Falls are undoubtedly the greatest threat to the health of older adults, as they represent the leading cause of non–fatal injuries responsible for hospital admissions and death in this age group. About one–third of adults over the age of 65 and one–half of adults over 85 will fall at least once each year, which leads to approximately 2.8 million ER visits, 800,000 hospitalizations, and 27,000 deaths annually. In addition, about 20–30% of falls cause moderate to severe injuries that have a significant impact on one’s functional mobility and independence, which makes them a top priority in healthcare.

Falls occur in older adults due to a combination of both nonmodifiable and modifiable risk factors. Nonmodifiable risk factors are those that one is unable to control or change, including their age, sex, race, having a history of prior falls, and having certain chronic conditions. Modifiable risk factors are those that can be altered, and there are many modifiable risk factors associated with falls, including one’s balance, muscle strength, mobility deficits, and the fear of falling. Another extremely important modifiable risk factor is medication usage, as certain medications and combinations of medications are known to increase the risk of falling.

With this in mind, a study was conducted to examine the relationship between certain prescription medications and the risk of sustaining a secondary fracture after an initial fracture. Investigators were also interested in whether having one fracture influences if doctors change their prescribing behaviors for drugs that either increase or decrease fracture risk.

Researchers examine the medical records of 168,133 Medicare beneficiaries

To conduct the study, researchers used Medicare data to identify beneficiaries who were living in assisted living facilities and who survived a fracture of the hip, shoulder, or wrist over a span of four years. Researchers then devised a list of 21 drug classes that are associated with an increased risk for fractures—including benzodiazepines, antidepressants, and anti–Parkinson disease drugs—and analyzed the use of these drugs within 120 days of the fracture to determine if there was any connection between their use and suffering a fracture.

A total of 168,133 patients with a fracture met the necessary criteria and were included in the study, with the average age of these patients being 80 years. Of the included patients, 76% were exposed to at least one non–opiate drug associated with an increased risk of fracture in the 120 days prior to the date of the fracture, and this finding was consistent across all fracture types. More than half of these patients (55.7%) were taking at least one drug that increases fall risk prior to the index fracture while 42.2% were taking at least one drug that decreases bone density. After the initial fracture, there were only minimal changes in the proportion of patients who continued taking drugs associated with an increased fracture risk, and most patients continued to fill the same number of prescriptions for high–risk non–opiate drugs after their index fracture. Finally, the use of drugs that decrease fracture risk was low, with less than one–quarter of patients filling a prescription for a drug that increases bone density in the 120 days prior to their initial fracture.

These findings show that the use of drugs associated with an increased risk for fracture is common in Medicare beneficiaries, which means that these drugs can be considered a key modifiable risk factor for preventing fractures. In addition, suffering a fracture does not seem to consistently affect patients’ exposure to potentially risky drugs, as most continued to be prescribed these high–risk drugs in the aftermath of their initial fracture.

This study should serve as a wake–up call for healthcare providers who treat older patients to be extremely careful about what drugs they prescribe, especially if a patient experiences a fall–related fracture. Older adults and their caregivers should also be more cognizant of the potential risks associated with each drug individually and how they interact with other drugs by asking their prescribing physician before taking any new medications. We also strongly advise older patients who would like to reduce their risk for falls to consider seeing a physical therapist, who can help address other modifiable risk factors by improving their strength, balance, and mobility.

Physical activity is essential for maintaining optimal overall health and exercising regularly is known to reduce the risk for heart disease, diabetes, depression, some cancers, and numerous other health–related issues. Yet despite this, it’s estimated that over three million people worldwide die prematurely each year because they are not getting enough physical activity.

One important factor that contributes to this issue is that many individuals spend a large portion of their days sitting, which is called a sedentary lifestyle. Following a sedentary lifestyle and sitting for too much time each day is now recognized as a dangerous habit that can lead to a variety of health problems, including obesity, heart disease, diabetes, and cancer. Evidence even suggests that individuals who are physically active and meet the recommended guidelines for activity are still at risk for certain health complications if they spend too much time sitting.

