Educational Articles -
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Reducing the risk of knee OA after knee injury - What you need to know

References:

  • Whittaker JL, et al. OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. Br J Sports Med. 2022 Dec;56(24):1393-1405. doi: 10.1136/bjsports-2022-106299. Epub 2022 Nov 15.
  • World Health Organization. WHO guidelines on physical activity and sedentary behaviour. World Health Organization, 2020. https://apps.who.int/iris/handle/10665/336656
  • Culvenor AG, et al. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med. 2019 Oct;53(20):1268-1278. doi: 10.1136/bjsports-2018-099257. Epub 2018 Jun 9.
  • Roos, E., Arden, N. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol  12, 92–101 (2016). doi: 10.1038/nrrheum.2015.135
  • Whittaker JL, et al. Risk factors for knee osteoarthritis after traumatic knee injury: a systematic review and meta-analysis of randomised controlled trials and cohort studies for the OPTIKNEE Consensus. Br J Sports Med. 2022 Dec;56(24):1406-1421. doi: 10.1136/bjsports-2022-105496. Epub 2022 Sep 2.
  • Bricca A, et al. Infographic. Therapeutic exercise relieves pain and does not harm knee cartilage nor trigger inflammation. Br J Sports Med. 2020 Jan;54(2):118-119. doi: 10.1136/bjsports-2019-100727. Epub 2019 Jun 21. PMID: 31227490.
  • Lo GH, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol. 2018 Sep;37(9):2497-2504. doi: 10.1007/s10067-018-4121-3. Epub 2018 May 4.
  • Arundale AJH, et al. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. J Orthop Sports Phys Ther. 2018 Sep;48(9):A1-A42. doi: 10.2519/jospt.2018.0303.
  • Knee and hip osteoarthritis. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim and the Finnish Orthopaedic Association. Helsinki: The Finnish Medical Society Duodecim, 2018. Available online at: www.kaypahoito.fi [in Finnish]
  • National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management [NICE Guideline No.115], 2022. Available at: https://www.nice.org.uk/guidance/ng226
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Last Reviewed:

July 28, 2023

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Rotator cuff related shoulder pain

  • Pribcevic M. The epidemiology of shoulder pain: narrative review of the literature. In: Ghosh S, ed. Pain in Perspective. New York, NY: Nova Science Publishers; 2012.
  • Lewis J. Rotator cuff related shoulder pain: assessment, management & uncertainties. Man Ther. 2016;23:57-58. doi:10.1016/j.math.2016.09.009.
  • Pieters L, Lewis J, Kuppens K, et al. An update of systematic reviews examining the effectiveness of conservative physical therapy interventions for subacromial shoulder pain. J Orthop Sports Phys Ther. 2020;50(3):131-141. doi:10.2519/jospt.2020.8498.
  • Powell A, Lewis J, Heerey J, et al. “Restoring that faith in my shoulder”: a qualitative investigation of how and why exercise therapy influenced the clinical outcomes of individuals with rotator cuff-related shoulder pain. Phys Ther Rehabil J. 2023;10(1):1-12. doi:10.7243/2055-2386-10-1.
  • Cuff A, Littlewood C. Subacromial impingement syndrome - What does this mean to and for the patient? A qualitative study. Musculoskelet Sci Pract. 2018;33:24-28. doi:10.1016/j.msksp.2017.11.002.
  • Frost P, Andersen JH, Lundorf E. Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement? J Shoulder Elbow Surg. 1999;8(6):565-568. doi:10.1016/s1058-2746(99)90090-1.
  • Teunis T, Lubberts B, Reilly BT, et al. A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. 2014;23(12):1913-1921. doi:10.1016/j.jse.2014.08.001.
  • Deville WL, van der Windt DA, Dzaferagic A, et al. A patient decision aid to facilitate shared decision-making for patients with shoulder pain associated with a non-traumatic rotator cuff tear. Cochrane Database Syst Rev. 2019;2019(12):CD013219. doi:10.1002/14651858.CD013219.
  • Hopewell S, Healey EL, Copsey BJ, et al. Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2*2 factorial, randomised controlled trial. Lancet. 2021;398:416-428. doi:10.1016/S0140-6736(21)00523-0.
  • Dominguez-Romero S, Fernandez-Lopez JC, Martin-Urrialde JA, et al. Exercise-based muscle development programmes and their effectiveness in the functional recovery of rotator cuff tendinopathy: a systematic review. Int J Environ Res Public Health. 2021;16(11):529. doi:10.3390/ijerph16110529.
  • Tangrood S, Lewis J, Heerey J, et al. Clinical course of pain and function in subacromial shoulder pain: a systematic review with meta-analysis. Phys Ther Rev. 2023. doi:10.1080/10833196.2023.2192620.
  • McCreesh KM, Anjum S, Crotty JM, et al. Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy. BMJ Open Sport Exerc Med. 2017;3(1):e000200. doi:10.1136/bmjsem-2016-000200.
  • Burne JA, Fearon AM, Twin J, et al. Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review. BMJ Open Sport Exerc Med. 2019;5(1):e000478. doi:10.1136/bmjsem-2018-000478.
  • Kashanchi N, Lee J, Makhni EC, et al. Level of obesity is directly associated with complications following arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2021;30:1581-1587. doi:10.1016/j.jse.2020.11.029.
  • Lango T, Kukkonen J, Lehtinen J, et al. Conservative versus surgical management for patients with rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2021;22(1):55. doi:10.1186/s12891-020-03877-9.
  • Peterson G, Pihlstrom H. Factors associated with neck and shoulder pain: a cross-sectional study among 16,000 adults in five county councils in Sweden. BMC Musculoskelet Disord. 2021;22(1):1-9. doi:10.1186/s12891-020-03876-w.
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Last Reviewed:

