Why caffeine matters for the athletes you treat

Caffeine is one of the most popular performance aids in sport, and a new meta-analysis points to a convenient way for athletes to use it: chewing gum.

For many of us, caffeine is part of the morning routine. It wakes you up, and it can make workouts feel better too. Athletes feel the same pull, and they are always looking for a small advantage. If you work with athletes in sports physical therapy or rehab, this is a research update worth knowing, because your patients are probably already asking about it.

What the meta-analysis found

Caffeinated chewing gum, taken shortly before a workout, was linked to better muscle endurance and higher jump height. If you want more details, check out the full meta-analysis study here. Let's look at the key points:

• Dose and timing. The research points to roughly 250 to 500 mg of caffeine, chewed about 5 to 10 minutes before training.
• What improved. Muscle endurance and jump height both improve
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Why protein counseling belongs in geriatric physical therapy

Helping older adults build and keep muscle takes more than exercise, and new research suggests the nutrition conversation you already have in the clinic may matter more than you think.

If you treat older adults, you see the goal every day: more strength, better function, fewer limits on what your patients can do. Muscle mass sits at the center of that goal, and dietary protein is one of the main building blocks that supports muscle protein synthesis. A recent systematic review looked at nutrition counseling for older adults and asked a practical question: what kind of counseling actually moves the needle on protein intake?

The answers are encouraging for physical therapists, because they line up with how we already work.

What the research shows about effective counseling

The counseling that worked best was sustained, individualized and specific. Three patterns stood out:

• Longer is better. Counseling that lasted mor
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Ask your caseload how they sleep, and you'll hear one supplement more than any other: melatonin. Most patients take it for one reason — to fall asleep. A recent meta-analysis suggests it may be doing more than that, especially for patients living with irritable bowel syndrome (IBS).

What the research found

Themeta-analysis pooled randomized trials of melatonin in adults with IBS. In two of the four studies included, patients reported improved IBS symptoms while taking 3 to 6 mg of melatonin daily. Treatment periods ranged from two to eight weeks, depending on the study.

That's a small evidence base, and the protocols varied. But the signal is interesting enough to deserve a closer look — and more research.

The big question: gut or sleep?

Here's what I keep coming back to. Is melatonin acting directly on the gut? Or is better sleep the real driver, improving the gut microbiome and overall gut health downstream?

Both paths are plausible. Melatonin is produced in large amounts in...

 What a 10-year, 125,000-person study reveals about plant-based diets

Costa Rica Series, Episode 3 · By Dr. Sean Wells, PT

You've heard it a hundred times, maybe even said it to your patients yourself: "Avoid ultra-processed foods." It's become one of the most repeated rules in nutrition, and even on our website material. But a large new study suggests the story is more nuanced, especially when it comes to plant-based eating.

For the third video in our Costa Rica series, we dug into research showing that people who ate a mostly plant-based diet had a lower risk of death and type 2 diabetes, even when some of those foods were ultra-processed. What mattered most wasn't the processing. It was the quality of the food.

PTs: want CEUs on this? See our nutrition series.

The study

Thompson and colleagues published this prospective cohort study in The Lancet Regional Health – Europe in 2026. The researchers followed 124,836 adults from the UK Biobank, aged 40 to 70 at the start, for rough...

In the U.S., most of us exercise on remarkably flat, predictable surfaces. Treadmills. Consistent gym flooring. Fixed machines that move our joints through the same safe, stable path every time.

It's no coincidence, then, that stepping off a curb wrong or catching an edge of uneven sidewalk is often what sends people to my clinic. We've trained our bodies for flat ground, and flat ground is not what real life gives us.

Here in Nosara, Costa Rica, the ground itself makes the opposite argument. The terrain is uneven — rocky trails, soft sand, tree roots underfoot. The lifestyle follows suit: hiking, walking, surfing, yoga. All of it constantly challenges the dynamic stabilizers most gym routines never touch — the intrinsic muscles of the feet, the gluteus medius, and the dozens of smaller muscles responsible for keeping the knees, ankles, and hips honest.

These muscles do more than stabilize joints. They're also a primary source of proprioceptive information — the constant stream of...

Hi all! We are taking a break from our Costa Rican Nutrition Series to bring you this fun research update -- enjoy it over some coffee or a Alani nu!

If you treat active patients, from college athletes to weekend warriors, you’ve probably seen the brightly colored cans of Alani Nu in your clinic's waiting room. Known for its aesthetic branding and sweet flavors, this energy drink has exploded in popularity.

This guide details the crucial steps and requirements for successfully completing your Arizona PT License Renewal with the Arizona State Board of Physical Therapy. Understanding these rules is key for every licensed physical therapist (PT) and physical therapist assistant (PTA) to maintain active status.

The Arizona PT License Renewal Cycle and Key Details

Arizona utilizes a biennial renewal cycle, meaning licenses expire every two years on August 31 of even-numbered years.

• License Term: Biennial (Two-Year Period).
• Expiration Date: All licenses expire on August 31 of every even-numbered year. Example August 31, 2028
• Renewal Fee (Active PT): $160.
• Official Link: https://ptboard.az.gov

Arizona PT/PTA CEU Requirements: Continuing Competence

Licensees must complete specific continuing education hours (CEUs), referred to as Continuing Competence activities, to qualify for Arizona PT License Renewal.

• Physical Therapists (PT): 20 contact hours required. At least 10 hours must b
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Mechanical loading builds bone, but metabolic bioavailability dictates whether the skeletal matrix actually forms. While filming in Costa Rica’s Nicoya Peninsula, the biological driver behind the local centenarians' exceptionally low hip fracture rates became glaringly clear: deep-aquifer hard water.

Key Clinical Insights for Physical Therapists

• Magnesi...

The 10,000-Step Fallacy

For years, the "10,000 steps per day" mantra has been the universal benchmark for health. And for years, most Westerners have compartmentalized that movement into a grueling hour at the gym, only to return to a completely sedentary lifestyle for the remaining 23 hours.

As a Physical Therapist focused on both structural mechanics and metabolic nutrition, I see the result daily: stiff hips, chronic inflammation, and slow injury recovery. The logic that an isolated fitness block can counteract a lifestyle defined by chronic vasoconstriction and stiffness is fundamentally flawed.

During my recent trip to Tokyo, navigating the complex transit and crowded crossings like Shibuya, I witnessed the alternative—and it is the native regulator of joint longevity.

The NEAT Solution: Walking as Life, Not Exercise

In Japan, the average person clears an impressive step count not because they are running on treadmills, but purely because of Non-Exercise Activity Thermogenesi...

Introduction: A Tale of Two Proteins

If you ask the average American what "fueling muscle" looks like, they will likely describe a massive 16-to-24-ounce steak, perhaps a bone-in ribeye, loaded with fat and flavor. We have been conditioned to believe that when it comes to protein consumption for muscle retention and structural repair, "more is better."

However, during my recent trip to Tokyo, specifically while navigating the iconic, smoky alleys of Omoide Yokocho (known as "Memory Lane"), I was struck by a powerful dietary contrast.

Here, surrounded by the glow of lanterns and the scent of charcoal, the concept of "eating meat" is radically different. And as a Physical Therapist focused on longevity, I believe it’s a lesson the West desperately needs to learn.

Today, we’re contrasting the American Mega-Steak with Japanese Yakitori.

The Protein Paradox: US vs. Japan by the Numbers

It is no secret that red meat consumption in the United States is among the highest globally. Accor...