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J Orthop Sports Phys Ther 2020;50(12)657-660. doi10.2519/jospt.2020.0111.A 57-year-old obese man was referred to a physical therapist 14 weeks after left knee arthroplasty due to loss of function and worsening symptoms. Following examination, due to the worsening and progressive weakness that is atypical after this surgery, the physical therapist and surgeon agreed to refer the patient to the emergency department. Magnetic resonance imaging revealed T11-12 spinal canal stenosis with cord compression. J Orthop Sports Phys Ther 2020;50(12)724. doi10.2519/jospt.2020.9655.

To prospectively investigate the recovery of athlete-reported symptoms and the condition-specific health-related quality of life (HRQoL) following sport-related concussion.

Prospective matched-cohort study.

We recruited amateur athletes who were diagnosed with sport-related concussion by emergency department physicians. Study participants were assessed at 3 time points following sport-related concussion. At each assessment, participants completed 5 condition-specific HRQoL patient-reported outcome measures to evaluate participants' perceptions of the effects of specific concussion-related symptoms on their HRQoL. We performed log-linear analyses to assess the proportion of concussed participants with clinically impaired condition-specific HRQoL compared with the proportion of participants in the control group with clinically impaired condition-specific HRQoL.

Fifty participants with sport-related concussion and 50 control participants matched by sex, age, and activity completed the study. Upon return r returning to sporting activity following sport-related concussion compared with nonconcussed, control participants. J Orthop Sports Phys Ther 2020;50(12)692-701. doi10.2519/jospt.2020.9485.

To compare physical and patient-reported outcomes between (1) individuals with symptomatic radiographic ankle osteoarthritis (OA) and asymptomatic individuals, and (2) asymptomatic individuals with and without radiographic ankle OA.

Cross-sectional study.

Ninety-six volunteers (31 symptomatic individuals with radiographic ankle OA, 41 asymptomatic individuals with radiographic ankle OA, and 24 asymptomatic individuals without radiographic ankle OA) completed a survey on quality of life (QoL), function, pain, disability, kinesiophobia, ankle instability, and physical activity, and undertook physical assessments of ankle muscle strength, heel-raise endurance, dorsiflexion range of motion (ROM), and ambulatory function.

Symptomatic individuals with radiographic ankle OA reported greater pain (standardized mean difference [SMD], 1.70; 95% confidence interval [CI] 1.18, 2.23), disability (SMD, 1.44; 95% CI 0.93, 1.95), and instability (SMD, -3.92; 95% CI -4.68, -3.17), and lower patient-reported function (aphic ankle OA. This suggests that disability in ankle OA is related to symptoms rather than to radiographic evidence of degeneration. J Orthop Sports Phys Ther 2020;50(12)711-722. doi10.2519/jospt.2020.9376.

The opioid crisis is more severe in the United States than in any other country. This may be due, in part, to a cultural problem related to pain Americans have come to expect quick, easy, physician-provided pain relief. Pharmaceuticals can neither cure injuries nor correct the underlying cause of any chronic musculoskeletal condition. Fortunately, people who regularly exercise have less pain, and guidelines for the management of painful chronic conditions already recommend exercise therapies over passive care. This suggests that self-care approaches emphasizing exercise are the logical, lowest-cost, first-line treatment. For patients who require guidance with exercise, the stepped-care approach to pain management commonly taught in medical school curricula should include guided physical rehabilitation early, if not first. This has been shown to be associated with fewer high-cost services and less opioid medication. Keeping people opioid naïve, when appropriate, could save tens of thousands of American livesth fewer high-cost services and less opioid medication. Keeping people opioid naïve, when appropriate, could save tens of thousands of American lives annually and many more globally. find more Attitudes, behaviors, and policies must evolve to shed the culture of first-line pharmaceutical pain management. J Orthop Sports Phys Ther 2020;50(12)661-663. doi10.2519/jospt.2020.0611.Although transgender women of color, specifically Black and Latina experience gender-based violence in a variety of contexts, one of the most consistently reported is from a dating or romantic partner. This qualitative study sought to understand the manifestations and consequences of stigma experienced by transgender women of color in their dating or romantic relationships. Between January and February 2019, we purposively recruited 33 transgender women of color to participate in five focus group discussions and complete a brief survey. We employed both inductive and deductive approaches to coding and thematic analysis. We identified different forms of anti-transgender interpersonal stigma experienced by transgender women of color seeking romantic relationships and by those in romantic relationships. For those dating and seeking relationships, anti-transgender interpersonal stigma took the form of dehumanizing stereotypes and sexual objectification. While these manifestations of anti-transgender interpersonal stigma persisted for some within relationships, concealment behaviors from partners was the predominant type of anti-transgender interpersonal stigma. Each of these forms of anti-transgender interpersonal stigma had significant gender-based violence consequences, specifically encountering physical violence, experiencing psychological trauma, and engaging in survival strategies. In the current climate of COVID-19, which is exacerbating risks of gender-based violence, there is an urgent need to understand and address the nuanced manifestations of stigma in relationships and their consequences on the lives of transgender women of color. Culturally grounded gender-based violence prevention policies and programs with transgender women should address these forms of stigma and build on community strengths. Findings also highlight the importance of future research and gender-based violence prevention programming with cisgender men in/seeking partnerships with transgender women of color.