|
PerspectiveBased on Science, Built on Trust
|
|
Prairie Doc Perspective Week of October 5th, 2025
“From Maiden to Mother to Matriarch: Understanding the Transition of Perimenopause” By Jill Kruse, DO Women experience distinct stages throughout their lives. In literature, these are often described as the maiden, the mother, and the matriarch phases. The transitions between these phases can be challenging times for a woman. Perimenopause is the transition between mother to matriarch. The prefix peri- means around, about or near, and menopause is defined as the point when a woman has not had a menstrual period for 12 consecutive months. The average age of menopause is 51 years old. Perimenopause typically starts for women in their 40s and lasts between four to ten years. In some cases, it can start as early as 30s or as late as 50s. During perimenopause, the ovaries start producing fewer hormones. Estrogen and progesterone levels can vary significantly week to week leading to the symptoms associated with perimenopause. Because of these hormonal shifts, lab tests for hormone levels can be unreliable for diagnosis. Elevated Follicle Stimulating Hormone (FSH) and low Estradiol levels in a woman over the age of 45 can suggest menopause, although repeated testing is usually needed to confirm a diagnosis. Thyroid Stimulating Hormone (TSH) is often checked in women, since low TSH can mimic perimenopause or menopause symptoms. One of the first perimenopause symptoms many women experience is menstrual cycle changes. Menstrual cycles may become more irregular, longer, shorter, heavier or lighter. Hormonal changes can also lead to hot flashes, night sweats, vaginal dryness, sleep problems, mood changes, and ‘brain fog’. Slower metabolism during perimenopause can also lead to weight gain in some women. While perimenopause is a natural part of aging, there are lifestyle changes and medications that can help minimize its symptoms. Limiting alcohol and caffeine, improving sleep quality, and reducing stress can all help diminish hot flashes. Doing more weight bearing exercises and taking a Calcium with Vitamin D supplement can help reduce the increased risk of osteoporosis and heart disease, which is caused by the decrease in estrogen. Quitting smoking is also an important step to help minimize symptoms of perimenopause and menopause. Discussing with your physician can help you find one of the multiple prescription medications that are available to help reduce symptoms. Although this transition from mother to matriarch is not always smooth or easy, knowing what to expect can help alleviate anxiety and fear. Making healthy lifestyle choices and maintaining regular doctor visits are key. If you are experiencing symptoms, speak with your doctor about possible treatments and how to best support your well-being through this important life phase. Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm). Prairie Doc Perspective Week of September 28th, 2025
Beyond the Baseline: Understanding Tennis Elbow By. Andrew Ellsworth, MD A few years ago, I was helping with my son’s baseball team. One day, for a routine practice, my role was to hit fly balls for the boys to catch. While I was confident at hitting fly balls, to make things easier for me, I was handed a racquet that, with a fairly easy swing, would launch the baseballs out to the boys. However, after 20 minutes, my elbow was getting sore. More groups of boys needed to rotate through and catch fly balls, so I kept at it. I swung the racquet and the baseballs flew to the outfield over and over. In the end, after less than an hour, my elbow was shot. I was experiencing lateral epicondylitis, or tennis elbow. It hurt on the lateral, or outside, part of my elbow, and while it did not hurt that bad, it was almost debilitating for certain movements. I took some ibuprofen, avoided certain activities, and needed to give it time to heal. Lateral epicondylitis, which now could also be called “pickleball elbow” with the big increase in pickleball players, is an over-use injury of the tendons at the elbow. Caused by any repetitive use of the forearm muscles, microscopic tears can form which cause pain at the insertion where the tendons attach to the bone at the elbow, known as the lateral epicondyle. The cause is not just limited to sporting activities. Manual laborers, painters, gardeners pulling weeds, musicians, and anyone doing an activity repetitively and more than their body is used to doing, can be susceptible to this injury. Golfers can experience a similar injury, but one that affects the inside part of the elbow, causing medial epicondylitis. One of the keys to recovery is paying attention to your body and avoiding activities that cause the pain. Pushing through may make it worse and make recovery last longer. Non-steroidal anti-inflammatories such as ibuprofen may help with the pain, as well as icing, stretches, and physical therapy. Some people may find benefit from using a brace wrapped around the forearm muscles, taking pressure off of the tendons. Rarely, steroid injections or an injection of plasma-rich protein may be used, although these are not without some risk. Other treatments can also include ultrasound and shock wave therapy. Thankfully, most cases will subside on their own with time. However, it can take a lot of time, oftentimes several months and possibly up to two years. In very rare cases, surgery to remove damaged tissue may be an option. In my case, the pesky elbow pain lingered for at least six months. This was all because of less than an hour of using a racquet that I refuse to ever use again. I am happy to hit fly balls and I still do, but give me the baseball bat, please. Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm). Prairie Doc Perspective Week of September 21st, 2025