Researchers conduct a study to examine the effects of occasional breaks from sitting

Physical activity guidelines typically make general recommendations for individuals to reduce their sedentary time, but they have not yet provided specific guidance on how often and how long sedentary time should be interrupted. With this in mind, a study was conducted to investigate whether taking occasional breaks from sitting had an effect on heart– and metabolism–related risk factors, and if so, how these effects changed with varying frequencies and durations.

Researchers selected 11 middle– and older–aged adults to participate in the study and instructed them to complete each of the following 8–hour conditions on 5 separate days:

• One uninterrupted sedentary condition (control intervention)
• Four acute trials that involved different frequency/duration combinations of sedentary breaks, which involved light–intensity walking (experimental intervention):
  • Sedentary breaks every 30 minutes for 1 minute each
  • Sedentary breaks every 30 minutes for 5 minutes each
  • Sedentary breaks every 60 minutes for 1 minute each
  • Sedentary breaks every 60 minutes for 5 minutes each

After each patient completed one intervention, they switched and completed the other intervention. Glucose levels were measured every 15 minutes and systolic blood pressure was measured every 60 minutes during these interventions.

Results showed that all intervals of sedentary breaks led to significant decreases in systolic blood pressure. The largest reductions in systolic blood pressure occurred in the group that took sedentary breaks every 60 minutes for 1 minute and every 30 minutes for 5 minutes. Similarly, glucose measurements also decreased after sedentary breaks, but the only significant reduction occurred when participants took breaks every 30 minutes for 5 minutes.

This study shows that taking sedentary breaks for different intervals is effective for reducing systolic blood pressure and glucose levels. Higher frequency and longer duration breaks (every 30 minutes for 5 minutes) appears to be most effective for targeting glycemic response, while shorter breaks may be sufficient for lowering blood pressure.

Therefore, if you currently spend most time of the day sitting, it appears that simply getting up for short, light–intensity walking breaks could counteract some of the negative effects of sedentary behavior by improving your glycemic control and blood pressure. But there’s a rule of thumb that also applies here: some is better than none, and more is better than less. So if you’re interested in becoming more physically active but feel that you can use a boost, a physical therapist can help you get there by designing a personalized exercise program based on your body type, abilities, and goals.

Ankle sprains are extremely common, especially for athletes and active individuals. In fact, if you are athletically involved to any extent, there is a strong chance that you will sprain your ankle at some point down the road. Ankle sprains account for up to 45% of all sports related injuries, and approximately 25,000 people sprain their ankle every day. Playing certain sports will also affect your odds, as football, basketball, and soccer have the highest rates of ankle sprains because they involve fast speeds and frequent changes in direction. Ankle sprains increase your injury risk, but physical therapy can help.

Recovery from Ankle Sprain

Most ankle sprains are relatively mild, and patients can typically expect to recover and return to their respective activity or sport in a reasonable amount of time. However, recovering from an ankle sprain is not always the end of the story. About 40% of individuals who sprain their ankle will go on to develop chronic ankle instability (CAI), which is a condition that involves persistent instability and an increased risk of experiencing additional ankle sprains due to a combination of impairments. On account of these impairments, patients with CAI may also be at an increased risk for subsequent injuries of the joints proximal to the ankle—the knees, hips, and lower back—because each of these joints influences the movement of the others.

Many experts believe that CAI increases the risk for injury to these proximal joints, but this has not yet been confirmed with research. Therefore, a study was conducted to investigate how many patients who initially suffered an ankle sprain went on to experience any knee, hip, or back issues within the following year, and whether therapeutic exercise had any effect on this relationship.

Medical records of nearly 34,000 military personnel examined over 12 months

Researchers extracted data from the medical records of military personnel in the US Military Health Repository and searched for individuals who experienced an ankle sprain over a two–year period. Medical records of these individuals were then examined to determine if any additional injuries occurred to the knee, hip, or lower back region within the following 12 months. Researchers also looked for data on how many patients underwent therapeutic exercise—such as physical therapy—and whether it affected their risk for experiencing subsequent injuries.

