Physicians Fitness

04/02/2026

Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study.

Objective:
Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger ( 40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS.

Design:
Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. Results: 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: 2.6, 3.9).

Conclusions:
Younger patients ( 40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials."

Pihl K, Turkiewicz A, Englund M, Lohmander LS, Jørgensen U, Nissen N, Schjerning J, Thorlund JB. Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study. Osteoarthritis Cartilage. 2018 Aug;26(8):1008-1016. doi: 10.1016/j.joca.2018.05.004. Epub 2018 May 22. PMID: 29792925.

03/31/2026

03/26/2026

Physicians Fitness Gym ➡️ Why We’re Different

Exclusive & focuses on outcome, assessment & precision ✅

Only 50 spots available!

03/20/2026

“If you think lifting weights is dangerous, try being weak. Being weak is dangerous.”
Bret Contreras, PhD

"Exercise is the closest thing there is to a miracle drug, and strength training is one of the best kinds of exercise. It’s practically like magic! It’s healthier and more efficient than most people know, and a valuable component of fitness and injury rehabilitation for a wide range of people — not just for gym lovers, and not only for the reasons most patients and professionals think about.

Strength training is more efficient and easier than most people realize, requiring less of a commitment. This particularly surprising point is covered in great detail in a separate article. It also has more lasting benefits than most people realize - permanently improved muscle cells!

Strength training is much better for general fitness, health, and weight loss than most people realize, and specifically it can partially replace so-called “cardio” workouts, which are highly repetitive and time-consuming and are a risk for all of the common repetitive strain injuries (RSIs like iliotibial band syndrome, plantar fasciitis, shin splints and several more). For instance, making muscles work hard is “essential” for people with diabetes, because there’s good evidence it controls blood sugar at least as well as aerobic workouts and probably better. It’s also anti-inflammatory and good for brain health, just as we have long known about exercise in general.

Strength training can be done safely and precisely, particularly aided by machines, so that you can pursue fitness without aggravating existing injuries or risking new ones - a critical rehabilitation advantage that is under-rated or missed entirely by nearly all professionals. Even many personal trainers fail to emphasize this. This makes it a great tool for “load management” in injury rehab.”

Ingraham P., Strength Training for Pain & Injury Rehab, 1.29.23,

Everything you need to know about strength training for rehab — the good news and the bad.

03/12/2026

99% of people over 40 have a rotator cuff ‘abnormality’ on MRI.

(Taken from )

Do we round up to everyone?

The FIMAGE study just dropped in JAMA Internal Medicine and it’s important for several reasons.

Here’s a quick overview of the study:

→ 602 people randomly selected from the Finnish general population (not a clinic sample)
→ Aged 41–76
→ Bilateral 3T MRI of both shoulders
→ Blinded reads by experienced musculoskeletal radiologists
→ Standardised clinical exams by shoulder surgeons with 10+ years experience

They found:

→ 98.7% had at least one RC abnormality
→ 7 out of 602 had completely normal tendons
→ 62% had partial-thickness tears
→ 11% had full-thickness tears (rose with age)
→ RC abnormalities were in 96% of pain-free shoulders AND 98% of painful shoulders

78% of all full-thickness tears were found in shoulders with zero symptoms.

Even combining state-of-the-art 3T MRI with experienced surgeon clinical exams could not reliably distinguish a symptomatic shoulder from an asymptomatic one.

The authors argue, and I think the data supports this, that most RC findings after 40 represent normal age-related structural change. Like grey hair. Like wrinkles. Like holes in your socks.

They emphasise a shift in language is warranted: away from ‘tear’ (which implies trauma and repair) toward terms like ‘structural alteration’ or ‘age-related change.’

When the baseline prevalence of an MRI finding approaches 100%, the finding itself has almost no diagnostic value.