Exercise and Arthritis: What Really Works By Becca Jordre, Ph.D., DPT If your joints ache after sitting too long or make crackling sounds when you get up, you’re not alone. More than half of older adults in the U.S. report having at least one arthritic joint, and while our understanding has improved over the past two decades, old myths still create confusion about how best to manage it. Is Exercise Safe? Many people fear that too much movement or vigorous exercise will wear out their joints and make arthritis worse. The surprising truth is that exercise is one of the most powerful ways to protect and even improve the health of cartilage. How it Works Cartilage, the smooth tissue that cushions our joints, doesn’t have a blood supply of its own. Instead, it depends on the surrounding fluid in the joint space. Movement acts like a pump: when cartilage is compressed and released, it pushes out waste and pulls in fresh fluid and nutrients. This happens each time you take a step, bend or jump. Think of it as CPR for your joints, compression and decompression pump fluid in and out, keeping cartilage alive and well. When Exercise Hurts For many, pain with certain movements is common, and pushing through pain can make things worse. “No pain, no gain” is not the answer. The key is to find activities that don’t hurt. Even small pain-free movements make a difference. Anything is better than nothing, and over time, those movements can pay off by allowing greater mobility with less pain. The Power of Water For many people with significant arthritis, water-based exercise is a game-changer. Water supports body weight, reducing pressure on joints, easing swelling and providing natural resistance for strength training. Great options include water aerobics or simply walking, running and jumping while in chest-deep water. Strength is Key Another key to managing joint health and improving function with arthritis is strength training. When muscles around the joint are strengthened, they act like shock absorbers and reduce joint stress. Resistance training can start with simple tools like exercise bands or body weight. Small resistance movements can gradually progress to larger, more challenging exercises as strength improves and pain decreases. Yes, arthritis is a pain - but avoiding movement only makes it worse. Find pain-free ways to move and build strength. Start small, stay consistent and your joints will thank you. Becca Jordre, Ph.D., DPT, is a professor of physical therapy at the University of South Dakota, board certified in geriatric physical therapy, and a certified exercise expert for aging adults. Her research centers on healthy aging, with a particular focus on athletes age 50 and older. She collaborates regularly with the National Senior Games Association and developed the Sustained Athlete Fitness Exam (SAFE), a tool designed to assess physical fitness in older athletes. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm). Prairie Doc Perspective Week of September 14th, 2025
“On the Spectrum” By Debra Johnston, MD I had a friend in high school who was generally considered a bit odd. He didn’t dress quite right, never knew how to “read the room,” and often talked far too long and in far to much detail about computers— at a time when very few households even had one. The movie Rain Man, in which an autistic character is abducted from an institution by his greedy younger brother, had yet to be released, and certainly no one in my circle was familiar with autism. Once we were, it was Dustin Hoffman’s portrayal of Raymond Babbitt that defined our understanding. For decades, this was the dominant image, even while the diagnostic criteria expanded to include people with less dramatic challenges. Today, I suspect my friend would have been recognized as being “on the spectrum.” Autism is an ancient condition. Some researchers suspect it explains stories about changelings, fey creatures swapped for humans. While most individuals with classic autism have disappeared from the historical record, and certainly, given that it wasn’t until the DSMIII was published in 1980 that autism was defined as a distinct condition, we can only speculate about historical figures. Nevertheless, many of our greatest thinkers and innovators may have been “on the spectrum.” Michelangelo, DaVinci, Newton, Einstein, Orwell, Twain. . . the list goes on. Sia, Bella Ramsey, Dan Ackroyd, Anthony Hopkins, and of course Elon Musk have all publicly disclosed their diagnoses. People with autism spectrum disorders are unique human beings, in the same way we are all unique. The condition may present very differently between one person and another. That can make it challenging, for families, schools, clinicians, and of course for the individual themselves! The support that is critical for one person may be utterly useless for another, but research consistently shows that the right support at the right time can help someone