From this search, 33,361 patients who suffered an ankle sprain were identified and included in the study. Of these, 6,848 individuals (20.5%) went on to sustain a secondary injury within the following 12 months, with 40% of these patients having a lower back injury, 39% having a knee injury, and 8% having a hip injury. The remaining patients had a combination of injuries in at least two regions. Further analysis revealed that only 28% of patients were prescribed therapeutic exercise after their initial ankle sprain; however, therapeutic exercise had a protective effect, as these individuals had a lower risk for experiencing a hip injury (32% reduction), lower back injury (18% reduction), or knee (13% reduction) injury.

Although these findings do not prove that ankle sprains directly cause secondary injuries in other joints of the body, they do suggest that there is a relationship between these events, and that ankle sprains appear to be associated with an elevated risk. Furthermore, this study provides evidence that patients who undergo therapeutic exercise after an ankle sprain are less likely to sustain further injury to the hips, knees, or lower back.

What you should do

At North Penn Physical Therapy, we encourage athletes and active individuals to recognize the importance of making a full recovery from an ankle sprain. Since therapeutic exercise was found to have a protective effect on injury risk, we also recommend seeing a physical therapist if you experience an ankle sprain. As part of your physical therapy treatment, you will receive a comprehensive program that will help reduce your risk for future ankle sprain injury. CALL US for more information or to make an appointment.

Ankle sprains are extremely common, especially for athletes and active individuals. In fact, if you’re athletically involved to any extent, there’s a strong chance that you will sprain your ankle at some point down the road. Ankle sprains account for up to 45% of all sports–related injuries, and approximately 25,000 people sprain their ankle every day. Playing certain sports will also affect your odds, as football, basketball, and soccer have the highest rates of ankle sprains because they involve fast speeds and frequent changes in direction.

The good news is that most ankle sprains are relatively mild, and patients can typically expect to recover and return to their respective activity or sport in a reasonable amount of time; however, recovering from an ankle sprain is not always the end of the story. About 40% of individuals who sprain their ankle will go on to develop chronic ankle instability (CAI), which is a condition that involves persistent instability and an increased risk of experiencing additional ankle sprains due to a combination of impairments. On account of these impairments, patients with CAI may also be at an increased risk for subsequent injuries of the joints proximal to the ankle—the knees, hips, and lower back—because each of these joints influences the movement of the others.

Many experts believe that CAI increases the risk for injury to these proximal joints, but this has not yet been confirmed with research. Therefore, a study was conducted to investigate how many patients who initially suffered an ankle sprain went on to experience any knee, hip, or back issues within the following year, and whether therapeutic exercise had any effect on this relationship.

Medical records of nearly 34,000 military personnel examined over 12 months

Researchers extracted data from the medical records of military personnel in the US Military Health Repository and searched for individuals who experienced an ankle sprain over a two–year period. Medical records of these individuals were then examined to determine if any additional injuries occurred to the knee, hip, or lower back region within the following 12 months. Researchers also looked for data on how many patients underwent therapeutic exercise—such as physical therapy—and whether it affected their risk for experiencing subsequent injuries.

From this search, 33,361 patients who suffered an ankle sprain were identified and included in the study. Of these, 6,848 individuals (20.5%) went on to sustain a secondary injury within the following 12 months, with 40% of these patients having a lower back injury, 39% having a knee injury, and 8% having a hip injury. The remaining patients had a combination of injuries in at least two regions. Further analysis revealed that only 28% of patients were prescribed therapeutic exercise after their initial ankle sprain; however, therapeutic exercise had a protective effect, as these individuals had a lower risk for experiencing a hip injury (32% reduction), lower back injury (18% reduction), or knee (13% reduction) injury.

Although these findings do not prove that ankle sprains directly cause secondary injuries in other joints of the body, they do suggest that there is a relationship between these events, and that ankle sprains appear to be associated with an elevated risk. Furthermore, this study provides evidence that patients who undergo therapeutic exercise after an ankle sprain are less likely to sustain further injury to the hips, knees, or lower back.

