Twelve different studies were selected as the best available studies. All studies were randomized trials. They were collectively analysed to determine the effect of stretching on delayed onset muscle soreness in adults.

AUTHORS’ CONCLUSIONS: The evidence from randomised studies suggests that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness in healthy adults.

(Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD004577.)

In addition and new to Thunder Bay, Fairway is pleased to offer intramuscular stimulation acupuncture (GunnIMS) to our collection of acupuncture services already available. Please visit the ‘Services’ section of our website for additional information on these forms of therapy. The link for the IMS service will be routinely updated to bring to you advances in research around this method of treatment for chronic pain.

In addition and new to Thunder Bay, Fairway is pleased to offer intramuscular stimulation acupuncture (GunnIMS) to our collection of acupuncture services already available. Please visit the ‘Services’ section of our website for additional information on these forms of therapy. The link for the IMS service will be routinely updated to bring to you advances in research around this method of treatment for chronic pain.

Reference:Leaver AM, et al A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Arch Phys Med Rehabil. 2010 Sep;91(9):1313-8.

The Question: Is neck manipulation more effective for neck pain than mobilization?

The Study: An RCT based in primary care physiotherapy, chiropractic, and osteopathy clinics in Australia. Patients with neck pain of less than 3 months in duration were randomly assigned to receive treatment with neck manipulations or mobilizations twice a week for 2 weeks (4 treatments sessions in total).

The Result: Patients treated with neck manipulations did not experience more rapid recovery than those treated with neck mobilizations.

The Conclusion: Cervical manipulations cannot be justified on the basis that they are ‘superior’ or that they provide faster relief.

Therefore, can the risk be justified?

Reference:Webster BS and Cifuentes M. Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes. Journal of Occupational & Environmental Medicine. 8-25-2010; 52(9):900-907.

The purpose of this 2010 study was to determine the “benefits” of early MRI for workers compensation cases with acute, disabling low back pain with respect to disability duration, medical costs, and surgery.

Over 3000 cases were followed-up for 2 years in which they concluded that of the patients who had early MRI, the investigation was neither essential nor medically indicated in the MAJORITY of the cases.

Most importantly, after controlling for covariates, the cases that had early MRI and simultaneously had little clinical reason to undergo early MRI were more likely to have worse outcomes.

What can we learn again and again from these studies? The iatrogenic effects of early MRI are:

i) Worse disability ii) Increased medical costs iii) Increased surgery rates

In November 2010 this study was presented at the 7th Interdisciplinary World Congress on Low Back & Pelvic Pain, held in Los Angeles.   Although this study has not been yet published (likely in 2011), here is a sneak preview.

This was a relatively large RCT looking at finally answering the question, which is more effective for patients with disc-related persistent low back pain, the McKenzie approach provided by physiotherapists or spinal manipulations provided by Chiropractors? And here are the results in a nutshell…

Result #1: Both groups showed clinically meaningful improvements in pain and functional scores.

Result #2: The Physiotherapy group had statistically significantly greater improvements pain and functional scores as compared to the chiropractic group at 2-month and 1-year follow up!

One great place to start is consulting with a kinesiologist or a physiotherapist to get a program designed to fit your goals and abilities.  Our physiotherapists and our kinesiologists are excellent at designing a program to fit your needs.  And if you are already a lifter or an athlete, you might want to check out an associate we often refer to, Paul Hemsworth.  You can find his website at http://www.hemsworthstrength.com/

Paul has been training people to lift properly for years and is a Certified Strength and Conditioning Coach.  We have worked with Paul and his style and skill is obvious.  He is a great instructor and works with all skill levels!

This month in the Journal of Orthopedic and Sports Physical Therapy, a study was published showing that a combination of TENS and specific exercise for knee osteoarthritis produced better results long term than either one on its own.   This study suggests that combining treatments and not sticking with the same thing over and over will be most helpful.  More importantly, it shows that without specific types of exercise (not just any leg exercise-they targeted specific exercises in specific ways) patients just simply don’t get where they should be getting to.

It also shows therapists who use ONLY one treatment, even just exercise alone, that there might be a better way: Combine treatments together!

http://www.cbc.ca/marketplace/2010/stretching_the_truth/main.html