succeed, academically, and socially. Of course this is true for us all, but since the challenges faced by people with autism are by definition greater, the need is greater. Autism is often accompanied by other conditions, such as ADHD, OCD, epilepsy, and allergies, and well recognized genetic disorders such as Down syndrome. This merely adds to the diversity of the autism experience, and further demonstrates why there isn’t a single “box” into which people with autism can be sorted. My high school friend? Well, we’ve lost touch over the years, but I know he followed his passion for computers and is very successful in his field. I hope he is surrounded by people who appreciate him for who he is. Dr. Debra Johnston is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm). Prairie Doc Perspective Week of September 7th, 2025
“What Questions Do You Have?” By Dr. Jill Kruse We have all heard it before. Before the end of the visit, the doctor will usually ask, “Do you have any questions?” That is usually the precise moment that my mind goes completely blank. Every question I can think of seems silly or embarrassing. I know the doctor is busy so I don’t want to “bother” him/her by taking up too much of their time. I really do not want to look stupid or ignorant. So, I say nothing, smile and the doctor leaves the room shortly afterwards. As soon as that door closes, the flood gates open and all the questions I should have asked bubble to the surface. Now it feels too late to ask them. Sound familiar? As we begin our next season of On Call with the Prairie Doc, I encourage all our viewers to come to us with those questions. This show is unique because we ask our audience to engage with the show. We do not want you to just be passive consumers of the knowledge. We want you to be co-creators of the show with us. While we will never replace your primary care physician, we want to answer the questions that you did ask during your last clinic visit. Since you can submit questions anonymously, ask that question you were too embarrassed to ask. Use this show to fact check that health information you saw on social media or heard someone talk about at the local café. We work hard to find the local experts for each show who can share with us their expertise. At the end of each season, we review our shows and look at what questions were asked. We see how many questions were answered for each show and what topics resonated the most with our viewers. We try to determine what topics you want to hear more about. We also look for emerging topics so you have up to date health information that is based in science and built on trust. The hardest part of planning this show is narrowing down all the topics we want to discuss with you to fit within our season. This is why we will have several “Ask Anything” shows each season. These shows ensure that you, our viewers, will always have a show where any question not only welcomed, but encouraged. The beautiful part of our show is that each show is fluid and we can pivot our focus based on the information you want most. The more you interact with this show, the better it will become. After twenty-four seasons we have yet to run out of questions to answer. This week and every week to follow, please ask anything. We will be here to answer. Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm). Prairie Doc Perspective Week of August 31st, 2025
Nurturing Active Childhoods in a High-Tech World By Dr. Patti Berg-Poppe and Dr. Hsin-yi “Tanya” Liu Long before children say their first words or pick up a pencil, they’re learning through their bodies. They kick, reach, roll, crawl and explore - hardwired to interact with the world through movement. From the very beginning, motor and sensory experiences are how babies discover their environment and how their brains begin to grow and organize. Simply put, our bodies in motion are the vehicles through which we learn. When children move, their brains light up. Their senses, muscles, emotions and attention systems all come online and begin working together. Through active exploration, children build the foundations of their sensory, perceptual and cognitive systems. Movement and imaginative play stimulate both brain and body, supporting not only strength and coordination but also emotional regulation, adaptive behaviors and social connection. A child building a tower of blocks isn’t just learning fine motor skills; they’re developing attention, problem-solving and perseverance. Free play fosters communication, cooperation and confidence. Movement is how learning begins … and how it continues to unfold. Yet despite all we know about the power of movement, children today grow up in an environment where active play is often displaced by screen time. Screens are nearly unavoidable and are often used to entertain, educate or soothe. For many families, technology helps manage the demands of modern life. But when screen use regularly replaces hands-on, movement-rich experiences, opportunities for growth are lost. A child passively watching a screen misses the sensory variety, trial-and-error learning and face-to-face interaction that come from real-world play. Over time, this shift can influence motor skills, attention, emotional regulation, sleep and readiness to learn, which are essential for thriving in school, relationships and everyday routines. The American Academy