BJSM Podcast

Consider psychological factors in when treating PFP. Prof Bill Vicenzino and Liam McLachlan #318

From the University of Queensland, Australia, physiotherapist and PhD candidate Liam McLachlan and Professor of Sports Physiotherapy Bill Vicenzino share clinical pearls relating to the patient with patellofemoral pain.
Dr Erin Macri, physiotherapist and BJSM editorial board member doing her postdoctoral studies at the University of Delaware leads the conversation.
• Why is it important to consider psychological factors in patellofemoral pain?
• Which instruments should I use in the clinic (clue, google “Startback tool”)
• Which comes first, the psychological distress or the pain?
• Can explanation and reassurance contribute to reducing pain and improving function?
• Bottom line – time to rethink from the narrow mechanical (only) perspective.
Here are some key links:
*Systematic review: The psychological features of patellofemoral pain: a systematic review. First author: Liam Maclachlan. http://bjsm.bmj.com/content/51/9/732 FREE
*Be sure to check the 3 BJSM Patellofemoral consensus statements (all free):
1. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. http://bjsm.bmj.com/content/50/14/839
2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) http://bjsm.bmj.com/content/50/14/844
3. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. http://bjsm.bmj.com/content/51/24/1713.long
*The STarT Back Screening Tool (SBST): Home page. https://www.keele.ac.uk/sbst/startbacktool/
Twitter: @Bill_Vicenzino: https://twitter.com/Bill_Vicenzino
@PaulWHodges: https://twitter.com/PaulWHodges (coauthor)

Olive oil, sunshine and a half hour walk - a conversation with Dr. Aseem Malhotra – Episode #317

In this Podcast, Heart Digital Media Editor Dr. James Rudd is joined by Dr. Aseem Malhotra from Lister Hospital, Stevenage, UK. They discuss what we should tell our patients about diet and exercise - high fat, low fat or something else?
Link to published paper: bjsm.bmj.com/content/51/15/1111
Further Listening
Management of mature athletes with cardiovascular conditions - https://soundcloud.com/bmjpodcasts/management-of-mature-athletes-with-cardiovascular-conditions?in=bmjpodcasts/sets/heart-podcast
Physical activity for the prevention of heart disease - https://soundcloud.com/bmjpodcasts/physical-activity-in-the-prevention-of-coronary-heart-disease-implications-for-the-clinician?in=bmjpodcasts/sets/heart-podcast
Aseem Malhotra on the impact of diet on heart disease https://soundcloud.com/bmjpodcasts/aseem-malhotra-dont-fear-the-fat
Fearless cardiologist author, Dr Aseem Malhotra, busts myths and shares Pioppi health secrets https://soundcloud.com/bmjpodcasts/fearless-cardiologist-author-dr-aseem-malhotra-busts-myths-and-shares-pioppi-health-secrets

Clinical tips from Dr. Kathryn Ackerman on how to manage athletes with low energy availability

Dr. Kathryn Ackerman talks in this podcast to Dr. Liam West about the hot topic of energy availability in sport giving us clinical tips to manage athletes we suspect might be at risk of the consequences of low energy availability.
Dr. Ackerman has undertaken board certification 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. Kathryn’s research focuses on the Female Athlete Triad and the various aspects of Relative Energy in Deficiency in Sport.
Related Articles
IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491
Misunderstanding the FAT - http://bjsm.bmj.com/content/48/20/1461
IOC RED-S Clinical Assessment Tool - http://bjsm.bmj.com/content/49/21/1354
Associated Podcasts
AMSSM Sports Medcast- Female Athlete triad - http://bit.ly/2lBP7WJ
Thoughts from the England Football CMO - http://bit.ly/2CpV6Zp
Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04
Podcast Quote
Low energy availability happens to others, it can happen to men, it can happen to disabled athletes.

How to keep athletes healthy when travelling. David Dunne explains the best strategies

For the 2nd time on the BJSM podcast, Sean Carmody is joined by David Dunne to discuss practical considerations for the travelling athlete. During his time with Orreco, David has worked closely with athletes from professional golf and the NBA, most of whom face gruelling travel demands during competition.
David and Sean delve into the strategies the practitioner can employ to help reduce the risk of illness, minimise the effects of jet lag, improve sleep and optimise performance. These strategies are complimented by lessons David has learnt during his PhD in Behaviour Change at Liverpool John Moores University.
Key research linked below:
Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2–3-fold increased risk of illness: http://bjsm.bmj.com/content/46/11/816.

