American Journal of Sports Medicine  2016;45:1206–1217

Long-distance running is a popular recreational sport, especially for many of our health enthusiast BJSM readers. However, we know one question looms: Is long-distance running good or bad for your knees? In this systematic review of 19 studies, a standard knee MRI assessing acute radiological changes post running provides some insight to this question.

The cohort included individuals with minor knee pain, healthy asymptomatic runners and those who had previous knee surgery. Running distances ranged from half to ultra marathons. Ten of 16 studies that assessed cartilage or meniscus discovered no significant morphological changes subsequent to running. Of the remaining studies that initially observed significant meniscal or cartilage changes within 3 days, all except one identified no further change at a second follow-up visit within 12 weeks. Surprisingly, one study even noted significant recovery from initial morphological changes at the second follow-up visit.

What does all this mean? Healthy athletes may indeed have some minor, acute structural knee changes but, importantly, it seems no irreversible permanent long-term damage occurs. Running enthusiasts, take a sigh of relief and enjoy that run!

Journal of Orthopaedic & Sports Physical Therapy  2017;47:241–251

So if running causes no permanent long-term damage, can it lead to long-term benefit? It’s no secret that impact exercise and resistance training has multiple health benefits including prevention of postmenopausal bone loss. However, the exact mode of exercise that provides maximal benefit for bone mineral density (BMD) in body sites at risk for fracture remains debated. For example, jumping exercises were thought to benefit multiple body sites; however, due to force attenuation occurring first at the hips, minimal effects reach the spine. The question remains: what type of exercise programme is best at preserving BMD in postmenopausal women?

This paper answers the question in a systematic review and meta-analysis of 11 randomised controlled trials with a cohort of 1061 postmenopausal women. Combined exercise programmes delivered superior results for BMD at several at-risk sites (lumbar spine, femoral neck, hip and total body) when compared with healthy controls. This paper highlighted that the effects of combined exercise programmes on BMD of osteoporotic women were greater in women <60 years; but positive effects were still observed in women >60 years.

What exercise is best for your aunt’s bones during postmenopause? A variety of exercise types, such as resistance, aerobic and impact activity training, is key to preserving BMD.

Journal of Science and Medicine in Sport  2017;20:123–127

If your aunt were to attend her general practitioner for a check-up, what’s the chances physical activity (PA) would be promoted? As clinicians, we have the power to positively influence patients’ PA behaviours.

In this study, 412 physicians (primary care and specialist) with an established interest in sport and exercise medicine (SEM) were questioned on their approaches and behaviours to exercise promotion. Almost 75% recommend PA to patients, however, it struck me that only 26% provided a written exercise prescription (an effective tool in influencing PA). Additionally, only half included PA as a vital sign during examination.

American Journal of Sports Medicine  2016;44:2827–2832

We’ve established benefits of exercise participation and, we acknowledge that we are not prescribing it enough, however, what about its risks? For adolescents, although participation in sport provides undeniable benefits, ACL injuries can be devastating. Surgical repair is thought to remedy the injury and provide a steadfast solution that prevents reinjury for the entirety of their playing days. Yet, sadly, recent research tells a different story.

This cohort study investigated reinjury rates in 316 adolescents (<20 years of age) who had undergone primary hamstring autograft ACL reconstruction surgery. It was shocking to note that 35% of the cohort suffered a subsequent ACL injury to either the reconstructed or contralateral knee. Even more alarming was that, close to 45% of males who underwent ACL reconstructive surgery prior to turning 18 sustained a subsequent injury to the graft knee or contralateral knee.

This paper highlights a concerning trend of high rates of reinjury in young, ACL reconstructed individuals. Provided the long-term implications of recurrent knee joint injuries, the high reinjury rates seen in this cohort should raise concern in the sports medicine community. It raises the question that needs answering: are we returning young athletes to sport too soon after ACL injuries?