We therefore encourage athletes and active individuals to recognize the importance of safely recovering from an ankle sprain and avoiding further exacerbations during this time. Since therapeutic exercise was found to have a protective effect on injury risk, we also recommend seeing a physical therapist if you experience an ankle sprain for a comprehensive rehabilitation program that will help to reduce your risk for future injuries of the ankle and other joints in the region.

Like it or not, injuries are a part of life. And if you’re an athlete or active individual, this fact is more likely to ring true, as you’re bound to experience an injury from time to time—or perhaps even more often.

After an injury occurs, the question that’s top of mind for most athletes is almost always the same: “how long before I can return?” The response to this question from trainers, physical therapists, and other professionals who work with athletes is often something along the lines of “it’s complicated,” which is accurate due to the various factors and nuances involved in each individual injury. However, there are some general concepts and timelines that can help to give you a better idea of what to expect the next time you get injured.

Average healing times for injured structures

Perhaps the most important concept to understand in this discussion is that although proper rehabilitation can significantly reduce pain levels and help patients regain lost physical function, there are limits to how much the recovery process can be sped up. Injuries cause damage and irritation of one or more structures—sometimes extensively—and it can take a fair amount of time for these structures to repair and remodel afterwards. The amount of blood flow to different tissues and structures also varies widely, which directly affects the amount of time needed for healing. Finally, the severity of an injury will—unsurprisingly—impact healing time, with more severe injuries typically taking longer to heal than mild injuries.

For more context, below is a list of the average time for tissue healing of several commonly injured structures based on a comprehensive literature review:

• Muscle strain
  • Grade 1: 2–8 weeks
  • Grade 2: 2–4 months
  • Grade 3: 9–12 months
• Ligament injury
  • Grade 1: 2–8 weeks
  • Grade 2: 2–6 months
  • Grade 3: 9–12 months
  • Surgical repair (eg, ACL): 12+ months
• Tendon injury
  • Acute: 2–6 weeks
  • Subacute: 2–4 months
  • Chronic: 3–9 months
  • Tear, surgical repair, or rupture: 4–12+ months
• Other injuries
  • Bone fracture: 6–12+ weeks
  • Articular cartilage: 9–24 months
  • Meniscus/labrum: 3–12 months

As you can see, the range for healing times is rather wide for some of these injuries—especially severe ones—which highlights the difficulty of predicting an accurate timetable for returning to sports. Other factors that influence healing time include how much the injured area is loaded, inflammation, cardiovascular health, nutrition, hydration, and sleep, as taking good general care of one’s body can speed up the recovery process. It’s also important to recognize that when pain is no longer detected, it doesn’t necessarily mean that the tissue has completely healed or remodeled. And on the flip side, the presence of pain does not necessarily indicate that there is significant tissue damage. Once again, each injury must be examined on a case–by–case basis by an expert who understands how injuries heal and when it’s safe to return to activity.

Physical therapy plays a pivotal role in facilitating recovery

Physical therapists are experts that specialize in helping patients recover from injuries as safely and efficiently as possible. And while we may not have the ability to speed up or change human biology, we do believe that physical therapy can play an essential part in the rehabilitation of most injuries. In each patient encounter we work towards several goals that all contribute to facilitating and expediting injury recovery, including the following:

• Determine an accurate diagnosis and prognosis
• Avoid or modify aggravating factors
• Reduce symptoms, normalize joint motion, minimize swelling
• Address factors that caused the injury or are making it an ongoing problem
• Monitor progress and help with exacerbation and recurrences
• Develop a long–term plan to reduce the risk for injury recurrence

As physical therapists who deal with injured patients constantly, we understand the frustration of not being given an exact timetable after an injury, but as we’ve shown you, predicting healing times is not an exact science. Injuries are tough, and not knowing when you’ll return is sometimes even tougher. But you should take solace in knowing that a physical therapist will always have your best interests and long–term health in mind, and that all decisions will be based on helping to ensure that you can continue doing what you love long into the future.

–Summarized from an article published by Evolve Flagstaff

Nearly 85% of shoulder conditions involve the rotator cuff, and among the most common of these is shoulder impingement syndrome (SIS). SIS results from the rotator cuff tendons becoming compressed—or “impinged”—as they pass through a small bone on top of the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, which eventually leads to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement, and pain.

