BJSM Podcast

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

Transparency and innovative thinking: how rugby is tackling concussion (Part two)

Rugby is often maligned in the press for its inevitable relationship with concussion, with numerous high-profile incidents only compounding the issue. If your reading is restricted to the newspapers, you’d be forgiven for thinking that a culture of denial is in place, however when you delve deeper, there are numerous examples of innovative and powerful research, all of which is already leading to law and policy changes. One leading light in the sport is the Rugby Football Union (RFU), who are actively conducting policy-informing research, and using this to shape the game in order to maximise player welfare. Steffan Griffin, of the BJSM, caught up with Dr Simon Kemp (Chief Medical Officer), Dr Matt Cross (Professional Rugby Medical Research Officer), and Dr Mike England (RFU’s Community Rugby Medical Director), who provide an insight into their work, which is not only shaping the way the game is played, but provides a fantastic blueprint for other sports to follow. Here is Part 2!
Timeline:
0.35: Is there a relationship between when players are removed & their subsequent recovery?
5.13: What else is the RFU doing around concussion?
8.36: Will we ever prevent concussions in rugby?
16.45: What are we hoping to hear about at the Berlin Consensus Conference?

Professor Lars Engebretsen on management of young, adult and older patients with knee injuries

Professor Lars Engebretsen is the Head of Scientific Activities in the Department of Medicine and Science at the International Olympic Committee. An orthopaedic surgeon, he is a strong advocate of the multidisciplinary approach to patient care. Among his many awards are the Nordic Prize in Medicine and the American Orthopaedic Society of Sports Medicine Hall of Fame. He is the Editor of the BJSM’s Olympic-supported issues (4 per year, usually numbers 1, 7, 11 and 17).
Timeline:
0:40 mins - Surgical management of the patient with the acute ACL rupture – emphasis on early rehabilitation
1.44 mins - Prehabilitation – a definite focus
5.54 mins - The locked knee – what is it and how does finding one affect management?
8.00 mins - Is surgery indicated for meniscal injuries or not?
9.12 mins - The paediatric ACL (age 8-12 years). What’s the best management?
13.50 mins - IOC education courses with a focus on the 2-year online diploma.

Pain Coach, how the first contact with a patient can be the most important moment of all

Do you consider the first 10 seconds of a consultation to be important? Have you looked at your clinic space and how that might affect your patients? In this podcast Steve Aspinall (BASRaT) speaks to Richmond Stace @painphysio about the importance of compassion and active listening in the treatment of pain.
Richmond is presenting at the BASRaT symposium on the 18th of November in London.
Our Symposium this year will focus on pain; with unmissable keynote speeches from experts in the field and presentations and workshops that will enrich your knowledge.
Focussing exclusively on pain and all its forms and manifestations it will be vital for practitioners to help manage and manipulate pain and help people from all walks of life.
Our unmissable range of speakers includes Richmond Stace who is leading advances in understanding and treating pain and has created the pain coach programme.
Richmond will look into the importance of the first point of contact, how we can gain information from the first few words.
We have a range of workshops including "Gold from Rio"- BASRaT Sport Rehabilitator, Hannah Crowley helped Ed Clancy on his road to recovery from a back injury and to his gold medal win at Rio.
Our closing keynote "Pain, the Brain and a little bit of Magic" will be presented by Professor Anthony Jones. Professor Jones is an MSK pain specialist and leads the Human Pain Research Group.
This one day event on Friday 18th November will be packed full of essential speeches, presentations and seminars, enriching your knowledge and aiding your work.
BOOK NOW. Visit basrat.eventbrite.co.uk.
Timeline:
1:03 How big is the problem of pain?
2:39 What does good communication mean?
8:00 What are the key points in an interview about pain?
12:11 How to pain the patients journey?
16:44 Is neuroscience education important?
18:59 Key messages for the clinician
Links:
http://basrat.org/
http://www.eventbrite.co.uk/o/british-association-of-sport-rehabilitators-and-trainers-6930299875

The Daily Mile: Is this the game changing public health initiative we have been waiting for?

Over the last 20 years across the western world the increasing toll of sedentary behaviour on young peoples physical and mental wellbeing is a well-documented phenomenon. Many different piecemeal policy initiatives have failed to tackle the problem. In this podcast Steve Aspinall (BASRAT) speaks to head teacher Elaine Wyllie about the daily mile initiative. This simple game changing initiative provides massive public health benefits though a simple philosophy of non-competitive outdoor fun that is accessible to all children regardless of age, gender, ability or socioeconomic background.
Listen to Steve and Elaine discuss this inspirational initiative and find out how you can get involved:
Timeline:
1:03 What is the daily mile?
1:49 How is the daily mile implemented in schools what are examples of best practice?
4:54 Does the daily mile work for all children?
8:56 How does the weather impact participation?
11:43 Local and national level support
15:04 Preliminary results of a large scale study
17:00 How to get involved
Links:
http://thedailymile.co.uk/
http://basrat.org/
http://www.eventbrite.co.uk/o/british-association-of-sport-rehabilitators-and-trainers-6930299875

