back pain cases is mechanical in nature.

A TENS device
click for larger view

"The strongest evidence showed that there is no benefit for people using TENS for chronic low-back pain," said guideline author Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center in Kansas City and a Fellow of the American Academy of Neurology. "Doctors should use clinical judgment regarding TENS use for chronic low-back pain. People who are currently using TENS for their low-back pain should discuss these findings with their doctors."

TENS however, continues to be recommended for TENS can be effective in treating diabetic nerve pain.

Reference:

Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
American Academy of Neurology (2009, December 31). Widely used device for pain therapy not recommended for chronic low back pain. ScienceDaily. Retrieved January 1, 2010, from http://www.sciencedaily.com /releases/2009/12/091230174120.htm

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Newly Discovered Sensory System in the Skin May Explain Fibromyalgia

December 14, 2009

A newly discovered sensory system hidden in a network located throughout our blood vessels and sweat glands, separate from the usual nerves that gives us the ability to touch and feel, may explain difficult to treat pain conditions like Fibromyalgia Read more

Written by chyetuan.chng · Filed Under Latest Research Findings | Comments

Elderly Balance Better After Foot Massages

December 4, 2009

Researchers found that elderly people were able to balance on their feet better with foot massages.

Jacques Valiant and his group of fellow researchers from Grenoble, France and Geneve, Switzerland found that a session of plantar massage and joint mobilisation of the feet and ankles with clinical balance performance tests in elderly people.

Dividing 28 subjects, aged between 65-95 years, into two groups:

1. An intervention group had a 20 minute session of massage and mobilisation to the feet and ankle,

2. A placebo group that was given an application of three demagnetized magnets in the region of the fifth metatarsal for 20 minutes.

The subjects were tested on their One Leg Balance (OLB), Timed Up and Go (TUG) and Lateral Reach performance. Results were compared between the two groups before and after the massage and application of the magnets.

The group who had massages and mobilisations showed significant improvements in performance of OLB and TUG after one session of intervention.

Reference:

Massage and mobilisation of the feet and ankles in elderly adults: Effect on clinical balance performance, J Vaillant et al., Manual Therapy 2009;14:661-664

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Tai Chi Reduces Knee Osteoarthritis Pain in the Elderly

November 10, 2009

Researchers from Tufts University School of Medicine have found that patients over 55 years old with knee osteoarthritis have lesser knee pain and better improvement in their physical functions with Tai Chi.

http://www.flickr.com/photos/edwinylee

Knee osteoarthritis is a degenerative condition that not only causes pain but also lead to poor muscle function, decreased knee proprioception, impaired physical functions and even psychological distress.

Tai Chi is an ancient Chinese exercise that encompasses mind and body approach to enhance muscle function, balance, flexibility and reduce pain, depression and anxiety may be a good approach to treat knee osteoarthritis.

In the research, Dr Jordan and his team randomly divided 40 participants of age 55 and above, suffering with osteoarthritis knee pain for most of the days in the past months into two groups – the Tai Chi group and Control group. All participants had to attend 60 minutes of either intervention two times weekly for 12 weeks.

A range of measuring tools that mainly measure pain, physical function, balance tests, self efficacy and depression were taken at the first week, 12 weeks, 24 weeks and 48 weeks of the interventions.

The Tai Chi group was taught 10 modified forms of exercise from the classical Yang style. Each session included 10 minutes of self massage and a review of Tai chi principles; 30 minutes of Tai Chi movements; 10 minutes of breathing technique; and 10 minutes of relaxation.

The control group on the other hand was taught stretching for 10 minutes and attended 40 minutes wellness education including osteoarthritis as a disease, diet and nutrition, therapies to treat osteoarthritis, or physical and mental health education.

The results showed that participants who continued Tai Chi after 12 weeks had more long-lasting benefits with lesser knee pain and better physical functions compared with the control group.

The researchers suggested that Tai Chi is an effective exercise to treat pain and physical impairment for patients with severe osteoarthritis knee but notes the need to carry out more research to further understand the mechanism of Tai Chi in osteoarthritis knee.

Reference:

Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial, C C Wang, C H Schmid, P L Hibberd, R Kalish, R Roubenoff, R Rones and T McAlindon, Osteoarthritis and Cartilage 2008;16:S32-33

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Different Compensation Strategies During Jogging by Low Back Pain Sufferers

November 2, 2009

I am sure all athletes have experienced the effects of muscle fatigue. You will use your body differently, trying to compensate by moving your limbs in a more comfortable way. Try going down stairs right after a marathon and you get the picture.

running form

An interesting question is, do everyone compensate using the same strategy? Apparently not. A recent study¹ shows people with recurrent low back pain jogs with a different compensation strategy compared to healthy individuals after a set of fatiguing lower back muscle endurance exercise.

