Centro Fisioterapia e Osteopatia Martinelli Gianluca

22/03/2026

22/03/2026

𝗦𝗮𝗿𝗰𝗼𝗽𝗲𝗻𝗶𝗮 𝗣𝗿𝗲𝘃𝗲𝗻𝘁𝗶𝗼𝗻 𝗶𝗻 𝗢𝗹𝗱𝗲𝗿 𝗔𝗱𝘂𝗹𝘁𝘀: 𝗔 𝗖𝗼𝗺𝗽𝗿𝗲𝗵𝗲𝗻𝘀𝗶𝘃𝗲 𝗟𝗼𝗼𝗸 𝗮𝘁 𝗡𝗼𝗻-𝗣𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗜𝗻𝘁𝗲𝗿𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝘀

⬛ As the global population ages, maintaining health span and independence in older adults has become a critical societal issue.
⬛ One of the greatest threats to healthy aging is sarcopenia, a condition characterized by the progressive, systemic loss of skeletal muscle mass, strength, and physical performance.
⬛ Affecting an estimated 10% to 16% of the older global population, sarcopenia increases the risk of falls, diminishes the quality of life, and is closely linked to higher mortality rates.
⬛ Because there are currently no established pharmacological treatments for sarcopenia, managing and preventing the condition relies heavily on non-pharmacological interventions.
⬛ A recent 2025 review article by Kim et al., published in Osteoporosis and Sarcopenia, evaluates the most effective strategies to combat this condition.
⬛ Here is a thorough breakdown of the review's findings on how to prevent and treat sarcopenia.

𝗟𝗘𝗫𝗘𝗥𝗖𝗜𝗦𝗘: 𝗧𝗵𝗲 𝗙𝗶𝗿𝘀𝘁-𝗟𝗶𝗻𝗲 𝗗𝗲𝗳𝗲𝗻𝘀𝗲 🏋️

⬛ Immobilization is a primary driver of muscle loss, making exercise the cornerstone of sarcopenia treatment.
⬛ Resistance Training is the Gold Standard: Engaging in machine-based or free-weight resistance training two to three times per week has been proven to significantly improve muscle mass, handgrip strength, lower limb strength, and gait speed in older adults.
⬛ It is highly effective not just as a treatment, but also as a preventive measure in the early stages of muscle decline (pre-sarcopenia).
⬛ Aerobic Exercise Enhances the Benefits: While aerobic training alone does not significantly build muscle strength, it improves metabolic regulation and cardiovascular function.
⬛ When combined with resistance training in "multicomponent" exercise programs, the overall therapeutic benefits are significantly enhanced.
⬛ Home-Based Workouts are Safe but Require Consistency: For those who cannot access a gym, home-based resistance exercises, such as Elastic Band Training (EBT), offer a safe alternative with a lower risk of injury.
⬛ However, because home-based workouts lack supervision, they often yield more modest results, highlighting the need for motivation to maintain adequate training intensity.

𝗡𝗨𝗧𝗥𝗜𝗧𝗜𝗢𝗡: 𝗙𝘂𝗲𝗹𝗶𝗻𝗴 𝗠𝘂𝘀𝗰𝗹𝗲 𝗣𝗿𝗲𝘀𝗲𝗿𝘃𝗮𝘁𝗶𝗼𝗻 🥗

⬛ Older adults frequently face malnutrition and "anabolic resistance" (a blunted muscle-building response to protein), which accelerates sarcopenia.
⬛ Targeted Supplementation: Diets rich in protein, specifically branched-chain amino acids like leucine and its metabolite HMB, can help increase fat-free mass in older individuals.
⬛ However, leucine or HMB alone has limited effects on raw muscle strength unless combined with other nutrients.
⬛ The Power of Vitamin D: Vitamin D suppresses myostatin, a negative regulator of muscle synthesis.
⬛ When older adults combined Vitamin D with whey protein or leucine, they saw massive improvements in lean mass, physical performance, and muscle strength.
⬛ Synergy with Exercise: Nutritional interventions are consistently most effective when paired with exercise.
⬛ Combining a protein-rich diet with resistance training improves muscle mass, lower limb strength, and gait speed far more effectively than either intervention alone.

