BJSM Podcast

Putting load management evidence into practice: Sometimes you can’t! Dr Darren Burgess

The BJSM community wants practical tips and this podcast earns 10/10 for that feature. The guest, @DarrenBurgess25 is an international leader in working in sports medicine/sports science at the highest level. BJSM Associate Editor Paul Visentini (@PaulVisentini) asks great questions.
1. How do you bring the evidence into your practical job at High Performance Manager at Port Adelaide Football Club (Australian Rules Football) (1 minute in)
2. The art from a master. What are the clinical features you use to determine what the players need? (4 minutes in)
3. How do you reconcile individual differences when you are working with a team? (7 minutes in)
4. Usain Bolt, Luis Suarez – they don’t follow the textbook. What are the minimum requirements for strength? (9 minutes in)
5. Capacity in tissue – and for a whole player. How much can we alter/improve capacity? (See also Jill Cook’s podcast on this and paper, link below)
6. What other features – beyond GPS and data – What do you look for in player welfare? (14 minutes in)
Personal note here from Karim Khan: What a great insight into top level sport!! I loved this podcast – the honesty, the specific points. Darren is a master of ‘the sticky message’. Has he read ‘Made to Stick’ or is he just a natural? Wow!! I feel privileged to be part of the BJSM community to learn like this.
Next week. Dr Kieran O’Sullivan (Ireland, @KieranOSull) and a German-language podcast where Aspetar’s Ekaterina Sandakova asks the questions of Keller Mattias. #InternationalCommunity
Links:
1. Very closely related podcast on load: Dream Team @TimGabbett and colleagues discuss how to manage load to improve performance and minimize injury risk http://ow.ly/4mYQmZ
2. Hear more from Darren Burgess here: Who should lead the sports medicine / high performance team? http://ow.ly/4mYRtm
3. The core concept of ‘tissue capacity’. @ProfJillCook and @SIDocking are the authors and here’s the link: http://ow.ly/4mYUMI
4. One cannot leave a load management chat without making sure you know about Tim Gabbett’s early contender for paper of the year. Open access: The training-injury prevention paradox: should athletes be training smarter and harder? http://ow.ly/4mYSkj

Criteria-based return to play. Psychological readiness. How? Whose call? Dr Clare Ardern explains

A recent keynote speaker at the Return to Play conference in Bern, the Arsenal FC Sport and Exercise Medicine Conference and the Isokinetic Football Medicine Strategies Return to Play conference in London, Clare Ardern is an emerging voice in sports medicine research. She currently occupies a postdoctoral position in the research department at Aspetar Sports Medicine Hospital, after doing the bulk of her research at La Trobe University in Melbourne, Australia. Her work focuses on the factors influencing return to play, particularly psychological readiness after ACL injury, as well as shared decision making and evidence based medicine.
Follow Clare on Twitter @clare_ardern
Timeline:
1:35 When can Sarah play again? Should she be playing again?
2:30 Need criteria-based progession through the rehab process , so that the focus shifts from “when” I can play again to “what” I need to achieve for successful return to play.
3:00 Education is key – both the patient and the coach. Motivation is important and can be positive or negative. Young athletes even more important
4:40 Are we moving back to biopsychosocial models, or have we moved on?
5:30 Understand the inherent risks that Sarah is facing, and make sure she understands them!
6:20 Psychological readiness for return to play – the ACL-Return to Sport after Injury (ACL-RSI) scale developed by Dr. Kate Webster and Dr. Julian Feller . It considers: confidence, risk appraisal and the athletes emotions. 12 questions completed in a few minutes. Also available as an Iphone app.
It’s sport specific AND IT’S FREE!!
7:45 We should be thinking different for all time-loss injuries.
8:15 Criteria-based rehabilitation – but beware – early return to sport for young athletes increase the risk of re-injury.
9:00 We need to become more systematic to address the psychological/emotional aspects of return to play during our clinical management of these athletes.
12:00 Should we get “informed consent” from the athlete before return to play?
12:50 SUMMARY – When can I play again?
1. Reshape the question – Will I play again? Not all athletes get back, and that doesn’t mean fail. What is the right thing for Sarah?
2. Consider the psychological aspect more systematically!
CONSENSUS PAPER on return to sport coming soon!
Check out some recent papers from Dr. Ardern:
Br J Sports Med 2014;48:1613-1619 doi:10.1136/bjsports-2014-093842The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction
http://bjsm.bmj.com/content/48/22/1613.full
Br J Sports Med 2014;48:1543-1552 doi:10.1136/bjsports-2013-093398 Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors
http://bjsm.bmj.com/content/48/21/1543.full
Br J Sports Med 2016;50:506-508 doi:10.1136/bjsports-2015-095475 It is time for consensus on return to play after injury: five key questions
http://bjsm.bmj.com/content/50/9/506.full
Further listening:
Podcast from Adam Gledhill which discusses a case study of ACL return to play considerations and different examples of strategies used to aid return to play experiences - https://soundcloud.com/bmjpodcasts/i-cant-return-to-play-when-fear-of-reinjury-dominates-after-acl-reconstruction-adam-gledhill

