BJSM Podcast

Need a big fat surprise? Iconoclast Nina Teicholz via Dr Mark Hyman on healthy fats. #Ep338

BJSM is one of very few channels that comments on food but doesn’t receive any funds from any food-related stakeholder. The BMJ doesn’t receive funds from food companies (as far as I know) and the new BMJ Open journal on nutrition doesn’t either. What about the ‘British Nutrition Foundation’ – sounds pretty helpful right? Well, it may be, but if you know where to click 5 times you can find that about 1/3 of its funding from corporate sponsors. The Academy of Nutrition and Dietetics has food sponsors too. That’s perfectly legal.
What about Government Food Guidelines – surely they are based on health evidence? Well, they may be, but governments run the food guidelines past their Departments of Agriculture before finalizing them. And that is OK too – I can understand why that would happen – of course that Department has to have input. Government requires balancing competing interests.
I don’t recommend people following national food guidelines (personal opinion – k2). I wouldn’t follow most nations’ food guidelines if I were given the food for free and paid $100 per day. Not for $500 per day – sorry. I’m fortunate as I’m on stable financial footing (touch wood). And what I eat may be ‘wrong’. This podcast is shared with the BJSM community in a spirit of humility and to provide data for folks to make up their own minds.
Nina Teicholz is a journalist (let’s get than in early to save the critics from bringing it up – pre-empting the ad hominem attack) and she has a fascinating book that argues fats have been unfairly demonized. Since that book was published the news that Harvard scientists were paid for a report suggesting that fats, not sugar, caused obesity. http://ow.ly/j1Bc30kCvqx. Nina Teicholz tweets from @bigfatsurprise.
Thanks to Dr Mark Hyman (@MarkHymanMD) for allowing us to edit his conversation with Nina Teicholz.
Link to a recent Nina Teicholz comment in The BMJ: https://www.bmj.com/content/360/bmj.k822/rr-13
Here’s a link to the book that documents the case for healthy fats: https://thebigfatsurprise.com/
The original (full version) of Dr Mark Hyman’s podcast with Nina Teicholz on YouTube https://youtu.be/Zc_e5ME_5Cg
Thanks again to Dr Mark Hyman and Nina Teicholz.

Treating hip pain including FAI syndrome. Arthroscopy or focused physio? Prof Damian Griffin Ep#337

Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Here’s a link to his personal website: http://www.hiparthroscopyclinic.co.uk/
He was the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302.
He has published a major paper in the field of hip pain in one of the top sports medicine journals – The Lancet. Published @TheLancet on June 2nd. http://ow.ly/4LhQ30kvJ1u BJSM fortunate to have chatted with @DamianGriffin courtesy of @footballmed. Podcast about it with the BJSM community in two weeks - 15th June (all 2018).
Previous podcast with Damian Griffin: About the FAI syndrome: http://ow.ly/oo7530kvJB5. Two years ago. Griffin DR, Dickenson EJ, O'Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med2016;50:1169-1176.
http://bjsm.bmj.com/content/50/19/1169
You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk

Anthem for football fitness. Football isn’t just fun, it’s broad-spectrum medicine. Ep #336

Dr Marcos Agostinho (@MarcMedMD) asks Professor Peter Krustrup (http://ow.ly/9slg30koLv1) about the history of football fitness. What is it? Does it involve games/competition? Who are the main beneficiaries? And what of ‘walking football’ – what does that entail? This short podcast is a celebration of the health benefits of football and it provides powerful practical examples of what can be done. Kudos!
The 2nd International Football and Medicine Conference will be held in Odense, Denmark, on 25-26th January 2019.
Here is a 2018 systematic review: Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis. http://ow.ly/oGBs30koLzT

Time to catch the brain bus to learn from pain educators. Lorimer Moseley and Karim Khan.