𝗘𝗟𝗘𝗖𝗧𝗥𝗜𝗖𝗔𝗟 𝗠𝗨𝗦𝗖𝗟𝗘 𝗦𝗧𝗜𝗠𝗨𝗟𝗔𝗧𝗜𝗢𝗡 (𝗘𝗠𝗦): 𝗔𝗻 𝗔𝗹𝘁𝗲𝗿𝗻𝗮𝘁𝗶𝘃𝗲 𝗳𝗼𝗿 𝘁𝗵𝗲 𝗜𝗺𝗺𝗼𝗯𝗶𝗹𝗲 ⚡

⬛ For older adults who suffer from severe mobility limitations or cannot engage in traditional exercise, Whole-Body Electrical Muscle Stimulation (WB-EMS) has emerged as a promising alternative.
⬛ EMS artificially induces muscle contractions, mimicking some microscopic cellular responses of exercise.
⬛ Mid-to-long-term use (2 to 6+ months) has been shown to improve isometric leg strength and appendicular skeletal muscle mass.
⬛ However, WB-EMS comes with strict limitations.
⬛ It is contraindicated for individuals with pacemakers, acute illnesses, untreated hypertension, and neurological disorders, and it carries a risk of rhabdomyolysis, a severe muscle-breakdown condition.

𝗧𝗵𝗲 𝗛𝗶𝗱𝗱𝗲𝗻 𝗖𝘂𝗹𝗽𝗿𝗶𝘁: 𝗖𝗵𝗿𝗼𝗻𝗶𝗰 𝗜𝗻𝗳𝗹𝗮𝗺𝗺𝗮𝘁𝗶𝗼𝗻 𝗮𝗻𝗱 𝗢𝗿𝗮𝗹 𝗙𝗿𝗮𝗶𝗹𝘁𝘆 🦷

⬛ One of the most fascinating aspects of the review is the emerging link between chronic, low-grade inflammation (often called "inflammaging") and muscle degradation.
⬛ Persistent systemic inflammation suppresses muscle protein synthesis and promotes muscle atrophy.
⬛ The Periodontitis Connection: Poor oral health directly impacts muscle health.
⬛ Periodontitis (gum disease) triggers systemic inflammation, elevating pro-inflammatory cytokines like IL-6 and TNF-α, which are known to break down muscle proteins.
⬛ Oral Frailty: Conditions like tooth loss, dry mouth, and difficulty chewing drastically reduce a person's ability to consume adequate protein, accelerating muscle loss.
⬛ Furthermore, oral pathogens can swallow into the digestive tract, altering the gut microbiota and causing metabolic dysfunctions that further drive sarcopenia.

𝗞𝗲𝘆 𝗧𝗮𝗸𝗲𝗮𝘄𝗮𝘆𝘀 𝗳𝗼𝗿 𝗦𝗮𝗿𝗰𝗼𝗽𝗲𝗻𝗶𝗮 𝗣𝗿𝗲𝘃𝗲𝗻𝘁𝗶𝗼𝗻 📌

⬛ The management of sarcopenia cannot rely on a single silver bullet.
⬛ A personalized, comprehensive strategy is strictly required to extend the healthy lifespan of older adults.
⬛ Effective prevention should include:
⬛ Consistent Resistance Training, ideally paired with aerobic activities.
⬛ Adequate Nutritional Support, focusing on protein, Vitamin D, and anti-inflammatory nutrients like Omega-3s.
⬛ Prioritizing Oral Health, treating periodontitis early to stop systemic inflammation at its source.
⬛ By combining physical activity, tailored nutrition, and diligent periodontal care, older adults can effectively preserve their muscle function, independence, and overall quality of life.

19/03/2026

Deep Neck–Shoulder Connection: Stability Meets Mobility

This image beautifully captures the intricate relationship between the cervical spine, scapula, and upper limb, highlighting how deep and superficial muscle layers integrate to control both stability and movement.

At the core of this system are the deep cervical muscles (like longus colli and longus capitis), which provide segmental stability to the cervical spine. These muscles act as fine-tuners, maintaining alignment and controlling small movements that protect the spine during dynamic tasks.

Layered over them are the posterior cervical extensors and fascial networks, which contribute to posture and load distribution. These structures connect seamlessly with the thoracic spine and scapular stabilizers, forming a continuous kinetic chain.

The levator scapulae (highlighted running from the cervical spine to the scapula) plays a key role in linking neck position to shoulder mechanics. When the scapula moves, the cervical spine responds—and vice versa. This explains why shoulder dysfunction often presents with neck pain or stiffness.

On the anterior side, muscles such as the scalenes and sternocleidomastoid contribute to both neck movement and breathing mechanics, while also influencing rib positioning and thoracic mobility.

The brachial plexus, passing through this region, further emphasizes the importance of space and coordination. Any imbalance in muscular tension or posture can alter this space, potentially leading to symptoms like radiating pain, tingling, or weakness in the arm.

Biomechanically, this region functions as a force transmission corridor. Loads from the upper limb travel through the scapula into the cervical and thoracic spine, while head and neck positioning directly influence shoulder mechanics and efficiency.

