Sep
5
2023
People who have migraines — either chronic or episodic — are more likely to suffer from serious skin pain and sensitivity, new research shows.
As many as two-thirds of those affected by migraines may also experience a condition called cutaneous allodynia. Cutaneous allodynia is skin sensitivity and pain so severe that everyday activities like brushing your hair or wearing jewelry can cause pain.
“The phenomenon of cutaneous allodynia seems to be correlated to true migraine,” said headache expert Dr. Bruce Silverman, a neurologist at Providence Hospital and Medical Centers in Southfield, Mich. “For those with migraine and cutaneous allodynia, the idea of treating prior to the onset of symptoms may offer a greater response.”
To assess the prevalence of cutaneous allodynia, researchers led by Dr. Marcelo Bigal, of Albert Einstein College of Medicine, New York City, surveyed almost 17,000 people who experienced headaches. Their questionnaires asked about the type of headaches suffered, how often, whether or not their quality of life was affected, whether or not they suffered from depression, or if they had any other illnesses that might cause pain. Survey participants were also asked to complete the allodynia symptom checklist (ASC), an assessment tool previously designed by the study’s authors.
The study, which is in the April 22 issue of the journal Neurology, found that almost 12,000 people reported suffering from migraines. Another 1,491 had headaches that were probably migraines, and 3,345 experienced other types of headaches, such as tension headaches.
Of those who reported having chronic migraines — daily headaches — 68 percent also experienced cutaneous allodynia. In those with episodic migraines, 63 percent also experienced the condition. Just 42 percent of those with suspected migraine reported cutaneous allodynia, and about 37 percent of those with other types of headaches reported allodynia, as well.
In people with migraine, cutaneous allodynia was more common in women, in those who had headaches more often, in people with a higher body mass index, and in those disabled or depressed.
http://www.healthcentral.com/migraine/news-250285-31.html
Sep
5
2023
Women who play sports are prone to tearing the Anterior Cruciate Ligament (ACL). Beyond the immediate pain and swelling it can cause, there’s now reason to suspect that this type of injury may lead to another vexing health problem.
Researchers at the Mayo Clinic in Rochester, Minn., found that young women who had surgery to repair the anterior cruciate ligament (ACL) suffered significant bone loss around the knee even two years later. And that damage was seen even though they had undergone rehabilitation.
“Despite telling them to weight-bear early and put weight on the leg, people are going to protect an operative limb,” said study author Dr. Diane L. Dahm, an assistant professor of orthopedics at Mayo. “So, it’s probable that the forces going across that operative limb were not as great as the opposite limb, early on especially.”
The findings were first reported at a meeting of the American Academy of Orthopaedic Surgery (AAOS).
Dahm and her colleagues studied 18 female athletes ranging in age from 16 to 40. All were fairly active and involved in some sort of exercise, although not necessarily an organized sport. The researchers chose age 40 as the cutoff to eliminate any patients who might have osteoporosis related to early menopause.
After undergoing ACL reconstruction, the women participated in a rehabilitation program that involved routine visits with physical therapists and sports psychologists.
Before surgery, there were no significant differences in bone density between the injured and uninjured legs. Three months after surgery, however, the researchers found striking differences in bone density between the injured limb and the unaffected one. While there were improvements in the women’s injured limbs over two years, “they did not get back to completely normal,” Dahm observed
Given the incidence of ACL injuries among women, orthopedists urge women athletes to take steps to prevent ligament tears from occurring. The AAOS recommends year-round training and conditioning, including strength training and practicing performing proper landing and cutting maneuvers.
http://www.healthcentral.com/diet-exercise/news-250370-31.html
Sep
5
2023
People do become shorter as they get older. While a small amount of height loss is unlikely to cause problems, losing a significant amount of height might indicate other health problems, such as osteoporosis. Loss of height can affect the normal functioning of lungs and the gastrointestinal tract, which can lead to loss of appetite, poor nutritional status and weight loss. It also appears to be associated with loss of muscle mass and strength.