3 take-home messages for physiotherapists from WCPT President Emma Stokes: Part 3 of 3

Dr Emma K Stokes is the President of the World Confederation of Physical Therapy. The first two parts of her discussion with the BJSM community has already had >9,000 listeners in just two months. In this part she previews the excitement of the IFOMPT Conference (Glasgow, July 2016), opportunities for sports physiotherapist to develop their careers. @EKStokes closes with 3 take-home messages including one slightly quirky one.
Thanks to James Walsh (@SportsOsteopath) BJSM podcast podcast associate editor.
Links:
First of 3 podcasts on BJSM: Physiotherapists in Leadership: https://soundcloud.com/bmjpodcasts/the-face-of-wcpt-dr-emma-k-stokes-unplugged-life-lessons-leadership-physiotherapy-success?in=bmjpodcasts/sets/bjsm-1#t=0:00
2nd of 3 podcasts: Direct Access, social media & more. https://soundcloud.com/bmjpodcasts/the-face-of-wcpt-dr-emma-k-stokes-unplugged-part-2?in=bmjpodcasts/sets/bjsm-1
Profile of President Stokes in the Independent of Ireland: http://www.independent.ie/life/health-wellbeing/health-features/world-leader-dr-emma-stokes-31375045.html
Emma’s podcast for the MACP (45 minutes): https://soundcloud.com/macp-3/macp-emma-stokes-podcast Interviewed by social media leader for MACP: Gerard Greene (@gerardgreenephy) .
Engage with WCPT here: http://www.wcpt.org/news/WCPT-look-forward

Dr Cristiano Eirale sul congresso mondiale di pubalgia nello sportivo e sul Doha consensus meeting

Il dottor Cristiano Eirale è un medico dello sport che lavora ad Aspetar, Qatar Orthopedic and Sport Medicine Center di Doha. In questo podcast interamente in italiano, discute con un misterioso intervistatore, la cui identità verrà rivelata alla fine del podcast stesso, sul congresso mondiale di pubalgia nello sportivo tenutosi nel novembre 2014 e sul Doha consensus sulla terminologia e sulle definizioni nella pubalgia dello sportivo.
Links:
Entire BJSM Theme Issue: http://bjsm.bmj.com/content/49/12
Groin Consensus Meeting Paper: http://bjsm.bmj.com/content/49/12/768.full

Dream Team of training load management: How training influences injury and performance

The BJSM community is well aware of the interest in the role of training load on injury. Dr Dr Tim Gabbett, Dr Alex Kountouris and Dr to be Michael Drew share insights into the principles that underpin successful player management. They give specific examples from football codes and cricket at the elite level. They also discuss what clinicians who do not have access to the full raft of data-gathering technology can do to advise players how to monitor load.
We thank Sports Physiotherapist Paul Visentini (who invented the VISA score for tendinopathy) for producing the very successful event and for sharing two podcasts with us. (The second will be posted here within a month). (Twitter = @PaulVisentini and @PhysioSports429)
The guests: Dr Tim Gabbett, Applied Sports Scientist who consults to elite teams the world over. He is one of only 5 invited Keynote Speakers at the IOC World Congress in Monaco 2017 #IOCPrev2017 @TimGabbett
Dr Alex Kountouris, Sports Science and Sports Medicine Director Cricket Australia @Alex_Kountouris
Mr Michael Drew Senior Sports Physiotherapist at the Australian Institute of Sport. @_MickDrew
Links to related podcasts:
Dr Tim Gabbett on how physiotherapists can work well alongside strength & conditioning coaches to prevent injuries and improve performance: http://ow.ly/10aOq2
Dr Alex Kountouris on how to prevent back pain in cricket: http://ow.ly/10aOHX
Link to papers on load monitoring:
Training – injury prevention paradox. Should athletes be training smarter AND harder (Gabbett) http://bjsm.bmj.com/content/early/2016/01/12/bjsports-2015-095788
Cricket fast bowling workload patterns as risk factors for tendon, muscle, bone and joint injuries. John W Orchard, Peter Blanch2, …, , Alex Kountouris et al, http://bjsm.bmj.com/content/early/2015/03/09/bjsports-2014-093683
And the home page with lots of good background for the conference (March 2016): http://physiosports.com.au/mastering-load-symposium-2016/