When this system is well-coordinated, it allows for smooth, pain-free movement with optimal load distribution. However, dysfunction—such as forward head posture, scapular instability, or muscle imbalance—can disrupt this harmony, leading to compensatory patterns and overuse injuries.

👉 The neck and shoulder don’t work in isolation—they are part of one integrated system.

13/03/2026

12/03/2026

Resistance training can reduce body fat percentage while simultaneously improving grip strength, representing an effective management strategy for sarcopenic obesity, reports a systematic review and meta-analysis in BMC Geriatrics.

Link in the comments.

08/03/2026

04/03/2026

Animal protein triggers a 47% higher muscle protein synthesis rate after a single meal. That finding is real. It comes from a 2023 study in the Journal of Nutrition.

However, when you extend the measurement window from hours to days. The same lab that produced the 47% figure found zero difference in daily muscle protein synthesis when they measured over 10 days (1.29% vs 1.23% per day, omnivore vs vegan). Two independent groups confirmed it. One found that meal distribution made no difference either: three meals or five, omnivore or vegan, all four groups produced identical results. Another ran a 10-week resistance training trial and measured actual muscle growth at 8.3% in both diet groups.

The per-meal spike is not the variable that predicts muscle gain. Total daily protein intake is. If you are consistently hitting 1.2 to 1.6 grams per kilogram of body weight per day, the source matters far less than most recommendations suggest.

Pinckaers et al., J Nutr, 2023. Domic et al., J Nutr, 2024. Askow et al., Med Sci Sports Exerc, 2025. Monteyne et al., J Nutr, 2023.

03/03/2026

After injury to the brain or spinal cord, ongoing neural signaling is often viewed as a hopeful sign that circuits remain functional. However, emerging findings indicate that excessive activity in the immediate aftermath of trauma can intensify harm, particularly to myelin. Myelin is the protective coating that wraps around nerve fibers and enables rapid, efficient transmission of electrical signals. It plays a central role in movement, thinking, and sensation, and its disruption is a defining feature of conditions such as traumatic brain injury and multiple sclerosis. The study suggests that heightened neuronal firing during the acute phase of injury may aggravate myelin damage before the brain’s repair systems are fully engaged.

The study shows that myelin deterioration does not occur all at once. Instead, the sheath initially swells and becomes distorted, entering a fragile intermediate state rather than immediately breaking down. During this early window, electrical activity within compromised circuits can place additional strain on vulnerable myelin and speed its degeneration. At the same time, injured myelin retains a surprising capacity for structural reorganization, as swollen segments can remodel in ways that help preserve function. These findings highlight the importance of timing: early rest may shield myelin from further damage, whereas carefully reintroduced activity later on could support repair and neural plasticity.

Reference: Nwangwu & Monje, Science (2026) — Neuronal activity exacerbates myelin damage in the acute period after injury.

02/03/2026

Your body may benefit most from consistency (how often you move)

This visual comes from long-term research following people for decades, tracking how different types of physical activity relate to overall lifespan.

What it shows is surprisingly simple:

🟢 Moderate movement matters most
Activities like walking, jogging, climbing stairs, and weight training were consistently linked with lower risk of early death.

🟡 Benefits appear early
Most of the longevity gain showed up at low to moderate activity levels. After that, the curve flattened. More wasn’t always better.

🔵 Variety helps
People who engaged in multiple types of movement over time tended to do better than those who stuck to just one.

This is observational data
It doesn’t prove cause and effect, but it reveals strong, long-term patterns across large populations.

Han et al. Physical activity types, variety, and mortality. BMJ Medicine, 2026.

01/03/2026

01/03/2026

𝗔𝘀𝘀𝗲𝘀𝘀𝗺𝗲𝗻𝘁 𝗼𝗳 𝗥𝗼𝘁𝗮𝘁𝗼𝗿 𝗖𝘂𝗳𝗳 𝗘𝘅𝘁𝗲𝗿𝗻𝗮𝗹 𝗥𝗼𝘁𝗮𝘁𝗶𝗼𝗻 𝗦𝘁𝗿𝗲𝗻𝗴𝘁𝗵 💪

Adequate strength of the shoulder external rotators is widely recognized as a cornerstone of both upper-limb performance and injury prevention. In overhead sports, the rotator cuff plays a decisive role in stabilizing the glenohumeral joint and dissipating high mechanical loads generated during throwing or serving actions (https://pubmed.ncbi.nlm.nih.gov/26972269/, https://pubmed.ncbi.nlm.nih.gov/23015931/). Deficits in external rotation strength have been linked to a higher risk of shoulder pathologies, including rotator cuff tendinopathy and labral lesions (https://pubmed.ncbi.nlm.nih.gov/20489215/, https://pubmed.ncbi.nlm.nih.gov/34276924/).