of Pediatrics recommends that children under 18 months avoid screen use altogether, and that children ages 2–5 be limited to no more than one hour of high-quality content per day. These guidelines aren't about restriction for its own sake; they reflect what we know about how children learn best - through movement, play and real-world interaction. Movement is also one of the most reliable indicators of healthy development. Nearly 9 out of 10 young children in the U.S. meet national physical activity guidelines. This number drops sharply with age. By 6 to 17 years, only about a quarter of children meet these standards. As screen time increases and free time shrinks, children’s need for movement can quietly go unmet. This steady trend of rising screen use and declining physical activity doesn’t mean we need to eliminate technology. Rather, we need to be more intentional about preserving time for play. Supporting active childhoods means prioritizing daily opportunities for whole-body movement, open-ended exploration and connection. That might look like a walk after dinner, dancing in the kitchen, building a blanket fort or inviting your child to help prepare a meal. As pediatric physical therapists, educators and parents, we see the impact of movement every day. Children don’t need expensive equipment or curated experiences. They need time, space and encouragement to move through their world and learn as they go. Fostering imagination, exploration and meaningful interactions with peers and caring adults helps children grow into strong, curious and resilient individuals. For guidance on creating a balanced media plan, visit: https://www.healthychildren.org/English/media/Pages/hhh.aspx Patti Berg-Poppe is a physical therapist and professor and chair of USD’s Department of Physical Therapy, where she also directs the Program for Advancing Early Childhood Intervention (PACE-i). She has extensive experience in pediatric physical therapy and early intervention, with a focus on preparing future professionals to support development through play, movement and family-centered care. Hsin-yi “Tanya” Liu is a pediatric physical therapist and researcher with expertise in early childhood development, mobility and assistive technology. She has practiced in both Taiwan and the United States and currently serves as assistant professor within USD’s Department of Physical Therapy. Her work focuses on how play, movement and adaptive tools support motor and social development in children. 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 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. Prairie Doc Perspective Week of July 27th, 2025
Feeling Dizzy? How Physical Therapy Can Help You Find Your Balance By Matt Leedom, PT, DPT, NCS Have you ever stood up too quickly and felt the room spin? Or rolled over in bed and suddenly felt like you were on a merry go round you didn’t ask to ride? Maybe you’ve started to notice you feel a little unsteady when walking or need to hold onto furniture “just in case.” If that sounds familiar, you are not alone. And more importantly, you are not without options. Dizziness and balance problems are surprisingly common. These issues can develop after a cold, a minor head injury, or simply as part of the aging process. But despite how common they are, they are often overlooked. Many people chalk them up to aging or learn to “just live with it,” avoiding stairs, skipping favorite outings, or giving up activities they enjoy because they don’t feel steady. That is where physical therapy can make a real difference. And no, it is not just about stretching or lifting weights. Physical therapists who focus on balance and vestibular care can help identify the source of your symptoms and offer practical, personalized solutions. Let’s start with one of the most common causes of vertigo: Benign Paroxysmal Positional Vertigo, or BPPV. It sounds complicated, but the fix is often simple. In BPPV, tiny crystals in your inner ear float into the wrong place and start sending confusing signals to your brain. The result? Sudden, brief spinning sensations with head movement or changes in position. A trained physical therapist can perform a series of head and body movements called repositioning maneuvers to guide the crystals back where they belong. Relief is often immediate. But not all dizziness is BPPV. Sometimes it stems from vestibular system weakness, where the inner ear is not working properly. This can be caused by a virus, changes that come with age or for reasons unknown. Other times, balance problems are linked to neurological conditions like Parkinson’s disease or stroke, or to weakness and reduced movement after illness. Even changes in vision or sensation in your feet can throw off your balance. That is why careful evaluation is so important. A physical therapist will assess how your eyes, ears, brain and muscles work together to keep you steady. Then they will create a personalized plan to help you feel more confident and stable. This may include exercises to improve gaze control, strengthen your muscles, practice safe walking and retrain your sense of balance. Most importantly, therapy helps you rebuild your confidence. When you are afraid of falling or feeling dizzy, it is easy to stop moving. But that can make things worse. Physical therapy offers a safe way to stay active and regain control. You do