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For years, people with knee or hip osteoarthritis have been told to avoid activities like running, tennis, jumping, or other high-impact exercises because they might "wear out" their joints faster. But new research published in the British Journal of Sports Medicine is challenging that long-held belief.
What Did the Study Find? Researchers followed more than 17,000 people with hip or knee osteoarthritis over a 12-month period to determine whether participating in high-impact physical activity increased the likelihood of needing a joint replacement. The results were surprising (not to us of course):
Does This Mean Everyone Should Start Running? Not necessarily. The key message isn't that everyone with osteoarthritis should suddenly begin high-impact exercise. Instead, the study suggests that high-impact activity isn't automatically harmful for people with osteoarthritis. The best exercise depends on several factors, including:
 Why Movement Matters One of the biggest misconceptions about arthritis is that painful joints should be rested. In reality, the opposite is often true. Regular exercise helps:
Don't Let Fear Stop You Many people avoid activity because they're worried they'll make their arthritis worse. Fortunately, research continues to show that "hurt" does not always mean "harm." Some soreness after activity is normal, especially when beginning a new exercise program. That doesn't necessarily mean you're causing damage. A physical therapist can help you understand the difference between expected discomfort and signs that an activity should be modified. How Physical Therapy Can Help Every person with osteoarthritis is different. A physical therapist can evaluate your movement, identify areas of weakness or stiffness, and develop a personalized plan that helps you stay active safely. Your treatment plan may include:
 The Bottom Line This new research offers encouraging news for people living with osteoarthritis. Higher-impact activities do not appear to increase the risk of joint replacement for most people with knee osteoarthritis and may even be associated with a lower risk of hip replacement in people with hip osteoarthritis. Rather than avoiding movement out of fear, work with a physical therapist to determine what types of exercise are safe and appropriate for your body. With the right guidance, staying active can help you move better, feel stronger, and maintain your independence for years to come. Reference: Liew BXW, Grønne DT, Roos EM, Skou ST. High-impact physical activity participation and 12-month risk of joint replacement: a longitudinal mediation analysis of 17,661 patients with knee or hip osteoarthritis. British Journal of Sports Medicine. Published online July 9, 2026.   Spinal manipulation therapy (SMT) has been around for decades, but conversations about its effectiveness are often clouded by outdated claims, misconceptions, and marketing noise. So what does the current research actually tell us?
A comprehensive review published in late 2024 examined more than 50 years of spinal manipulation research. It looked at how evidence has evolved, where gaps still exist, and what modern clinical practice guidelines recommend. The findings are both reassuring—and clarifying. What the Evidence Supports The review analyzed 33 clinical practice guidelines (CPGs) and 59 recommendations related to spinal manipulation. The results were strikingly consistent:
What the Evidence Does Not Support Equally important is what spinal manipulation doesn’t do. Despite persistent claims you may see online or hear in certain settings, research does not support spinal manipulation for:
Why This Matters This distinction is critical for both clinicians and patients. Spinal manipulation is a valuable, evidence-based tool—but only when used appropriately. When applied to the right conditions (primarily MSK issues), it can help reduce pain, improve mobility, and support recovery. But when it’s promoted as a cure-all, it undermines trust and distracts from what actually works. A Note on the Research One of the most compelling aspects of this review is that it includes research from across professions—including chiropractic literature. Even within that body of work, the conclusion is consistent: Spinal manipulation is effective for musculoskeletal conditions—and not for systemic or non-MSK issues. This is especially helpful in clinical discussions, where differing viewpoints often come up. The evidence itself provides a common ground. The Bottom Line Spinal manipulation isn’t magic—and it doesn’t need to be. It’s a well-supported, targeted intervention for specific conditions, particularly:
And as always, the goal isn’t just to reduce symptoms—it’s to help people move better, feel better, and get back to doing what matters most. Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC11476883/  When it comes to improving sleep, one question comes up again and again: Is it better to exercise in the morning or at night? You’ve probably heard strong opinions on both sides—morning workouts to “set your rhythm,” or evening sessions to “burn off stress.” But what does the research actually say? A recent 12-week randomized controlled trial set out to answer exactly that. Source: https://pubmed.ncbi.nlm.nih.gov/40419564/ What the Study Looked At Researchers followed healthy young adults (ages 23–28) and split them into three groups:
The Results: A Slight Edge… But a Clear Winner There was a small difference:
Any exercise—regardless of time of day—significantly improved sleep compared to doing nothing. That’s the real takeaway. Why This Matters It’s easy to get caught up in optimizing the details:
Consistency beats timing. If you’re exercising regularly, you’re already doing the thing that matters most for sleep. Breaking Down the Takeaways 1. Morning Exercise May Slightly Improve Sleep
2. Evening Exercise Isn’t the Enemy
3. The Biggest Impact: Just Move
So… When Should You Exercise? Here’s the honest answer: The best time to exercise is when you can do it consistently. Not when your schedule is perfect. Not when motivation is highest. Not when the internet says it’s optimal. When you can actually show up and do it regularly. Practical Advice If you’re trying to improve sleep:
If evenings work → also great. Final Thoughts This study answers one of those “in the weeds” questions we tend to overthink. Yes, morning exercise may have a slight edge for sleep—but it’s a small one. The real difference comes from:
 From Day 1 on 4/24/26 to 6/15/26, this patient has shown consistency, and dedication!  Week Zero: Fresh post-op, managing swelling, protecting the knee, and taking those first important steps toward recovery.  1 Month: Incision healing beautifully, mobility improving, strength returning, and confidence growing.  7.5 Weeks: Improved extension, decreased swelling, better movement, and a stronger, more functional knee ready for the next phase of recovery!  A total knee replacement isn’t just about the surgery—it’s about the commitment to the rehab process. Every degree gained, every step taken, and every exercise completed adds up to moments like this.
We are so proud of this patient’s determination and progress! ❤️ Your comeback story starts with the first step. Let us help you move better, feel stronger, and get back to doing what you love. When it comes to improving performance in the gym, most athletes are looking for anything that gives them an edge—especially on heavy training days. |
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Why looking beyond the foot matters—especially for runners
Plantar fasciitis is one of the most common causes of heel pain, particularly among runners. Traditionally, treatment has focused on the foot itself—stretching the plantar fascia, improving ankle mobility, and addressing footwear. While these interventions can be helpful, emerging research continues to highlight an important truth:
The source of the problem isn’t always where the pain is!!!
Plantar fasciitis is one of the most common causes of heel pain, particularly among runners. Traditionally, treatment has focused on the foot itself—stretching the plantar fascia, improving ankle mobility, and addressing footwear. While these interventions can be helpful, emerging research continues to highlight an important truth:
The source of the problem isn’t always where the pain is!!!
Looking Up the Chain
A 2025 study published in BMC Sports Science, Medicine & Rehabilitation by Li D. and colleagues adds to a growing body of evidence supporting the role of proximal strength (strength closer to the trunk, such as the hips and thighs) in lower extremity injuries.
In this prospective study:
Your foot doesn’t function in isolation—it’s part of a larger system. Weakness or imbalance at the hip or knee can alter how forces travel down the leg during activities like running.
For example:
Clinical Takeaway
We cannot assume that distal pain (like plantar fasciitis) is caused only by distal issues.
Instead, effective evaluation and treatment should:
If you’re dealing with plantar fasciitis—or trying to prevent it—consider incorporating:
The Bigger Picture
This study reinforces a key principle in physical therapy:
Treat the whole system, not just the site of pain.
At ProFormance Therapy & Wellness, we take a comprehensive approach to injury care—looking at how your body moves as a whole to uncover the true drivers of your symptoms.
If you’re a runner dealing with heel pain or looking to stay injury-free, we’re here to help you build strength where it matters most.
Ready to move better and run stronger?
