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Achilles Tendinopathy: A Clinical Practice Guideline Update

We discuss the 2024 Clinical Practice Guidelines for midportion Achilles tendinopathy, developed by the Academy of Orthopaedic Physical Therapy. It offers an updated, evidence-based framework for physical therapy management, covering diagnosis, prognosis, and intervention strategies. The guidelines specifically address various treatment modalities, including different forms of exercise, patient education, manual therapy, dry needling, and the use of heel lifts and taping, while also discussing the efficacy of modalities like low-level laser therapy and therapeutic ultrasound. The content is structured with summaries of recommendations, evidence updates, and identified gaps in current knowledge for each intervention, aiming to inform clinicians and improve patient outcomes.

LINK TO ARTICLE: https://shorturl.at/yziO1

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FOOTBALL RECOVERY STRATEGIES
We discuss an article and a YouTube video from the "Aspetar Sports Medicine Journal" on football recovery strategies. Both detail the demands placed on elite soccer players due to congested match schedules, emphasizing the increased risk of chronic fatigue and injury. They identify key mechanisms contributing to post-match fatigue, such as glycogen depletion, muscle damage, and mental exhaustion. The sources also evaluate the scientific evidence behind various recovery methods, including nutrition, hydration, sleep, cold water immersion, and other common practices, ultimately recommending a practical, evidence-based recovery protocol for professional footballers.

LEARN MORE: https://www.fitasaphysio.com/blog/recovery-protocol

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A recent article from "The Conversation", discuss the common misconception that running damages knees. It explains that while running involves significant impact, the body is designed to adapt, and this load can actually strengthen bones and cartilage. The article suggests that runners tend to have healthier knees and better bone density than non-runners, and that cartilage temporarily thinning during a run may even facilitate nutrient flow. Furthermore, the sources address the safety of starting running later in life, noting that studies on high-intensity jump training in older adults suggest running is likely safe and effective, provided one starts slowly. Finally, it clarifies that most running-related injuries are "overuse" injuries, caused by increasing intensity too quickly, rather than running inherently being bad for the body, emphasizing the importance of gradual progression, proper nutrition, and listening to one's body to mitigate risks.

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Predicting Resistance Repetitions at Various Loads: A Meta-Analysis
This review article focuses on the maximal number of repetitions (REPS) achievable at various percentages of one repetition maximum (%1RM), a critical relationship for resistance exercise programming. The authors conducted a meta-regression and moderator analysis using data from nearly 7,000 individuals to update existing guidelines, which were based on limited studies and lacked measures of uncertainty or individual variation. Their findings suggest that while sex, age, and training status have minimal influence on this relationship, specific exercises like the leg press and bench press demonstrate unique REPS ~ %1RM profiles, necessitating separate recommendations. Ultimately, this research provides more precise and comprehensive tables for prescribing resistance exercises, acknowledging the need for further data collection on other exercises and diverse populations.

ARTICLE: https://www.fitasaphysio.com/uploads/4/3/3/4/43345381/s40279-023-01937-7.pdf

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We provide a comprehensive overview of low back pain (LBP), distinguishing between the common, non-specific type and rare, serious pathologies. They explain that LBP is highly prevalent, often self-limiting, and rarely indicates structural damage, with pain intensity frequently reflecting the body's protective sensitivity rather than injury severity. We emphasize the importance of early assessment, identifying psychosocial factors, and judiciously using imaging only when serious conditions are suspected. Furthermore, we advocate for patient education, self-management through activity and lifestyle changes, and judicious use of pain medication, promoting active coping strategies and a multidisciplinary approach to care.

LEARN MORE: https://www.fitasaphysio.com/back-pain.html

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A comprehensive overview of anterior cruciate ligament (ACL) ruptures, explaining what the ligament is and how it functions as a stabilizer in the knee. They detail common causes of injury, often sports-related, and list symptoms that may indicate an ACL tear. TheY present various treatment options, including surgical reconstruction, non-surgical rehabilitation, and the ACL Cross Bracing Protocol, outlining the advantages and disadvantages of each. Furthermore, they emphasise the importance of post-injury rehabilitation and discuss factors influencing recovery time and return to sport.

LEARN MORE: https://www.fitasaphysio.com/acl-rupture.html

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Osgood-Schlatter's Disease is an overuse injury affecting the front of the knee, particularly common in growing children aged 9-12 who participate in activities involving a lot of running and jumping. This condition results from the body's inability to recover sufficiently during periods of rapid growth and intense physical training. It is a self-limiting condition with no long-term complications, resolving once growth stops. Management primarily involves conservative approaches such as rest, ice, improved nutrition, and adjusting training load based on pain levels, rather than requiring invasive procedures.

LEARN MORE: https://www.fitasaphysio.com/blog/osgood-schlatters-disease

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This podcast from Fit As A Physio discusses load management for injury prevention in athletes. It highlights the importance of balancing acute workload (recent training) with chronic workload (longer-term training history) to reduce injury risk. The post explains how to measure training load using session RPE multiplied by duration and introduces the concept of training-stress balance. A negative balance, where recent workload significantly exceeds chronic workload, is shown to increase injury risk, emphasising the need to avoid sudden large increases in training volume, especially for those more prone to injury.

LEARN MORE: https://www.fitasaphysio.com/blog/training-stress-balance

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This discussion summarises a systematic review and meta-analysis that investigated risk factors for developing knee osteoarthritis (KOA) throughout life. The study identified over 150 potential factors through a review of 131 studies. Key findings indicate that previous knee injury, older age, and high bone mineral density are significantly associated with an increased risk of radiographic KOA. Notably, overweight/obesity and prior knee injury together account for a substantial portion of incident radiographic KOA cases. The authors conclude that new interventions targeting modifiable risks like weight, knee injuries, and occupational physical activity are essential to mitigate the overall impact of KOA.

LEARN MORE: https://www.fitasaphysio.com/uploads/4/3/3/4/43345381/1-s2.0-s106345842500860x-main.pdf

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This discussion provides an overview of osteoarthritis (OA), a condition characterized by structural changes in joints due to cartilage damage and bone build-up. It explains that OA is a major cause of disability and highlights key contributing factors, including previous injury, genetics, and body mass index (BMI), with inflammation linked to fat tissue playing a significant role. While joint changes are common with age, pain is not always present and may fluctuate, often linked to the body's perception of joint vulnerability. Effective management strategies discussed include weight loss, exercise, and pain relief methods, with surgery considered for severe, unmanageable pain, but noting that arthroscopic procedures are often less effective than exercise.

LEARN MORE: https://www.fitasaphysio.com/blog/osteoarthritis

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