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No downsides found in skipping the physician referral and seeing a physical therapist on your own accord
For most people who go to a physical therapist for treatment, the process usually entails an initial visit to a physician, who will review the patient's condition and refer them to a physical therapist if they see fit. While this is often the standard protocol, some suggest that the referral from the physician is unnecessary and more costly, and that patients can instead use what's called "direct access" in certain cases and refer themselves to a physical therapist. Opponents cite potential backlashes from this system, and in select states, as well as under certain insurance policies, it's not allowed; however, a study that compared a group of patients who were self-referred with a group that was physician-referred found no significant differences between groups when assessing cost and overall improvement of patients. These findings suggest that physician referrals may oftentimes not be required, and that patients can instead take matters into their own hands and refer themselves whenever possible.

Most marathon runners are inexperienced and unaware of dangers of not hydrating properly
The popularity of marathon running has skyrocketed in recent history, and what was once an event reserved for the elite competitors throughout the world has come to include all walks of life and a wide variety of skill levels. Due to this process, a large percentage of marathon runners are first-timers, and many are inexperienced in running and the precautions that should be taken while competing in a marathon. To get a clearer sense of this breakdown, surveys were distributed to a large sample of marathon runners to evaluate their perceptions on the race. Unsurprisingly, many of these runners were inexperienced, with only about half having run at least two marathons in the past, but more importantly, the majority of runners displayed a lack of knowledge regarding hydration techniques and how to avoid injuries that arise from improper hydration. This calls for more education on this topic for newcomers to the sport who might not know all the risks involved.

Exercise for elders can lead to improvements in mental health, too
Reaching old age comes with a multitude of associated ailments, particularly in the physical realm with issues like weakening joints and muscles, but also in the mental realm with possible memory loss, depression and anxiety. Getting regular exercise has always been recommended to elders for the plethora of physical benefits it can provide, but in addition to that, it's been suggested that exercise can lead to improvements for the mind as well. To look into this matter in greater detail, a review was conducted that analyzed all available information on the topic, and results supported this notion with a number of significant figures. This led researchers to suggest a minimum of two 45-minute sessions of light-to-moderate intensity exercise each week for those over 65 to help improve mental wellbeing.

Protocols for determining when an injured athlete is ready to return to sports need to be improved
For any injured athlete of any level of competition, the most pressing question following an injury is always, "how long until I can return?" Answering this question and returning an athlete to competition as quickly as possible while also ensuring their safety is a difficult matter for physicians, and evaluating these cases requires consideration of a number of important factors. While there are certain common denominators across the board when it comes to making these decisions, there's also a great amount of variation from one physician to another, which calls for the need of more definitive guidelines to help medical professionals navigate this process. Taking note of this, two physicians highlighted all current guidelines on the topic and pointed out the gaps that need to be improved upon, including in these reviews some useful tests that can gauge an athlete's readiness to return and some vital categorizations that divide athletes into appropriate groupings.

Attempting to prevent injuries before they occur by using a neuromuscular training program
What if, rather than crossing fingers and hoping for the best, athletes were better equipped to avoid injuries by a training program that teaches their bodies and brains how to react in a situation that might cause injury? Effective use of such a program could significantly reduce the rate of sports-related injuries and save the health-care system huge amounts from the second most common source of injuries behind domestic accidents. Proprioceptive and neuromuscular training programs (PT/NT) are designed to prevent injuries by improving the body’s stability and balance, but they’re not used universally due to conflicting views on their effectiveness. To clear up this matter, a review was conducted on pertinent literature, which found these types of training exercises to be effective at reducing the rate of a number of injuries in certain sports. Ample consideration should therefore be given to using these programs in sports where they can better prepare athletes in competition and lower their chances of sustaining injury.

Balance training program helps reduce the likelihood of repeated ankle injuries
One ankle sprain is usually bad enough for the person who experiences it, but for some, if the proper moves aren't made, it could mean the start of an ongoing and bothersome condition known as chronic ankle instability (CAI).  CAI is the tendency towards repeated ankle sprains and recurrent symptoms (pain, weakness, giving way), and occurs in about 40-70% of patients who suffer from an initial lateral ankle sprain.  One suggested method to prevent CAI from occurring is by improving balance and proprioception (the sense of your joint's position in your body) after the first ankle sprain.  To investigate this theory, a study evaluated the effect of a balance training on study subjects and found it to significantly improve balance and proprioception, meaning such a program has the potential to reduce the occurrence of CAI if administered after the initial injury is sustained.