03/05/2026

Dysfunction of the muscles can lead to persistent postpartum low back pain

An interesting and important article regarding Recovery of Abdominal Muscle Thickness and Contractile Function in Women after Childbirth

“Abstract

Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The recovery process of the abdominal muscles following childbirth is not well understood. This study aimed to demonstrate the changes in the thickness and contractile function of abdominal muscles during the first six months postpartum. Nine perinatal and 15 nulliparous females participated. The thicknesses and contraction/relaxation thickness ratios of the re**us abdominis (RA), external abdominal oblique (EO), internal abdominal oblique (IO), and transverse abdominis (TrA) were measured using ultrasound images from 36–39 weeks’ gestation until six months postpartum. The RA, IO, and TrA muscles were thinner in perinatal females than controls at 36–39 weeks of gestation (4.8 vs. 9.47 mm (RA), 5.45 vs. 7.73 mm (IO), 2.56 vs. 3.38 mm (TrA), respectively). The thinner IO muscle persisted for six months after delivery. The decreased TrA thickness ratio persisted until four months post-delivery. Abdominal muscle thickness and contractile function decreased in the postpartum period. Therefore, abdominal muscle exercises might help prevent postpartum symptoms; however, because deterioration of muscle function is significant in the first four months, careful attention should be paid to exercise intensity. The study limitation was a relatively small sample size, thus future studies should involve more participants.”

Fukano M, Tsukahara Y, Takei S, Nose-Ogura S, Fujii T, Torii S. Recovery of Abdominal Muscle Thickness and Contractile Function in Women after Childbirth. Int J Environ Res Public Health. 2021 Feb 22;18(4):2130. doi: 10.3390/ijerph18042130. PMID: 33671663; PMCID: PMC7926552.

02/26/2026

Just because the MRI shows some degenerative changes in your rotator cuff doesn't mean that's the reason for your shoulder pain (absent a traumatic event)... be careful about attributing a direct cause and effect relationship between your shoulder pain and what an MRI shows especailly after 40 years old according to this study:

Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging

Abstract

Importance:
Shoulder pain is a common musculoskeletal complaint often attributed to rotator cuff (RC) abnormalities. Diagnostic imaging is frequently used, but the association between RC abnormalities and shoulder symptoms remains uncertain.

Objective:
To determine the prevalence of RC abnormalities in a general population sample and their association with shoulder symptoms.

Design, setting, and participants:
Population-based cross-sectional study in a nationally representative random sample of adults aged 41 to 76 years who underwent standardized clinical assessment and bilateral 3-Tesla magnetic resonance imaging (MRI) of the shoulders conducted from February 2023 to April 2024 in Finland. Eligibility criteria included ability to undergo MRI and absence of previous shoulder replacement surgery.

Exposures:
Structured interviews, standardized questionnaires, clinical shoulder tests, and shoulder MRI.

Main outcomes and measures:
RC tendon status was classified on MRI as normal, tendinopathic, partial-thickness tear (PTT), or full-thickness tear (FTT). Shoulder symptoms were defined as pain or dysfunction in the preceding week. The prevalence of RC abnormalities was compared across age groups and between symptomatic and asymptomatic shoulders, adjusting for demographic factors, concurrent MRI findings, and clinical examination.

Results:
Among 602 participants (median age, 58 [range, 41-76] years; 52% female), RC abnormalities on MRI were found in 595 (98.7%; 95% CI, 97.5%-99.5%): 25% tendinopathy, 62% PTT, and 11% FTT. The prevalence and severity of abnormalities increased with age but did not differ between sexes. RC abnormalities were present in 96% of asymptomatic shoulders (1039 of 1076) and 98% of symptomatic shoulders (126 of 128). Only FTTs were more prevalent in symptomatic shoulders (14.6%) than in asymptomatic shoulders (6.5%), but this difference diminished after adjustment (absolute difference, 0.8%; 95% CI, -3.4% to 6.0%).

Conclusions and relevance:
In this population-based study, RC abnormalities were nearly universal after age 40 years and showed poor concordance with shoulder symptoms. These findings suggest that RC abnormalities often represent normal age-related changes rather than disease and call into question the clinical value of routine imaging for atraumatic shoulder pain.