SIS is most common in individuals that regularly perform lots of overhead activities, especially golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side regularly, which can strain the shoulder and cause impingement over time.

SIS is closely related to rotator cuff tendinitis and subacromial pain, and in some cases, the terms are used interchangeably. When any of these conditions develop, the best course of action is a comprehensive physical therapy program, which utilizes movement–based treatments to alleviate pain and increase strength, flexibility, and physical function. However, many patients with SIS go to a primary care physician or some other healthcare provider rather than a physical therapist, and while these providers typically do what they think is best for patients, in some cases they prescribe interventions that are costly and/or ineffective for alleviating shoulder pain.

Researchers review three studies comparing injections to physical therapy

One of these interventions is steroid injections, which some healthcare providers use to provide short–term pain relief for conditions like SIS. However, research analyzing the differences between physical therapy and steroid injections is limited, and this led a team of researchers to conduct a study called a systematic review to compare these two interventions.

For the systematic review, investigators searched a major medical database for studies that compared physical therapy to steroid injections for patients with shoulder pain caused by SIS. This search led to three high–quality studies called randomized–controlled trials being included in the review, which featured data on 452 patients.

Results from these three studies revealed that both physical therapy and steroid injections led to improvements in pain, shoulder range of motion (ROM), and shoulder function in the short term (1–3 months), medium term (6 months), and long term (12 months). Although steroid injections were more effective than physical therapy for improving shoulder function in the short term at 6–7 weeks, there were no significant differences between these interventions in pain, shoulder ROM, or shoulder function at the medium–term or long–term follow–ups.

Based on these findings, it appears that both physical therapy and steroid injections provide similar benefits for patients with shoulder pain caused by SIS, with neither intervention found to be superior to the other. Therefore, researchers recommend that patients should be educated on the risks versus benefits of each intervention and given the choice between interventions based on their preference. As a part of this discussion, patients should be informed that physical therapy is generally regarded as a lower–risk treatment option, as evidence on the long–term risks of steroid injections is limited and some studies have found that injections can lead to a compromised immune system and cartilage toxicity over time.

If you’re currently dealing with SIS, we encourage you to explore all treatment options available to you before making a decision. And if you decide that physical therapy is right for you, we’d be more than happy to get you started on a comprehensive treatment program right away.

Low back pain is jarringly common. About one–half of all working Americans experience symptoms at least once every year, and roughly 31 million are affected by it at any given point in time. So if you happen to place yourself in this category, you’ll have an abundance of company.

Dealing with low back pain can be troublesome and place a strain on everyday life. Typical movements like bending over to pick something off the ground or twisting your torso when looking to the side might suddenly make you pause and cause you to be less mobile as a result. This naturally leads to frustration and can often shift to a focus on one main question: “what’s causing my pain?”

Many patients with low back pain therefore begin to place a strong emphasis on obtaining a diagnosis. Patients who do this usually believe that obtaining a diagnosis will clearly explain what’s causing their pain and will make it easier for them to receive appropriate treatments. But sadly, searching for a low back pain diagnosis is complicated and often does not lead to the outcomes that most patients hope for. And in many cases, it can do more harm than good.

When seeking a diagnosis, many patients will have an imaging test (X–ray, MRI, or CT scan) performed, either by the doctor’s order or their request. These types of tests are essential for diagnosing numerous conditions throughout the body, but when it comes to low back pain, their usefulness is limited. The primary issue is that imaging tests are only one component of a diagnosis, in addition to a detailed patient interview and thorough physical examination. Plus, many “abnormal” results from imaging tests could be simple age–related changes that are not contributing to a patient’s pain, but this won’t stop certain practitioners from treating the “problem” nonetheless.

