BJSM Podcast

Prof. Kay Crossley on treatment for patellofemoral pain

Are you old enough to remember the storm when Jenny McConnell first proposed new exercise and taping procedures for patellofemoral pain (PFP)? It revolutionised rehabilitation for the many sufferers of the condition and it promoted much-needed research. So do we still need to tape and focus on the vastus medialis?
Professor Kay Crossley of La Trobe University is a present-day expert in PFP, having completed several key RCTs on patellofemoral pain. She discusses (i) the outcomes of the 3rd International Patellofemoral Retreat (BJSM 2014, see below), (ii) the best PFP treatments and evidence for them as well as (iii) new insights into knee pain after ACL reconstruction.
See also the following papers:
Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial http://goo.gl/yhPfxp
Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013 http://goo.gl/CxgClm
Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? http://goo.gl/Z8Aw1Y

Managing muscle injuries – Does the Munich Consensus Statement help? Part 2 of 2

Dr G.M.M.J. (Gino) Kerkhoffs is professor of Orthopaedics at the Faculty of Medicine of the University of Amsterdam (AMC-UvA), with a special emphasis on sports traumatology.
Grading of muscle injuries should have a big influence on time to return to sport but it’s not so easy!
Babette Pluim asks Prof Kerkhoffs how the Munich Consensus Statement of terminology and classification of muscle injuries in sport was developed. And what are the practical implications for clinicians?
Prof Kerkhoffs also shares his dream about the development of a centre of expertise for the advancement of care for injured athletes, with integrated diagnostics, customised treatment and monitoring of treatment results in Amsterdam, and the steps that have already been taken.
See also:
Terminology and classification of muscle injuries in sport: the Munich consensus statement http://goo.gl/7tM2PF
https://www.amc.nl/web/Het-AMC/Afdelingen/Medische-afdelingen/Orthopedie/Orthopedie/Afdeling.htm
Amsterdam Institute of Sports Sciences: http://aiss.nl/

Managing the difficult ankle and foot with Prof Gino Kerkhoffs - Part 1 of 2

Dr Gino Kerkhoffs is professor of Orthopaedics at the Faculty of Medicine of the University of Amsterdam (AMC-UvA), with a special emphasis on sports traumatology.
He shares his expertise on ankle injuries with Dr Babette Pluim, and discusses evidence based treatment options of ankle impingement, ligament injuries and osteochondral lesions.
Prof Kerkhoffs also discusses treatment of the slow healing metatarsal V stress fractures.
See also:
Economic evaluations of diagnostic tests: treatment and prevention for lateral ankle sprains: a systematic review
http://goo.gl/Pn9FMp
A twist on the athlete's ankle twist: some ankles are more equal than others http://goo.gl/3FhGBT
Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline http://goo.gl/7ITP7S
Treatment of proximal metatarsal V fractures in athletes and non-athletes http://goo.gl/fKaib6

Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’

Peter O’Sullivan has two recent BJSM podcasts (see below). In this podcast he shares his thoughts on the recent media attention around Tiger Woods' obvious back pain while playing in the US PGA.
He discusses what the pathology might be, why the media suggested that Mr Woods’ ‘sacrum went out’. He contends that ‘core strengthening’ may not be the panacea.
The lessons apply to the management of low back pain, and other pain, in a myriad of settings.
See also
Read Professor O'Sullivan's blog on Tiger Wood's back pain: http://bit.ly/1zaISGz
Listen to his podcast on lower back pain: http://goo.gl/jrQxSe
Listen to his podcast on overtreatment and overdiagnosis in sports medicine: http://goo.gl/vPZ3g8

Michael Kjaer on the pathogenesis of tendinopathy and tendon healing

Professor Michael Kjaer is Professor in Sports Medicine at the Institute of Sports Medicine and Centre for Healthy Ageing in Copenhagen, Denmark. He has published articles in the areas of Sports Medicine and muscle and tendon adaptation at the structural and mechanical levels as well as at the cellular and molecular level. Michael is interested in mechanisms of adaptations to muscle and tendon following exercise, disuse, disease and ageing.
In this podcast on tendon and tendon pathology he gives a synthesis of seven models of tendinopathy, explains the difference between mid-tendon and insertional tendinopathy, presents his views on the healing capacity of tendons, talks about the (absence of a) link between tendinopathy and tendon rupture, and discusses the various interventions that are used in an attempt to promote tendon healing, including eccentric and concentric exercises.
Links to articles:
Heinemeier KM, Schjerling P, Heinemeier J, Magnusson SP, and Kjaer M. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C. FASEB Journal 2013;27:2074–9. http://goo.gl/MRmulq
Kjaer M. Role of extracellular matrix in adaptation of tendon and skeletal muscle to machanical loading. Physiol Rev 2004;84:649-8. http://goo.gl/tEiirg
Magnusson SP, Langberg H, Kjaer M. The pathogenesis of tendinopathy: balancing the response to loading. Nat Rev Rheumatol 2010;6:262-8. http://goo.gl/s1dpDc