Can my athlete handle more training? High tech and low tech instruments: Dr Anna Saw

Dr Anna Saw is in the Faculty of Health in the School of Exercise & Nut. Sci.at Deakin University’s Burwood Campus.
Further reading:
Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review - http://ow.ly/ZEkmA

Wie können Verletzungen beim Skifahren möglichst vermieden werden?

Interview mit Ass.-Prof. Dr. Gerhard Ruedl (Innsbruck)
Das Skifahren ist eine beliebte Freizeitsportart bei Groß und Klein, Alt und Jung, Anfänger und Könner und zieht jedes Jahr Millionen von Wintersportlern in die Berge auf die Skipisten.
Doch wie groß ist das Verletzungsrisiko auf der Piste?
Was sind die häufigsten Verletzungsursachen?
Assistenz-Professor Dr. Gerhard Ruedl erörtert diese Fragen und mehr im Gespräch mit Dr. Markus Laupheimer (Associate Editor BJSM).
Gerhard ist Experte für Unfallursachen und Verletzungsrisiko beim Alpinen Skifahren, welches er mit seinen Kollegen an der Universität Innsbruck beforscht.
Gerhard erläutert uns auch seine neulich im BJSM veröffentlichte Studie, wodurch möglicherweise die große Zahl an Knieverletzungen bei Frauen reduziert werden könnte.
Auch werden mögliche Präventivmaßnahmen besprochen, welche uns und unseren Patienten helfen sollen verletzungsfrei durch die Skisaison zu kommen.
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)
Euch einen aktiven und bewegungsreichen Tag!
Nun viel Spaß mit diesem Ski 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
Links:
Skibindung und Knieverletzung Paper 2016:
http://bjsm.bmj.com/content/50/1/37.abstract?sid=d457e29b-45f1-4b81-a09b-cfc04d4ae602
Ski Helm Editorial:
http://bjsm.bmj.com/content/46/16/1091.extract?sid=d457e29b-45f1-4b81-a09b-cfc04d4ae602

“I can’t return to play” – When fear of reinjury dominates after ACL reconstruction: Adam Gledhill

Adam Gledhill (http://www.leedsbeckett.ac.uk/staff/adam-gledhill/) is a Senior Lecturer in Sport and Exercise Therapy at Leeds Beckett University. He has a terrific amount of experience in sport psychology in football at the elite level, particularly among top female football players.
Adam (@Gleds13) shares the case of Joanna (pseudonym) who has returned from ACL injury but is losing confidence ahead of a major game. We learn which specific tools can be used to address psychological readiness and how this worked out in real life.
We wish Adam the best as he completes his PhD focusing on psychosocial factors associated with talent development in female soccer.
Additional resources:
Read the systematic review: Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review. Dale Forsdyke, Andy Smith, Michelle Jones, Adam Gledhill
http://bjsm.bmj.com/content/early/2016/02/17/bjsports-2015-094850.abstract
Links for sports psychology tools mentioned in the podcast:
Evans et al (2008) The development of a measure of psychological responses to injury (paper looking at the development of the psychological responses to sports injury inventory) http://www.ncbi.nlm.nih.gov/pubmed/18270384
Glazer (2009) Development and Preliminary Validation of the Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657021/
Smith et al (1990) The psychological effects of sports injuries: Coping (paper for the Emotional Responses of Athletes to Injury Questionnaire)http://link.springer.com/article/10.2165/00007256-199009060-00004
Walker et al. (2010) A preliminary development of the Re-Injury Anxiety Inventory (RIAI). http://www.ncbi.nlm.nih.gov/pubmed/20129120
Another paper that Adam didn't use with this particular client but that he also recommends is:
Taylor and May (1996) Threat and coping appraisal as determinants of compliance with sports injury rehabilitation: an application of Protection Motivation Theory (paper for the development of the sports injury rehabilitation beliefs survey) http://www.ncbi.nlm.nih.gov/pubmed/8981286
Further listening:
Also check this podcast by Dr Clare Ardern which discusses criteria-based return to play decisions in the case of "Sarah". This complements much of the work conducted with "Joanna" in this podcast. Great food for thought for practical return to play decision-making - https://soundcloud.com/bmjpodcasts/return-to-play

