|
PerspectiveBased on Science, Built on Trust
|
|
Prairie Doc Perspective Week of August 24th, 2025
Peripheral Artery Screening: A Lifesaving Check-Up for Your Circulation By Adam Ladwig, Ph.D., DPT and Jed Droge, DPT While you’ve likely had your blood pressure checked in your arm countless times, you may have never had it measured in your leg. Yet this simple and often overlooked screening can be critical for detecting restricted blood flow. If left untreated, inadequate blood flow could lead to serious complications including limb loss, disability or even death. Many people are unaware of a common and serious condition known as peripheral artery disease (PAD). PAD occurs when the arteries in your legs become narrowed or blocked due to plaque buildup, reducing blood flow to your lower limbs. This condition affects over 8 million Americans and is especially common in those over 60 or with a history of smoking, diabetes or heart disease. PAD doesn’t always come with obvious symptoms, but when it does, they may include leg pain or cramping during walking (called claudication), numbness, cold feet or wounds on the legs or feet that are slow to heal. Unfortunately, because these symptoms can be subtle or mistaken for other issues like arthritis or aging, PAD is often overlooked, until it leads to serious complications like infections, non-healing wounds or even amputation. PAD can be detected easily and painlessly with a simple screening called the ankle-brachial index (ABI). Although traditionally completed with a Doppler ultrasound, screening can be completed with an automatic blood pressure cuff. The ABI test compares the systolic blood pressure (the first number) in your ankle to the blood pressure in your arm. The whole process takes only a few minutes and can help identify if blood is not flowing properly to your legs. Health care providers, including physical therapists, are trained to help identify conditions like PAD early. If we detect signs of reduced circulation through an ABI screening, we’ll refer you to a medical provider for further evaluation. If PAD is diagnosed, treatment often begins with lifestyle changes like quitting smoking, increasing physical activity (especially walking) and managing other health conditions such as high blood pressure or diabetes. Physical therapy can play a key role in treatment. One of the most effective approaches is supervised exercise therapy, which has been shown to improve walking distance, reduce symptoms and enhance overall cardiovascular health. In a supervised setting, physical therapists guide patients through structured walking programs, gradually improving circulation and tolerance to activity in a safe, monitored environment. In some cases, medications or procedures may be needed to improve blood flow. Screening for PAD is especially important because many people don’t know they have it until it's advanced. Early detection can prevent serious outcomes and allow you to keep moving and living independently. If you're over 60, have diabetes, smoke or have a family history of cardiovascular disease, consider asking your health care provider or physical therapist about ABI screening. It's quick, non-invasive and could make a life-saving difference. Your legs have something important to tell you. Make sure you're listening. Adam Ladwig, Ph.D., DPT, is an associate professor at the University of South Dakota where he teaches cardiovascular and pulmonary physical therapy as well as differential diagnosis. He has 13 years’ experience as a clinician and maintains practice in rural South Dakota. Jed Droge, DPT, is an assistant professor at the University of South Dakota, where he teaches a variety of subjects, including differential diagnosis, to entry-level physical therapy students. He has 15 years’ experience as a clinician, primarily in rural Nebraska. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm streaming on Facebook), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust Prairie Doc Perspective Week of August 17th, 2025
“Why Pelvic Health Matters: More Than Just Kegels” By Dr. Patti Berg-Poppe and Dr. Staci Wietfeld In our research and clinical practice experiences, a common theme emerges from people living with pelvic floor issues -- “I wish someone had told me about this sooner.” Through interviews and conversations, we’ve documented the stories of individuals who didn’t know what questions to ask, didn’t realize their symptoms were treatable, and often assumed they were alone. In her practice, Staci sees these realities unfold in the clinic every day, as both male and female patients arrive with frustration, confusion and a long history of being told that their concerns are normal, inevitable or simply something to live with. Pelvic floor disorders such as urinary incontinence, constipation, pelvic pressure, pain with intercourse and pelvic floor dyssynergia (poor coordination) are more common than most people realize. These symptoms affect millions of adults. Nearly one in four women and one in eight men in the U.S. will experience some form of pelvic floor dysfunction in their lifetime. Yet these issues are often dismissed, hidden or normalized. Although not uncommon, we want to emphasize that dysfunction in the system is not normal. It is treatable. Conversations around pelvic health often begin only after childbirth, surgery or the slow accumulation of symptoms that have significantly affected quality of life. By that point, the affected person is often dealing not only