not have to live in fear of the next dizzy spell or miss out on the things you enjoy. If you are feeling off balance, ask your doctor if a referral to a vestibular trained physical therapist is right for you. The path to steady footing might be closer than you think. Matt Leedom, PT, DPT, NCS, is a board-certified clinical specialist in neurologic physical therapy and an assistant professor in the Department of Physical Therapy at the University of South Dakota. He earned his B.S. in psychology from USD and his Doctor of Physical Therapy degree from Creighton University. Leedom’s clinical expertise includes the treatment of individual neurological conditions, including vestibular disorders. His research focuses on improving mobility and quality of life for individuals with Parkinson’s disease, with current projects exploring cognitive flexibility training and non-invasive brain stimulation to address gait and postural impairments. 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 the Prairie Doc Facebook page), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust. Prairie Doc Perspective Week of July 20th, 2025
Spiritual Pain and Grief By The Rev. Kari Sansgaard, Avera@Home Hospice Chaplain – Sioux Falls, SD After nearly twenty years of parish ministry, I entered the world of health care, which, I learned, abounds in acronyms. My first clue was in chaplaincy training, known as “CPE” (Clinical Pastoral Education), the required education for most hospital and hospice chaplains. CNA, SoB (Shortness of Breath), PRN, HoH (Hard of Hearing), and a myriad of other acronyms are now part of my own vernacular. QoL (Quality of Life) is the ‘big’ one in hospice, sometimes called “comfort care.” When quantity of life becomes diminished, it’s all about quality. Dame Cicely Saunders, the founder of hospice as we know it, understood human suffering as a combination of physical, psychological, social and spiritual pain. She famously said the following: YOU MATTER BECAUSE YOU ARE YOU, AND YOU MATTER TO THE END OF YOUR LIFE. I suggest that all people are spiritual, where spirituality is defined as the source(s) of meaning and purpose that guide and encourage us. Spiritual pain, then, is part and parcel of being human. I describe it simply as anything that breaks your heart. A pet dies; a friend moves away; a family member becomes estranged; a dream is not realized; divorce, death, broken trust, and so on. In hospice, when death is impending, spiritual pain can lead us to ponder existential questions, such as the following:
In addition to supporting areas of spiritual pain, chaplains are curious about sources of meaning in our lives (our spiritual resources). In whom or what do you place our ultimate trust? What people, experiences, music, places and/or Higher Power enliven your spirit and ground you? Life review in this realm can lead to laughter, connection and peace. SPIRITUAL CARE IS NOT AN OPTIONAL EXTRA FOR THE DYING. -Dame Cicely Saunders When we are grieving, spiritual pain can be exhausting. We can move through anger, sadness, numbness and peace in the course of thirty minutes. How do we ‘do’ life with the emptiness we feel? We are not made to endure this suffering alone. Grief groups, clergy, therapists, good friends, music, books, podcasts and nature walks, are among the resources available to us. It is important, in all life chapters, to nurture our spiritual resources. When crises come, our spiritual grounding can buoy us. As you tend to your body, mind and spirit through in this complex and beautiful life, may your QoL be well. Pr. Kari Sansgaard, is an ELCA pastor who serves as Avera Hospice Chaplain at Daugherty House Prince of Peace and Touchmark All Saints in Sioux Falls. 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 July 13th, 2025
“The Implant and Surgical Approach Choices Every Cataract Patient Should Understand” By Vance Thompson, MD Introduction Few decisions in life are more impactful than the choice to undergo cataract surgery—and how to have it done. Because cataract surgery is so common, many patients don’t realize it involves important decisions that can affect their vision for the rest of their lives. Modern technology has introduced new options for how the surgery is performed and what type of lens implant is used. These choices matter. Before we explore the available options, it’s important to first understand what a cataract is and the role of the natural lens in our vision. The Lens of the Eye Behind the pupil sits the eye’s natural lens. When we’re young (typically under age 40), this lens is flexible and able to shift focus to help us read and see clearly at all distances. It also contributes about 20% of the eye’s focusing power. As we age, this lens gradually becomes stiffer—often starting in our 40s—leading to difficulty seeing up close. This is why people begin to need reading glasses or bifocals. Over time, the lens also becomes cloudy, reducing the quality of vision even with glasses. When this happens, it’s called a cataract. Cataract surgery is one of the most successful and common procedures in the world. It involves replacing the cloudy natural lens with a clear artificial lens implant. Lens Replacement Surgery: More Than Just Cataract Removal During cataract surgery, we remove the clouded lens and replace it with a new, clear one. Some lens implants restore clarity but still require glasses—often trifocals—to help patients see far away, up close, and at intermediate distances (like a computer screen). Other advanced lens implants do much more. They restore both clarity and a full range of vision, often giving patients the ability to read, work, and drive without glasses—similar to the visual range they had in their 30s. It’s important to understand:
Surgical Technique: Manual vs. Laser Lens Capsule Opening The natural lens is housed in a thin, clear membrane called the capsule—imagine a grape inside a grape skin. During surgery, the surgeon must create a round opening in the front of the capsule, about 5.0 mm in diameter, perfectly centered over the lens. This allows the lens to be removed and the new implant to be placed in the capsule. After surgery, the capsule naturally "shrink-wraps" around the new lens implant. This process, called capsule contraction, helps hold the lens in place for the rest of the patient’s life--and does this the best if the opening overlaps the edge of the implant for 360 degrees. Achieving this ideal overlap is a key to long-term stability of the implant. There are two main methods for creating the capsule opening:
Conclusion When considering cataract surgery—or elective lens replacement—patients should be informed about:
Vance Thompson, MD is an internationally recognized specialist in refractive cornea, phakic IOL and lens replacement surgery. He is the Founder of Vance Thompson Vision Sioux Falls, SD and the Director of Refractive Surgery. Vance Thompson Vision has grown to serve the mid and mountain west with nine locations. Dr. Thompson also serves as a Professor of Ophthalmology at the Sanford USD School of Medicine. As a leading international researcher, he has played a key role in the development of the most advanced technologies and techniques for both laser and implant vision correction. He has a passion for research and development of new technologies and has served as the medical monitor or principal investigator in over 130 FDA monitored clinical trials studying laser and implant surgery. Dr. Thompson is the immediate Past President of the American Society of Cataract and Refractive Surgery (ASCRS) a nd is also on the Executive Committee as Vice President of the International Intraocular Implant Club (IIIC) that was founded in 1966 by Sir Harold Ridley, the inventor of the Lens Implant that revolutionized cataract surgery and refractive lens exchange. In addition, Dr. Thompson has published numerous papers and book chapters and is co-author of the textbook Refractive Surgery. He has lectured and taught advanced laser and implant surgery to thousands of surgeons all around the world. 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 July 6th, 2025
“Motion is Lotion; the Importance of Movement” By Anthony P. Fiegen, MD Orthopedic medicine is truly a team sport; we have the opportunity to collaborate with nonsurgical professionals, including physical therapists, occupational therapists, athletic trainers, among others, to deliver comprehensive musculoskeletal care. While there are proven surgical options to help our patients where indicated, in many cases, patients are able to achieve pain relief and improved function with nonsurgical treatment options. Much of orthopedic surgical training is appropriately dedicated to the planning and execution of surgery, but it is also important to understand and recognize patients who present with conditions readily addressed without surgery and the accompanying risks of invasive procedures. It is also important to advocate the idea of prevention. A phrase that is often loosely spoken within our clinic is, “Motion is Lotion.” What does this mean? This is a simple phrase to express the importance of movement and activity, whether that be independent exercise, supervised or specialized therapy, or simply taking a walk outside. With inactivity, we naturally are at risk for muscle loss, obesity, and the many adverse health conditions associated with obesity. It is important to consider exercise and its many health benefits. More specifically, resistance training and cardiovascular exercise have been shown to have robust benefits to our overall physical and mental health and function. The National Institute of Health has been studying the effect of strength training for more than 40 years, demonstrating beneficial results in adults including maintained muscle mass, maintenance and improvement of mobility, and increasing healthy years lived. Not all resistance training is the same, however, the effects on improved function largely are the same. Resistance training promotes muscle strength and growth, simultaneously improving our overall cardiovascular health. Studies have demonstrated that our muscle mass peaks around the age of 35. Naturally, muscle volume and performance decline slowly until we reach the age of approximately 65 where muscle volume loss proceeds faster. However, this decline in muscle volume and strength is substantially slowed by resistance training. Dr. Fielding with Tufts University, an NIH-supported scientist, has studied resistance training at a molecular level. His research has suggested that the best recipe for improving physical function and avoiding disability is a combination of walking and resistance training, whether resistance be against gravity or moving weight. The