Clinical guidelines and experts have long recommend that imaging tests for low back pain should only be performed if one or more “red flags” is identified during an examination. Red flags for low back pain include the following:

• Loss of bladder or bowel control
• Signs of severe or worsening nerve damage
• Serious underlying problems like cancer or spinal infections
• Unexplained weight loss
• Abnormal reflexes
• Recent serious fall or injury
• Worsening numbness or weakness in one leg

If none of these red flags are present, having an imaging test is not recommended because it’s not likely to provide any valuable information or lead to better outcomes. Yet many patients with low back pain and no red flags still undergo MRIs of their spine.

Greater use of healthcare services leads to higher costs for patients undergoing MRIs

A 2015 study illustrates the implications of unnecessarily having an MRI for low back pain instead of seeing a physical therapist. For the study, researchers analyzed data from the medical records of 2,893 patients with low back pain that were identified through a comprehensive search. Of these patients, 841 received treatment outside of primary care within the first six weeks of their diagnosis, with 46% receiving a diagnostic test—usually an MRI—and 45% receiving physical therapy.

A comparison of these two groups showed that those who received a diagnostic test first utilized significantly more healthcare services than those who underwent physical therapy first. For example, patients who first received a diagnostic test were more than 3 times more likely to undergo surgery, almost 4 times more likely to have injections, and about 7 times more likely to see a spine surgeon compared to those who saw a physical therapist first. As a result, healthcare costs for low back pain over one year were about $4,700 higher when imaging was performed first due to the increased use of these healthcare services.

This study clearly shows why it’s usually best for patients with low back to visit a physical therapist early after noticing pain rather than going to a primary care physician or specialist, who may be more likely to order a diagnostic test. With this in mind, we strongly recommend that you consider seeing a physical therapist if low back pain is bothering you and to avoid the temptation of relying too heavily on a diagnosis for the reasons we’ve described here.

Knee osteoarthritis is a disorder that involves age–related changes to the cartilage in a knee joint. In a normal knee, the ends of each bone are covered by cartilage, a smooth substance that protects the bones from one another and absorbs shock during impact. In knee osteoarthritis, this cartilage becomes stiff and loses its elasticity, which makes it more vulnerable to damage. Cartilage may begin to wear away over time, which greatly reduces its ability to absorb shock and increases the chances that bones will touch one another. When this occurs, it typically results in pain within and around the knee that gets worse with activities like walking, going up/down stairs, or sitting/standing. Swelling, tenderness, and stiffness are also common.

Although no treatment can slow or stop this loss of cartilage, physical therapy is strongly recommended as an initial intervention for all cases of knee osteoarthritis. Undergoing a comprehensive course of physical therapy can help reduce pain levels and preserve knee function through movement–based strategies like stretching and strengthening exercises, hands–on therapy, bracing, and recommendations on how to modify pain–inducing activities. Physical therapy can also reduce the need for other interventions that may be potentially unnecessary or dangerous, such as surgery or opioids, and research has shown that the earlier physical therapy is initiated, the greater its benefits.

Researchers review data over 20 years to search for connections between early physical therapy and opioid use

Despite these recommendations, many patients with knee osteoarthritis either never see a physical therapist or fail to do so until much time has passed, which can lead to worse outcomes. With this in mind, a study was conducted to investigate whether there is an association between early versus late initiation of physical therapy for knee osteoarthritis and the future use of opioids.

For the study, investigators searched Medicare and commercial health insurance claims data from 1999 to 2018 for information on adults with knee osteoarthritis who were referred to physical therapy within one year of their diagnosis. Patients identified through this search were then categorized as either “opioid naïve” (meaning they did not use opioids) or “opioid experienced” based on prescription history with these drugs before initiating physical therapy for knee osteoarthritis. Finally, researchers examined the relationship between when physical therapy was initiated and with the use of opioids—including chronic opioid use—over 1 year.

Researchers identified 67,245 patients with knee osteoarthritis, 35,899 of whom were classified as “opioid naïve” and 31,346 of whom were “opioid experienced.” In the opioid naïve group, the risk for any opioid use was higher for patients that delayed starting physical therapy compared to those who began within one month of their diagnosis, and this risk continued to increase as the length of the delay grew (up to 12 months). Similar results were found for the risk of chronic opioid use, which was 2.5 times higher for patients who waited 9–12 months to see a physical therapist compared to those who started physical therapy within one month. The same trends were identified in the opioid experienced group, with increased risks for both opioid use overall and chronic opioid use in patients who waited to see a physical therapist versus those who saw one within one month.

