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Nutrition Science, Part IV – Moving Forward: Improving the approach

It is important to note that the assumptions discussed in the last article are not arbitrary to the biomedical model, but legitimized through common sense in the context of a given research topic (32). A common-sense approach to nutrition, therefore, is one which can legitimize a modified approach to scientific inquiry into diet-disease relationships. Although …

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Nutrition Science, Part III – The Awkward Fit: RCTs and Nutrition ScienceNutrition Science, Part III – The Awkward Fit: RCTs and Nutrition Science

Nutrition Science, Part III – The Awkward Fit: RCTs and Nutrition Science

In the second part of this article series we discussed the utility, limitations, and misconceptions related to the prospective cohort design for nutrition science. As discussed in part I, the reductionist biomedical model and its gold standard randomized controlled trial (RCT) is ill-equipped for studying complex dietary patterns in a way that can effectively inform …

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Shoulder, Part IV: The Rotator Cuff Teardown

Shoulder, Part IV: The Rotator Cuff Teardown

The “rotator cuff” is a set of four muscles around the glenohumeral joint including the supraspinatus, infraspinatus, subscapularis, and teres minor (see figure). These muscles all originate from the scapula, insert at various points on the humerus, and serve multiple coordinated functions including abduction, adduction internal rotation, external rotation, and stabilization. Each muscle is considered …

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Nutrition Science, Part II: The Prospective Cohort Design

Nutrition Science, Part II: The Prospective Cohort Design

In the first article in this series we discussed the history of nutrition science and traced its evolution alongside the biomedical model. We also introduced the discussion of nutritional epidemiology in comparison to the “gold standard” biomedical trial design: the randomized controlled trial. In this second article, we’ll discuss the utility, limitations, and misunderstandings about …

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Nutrition Science, Part I: How Did We Get Here?

Nutrition Science, Part I: How Did We Get Here?

To anyone versed in biomedicine, the so-called “hierarchy of evidence” is well-established and unquestioned. The randomized , double-blind, placebo-controlled trial (RCT) is considered the gold standard trial design, because it offers the ability to randomly allocate a treatment, minimize potential sources of bias, and compare the exposure or intervention of interest to a placebo. There is …

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The Shoulder, Part III: Internal Impingement

The Shoulder, Part III: Internal Impingement

In part 2 of our shoulder series we discussed the topic of “shoulder impingement”, which is commonly understood as the mechanical compression of the tissues beneath the acromion process, resulting in pain or dysfunction — better known as external impingement. We described the biomechanical theory behind this diagnosis, and examined the available research evidence on …

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The Shoulder, Part II: External Impingement

In the first article of this series we discussed the concept of “normal” or “abnormal” scapular movement (i.e., scapular dyskinesis), which is the pathomechanical foundation upon which other shoulder-related diagnoses and narratives are built. “Shoulder impingement” is one of these ideas that is commonly discussed in the coaching, rehab, and orthopedic worlds. The narrative describes …

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Navigating Potholes: My Back Pain Experience

The Shoulder, Part I: Scapular Dyskinesis

The shoulder joint is complex, and pain affecting its use in daily activities and sport is common. This article series will review common shoulder diagnoses, critically assess the associated narratives provided to patients, and describe their impact on real-world outcomes. We will begin with the assessment of the scapula and its movement. The interaction between …

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