Pollack Rehab

09/15/2025

⚠️ FAQ: My knees make noise, should I be worried?

Short answer: No.

Self-reported knee crepitus — an audible crackling or grinding noise during knee movement — did not predict worsening osteoarthritis (OA) features in either the patellofemoral or tibiofemoral compartment over the next 5 years, according to a 2025 study published in Arthritis Care & Research.

Joints are designed to make noise. Crackling is normal. Although this study found that crepitus was a bad sign after anterior cruciate ligament (ACL) reconstruction, there is probably nothing to worry about for the general population. Movement is medicine for mechanical knee pain, with or without crepitus.

Knee crepitus after anterior cruciate ligament reconstruction is tied to cartilage damage and worse patient-reported symptoms 1 year after surgery but doesn’t predict worsening joint damage over time.

09/08/2025

09/03/2025

🗣️ Language matters: Health is determined by biological, psychological and social factors (the biopsychosocial model).

Diagnosing “wear and tear” is biologically wrong and psychologically disempowering.

It is always important to emphasize that function trumps structure for things like knee osteoarthritis or shoulder tendinopathy.

“Take good care of yourself and your body will do the rest!”





📊: RunningPhysio

09/03/2025

Shawn Thistle (RRS Education): Kerry and colleagues outlined a contemporary framework for teaching and applying manual therapy, including spinal manipulative therapy and mobilization. Rather than relying on traditional concepts like clinician-centered assessment, pathoanatomical reasoning, and highly specific technique selection – which generally lack strong support in the scientific evidence; the updated model emphasizes three key humanistic dimensions for both patients and practitioners: safety, comfort, and efficiency. This approach shifts the focus toward a truly person-centered style of care, where shared decision-making, clear and positive communication, and a supportive clinical environment are central to the therapeutic process.

Blog: Dr. Shawn Thistle reflects on the recent series of papers on chiropractic spinal manipulation published in CMT.

08/27/2025

🩻 Question: Do older adults with back-related disability require an x-ray before receiving chiropractic care?

Answer: No.

"Like grey hair or wrinkles," common degenerative changes of the spine (otherwise known as normal aging) do not correlate with symptoms of back pain or disability.

For example, lumbar spinal stenosis is a finding estimated to be present in 1 out of 5 adults over 60 years old and increases with age. Notably, more than 80% of these cases are asymptomatic. However, most people with back pain and spinal stenosis will be referred to an orthopedic surgeon. Most of those referrals are unnecessary.

The good news: In this study, after 12 weeks of treatment, 42% of the older adult participants achieved a clinically important response to chiropractic care (30% improvement in back disability), regardless of severity of radiographic findings.

"The result of this study suggests imaging may not be helpful for predicting who will be a responder to chiropractic spinal manipulation and home exercise, and that spinal manipulation may reasonably proceed without imaging on older adult patients in the absence of red flags or suspected contraindications to care," according to a 2025 study published in Chiropractic & Manual Therapies.

Background Some chiropractors use spinal x-rays to inform care, but the relationship between radiographic findings and outcomes is unclear. This study examined the association between radiographic findings and 30% improvement in back-related disability in older adults after receiving 12 weeks of chi...

08/25/2025

As a general rule, tendinopathy should be managed with exercise and education on load management.

Unfortunately, passive modalities such as laser therapy, electrotherapy, ultrasound and shockwave are common despite a lack of supporting evidence.



📊: RunningPhysio

08/25/2025

🥩 Medscape: Chefs and restaurants say all kinds of things, but the real definition is simple: Mammals are red meat, and birds are white meat.

Now, there’s another thing we need to explain. We have red meat, but we also have processed red meat. Processed red meat is when red meat is transformed in some way — and that doesn’t mean cooking. If you just take a piece of steak and cook it on your barbecue or in the oven, that’s not processed meat. Processing is doing things like salting the meat, smoking it, or curing it. Processed meat includes items like bacon, sausages, hot dogs, salami, corn beef, and smoked meat.

So, when we talk about red meat and health risks, we are primarily talking about processed red meat.

