PT Crab 34 Blue Crab Edition

Welcome to the 34th week of PT Crab. Did you know that means we’re 65.38% of the way to the end of our first year? Wow. What a meaningless number. Fortunately, there’s a bundle of meaningful stuff down below about how to avoid muscle soreness and how to treat patients who are survivors of sexual assault. 1 in 4 women experience sexual assault, and I’ll bet your school didn’t really cover that, so this is a great place to brush up on it.

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One last thing! I’m looking at you, Therapeutic Associates Physical Therapy. A bunch of ya’ll have signed up recently and I really appreciate it. I’m glad PT Crab has been helping you out. If you want everyone at TAIPT to get access to the King Crab edition, be sure to tell your overlords (AKA clinic managers) that we have a clinic-wide/enterprise plan now. Just email me at Luke@PTCrab.org for more. Thanks for reading and sharing up in the PNW.

And with that, let’s dive in!

Want to Avoid DOMS? Try this one weird trick.

The Gist - These researchers popped out a systematic review devoted to discovering how to cut down on delayed onset muscle soreness and looked into BFR without exercise as one of the solutions. It’s not a method I’d ever heard of before, but they were able to find 6 papers that tried it out, and 17 papers that looked into low intensity exercise with the same goal in mind. The BFR studies had 113 participants and gave us a maybe answer. BFR may help heal muscle damage and prevent DOMS, but only in untrained populations, not in your athletes.

What about low intensity exercise? That’s a big 👍, especially for low intensity eccentric exercise. That type crushed it, provided a protective effect against muscle damage and pain when used either before exercise or after. Great news!

Tell Me More - Let’s look at some details. The protective effects of the low intensity exercises were highest at about 10% of maximal eccentric strength and provides muscle protection for up to 28 days, though most studies showed a shorter duration (a few days to a week). Isometrics helped almost as much as eccentrics, with the best effects when the muscle was in a lengthened position.

Why does this work? Increased blood flow, increased respiratory enzymes, and increased muscle compliance and elasticity most likely. Researchers refer to the overall effect as the “repeated bout effect.” It’s “a smaller decrease in muscle function with less muscle damage and faster recovery in performance following the second bout of eccentric activity” and seems to work in all muscles. The nature of the low intensity exercise can be varied as well. The researchers recommend light walking, jogging, or resistance exercise.

Paper por favor. I see you’ve learned some Spanish, good for you! Here’s your papel.

A PT’s role in treating survivors of sexual assault

The Gist - This is another one of those “hey, just go read the thing!” articles, and this one is fortunately very short and open access. I am going to pull out the key points for you in case you don’t have time, but do highly recommend reading this two page article written by PTs and psychologists from Australia.

In brief - one in four women (on average) has experienced sexual assault, which means that PTs should have some understanding about how to best care for this large patient population. In case you somehow think this can’t apply to PT, sorry, that’s just not the case. Sexual assault impacts physical, social, emotional, and psychological health. Even if you don’t believe in the Biopsychosocial model of pain (and you should), this has a real impact on treatment. And if you’re a pelvic floor specialist, this doubly applies. Both because people who have been sexually assaulted experience more incontinence and constipation and because they are more sensitive about their treatment.

Want more physical stuff? How about tonic immobility? 70% of women report tonic immobility during sexual assault. It’s a profound, global motor inhibition where skeletal muscles tense rigidly and can’t be moved. This diminishes vocal capacity and has long term muscular consequences.

I’m done summarizing, please read the two pages. It’s less than 5 minutes that could change how you practice entirely.

Tell Me More - Nope! Read the paper.

Paper Please! I’m glad you asked. Here you go.

That’s our week! Thanks for tuning in and reading that second paper. Wait you didn’t?! Stop reading this and do so now.

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See you next week!