Transparency and innovative thinking: how rugby is tackling concussion (Part One)

Rugby is often maligned in the press for its inevitable relationship with concussion, with numerous high-profile incidents only compounding the issue. If your reading is restricted to the newspapers, you’d be forgiven for thinking that a culture of denial is in place, however when you delve deeper, there are numerous examples of innovative and powerful research, all of which is already leading to law & policy changes. One leading light in the sport is the Rugby Football Union (RFU), who are actively conducting policy-informing research, and using this to shape the game in order to maximise player welfare. Steffan Griffin, of the BJSM, caught up with Dr Simon Kemp (CMO), Dr Matt Cross (Professional Rugby Medical Research Officer), and Dr Mike England (RFU’s Community Rugby Medical Director), who provide an insight into their work, which is not only shaping the way the game is played, but provides a fantastic blueprint for other sports to follow. This is Part 1: in the build up to the Berlin Consensus Conference.
Timeline:
01:15: Can you give us some insight into the scale of concussion in Rugby Union?
04:00: Are the rising rates due to increased incidence or due to people being more likely to recognise and report it nowadays?
06:45: What is the RFU’s general approach to the management of Concussion?
08:45: Can you tell us a little about the ‘recognise, remove, recover and return’ campaign?
14:00: So the aim is to remove as many concussed players from the pitch as soon as possible: what else is the RFU doing to try and ensure this?
19:15: you have published a number of papers in the BJSM – one of which showed a relationship between concussion and subsequent musculoskeletal injuries – could you please elaborate?
21:50: What does this mean about the return to sport following concussion? How could this influence practice?
Links
Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015 http://bjsm.bmj.com/content/early/2016/09/01/bjsports-2016-096461.abstract
The accuracy and reproducibility of video assessment in the pitch-side management of concussion in elite rugby http://www.jsams.org/article/S1440-2440(16)30142-6/abstract
Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes http://bjsm.bmj.com/content/early/2015/12/01/bjsports-2015-094982.full
BJSM Podcast with the Heath Brothers & Mike Evans: https://soundcloud.com/bmjpodcasts/23-5-hours-to-switch-behaviour?in=bmjpodcasts/sets/bjsm-1

Phil Glasgow talks all things around the hip and treatment

Phil Glasgow is the head of sports medicine at the Sports Institute, Northern Ireland. A vastly experienced physiotherapist, he has worked at 3 Olympic Games, and has just returned from Rio. In this podcast, we discuss a case history of a football player with hip pain, from assessment to RTP. We look at the sensitivity vs. specificity of various tests, how to explain the symptoms to patients, and any co-existing pathologies there may be in the athlete. Finally, the discussion moves to treatment, the role of manual therapy, and exercises the patients can do to increase strength in the tissue.
The 2nd World Conference of Sports Physiotherapy will be held in Belfast, 2017- details can be found here: http://bit.ly/2dP2HjH
Timeline
0.40 - Hip pain: a case history and when is it reported to the physio?
3.08 - Ruling things out in the hip is easy: how do we rule things in?
7.30 - Things to consider when treating the hip
10.30 - Prescribing exercise for the patient - how do we go about it?
13.00 - How to increase the load in the injured athlete
18.26 - Bridging exercises for the hip
22.50 - Building a model for the pain and tips from the top

Professor Peter Brukner on food as medicine. No industry funding.

“A few years ago, like most doctors, I was pretty ignorant on the topic of food and medicine” is how Peter Brukner, Professor at Latrobe University’s Sport and Exercise Medicine Research Centre opens this podcast. He summarises 4 years of engaging seriously with nutrition for health and in sport. His comments apply to the general public, the recreational athlete and he shares his experience from elite level sport. Peter has been involved in an international nutrition educational leadership group that includes Professor Timothy Noakes, Dr Aseem Malhotra, Dr Sarah Hallberg, Dr Jason Fung, Nina Teicholz and Gary Taubes. Recent reports that the sugar industry paid two Harvard professors to write a piece for the New England Journal of Medicine https://www.statnews.com/2016/09/12/sugar-industry-harvard-research/ makes the opinion of unbiased academic clinicians like Peter Brukner even more timely.
Relevant links:
Peter Brukner on the other side of the mike interviewing Professor Timothy Noakes: https://soundcloud.com/bmjpodcasts/high-fat-for-health
Dr Jason Fung on the impact of diet on obesity and type 2 diabetes mellitus: https://soundcloud.com/bmjpodcasts/dr-jason-fung-on-the-impact-of-diet-on-obesity-and-type-2-diabetes-mellitus
Prof Stephen Phinney on the science behind low carb diets for athletes: A rational approach:
https://soundcloud.com/bmjpodcasts/prof-stephen-phinney-on-the-science-behind-low-carb-diets-for-athletes-a-rational-approach?in=bmjpodcasts/sets/bjsm-1
If you think that BJSM is only sharing one side of the story please use our various channels to contribute. Papers, blogs, podcasts, Twitter, Facebook - we’d love to hear from you. We haven’t rejected any papers saying that hi-carb is good for you!