BJSM Podcast

Tennis Medicine – there’s more than meets the eye! Episode #386

It has been another big year for tennis, and for British Tennis in particular with further successes in the Fed Cup and a number of exciting juniors making an impact on the world stage. In the run up to Wimbledon, we thought we’d catch up with some of the practitioners
tasked with not only caring for these athletes, but responsible for the medical provision at some of the biggest sporting events in the international calendar.
In this podcast we hear from Dr Jo Larkin and Dr Wing Chu. Jo is a Sport & Exercise Medicine consultant and Lead Doctor for British Tennis, with Wing an SEM registrar and qualified GP who works with Jo at the Lawn Tennis Association. In this podcast, you can hear about everything from the challenges of working in tennis, to some of the often under-appreciated public health benefits linked to the sport.
 Patients needing advice & input across multiple continents at the same time
 Policy-making as well as ‘pitch-side’ care
 Population health – what role does tennis have?
Do you know someone who could benefit from a healthier heart, reduced stress and a leaner body? Or, does this sound like a personal target for you? We would implore the #SEM community to share the podcast, infographics, papers and animations widely in order to try and spread the knowledge not only of #TennisMedicine, but tennis AS medicine
https://www.youtube.com/watch?v=X4UHmZ6PL30
Seminal Papers
Health Benefits of tennis infographics: https://bjsm.bmj.com/content/52/3/201
Health Benefits of tennis paper: https://bjsm.bmj.com/content/41/11/760
Associations of specific types of sports and exercise with all-cause and cardiovascular-
disease mortality https://bjsm.bmj.com/content/51/10/812.long
Leisure-Time Physical Activity & Life-Expectancy
https://www.mayoclinicproceedings.org/article/S0025-6196(18)30538-X/fulltext

More important than life and death? Liverpool FCs Dr Andy Massey’s view of football medicine. Ep#385

What is like working at one of the biggest clubs in the world? How do you manage the intense workload of the English premier league? What happens when players retire? In this hard hitting BJSM podcast, we are joined by Dr Andy Massey, physiotherapist and doctor who currently works as head of medical services at Liverpool FC. Topics discussed include:
● Managing the load of the premier league footballer
● Looking at the whole squad; substitutes and non-playing members
● The £177 million conundrum; the cost of injured players to the league
● Managing a rectus femoris injury; how to approach it?
● 1%ers- what is their place in football?
● Transitioning into retirement- do we do enough?
● Top tips for early career professionals wanting to work in football
Links to some of the papers mentioned:
Bye Bye MRI? https://bit.ly/2KfChKQ
POLICE principle for treating injuries : https://bit.ly/2EHcS9C

Osgood Schlatter – not the self-limiting condition we once thought. Episode #384

Have we been thinking about Osgood Schlatter Disease (OSD) all wrong? To answer this question, Dr. Erin Macri interviewed Prof. Jens Lykkegaard Oleson and Dr. Sinead Holden from Aalborg University on a recent visit to Denmark.
Prof. Olesen is a rheumatologist and sports medicine physician, currently located at the Center for Almen Medicine at Aalborg University. His research focuses on tendon and fascia tissue adaption to loading, and the use of ultrasound examination in tendon and fascia pathology. Dr. Holden is a Senior Researcher at the Center for General Practice in Aalborg, where she is co-founder and research co-ordinator for the OptiYouth Research Group focused on ‘optimising physical health in youth’. Her research aims to increase understanding of musculoskeletal injuries and pain in youth, to identify those at increased risk for developing chronic MSK problems.
In this episode, we delve into some recent evidence suggesting the OSD may not be the self-limiting condition we have typically believed it to be. In fact, OSD may be more akin to a tendonopathy in its presentation, which lends itself to exploring some novel treatment approaches that may change OSD management in clinical practice.
Related Articles and Links
OSD table: http://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2019/06/OSD-table.pdf
Cairns G, Owen T, Kluzek S, Thurley N, Holden S, Rathleff MS, Dean BJ. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med. 2018 Aug 13;4(1):e000383. doi: 10.1136/bmjsem-2018-000383
https://bmjopensem.bmj.com/content/4/1/e000383
Holden S, Winiarski L, Krommes K, Thorborg K, Olesen JL, Hölmich P & Rathleff MS. Prognosis of Osgood-Schlatter - poorer than anticipated? A prospective cohort study with 24-month follow-up. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark.
Vad, CG; Rathleff, MS; Jensen, HP; Holden S. Osgood Schlatter is associated with significant impairments in knee function and quality of life 4 years after diagnosis: a retrospective study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark.
Lyng K, Rathleff MS, Dean B, Kluzek S, Holden S. Current Management Strategies in Osgood Schlatter: A quantitative study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark.
Kaya DO, Toprak U, Baltaci G, et al. Long-term functional and sonographic outcomes in Osgood-Schlatter disease. Knee Surg Sports Traumatol Arthrosc 2013;21(5):1131-9.
Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop 1990;10(1):65-8.

