Dr. Hanjabam Barun, Sports & Exercise Medicine Specialist, New Delhi (2026)

15/03/2026

NMOCON’26 presents Fitness From A Shoe String
By Experts from IMS, BHU and Indian Society of Sports and Exercise Medicine (ISSEM) life members.

All NMOCON Participants can register for this workshop

Limited Slots (first come first serve basis)
NMOCON 2026 being organised by NMO, Vadodara (Gujarat Prant) on March 20-21-22, 2026 in Baroda Medical College, Vadodara, Gujarat.
Registration and other details: https://www.nmocon.org/ 🚩🚩

15/03/2026

📖🧐 The 1964 Intradiscal Pressure Study: One of the Most Misinterpreted Findings in Spine Research

In 1964, Alf Nachemson published a landmark paper:
“In Vivo Measurements of Intradiscal Pressure: Discometry, a Method for the Determination of Pressure in the Lower Lumbar Discs.”

The study measured intradiscal pressure in different body positions, demonstrating how mechanical loading changes across common postures such as standing, sitting, bending, and lifting.

However, over the years this work has often been misinterpreted.

The findings have sometimes been used to support the idea that:
➡️ The intervertebral disc is a primary pain generator, and
➡️ Higher biomechanical load inevitably leads to greater pain.

But.......... .......
But..

But this was not the conclusion of the study.

As Nachemson (2006) later clarified:
“This experiment has been misinterpreted as evidence that the disc is a significant pain generator and that increasing the biomechanical load leads to greater pain.”

In reality, the study simply demonstrated how the lumbar spine responds to normal physiologic loading in different body positions.

It did not determine the origin of back pain.

✅ Clinical message for physiotherapists
This reminds us of an important principle in musculoskeletal care:
• Mechanical load ≠ pain
• Tissue stress ≠ tissue damage
• Structural findings ≠ symptom source

Low back pain is a complex biopsychosocial condition, involving interactions between:
+ tissue physiology
+ nervous system processing
+ psychological factors
+ movement behaviours
+ social and contextual influences.....

Disclaimer:
👉 Sharing a study is NOT an endorsement.
👉 You should read the original research yourself and be critical.

15/03/2026

Tribute and Condolence Message

Prof. (Dr.) Arun Kumar De
One of the Pioneers of Exercise Physiology and Sports Medicine in India
Retired Professor and Head,
Department of Physiology, Institute of Medical Sciences (IMS),
Banaras Hindu University (BHU), Varanasi (U.P.), India.

The Indian Society of Sports and Exercise Medicine (ISSEM) expresses its profound sorrow on the passing of Prof. (Dr.) Arun Kumar De, an eminent physiologist and one of the pioneers of Exercise Physiology and Sports Medicine in India, who passed away on 14 March 2026 in Varanasi.

Prof. De made immense and lasting contributions to the development of Sports and Exercise Sciences in the country. He was instrumental in establishing the Sports Medicine and Pulmonary Physiology Unit in the Department of Physiology, Institute of Medical Sciences, Banaras Hindu University (IMS-BHU), Varanasi, which emerged as one of the earliest academic centres in India dedicated to research, teaching, and scientific advancement in Exercise Physiology and Sports Medicine.

At a time when research infrastructure in India was limited and sophisticated electronic equipment was scarcely available, Prof. De demonstrated exceptional scientific vision and perseverance. Despite these constraints, he conducted pioneering physiological investigations and published several high-quality research articles in reputed international journals, including the British Journal of Sports Medicine.

Prof. De was among the earliest Indian medical doctors to publish in the British Journal of Sports Medicine, particularly during the late 1970s and early 1980s, when contributions from India to international sports medicine literature were extremely rare. One of his notable paper “Some Physical Efficiency Tests on Bengalese Football Goalkeepers” (British Journal of Sports Medicine, 1979) examined anthropometric and physiological characteristics of athletes and provided valuable early scientific data on sports performance in the Indian context.