November 15, 2023

|

Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Understanding diabetes - Type 1, type 2 and gestational diabetes

  • Solis-Herrera C, Triplitt C, Reasner C, DeFronzo RA, Cersosimo E. Classification of Diabetes Mellitus. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; February 24, 2018.
  • Type 2 diabetes. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim and the Finnish Cardiac Society. Helsinki: The Finnish Medical Society Duodecim, 2022 (referred October 15, 2023). Available online at: www.kaypahoito.fi
  • Nakhleh A, Shehadeh N. Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention. World J Diabetes. 2021;12(12):2036-2049. doi:10.4239/wjd.v12.i12.2036
  • Type 1 diabetes. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim and the Finnish Cardiac Society. Helsinki: The Finnish Medical Society Duodecim, 2022 (referred October 15, 2023). Available online at: www.kaypahoito.fi
  • Uusitupa M, Khan TA, Viguiliouk E, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients. 2019;11(11):2611. Published 2019 Nov 1. doi:10.3390/nu11112611
  • Kelly SJ, Ismail M. Stress and type 2 diabetes: a review of how stress contributes to the development of type 2 diabetes. Annu Rev Public Health. 2015;36:441-462. doi:10.1146/annurev-publhealth-031914-122921
  • Schipper SBJ, Van Veen MM, Elders PJM, et al. Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature. Diabetologia. 2021;64(11):2367-2377. doi:10.1007/s00125-021-05541-0
  • Gestational diabetes. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim and the Finnish Cardiac Society. Helsinki: The Finnish Medical Society Duodecim, 2022 (referred October 15, 2023). Available online at: www.kaypahoito.fi

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Last Reviewed:

November 15, 2023

|

Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Mindfulness - The tree pillars of integrated awareness practices

  • Siegel Daniel J. Aware. Research and The Science and Practice of Presence. 2018 Mind Your Brain, Inc., New York
  • Siegel Daniel J. ItraConnected: MWe (Me+We) as the Integration of Self, Identity and Belonging (Norton Series on Interpersonal Neurobiology). 2022 W.W. Norton, New York
  • Price CJ, Weng HY. Facilitating Adaptive Emotion Processing and Somatic Reappraisal via Sustained Mindful Interoceptive Attention. Front Psychol. 2021 Sep 8;12:578827. doi: 10.3389/fpsyg.2021.578827.
  • Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, Urbanowski F, Harrington A, Bonus K, Sheridan JF. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003 Jul-Aug;65(4):564-70. doi: 10.1097/01.psy.0000077505.67574.e3.
  • Fredrickson BL, Grewen KM, Coffey KA, Algoe SB, Firestine AM, Arevalo JM, Ma J, Cole SW. A functional genomic perspective on human well-being. Proc Natl Acad Sci U S A. 2013 Aug 13;110(33):13684-9. doi: 10.1073/pnas.1305419110.
  • Gibson J. Mindfulness, Interoception, and the Body: A Contemporary Perspective. Front Psychol. 2019 Sep 13;10:2012. doi: 10.3389/fpsyg.2019.02012.
  • Weng HY, Feldman JL, Leggio L, Napadow V, Park J, Price CJ. Interventions and Manipulations of Interoception. Trends Neurosci. 2021 Jan;44(1):52-62. doi: 10.1016/j.tins.2020.09.010.
  • Ansari A, Pillarisetty LS. Embryology, Ectoderm. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30969658. Accessed: June 5th 2023 [https://pubmed.ncbi.nlm.nih.gov/30969658/]
  • Nathalie Delay. La Voie du Réel: Yoga tantrique - Retour à Soi. Éditions Synchronique, Paris, France 2022
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Last Reviewed:

August 30, 2023

|

Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence: