By Dr. Sean M Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

For many decades nutrition experts and researchers were aware that fasting could impact certain disease states. From rheumatoid arthritis (RA), osteoarthritis, and several metabolic diseases (e.g. gout), fasting could reduce symptoms, improve functioning, and/or improve metabolic profiles for a short period. This short period of improvement could help patients during flares or bouts but couldn't offer long lasting effect. Many physiotherapists in the United Kingdom are aware of the power of fasting and vegetarian diets for patients with RA. 

The understanding of how symptomology would improve in light of fasting was not well understood. Some authors offered the notion of the soma vs metabolic tradeoff, where the body took its time to repair its systems vs channeling energy into digesting food. Other researchers suggested that certain foods promote inflammation, and thus, removing food could reduce inflammation. W...

By Dr. Sean M. Wells, PT, DPT, ATC/L, OCS, CSCS, CNPT, Cert-DN

Cardiac physical therapy is a rewarding area of PT practice that takes precision, complex thinking, and a team of specialists working toward a common goal. Often patients in cardiac rehabilitation present with chest pain (angina), ischemic heart disease, stents, bypass surgeries, and/or heart failure.

Doctors of physical therapy do their best to push these patients to maximize their endurance, functioning, and cardiac capability. We often do this through various interventions like treadmill exercises, stepping, strengthening, and breathing techniques.  After a recent study, nutrition may be one of those interventions that PTs need to focus more on.

New Study

Published in the British Journal of Nutrition, researchers found a correlation with plant-focused diets, like the MIND and Mediterranean diets, with left ventricular function. Specifically the researchers looked at cohort sample of 2,512 patients from the Framingham...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, CNPT, Cert-DN

Vitamin D is a crucial nutrient that can be obtained from the sun and has seemingly endless roles in human health. Despite our ability to gain vitamin D from the sun, most Americans are deficient, perhaps due to improper or lacking sun exposure, dietary patterns, or other reasons. Supplementation is simple, effective, and has been shown to have positive impacts on not just our bones -- it can help muscle strength, balance, and even the immune system for some patients.

Yet another role for vitamin D may be in the prevention of benign paroxysmal positional vertigo, or BPPV. BPPV is one of the most common neuro-otological conditions DPTs see in clinical practice. BPPV can leave patients with a spinning sensation, inability to sleep, and balance or fall issues. Physical therapists commonly treat patients with BPPV using the evidenced based technique known as the Epley Maneuver. Other treatments include patient education regar...

"D" in the in professional abbreviation DPT stands for Doctor, as in Doctor of Physical Therapy. Our profession has made great leaps and bounds in its stride to becoming experts in movement, the neuromuscular system, and wellness. Much of our success has been through diligent efforts to improve the educational standards of our PT students. We've also continually raised the bar by encouraging most States to enact stricter continuing education standards, licensing, and rigorous specializations and fellowships. Such training and advanced education, along with our doctorate, prepares us to provide care in direct access, primary care, wellness centers, rehab facilities, hospital, gyms, and sports complexes to name a few. We are managing simple injuries now without much of the red tape and bureaucracy, while helping those with devastating diseases and ailments get better. Despite all the progress I feel we still have a stock of PTs that are holding us back, especially in regards to adopting ...

Emerging evidence is revealing how Vitamin D can help patients with COVID-19, commonly known as the Coronavirus.  Vitamin D is known as the "sunshine vitamin" as it is produced in the skin with sun exposure. Most Americans are deficient in Vitamin D, possibly due to the lack of optimal sun exposure and/or their poor diets. In order to get peak Vitamin D levels from sun exposure, a person must remain in direct sun with most the body exposed for 20 minutes under peak sun (usually 11am to 1pm). Vitamin D can be found as a fortification in many foods such as cereals, dairy milk, plant-based milks, while it is found naturally in some mushrooms. The specific Vitamin D in focus would be D3, also known as cholecalciferol.

So what's the data on Vitamin D and COVID-19? Well, randomized trials and cross sectional studies have shown that ~60% of patients with COVID-19 were vitamin D deficient upon hospitalization, with men in the advanced stages of COVID-19 pneumonia showing the greatest deficit....