Ross Tucker on what makes a champion

Dr Ross Tucker is an Exercise Physiologist and High Performance Sports Science Consultant. He obtained a PhD in Exercise Physiology from the University of Cape Town in 2006, and graduated at the same time with a Post-Graduate in Sports Management from the Faculty of Commerce. Ross is hot on social media, with a cool website (http://www.sportsscientists.com), over 12.000 likes on Facebook, and more than 40.000 twitter followers (he's @Scienceofsport ).In this podcast with Babette Pluim he gives an update on what makes a champion, discusses all the fuss about low carb and high fat diets, comments on barefoot running and takes the 10,000 hour paradigm apart. See also:The anticipatory regulation of performance: The physiological basis for pacing strategies and the development of a perception-based model for exercise performance http://goo.gl/tDs9AfThe physiological regulation of pacing strategy during exercise: a critical review http://goo.gl/Oe5LluWhat makes champions? A review of the relative contribution of genes and training to sporting success http://goo.gl/moG4De

David Epstein – ‘The Sports Gene’ author (Part 1) – Why Champions are Champions

In one of 2014’s ‘highlight’ podcasts, New York Times best-selling author David Epstein simplifies genetics and explains that intricate relationship between nature and nurture.
David Epstein’s research took him to all corners of the globe and you’ll hear about ‘Superbaby’ (a newborn with muscles sculpted like a powerlifter), ‘A tale of two high jumpers’ (no hints, spoiler alert), and a person whose genes drove her to exercise so much that she had to talk to David on her cellphone while running around an airport parkade.
You’ll be convinced that the ’10,000 hours’ argument (Malcolm Gladwell – Outliers) needs to be put in the scientific trash can. Thought-provoking and entertaining, David Epstein should be a household name for the BJSM community.
David delivered the President’s lecture at the 2014 AMSSM Annual Meeting (New Orleans). Recorded at the Summit – Leaders in Performance – New York (June 17/18 2014); with permission from Leaders (James Worrall)
See also:
This podcast builds on a 2012 podcast and paper by Ross Tucker (“What makes a champion?”) - Podcast: bit.ly/1oJNJ1R, Paper: R Tucker, M Collins bit.ly/1iJG3Vp
David’s TED Talk “Are athletes really getting faster, better, stronger?”: bit.ly/SVMy09
What makes champions? A review of the relative contribution of genes and training to sporting success: http://bit.ly/XmmYEY
The genetic basis for elite running performance: http://bit.ly/1oUPx6x
Podcast- David Epstein – ‘The Sports Gene’ author (Part 2) – Hearts and blood: http://bit.ly/1t2rEJK

David Epstein – ‘The Sports Gene’ author (Part 2) – Hearts and blood

If you enjoyed Part 1 of David Epstein’s BJSM podcast listen to this one to hear about the genetic contribution to hypertrophic cardiomyopathy, the reason it is so hard to detect in all cases, and real life choices that some players made when offered genetic screening opportunities. We finish by discussing whether an Olympic cross-country ski champion with a hematocrit of 65 is a blood-doper or the carrier of an unusual single-gene mutation.
I learned a great deal from David Epstein in both podcasts; David has put the bar very high for future podcast guests.
Recorded at the Summit – Leaders in Performance – New York (June 17/18 2014); with permission from Leaders (James Worrall).
David Epstein’s session at Leaders was sponsored by Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
For more related content:
Sports Cardiology module on BMJ Learning including Seattle Criteria: bit.ly/1lI8djo
J Drezner, M Ackerman, J Anderson et al, Electrocardiographic interpretation in athletes: the ‘Seattle Criteria’ bit.ly/1ic8P6i
Advances in Sports Cardiology November 12, Volume 46: bit.ly/1pitAMf
J Drezner, Standardised criteria for ECG interpretation in athletes: a practical tool, bit.ly/1lYQc5f
Bruce Hamilton, Ben Levine, Paul Thompson, Greg Whyte, Mathew Wilson, Debate: challenges in sports cardiology; US vs European approaches bit.ly/1lEudzX
Unravelling the grey zone: cardiac MRI volume to wall mass ratio to differentiate hypertrophic cardiomyopathy and the athlete's heart: http://bit.ly/1t1LlmQ
Sudden Cardiac Arrest and Cardiac Screening: A trainee perspective: http://bit.ly/1oUOWSk
Peripheral vascular structure and function in hypertrophic cardiomyopathy: http://bjsm.bmj.com/content/46/Suppl_1/i98.full
Unraveling the grey zone: cardiac MRI volume to wall mass ratio to differentiate hypertrophic cardiomyopathy and the athlete's heart: http://bjsm.bmj.com/content/early/2013/06/13/bjsports-2013-092360.full
Screening athletes for cardiovascular disease in Africa: a challenging experience: http://bjsm.bmj.com/content/47/9/579.full