To study the problem, researchers from the Royal Free and University College Medical School and the University of London, involved in the British Regional Heart Study screened 7,735 men ages 40 to 59 years drawn from one general practice in 24 British towns between 1978 and 1980. After 20 years, all those who survived — now ages 60 to 79 — were asked to come in for a follow-up examination. Among other tests, the men’s height and weight were measured without shoes at the baseline examination and at 20 years later. A total of 4,252 men took part in the follow-up height and weight screening. Of these, valid measures of height change were available in 4,213 men.
Recordings were monitored during the entire period to identify deaths and heart disease in all those who took part in the initial part of the study. The men in the study also filled out surveys that detailed their habits and their medical histories. They were asked to describe their health status as excellent, good, fair or poor. They were also asked if their physicians had ever told them they had heart disease, as well as other chronic health conditions.
On average, the men lost 1.67 centimeters in height during the 20 years of the study. However, that height loss varied with individuals. Mean height loss increased with increasing age.
The researchers found that the risk of dying increased with the loss of height and was much higher in men who were three centimeters or more shorter than they had been when they were middle-aged. Losing three centimeters or more in height was also associated with an increase in risk for major heart disease problems.
The researchers noted that when the subjects became three centimeters or more shorter as they aged significantly increased the risk of death in the men, “largely owing to an excess in cardiovascular (heart and blood vessel), respiratory (lung) and other non-CVD (cardiovascular disease), non-cancer deaths.” They noted that while loss of height was associated with heart disease, it was not associated with stroke.
The researchers noted that the relationship between height loss and death is unclear. They hypothesized that osteoporosis or loss of bone mass is known to be associated with increased death rates and is also a reason for loss of height in men. However, the height loss associated with osteoporosis is usually much greater than that, and the researchers said osteoporosis is unlikely to be the only reason. Certain underlying features that may be a fault in heart disease may also contribute to loss of height, the researchers said. However, they said the relationship remains unclear and warrants further study.
The bottom line: Losing significant amounts of height as you age may mean that you are at increased risk of developing heart disease. Talking with your doctor about these risks may enable you to reduce the threat.
Reference
S. Goya Wannamethee, PhD; A. Gerald Shaper, FRCP; Lucy Lennon, MSc; Peter H. Whincup, FRCP, PhD, “Height Loss in Older Men: Associations With Total Mortality and Incidence of Cardiovascular Disease,” Arch Intern Med. 2006;166:2546-2552
Sep
5
2023
People who have acute lower-back pain should undertake self-care and massage and spinal manipulation,
according to a recommendation from a study published in the Annals of Internal Medicine October 2007.
The study reccomends that for patients who do not improve with self-care options, clinicians (Doctors) should consider the addition of nonpharmacologic therapy with proven benefits—for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation.
The study was co-authored by the American College of Physicians and the American Pain Society. The Annals of Internal Medicine examined and gathered data from Medline studies, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Embase to formulate its lower-back pain guidelines. For full report on the guidelines see: http://www.annals.org/cgi/content/full/147/7/478
Sep
5
2023
A study published in the Journal of Manipulative and Physiological Therapeutics in the February 2007 evaluated the perceptions of research, frequency in use of research findings in practice, and the level of research skills of chiropractors and massage therapists in Canada. The study was conducted by the Health Systems and Workforce Research Unit of the Calgary Health Region in Calgary, Alberta, Canada.
The study, titled “How important is research-based practice to chiropractors and massage therapists?” stated chiropractors and massage therapists reported a generally positive perception toward research and acknowledged the importance of research to validate their practice.
A survey was mailed to members of the College of Chiropractors of Alberta (833 practitioners) and the
Massage Therapist Association of Alberta (650 practitioners). Only 483 questionnaires were returned (response rate, 33%). Chiropractors had a higher response rate (39%) compared to massage therapists (160 respondent; 24%). Chiropractors and massage therapists reported an overall positive perception toward research, acknowledging the importance of research to validate their practice.