Ibounig T, Järvinen TLN, Raatikainen S, Härkänen T, Sillanpää N, Bensch F, Haapamäki V, Toivonen P, Björkenheim R, Ryösä A, Kanto K, Lepola V, Joukainen A, Paavola M, Koskinen S, Rämö L, Buchbinder R, Taimela S. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. 2026 Feb 16:e257903. doi: 10.1001/jamainternmed.2025.7903. Epub ahead of print. PMID: 41697693; PMCID: PMC12910452.

02/20/2026

DID YOU MISS THE EXCITING NEWS?! Check out the details below

New Facility Coming Spring 2026

02/18/2026

THE BIG NEWS IS HERE - NEW FACILITY COMING SOON ✨

PHYSICIANS FITNESS, LLC - A PRIVATE MEDICAL EXERCISE AND FITNESS FACILITY!

We are pleased to announce the opening of our new and exclusive facility located at 7412 Sawmill Road, Columbus, Ohio.

ONLY 50 EXCLUSIVE MEMBERSHIPS ARE BEING OFFERED
JOIN THE EXCLUSIVE INTEREST LIST - QR CODE NEXT SLIDE - https://lp.constantcontactpages.com/sl/E9QJg8a

Physicians Fitness is not a commercial gym.

It is a controlled, assessment-driven facility where exercise is prescribed, monitored, and progressed with clinical precision by experienced professionals.

This environment is designed for individuals who expect a higher standard of care — quiet, focused, and highly personalized — without crowds, waiting for equipment, or distractions.

*note: This does not effect regular client sessions & assessments with our staff. Memberships are not required to continue with Physicians Fitness services.

02/12/2026

Naming or labeling your disease may not be as helpful as you think...

The Effect of Diagnostic Labels on Treatment Preferences and Beliefs in People With Musculoskeletal Pain. A Systematic Review of Randomized Trials

“OBJECTIVE: To assess how different diagnostic labels affect treatment preferences and beliefs in people with musculoskeletal pain.

RESULTS: Five vignette-based randomized trials involving 7575 participants were included. Risk of bias was rated as low to some concerns across all outcomes. Low-certainty evidence suggested that specific diagnostic labels may increase patient preferences for imaging and surgery and may increase the perceived seriousness of the condition. Non-specific labels may lead to more positive recovery beliefs and reduced perceived need for invasive treatments, and to lower patient satisfaction. The information accompanying these labels (eg, explanations, reassurance) may have influenced outcomes.

CONCLUSION: Based on low-certainty evidence, specific diagnostic labels may increase demand for invasive care and foster more negative recovery expectations. Non-specific labels may encourage non-invasive management but can contribute to patient dissatisfaction. J Orthop Sports Phys Ther 2026;56(1):4-15. Epub 3 December 2025. doi:10.2519/jospt.2025.13759

DESIGN: Systematic review of randomized trials.

LITERATURE SEARCH: PubMed, Web of Science, MEDLINE, CINAHL, SPORTDiscus, PsycINFO, ClinicalTrials.gov, and the Australian New Zealand Clinical Trials Registry (ANZCTR) (from inception to September 17, 2025).

STUDY SELECTION CRITERIA: Randomized trials evaluating the impact of diagnostic labels for musculoskeletal pain on treatment preferences and beliefs. Studies using hypothetical vignettes were eligible.

DATA SYNTHESIS: The primary outcomes were patient treatment preferences and beliefs. Due to heterogeneity of labels and accompanying explanations, a narrative synthesis approach was conducted. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.”

Martin S, Smith M, Wilson DA, Zadro JR, Ferreira GE, O'Keeffe M. The Effect of Diagnostic Labels on Treatment Preferences and Beliefs in People With Musculoskeletal Pain. A Systematic Review of Randomized Trials. J Orthop Sports Phys Ther. 2026 Jan;56(1):4-15. doi: 10.2519/jospt.2025.13759. PMID: 41476426.