BJSM Podcast

Player Medicals and Screening at Arsenal FC - Part Two

Screening is one of the hottest topics in Sports Medicine, and a topic which is constantly evolving. The BJSM has provided a platform for much of the academic literature concerning screening, but what actually happens at the coalface? In part one of this special podcast with Arsenal FC giants Colin Lewin, and Dr Gary O’Driscoll, we heard about the role of screening in professional sport, and how it ties in with player medicals, which is further elaborated on in this podcast. Other topics that are touched upon include the role of technology in predicting injury, the pressure of the jobs, and some tips for anyone working in football medicine/hoping to do so one day!
This podcast is bound to generate some deal of controversy, and if you’re looking for a platform to voice your opinion, you shouldn’t miss the Arsenal SEMS conference, with insights from the likes of Professor Roald Bahr, Adam Meakins, and Des Ryan amongst other influential names. The link to the event can be found at http://www.arsenal.com/semsconference - it’s bound to be one of the most insightful conferences of 2017!

Professor Bruce Forster: Using ultrasound imaging in the physiotherapy clinic. Pearls, pitfalls.

Bruce Forster is the Head of Radiology at the University of British Columbia. He was previously the director of diagnostic imaging at the Vancouver Winter Olympics and has authored over 80 peer-reviewed publications. In this podcast, we discuss:
- The role of MSK ultrasound in sports medicine and how to learn
- Structures that can be imaged and their challenges
- What to look for when purchasing an ultrasound machine?
- Ultrasound guided injections, including evidence behind PRP, stem cells and cortisone
- Pain science and the role of radiology in treating chronic pain
- Imaging for prognosis and RTP -when to image?
Bruce is presenting a workshop at the IOC Prevention Conference- details can be found here : http://ow.ly/SFcJ309KUve

Player Medicals and Screening at Arsenal FC - Part One

Screening is one of the hottest topics in Sports Medicine, and a topic which is constantly evolving. The BJSM has provided a platform for much of the academic literature concerning screening, but what actually happens at the coalface? BJSM Associate Editor Steffan Griffin chats to two giants of the football (and sports) medicine world – Colin Lewin, and Dr Gary O’Driscoll, who both head up the medical department at Arsenal Football Club – about the practical aspect of screening, and what role it plays in elite sport.
This podcast serves as a little taster to the Arsenal SEMS conference, which this year focuses on the role of screening, with insights from the likes of Professor Roald Bahr, Adam Meakins, and Des Ryan amongst other influential names. The link to the event can be found at http://www.arsenal.com/semsconference
Topics covered in this part one include:
What is involved with a player ‘medical’?
Who is involved with a player’s ‘medical’?
Is there a role for screening in elite sport?
Look out for the upcoming Part Two – where screening and player medicals are discussed in further detail.

Do platelet-rich plasma and stem cells have a role in sports medicine? Genetic testing?

Professor Tim Caulfield (@CaulfieldTim) is a best-selling author in the health and popular science domain. He has published over 300 articles into the ethical, legal and health policy of a broad range of topics including stem cell therapies, genetic testing, obesity treatment and the prevention of chronic disease. In this podcast, we discuss:
• Genetic testing and its predictive value- what place does it have in sports medicine?
• Stem cell therapies- evidence behind it and how it is portrayed by the media
• PRP- therapeutic benefits or another health fad?
• The role of athletes as celebrities in advocating new treatments
• 6 simple ways to maintain a healthy lifestyle.
Links to Tim’s hugely successful books can be found here http://ow.ly/TEfJ309ise8
David Epstein (@DavidEpstein) book The Sports Gene here: http://thesportsgene.com/

Professor David Hunter talks osteoarthritis exercise therapies: better outcomes

Professor David Hunter is a leading rheumatologist and researcher working at the University of Sydney. David has over 350 publications in rheumatology and has co-authored several books providing self-management strategies for patients with osteoarthritis. In this podcast, we discuss:
• Treatments of OA, what does and doesn’t work
• How to take a detailed history and examination from a patient with OA
• Cornerstones of patient care: behavioral change, self management and weight loss
• Weight loss strategies and how to maintain it
• Physiology behind how exercise improves symptoms
• Pharmacological and surgical treatments for OA
David caught up with Karim Khan after the 2017 Australasian College of Sport and Exercise Physicians (ACSEP) conference in the Gold Coast. The next event is February 2018 and is sure to be a huge success! http://ow.ly/t20j3093yZq

Dr Eammon Delahunt, international authority: Ankle sprain management and chronic instability

