Human Locomotion
Tom’s Corner
Dr. Michaud chooses clinically relevant articles & summarizes them for your educational reading pleasure.
Parisien M, et al. Acute inflammatory response via neutrophil activation protects against the development of chronic pain. Sci Transl Med 2022; 14:1-11.
Chronic pain is pervasive in modern society, and chronic low back pain is the most frequently reported chronic pain condition. Current drug treatments for low back pain often target the immune system and include anti-inflammatory drugs (NSAIDs), acetaminophen, and corticosteroids, which have been proven to be minimally effective at best. Additionally, despite the widespread use of NSAIDs in managing chronic low back pain, very little is understood about the molecular mechanisms associated with...
Bove G. et al. Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury. J Neurological Sciences 2016; 168-180.
This is far and away one of the best papers ever done on the efficacy of manual methods for managing musculoskeletal injuries. The lead author, Geoffrey Bove, practiced as a chiropractor prior to getting a PhD in Neurobiology and Anatomy at the University of North Carolina. In this study, Dr. Bove and colleagues set out to determine if massage and joint mobilization could reduce pain, improve motor function, and prevent the formation of scar tissue associated with high repetition overuse...
Yoshida R, et al. Analysis of cervical and upper thoracic spinal segmental rotation angles during end-range neck rotation: Comparison with and without neck pain. J Man & Manip Therapy, April 6, 2022.
According to the authors of this study, as many as 70% of the individuals will experience neck pain at least once in their life, and nearly 60% of these people will continue to report pain 5 years after initial onset of pain. The economic cost of managing both back and neck pain continues to skyrocket, increasing by more than $57 billion between 1996 and 2013. The authors also refer to prior studies confirming that upper thoracic spine manipulation effectively reduces neck pain and increases...
Taddei U, Matias A, Duarte M, Sacco I. Foot core training to prevent running-related injuries: a survival analysis of a single-blind, randomized controlled trial. Am J Sports Med 2020; 48:3610-3619.
In any given year, nearly 80% of long-distance runners are injured. The authors of this study point out that to date, no satisfactory treatment has ever been developed to prevent running-related injuries. To that end, the authors set out to determine if foot strengthening exercises could reduce the rate of running-related injuries in recreational long-distance runners over the course of 1 year. 118 runners were recruited with 57 of them being placed in an intervention group incorporating...
Kotsifaki A, Van Rossom S, Whiteley R, et al. Single leg vertical jump performance identifies knee function deficits at return to sport after ACL reconstruction in male athletes. Br J Sports Med 2022;56:490–498.
Following ACL reconstruction, most practitioners determine when an athlete should return to sport by measuring horizontal distance during various hop tests. Hop tests have been widely adopted by the rehab community, mostly because they are easy to perform and do not need expensive equipment. Unfortunately, these tests are unable to predict successful return to sport one year following injury causing some experts to question their validity as a return to sport metric. This study confirms that...
Park K, Keyak J, Kulig K Powers W. Persons with patellar tendinopathy exhibit greater patellar tendon stress during a single-leg landing task. Medicine and Science in Sports and Exercise 2022.
These are some of the best authors in the field of biomechanics. The research facility at the University of Southern California consistently puts out clinically significant studies. This paper is no different as the authors demonstrate that compared to a control group, individuals with patellar tendinopathy exhibit significantly larger tibiofemoral joint internal rotation when performing single-leg landing. In fact, the authors state “transverse plane rotation of the tibiofemoral joint was the...
Harutaichun P, Vongsirinavarat M, Pakpacorn P, et al. Can orthotic wedges change the lower-extremity and multi-segment foot kinematics during gait in people with plantar fasciitis? Gait & Posture 2022;97:174-183.
Plantar fasciitis is a common overuse syndrome that can take years to recover from. The authors of this paper theorized that you could effectively manage chronic plantar fasciitis by incorporating a 2-piece varus posting system placed beneath the patient’s insoles. The varus posts were made from solid rubber with a thin fabric cover and were available in 3 sizes depending on the person’s foot size. The authors incorporated various combinations of 3°, 6°, and 8° angled wedges and then measured...
Differences in foot muscle morphology and foot kinematics between symptomatic and asymptomatic pronated feet. Zhang et al. Scand J Med Sci Sports. 2019;00:1–8.
This was an interesting study in that researchers took 30 young physically active adults with pronated feet and divided them into two groups: one group with a history of prior injury, and another group that had not been injured. The authors analyzed three-dimensional motion during the gait cycle, and used ultrasonography to measure cross-sectional area of the peroneal muscles, flexor digitorum longus and brevis, and the abductor hallucis muscles. The authors concluded the symptomatic pronators...
The effectiveness of a balance training intervention in reducing the incidence of noncontact ankle sprains in high school football players. McHugh M, et al. Am J Sports Med 2007, 35;8:1289.
This is one of my all-time favorite ways to improve balance and/or prevent ankle injuries. In this study, researchers followed 125 high school football players for anywhere from 1 to 4 seasons. Players were classified as low-, moderate-, or high-risk for reinjury, depending upon their body mass index and/or their prior history of ankle sprain. The authors note that at the start of the study, the overweight, previously injured football players were 19 times more likely to be injured than the...
Effects of two types of 9-month adapted physical activity program on muscle mass, muscle strength, and balance in moderate sarcopenic older women. Piastra G, et al. BioMed Research International Volume 2018 (Open Access).
In this study, 72 older adults were randomly assigned to a strength training program or a postural training program. Both the strength training and postural programs were performed twice per week for 36 weeks with each session lasting 60 minutes. The strengths training program consisted of a brief warm-up, followed by low/moderate intensity exercises for both the upper and lower extremities. Postural exercises consisted of a wide range of stretches and mobilizations, including “spine...