All this to say, if you eat hot dogs every day of your life, your risk of getting colon cancer goes up by 1 percentage point on the absolute scale. Now, on first instinct you might say, "Pfff, that’s nothing. Pass the bratwurst." But 1% on the absolute scale is not trivial. That’s thousands of cases per year. Millions of cases over the course of your lifetime in a country of 300 million people. It has some important public health implications.

The WHO has declared red meat a carcinogen. So, Dr Christopher Labos asks the question we're all thinking: Is a hot dog really as bad as a cigarette?

08/15/2025

🪜 No more graffiti in our parking lot!

When the owner refused to remove offensive graffiti from the back of their building, Kevin Darrah - Fredericton Ward 7 Councillor & Downtown Fredericton stepped up to support small business and the downtown community.

Thank you!

08/15/2025

🧰 New look at the office thanks to Adam Flanagan Therapeutics!

08/07/2025

Medscape: Contrary to popular wisdom, people can get the same health benefits from walking 7000 steps a day as they do from walking 10,000 paces, according to a comprehensive review and meta-analysis published in The Lancet Public Health.

The researchers looked at nine different health outcomes: all-cause mortality, the incidence of and deaths from cardiovascular disease, dementia, cancer incidence and mortality, the incidence of type 2 diabetes, depressive symptoms, and falls. Every outcome showed improvement as the amount of daily activity increases, but for most people the benefits tapered off at around 5000-7000 steps per day.

Compared with taking just 2000 steps per day, walking approximately 7000 steps per day reduced all-cause mortality by 47% and decreased the incidence of cardiovascular disease by 25%, of cancer by 6%, of type 2 diabetes by 14%, of dementia by 38%, of depression by 22%, and of falls by 28%.

The study also highlighted that even modest step counts of around 4000 per day were beneficial compared with lower activity of just 2000 steps. “Every step counts,” said Katherine Owen, PhD, biostatistician at the University of Sydney, Australia, who led the review. “All physical activity is beneficial, but increasing daily steps to around 7000 steps is optimal to improve all health outcomes.”

Health benefits of physical activity plateau around 7000 steps a day for a variety of conditions.

06/09/2025

This video demonstrates some safe & easy ways to reduce sacroiliac (SI) joint pain. Sometimes the SI joints will "pop" (self-adjust), but these mobilizations will help even if they don't.

📷: SpineCare Decompression and Chiropractic Center

Dr. Rowe shows how to safely self pop your sacroiliac joint for instant pain relief.This video will be broken into an EASY step-by-step guide that will show ...

05/22/2025

Medication overuse headaches (also called "rebound headaches") are paradoxically caused by the frequent use of medication to treat headaches. Unfortunately, an underlying headache disorder such as migraine or tension-type headache (TTH) can transform over time from an episodic condition to a chronic daily headache due to excessive intake of acute headache relief medications.

Medication overuse headaches (MOH) are most commonly caused by analgesics (such as ibuprofen and acetaminophen), triptans, ergotamines, opioids and especially combination pain relievers. Butalbital is a barbiturate drug used for symptomatic treatment of TTH in various combinations with acetaminophen, aspirin, caffeine, and codeine.

Chiropractic spinal manipulative therapy (SMT) can help reduce TTH and therefore reduce the risk of MOH, according to a 2024 retrospective cohort study published in the journal Health Science Reports.

A retrospective cohort study is an observational study where researchers identify a cohort based on past exposures or experiences, and then follow this group forward to examine the development of a specific outcome or disease. "This study divided patients into two cohorts: (1) SMT and (2) non-SMT, using propensity matching to control for demographics and other variables associated with likelihood of butalbital prescription and MOH. Three thousand one hundred and sixteen patients remained per cohort after matching," according to the abstract. The advantage of this type of study is big data: A study this large produces compelling (observational) evidence.

"Adults receiving chiropractic SMT had a significantly lower likelihood of butalbital prescription and, tentatively, MOH compared to matched controls not receiving SMT. These findings support current guideline recommendations favoring SMT in TTH care, though future studies should replicate and compare these findings with other nonpharmacologic clinicians and interventions," the study concluded.

Adults receiving chiropractic SMT had a significantly lower likelihood of butalbital prescription and, tentatively, MOH compared to matched controls not receiving SMT. These findings support current guideline recommendations favoring SMT in TTH care, though future studies should replicate and compar...