7The Effect of Microwave Therapy on Muscle Blood Flow
British Journal of Sports Medicine (1976) · D. J. Wyper, D. R. McNiven
This study measured muscle blood flow using a radioactive tracer technique in five healthy subjects. Researchers found that microwave therapy at 2450 MHz significantly increased muscle blood flow compared to resting values. The mean blood flow increased from 2.9 ml/100g/min at rest to 11.4 ml/100g/min during microwave therapy. The study concluded that microwave therapy has a greater effect on muscle blood flow than other therapeutic modalities, highlighting its potential benefits for tissue perfusion and recovery.
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42Weak Evidence for the Safety and Effectiveness of Endoscopic Plantar Fascia Release
Foot and Ankle Surgery (2020) · Michael-Alexander Malahias, Erwin Brian Cantiller, Vikram V. Kadu, Sebastian Muller
This review evaluated 15 studies on endoscopic plantar fascia release (EPFR), totaling 535 patients and 576 feet. Most studies were low-quality case series, with only two randomized controlled trials. Though subjective scores improved postoperatively, the review concluded there is weak evidence supporting EPFR as safe or effective. The overall complication rate was 11.0%, with persistent heel pain (5.6%), paresthesias or numbness (4.3%), soft tissue healing issues (1.7%), and superficial infection (0.4%) being the most common.
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70COX-2 Inhibitors Significantly Delay Rotator Cuff Tendon Healing
Chinese Medical Journal (2015) · Lu Y, Li Y, Li FL, Li X, Zhuo HW, Jiang CY
This controlled study evaluated the effects of three common anti-inflammatory drugs on rotator cuff healing in 96 rabbits. After rotator cuff repair surgery, animals were divided into four groups: ibuprofen, celecoxib (a COX-2 inhibitor), flurbiprofen, and a control group receiving no medication. After 7 days of treatment, the celecoxib group showed significantly lower failure loads and reduced type I collagen at all time points (3, 6, and 12 weeks) compared to controls. For example, at 3 weeks, collagen was 11.5% in the celecoxib group versus 27.6% in controls. The findings confirm that selective COX-2 inhibitors significantly impair rotator cuff tendon healing, particularly in the early stages of recovery.
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72Rotator Cuff Tears Increase With Age and Are Often Asymptomatic
Journal of Shoulder and Elbow Surgery (2014) · Teunis T, Lubberts B, Reilly BT, Ring D
This systematic review pooled data from 30 studies encompassing 6,112 shoulders to determine how common rotator cuff abnormalities are across different age groups. The researchers found that rotator cuff tears become increasingly common with age, rising from 9.7% in people aged 20 and younger to 62% in those aged 80 and older. Crucially, a high percentage of these tears were found in people with no symptoms at all, suggesting that many rotator cuff tears exist without causing pain. The prevalence of asymptomatic tears was high enough that the authors concluded rotator cuff degeneration should be considered a normal aspect of human aging, making it difficult to determine when a tear is new or the actual cause of symptoms.
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73Many Rotator Cuff Tears Cause No Symptoms
Annals of the Royal College of Surgeons of England (2006) · Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ
This review analyzed cadaveric and radiological studies to determine how common rotator cuff tears really are. Among cadaveric specimens, the prevalence of full-thickness tears was 11.75% and partial-thickness tears was 18.49%, for a total of 30.24%. Strikingly, among living subjects examined with ultrasound, 38.9% of those with no symptoms had rotator cuff tears. MRI findings showed 26.2% of asymptomatic individuals had tears. The study concludes that rotator cuff tears are frequently asymptomatic, meaning many people have tears without knowing it. This finding highlights that the presence of a tear on imaging does not necessarily mean it is the source of pain, and that many tears can exist without causing problems.
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78NSAIDs Significantly Increase Risk of Gastrointestinal Bleeding
Drug Safety (2012) · Castellsague J, Riera-Guardia N, Calingaert B, Varas-Lorenzo C, Fourrier-Reglat A, Nicotra F, et al.
This systematic review and meta-analysis analyzed 28 observational studies to evaluate the risk of upper gastrointestinal complications associated with individual NSAIDs. The study found that all NSAIDs carry a risk of serious GI complications including bleeding, perforation, and obstruction, but the risk varies significantly between specific drugs. Ibuprofen had a relative risk of 1.84 compared to non-use, while naproxen carried a relative risk of 4.10. Other commonly used NSAIDs showed even higher risks, with piroxicam at 7.43 and ketorolac at 11.50. Importantly, the study found that high daily doses of NSAIDs carried 2 to 3 times greater risk than low daily doses, confirming that both the dose and duration of NSAID use directly affect the likelihood of gastrointestinal injury. The researchers analyzed data from studies covering clinical practice settings, making the findings applicable to real-world use. These results support the recommendation that NSAIDs should be used at the lowest effective dose for the shortest possible duration, taken with food, and timed to avoid periods of activity where pain masking could lead to reinjury. The dose-dependent nature of the risk reinforces the guidance that extended, around-the-clock NSAID use carries significant cumulative danger to the gastrointestinal system.
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54Electrical Stimulation Can Induce Significant Muscle Damage
European Journal of Applied Physiology (2011) · Kazunori Nosaka, Abdulaziz Aldayel, Marc Jubeau, Trevor C. Chen
This study examined the extent of muscle damage caused by electrical stimulation (ES), particularly during isometric contractions. Using typical therapeutic settings (75 Hz, 200-400 us pulse width), ES was found to produce significant muscle damage comparable to that from maximal voluntary eccentric contractions. Indicators of damage included strength loss, increased creatine kinase (CK) levels, and delayed-onset muscle soreness (DOMS). The authors attribute the effect to the non-selective, synchronous, and spatially fixed recruitment of motor units under ES, which results in excessive localized mechanical stress. A protective adaptation was noted after repeated ES exposure 2-4 weeks later, but initial applications can be harmful if used during early recovery.
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