What to Make of Low-carb Promises?

Are carbs getting a bad rap because they convert so easily to sugar? Here, a look at what the research currently says about the matter.
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A Slow-motion Walk Through Running Form

Running form from toe-off through swing-through should not ignore upper body movements and how they coordinate with lower body ones.
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New Running Tech Monitors Cadence and Footstrike

The new generation of training devices includes features that can measure stride length, heel-toe footstrike ratios, stance time and cadence.
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Kids and Healthy Food: Reverse Psychology? None is Better Still

It may be that positive-benefit food messages can somehow foster the idea in children that if something is good for us, it must surely taste bad.
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A Guide to Buying Children's Running Shoes

By Mark Cucuzzella, MD, FAAFP

Here are a few things to consider before you start shopping for your kids’ gym shoes, track shoes and more.
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The New Old Age

Professor Warren Sanderson is working on ways to define aging other than the passing of years.
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The Clinic

Potassium Keeps Muscle Cramps Away
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Why Train Long and Slow?
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Groin Pain Starts When I Stop
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The Young Runner's Diet
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The Back Page

XC BORDER WAR: 9th Annual Battle of the Potomac MD vs. VA vs. WV vs. DC


CROSS COUNTRY RACING:  Aiming to Peak for the Post-Season

Seen and Heard While Running
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Today's Screen Time Means More Neck and Back Pain

Time was, as our parents warned at least, all we really had to worry about was “eye strain” from spending too much time, too close, in front of the TV. In later decades, the workplace PC began to trouble all office workers—no longer only copywriters, programmers, typists and the like—with the consequences of hunched posture eight hours a day, five days a week.

Now, in the age of the tablet, phablet, e-reader and smartphone in addition to the desktop and laptop, the potential for neck and back strain follows nearly all of us everywhere all the time, with weekend and vacation screen-time reprieve a thing of the past. Walk through any public space and observe the majority of humans with heads angled down, shoulders crimped, checking email, voicemail and text messages while engaging with an almost infinite number of other apps and services, hardly looking up anymore to order—or even pay for—coffee.

This 21st century public health issue isn't just anecdotal. A study from the Harvard School of Public Health, Brigham and Women’s Hospital, and Microsoft showed that holding a tablet too low in your lap can place the small, interlocking bones at the top of the spine (the cervical vertebrae) and the neck muscles into an unnatural posture. This can strain muscles, nerves, tendons, ligaments and spinal discs. (continued)

Linus makes an observation

Linus makes a good observation on his Dad’s attempt to start a running program. It is not about how far you run or how long you run. It is about getting out there and doing it! (continued)

Knee Surgery No-No?

Arthroscopic surgery appears no better than nonoperative treatments in patients with degenerative meniscal tears without osteoarthritis, according to a meta-analysis in the Canadian Medical Association Journal.

The analysis included seven randomized trials in which just over 800 patients with degenerative meniscal tears and mild or no osteoarthritis were assigned to undergo either “arthroscopic meniscal debridement” or nonoperative treatment (e.g., exercise programs, steroid injections or sham surgery). Debridement refers to the medical removal of dead, damaged or infected tissue to improve the healing potential of remaining healthy tissue.

The researchers searched three medical databases for randomized controlled trials published from all the way back to January 1946 up to January 2014. They assessed risk of bias for all included studies and pooled outcomes using a random-effects model. The outcomes were based on function and pain relief, and divided into two sets, short-term (less than six months) and long-term (less than two years) data.

The pooled treatment effect of arthroscopic surgery did not show a significant or minimally important difference between treatments for long-term functional outcomes. Short-term functional outcomes between groups were significant but did not exceed the threshold for “minimally important difference.” Arthroscopic surgery also did not result in a significant improvement in pain scores in the short term or in the long term.

Arthroscopic surgery therefore appeared to offer no meaningful benefit over the other treatments in terms of pain or function, either within six months or two years. The authors conclude that in this patient population, “There is moderate evidence to suggest that there is no benefit to arthroscopic meniscal debridement for degenerative meniscal tears in comparison with nonoperative or sham treatments...”

Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for patients is not very clear. This systematic meta-analysis undermines the efficacy of arthroscopic meniscal debridement in comparison with nonoperative treatments in patients with knee pain, at least for middle-aged patients with mild or no concurrent knee osteoarthritis.

The benefits of non-surgical options like specific exercises and physical therapy are becoming increasingly known and understood. But the fact that in addition to these widely accepted treatments sham surgery fared as well as surgery is disconcerting. What not terribly long ago seemed a standard, almost inevitable option for countless athletes and recreational runners with knee problems now looks to be seriously under question. In any case, it is good to have moved firmly into an era where first-line treatment options almost always involve nonoperative management of injuries even as debilitating as meniscal tears.

CMAJ, August 25, 2014, doi: 10.1503/cmaj.140433, http://www.cmaj.ca/content/early/2014/08/25/cmaj.140433


editorial board

Kenneth Cooper, MD
Kevin Beck
Jack Daniels, PhD
Randy Eichner, MD
Mary Jo Feeney, MS, RD
Mitchell Goldflies, MD
Paul Kiell, MD
Sarah Harding Laidlaw, MS, RD
Paul Langer, DPM
Douglas Lentz, CSCS
Todd Miller, MD
Gabe Mirkin, MD
Col Francis O’Connor, MD
Stephen Perle, DC, CCSP
Pete Pfitzinger, MS
Charles L. Schulman, MD
Bruce Wilk, PT, OCS
Mel Williams, PhD
Michael Yessis, PhD
Jeff Venables, Editor

board of directors

Jeff Harbison, President
Bill Young, Secretary-Treasurer
Immediate Past-President
(Vacant) Vice President
Robert Corliss
Charles L. Schulman, MD, AMAA Pres.
AMAA President
Terry Adirim, MD, MPH
Gayle Barron
Sue Golden
Senator Bill Frist, MD
Jeff Galloway
Jeff Harbison
Ronald M. Lawrence, MD, PhD
Jeff Moore
Noel D. Nequin, MD
David Pattillo

Association Staff

Executive Director: Dave Watt
Project Consultant: Barbara Baldwin, MPH

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