However, a positive perception does not necessarily translate into practice, which was confirmed in the study: although almost 80% of the respondents strongly agreed with the statement that research adds credibility to their practice, only about 25% reported that they apply research in their practice in a consistent manner.
Chiropractors and massage therapists in this study indicated minimal use of evidence-based information sources, such as peer-reviewed journals and electronic databases, and instead indicated a preference for handbooks and consulting with colleagues.
While both groups felt comfortable using the library, they had little confidence in their research skills and overall application of research in practice was limited. Significant differences were found between the 2 professional groups, with chiropractors reporting more research skills and evidence-based practice.
It appears that in Canada neither chiropractors nor massage therapists consistently apply research
in practice, which may result from a lack of research education and research skills. The differences between the 2 professional groups may be attributed to the chiropractic profession’s relatively more research-focused professional training. Strategies to encourage greater research uptake and evidence-based behavior by practitioners include professional association incentives, such as education credits or practitioner cooperatives that would provide time and support for research.
Sep
5
2023
Objective
The usefulness of massage as a recovery method after high-intensity exercise has yet to be established. We aimed to investigate the effects of whole-body massage on heart rate variability (HRV) and blood pressure (BP) after repeated high-intensity cycling exercise under controlled and standardized pretest conditions.
Methods
The study included 62 healthy active individuals. After baseline measurements, the subjects performed standardized warm-up exercises followed by three 30-second Wingate tests. After completing the exercise protocol, the subjects were randomly assigned to a massage (myofascial release) or placebo (sham treatment with disconnected ultrasound and magnetotherapy equipment) group for a 40-minute recovery period. Holter recording and BP measurements were taken after exercise protocol and after the intervention.
Massage—myofascial induction protocol
| Massage technique | Body area | Approximate time (min) |
|---|---|---|
| Long J-stroke | Gastrocnemius | 3 |
| Long J-stroke | Biceps femoris | 3 |
| Cross hand technique | Thoracolumbar fascia | 12 |
| Sustained pressure | Occipital condyles | 5 |
| V spread | Frontalis | 5 |
| Ear pull | Temporalis | 4 |
| Cross hand technique | Quadriceps | 8 |
Results
After the exercise protocol, both groups showed a significant decrease in normal-to-normal interval, HRV index, diastolic BP (P > .001), and low-frequency domain values (P = .006). After the recovery period, HRV index (P = .42) and high-frequency (HF) (P = .94) values were similar to baseline levels in the massage group, whereas the HRV index tended (P = .05) to be lower and the HF was significantly (P < .01) lower vs baseline values in the placebo group, which also showed a tendency (P = .06) for HF to be lower than after the exercise. Likewise, diastolic BP returned to baseline levels in the massage group (P = .45) but remained lower in the placebo group (P = .02).
Conclusion
Myofascial release massage favors the recovery of HRV and diastolic BP after high-intensity exercise (3 Wingate tests) to preexercise levels.
Reference:
Manuel Arroyo-Morales, Nicolas Olea, Manuel Martinez, Carmen Moreno-Lorenzo, Lourdes Daz-Rodrguez and Amparo Hidalgo-Lozano.Effects of Myofascial Release After High-Intensity Exercise: A Randomized Clinical Trial. Journal of Manipulative and Physiological Therapeutics
doi:10.1016/j.jmpt.2008.02.009 March 2008, Pages 217-223
The authors are from: University of Granada, Spain and the paper wins an award at the 2007 ACC-RAC Conference.
Sep
5
2023
This study was published in the British Journal of Sports Medicine, April 2008. The authors and studies are from Chukyo University, Japan.
WHAT IS ALREADY KNOWN ON THIS TOPIC
It is generally believed that the massage is effective for recovery of the fatigue after the exercise.