list of research-proven benefits of resistance training is quite impressive. In addition to improved muscle mass and cardiovascular health, resistance training offers improved metabolism and promotes weight loss of adipose tissue, increased bone density potentially preventing fractures associated with aging and fragility, improved balance and coordination, and natural release of anti-inflammatory mediators. Outside of bone and muscle anatomy, being active and exercising has been proven to reduce stress, improve our mood and cognitive performance, boost our energy and libido, as well as provide a mean of self-confidence. Now understanding the many benefits of physical activity, where do we start? If you are looking for some help, reach out to your physician, a personal trainer, or other trained professionals such as a physical therapist or athletic trainer for guidance. The health benefits will not be immediately realized, but you will eventually notice an improvement in your mood, and perhaps many years from now, also an improvement in your overall physical health. “Motion is lotion.” Let’s get out and move! Anthony P. Fiegen, MD is a fellowship-trained orthopedic sports medicine physician specialized in treating conditions of the shoulder, hip, and knee at the Orthopedic Institute. In addition to a comprehensive sports medicine practice and joint preservation, he also performs joint replacement of the shoulder, hip, and knee. Dr. Fiegen grew up in Madison, SD. He attended South Dakota State University competing for the Jackrabbits’ men’s basketball team from 2009-2013. Prior to joining Orthopedic Institute in 2024, Dr. Fiegen completed orthopedic surgery residency at Mayo Clinic in Rochester, MN. He then went on to complete a sports medicine fellowship at Wake Forest University in Winston-Salem, NC, where he served as a team physician for the ACC Wake Forest football, men’s basketball, and baseball teams. 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 or 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 June 29th, 2025
“Know your Family Health History” Roberta K. Olson, PhD, RN Foundational education as an RN with a BSN from South Dakota State University provided a broad understanding of how our bodies function. One of the lessons that was high lighted over the years was the need to pay attention to changes, e.g., my two sisters needed total knee replacement and so did I; my paternal grandfather had a massive stoke and died at the age of 61 years in 1948 from what? It was never diagnosed. My father thought that his dad, who was a farmer, was too stubborn to get regular check-ups from a physician and probably had heart problems in addition to his high blood pressure. When I was diagnosed with elevated blood pressure in 2015. My only symptom was ocular migraines; I started taking blood pressure medication. Both of my parents had low (normal) blood pressure and when I was pregnant with our two sons, my blood pressure was consistently in the low normal range. At first, I thought that perhaps the blood pressure machine wrong but with further tests, I was diagnosed with hypertension. My blood pressure stayed elevated even with the daily medications that I took to keep the hypertension in check. In June 2024 my pulse slowly dropped to 34 (normal is 70-80/minute). On Thursday my primary care physician ordered an echocardiogram for the following Monday because my pulse was 40 bpm in the office. On Sunday night at midnight, I was awake, got up and measured my pulse. It was 34 bpm. I debated whether to wait 10 hours for the scheduled echocardiogram or call 911. I called 911. The ambulance came at 12:30 a.m. and I was taken for an assessment to the Brookings Emergency Department. Further assessment indicated that I was in a 3rd degree heart block and would need a pacemaker. A cardiac surgeon had accepted the request from the Brookings ED Physician. By 4:00 a.m. I arrived at the Avera Heart Hospital in Sioux Falls via ambulance. I was monitored the entire time by the EMT. Further assessment was done by the technicians and at 8:30 a.m. I was on the operating table with the cardiac surgeon ready to insert a pacemaker. I stayed one night in the hospital for observation and was discharged on Tuesday morning. We are fortunate in South Dakota to have responsive EMTs, competent MDs at all times in the Emergency Department, and Cardiac Surgeons ready to assist as needed at the Avera Heart Hospital. Following the “organ recital” discussion with my sisters, I learned that a third cousin who lived in Illinois and is four years younger than I am also had a pacemaker inserted a few years ago. Our grandfathers were brothers. Genetics in your family history is important to know and understand. Dwelling on every ache and pain is not necessary but know your body and changes in the usual patterns of wellness. Post pacemaker my blood pressure is consistently within the low normal range. Roberta K. Olson, PhD, RN earned her MSN in Nursing of Children at Washington University, St. Louis, MO and her PhD in Higher Education at Saint Louis University. She served in four academic institutions prior to returning to her alma mater and serving the last 20 years of her career as the Dean of Nursing at South Dakota State University. 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. |
Archives
August 2026
Categories |
RSS Feed
