The body doesn’t lie—when physiology changes, function follows.

Introduction
When we think about diabetes, we often picture glucose levels, insulin, and the classic complications—nerve damage, kidney disease, vision loss. But what if the condition also quietly reshapes how we move every day? A recent study by Petrovic et al. sheds light on a lesser-known consequence of diabetic neuropathy: impaired tendon mechanics, particularly in the Achilles tendon, during walking. This discovery doesn’t just add a new layer to diabetes management—it challenges how we approach rehab and movement training in these patients.

Function Follows Physiology
The Achilles tendon plays a vital role in walking by acting like a spring—storing elastic energy when your foot hits the ground and releasing it as you push off. But in individuals with diabetic neuropathy, this elegant process is disrupted.

Here’s what Petrovic’s study revealed:

• Increased tendon stiffness: Tendons are supposed to stretch and recoil, but stiffness limits that function, reducing fluid movement and shock absorption.
• Reduced energy storage and return: The tendon’s ability to act like a spring is diminished. Instead of rebounding with ease, it’s more like a rigid cable—less energy-efficient and less adaptive to movement demands.
• Higher hysteresis: More energy is lost as heat rather than being recycled into forward motion. This “energy leak” makes walking more fatiguing and less biomechanically efficient.
• Greater muscular workload: Because the tendon isn’t doing its job as a passive energy recycler, muscles have to work harder to compensate—resulting in quicker fatigue and reduced gait endurance.

Why It Matters in Rehab
These changes aren’t just biomechanical trivia—they have real implications for daily function and rehabilitation. Patients with diabetes may struggle more with walking not only due to neuropathy but because their tendons are working against them.

A few clinical considerations:

• Rehab plans should address muscle endurance and coordination since tendons can’t carry as much of the load.
• Incorporating eccentric loading and mobility-focused exercises may help improve tendon elasticity over time.
• Therapies aimed at improving metabolic health—like nutrition, glycemic control, and aerobic conditioning—may indirectly benefit tendon function.

Conclusion
Tendons may not be the first structure we think of when managing diabetes, but they are a crucial link in the movement chain. The phrase “function follows physiology” reminds us that even subtle metabolic changes can ripple through the body in profound ways. By better understanding and addressing tendon dysfunction in diabetic patients, we can design smarter, more supportive rehabilitation plans—ones that truly meet patients where they are, structurally and metabolically.

People with diabetic neuropathy: implications for metabolic energy saving. Journal of applied physiology. 2018 May 1;124(5):1333-40.

Fong, D. T.-P., et al. (2022). “Metabolic Dysfunction and Tendon Health: Mechanisms and Clinical Implications.” Journal of Clinical Medicine, 11(6), 1666.

Improved Access to Chiropractic and Other Local Services Across Illinois

As of May 2025, the U.S. Department of Veterans Affairs (VA) has implemented a major policy change that could dramatically improve access to timely, high-quality care for veterans. This update eliminates a longstanding administrative hurdle that often delayed referrals to community-based providers—including chiropractors—despite agreement between the veteran and their VA clinician.

What Changed?

Previously, even if a VA provider determined that community care was in the best medical interest of the veteran, the referral required a second clinical review. This extra layer frequently caused delays, confusion, and even denial of services, preventing veterans from receiving needed care close to home.

With the new policy, VA providers can now directly refer patients to non-VA providers in the Community Care Network without unnecessary bureaucratic barriers. This applies when community care is deemed clinically appropriate and in the veteran’s best interest.

Why This Matters

• Faster access to care: Veterans can now get timely services from chiropractors and other specialists.
• Local options: Care can be delivered in community settings, reducing travel burden and wait times.
• Veteran and provider collaboration respected: Clinical judgment and patient preference now play a greater role in the referral process.

Who Benefits?

Veterans throughout Illinois—and across the U.S.—who need care outside the VA system now face fewer delays. This is especially important for chiropractic care and other specialties where community providers can often deliver faster, more accessible services.

This information was just released, and we will share additional updates as they become available. If you have further questions, please contact your local VA center.

🌿 Outdoor Exercise Boosts Kids’ Brain Power More Than Indoor Workouts

Remember when your mom thru you out of the house and told you to come back for dinner? Your mom was right kids should be outside playing and not in front of the T.V. .

A recent study reveals that physical activity outdoors leads to greater cognitive benefits in children compared to similar indoor workouts. This is the first study to directly compare the two settings for brain function improvement.