Through his pioneering studies on physical efficiency, cardiopulmonary responses to exercise, respiratory physiology, and physiological characteristics of athletes, Prof. De helped bring early international recognition to Indian research in Exercise Physiology and Sports Medicine. His work demonstrated that meaningful and impactful scientific research could emerge even in the absence of advanced laboratory infrastructure.

Through his dedication to scientific inquiry, teaching, and mentorship, Prof. De played a pivotal role in laying the scientific foundation for Sports Medicine and Exercise Physiology in India. Generations of students, researchers, and clinicians have benefited from his guidance, inspiration, and academic leadership.

Prof. (Dr.) Arun Kumar De will be remembered not only for his outstanding academic contributions but also for his humility, wisdom, and commitment to nurturing young scientists. His legacy will continue to inspire the Sports & Exercise Medicine and Exercise Physiology community for years to come.

On behalf of the Indian Society of Sports and Exercise Medicine (ISSEM), we extend our heartfelt condolences to his family, colleagues, students, and all those who had the privilege of learning from and working with him. The entire Sports-Exercise Medicine & Sciences fraternity deeply mourns this irreparable loss.

May his soul rest in eternal peace, and may his remarkable legacy continue to inspire future generations.

Indian Society of Sports and Exercise Medicine (Reg. No. S-E/1633)
www.issem.in
________________________________________

Historical Photograph
Prof. (Dr.) Arun Kumar De with Dr. H. E. Robson at the Monastery Ruins, Dhamek Stupa Complex, Sarnath, near Varanasi (1980).

In the photograph (from right to left): Prof. (Dr.) Arun Kumar De and Dr. H. E. Robson (one of the pioneers of British Sports Medicine). The photograph was taken during Dr. Robson’s visit to Banaras Hindu University (BHU) when he came to India as one of the faculty members of the Asian Sports Medicine Course.

During this visit, Dr. Robson delivered a lecture at BHU attended by approximately 150 faculty members, staff, and students from various institutes and faculties of the university. After his visit to Varanasi, Dr. Robson travelled to the Delhi Sports Stadium and later to the Netaji Subhas National Institute of Sports (NS NIS), Patiala.

A few years later (1986–1987), the first Medical Council of India (MCI) recognized postgraduate specialization in Sports Medicine — the Diploma in Sports Medicine (DSM) — was initiated at NS NIS Patiala. This qualification is now recognized by the National Medical Commission (NMC) as one of the alternative academic qualifications (along with MS in Orthopaedics, MD in Physical Medicine & Rehabilitation, and MD in Physiology) for eligibility as Sports Medicine faculty during the transition period.

________________________________________
1. Robson H. Some impressions of India and the sports medicine course. Br J Sports Med. 1980;14(1):61–63.
Available from:
https://pmc.ncbi.nlm.nih.gov/articles/PMC1858782/
https://bjsm.bmj.com/content/bjsports/14/1.toc.pdf
2. Sharma HB. Sports and exercise medicine in India: The past and the challenges. J Clin Diagn Res. 2022;16–CE06.
Available from:
https://jcdr.net/articles/PDF/15953/53390_CE%5BRa1%5D_F%5BSH%5D_PF1%28AG_SS%29_PFA%28SS_AG_KM%29%29_PN%28KM%29.pdf
________________________________________
Indian Society of Sports and Exercise Medicine (ISSEM)
www.issem.in

15/03/2026

It is called Menopausal Musculoskeletal Syndrome. MMS.

During perimenopause and menopause, estrogen levels drop. And estrogen does more than people realize; it reduces inflammation, protects cartilage, supports collagen production, and modulates how the brain processes pain signals.

When estrogen falls, pain sensitivity rises. Joints stiffen. Recovery slows. Morning soreness, nerve-like sensations, whole-body achiness; symptoms that often get labeled as early arthritis, fibromyalgia, or depression.

But here is what most physicians do not know: these symptoms are real, common, hormonally driven, and frequently misattributed because doctors are not trained to connect them.

I have seen this exact pattern in patient after patient. The joint pain is not in your head. It is in your estrogen levels.

What actually helps: anti-inflammatory movement (strength training is critical), sleep optimization, an anti-inflammatory diet built around whole plants, and in many cases, a frank conversation with your doctor about hormonal management.