Returning to play in 2019 with Dr Clare Ardern. Episode #383

On this week’s BJSM podcast, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) EIC elect Dr Clare Ardern PhD (T: @clare_ardern) joins BJSM EIC Prof Karim Khan to answer the difficult questions about return to play.
Dr Clare Ardern is a physiotherapist and clinical researcher who completed her award-winning PhD on return to play in 2013. Since then, Clare has worked as a clinical researcher at the Aspetar Orthopaedic & Sports Medicine Hospital (Qatar) and Linköping University (Sweden). Clare led the 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. She has a particular interest in the psychological aspect of returning to play and how the return to play transition can be improved with specific clinical interventions and superior clinical decision making.
We here at BJSM would like to thank Clare for her tireless work as BJSM Deputy Editor and wish her all the best for her upcoming role as EIC at JOSPT!
In this 30-minute conversation, Clare discusses:
· Tips for clinicians when approaching RTP with athletes
· The psychological aspects of RTP and the importance of shared decision making
· Athletes’ biggest fears when RTP
· Non-operative management of ACL injuries
· Paediatric ACL injuries
On Oct 4-5, Clare will be speaking at the The IFSPT Third World Congress of Sports Physical Therapy in Vancouver, Canada. She will be presenting alongside a world-class line up of local and international experts exploring the theme “High performance to clinical practice”. https://www.sportphysio.ca/calendar-of-upcoming-events/spc2019/
Mentioned in this episode:
Ardern CL, Ekås G, Grindem H, et al. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018;doi:10.1136/bjsports-2018-099060 (article co-published by Knee Surgery Sports Traumatology Arthroscopy, Journal of ISAKOS and Orthopaedic Journal of Sports Medicine).
https://bjsm.bmj.com/content/52/7/422
Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med 2016;50:853-864. https://bjsm.bmj.com/content/50/14/853
Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med 2014;48:1543-1552.
Grindem H, Snyder-Mackler L, Moksnes H, et al Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study British Journal of Sports Medicine 2016;50:804-808. https://bjsm.bmj.com/content/50/13/804
Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine. 2010 Jul 22;363(4):331-42.
Headspace App: https://www.headspace.com/headspace-meditation-app

Tackling concussion prevention in youth with Prof. Carolyn Emery. Episode #382

What are the most effective strategies for preventing sport-related concussions in youth? What role do clinicians have in this arena? Dr. Erin Macri took advantage of Prof. Emery’s recent visit to the Netherlands to get caught up on the latest evidence in concussion prevention.
Prof. Emery is a physiotherapist and epidemiologist. She currently holds an appointment in the Faculty of Kinesiology at the University of Calgary, with joint appointments in Pediatrics and Community Health Sciences, Cumming School of Medicine, and is Chair of the Sport Injury Prevention Research Centre at the University of Calgary. Her research focuses on injury prevention in youth sport and recreation, concussion, and pediatric rehabilitation.
In this episode, Prof. Emery discusses over a decade of work aimed at preventing sport-related concussion in ice hockey in Canada.
Related Articles and Links
Emery CA, Black AM. Are rule changes the low-hanging fruit for concussion prevention in youth sport?
JAMA pediatrics 2019. E-pub ahead of print doi:10.1001/jamapediatrics.2018.5498
Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med 2017;51(12):978-84
Kolstad A, Nadeau L, Eliason P, Palacios-Derflingher L, Goulet C, Emery CA. The Effect Of Body Checking Policy Change On Offensive Game Skill Performance In 13–14 Year Old Ice Hockey Players. Br J Sports
Med 2017;51(4):345-45
McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ,
Castellani RJ, Davis GA. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun 1;51(11):838-47.
Concussion: prevention, detection and management (online course):
https://www.ucalgary.ca/knes/online-concussion-course
Concussion Awareness Training Tool: https://cattonline.com/
Canadian Concussion Guidelines and other resources, Parachute Canada:
http://www.parachutecanada.org/injury-topics/item/concussion

Empowering female athletes one marathon at a time with Kathrine Switzer. Episode #381

On this week’s BJSM podcast, Kathrine Switzer (T: @KVSwitzer) joins BJSM’s Daniel Friedman (T: @ddfriedman) to chat about empowering female athletes and the changing face of women’s sport in 2019.
In 1967, 20-year-old Kathrine Switzer became the first woman to complete the all-male Boston Marathon as an official entrant. She managed to fight off a race official who tried to force her from the course after only several kilometres, and made history as she crossed the finish line four hours later. Empowered by her experience, Kathrine became determined to create change for all women and has dedicated her career to advancing women’s sport, health and equality. https://kathrineswitzer.com/
In this 25-minute conversation, Kathrine discusses:
· The story of her historic 1967 Boston Marathon
· Her activism in advancing women’s running
· 261 Fearless – a global supportive social running network http://www.261fearless.org/
· The biggest barriers to female participation in sport today
· What SEM clinicians can do to help out
On June 6-8, Kathrine will be speaking at the 4th biennial Female Athlete Conference in Boston. She will be presenting alongside a world-class line up of local and international experts on women’s sport and exercise medicine, coaching, leadership and culture. https://bostonchildrens.cloud-cme.com/default.aspx?P=1&EID=910
Learn more about NZ’s Green Rx: https://www.health.govt.nz/our-work/preventative-health-wellness/physical-activity/green-prescriptions

