Ridgefield Sports Medicine

The perfect blot!

Ridgefield has athletes in the Olympics, NFL and some ECNL soccer players that have come in 2nd in the nation with CFC ECNL FC. I have been blessed to be apart of some of their journey to greatness providing preventative/ performance care. Keep being amazing Maeve & Jackson! 💪🏼👊🏼✨⭐️ 🙌🏼😘

Preventative

God Bless the USA!

Just published 🔥

Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain: a randomized controlled trial 🦶

👉 Patellofemoral pain syndrome (PFPS) is one of the most common knee problems that disturb function and daily activities (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764329/). Symptoms of PFPS can develop either slowly or abruptly, and pain tends to worsen with activities such as squatting, prolonged sitting, stair climbing, jumping, or running (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764329/). PFPS affects approximately 25% of physically active individuals (https://pubmed.ncbi.nlm.nih.gov/26792702/). The development of patellofemoral pain is believed to have multiple contributing factors, including proximal, local, and distal factors (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909566/).

📘 Kamel and colleagues (https://pubmed.ncbi.nlm.nih.gov/38561773/) examined the effects of adding the short foot exercise to hip and knee focused exercises in 28 male and female (18-35 years) patients with patellofemoral pain (at least 2 painful isometric muscle contraction tests with a slight bent knee, (ii) palpation of the patellofemoral joint line, (iii) patellar compression against the femoral bone, and (iv) active resisted knee extension, https://pubmed.ncbi.nlm.nih.gov/28844333/) and a navicular drop test of more than 10 mm (https://pubmed.ncbi.nlm.nih.gov/34024814/).

📊 Participants received their interventions during 6 consecutive weeks (12 sessions). Pain intensity, function, abductors quadriceps muscle strength, and balance were assessed using the Visual Analog Scale, anterior knee pain scale (AKPS), hand-held dynamometer, and the Biodex Balance System respectively. All measurements were taken before and after 6 weeks of intervention in both groups.

🦶To perform the short foot exercise (SFE), participants were A to elevate the medial longitudinal arch (MLA), shorten the foot in the anterior-posterior line, and approximate the first metatarsal head toward the heel without toe flexion (s. picture). The elevated MLA position would be maintained for five seconds in each repetition. Participants performed the SFE in 3 sets of 15 repetitions each day for two days per week for 6 weeks (with at least one day between each session, https://pubmed.ncbi.nlm.nih.gov/34024814/). The participants had to start the exercise in a sitting position (in the first and second weeks) and then progress to a double stance (in the third and fourth weeks), then a single-leg stance position (in the fifth and sixth weeks, https://pubmed.ncbi.nlm.nih.gov/34024814, https://pubmed.ncbi.nlm.nih.gov/30860412/). In addition to the SFE program, the participants in this group received hip and knee focused exercise program, while the participants in the control group received only a hip (side-lying hip abduction, hip external rotation (clamshell), and prone hip extension) and knee focused (supine straight leg raises, supine terminal knee extensions (from 10° flexion to full extension), and a mini-squat (45° flexion)) exercise program.

🦵 For the hip and knee focused exercises: the number of repetitions is increased from 3 sets of 10 repetitions to a maximum of 3 sets of 20 repetitions. Thereafter resistance is increased using a weight cuff or resistance tubing. Repetitions were performed dynamically over 2–3 s. 2-second pause between repetitions. 30-second pause between sets for two days per week for six weeks. Minimum one rest day between sessions.

📊 The within-group comparison showed significant improvement in pain severity, function, balance, and hip abductors, and quadriceps muscles strength in both groups post-treatment compared with pre-treatment. Between groups analysis, however, showed a significant statistical difference between both groups in pain (mean difference 2.6 (1.8, 3.4)/10), function (-4 (-7, -1)/100), and mediolateral stability which showed better improvement compared to the control group. All others assessed variables showed no between group differences.

👉 Previous studies have found that individuals with a pronated foot exhibit reduced electromyographic activity in the Abductor Hallucis (AbdH) muscle (https://pubmed.ncbi.nlm.nih.gov/14688773/, https://pubmed.ncbi.nlm.nih.gov/15109760/), which works together with the peroneus longus muscle to support the MLA. A study by Jung et al. (https://pubmed.ncbi.nlm.nih.gov/22142711/) reported a significant increase in the cross-sectional area of the AbdH muscle after performing the SFE exercises with foot orthoses.

🤔 The authors speculate that thee SFE can elevate MLA through a closed kinetic chain mechanism, potentially correcting foot pronation and altering foot biomechanics (https://pubmed.ncbi.nlm.nih.gov/28167183/). Moreover, these changes in foot mechanics may have a kinematic impact on the entire lower extremity, potentially reducing internal tibial rotation and hip adduction. This, in turn, may lead to a decrease in internal femoral rotation, thereby reducing lateral compressive forces on the patella. This can be beneficial for improving knee pain (https://pubmed.ncbi.nlm.nih.gov/24359629/, https://pubmed.ncbi.nlm.nih.gov/14669959/, https://pubmed.ncbi.nlm.nih.gov/19996330/).

