BJSM Podcast

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.

Am I safe to move? Professor Lorimer Moseley: New understanding of pain and focusing on the patient

Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. http://people.unisa.edu.au/lorimer.moseley
He combines Oxford rigour with a laconic and very popular Australian style of communication. In this podcast he addresses the questions:
What’s new in our understanding of the spinal cord?
What should we be telling patients?
Is the ‘hands on, hands off’ debate a useful one?
How do you feel the profession is performing right now?
On the subject of what should we be telling patients, he argues we should train them to ask clinicians 3 questions.
1. How do I know my pain system is over-protective?
2. What can I do to retrain my system to be less protective?
3. Am I safe to move?
You can find his patient website ‘Tame the Beast’ here: https://www.tamethebeast.org/#home
And is previous BJSM podcast was on tendons. It has had >17K listens: http://ow.ly/5OGN30gkaD7.
And here is a link to the Pain Revolution website: https://www.painrevolution.org/

Would school rugby be better if collisions and tackles were banned? Prof Allyson Pollock

Allyson M Pollock is professor of public health and Director of Institute of Health and Society in the Medical Faculty of Newcastle University. She is a public health doctor and has been researching injuries and rugby injuries for more than ten years.
She takes what she describes as the ‘child’s perspective’ and asks – Do children know the risks of playing school rugby? Do all schools have appropriate risk mitigation? She reminds us that the health benefits of physical activity are well proven – but if one critically reviews the literature those benefits have not been proven for school rugby. This is a controversial position that is strongly countered by others. BJSM doesn’t have a position in this debate – our job is to highlight that there is a respectful debate and to encourage scrutiny of the existing evidence. We encourage researchers to add new data to this question and similar ones in sport.
Links:
University of Newcastle Press Release: Prof Pollock’s letter to all 4 Chief Medical officers of the UK: http://www.ncl.ac.uk/press/news/2017/09/banrugbytackleforkids/
World Rugby’s reply to above call. From The Guardian. https://www.theguardian.com/sport/2017/sep/26/ban-harmful-contact-from-school-rugby-games-to-reduce-injury-risk-say-experts
Professor Pollock’s call to ban tackling in rugby in the BMJ: http://blogs.bmj.com/bmj/2017/09/25/allyson-pollock-and-graham-kirkwood-tackle-and-scrum-should-be-banned-in-school-rugby/
A reply to Prof Pollock by Dr Ross Tucker and colleagues: http://bjsm.bmj.com/content/50/15/921
Prof Pollock’s reply to World Rugby: http://bjsm.bmj.com/content/51/15/1113
The BMJ profile of Prof Pollock – “BMJ Confidential” (must have BMJ subscription): http://www.bmj.com/content/359/bmj.j4625
Prof Pollock’s Wikipedia page: https://en.wikipedia.org/wiki/Allyson_Pollock

Key components of managing groin injuries in the elite athlete

Why are groin injuries so difficult to manage? How has rehabilitation advanced over the years? In this BJSM podcast, we interview Professor Michael Callaghan, Professor of Physiotherapy at Manchester Metropolitan University and Head of Physical Therapies at MUFC. We discuss the pressures of dealing with groin injuries in a team environment, the use of 1%ers, and surgical options for dealing with the groin.
Michael is involved with the organisation of the inaugural MUFC Conference starring experts in the field such as Damian Griffin, details of which can be found here: www.manutd.com/medicalconference
Another key BJSM podcast focusing on the biomechanics of groin injury can be here: https://goo.gl/GWeQ62
Adam Weir, vastly experienced physiotherapists, also shares his pearls on groin treatment here: https://tinyurl.com/y88zplkb