If you have been dismissed, find a physician who knows what MMS is.

13/03/2026

*One of the Pre-Conference Workshops on 10th April 2026*:

*Clinical Exercise Physiology: From Disease Centred to Health Oriented Practice*

*3rd International Conference of Indian Society of Sports and Exercise Medicine (www.issem.in) 2026 at Sports Injury Centre, VMMC & Safdarjung Hospital, New Delhi from 10th to 12th April 2026*.

*Registration*: https://www.issemcon2026.com/registration_details.php *For details*: www.issemcon2026.com *Email*: issemcon2026@gmail.com

*Hurry!! Seats are Limited*

13/03/2026

𝗧𝗼 𝗙𝗹𝗲𝘅 𝗼𝗿 𝗡𝗼𝘁 𝘁𝗼 𝗙𝗹𝗲𝘅? 𝗗𝗲𝗯𝘂𝗻𝗸𝗶𝗻𝗴 𝘁𝗵𝗲 "𝗦𝘁𝗿𝗮𝗶𝗴𝗵𝘁 𝗕𝗮𝗰𝗸" 𝗟𝗶𝗳𝘁𝗶𝗻𝗴 𝗠𝘆𝘁𝗵

◼️ Low back pain (LBP) is the leading cause of disability worldwide, and lifting objects is commonly blamed as a primary risk factor.
◼️ For decades, workplace safety guidelines and healthcare professionals have preached a universal rule: avoid bending your spine and lift with a "straight back" to prevent injury.
◼️ But what if this deeply ingrained public health dogma isn't actually supported by science?
◼️ A fascinating systematic review and meta-analysis by Saraceni et al. (2020) set out to investigate the core idea behind this rule.
◼️ The researchers asked two fundamental questions: Is lifting with a flexed lumbar spine actually a risk factor for developing or worsening LBP? And do people with LBP actually bend their spines more during lifting than people without pain?
◼️ Here is a deep dive into the idea behind the review, what the researchers found, and why it might change how we think about lifting.

🧠 𝗧𝗵𝗲 𝗢𝗿𝗶𝗴𝗶𝗻 𝗼𝗳 𝘁𝗵𝗲 "𝗦𝘁𝗿𝗮𝗶𝗴𝗵𝘁 𝗕𝗮𝗰𝗸" 𝗗𝗼𝗴𝗺𝗮

◼️ The advice to maintain a straight back or neutral spine while lifting didn't come from nowhere.
◼️ It was largely based on early cadaveric studies, which demonstrated that a dead spine is more susceptible to structural failure when it is repeatedly flexed and compressed at the same time.
◼️ However, dead tissues do not accurately represent living, breathing human bodies.
◼️ The researchers noted that we do not fully understand how applicable these cadaver studies are to real-life, in vivo (living) lifting situations.
◼️ In fact, recent biomechanical studies on living humans show that spinal loads (disc pressure, compression, and shear strain) are actually very similar whether you lift with a flexed spine or a straight spine.

📊 𝗪𝗵𝗮𝘁 𝘁𝗵𝗲 𝗗𝗮𝘁𝗮 𝗔𝗰𝘁𝘂𝗮𝗹𝗹𝘆 𝗦𝗵𝗼𝘄𝘀

◼️ To test the idea that spinal flexion is dangerous, the researchers analyzed 12 independent studies involving nearly 700 participants.
◼️ They compared the lumbar spine kinematics (movement) of people with LBP to those without it during natural, unconstrained lifting tasks.
◼️ The findings were highly consistent and directly challenge conventional wisdom.
🔹 No increased risk:
◼️ There is no credible longitudinal or cross-sectional evidence showing that greater lumbar spine flexion during lifting is a risk factor for the onset or persistence of LBP.
🔹 No significant difference:
◼️ Most studies found absolutely no difference in peak lumbar spine flexion between people who have LBP and people who are pain-free.
🔹 Less flexion, not more:
◼️ When differences were observed, the data actually trended in the opposite direction.
◼️ Several cross-sectional studies revealed that people with LBP often lifted with less lumbar flexion than healthy controls—likely as a protective adaptation to pain or because they were previously advised to keep their backs straight.
◼️ In short, out of 43 different lifting comparisons analyzed in the review, only two suggested that people with LBP used more spinal flexion, while the vast majority showed no difference or less flexion.