Have you ever felt frustrated that research doesn’t get into the public domain? It’s stuck in journals, on shelves. But Lorimer is tackling that head on with community based engagement in his characteristic quirky way.
Listen to the story of the ‘Pain Revolution’ – a movement that engages local communities by having trained pain educators share contemporary pain science in accessible ways. Ignore the massive bike ride that Lorimer and friends undertake to spread the message and raise the funds (for now!). Listen to the story that underpins ‘Tame the Beast’ and watch it. Share it widely.
Part 2 next week!
Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. people.unisa.edu.au/lorimer.moseley
He combines Oxford rigour with a laconic and very popular Australian style of communication.
You can find his patient website ‘Tame the Beast’ here: www.tamethebeast.org/#home
You can find his academic/health professional website ‘Body in Mind’
here:www.bodyinmind.org/
Lorimer’s 2014 BJSM podcast was on tendons. Still worth listening to. It has had 20K listens:ow.ly/5OGN30gkaD7.
The 2017 podcast on pain was on pain (some overlap): http://ow.ly/XgNi30kaQax

Running Biomechanics 101 with Chris Bramah. Episode #334

How do we assess running biomechanics? Does it translate to practice? BJSM editor Tej Pandya chats with Chris Bramah (@chrisbramah), England Athletics physiotherapist and biomechanist based at the Manchester Institute of Health and Performance. Chris is completing a PhD dissertation on the links between running gaits and running injuries.
They discuss:
- Biomechanics of elite running athletes
- Applying biomechanics to produce clinically relevant outcomes
- A case of ITB syndrome in runners: What’s the role of biomechanical assessment?
- Advances biomechanics technology
- How the clinician can use biomechanics to assess athletes
Links to some of the papers mentioned in the podcast:
- How to estimate centre of mass in running? https://bit.ly/2k4KbbV
- Movement of the spine and pelvis during running. https://bit.ly/2La501S

What limits sporting performance? Is it in the muscles or does the mind matter? Dr Alex Hutchinson

A great conversation between the fascinating Dr Alex Hutchinson and sports physiotherapist Chris Napier. Alex Hutchinson will be known to many because of his sports writing for Runners World (in the past) and Outside Magazine (now). He spent 9 years asking the question that is the title of this podcast – you get the answers in 20 minutes!
In addition to the discussion of limits of performance, they share practical tips on how to improve your own running times!
Here’s a link to Alex’s website https://alexhutchinson.net/about.htm and his twitter handle is @SweatScience. Here’s the link to Alex’s book ‘Endure’: http://ow.ly/oqlF30jWuiw
The insightful interviewer is also a runner - the Vancouver sports physiotherapist and near PhD graduate – Chris Napier @RunnerPhysio. Chris heads the Scientific Committee for the World Congress in Sports Physiotherapy (2019). That conference, which builds on previous World Congresses in Bern and Belfast will be held in Vancouver, Canada, October 4-5, 2019. http://ow.ly/Y1Qj30jWutO. The World Congress is being hosted by Sports Physio Canada @SportPhysio_ON.

Sport 1st, disability 2nd. Paralympian Cheri Blauwet discusses SEM in elite disability sport #322

Dr. Cheri Blauwet is a leading and inspiring voice in sport and exercise medicine (SEM). She is a former Paralympic athlete in the sport of wheelchair racing, competing for the United States Team in three Paralypmic Games (Sydney '00, Athens '04, Beijing '08) and bringing home a total of seven Paralympic medals. She is also a two-time winner of the Boston Marathon.
After an elite sporting career, she turned her attentions to medicine. Dr. Blauwet completed her residency training in Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital/Harvard Medical School and followed this by a Sports Medicine Fellowship at the Rehabilitation Institute of Chicago. A successful and influential career in SEM has so far culminated in Cheri acting as the Chairperson of the International Paralympic Committee’s Medical Commission. She also serves on the Board of Directors for the United States Anti-Doping Agency (USADA), promoting clean competition in sports.
BJSM’s Liam West talks to Dr. Blauwet to highlight top learning points from her journey into SEM and the must know topics in disability sport.
You can hear Cheri talk further on this topic at the Canadian Academy of SEM 2018 conference in New Halifax in June - https://bit.ly/2rif5S0
Similar Podcasts;
Cerebral Palsy Soccer - https://soundcloud.com/bmjpodcasts/cerebral-palsy-football-1?in=bmjpodcasts/sets/bjsm-1
Further Reading;
Webborn N, et al. Heads up on concussion in para sport. Br J Sports Med 2017 doi:10.1136/bjsports-2016-097236
Derman W, et al. Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-097962
Mountjoy M, et al. The IOC Consensus Statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med 2016 doi:10.1136/bjsports-2016-096121
Derman W, et al. High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-098039
Blauwet CA, et al. Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline A Prospective Cohort Study at the London 2012 Paralympic Games. Am J Sports Med 2016;44:6
Blauwet CA, et al. Low Energy Availability, Menstrual Dysfunction, and Low Bone Mineral Density in Individuals with a Disability: Implications for the Para Athlete Population. Sports Med 2017;47(9):1697-1708