Preventing and managing hamstring strain injuries: the Holy Grail of football medicine

In this podcast, Dr Sean Carmody speaks to Dr Nick van der Horst, who has recently published a paper on decision-making and medical criteria for return to play following hamstring strain injuries. Nick, who is First team physiotherapist at the Go Ahead Eagles in the Dutch Eerst Divisie and holds a PhD in football medicine, provides his thoughts on the controversies around the role of MRI and eccentric strength in determining return to play, and also shares his beliefs about why hamstring strain injuries continue to rise. Finally, Nick closes the podcast with his key tips for clinicians managing hamstring strain injuries.
There is lots of research referred to during the podcast, and these are linked below:
Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making:
http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-097206
Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study:
http://bjsm.bmj.com/content/early/2016/01/08/bjsports-2015-095359
Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey:
http://bjsm.bmj.com/content/early/2015/05/20/bjsports-2015-094826
Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making:
http://bjsm.bmj.com/content/early/2015/06/02/bjsports-2014-094569.short?rss=1
Hamstring injuries and predicting return to play: ‘bye-bye MRI?’
http://bjsm.bmj.com/content/49/18/1162
MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes:
http://bjsm.bmj.com/content/early/2015/08/24/bjsports-2015-094892

Rugby’s journey to improving player welfare – with Dr Martin Raftery & Dr Ross Tucker

Over the last few years, rugby medicine has been somewhat mired with controversy. From ‘Bloodgate’, to concussion, there have been many back-page features in the press, often calling for quite sensationalist measures.
Against this backdrop, and away from the gaze of the press, World Rugby have been busy synthesising an evidence base, and adapting the game to try and maximise player welfare. Such efforts have often flown under the radar, and today on the podcast we hear from its Chief Medical Officer & Senior Scientific Advisor, who address a variety of topics including:
-The process behind the recent law changes
-Trying to optimise the prevention and management of concussion
-Injury prevention
-Trying to build an evidence-informed player welfare initiative
Some resources that you may find useful, and are mentioned in the podcast include:
-World Rugby Medical website http://playerwelfare.worldrugby.org/
-The evidence underpinning the tackle laws
-Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies http://bjsm.bmj.com/content/51/15/1152
-Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review http://bjsm.bmj.com/content/50/15/921
-Tackle technique and body position of the tackler and ball carrier significantly influences head injury risk in rugby union http://bjsm.bmj.com/content/51/11/A70.2
-Berlin Concussion Consensus http://bjsm.bmj.com/content/51/11/838
Let us know your thoughts on what is discussed via the normal social media channels – we look forward to hearing from you!

Physical activity in the curriculum: impact in Schools of Medicine and new healthcare professionals

Embedding physical activity in the undergraduate healthcare curriculum is an important step to building capacity in the future workforce to promote physical activity, every contact.
This podcast features two UK medical schools and schools of health describing their approaches to upskilling tomorrow’s healthcare professionals, in physical activity, for tomorrow’s patients using the #MovementForMovement educational resources and a community of practice approach.
More about Ann Gates here: http://www.exercise-works.org/.
And here is the BJSM 2015 podcast with Ann Gates and Ian Ritchie on this topic - https://soundcloud.com/bmjpodcasts/training-tomorrows- doctors-in- exercise-medicine-for-tomorrows- patients. 6,000 listens already.

Low back pain in adolescents: Professor Stanley Herring talks spondylolysis

Professor Stanley Herring is a clinical professor at the University of Washington (UW) in the Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine, and Neurological Surgery. He is director of the UW Medicine Sports Health & Safety Institute, medical director of Sports, Spine and Orthopedic Health for UW Medicine, and co-medical director of the Sports Concussion Program, a partnership between UW Medicine and Seattle Children's.
Dr. Herring's clinical interests include non-operative musculoskeletal and sports medicine with a particular interest in disorders of the spine and sports concussion. He is a team physician for the Seattle Mariners and a consultant to the UW Sports Medicine Program.
In this podcast he talks to BJSM’s Liam West about an important cause of low back pain in our adolescent sporting population – spondylolysis. They discuss common presentations, examination techniques, imaging protocols and clinical pearls for treatment.
References
Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis - http://bjsm.bmj.com/content/40/11/940.info
Nonoperative treatment of active spondylolysis in elite athletes with normal X-ray findings: literature review and results of conservative treatment - https://www.ncbi.nlm.nih.gov/pubmed/11806390
Union of defects in the pars interarticularis of the lumbar spine in children and adolescents - http://bjj.boneandjoint.org.uk/content/86-B/2/225
Nonoperative treatment in lumbar spondylolysis and spondylolisthesis: a systematic review - https://www.ncbi.nlm.nih.gov/m/pubmed/24427393/