with physical discomfort, but with years of self-doubt or embarrassment. The pelvic floor is a group of muscles that sits at the base of the pelvis. These muscles are responsible for more than most people are ever taught. In both men and women, the pelvic floor supports the bladder, bowel, abdominal and reproductive organs. It helps control continence, allows for sexual function, and plays a role in basic breathing, posture and core stability. Despite all of this, most people grow up never learning about their pelvic floor, how it functions, or how to care for it. This lack of awareness isn’t just a missed opportunity for treatment; it’s a missed opportunity for prevention. Every human has a pelvic floor. Pelvic health should be part of basic health education, not a niche topic reserved for specialists. Young people deserve to understand how their bodies work, and that includes the pelvic floor. Learning about healthy habits, such as avoiding excessive straining, practicing coordinated breathing during physical exertion, and developing strength, coordination and flexibility throughout the hips and core, can make a meaningful difference later in life. And for those planning for pregnancy, knowledge of pelvic floor function before and during pregnancy can support smoother recovery and reduce complications down the line. Gaining understanding of how the pelvic systems change with age, after surgery, or with the hormone changes of peri- and post-menopause also offers people a chance to create change and retain optimal function. Kegels are often the only pelvic health advice people hear, but the solution is rarely that simple. Some individuals need strengthening; others need help learning to relax and coordinate pelvic floor muscles properly. Pelvic health is not a “one-size-fits-all” issue, and that’s why education before symptoms emerge is so important. When problems do arise, they’re worth bringing up. Leakage, pressure and pain are common, but they’re not normal or untreatable at any age. Pelvic health physical therapists and other providers trained in this area can offer effective, individualized care. But even better is helping people know enough to ask questions earlier, build healthy habits sooner and prevent dysfunction before it starts. Pelvic health matters. And the earlier we begin talking about it, the better. Patti Berg-Poppe is a professor and chair of the Department of Physical Therapy at the University of South Dakota. Her research focuses on pelvic health, including postpartum recovery and pediatric pelvic floor dysfunction, as well as motor control and learning in special populations. She has led interdisciplinary studies on the effects of intrapartum pelvic trauma on sexual function, return to participation and family well-being and has published on exercise interventions for conditions like diastasis recti and dysfunctional voiding in children. Staci Wietfeld is a board-certified orthopedic clinical specialist and certified pelvic rehabilitation practitioner. She specializes in treating complex musculoskeletal conditions and pelvic floor dysfunction, integrating advanced manual therapy and patient education to promote recovery and well-being. In addition to her clinical practice with Avera Health Systems in Sioux Falls, South Dakota, she contributes to research and public education on pelvic health and physical therapy. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust Prairie Doc Perspective Week of August 10th, 2025
Running and Knee Pain: Debunking the Myths with Science By Matt Dewald, PT, DPT You’ve likely heard -- maybe even from a medical professional -- that “running is bad for your knees.” But robust scientific evidence, including X-rays, MRIs, population surveys and long-term data, tells a different story: recreational running doesn’t increase the risk of hip or knee osteoarthritis (OA). In fact, it may reduce it. Debunking the Arthritis Myth Despite popular belief, running isn’t a cause of OA. A 2017 meta-analysis in the Journal of Sports and Orthopaedic Physical Therapy found lower OA rates among recreational runners compared to sedentary individuals. More recently, Hartwell et al. (2024) surveyed 3,804 marathon runners and found no increased OA rates, even among those with decades of high-mileage training. Impressively, 94% reported no diagnosis of hip or knee OA, and many with more years and higher mileage reported less joint pain overall. The Osteoarthritis Initiative, a longitudinal study of nearly 4,800 individuals over eight years, adds further support. Runners showed no structural progression or narrowing in joint imaging, even among those with pre-existing OA. Interestingly, runners who continued to run were more likely to experience resolution of knee pain than those who didn’t. The Role of Metabolism in Joint Degeneration OA is increasingly understood as a metabolic condition rather than a wear-and-tear issue. Risk factors like obesity, high blood pressure, elevated cholesterol and insulin resistance, which are components of metabolic syndrome, can accelerate cartilage breakdown and raise the likelihood of requiring total knee arthroplasty (TKA). A large Norwegian cohort study (HUNT data) linked to the Arthroplasty Register found those with metabolic syndrome were significantly more likely to undergo TKA, even when adjusting for lifestyle factors. Similarly, a 2025 case-control study found that 68% of OA patients who had TKA met criteria for metabolic syndrome -- nearly double the rate of