Contact us today to schedule an evaluation.
Source:
https://pubmed.ncbi.nlm.nih.gov/40877885/
A 2025 study published in BMC Sports Science, Medicine & Rehabilitation by Li D. and colleagues adds to a growing body of evidence supporting the role of proximal strength (strength closer to the trunk, such as the hips and thighs) in lower extremity injuries.
In this prospective study:
- 177 male recreational marathon runners (ages 18–30) were evaluated
- Strength was measured using hand-held dynamometry
- Participants were tracked over a 3-month period
- Hip abduction asymmetry (outsides of the hips) and knee flexion asymmetry were significantly associated with the development of plantar fasciitis
- Runners with >32.5% asymmetry in hip abduction strength had a 3.6x greater risk of developing plantar fasciitis
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Your foot doesn’t function in isolation—it’s part of a larger system. Weakness or imbalance at the hip or knee can alter how forces travel down the leg during activities like running.
For example:
- Weak hip abductors can lead to poor pelvic control
- This may cause excessive inward collapse of the knee (valgus)
- Which in turn increases strain on the foot and plantar fascia
Clinical Takeaway
We cannot assume that distal pain (like plantar fasciitis) is caused only by distal issues.
Instead, effective evaluation and treatment should:
- Assess strength and symmetry at the hips and knees
- Identify movement patterns during walking or running
- Address underlying biomechanical contributors, not just symptoms
If you’re dealing with plantar fasciitis—or trying to prevent it—consider incorporating:
- Hip strengthening exercises (e.g., side-lying leg raises, band walks)
- Posterior chain work (glutes and hamstrings)
- Single-leg stability training
- Movement assessments to identify asymmetries
The Bigger Picture
This study reinforces a key principle in physical therapy:
Treat the whole system, not just the site of pain.
At ProFormance Therapy & Wellness, we take a comprehensive approach to injury care—looking at how your body moves as a whole to uncover the true drivers of your symptoms.
If you’re a runner dealing with heel pain or looking to stay injury-free, we’re here to help you build strength where it matters most.
Ready to move better and run stronger?
Contact us today to schedule an evaluation.
Source:
https://pubmed.ncbi.nlm.nih.gov/40877885/
In talks around sleep hygiene, exercise can be a tough one to pin down. Most voices in our tribe fall in the "train hard, sleep hard" camp, but that's tough to reconcile with the well known fact that exercise gives you an energy boost. How can that possibly be helpful for sleep?
This open access paper in Nature brings a bit of an evidence based perspective via analysis of nearly 15,000 folks across a one year time span. From the publication: "Our results suggest evening exercise—particularly involving high exercise strain—may disrupt subsequent sleep and nocturnal autonomic function. Individuals aiming to improve sleep health may benefit from concluding exercise at least 4 hours before sleep onset or electing lighter strain exercises within this window.".
The paper further discusses how high intensity exercise might disrupt quality and timing of sleep.
So, get it in, but get it in early!
This open access paper in Nature brings a bit of an evidence based perspective via analysis of nearly 15,000 folks across a one year time span. From the publication: "Our results suggest evening exercise—particularly involving high exercise strain—may disrupt subsequent sleep and nocturnal autonomic function. Individuals aiming to improve sleep health may benefit from concluding exercise at least 4 hours before sleep onset or electing lighter strain exercises within this window.".
The paper further discusses how high intensity exercise might disrupt quality and timing of sleep.
So, get it in, but get it in early!
Leota, J., Presby, D.M., Le, F. et al. Dose-response relationship between evening exercise and sleep. Nat Commun 16, 3297 (2025). https://doi.org/10.1038/s41467-025-58271-x
| What is collagen? Collagen is a distinctive protein and a major component of connective tissues like skin, bones, and cartilage. In the body, collagen is made up of chains of repeating amino acid units, with a high prevalence of glycine, proline, and hydroxyproline. These chains are wound together in very strong, braid-like triple helixes. Collagen makes up about 30% of the body's |  |
protein content. Critical to the body's scaffolding system, collagen provides the strength and flexibility needed by our bones, joints, tendons, and cartilage. Likewise, collagen supports skin integrity by helping maintain its moisture and elasticity.