Key Highlights

• 🧠 Outdoor exercise improved attention, working memory, and self-control more than indoor exercise.
• ⏱️ Kids responded faster and more accurately on brain tests after outdoor activity sessions.
• 🌳 Nature exposure may enhance the positive effects of physical activity on the brain.
• 💡 Outdoor environments offer a low-cost, high-impact way to support healthy cognitive development in children.

The Study at a Glance

• Participants: 45 children, ages 11–13
• Method: Each child did the same workout both outdoors and indoors, then completed brain function tests before and after.
• Results: Outdoor workouts consistently led to faster reaction times and better accuracy on tasks related to memory, attention, and control.

Why It Matters
This study is the first to show that combining physical activity with nature exposure offers greater cognitive benefits than exercising indoors alone. It supports the idea that schools, parents, and communities can boost kids’ brain health by encouraging outdoor play and movement.

So, send your kids to park or back yard to play and they might come back smarter.

If there any pain preventing your child from playing outside, make an appointment with Dr. Steve. He can mostly like your child feel better.

If you’ve ever spent the night tossing and turning, you know how frustrating and exhausting chronic insomnia can be. Up to 12% of Americans suffer from persistent sleep difficulties, often turning to cognitive behavioral therapy for insomnia (CBT-I) or sleep medications for relief. Some sleep aids often fail to mimic natural sleep cycles and come with unwanted side effects.

But what if there was an alternative that’s accessible, affordable, and beneficial for overall health? According to new research, exercise may be the answer.

Can Exercise Improve Sleep? What the Research Says

A recent meta-analysis of randomized controlled trials (RCTs) explored the impact of exercise on sleep quality. Researchers analyzed 19 studies involving 1,233 participants diagnosed with insomnia but without other sleep-related disorders. Unlike studies that combined exercise with other treatments, this review focused on exercise as a standalone intervention.

How Exercise Affects Sleep

The study assessed both objective (measured with sleep tracking devices) and subjective (self-reported) sleep outcomes:

✅ Improved Sleep Efficiency – Participants spent more of their time in bed actually sleeping.
✅ Less Wakefulness During the Night – People who exercised woke up less frequently after initially falling asleep.
✅ Higher Sleep Satisfaction – Even when objective measurements showed little change in sleep duration, participants felt like they slept better and woke up more refreshed.

However, exercise didn’t lead to falling asleep faster (sleep onset latency) or increased total sleep time. This means people weren’t necessarily sleeping longer, but their sleep quality improved significantly.

The Role of Exercise Intensity

The study also found that:

📌 Higher-intensity exercise produced greater improvements in sleep quality.
📌 Older adults and women benefited the most—potentially due to lower fitness levels at baseline.

Interestingly, most of the included studies used low-to-moderate intensity exercise (such as light walking or cycling). This suggests that even small amounts of movement can positively impact sleep—though higher-intensity workouts may lead to even better results.

Limitations and What We Still Don’t Know

While this study highlights the potential of exercise as a natural sleep aid, there are still some unanswered questions:

🔹 How much exercise is ideal? The study didn’t pinpoint a specific “exercise prescription” for insomnia.
🔹 Does exercise work better when combined with other treatments? More research is needed to explore how exercise interacts with CBT-I or other interventions.
🔹 Will people who are already active see additional sleep benefits? The study didn’t examine whether adding more exercise improves sleep for those already exercising regularly.

The Bottom Line: Move More, Sleep Better

When you’re exhausted from lack of sleep, working out might be the last thing you want to do. But staying sedentary can worsen the cycle of poor sleep and fatigue. The good news? Even light exercise can help improve sleep quality—so if you’re not active yet, starting small can still make a difference.

If you’re struggling with insomnia, consider adding consistent physical activity to your routine. Whether it’s a short walk, a yoga session, or strength training, movement can be a powerful, drug-free tool to support better sleep.

If pain is limiting your ability to exercise, seeing a chiropractor may help you regain mobility and comfort. Misalignments, muscle tension, or joint restrictions can make movement difficult, leading to further inactivity and worsening symptoms. Chiropractic care focuses on realigning the spine, reducing inflammation, and restoring function—helping you move pain-free. By addressing the root cause of discomfort, you can get back to your workouts, improve your sleep, and enhance your overall well-being. Don’t let pain keep you from staying active—consider a seeing Dr. Steve for a consultation today!

💤 Sleep better, feel better—start moving today! 🚶‍♀️🏃‍♂️