BJSM Podcast

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

‘Overdiagnosis’ / ‘overtreating’– relevant in sportsphysio/medicine? Professor Peter O’Sullivan

Did you listen to Ray Moynihan’s podcast on ‘’Overdiagnosis in sports medicine”? That’s a ‘gold’ podcast (>5000 listens) and Peter O’Sullivan now extends those ideas into the realm of sports physiotherapy.
“We can massively create health problems” warns Prof O’Sullivan speaking about the way clinicians may explain pathology to patients. If not explained appropriately, MRI and other imaging can have a negative effect on a patient’s perception of injury.
Pete refers to this free paper in RADIOLOGY: McCullough et al. Lumbar MR imaging and reporting epidemiology: do epidemiologic data in reports affect clinical management? Radiology. 2012 Mar;262(3):941-6. doi: 10.1148/radiol.11110618.
If you missed Ray Moynihan’s podcast, here’s the link: http://bit.ly/1oA45UC
See also:
Listen to Prof O'Sullivan discussing low back pain: http://goo.gl/WgseGQ
It's time for change with the management of non-specific chronic low back pain: http://bjsm.bmj.com/content/46/4/224.full
Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/
Professor Peter O’Sullivan (Curtin) walks you through two cases of low back pain: https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-curtin-walks-you-through-two-cases-of-low-back-pain
‘Overdiagnosis’ in sports medicine? FAI for example? The great Ray Moynihan (‘Selling sickness’: https://soundcloud.com/bmjpodcasts/overdiagnosis-in-sports-medicine-fai-for-example-the-great-ray-moynihan-selling-sickness

Professor Peter O’Sullivan (Curtin) walks you through two cases of low back pain

Who are the biggest names in the back pain world? Correct – Peter O’Sullivan is one of them.
He's provocative, clinically-relevant, and vastly experienced. He’s desperate to help patients, that’s obvious! But not everyone has to agree. Listen to his take on management of both chronic, and acute, back pains – does it make sense to you?
Peter O’Sullivan is Professor of Musculoskeletal Physiotherapy at Curtin University, Perth, (http://goo.gl/Dk6beV)and a Specialist Musculoskeletal Physiotherapist who consults at bodylogicphysiotherapy.com.
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See also:
It’s time for change with the management of non-specific chronic low back pain (2012) http://bit.ly/1nY6YxK
Professor O’Sullivan discusses the risk of clinicians ‘overservicing’ or ‘overdiagnosing’ various conditions in another BJSM podcast: http://goo.gl/7HYDiX
Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/
‘Overdiagnosis’ / ‘overtreating’– relevant in sportsphysio/medicine? Professor Peter O’Sullivan: https://soundcloud.com/bmjpodcasts/overdiagnosis-overtreating-relevant-in-sportsphysiomedicine-peter-osullivan

Assistant Professor Aaron Baggish – Sports Cardiologist / Boston Marathon

In this concise, information-rich BJSM podcast, sports cardiologist Aaron Baggish shares his expertise on the critical issue of sudden cardiac death in sport.
He explains how to determine which ECG changes in athletes are sinister and which may not be (such as right bundle branch block). He argues for a detailed screening program for elite athletes and gives advice for those whose care is not covered by a professional sporting organization.
The Boston Marathon has provided valuable lessons for where to locate defibrillators in this type of event. A sports cardiology refresher in just 11 minutes!
Recorded at the Summit – Leaders in Performance – New York (June 17/18 2014); with permission from Leaders (James Worrall). Aaron Baggish's session at Leaders was sponsored by Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
See also:
J Drezner, M Ackerman, J Anderson et al. Electrocardiographic interpretation in athletes: the ‘Seattle Criteria’ bit.ly/1ic8P6i
P Biddinger, A Baggish, L Harrington, P d’Hemecourt, J Hooley, The Boston Marathon and Mass-Casualty Events bit.ly/1lEtkaK
BMJ Learning: ECG interpretation in athletes: bit.ly/1lI8djo
Incidence of sudden cardiac death in athletes: a state-of-the-art review: http://bjsm.bmj.com/content/48/15/1185.full
The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care: http://bjsm.bmj.com/content/47/18/1199.full
Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG: http://bjsm.bmj.com/content/48/15/1172.full
Mass ECG screening of young athletes: http://bjsm.bmj.com/content/42/9/707.full
Sudden Cardiac Arrest and Cardiac Screening: A trainee perspective: http://blogs.bmj.com/bjsm/2012/10/18/sudden-cardiac-arrest-and-cardiac-screening-a-trainee-perspective/
David Epstein – ‘The Sports Gene’ author (Part 2) – Hearts and blood: https://soundcloud.com/bmjpodcasts/david-epstein-the-sports-gene-author-part-2-hearts-and-blood