Why is collagen important?
Your body’s ability to produce collagen decreases by about 1% every year. For most people, collagen production begins to decline in your 20s, which can impact the health of your skin, joints, and hair over time. When you ingest collagen peptides, they help stimulate fibroblasts in your skin, which trigger the production of collagen, elastin, and hyaluronic acid.
How does collagen work?
In the diet, collagen supplementation helps provide the body with key amino acids that act as the building blocks for collagen production. Collagen peptides also appear to have bioactive capabilities, which may trigger the synthesis of new collagen fibers, further supporting the structure of skin, bone, and joint tissue.
What does this mean for us?
As we place extra strain on our tissue with increased training levels, adding collagen to our diet helps our bodies repair the damage, become stronger, and feel better.
How much should I take?
Start with 2 TBS a day. As you get accoustomed to it, increase to 4 TBS to address pain and increased activity. For clients who are participating in heavy workouts, aim for 6 TBS a day. For clients who are working very hard, over 2 hours a day, or participating in 2-a-days aim for up to 8 TBS a day.
If counting your macros, account for the collagen protein intake.
Check your physician to see if collagen supplementation is safe for you.
Why is collagen important?
Your body’s ability to produce collagen decreases by about 1% every year. For most people, collagen production begins to decline in your 20s, which can impact the health of your skin, joints, and hair over time. When you ingest collagen peptides, they help stimulate fibroblasts in your skin, which trigger the production of collagen, elastin, and hyaluronic acid.
How does collagen work?
In the diet, collagen supplementation helps provide the body with key amino acids that act as the building blocks for collagen production. Collagen peptides also appear to have bioactive capabilities, which may trigger the synthesis of new collagen fibers, further supporting the structure of skin, bone, and joint tissue.
What does this mean for us?
As we place extra strain on our tissue with increased training levels, adding collagen to our diet helps our bodies repair the damage, become stronger, and feel better.
How much should I take?
Start with 2 TBS a day. As you get accoustomed to it, increase to 4 TBS to address pain and increased activity. For clients who are participating in heavy workouts, aim for 6 TBS a day. For clients who are working very hard, over 2 hours a day, or participating in 2-a-days aim for up to 8 TBS a day.
If counting your macros, account for the collagen protein intake.
Check your physician to see if collagen supplementation is safe for you.
Sources:
https://greatlakeswellness.com/blogs/news/collagen-101
https://www.vitalproteins.com/blogs/stay-vital/benefits-of-collagen
https://greatlakeswellness.com/blogs/news/collagen-101
https://www.vitalproteins.com/blogs/stay-vital/benefits-of-collagen
Join us on September 6th for a chance to win a FREE mini session of cupping/blading, dry needling, or stretching. We will also be giving out shaker bottles and lacrosse balls.
As the Wellness Festival of the season, F5 is the place to be to discover the wealth of wellness at your fingertips. This is a perfect opportunity to treat yourself and connect with your community. We will be providing FREE services and Information. We will also have a giveaway for a FREE mini cupping/blading, dry needling, or stretch wellness visit session in the clinic. Mark your calendars and invite your friends! We can't wait to see you there. #DryNeedling #Health #fleetfeethuntsvillemadison #HuntsvilleAlabama #Wellness #5K
As the Wellness Festival of the season, F5 is the place to be to discover the wealth of wellness at your fingertips. This is a perfect opportunity to treat yourself and connect with your community. We will be providing FREE services and Information. We will also have a giveaway for a FREE mini cupping/blading, dry needling, or stretch wellness visit session in the clinic. Mark your calendars and invite your friends! We can't wait to see you there. #DryNeedling #Health #fleetfeethuntsvillemadison #HuntsvilleAlabama #Wellness #5K