The exercise was to hold the lower back in an extended position until their muscles shows signs of fatigue on surface electromyography (EMG).

The low back pain group was found to jog with a more extended or arched lower back and had more hip movements whereas the normal healthy group runs with a more forward flexed trunk. This may be why it is a common for people with chronic low back pain to complain of hip muscle soreness and fatigue after endurance exercises.

It is a known fact that chronic low back pain sufferers have poor core muscle function. This adaptation of running with an extended back may be a strategy to stabilise the lower back without the need to use core muscles and yet able to continue running. On the other hand, healthy individuals are able to use their core muscles as a natural trunk stabiliser and prevent unnecessary movements.

Parallels can be drawn with long hours of sitting where the body requires muscle endurance to sustain in a single position. When fatigue sets in, the body may adopt a different strategy to try to protect the back and inadvertently creates a wrong movement pattern or mal-adaptation. Therefore, correcting wrong movement patterns and strengthening of the core muscles are important aspects of treating chonic low back pain.

Reference:

1. Hart JM, Kerrigan DC, Fritz JM, Ingersoll CD. Jogging Kinematics After Lumbar Paraspinal Muscle Fatigue Journal of Athletic Training. 2009; 44(5):475–481

Picture: www.amercianrunning.org

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Running Patterns Change as Shoes Wear Out

October 21, 2009

Researchers at University of Texas and Nanyang Technological University investigated the biomechanical effects of running using new versus worn out shoes, as well as comparing three types of cushioning footwear – air, gel and spring.

Dr. Kong and his team studied 24 runners (14 men and 10 women) who were asked to run 200 miles in the same pair of shoes with assigned cushion consisted either of air, gel or spring. They were tested on a 20m laboratory runway, running at 4.5ms^-1 (16.2 kph or approximately 3.7 minute kilometre pace) using a forceplatform and a motion capture system

Pre and post reading of the stance time by using force data, external loads by maximum vertical force and loading rate and kinematic changes on angles of the torso, hip, knee and ankle were calculated during the run.

The results showed that for worn-shoes there was an increase in stance time. Additionally, there were also decreased torso leaning forward (running more upright) and less forward lean during toe- off, decreased maximum ankle dorsiflexion and increased in ankle plantarflexion during toe-off.

But there was no change in knee and hip angles found in all three types of cushioning footwear or either between new or worn shoes.

The researchers suggested that runners modify their running pattern to adapt to the condition of the shoes (decrease in cushioning during wearing out process) to maintain constant external loads. The adaptation changes among different types of shoes cushioning in running were similar. Therefore, types of shoes cushioning should not be the main factor to consider when choosing a pair of running shoes.

Reference:

Running in new and worn shoes: a comparison of three types of cushioning footwear, P W Kong, N G Candelaria, D R Smith, British Journal of Sports Medicine 2009;43:745-749

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Does more MRI scanners do more good or harm?

October 16, 2009

Research has found that countries with more access to MRI have higher number of unnecessary back surgery. MRI may reveal too many abnormalities that mislead the doctor in coming up with the correct diagnosis of the problem. As such, the doctor may end up carrying out unnecessary surgery that may not benefit the patient. Click the following link to find out more.

http://www.bloomberg.com/apps/news?pid=20601124&sid=anaZbOvJquNs

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MRI Identifies Five Causes Of Complications From ACL Reconstructive Surgery

October 14, 2009

MRI has identified five possible causes of patient complications from anterior cruciate ligament (ACL) reconstructive surgery, according to a study performed at Emory University Hospital in Atlanta, GA, and Sahlgrenska-Molndal University Hospital in Gothenborg, Sweden.

Sixteen patients with symptoms suggesting ACL reconstruction failure underwent MR imaging three weeks to three years following surgery to possibly determine the cause(s) of their complications.

“Persistent pain is the most consistent patient complaint. Others complain of instability, joint swelling and infection,” said Claude Pierre-Jerome, MD, lead author of the study.

The study found that there were five possible causes of reconstruction failure and patient complication:

graft discontinuity (a tear or impingement in the graft, 5 knees),
inappropriate position of the femoral and/or tibial tunnel (graft will not function properly without proper tunnel positioning, 2 knees)
hardware failure (screws may not be in the right position, 3 knees),
infection (1 knee) and
intra-articular arthrofibrosis (affecting movement of the joint, 4 knees).

“These are only preliminary results for a much larger study,” said Dr. Pierre-Jerome.

Adapted from materials provided by American Roentgen Ray Society.

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