However, the authors believed that the type of massage is an important factor. For example, the authors assumed that effleurage has little effect on blood flow.
WHAT THIS STUDY ADDS
This study shows that petrissage massage had effective for decrease of perceived lower-limb
fatigue and muscle stiffness, and recovery of total power during bicycle ergometer pedaling.
Objective: Petrissage is assumed to influence circulation as well as interstitial drainage of both superficial and deep tissues. To study its effect it was applied between consecutive bouts of supra-maximal exercise performed by the lower leg muscles.
Methods: Subjects were 11 healthy female students actively engaged in sports. Exercise bouts of ergometer cycling at loads determined individually (0.75 kp x body weight [kg]) for 5 sec repeated 8-times at intervals of 20 sec had to be performed twice on an experimental day with 35 min intermittent bed rest. Each subject was investigated on two occasions with a minimum interval of one week, once without (control, CO) and once with 10 min petrissage (massage, MA) of the exercising lower leg during the bed rest phase. Effects of exercise bouts on blood lactate, muscle stiffness and perceived lower-limb fatigue and their recovery before and after the second exercise bout were determined.
Result: For the first exercise bouts total power did not differ between massage and control. Courses of blood lactate did not differ between massage and control. However, recovery from measured muscle stiffness and perceived lower-limb fatigure were more pronounced, and total power during the second exercise bout was enhanced in massage as compared to control subjects.
Conclusion: Petrissage improved cycle ergometer pedaling performance independent of blood lactate, but in correlation with improved recovery from muscle stiffness and perceived lower-limb fatigue.
http://bjsm.bmj.com/cgi/content/abstract/bjsm.2007.044396v1
Sep
5
2023
It can happen for no reason, it seems, taking you completely by surprise. And it can be excruciating. Suddenly, a muscle contracts violently, as if it had been prodded with a jolt of electricity. And it remains balled in a tight knot as painful second after painful second drags on. Cramps afflict 39 percent of marathon runners, 79 percent of triathletes, and 60 percent of cyclists at one time or another, said Dr. Martin P. Schwellnus, a professor of sports medicine at the University of Cape Town.
Cramps can occur during exercise, immediately after, or he said, as long as six hours later. Yet common as they are and terrible as they can be, no one really understands cramps. They are a medical mystery. “I would say, bottom line, there is no really convincing biological explanation for muscle cramps,” said Dr. Andrew Marks, a muscle researcher and chairman of the department of physiology and cellular biophysics at Columbia University College of Physicians and Surgeons. Medical textbooks skirt the topic, he added, often avoiding any explanation. And few scientists have studied cramps. But as anyone who has ever complained of cramps will attest, lots of advice is circulating on how to avoid them and lots of people — friends, coaches, doctors — think they have a solution.
Take a multivitamin pill to get zinc and magnesium. Massage the muscles. Drink plenty of water. Be sure to get enough electrolytes like sodium and potassium. Stretch before you start to exercise. No, stretch as soon as you finish. See a nutritionist to correct imbalances in your diet. See a trainer to be sure you are moving correctly.
Of course, Dr. Marks said, medical conditions can lead to cramps, including narrowed blood vessels, usually from atherosclerosis, or compression of a nerve, as happens in spinal stenosis. Cramps also can arise from hypothyroidism. And they can be a side effect of medications like diuretics, used to lower blood pressure, which can lead to a potassium deficiency that can cause cramps.
But, he and others said, those conditions do not explain the vast majority of cramps. “You are left with the fact that cramping usually occurs in healthy people without any underlying disease,” Dr. Marks said. There are three leading hypotheses about how to treat cramps and how to prevent them.
There’s the dehydration proposal: you just need more fluid. But, Dr. Schwellnus said, he studied athletes who cramped and found that they were no more dehydrated before or after a race than those who did not have cramps.
