About

Paul Borsa, Ph.D., came to UF in 2003. He is the director of the Sports Medicine Research Laboratory (2003-present) and has served as the graduate coordinator (2003-2004). In April 2001, he was awarded Fellowship of the American College of Sports Medicine. Borsa has served on the Convention Committee of the National Athletic Trainer’s Association as well as on the Editorial Boards of the Journal of Athletic Training (Section Editor) and the Journal of Sports Rehabilitation. His research interests include the kinematical and mechanical behavior of the shoulder joint and the treatment of musculoskeletal injuries by phototherapy.

Research topics

• Physical therapy
• Medicine
• Anesthesia
• Internal medicine
• Engineering
• Orthodontics
• Psychiatry
• Physics
• Geometry
• Surgery
• Mathematics

Selected publications

• Impact of Propranolol and Psychologically Informed Intervention on Pain Sensitivity: Secondary Analysis from the Biopsychosocial Influence on Shoulder Pain Preclinical Randomized Trial

  Journal of Pain Research · 2025-04-01 · 1 citations

  articleOpen access

  Purpose: Measures of pain sensitivity have potential relevance for patient care. We previously identified a subgroup of people at risk for ongoing pain characterized by genetic AND psychological factors. Here, we report planned secondary analyses examining the effect of personalized interventions on pain sensitivity outcomes. Patients and Methods: Two hundred and sixty-one healthy individuals with the COMT SNP rs6269 AA genotype and Pain Catastrophizing Scale scores of 5 or higher received exercise-induced muscle injury, followed by a randomly assigned treatment: (1) general education and placebo; (2) personalized psychological intervention and placebo; (3) general education and propranolol; or (4) personalized psychological intervention and propranolol. Pain sensitivity outcomes (pressure pain thresholds (PPT), suprathreshold heat rating, temporal summation, and conditioned pain modulation efficiency) were compared using a mixed effect model to examine difference among groups, adjusted for age, sex and race. Results: No main effects for group assignment were noted (p > 0.05 for all), when considered as 4 groups or 2 collapsed groups (ie propranolol vs placebo or personalized psychologic vs general education). Interaction terms were then entered into our models in an exploratory fashion. For PPT outcomes interactions were noted for, sex and time, and race and time (p<0.015). For temporal summation outcomes, interactions were noted for sex and group and race and group (p < 0.015). Conclusion: Results indicated no statistically reliable changes in pain sensitivity when considering matched vs unmatched treatment groups. Caution is needed in this interpretation given that the trial was not powered to specifically identify these differences. Exploratory analysis of interactions among ethnic/racial and gender identities by treatment, however, showed the potential for differential effects for specific pain sensitivity measures. Significant interactions across modalities suggest analysis of higher order interactions/intersectionality could be of great interest for testing efficacy of personalized interventions in future trials.

  PublisherDOI

• Oral Cannabidiol Treatment Is Associated with an Anti-Inflammatory Gene Expression Signature in Myeloid Cells of People Living with HIV

  Cannabis and Cannabinoid Research · 2024-01-22 · 10 citations

  article

  Introduction: HIV-related comorbidities appear to be related to chronic inflammation, a condition characterizing people living with HIV (PLWH). Prior work indicates that cannabidiol (CBD) might reduce inflammation; however, the genetics underpinning of this effect are not well investigated. Our main objective is to detect gene expression alterations in human peripheral blood mononuclear cells (PBMCs) from PLWH after at least 1 month of CBD treatment. Materials and Methods: We analyzed ∼41,000 PBMCs from three PLWH at baseline and after CBD treatment (27–60 days) through single-cell RNA sequencing. Results: We obtained a coherent signature, characterized by an anti-inflammatory activity, of differentially expressed genes in myeloid cells. Conclusions: Our study shows how CBD is associated with alterations of gene expression in myeloid cells after CBD treatment. Clinical Trial Registration: NCT05209867.

  PublisherDOI

• Oral CBD treatment is associated with an anti-inflammatory gene expression signature in myeloid cells of people living with HIV

  medRxiv · 2023-02-24 · 1 citations

  preprintOpen access

  Abstract HIV-related comorbidities appear to be related to chronic inflammation, a condition characterizing people living with HIV (PLWH). Prior work indicates that cannabidiol (CBD) might reduce inflammation; however, the genetics underpinning of this effect are not well investigated. Our main objective is to detect gene expression alterations in human peripheral blood mononuclear cells (PBMCs) from PLWH after at least one month of CBD treatment. We analyze ∼41,000 PBMCs from three PLWH at baseline and after CBD treatment (27-60 days). We obtained a coherent signature, characterized by an anti-inflammatory activity, of differentially expressed genes in myeloid cells. Our study shows how CBD is associated with alterations of gene expression in myeloid cells after CBD treatment.