The face of WCPT: Dr Emma K Stokes unplugged (part 2): direct access, best practice, social media

Dr Emma K Stokes (@ekstokes) is the President of the World Confederation of Physical Therapy. This is the second of three podcasts.
Karim and Emma continue their discussion and touch on direct access to physiotherapy around the world, the changing role of the physiotherapist in the multi-disciplinary team, and best practice for dealing with social media as a professional.

Muskelverletzungen im Sport – Interview mit Priv.-Doz. Dr. Peter Ueblacker

Wie die Muenchener Klassifikation helfen kann, Athleten mit Muskelverletzungen besser zu behandeln
Peter Ueblacker ist ein international renommierter Orthopäde und Sportmediziner, der als einer der Mannschaftsärzte in den Jahren 2009 bis 2015 eine lange und erfolgreiche Karriere beim FC Bayern München hatte . Er arbeitet in eigener Praxis mit Hans-Wilhelm Müller-Wohlfahrt (http://ow.ly/U2mch ). BJSM Redakteur Dr Markus Laupheimer stellt die Fragen in deutscher Sprache.
Inhalt (Zeit)
1: 00min - Warum Muskelverletzungen klassifizieren?
3: 00min - Einschränkungen der früheren Klassifikationsverfahren und Notwendigkeit einer neuen Klassifikation - die Entstehungsgeschichte des Münchener Muskelklassifizierungssystems. Hier ist der Link zur Open-Access-Publikation in BJSM (> 55.000 views) http://ow.ly/U2pMG
4: 18min - Was sind die Vorteile für die medizinische Abteilung eines Fussballklubs (Physiotherapeuten, Arzte & Fitnesscoach), die die Münchener Klassifizierungssystem verwenden? Definition und Differenzierung von "direkten" und "indirekten" Muskelverletzungen.
5: 00min - Die Herausforderung der "funktionellen" (nicht-strukturellen) Muskelverletzungen. Keine Pathologie im MRT erkennbar - und doch von hoher Relevanz für Fußballmannschaften, weil diese Verletzungen häufig sind und Spieler nicht spielen können – „time-loss“-Verletzungen.
6: 00min - Verschiedene Typen von Muskelverletzungen ziehen unterschiedliche Fehlzeiten im Sport nach sich. Ist das eine 2-Wochen-oder 6-Wochen-Verletzung?
6: 40min - Der Versuch, die Prognose vorherzusagen - ist das möglich? Was können wir dem Trainer sagen? Hier finden Sie eine Gegenargument http://ow.ly/U2qFJ
7: 10min – Komm auf den Punkt! Strukturelle Muskelverletzungen. Intramuskuläre Sehnenverletzungen sind häufig und relevant (siehe Peter Brukner Papier: http://ow.ly/U2rBc)
8: 15min - Welchen Einfluß die Wirbelsäule auf Muskelverletzungen hat.
10: 00m - Ein praktischer Spaziergang durch das Management der ischiokruralen Muskelverletztungen („hamstrings“).
Weiterführende Links:
http://ow.ly/U2mUG - Podcast mit Professor Gino Kerkhoffs berücksichtigt auch das Münchener Konsenspapier. Ergänzt den vorliegenden Podcast in seinem größeren Fokus auf die Konsensprozesse und diskutiert die Wertigkeit des MRTs- bei Muskelverletzungen (auf englischer Sprache).
http://ow.ly/U2o0Q - Podcast mit Professor Jan Ekstrand Schwerpunkt auf Muskelfaserriss
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