Then there’s the electrolyte hypothesis: what you really need is sodium and potassium. Michael F. Bergeron, who directs the environmental physiology laboratory at the Medical College of Georgia, said the electrolyte hypothesis applies to a specific type of cramp that is related to excessive sweating. It occurs, he said, when the fluid that bathes the connection between muscle and nerve is depleted of sodium and potassium, which was lost through sweat. The nerve then becomes hypersensitive, Dr. Bergeron said. “Usually you feel little twitches first,” he explained. “They last for 20 to 30 minutes and if you don’t do anything you can be in full-blown cramps.” Those cramps, he continued can move from place to place on your body, from one leg to the next, to your arms, stomach, even your fingers or your face. The solution, Dr. Bergeron said, is to drink salty fluids like Gatorade (the company sponsors his research). He said he had prevented cramps in tennis players this way. But asked whether there are any rigorous studies to confirm this hypothesis, he said no. “We haven’t done the study yet,” he said. “We’re at the point of kind of connecting the dots.”
The third hypothesis is advanced by Dr. Schwellnus. He questions the electrolyte hypothesis because his studies of Ironman-distance triathletes as well as other studies of endurance athletes found no difference in electrolyte levels between those who suffered cramps and those who did not. DR. SCHWELLNUS proposes that the real cause of cramping is an imbalance between nerve signals that excite a muscle and those that inhibit its contractions. And that imbalance, he said, occurs when a muscle is growing fatigued. His solutions for cramps are to exercise less intensely and for shorter times, to be sure you had enough carbohydrates to fuel your muscles, to train sufficiently and to regularly stretch the muscles that give you problems. These recommendations are based on his recent study of Ironman triathletes, Dr. Schwellnus said. But while he advocates those practices, he said, they have not been proved in a rigorous study. In the meantime, some doctors have resorted to experimenting on themselves, devising their own explanations and cures.
Dr. Charles van der Horst, an AIDS researcher at the University of North Carolina, said he was stunned when his calf started to cramp without warning when he was running. The pain was almost unbearable, he said, and even when the muscle finally relaxed, it cramped again when he resumed running. “I started carrying a cellphone with me on long runs,” Dr. van der Horst said. When a cramp struck, he called his wife to ask her to drive out and get him. “I think I was getting calcium deposits or something,” Dr. van der Horst said. His solution was to massage his calves at all hours, pushing deep into the muscle. This seems to work, he said, explaining that it’s been a year now since he had a cramp.
Dr. Stephen Liggett, a professor of medicine and physiology at the University of Maryland, has a different solution. He got terrible cramps in his calf during yoga. The culprit, he decided, was the drugs he takes for asthma, which can diminish the body’s supply of potassium. He knew that potassium is sold over the counter. But because high levels of potassium can be dangerous, store-bought potassium supplements are not very strong.
Dr. Liggett’s solution is not one anyone who is not a doctor should try at home. Before he does yoga, he measures the potassium levels in his blood before and after taking what he describes as a hefty dose of over-the-counter supplement. Then he calculates how much additional potassium he thinks he needs, securing it from concentrated potassium tablets from his research lab — how much he declined to say. “I didn’t want to drink two gallons of Gatorade,” Dr. Liggett explained. He hasn’t had cramps since he began “preloading,” as he calls it, with potassium. But, he said, “I haven’t done a controlled trial.” Dr. Marks, for one, is not convinced by the evidence for any of the hypotheses, nor by any of the proposed remedies. What causes cramps? “I would say the answer to that question is still open to investigation,” he said. And, he added, he hopes someone takes it up.
http://www.gainesvillesun.com/article/20080214/ZNYT04/802140319
Sep
5
2023
Saw it on ABC’s The New Inventors. Ryan Kendrick a physio from Corindi Beach, north of Coffs Harbour invented PosturePals. PosturePals are adhesive spinal supports applied to the back area to re-educate posture and avoid people adopting flexed or loaded postures. Similar to the taping commonly used by physio, but now anyone can buy it off the shelf. PsoturePals also use more flexible material rather than the rigid tape.