⚠️ 𝗪𝗵𝘆 𝗧𝗵𝗶𝘀 𝗠𝗮𝘁𝘁𝗲𝗿𝘀: 𝗧𝗵𝗲 𝗗𝗮𝗻𝗴𝗲𝗿 𝗼𝗳 𝗙𝗲𝗮𝗿

◼️ The idea behind this review extends beyond just body mechanics; it touches on psychology.
◼️ LBP is strongly influenced by biopsychosocial factors, including negative beliefs and a fear of movement.
◼️ When authorities constantly warn people that bending their back is dangerous, it can create a pervasive fear of normal human movement.
◼️ Because there is no in vivo evidence to support the warning that lumbar flexion causes LBP, the researchers argue that continuing to prescribe the "straight back" advice is unjustified and potentially harmful if it makes people unnecessarily afraid to move their bodies.

⚖️ 𝗡𝘂𝗮𝗻𝗰𝗲 𝗮𝗻𝗱 𝗟𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀

◼️ While the idea that we don't need to fear spinal flexion is liberating, the review does come with a few important caveats.
🔹 Low-Quality Evidence:
◼️ The researchers graded the overall quality of the available evidence as "low," largely because biomechanical studies often use small sample sizes and different motion-capture methods.
🔹 Weight Limits:
◼️ The studies included in the review only tested participants lifting objects weighing up to 12 kg (about 26.5 lbs).
◼️ Therefore, these findings confidently apply to everyday lifting, but we cannot safely extrapolate them to heavy occupational lifting or maximum-effort weightlifting.
🔹 Laboratory Settings:
◼️ All the analyzed studies took place in labs, meaning we need more field-based research to see how these mechanics play out during repeated manual labor in actual workplaces.

✅ 𝗧𝗵𝗲 𝗧𝗮𝗸𝗲𝗮𝘄𝗮𝘆

◼️ The central idea of this comprehensive review is a paradigm shift: there is no credible evidence that bending your lower back when you lift causes low back pain.
◼️ While we still need more research on heavy occupational lifting, the current science suggests that the human spine is robust and capable of bending safely.
◼️ Instead of fearing flexion and forcing a rigid "straight back," we may need to rethink our approach to manual handling and focus on building resilience rather than restricting natural movement.

-----------------
⚠️Disclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.⚠️

Link to Article 👇

13/03/2026

🧊 𝗔 𝗗𝗲𝗲𝗽 𝗗𝗶𝘃𝗲 𝗶𝗻𝘁𝗼 𝘁𝗵𝗲 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁 𝗼𝗳 𝗙𝗿𝗼𝘇𝗲𝗻 𝗦𝗵𝗼𝘂𝗹𝗱𝗲𝗿: 𝗜𝗻𝘀𝗶𝗴𝗵𝘁𝘀 𝗳𝗿𝗼𝗺 𝗮 𝗖𝘂𝗿𝗿𝗲𝗻𝘁 𝗖𝗼𝗻𝗰𝗲𝗽𝘁 𝗥𝗲𝘃𝗶𝗲𝘄

◼️ If you have ever experienced or treated adhesive capsulitis—commonly known as frozen shoulder or periarthritis shoulder—you know how debilitating the pain and stiffness can be.
◼️ A recent 2023 review published in the IP International Journal of Orthopaedic Rheumatology by authors Sudhaker Kolathuru, Manish Khanna, and Madhan Jayaraman offers a comprehensive look at how this challenging condition is staged and treated, along with exciting new medical advances.

🔬 𝗪𝗵𝗮𝘁 𝗶𝘀 𝗙𝗿𝗼𝘇𝗲𝗻 𝗦𝗵𝗼𝘂𝗹𝗱𝗲𝗿?