Family history shown to be major predictor of hallux valgus, while high-heeled shoes are deemed safer than believed
Hallux valgus is a chronic condition in which the big toe deviates inward towards the smaller toes, eventually leading to the development of a bump on the side of the foot called a bunion. If the condition isnÕt treated properly and the bunion grows, pain and discomfort will result and lead to disability in every day life. The specific causes of hallux valgus are not known, but many believe improper footwear such as high heels can lead to its occurrence due to excessive pressure on the feet. To test this theory, a study was performed on a population of females in China, and found family history of the condition, and not high heel usage, to be the most indicative predictor of hallux valgus. With this, high heel use should not be encouraged, but those who do wear them should feel secure in knowing they donÕt contribute to the condition.

Ankle sprain prevention program dramatically saves money for health-care system
Acute ankle injuries are far and away the most common musculoskeletal injuries throughout the world, with lateral ankle sprains occurring more often than any other. To combat this issue, a number of preventative intervention programs have emerged as of late, and many of them have proven to be effective in reducing ankle sprain recurrence. The only thing lacking is a full-scale analysis on the cost-effectiveness of such a program on the health-care system. Therefore, researchers tested a particular program and calculated the savings of a reduction in ankle sprains, finding it to beneficial and economically advantageous to those who implement it.

Most patients are incredibly satisfied with musculoskeletal physical therapy
Today, more than ever, health-care providers are concerned with implementing patient-centered care, the goal of which is to provide the highest quality and most cost-effective treatment for every patient. Following this trend, one of the main indicators for evaluating quality care is patient satisfaction, which is doubly important because satisfied patients are also more likely to adhere to treatments and benefit from their health care. With a desire to evaluate patient satisfaction in the physical therapy setting, a team of researchers conducted a review of all available literature on the topic. Results showed that patients are predominantly satisfied with the musculoskeletal physical therapy they were receiving, with an overall satisfaction estimate for all patients of 4.44 out of 5 (with 1 being very dissatisfied and 5 being very satisfied.)

Evaluating the effectiveness of exercise therapy for groin pain in athletes
Groin pain is a common ailment for many athletes, particularly those involved in sports like football and soccer, where running and sudden changes in direction make the risk of developing this pain more likely. Diagnosing these injuries is difficult, and treating it is even harder due to the fact that only minimal research exists on treatments that have been proven to be effective. A review of all available literature on the topic was therefore conducted, and it found exercise therapy to be an incredibly helpful intervention, as it led to favorable outcomes in helping athletes return to sport in all research found, with two studies even reporting it significantly reduced symptoms.

Surgical vs. non-surgical treatment for Achilles tendon rupture
The course of treatment for Achilles tendon rupture is one that continues to change on a regular basis, and a general consensus on the best way to approach it is yet to be reached. While re-rupture rates are slightly lower with surgery compared to rehab, the complications and costs associated with surgical intervention are much higher, and some meet it with caution. The recent development of a functional brace that allows movement, however, has given more credence to the possibility of a non-surgical intervention. To determine the effectiveness of this new brace, a study compared it to patients who underwent surgery, and found only minimal differences in re-rupture rates, boosting the stock of rehab over surgery.

Stretching shown to have benefits associated with looseness and soreness, but not in preventing injury
For quite some time, stretching before and after physical activity has been a popular course of action performed by many and underscored with the belief that it reduces the risk of injury while engaged in activity. Surprisingly enough, despite its widespread usage across the gamut, the specific benefits of stretching to prevent injury are not well established, and many studies have shown them to be questionable. To evaluate this matter in greater detail, a powerful study was conducted and found stretching to be effective in increasing the feeling of looseness and reducing some soreness, but debatable in terms of preventing injury.

Understanding possible causes and prevention methods for cramps induced by exercise
Exercise-associated muscle cramps (EAMC) consist of acute pain, stiffness and muscle knotting, and usually occur during or shortly after exercise and last for several days. These types of cramps can be extremely debilitating for athletes and can prevent them from participating at full capacity. Medical professionals believe that by understanding the cause of EAMC, better treatment and prevention methods can be established. Two main schools of thought exist on the subject, one that believes the cramps are due to dehydration imbalances, and another that claims they're a result of deeper-rooted neuromuscular changes. Both theories have some strong points, as well as flaws, and are examined in greater detail here.