  PublisherOA PDFDOI

• Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial

  Journal of Pain · 2023-05-12 · 5 citations

  articleOpen access
  PublisherOA PDFDOI

• Therapeutic Photobiomodulation Before Strenuous Exercise Attenuates Shoulder Muscle Fatigue

  Journal of Athletic Training · 2023-11-28 · 9 citations

  articleOpen accessSenior author

  CONTEXT: Photobiomodulation therapy (PBMT) applied as a preconditioning treatment before exercise has been shown to attenuate fatigue and improve skeletal muscle contractile function during high-intensity resistance exercise. Practical implications for preconditioning muscles with PBMT before fatiguing exercise include a safe and noninvasive means to enhance performance and reduce the risk of musculoskeletal injury. OBJECTIVE: To examine the muscle fatigue-attenuating effects of PBMT on performance of the shoulder external-rotator muscle group when applied as a preconditioning treatment before high-intensity, high-volume resistance exercise. DESIGN: Sham-controlled, crossover design. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty healthy men (n = 8) and women (n = 12) between the ages of 18 and 30 years. INTERVENTION(S): Photobiomodulation therapy was administered using a near-infrared laser (λ = 810/980 N·m, 1.8 W/cm2, treatment area = 80-120 cm2) to the shoulder external-rotator muscles at a radiant exposure of 10 J/cm2. Participants performed 12 sets of isokinetic shoulder exercise. Each set consisted of 21 concentric contractions of internal and external rotation at 60°/s. The sets were subdivided into 3 blocks of exercise (block 1: sets 1-4; block 2: sets 5-8; block 3: sets 9-12). MAIN OUTCOME MEASURE(S): Normalized peak torque (N·m/kg), average peak torque (N·m), total work (N·m), and average power (W). RESULTS: During the last block of exercise (sets 9-12), all performance measures for the active PBMT condition were 6.2% to 10% greater than the sham PBMT values (P < .02 to P < .001). CONCLUSIONS: Photobiomodulation therapy attenuated fatigue and improved muscular performance of the shoulder external rotators in the latter stages of strenuous resistance exercise.

  PublisherOA PDFDOI

• Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury

  Pain · 2022 · 6 citations

  • Medicine
  • Physical therapy
  • Internal medicine

  ABSTRACT: Prior cohort studies validated that a subgroup defined by a specific COMT genotype and pain catastrophizing is at increased risk for heightened responses to exercise-induced or surgically induced shoulder pain. In this clinical trial, we used our preclinical model of exercise-induced muscle injury and pain to test the efficacy of interventions matched to characteristics of this high-risk subgroup (ie, personalized medicine approach). Potential participants provided informed consent to be screened for eligibility based on subgroup membership and then, as appropriate, were enrolled into the trial. Participants (n = 261) were randomized to 1 of 4 intervention groups comprised of pharmaceutical (propranolol or placebo) and informational (general education or psychologic intervention) combinations. After muscle injury was induced, participants received randomly assigned treatment and were followed for the primary outcome of shoulder pain intensity recovery over 4 consecutive days. Recovery rates were 56.4% (placebo and psychologic intervention), 55.4% (placebo and general education), 62.9% (propranolol and psychologic intervention), and 56.1% (propranolol and general education). No statistical differences were found between intervention groups in the primary analyses. Additional analyses found no differences between these intervention groups when shoulder pain duration was an outcome, and no differential treatment responses were detected based on sex, race, or level of pain catastrophizing. This trial indicates that these treatments were not efficacious for this high-risk subgroup when shoulder pain was induced by exercise-induced muscle injury. Accordingly, this phenotype should only be used for prognostic purposes until additional trials are completed in clinical populations.