Professor Jan Ekstrand on hamstring injuries in football

Professor Jan Ekstrand is orthopedic surgeon and vice-chairman of the UEFA medical committee. He is professor of Sports Medicine at the University of Linköping, Sweden. He has been team physician of the Swedish National Soccer team.
Since 1982, professor Ekstrand has been running prospective studies related to the epidemiology of sports injuries in football. Since 2001, he has carried out EUFA injury audits in elite professional football with the aim of increasing safety in football through prospective research of 75 professional football clubs from 10 different European countries.
In this podcast with Babette Pluim, he discusses hamstring injuries.
See also:
Terminology and classification of muscle injuries in sport: The Munich consensus statement http://goo.gl/AnZxHL
Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play http://goo.gl/dXCJ8Z
Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification http://goo.gl/8ETTeC
Diagnosis and prognosis of acute hamstring injuries in athletes http://goo.gl/WhfzyN
Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme: http://bit.ly/1BjpMSB
The predictive validity of a single leg bridge test for hamstring injuries in Australian Rules Football Players: http://bit.ly/1rd8uUJ
Risk factors for hamstring injuries in community level Australian football: http://bit.ly/1rzW19c
Predicting return to play after hamstring injuries: http://bit.ly/1sIJMvh
Hamstring injury mini-symposium (BJSM papers that will help you manage hamstring injuries): http://bit.ly/1uWyHot
Injuries will decide the English Premier League Title (once again!): http://bit.ly/1m18dN9

Professor Jan Ekstrand on the epidemiology of football injuries

Professor Jan Ekstrand is orthopedic surgeon and vice-chairman of the UEFA medical committee. He is professor of Sports Medicine at the University of Linköping, Sweden. He has been team physician of the Swedish National Soccer team.
Since 1982, professor Ekstrand has been running prospective studies related to the epidemiology of sports injuries in football. Since 2001, he has carried out EUFA injury audits in elite professional football with the aim of increasing safety in football through prospective research of 75 professional football clubs from 10 different European countries.
In this podcast with Babette Pluim, he discusses the outcome and major trends of the UEFA Study.
See also:
Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study http://goo.gl/uyubyI
Fifth metatarsal fractures among male professional footballers: a potential career-ending disease http://goo.gl/9gd93a
Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study http://goo.gl/hunCiJ
Methods for epidemiological study of injuries to professional football players: developing the UEFA model http://goo.gl/vKiYd4
Muscle injury rates in professional football increase with fixture congestion: an 11-year follow-up of the UEFA Champions League injury study http://bjsm.bmj.com/content/47/12/743
Comparison of injury incidences between football teams playing in different climatic regions http://goo.gl/kkLcmh
Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study http://bjsm.bmj.com/content/47/12/763
The Nordic Football Injury Audit: higher injury rates for professional football clubs with third-generation artificial turf at their home venue http://goo.gl/Kazt3B
The UEFA injury study: 11-year data concerning 346 MCL injuries and time to return to play http://bjsm.bmj.com/content/47/12/759.abstract
Time-trends and circumstances surrounding ankle injuries in men’s professional football: an 11-year follow-up of the UEFA Champions League injury study http://bjsm.bmj.com/content/47/12/748.abstract
Epidemiology of injuries in the Australian Football League, seasons 1997–2000: http://bit.ly/1m18vDV
UEFA Champions League study: a prospective study of injuries in professional football during the 2001–2002 season: http://bit.ly/1pQSQuE
Evaluating the level of injury in English professional football using a risk based assessment process: http://bit.ly/1oA2K5C
Injury patterns in high-performance curlers (the sport has 2 million players worldwide although has 200x less publications than Aussie Rules Football!): http://bit.ly/1uAD636