Moderate exercise proven to be safe for fetus in last trimester of pregnancy
Exercise of any sort throughout the course of a pregnancy has long been a debated topic that continues to attract varying viewpoints. Of the greatest concern is the final trimester of a pregnancy, a time vital to the development of fetal lungs and other organs, which leads to questions regarding the effect of exercise on the homeostasis of the maternal-fetal unit. To better understand the connection between moderate exercise and the safety of fetuses in the final trimester of a pregnancy, a study was conducted on pregnant women and found no noticeable effects that were negative to the development of the fetus resulting from exercise.

A choice of words: what to use, what to avoid when delivering news to patients
When it comes to hearing news regarding an important, possibly life-altering condition, patients are at an increased level of susceptibility and vulnerability. For this reason, the manner in which news is delivered to patients is of extreme importance, and it can go on to have a major impact on how they come to deal with their diagnosis. Some medical professionals still manage to err in this sensitive process, but this pamphlet should elucidate on the most common mistakes and how to properly deliver these pieces of news.

Differences between running-related injury predictors for male and female novice runners
Running is far and away the most popular form of physical activity throughout the world, primarily due to the fact that just about any able-bodied person in just about any location can do it. With its popularity, however, also comes a high risk of injury, as some studies report numbers as high as 79% of all runners sustaining a running-related injury (RRI) at some point in their career. To evaluate the inherent risks associated with running and to determine the differences in risk factors for male and female novice runners, a randomized control trial was performed with these objectives in mind.

Evidence-based medicine: the importance of understanding varying levels of evidence
With the overwhelming slew of information on the Internet regarding just about any subject imaginable, including medical research and advice, it's difficult for the common man to determine what to believe and what to dismiss. Evidence-based medicine (EBM) uses a system that assigns a number to each medical study according to its strength of evidence, and as a result, makes the process of deciding what to trust as credible much easier.

Common training mistakes for marathon and half marathon runners
Making the decision to participate in a marathon (26.2 miles) or half marathon (13.1 miles) usually means one will be spending a sizable period of time prior to the race involved in a serious training program.  For many who follow these programs, however, a number of minor but common mistakes in the course of training or on the day of the race can have negative effects on performance, but can easily be avoided by following these guidelines.

Evaluation of osteoporosis risk factors and recommendations for prevention
It's estimated that 1 in 4 women and 1 in 8 men in Canada have osteoporosis, a skeletal condition that occurs as a result of low bone mineral density. Osteoporosis particularly affects those over the age of 65 and has significant implications for those who suffer from it and on the entire health care system due to its prevalence. By understanding who's at risk and by following some simple preventative measures given by the organization Osteoporosis Canada, the rate of osteoporosis can be lowered, saving money and reducing complications for all those affiliated with the condition.

The effect of Pilates on adult fitness characteristics

The benefits of dealing with obesity in patients with knee osteoarthritis
People who suffer from obesity are at an increased risk of obtaining knee osteoarthritis (OA) due to excessive pressure on joints in the knee, and for obese patients who already have the condition, not doing anything about it can lead to further complications. Increased physical activity and dietary modifications with the purpose of losing weight are therefore considered productive methods to prevent knee OA and lessen the severity of pain in those who have it. To highlight these benefits and prompt physicians to encourage weight-loss treatment programs, a study was conducted and published in The Journal of Musculoskeletal Medicine.

Obesity accounts for nearly 10% of all medical spending in the United States
Recent research released by the U.S. Center for Disease Control and Prevention (CDC) claims that obesity-related diseases account for 9.1% of all medical spending in the U.S., or about $147 billion annually. With this in mind, the CDC emphasizes the importance of reducing the national obesity rate in order to lower health care costs, and suggests certain ways in which this can be accomplished.

What studies have more validity and why: The importance of clinical trials
With such an abundance of medical reports being released by the media, it has become a difficult task to determine whether a source or study is trustworthy. Clinical trials, due to a number of powerful factors, are proven to be the most accurate of studies, even when their conclusions contradict popular belief.

Breaking down injuries in the NFL during preseason and training camp
The NFL preseason, while imperative for a fully functioning team, also happens to be a period of time where injuries occur on a far-too-often basis.One study followed an NFL team through their preseason for 10 consecutive seasons, recording all statistics relevant to injury, and produced an in-depth break down of the most common injuries, the most dangerous positions, and other related information.

How ethnicity affects the willingness to undergo knee replacement surgery
In order to deem if there exists a difference between ethnic groups and the willingness to undergo knee replacement surgery for something like osteoarthritis (OA) knee, researchers surveyed 193 African-Americans, Hispanics and Caucasians on the amount of money they'd be wiling to pay for said surgery. The study found that Caucasians were the most inclined to pay for surgery, followed by Hispanics, and then by African-Americans.