BJSM Podcast

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

How many push-ups can you do? Assessing cardiovascular risk with Dr Alex Hutchinson PhD. #376

Drop and give us 20.
On this week’s BJSM podcast, Dr Alex Hutchinson PhD (T:@sweatscience) joins BJSM’s Daniel Friedman (T: @ddfriedman) to make sense of all of the click-bait headlines and explore whether push-up prowess is the secret to long life.
Alex writes Outside’s Sweat Science column, about the science of endurance and adventure. He started out as a Cambridge-trained physicist and long-distance runner on the Canadian national team. As a journalist, he earned a National Magazine Award for his energy reporting with Popular Mechanics, covered adventure travel for The New York Times, and wrote a training column for Runner’s World. His latest book, out in February 2018, is ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance. He lives in Toronto, where he runs fast, climbs poorly, and gets outside as much as possible with his wife and daughters.
In this 17-minute conversation, Alex discusses:
· If push-ups can predict your likelihood of future cardiovascular events
· What we can learn from functional tests that aim to assess different health outcomes
· New data on the cardio vs weights debate
Further reading:
Yang J, Christophi CA, Farioli A, Baur DM, Moffatt S, Zollinger TW, Kales SN. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA network open. 2019 Feb 1;2(2):e188341-. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778
Stamatakis E, Williamson C, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH. Infographic. Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts. Br J Sports Med. 2019 Mar 1:bjsports-2018. https://bjsm.bmj.com/content/early/2019/03/01/bjsports-2018-100468.abstract
Harb SC, Cremer PC, Wu Y, Xu B, Cho L, Menon V, Jaber WA. Estimated age based on exercise stress testing performance outperforms chronological age in predicting mortality. European journal of preventive cardiology. 2019 Feb 13:2047487319826400. https://journals.sagepub.com/doi/10.1177/2047487319826400

Talking Tendinopathies & Solving the Soleus Conundrum with Seth O’Neil. Episode #375

Seth is a physiotherapy lecturer at the University of Leicester with a special interest in calf & Achilles injuries, having completed his PhD on Achilles Tendinopathy. He joins us to answer some of these questions
· What are the biggest risk factors for Achilles tendinopathy (AT)?
· What would be your biggest bang-for-buck treatments for AT?
· What would you say were the most useful markers for progression?
· Where do you think people are going wrong in the treatment of AT in general – what are the most common misconceptions/mistakes?
· How important is the role of the soleus in ankle/calf function, and sporting performance in general?
· In terms of managing soleus injuries, what tips would you have for clinicians out there?

In pursuit of the unbreakable athlete with Tim Gabbett. Episode #374

What comes first—the robust athlete or the high training load? What is the role of moderating factors in training load? And is the ‘10% rule’ a myth?
On this episode, Dr. Tim Gabbett PhD x2 (T: @TimGabbett) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss all things training load and debunk some common misconceptions.
Tim has over 20 years of experience working as an applied sport scientist with elite athletes, coaches, and high performance teams from around the world. He holds a PhD in Human Physiology (2000) and has completed a second PhD in the Applied Science of Professional Football (2011), with special reference to physical demands, injury prevention, and skill acquisition. www.gabbettperformance.com
In this 20 minute conversation, Tim discusses:
· The definition of training load and its different components
· The Acute:Chronic Workload Ratio (ACWR) and its limitations
· What separates robust from fragile athletes
· The 10% rule ‘myth’
· How to design a rehabilitation training program for an injured athlete
Further reading:
Gabbett TJ, Nielsen RO, Bertelsen ML, Bittencourt NF, Fonseca ST, Malone S, Møller M, Oetter E, Verhagen E, Windt J. In pursuit of the ‘Unbreakable’Athlete: what is the role of moderating factors and circular causation? https://bjsm.bmj.com/content/early/2018/11/13/bjsports-2018-099995
Gabbett TJ. Debunking the myths about training load, injury and performance: empirical evidence, hot topics and recommendations for practitioners. Br J Sports Med. 2018 Oct 26:bjsports-2018. https://bjsm.bmj.com/content/early/2018/10/26/bjsports-2018-099784
Gabbett TJ. The training—injury prevention paradox: should athletes be training smarter and harder?. Br J Sports Med. 2016 Mar 1;50(5):273-80. https://bjsm.bmj.com/content/50/5/273
Hulin BT, Gabbett TJ, Lawson DW, Caputi P, Sampson JA. The acute: chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med. 2016 Feb 1;50(4):231-6. https://bjsm.bmj.com/content/50/4/231
Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett T, Gleeson M, Hägglund M, Hutchinson MR, Van Rensburg CJ. How much is too much?(Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016 Sep 1;50(17):1030-41. https://bjsm.bmj.com/content/50/17/1030

Upper extremity issues in the adolescent overhead throwing athlete. Episode #373

What common injury patterns do adolescent overhead throwing athletes face? What are the current pitch count recommendations and evidence for their use? How can we best monitor and encourage compliance with these recommendations? Host Dr. Devin McFadden, MD is joined by Dr. Jason Zaremski to explore these topics and more on the AMSSM Sports Medcast.
Dr. Zaremski is an assistant professor from the Division of Physical Medicine and Research, Department of Orthopaedics and Rehabilitation and Co-Medical Director of the Adolescent and High School Outreach Program at the University of Florida College of Medicine in Gainesville, Florida. He is also a past participant in the AMSSM International Travelling Fellowship program, having recently travelled to Scandinavia where he shared insights on the above topics and learned how the Scandinavians deal with similar injuries.
In this 30 minute conversation Dr. Zaremski addressed the following topics:
What are common injury patterns in adolescent overhead throwing athletes?
What injury prevention strategies have been enacted and what is the evidence for their use?
When to consider operative rather than conservative treatments.
Mechanisms and Treatment of Throwing Injuries- https://journals.lww.com/acsm-csmr/fulltext/2017/05000/Mechanisms_and_Treatments_for_Shoulder_Injuries_in.17.aspx
Zaremski ZL, Wasser JG, Vincent HK. Mechanisms and Treatments for Shoulder Injury in Overhead Throwing Athletes. Current Sports Medicine Reports. 2017;16(3):179-188
Unaccounted Workload in Pitch Counts- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894908/
Zaremski JL, Zeppieri G, Jones DL, et al. Unaccounted workload factor: game-day pitch counts in high school baseball pitchers- an observational study. Orthop J Sports Med. 2018;6(4):1-7
The Thrower’s Ten Exercises- https://insights.ovid.com/pubmed?pmid=28498227
Wilke KE, Yenchak AJ, Arrigo CA, et al. The advanced throwers ten exercise program: a new exercise series for enhanced dynamic shoulder control in the overhead throwing athlete. Phys Sportsmed. 2011;39(4):90-97.