👉 Results by Mølgaard et al. (https://pubmed.ncbi.nlm.nih.gov/28844333/) corroborated these results, documenting improved knee pain following adding foot-focused exercises and foot orthoses to knee-focused exercise program.

💡 In conclusion, the findings of this study showed that adding SFE to hip and knee exercise improved pain, function, and mediolateral stability in the treatment of patients with PFPS. This can help clinicians improve their treatment program for PFPS patients to achieve better results with them, decrease recurrence rate, and improve disease prognosis.

How Quality Sleep Improves Youth Athletic Performance Sleep is a pillar of health, so it’s no surprise that young people who lack adequate sleep may suffer consequences.

While spinal anatomy is designed to be incredibly strong and highly flexible, it is often a source of back pain. Here's what you should know about spinal anatomy and common causes of back pain: https://bit.ly/37rTIlE

Falls are the leading cause of injury in adults aged 65 years or older.

This JAMA Patient Page describes risk of falls in older adults and fall prevention recommendations from the US Preventive Services Task Force. https://ja.ma/3RdXG8W

Cardiovascular disease is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths. Each year, an estimated 605,000 people in the US have a first myocardial infarction and an estimated 610,000 experience a first stroke.

Read the most cited JAMA article “Aspirin Use to Prevent Cardiovascular Disease.” https://ja.ma/3wUlN5O

Pathophysiology of lumbar disc degeneration, disc herniation, and discogenic pain in a nutshell 💡

👉 Interaction of chemical and mechanicals factors as illustrated by Netter

📸Illustration: https://link.springer.com/chapter/10.1007/978-3-031-50357-3_24

Went to go watch a patient today! She was amazing!

These!

The Secret to Athletic Enhancement Enhance your body today

running 🙏🏼♥️

Just published 🔥

🏃‍♂️🏋️‍♀️Exercise as a treatment for depression: 5️⃣ things to know about in clinical practice

https://www.cmaj.ca/content/196/17/E59

1️⃣ Exercise therapy effectively treats depression and may decrease su***de attempts

A 2023 meta-analysis of randomized controlled trials (RCTs) found that supervised, group or non-group, moderate- or vigorous-intensity, aerobic or resistance exercises (excluding mind–body activities such as yoga) decreased depressive symptoms among participants with depression, with a number needed to treat of 2 and an effectiveness comparable to first-line treatments such as psychotherapy and medication (https://pubmed.ncbi.nlm.nih.gov/36731907/) Another 2023 meta-analysis of RCTs found that exercise decreased su***de attempts among people with mental or physical illness (https://pubmed.ncbi.nlm.nih.gov/36871911/)

2️⃣ Address psychological barriers to exercise!

For people with depression, these include amotivation, low energy, and perceived fatigue, among others (https://pubmed.ncbi.nlm.nih.gov/36253441/). While meta-analyses have found positive effects of exercise interventions, these largely involved willing participants with professional support (https://pubmed.ncbi.nlm.nih.gov/36731907, https://pubmed.ncbi.nlm.nih.gov/36871911/). Addressing psychological barriers is important for exercise implementation.

3️⃣ Prescribe exercise specifically and promote supervision!

Clinicians should specify the frequency, intensity, time, and type of exercise for patients (https://pubmed.ncbi.nlm.nih.gov/26897182/). Moderate- to vigorous-intensity aerobic or resistance exercise for 30–60 minutes 3–5 times per week has been shown to have antidepressive effects (https://pubmed.ncbi.nlm.nih.gov/36253441/), although any physical activity is better than none (https://pubmed.ncbi.nlm.nih.gov/33064071/), and supervision by an exercise professional can maximize effects (https://pubmed.ncbi.nlm.nih.gov/36731907/, Most importantly, patients should be involved in the choice of exercise to increase adherence (https://pubmed.ncbi.nlm.nih.gov/33064071/).

4️⃣ Use behavioural change techniques, tailored to each stage of change, to increase exercise initiation and adherence!

Clinicians should begin with motivation-building techniques, then progress to action-oriented strategies, and, finally, focus on maintenance. They should regularly assess progress, adapt strategies as needed, and provide positive reinforcement. Fortier and colleagues (https://pubmed.ncbi.nlm.nih.gov/33064071/)have provided a practical guide for exercise among people with depression.

5️⃣ Exercise interventions are generally safe!

Exercise in this population is well tolerated, with minor adverse events such as joint pain, headache, and fatigue (https://pubmed.ncbi.nlm.nih.gov/36731907/,https://pubmed.ncbi.nlm.nih.gov/36871911/). Patients should be screened for pre-existing comorbidities such as injuries, physical inability, and conditions such as severe cardiovascular disease that increase the risk of exercise (https://pubmed.ncbi.nlm.nih.gov/36731907/). Among those without such comorbidities, clinical supervision is not necessary for safety (https://pubmed.ncbi.nlm.nih.gov/26897182/).

Infographic: Human Kinetics based on https://us.humankinetics.com/products/clinical-exercise-physiology-5th-edition-with-hkpropel-access