◼️ Adhesive capsulitis is characterized by severe shoulder pain, stiffness, and a significant loss of both active and passive range of motion.
◼️ The hallmark of the condition is the contracture of the glenohumeral capsule caused by inflammation and reactive fibrosis.
◼️ While the exact pathogenesis remains somewhat of a mystery, it affects about 2% to 5% of the general population—and strikes up to 20% of people with diabetes.

🧭 𝗧𝗵𝗲 𝗙𝗼𝘂𝗿 𝗦𝘁𝗮𝗴𝗲𝘀 𝗼𝗳 𝗣𝗿𝗼𝗴𝗿𝗲𝘀𝘀𝗶𝗼𝗻

◼️ The review outlines the natural progression of the disease into four distinct clinical and arthroscopic stages based on Neviaser and Neviaser.
◼️ Stage I (Inflammation): Patients experience shoulder pain, particularly at night, but their range of motion is preserved. Arthroscopically, synovitis is present without major adhesions.
◼️ Stage II (Freezing): Stiffness begins to develop alongside early adhesion formation and capsular contracture.
◼️ Stage III (Frozen): There is a profound, global loss of range of motion and pain at the extremes of movement. Significant adhesions form while the initial synovitis begins to resolve.
◼️ Stage IV (Thawing): The pain becomes minimal, but stiffness persists. Fortunately, patients typically observe a slow improvement in shoulder mobility during this phase.

💊 𝗦𝘁𝗮𝗻𝗱𝗮𝗿𝗱 𝗖𝗼𝗻𝘀𝗲𝗿𝘃𝗮𝘁𝗶𝘃𝗲 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁

◼️ The good news is that frozen shoulder is often self-limiting, generally resolving over 1 to 3 years.
◼️ However, because patients rarely want to wait years for symptom relief, a variety of conservative treatments are utilized.
◼️ Medications: Oral NSAIDs provide short-term pain relief during early inflammatory stages, while oral corticosteroids offer significant short-term improvements in pain and mobility though effects may wane after 6 weeks.
◼️ Injections: Intraarticular injections of corticosteroids or sodium hyaluronate can inhibit inflammation, reduce stiffness, and offer faster pain relief than oral medications.
◼️ Suprascapular nerve blocks can also provide temporary pain relief.
◼️ Physical Therapy: PT is widely used to prevent capsular contraction.
◼️ The review notes that gentle physical therapy is more effective than intensive therapy during the painful frozen phase, with intensity ramping up during the thawing phase.
◼️ Arthrographic Joint Distention: Injecting fluid like saline and steroids to stretch the contracted capsule can provide short-term pain relief and increase intracapsular volume.

🏥 𝗪𝗵𝗲𝗻 𝗶𝘀 𝗦𝘂𝗿𝗴𝗲𝗿𝘆 𝗡𝗲𝗰𝗲𝘀𝘀𝗮𝗿𝘆?

◼️ If a patient undergoes 3 to 6 months of nonoperative care without success, surgical intervention may be considered.
◼️ Closed Manipulation Under Anesthesia: Mobilizing the shoulder to tear adhesions, though its safety remains controversial due to potential complications like fractures or labral tears.
◼️ Arthroscopic Capsular Release: A safe and effective option that allows surgeons to directly visualize and release tightened structures.
◼️ Open Capsulotomy: Rarely used today, this is reserved for cases where other surgical methods have failed.

🧬 𝗥𝗲𝗰𝗲𝗻𝘁 𝗔𝗱𝘃𝗮𝗻𝗰𝗲𝘀 𝗮𝗻𝗱 𝗥𝗲𝗴𝗲𝗻𝗲𝗿𝗮𝘁𝗶𝘃𝗲 𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲

◼️ Perhaps the most exciting section of the review details recent technological and biological advancements in treating shoulder pathology.
◼️ Platelet-Rich Plasma (PRP): PRP contains cytokines and growth factors that attenuate inflammatory responses.
◼️ Studies have shown PRP can decrease pro-inflammatory cytokines, serve as a prophylactic measure against frozen shoulder, and even improve the healing rate of rotator cuff tears.
◼️ Mesenchymal Stromal Cells (MSCs) and Exosomes: Stem cell therapies are showing promise in promoting tendon healing, attenuating inflammation, and reducing re-tear rates in rotator cuff disorders.
◼️ Whole Body Cryotherapy (WBC): Exposing patients to extremely cold air -110°C to -140°C is emerging as a novel adjunct therapy.
◼️ It produces anti-inflammatory and analgesic effects by increasing endorphins and slowing nerve conduction.