The holidays are here and our clients are busy hanging decorations and eating lots of holiday food. Most of this holiday food is loaded with extra calories from added sugars, fat, and processed junk. After climbing their ladders, lifting the boxes, and the stress of traveling and seeing family, they come crawling into our clinics or gyms with extra weight and a sore back.

What can we do as Doctors of Physical Therapy (DPTs)? Aside from our traditional physical therapy treatments like manual therapy and exercise, we should be using patient education for weight loss. Here are some of our top tips for PTs and weight loss.

Journal Your Foods

Holidays bring big emotions and lots of junk food. Many of this junk food is eaten without our clients' being aware they are eating hundreds, if not thousands, of extra calories. These calories add up quickly promoting weight gain, reducing glycemic control, and stimulating inflammation.

To improve your PT outcomes and shed some pounds, data show t...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

If you were reading the news last week then you might have seen an article that sounds something like: "Good News, Meat May Protect You from Heart Disease." While this sounds exciting and promising, many of the published media articles just don't dive into the science enough to give citizens and clinicians an educated viewpoints. Let's examine the new evidence, its science, and what impact it should have on physical therapy practice.

The Article

The main research paper the media is slinging around can be found in mSystems, an open access journal. The authors, Kivenson and Giovanni, published the paper title An Expanded Genetic Code Enables Trimethylamine Metabolism in Human Gut Bacteria, which full-text can be found here. Both Kivenson and Giovanni are researchers at Oregon State University and their primary focus is in microbiology.

mSystems is a relatively new journal. Overall it has an impact factor of 6.28...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Sports Nutrition

One of the hottest terms in the last decade: sports nutrition. Ask any exercise scientists, personal trainer, or athletic trainer, and they will say that sports nutrition has become a booming topic of interest and a huge market. Physios may be behind the curve a bit on this topic, so we thought we'd offer a nice review of sports nutrition specific to sports physical therapy practice.

For PTs, the 3 main areas of sports nutrition we should be focused on would include:

1. Recovery
2. Immunonutrition
3. Performance enhancement

Let's dive into each of these and see what PTs need to consider from a dietary perspective.

Recovery

Helping athletes rehabilitate after an injury is an important role of a sports physio -- but what about recovering from resistance training, practice, or competition? Recovering from training and competition can translate into athletes gaining more strength, playing better, ...

By Dr. Sean M. Wells

Many facets of nutrition can impact older adults' function and health. The focus on this blog article will be to highlight how inflammation, which can be mediated via diet, impacts older adult function and health. 

Using the Dietary Inflammatory Index (DII), physical therapists can quantify the amount of inflammation a client's diet is provoking. Essentially the score ranges from as low as -5 to as high as 5, with a "fast food diet being reported at 4 and a macrobiotic diet being listed at -5. Probably the best diets on the DII are vegetarian Indian diets and other Asian diets rich in vegetables and spices. Another way of "scoring" or ranking the inflammation cause by a diet is to use an A-F system. An "A" score would be ideal and the most negative (e.g. close to -5, which is the least inflammatory), while "F" is the most inflammatory (e.g. most positive, 5). An average, or "C" score, would be a 0. 

 Using the DII, PTs can see how diet impacts health and functio...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Continuing our series on gut health and the gut microbiome, we are going to talk about a new finding in the ever-expanding gut bacteria research: a gut biome health score.

Similar to how we have credit scores, which can denote whether a person has good or bad credit history, a gut biome health score may give physios and other healthcare providers insight into many facets of a patient's lifestyle.

Recall the gut biome is the bacteria, archaea, fungi, and some viruses that live within our small and mostly large intestines. These small bugs live in a symbiotic relationship with our bodies and:

• Help to produce neurotransmitters (90% of serotonin is made by gut bacteria)
• Process foods to make health short chain fatty acids (SCFA) which can improve cardiovascular health
• Modulate the immune system response

The last factor likely has the biggest implications for physical therapists (PTs). As rehabilitation prof...