Clinicians and sport scientists rely on different testing modalities to quantify this strength. Isokinetic dynamometry is often considered the reference standard, yet its cost and limited accessibility restrict routine use. As a result, handheld dynamometry and repetition-maximum (RM) testing have become practical alternatives (https://pubmed.ncbi.nlm.nih.gov/21570036/). However, whether isometric and isotonic testing modes provide comparable or interchangeable insights into rotator cuff function remains insufficiently explored.

A brand-new study by Maestroni et al. (https://pubmed.ncbi.nlm.nih.gov/41562747/) sought to close this gap by examining the reliability and relationships of commonly used shoulder external rotation strength tests.

📋Methods

Thirty-eight healthy adults (19 females; 19 males; 25.7 ± 6.0 years) completed three strength assessments: Prone isometric, Standing isometric, and Seated isotonic 5-repetition maximum (5RM) external rotation (“the P**n Star” 😂”, picture below ). Reliability, inter-test associations, and the effects of s*x and limb dominance were analyzed.

📊 Results

✅ All tests demonstrated excellent intra-session reliability. Limb dominance did not affect performance. Males showed higher strength in isometric tests, whereas isotonic 5RM values did not differ between s*xes.

✅ Importantly, the study provides 𝗻𝗼𝘃𝗲𝗹 𝗿𝗲𝗳𝗲𝗿𝗲𝗻𝗰𝗲 𝘃𝗮𝗹𝘂𝗲𝘀 for isotonic shoulder ER strength: relative “P**n Star” 5RM performance averaged ~0.10 ± 0.03 𝗸𝗴/𝗸𝗴 𝗯𝗼𝗱𝘆 𝗺𝗮𝘀𝘀 for both dominant and non-dominant limbs in healthy young adults. Thus, an 80-kg individual would be expected to achieve a Seated 5RM external rotation load of around 8 kg, with a plausible range (considering ±0.03 kg/kg SD) of roughly 5.6–10.4 kg.

✅Isometric tests correlated only moderately, and Prone isometric strength explained just over 50% of the variance in isotonic performance.

💡 Conclusion

While both testing modes are highly reliable, they assess distinct strength qualities. Isometric tests reflect angle-specific force, whereas isotonic 5RM testing captures dynamic strength across the full range of motion. Integrating both approaches may therefore provide a more complete evaluation of rotator cuff function

📷 Picture 1: The Seated 5RM shoulder external rotation test (“P**n Star”) was performed with the subject sitting on a flat bench while holding a dumbbell. One foot was placed on the bench with the knee bent to support the testing arm, and the elbow rested on this knee. Knee height was adjusted to set the shoulder at the required abduction angle, while the elbow remained flexed at 90 degrees and the trunk stayed upright. An iPhone with a goniometer app was attached to the forearm to ensure that the full rotational range of motion was used during each repetition. Subjects were instructed to rotate as fast and forcefully as possible through the concentric phase and control the movement eccentrically, reaching full internal and external rotation each time. The load was progressively increased until a 5-repetition maximum was reached within two to four attempts, with three to five minutes of rest between sets. A second 5RM trial was then completed, and the final score was calculated as the average of the two trials, normalized to body weight, for statistical analysis.

⭕Limitations: Data limited to young, health adults from different sports; only intra-session reliability was assessed, and inter-session reliability remains untested.

24/02/2026

Research into alcohol’s impact on brain health suggests that drinking alcohol is not just a lifestyle choice but may influence the risk of Alzheimer’s disease and dementia over time. Studies using animal models of Alzheimer’s like pathology have shown that even moderate alcohol consumption can accelerate brain cell loss and increase the buildup of amyloid plaques, which are toxic protein deposits associated with Alzheimer’s related neurodegeneration. These experimental findings imply that alcohol might push the brain toward damaging changes earlier than it otherwise would.

Human population studies have also found links between alcohol intake and brain damage markers linked with dementia. For example, people who consumed eight or more alcoholic drinks per week showed higher odds of vascular brain lesions and tau tangles, both of which are associated with memory decline and cognitive impairment. Former heavy drinkers also exhibited signs of brain injury long after stopping regular alcohol use, and some groups showed reduced brain mass and poorer thinking skills.

The relationship between alcohol and Alzheimer’s risk is complex. Some research has noted that very low or moderate consumption may relate differently to dementia risk, while other studies highlight that even moderate drinking could accelerate harmful processes if underlying pathology exists. What is clear from current evidence is that alcohol influences the brain through inflammation, oxidative stress, vascular damage, and disruptions to protein clearance, all of which can make the brain more vulnerable to Alzheimer’s related damage.

Research Paper 📄
DOI: 10.1016/j.nbd.2022.105967