Patient’s Voice: It felt like my entire shin had dislocated from the rest of my body. Episode #331

Thanks to Christina Le for providing the first ‘patient voices’ podcast for BJSM. Christina is speaking as a 31-year old patient who is dealing with a common scenario – non-contact ACL rupture while playing soccer. You can follow her patient journey and obtain advice from a top sports physio at @YEGphysio. Christina chatted with BJSM editor-in-chief Karim Khan.
Christina addresses these common questions:
How did the injury occur? Did you feel any pain later? How did you decide whether to opt for surgery or no surgery? What lifestyle changes are you prepared to make after this injury? With whom did you discuss further options? How do you know when to return to sport?
Links: Return to play: 2016 Consensus statement link - http://bjsm.bmj.com/content/50/14/853
Dr Stepanie Filbay on return to sport factors post ACL reconstruction. https://www.ncbi.nlm.nih.gov/pubmed/27167588
Patient voices: Thanks to Osman Ahmed and Tracy Blake for launching the BJSM series. Read the blog here. http://ow.ly/1s4H30jHO1U.

Taking the stress out of stress fractures. Deep dive & clinical tips w/ Dr. Kathryn Ackerman

Managing stress fractures in any athlete can be difficult. Liam West discussed the topic with international expert Dr. Kathryn Ackerman, to find out clinical management gems.
Dr. Ackerman has specialist training in Internal Medicine, Sports Medicine and Endocrinology, Diabetes & Metabolism. This training has cumulated in positions as Medical Director of the Female Athlete Program at Boston Children's Hospital, Associate Director of the Sports Endocrine Research Lab at Massachusetts General Hospital, and Assistant Professor of Medicine at Harvard Medical School. She has focused research efforts on hormonal treatments to improve bone density and fracture healing, as well as various imaging modalities for assessing bone quality.
Related Articles
Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. bjsm.bmj.com/content/49/6/370.long
IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491
Associated Podcasts
Management of difficult stress fractures in sport - http://bit.ly/2EVorIM
Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04
Podcast Quotes
“There is a transient osteopenia during adolescenece that predisposes them to stress fractures”
“Amenorrhic athletes have wider but weaker bones”

“Dr Skynet will see you now.” Machine learning in sports medicine: Tommy Wood and Chris Kelly #329

Machine learning. One of the buzz expressions currently being bandied around healthcare. But how can it be applied in sports medicine? In this BJSM podcast, we discuss it with two scientists currently applying machine learning to their practice, Chris Kelly and Dr Tommy Wood from nourishbalancethrive, a US-based performance optimization company. We discuss the applications of machine learning and its potential implications for healthcare.
Topics include:
- How to go about creating a machine learning model
- What have they managed to predict so far
- Limitations of using machine learning
- Where do they see this technology moving forward to the future?
- How can clinicians in sports use machine learning in practice?
- How can anyone learn about machine learning?
Link to nourishbalancethrive: https://bit.ly/2q3Yyk4
Link to an easy way to getting into coding: https://bit.ly/2EjQM9Y