🔮 𝗟𝗼𝗼𝗸𝗶𝗻𝗴 𝘁𝗼 𝘁𝗵𝗲 𝗙𝘂𝘁𝘂𝗿𝗲

◼️ The review also highlights future directives that may soon change the landscape of treatment.
◼️ Enzymatic capsulotomies, which utilize FDA-approved collagenase currently used for Dupuytren’s disease to break down peptide bonds in collagen, are being explored off-label for adhesive capsulitis.
◼️ Additionally, Botox injections are being investigated for chronic musculoskeletal pain relief.

📌 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻

◼️ While managing adhesive capsulitis remains a challenge for orthopedic surgeons, a customized approach based on the disease's stage and the patient's functional status is key.
◼️ With conservative methods effectively managing most cases and regenerative therapies like PRP and MSCs on the horizon, the future of treating frozen shoulder is looking highly promising.

-----------------
⚠️Disclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.⚠️

Link to Article 👇

13/03/2026

A groundbreaking discovery in genetics shows that targeting specific genes may one day help reverse osteoporosis and rebuild bone naturally. Researchers found that manipulating certain genetic pathways can stimulate bone growth while reducing the loss that causes fragile, brittle bones. This approach focuses on addressing the root cause of osteoporosis instead of just managing symptoms, offering the potential for long-term improvement in bone density and strength.

Early laboratory studies demonstrate that activating these genes encourages bone-forming cells to work more efficiently, creating stronger and healthier skeletal structures. Scientists are optimistic that this method could eventually complement or even replace current treatments, which often involve medications that slow bone loss but do not restore what has already been lost.

While more research is needed to bring this therapy safely to humans, the discovery represents a major step toward regenerative bone medicine. It opens the door to a future where bones can heal and rebuild themselves, transforming how we approach aging, fractures, and osteoporosis management. The potential of our own genes may hold the key to restoring strength that was once thought lost forever.

12/03/2026

Resistance training can reduce body fat percentage while simultaneously improving grip strength, representing an effective management strategy for sarcopenic obesity, reports a systematic review and meta-analysis in BMC Geriatrics.

Link in the comments.

12/03/2026

As a medical school professor, I was taught to treat obesity and cancer as separate problems.

That was wrong.

A major new JAMA review confirms obesity drives 12 cancer types — and accounts for 10% of ALL new cancer cases in the US. For endometrial and liver cancers, it's up to 50%.

The 5 pathways:
- Adipose tissue inflammation (IL-6, TNF-α)
- DNA damage from oxidative stress
- Altered energy metabolism feeding cancer cells
- Immune suppression (fewer T cells, more tumor-shielding cells)
- Gut microbiome disruption

The good news: >10% weight loss significantly reduces risk. Bariatric surgery cut obesity-related cancer 32%. GLP-1 drugs cut pancreatic cancer risk by 59%.

This isn't about vanity. It's about metabolic dysfunction fueling the cells that kill you.

In my book "Lies I Taught in Medical School," I explain why we missed these connections for decades.

Full breakdown coming on the Health Longevity Secrets podcast.

Source: https://jamanetwork.com/journals/jama/article-abstract/2832458

12/03/2026

Most people assume getting weaker with age is inevitable.

It’s not.

A huge portion of what we call “aging” is actually loss of muscle from inactivity. Research shows adults can lose up to 3–8% of muscle mass per decade if they don’t train.

Less muscle means slower metabolism, weaker bones, and reduced resilience.

But here’s the good news. The body adapts at any age.

Lift weights. Walk daily. Prioritize protein.

You’re not just exercising. You’re protecting your future.

Dr. Hanjabam Barun, Sports & Exercise Medicine Specialist

15/03/2026

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