BJSM Podcast

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

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