  PublisherOA PDFDOI

• PP 4.27 – 00202 Single-cell RNA sequencing reveals CBD genetic signature in monocyte gene expression

  Journal of Virus Eradication · 2022-12-01

  articleOpen access
  PublisherDOI

• Sensory and Psychological Factors Predict Exercise-Induced Shoulder Injury Responses in a High-Risk Phenotype Cohort

  Journal of Pain · 2021-01-02 · 4 citations

  articleOpen access
  PublisherOA PDFDOI

• Pitching shoulder passive flexibility: torque-angle analysis for external rotation and internal rotation

  Sports Biomechanics · 2020 · 7 citations

  • Mathematics
  • Orthodontics
  • Physics

  In this study, a custom device was developed to analyse the pitching shoulder's external rotation (ER) and internal rotation (IR) passive flexibility. We analysed three novel measures: the resistance onset angle (ROA = angle where the shoulder begins stretching), rotational stiffness, and torque at the end range of motion (ROM). The purpose was to conduct a bilateral analysis to determine if there are significant differences between the throwing and non-throwing shoulder. Participants were 30 upper level pitchers (13 division I, 17 minor league). During testing, pitchers laid supine on a treatment table and the arm was secured to a rotational wheel with the shoulder abducted 90° and elbow flexed 90°. Dependent t-tests revealed significant (p < 0.01) and relatively extreme bilateral differences for all three variables. The throwing shoulder had: increased ER ROA (9°), decreased IR ROA (5.3°), increased ER stiffness (17%), increased IR stiffness (34%), increased ER torque (21%), and increased IR torque (30%). Secondary correlation analysis was completed to determine if the torque-angle variables were good predictors of the end ROM. Stiffness correlations were weak for ER (r = 0.35, p = 0.048) and IR (r = 0.42, p = 0.017) but ROA correlations were strong for ER (r = 0.85, p < 0.001) and IR (r = 0.86, p < 0.001).

  PublisherDOI

• Plasma Concentrations of Select Inflammatory Cytokines Predicts Pain Intensity 48 Hours Post-Shoulder Muscle Injury

  Clinical Journal of Pain · 2020 · 12 citations

  • Medicine
  • Internal medicine
  • Physical therapy

  OBJECTIVES: The relationship between elevated inflammatory cytokine levels and peak pain intensity following acute musculoskeletal injury has not been fully elucidated in high risk subgroups. Identifying the role that these cytokines have on pain responses may help with developing tailored therapeutic approaches. METHODS: Data were collected from 54 participants who were vulnerable to a robust pain response and delayed recovery following musculoskeletal injury. Participants completed baseline active and resting pain measurements and a blood draw before an exercised induced shoulder muscle injury. Participants returned at 24 and 48 hours postinjury for follow-up pain measurements and blood draws. Blood plasma was analyzed for interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor α. Pearson bivariate correlations were performed between cytokines and pain measurements to identify candidate variables for stepwise multiple linear regression predicting pain intensity reports. RESULTS: Pearson bivariate correlation identified 13/45 correlations between inflammatory cytokines and resting pain intensity and 9/45 between inflammatory cytokines and active pain (P<0.05, r≥0.3 or r≤-0.3). This led to 5 stepwise multiple linear regression models, of which 4 met the statistical criterion (P<0.0167); including IL-10 baseline plasma concentrations predicting active pain (r=0.19) and resting pain (r=0.15) intensity 48 hours postinjury. IL-6 and IL-10 plasma concentrations at 48 hours were respectively associated with active and resting pain at 48 hours. DISCUSSION: These findings suggest that elevated concentrations of inflammatory cytokines, specifically IL-10 (at baseline and 48 h) and IL-6 (at 48 h), may play a role in heightened pain responses following exercise-induced muscle injury.

  PublisherOA PDFDOI

Frequent coauthors

• Steven Z. George

  Clinical Research Institute

  29 shared

• Mark D. Tillman

  Jacksonville University

  23 shared

• Erik A. Wikstrom

  University of North Carolina at Chapel Hill

  19 shared

• Jeffrey J. Parr

  University of Southern Mississippi

  18 shared

• Joshua F. Yarrow

  University of Florida

  18 shared

• Scott M. Lephart

  University of Kentucky

  16 shared

• Eric L. Sauers

  15 shared

• Roger B. Fillingim

  University of Florida

  15 shared

Labs

• Sports Medicine Research LabPI

Education

• PhD, HPRED

  University of Pittsburgh

  1994

• Master of Science, HPRED

  University of Pittsburgh

  1992

• Bachelor of Science, Health, Physical & Recreation Education

  University of Pittsburgh

  1988

Awards & honors

• Fellowship of the American College of Sports Medicine (2001)