Was ist evidenz basierte Medizin und warum ist es so wichtig für unser tägliches Handeln?

Die Evidenz basierte Medizin ist ein Grundpfeiler medizinischen Handelns und ist im täglichen Leben des Arztes und Physiotherapeuten nicht mehr wegzudenken.
Dr Andreas Waltering (IQWIQ) gibt uns eine Einführung in die Evidenz basierte Medizin (EBM). Anfangen mit der Entstehungsgeschichte der EBM. Die EBM wurde im Gegensatz zu Deutschland von der Ärzteschafft selber gefordert. Im deutschsprachigen Raum wurde die EBM primär eingeführt um der Fehlversorgung entgegen zu wirken.
Dr Markus Laupheimer (@swisssportscare) stellt die Fragen.
Wieso ist EBM wichtig?
Sollen wir den Vorlieben der Chef oder Oberärzte folgen? Oder sollen wir Patientenbezogen die EBM einsetzten?
EBZ ist für ein Gesundheitssystem wichtig um Therapien die nachweislich was Bewirken zu fördern und zu bezahlen. Im Gegensatz dazu sollten Therapien die Nachweislich keinen Nutzen haben nicht von der Solidargemeinschaft bezahlt werden.
Systematische Übersichtsarbeiten helfen Verzerrungen von einzelnen Studien zu vermeiden um den größten Aussagewert zu erhalten.
Hierarchie der Evidenz: http://canberra.libguides.com/c.php?g=599346&p=4149721
Praktisches Beispiel in der Sportmedizin gibt es viele, jedoch eines der meisten untersuchten Therapien ist die Arthroskopie bei Gonarthrose, welche keinen Vorteil zu Placebo zeigt.
#Bewegungsmedizin #Evidenzbasiert
Dabei sollten wir nicht vergessen “Bewegung bringt Heilung” (https://soundcloud.com/bmjpodcasts/einfuhrung-in-die-bewegungsmedizin-bewegung-bringt-heilung-mit-dr-boris-gojanovic?in=bmjpodcasts/sets/bjsm-1)
Weitere links zur Evidenzbasierten Medizin:
Deutsches Netzwerk Evidenzbasierten Medizin e.V.
http://www.ebm-netzwerk.de/
Center of evidence-based medicine University of Oxford
IQWIQ : Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen
https://www.iqwig.de/
Euch einen aktiven und bewegungsreichen Tag!
Nun viel Spaß mit diesem Podcast des BJSM. Und vergesst nicht uns auf Twitter @BJSM_BMJ, Facebook oder google+ zu folgen. Da gibt es regelmäßig neue updates.
Für feedback oder Anregungen für neue Podcasts schreibt mir einfach eine mail markus@swisssportscare.com

Behind the scenes of the new SCAT5 – tips, tricks and clinical pearls for treating concussion

Dr. Michael Makdissi is a Sports & Exercise Medicine (SEM) Physician based in Melbourne. He has pursued a career that blends both clinical and research roles. His research is mainly based around concussion and it is this area where he has become a globally respected voice.
Liam West poses the questions in this podcast that sees Dr. Makdissi discuss the new Sports Concussion Assessment Tool (SCAT) 5, common mistakes made when managing athletes with concussion, updates within the SCAT5 and tips on how to use it.
To read the full paper related to the new SCAT5 please follow the link, The Consensus Statement - http://bjsm.bmj.com/content/51/11/838.
Or head to the BJSM website to find further related papers:
The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale - http://bjsm.bmj.com/content/51/11/848;
Sport concussion assessment tool - 5th edition - http://bjsm.bmj.com/content/51/11/851.