September 2026
September 2026How Exercise Improves Cognitive Function
The pot of gold at the end of the rainbow or the Holy Grail of fitness in older age is the maintenance of independence, especially of cognitive function. Many studies have demonstrated the benefits of exercise with regard to fall prevention, metabolic and cardiovascular health, and physical function via physiological and mechanical improvements. Likewise, many studies have shown brain and cognitive improvements that relate to cardiovascular improvements but the deeper question of how movement itself works on the brain remains unanswered.
Despite decades of studies showing that a single bout of exercise improves cognitive function, the exact brain pathways are still a mystery.
A review of the literature confirmed that “acute exercise triggers the release of dopamine in the living human brain, and that this release directly correlates with improved cognitive performance.” The authors propose that changes in brain chemical signaling (neuromodulation) drives these benefits. To separate the role of intentional, brain-driven activity from its benefits, they tested movements of muscles activated by electrical stimulation (ES), bypassing the brain sending the signals to contract.
They found that peripheral activation via ES did not “induce substantial cognitive improvements when compared to voluntary [brain-induced] exercise”.
This suggested that neural activity that instigates voluntary exercise is “critical for enhancing neuromodulation.”
Translation: it is muscle action produced by intentional cognitive signaling that then stimulate brain changes associated with improved cognitive function. Or, to put it bluntly, making your body move makes your brain improve.
ACSM Sports Medicine Bulletin, July 2026
Ankle Sprains Last Forever Unless…
Ankle sprains (AS) come in three types: lateral (outer), medial (inner), and rarely high (top) sides. Without going into the causes of each, other than to say that all sprains involve the ligaments being stretched or torn, the lateral, which is the most common, entails twisting the ankle inward beyond what the ligaments can support. If inadequately treated, this can lead to chronic ankle instability (CAI) which, over time and with continued abuse, can lead to osteoarthritis (OA) which may require a total replacement in the future.
A meta-analysis “explore[d] the pathological changes in anatomical structure and signaling pathways in AS” to better understand the “molecular mechanisms driving poor rehabilitation outcomes”.
Twenty references were evaluated. Ultimately, “transforming growth factor beta-1 drives fibrosis [leading to] collagen overproduction, exacerbating ligament stiffness; [a gene] dysfunction impairs mechanosensation, contributing to proprioceptive [sensory] deficits in CAI; and [other molecular activations] perpetuate inflammation and extracellular matrix degradation. Additionally, dysregulated apoptotic pathways further compromise ligament and cartilage integrity.”
All that to say, the stiffening of ligaments after injury persists such that it reduces their capacity to help control the foot and ankle’s ability to control balance and stability.
Too, the compromised ligament and cartilage integrity will persist unless exercise and “mechanoimmunom-odulatory therapies…break the cycle of instability and degeneration.”
It’s not just a twisted ankle; it’s a permanent condition unless managed properly.
Bone Joint Res, Apr. 2026
Tid Bits
Shoulder pain really hurts and the prospect of doing resistance training to help restore function is, for some, frightening. The fear can lead to catastrophizing – fear that something is going to make it worse even before engaging in that something. A recent study of those with shoulder pain doing physical therapy for 8 weeks found that “pain-related fear and catastrophizing changed over time” such that those who were satisfied with their therapy had reduced fear and catastroph-izing which was “related to decreased disability.” JOSPT Aug. 2026
After a knee or hip replacement, pharmaceutical therapies are prescribed to minimize blood clots that could lead to deep-vein thrombosis or the more dangerous pulmonary (lung) embolism. Most surgeons now prescribe rivaroxaban (Xarelto: a blood thinner) for +/-5 days and then a baby aspirin for 9 additional days for knees and up to 30 days for hips. 5429 patients were randomly divided into a combo (Comb) and aspirin only (Asp) group for 3 months post surgery for major and non-major bleeding events. It turns out that aspirin-only worked as well as the combo therapy and is cheaper. NEJM July 2026
Body composition is a term applied to the relative distribution of fat to lean body mass (muscle, bone, organs, blood.) Body recomposition (BR) refers to lifestyle changes designed to increase muscle mass or lose fat mass. But those two goals require opposite nutritional strategies: increased calories vs decreased calories. A narrative review found that BR is possible but the “strategies were mixed, results were inconsistent, and populations [of the studies] varied widely.” In general, a “caloric surplus appears essential, whereas a deficit, although effective at reducing body weight and fat mass, tends to result in a loss of fat-free mass.” What was found to be “crucial” was to maintain high protein intake (>1.6 g/kg/day) to support the benefits of resistance training: building muscle. Strength & Conditioning J, June 2026