those who avoided surgery. Why Running Helps Recreational running addresses key metabolic stressors that contribute to OA. It reduces body fat and inflammation by lowering levels of harmful adipokines, which are hormones released by fat cells that promote cartilage damage. Running also boosts insulin sensitivity and helps regulate blood sugar, reducing the low-grade inflammation associated with metabolic syndrome. From a mechanical perspective, running supports joint integrity. Cartilage thrives on cyclical loading, and running supplies the ideal stimulus to help it stay nourished. Maintaining a healthy weight is also crucial; every extra pound of body weight adds roughly four pounds of compressive force to the knee with each step. Strengthening muscles and building bone density through running improves joint stability, reducing the risk of deterioration. Smart Training = Injury Prevention Running injuries are more often linked to training mistakes than to running itself. Sudden mileage increases, lack of strength support or ignoring warning signs are common culprits. To minimize risk:
Bottom Line Far from being a joint hazard, running can be a powerful protector, especially for those managing metabolic risk factors. It strengthens supportive structures, counters inflammation and may delay or prevent OA and even TKA. With thoughtful training, running can help preserve joint health for decades to come. Matt Dewald is a physical therapist who holds a position as an associate professor in the University of South Dakota’s Department of Physical Therapy. He also serves as director of the Sanford Health and USD Sports Physical Therapy Residency, where he treats runners. His research focuses on running injuries, and he serves as education chair of the Running Special Interest Group within the American Academy of Sports Physical Therapy. A dedicated runner himself, Matt starts most mornings on the move outdoors. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust. Prairie Doc Perspective Week of August 3rd, 2025
Breaking the Silence: Ending the Stigma Around Addiction and Mental Health By Dr. Melissa Dittberner In South Dakota and across the whole United States, addiction and mental health struggles touch every community. Yet far too often, people suffer in silence—not because help isn’t available, but because stigma keeps them from reaching for it. Stigma shows up in many forms. It’s the harmful comments we hear about people who use substances. It’s the judgment directed at those struggling with depression, anxiety or trauma. It’s even the quiet self-blame people carry, believing they should be able to “snap out of it” or that asking for help makes them weak. Social stigma is deeply embedded in our systems and culture. It can show up in the way medical professionals talk about patients, in media portrayals that dehumanize or in policies that punish rather than support. When people internalize these messages, they may avoid seeking care altogether—also known as label avoidance. They fear being labeled as “addicts” or “crazy,” and would rather struggle alone than face the shame and judgment that too often follows disclosure. This silence can be and is deadly. Addiction is a treatable health condition. Mental health challenges are human, not moral failings. But when stigma gets in the way, it cuts people off from connection, care and healing. So how do we fight it? We lead with compassion. We create spaces where people are met with dignity, not dismissal. We challenge our own biases and educate ourselves on the realities of addiction and mental health. We tell the truth: recovery is possible, and people are so much more than their struggles. At the University of South Dakota, the Department of Addiction Counseling & Prevention is committed to changing the narrative. Our students and faculty work to educate, advocate and care for people across the region—whether in treatment settings, prevention programs or community outreach efforts. To help make that shift, faculty members in the department are using a grant to provide prevention, harm reduction, treatment and recovery services for those individuals with substance use disorders who are involved with the courts. The $2 million grant will integrate:
Ending stigma won’t happen overnight, but it starts with all of us. We can speak up when we hear harmful language. We can be a listening ear. We can make room for people to show up exactly as they are—and meet them with respect. Let’s be a community where no one has to hide their pain. Let’s create a South Dakota where people feel safe to heal. Melissa Dittberner, or “Dr. Mo” as she is known to her students, is a professor in the Addiction Counseling & Prevention Department at the University of South Dakota. She has a Ph.D. in counseling and psychology in education, master’s degree in addiction studies and a bachelor’s degree in health sciences. She does research on college students’ substance use, pedagogy, addiction and harm reduction. Not only is she very passionate about drug and alcohol prevention, helping skills and Telehealth technology, she has also worked on many grants surrounding substance use disorders. Dr. Mo is also a certified prevention specialist. In addition to her work at USD, she’s also worked with communities across the state to create addiction prevention programs like Straight Up Care Telehealth and Midwest Street Medicine. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust. |
Archives
February 2026
Categories |
RSS Feed