Eamonn is a wonderful clinician-scientist who graduated with a 1st Class Honours Degree from the University College Dublin (UCD) School of Physiotherapy in 2003 placing first in his class. Eamonn received a prestigious Irish Research Council for Science Engineering and Technology (IRCSET) post-graduate research scholarship. He was awarded his PhD from the UCD School of Physiotherapy and Performance Science in 2006, In this podcast that combines science with clinical application topics include:
• The high prevalence of ankle injuries and the high risk of the development of chronic residual symptoms.
• The characteristic features of CAI.
• How to manage the young soccer player who sustains an ankle injury.
• Detailed discussion of (1) modified Ottawa Ankle Rules; (2) determination of lateral ligament laxity; (3) syndesmosis assessment.
• How to assess for chronic ankle instability
• Mechanical insufficiencies including: (1) pathological laxity; (2) arthrokinematic restrictions; (3) synovial changes; (4) degenerative changes.
• Functional insufficiencies including: (1) impaired proprioception; (2) impaired neuromuscular control; (3) impaired postural control/postural balance; (4) impaired strength.
• Assessment of laxity and the use of taping and bracing.
• Patient-reported outcome measures clinicians can use including the FAAM, CAIT & idFAI
Associated papers and tools:
Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis
http://bjsm.bmj.com/content/early/2016/11/24/bjsports-2016-096858.long
Cumberland ankle instability tool ( 11 – chronic ankle instability (>11)
Foot and ankle ability scale: FAN ADL(21 items) and FAN sport (8 minutes)
Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium.
http://bjsm.bmj.com/content/48/13/1014
2016 consensus statement the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains.
http://bjsm.bmj.com/content/50/24/1493.long

Nutrition pearls for sport performance: Professor Graeme Close provides 27 practical tips

You want the big names on BJSM podcasts and Twitter asked for Dr Graeme Close. Fresh from the UK undergraduate student conference, Graeme shares pearl after pearl on this top podcast. What do you do in a first consultation? How does nutrition in team sport vary from individual sport? What’s the key to a successful pre-game routine? How should nutrition change when an athlete is injured? Supplements? Coffee? Sleep? Take home tips – all in this 16 minute gem.
Graeme has a great CV for his role in top sport. He is (i) a former professional rugby league player (clips here https://youtu.be/1mHljSGlQwA) (ii) a sports science PhD and now faculty at Liverpool John Moores University (iii) rumored to be the only person in the UK accredited with the official bodies for sports science (BASES), sports nutrition (SENr) and strength & conditioning (UKSCA). We call that the ‘triple crown’.
Kudos to medical student Tej Pandya for organizing the conference and for a great debut as a podcast host. BJSM’s podcasts have been hosted by 23 different interviewers and there are podcasts in 5 languages. Feel free to submit a podcast for our consideration. (info.bjsm@bmj.com)

Sports physiotherapist Dr Kristian Thorborg drills down on optimal loading. Heavy and Slow!

A world leader in sportsphysiotherapy, Associate Professor Dr Kristian Thorborg is from Copenhagen University. He is renowned for his studies and clinical workshops related to patients with hip, groin, hamstring and knee related injuries.
Here he outlines:
- the paradigm shift for the use of exercise to treat conditions such as tendinopathy and hamstring strains. He addresses questions such as ‘What is the ideal type of exercise?’ and ‘Does the body know if the exercise is concentric or eccentric?’
- cheap technology that can be used to help patients measure the load they are using and to check compliance
- the challenge of treating patients in season
- the concept of progression and the different stage of rehab that is preparation for ‘return to play’
- prevention – it needs monitoring of the players – waiting until they show up with pain is too late

Shoulder focus with leading sports physiotherapist Adam Meakins. Practical clinical pearls

How does a leading shoulder physiotherapist approach patients in the clinic? What are 3 fundamental principles that guide every consultation? Hear from extended scope practitioner Adam Meakins on how his approach to the patient with shoulder pain has changed over the past years.
Learn how you can provide exercises for your patient without needing sophisticated video equipment or cameras. Listen to tips on how to tell if the patient is fearful, perhaps at greater risk for a central contribution to pain.
Timeline
0:40 - Adam makes the case for 3 principles that guide every consultation
2:30 - Encouraging movement – both for health and to exercise injured parts (e.g. the shoulder)
4:00 - The need for patient education and advice. And how to do it.
8:35 - How much pain is OK?
10:30 - Treating the patient as an individual – the whole patient
12:40 - Is there a central component of pain?
13:19 - Which exercises to choose

Only 10 percent of concussions include loss of consciousness. Jon Patricios and Paul McCrory

The Berlin Concussion in Sport Consensus Meeting was held in October 2016 and the experts are currently writing the systematic reviews and agreeing on the final statement from this event. In the meantime, various panel members are sharing some key messages the world over. The knowledge translation needed from event such as this is extensive.
The experts are Dr Jon Patricios, sports physician and former President of the South African Sports Medicine Association (SASMA) and Paul McCrory, Associate Professor and neurologist at the Florey Institute of Neuroscience and Mental Health, Australia. Both attended the Berlin meeting.
Timeline:
0:45 Immediate management of concussion
2:54 Differences and common ground from elite level competition to the community setting
5:00 Balance and visual disturbances
8:26 Concussion in the developing brain
14:34 The update on CTE – chronic traumatic encephalopathy
16:40 Take home messages