These findings suggest that delaying the start of physical therapy may increase the risk for using opioids compared to starting it early (within one month) for patients with knee osteoarthritis, and the longer the delay, the greater the risk for opioid use. Therefore, if you’re currently dealing with knee osteoarthritis, we strongly recommend that you visit a physical therapist sooner rather than later.

We spend roughly one–third of our lives sleeping, so it follows that the habits we keep during the night have a major impact on our waking lives. Sufficient sleep is an essential component of good overall health, as getting between 7–9 hours of sleep every night is linked with countless benefits, including stress relief, a reduced risk for many chronic disorders, improved memory and cognitive function, and possibly weight loss and a longer lifespan. Proper sleep is even more essential for athletes and anyone dealing with a painful condition, as it represents one of the most effective recovery strategies one can follow. Some experts even recommend that athletes should aim to get 9–10 hours of sleep each night to help them reach their full potential.

To elaborate on the association between sleeping habits and recovery, here are a few research examples that highlight the negative impact of sleep deprivation on both physical and cognitive performance:

• Individuals with poor sleeping habits have lower general health and increased stress and confusion
• Inadequate sleep impairs maximal muscle strength during certain movements
• Adolescent athletes who average less than 8 hours of sleep per night have a 1.7 times greater risk of injury than those who sleep more than 8 hours per night
• Sleep may be important for bone health, and sleep deprivation may contribute to the development of bone stress injuries
• Insufficient sleep and chronic pain have a bi–directional relationship, meaning they each contribute to one another; one study found that <7 hours of sleep was associated with a significant increase in the risk for new injuries in athletes, while getting >7 hours was linked to a significant decrease in injury risk

Yet despite this growing body of evidence, many individuals still aren’t getting enough sleep. Statistics suggest that 35% of Americans get less than 7 hours of sleep per night and 63% claim that their sleep needs are not met during the week. This problem exists in athletic populations as well, with research showing that 50–78% of elite athletes experience sleep disturbance and 22%–26% suffer from highly disturbed sleep. The reasons why so many don’t get adequate sleep are complex and multifaceted, but some contributing factors include the fast pace of modern life, dietary habits, insomnia, and excessive light exposure from bright screens—especially at nighttime—which suppresses melatonin, the major hormone that controls sleep and wake cycles.

Take better control of your sleeping habits with these tips

If you’re trying to improve your sleeping habits, here are some of the most effective strategies to help you make it happen:

• Spend as much time as possible outdoors and exercise regularly
• Make your bedroom a sanctuary and keep it cool, quiet, and dark, with a high–quality mattress that’s comfortable and not worn out
• Make sure your final hour before bed is relaxing and free of much stimulation; avoid bright screens during this time, as well as eating, working, or reading in bed
• Try to go to bed and wake up around the same time every night; on weekends, try to stick to this and only allow about a one–hour difference
• Avoid nicotine and caffeine, especially in the final hours before bed, since they are stimulants that can interfere with sleep
• Avoid big meals a few hours before and alcohol right before bedtime
• If needed, squeeze in a nap during the day, but try to keep it to 20–30 minutes and only take them in the early afternoon

It’s also essential to identify and remove any barriers that might be directly interfering with proper sleep. For example, if you’re dealing with pain that’s preventing you from getting enough sleep, you need to first take steps to address it—like seeing a physical therapist—before you can expect the other strategies to work effectively. Self–reported measures of sleep like sleep diaries and fitness trackers that monitor sleep can be extremely helpful as well. And for athletes, an additional step is to work with coaches and other team members to discuss your changing sleep habits and collectively identify approaches that work for you.

The importance of sleep cannot be overstated, and even getting slightly more sleep than you’re currently getting can make a big difference. We understand that it’s easy to neglect sleep in an age when life moves fast and distractions seem to be everywhere, but if you take your sleep seriously, you’ll likely start to notice significant changes in your athletic performance and life in general.