Assessing concussion—as easy as ABC. Dr Jim Bovard. Episode #380

What venue are we at today? Which half is it now? Who scored last in this match? The Maddocks questions are a key part of immediate or on-field assessment of concussion. But do you have an easy way of remembering what else needs to be done?
On this week’s episode, Dr Jim Bovard joins BJSM’s Daniel Friedman (T: @ddfriedman) to share his ABC concussion tool for rapid on-field assessment.
Dr Bovard is the team physician for the Vancouver Canucks and Vancouver Whitecaps. He currently consults for Canada Snowboard and Tennis Canada.
In this 20 minute conversation, Dr. Bovard discusses:
· Clinical reasoning for approaching the collapsed athlete
· His own ABC concussion tool for on field assessment
· Tips for coaches and parents for managing concussion
· The difference between caring for elite athletes vs general population
Further reading:
Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenbogen RG, Echemendia RJ, Makdissi M, Sills A, Iverson GL. The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). Br J Sports Med. 2017 Apr 26:bjsports-2017. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

AMSSM Journal Club: Looking back at 2018. Episode #379

What are your favourite sports medicine research articles from 2018?
This week, we are excited to share an AMSSM Sport Medcast hosted by Drs Scott Young and Dr. Meghan Raleigh In this abbreviated episode, learn about the latest research regarding:
· Treatment of Achilles tendinopathy
· Effect of NSAIDs on bone healing rates
· Management of lateral hip pain
· Exercise as medicine for concussion
· Physiotherapy vs surgery for meniscal tears
To listen to the full episode and learn about all ten studies, please visit the AMSSM’s website: https://www.amssm.org/E-Learning.php
Further reading:
Johannsen F, Jensen S, Wetke E. 10-year follow-up after standardised treatment for Achilles tendinopathy. BMJ open sport & exercise medicine. 2018 Oct 1;4(1):e000415.
Wheatley BM, Nappo KE, Christensen DL, Holman AM, Brooks DI, Potter BK. Effect of NSAIDs on Bone Healing Rates: A Meta-analysis. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2019 Apr 1;27(7):e330-6.
Nissen MJ, Brulhart L, Faundez A, Finckh A, Courvoisier DS, Genevay S. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clinical rheumatology. 2019 Mar 14;38(3):647-55.
Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is medicine for concussion. Current sports medicine reports. 2018 Aug 1;17(8):262-70.
van de Graaf VA, Noorduyn JC, Willigenburg NW, Butter IK, de Gast A, Mol BW, Saris DB, Twisk JW, Poolman RW. Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the ESCAPE randomized clinical trial. Jama. 2018 Oct 2;320(13):1328-37.

How does a ‘heart patient’ build a sports club? Patient empowerment for health. #378

Farooq Mohammed was a football fan who discovered that he has heart disease. In this BJSM podcast, we focus on the patient voice and hear from Farooq who shares his own lived experience with the disease and, importantly, how football became part of his rehabilitation.
Farooq shows that by empowering patients to take control of their own health, rehabilitation can become a fun activity, not a boring ‘must do’ where the individual is counting down the minutes until it’s over.
If you want to learn more about the “friendly group of ‘Heart Patients’ from #EastLondon” who make up Two Touch Athletic Football Club, connect with them on Twitter (@TwoTouchAFC) or Linked In (TwoTouchAthleticAFC).
The conference that Farooq refers to was the 2019 Football is Medicine conference, University of Southern Denmark, Odense. It was led by Professor Peter Krustrup: http://ow.ly/7Xxn30oxFFR
You can find another BJSM patient podcast here: http://ow.ly/rXis30oxFMJ Christina Le shares her lived experience of suffering an ACL injury in 2017.

Physical Activity and Cancer, an update with Dr Rebecca Robinson. Episode #377

In this podcast Dr Katie Marino interviews Dr Rebecca Robinson about physical activity & cancer. Dr Robinson is a Sport and Exercise Medicine Consultant in Sheffield who has clinics at Weston Park Hospital in Sheffield working directly with cancer patients. During the podcast she gives a great insight into our current understanding of the use of physical activity in cancer patients. As Macmillan quote that by 2020 almost half the population will develop some form of cancer in their lifetime, it is important that we increase our understanding of how physical activity can be used to improve quality of life in this patient group. As mentioned in the podcast, please visit the following link for more information:
https://movingmedicine.ac.uk/disease/cancer/#start