See the video of The New Inventors here:http://www.abc.net.au/tv/newinventors/txt/s2204746.htm
Or Buy PosturePals from Ryan’s website: www.posturepals.com.au
The shoulder strap is $15 and the back strap is $12. A real bargain. Save your $$ from goinf to physio.
Sep
5
2023
Research suggests that exercises that target core muscles may reduce back pain and prevent future injury, but whether these exercises are substantially better than other structured exercise programs for chronic back pain has not been proved. And not all researchers agree on which components of the body’s core muscles are most crucial to preventing a back injury and reducing pain after suffering an injury.
A seminar on the role of core stability in reducing and preventing back pain was held at at the American College of Sports Medicine’s 12th annual Health and Fitness Summit and Exposition in Long Beach 24-27 March 2008. Presenter Marjorie King, director of the graduate athletic training program at Plymouth State University, in Plymouth, N.H., outlined the current state of the field: a need for more research and moderate support for the use of core stabilization exercises to decrease low-back pain and increase low-back function.
King thinks that some who practice core stability are missing at least part of the boat. “One of the biggest misconceptions people have about core stability is that by doing crunches, they’re getting at core stability,” she says. Crunches address the trunk, or “global” muscles, which exercisers more commonly work. But to really target core stability, she says, exercisers need to attend to the often-ignored spinal, or “local” muscles.
Local muscles include the little intersegmental muscles, the multifidi, that run along the vertebrae. These muscles don’t move a lot but are thought to play a role in keeping the spine stable during movement.
Other musculature involved in local stabilization include pelvic floor muscles and the transversus abdominis muscle, the deepest of the abdominal muscles. This muscle is horizontal in design, King says, and functions like a corset, stabilizing the spine.
Core stability training “is the standard of care, it’s what people do, in my field anyway,” says Dr. Christopher Standaert, a physiatrist (a physician specializing in physical medicine and rehabilitation) and clinical associate professor of rehabilitation medicine at the University of Washington in Seattle. But, he adds, “There’s never even been a uniform agreement on the definition.”
Among those who think — based on their clinical experience — that core training works, there are two schools of thought on exactly how it works. Some think, as King does, that local muscles such as the multifidi and the transverse abdominis are critically important.
But, Standaert says, “there are other people who . . . think it’s more about training movement patterns and broader motions and coordination of multiple muscles through your trunk to help your spine move more effectively . . . . So it’s about the whole system.”
In fact, Standaert adds, whether one is talking about local or global core stabilization, the rush to embrace core training has gotten ahead of the science. “People need to know that the scientific clinical foundation, the research, doesn’t match the extent of emphasis that trainers and therapists and all sorts of people put on it,” he says.
As back experts continue their debates and research, those who want to prevent or deal with their back pain need solutions now. Those with persistent, chronic back pain should see a physician and get a proper diagnosis, says Dr. Robert S. Bray Jr., a neurological spinal surgeon and founding director of D.I.S.C. Spine and Sports Center in Marina del Rey. A sports medicine physician or physiatrist are good places to start.
In addition, anyone who is doing exercises to reduce back pain should do so with guidance from an exercise or back-care professional, such as a physical therapist, chiropractor or certified athletic trainer.
Regardless of the state of the science, working the core’s local stabilizers won’t hurt and will probably help, King says. Targeting those muscles doesn’t even require going to the gym.
The best way to stabilize the spine, she says, is to stand up straight (stomach in while still breathing, equal weight on both feet, feet straight ahead, glutes flexed, pulling up through the pelvic floor) and sit up straight (stomach in, both feet on the ground, again, pulling up through the pelvic floor).
“Any time you sit or stand, in the line at the grocery store, stuck in traffic, brushing your teeth” is an opportunity to correct your posture, she says. “You don’t necessarily need a huge difference, you just need a bit of a difference.”
http://www.latimes.com/features/health/la-he-backpain31mar31,1,261211.story