Professor Irene Davis - Does the concept of the abdominal ‘core’ apply to the foot too?

Irene Davis is a renowned biomechanics clinician and scientist. Barefoot running has been one of her areas of focus and she co-authored the Nature paper that received cover attention and created mainstream attention to that topic.
She and first author Dr Patrick McKeon, conceived of the idea of a foot ‘core’; if certain foot muscles act as a core it has immediate implications for management in clinical practice.
Listen to Professor Davis and see the linked paper (below). Let us know if you agree, disagree. Tweet or write a blog post (email to karim.khan@ubc.ca).
One of few researchers who addresses this issue, Prof Davis is a regular keynote speaker at major international conferences. In this BJSM podcast she shares her clinical approach to assessing patients where the ‘foot core’ may be relevant.
See also:
‘The foot core system: a new paradigm for understanding intrinsic foot muscle function’: http://bit.ly/1zw4Syw
Listen to Prof Davis discussing how to treat patellofemoral pain in another BJSM podcast: http://goo.gl/kxse10
Barefoot running: an evaluation of current hypothesis, future research and clinical applications: http://bjsm.bmj.com/content/48/5/349.full
The foot core system: a new paradigm for understanding intrinsic foot muscle function: http://bjsm.bmj.com/content/early/2014/03/21/bjsports-2013-092690.full
Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study: http://bjsm.bmj.com/content/47/6/387.full
Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013: http://bjsm.bmj.com/content/48/6/411.full
Baffled by the barefoot running vs traditional running shoe controversy? How to make an informed choice!: http://blogs.bmj.com/bjsm/2013/10/28/baffled-by-the-barefoot-running-vs-traditional-running-shoe-controversy-dont-be-make-an-informed-choice/
Patellofemoral pain syndrome? Consider orthoses or more comfortable shoes!: http://blogs.bmj.com/bjsm/2011/02/24/patellofemoral-pain-syndrome-consider-orthoses-or-more-comfortable-shoes/
Professor Irene Davis (Harvard) on treating patellofemoral pain: https://soundcloud.com/bmjpodcasts/professor-irene-davis-harvard-on-treating-patellofemoral-pain

Professor Irene Davis (Harvard) on treating patellofemoral pain

The most prevalent condition diagnosed in most sports medicine clinics is patellofemoral pain. Professor Irene Davis is one of the world’s leading physiotherapists and researchers who addresses this issue.
She’s a regular keynote speaker at major international conferences. In this BJSM podcast she shares her approach to assessing the patient with patellofemoral pain. From this basis she outlines a range of therapeutic options.
Professor Davis was a catalyst for the International Patellofemoral Pain Research Retreats (IPFRR). You can read the full Consensus Statement from the 3rd of these conferences in the special BJSM theme issue highlighted by the Swiss Sports Physiotherapy Association (http://www.sportfisio.ch/) at the link below.
See also:
Patellofemoral Pain Consensus statement: http://bit.ly/RzNirr
Introduction/overview – why have an international patellofemoral pain consensus meeting?: http://bit.ly/TZvtmO
Professor Davis discussing ‘the foot core’ concept in another BJSM podcast: http://goo.gl/nUigMB
Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013: http://bjsm.bmj.com/content/48/6/411.full
The 3rd International Patellofemoral Research Retreat: An international expert consensus meeting to improve the scientific understanding and clinical management of patellofemoral pain: http://bjsm.bmj.com/content/48/6/408.full
Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis: http://bjsm.bmj.com/content/48/14/1088.full
High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: Is PFP itself a predictor for subsequent ACL injury?: http://bjsm.bmj.com/content/early/2014/03/31/bjsports-2013-092536.full
Patellofemoral pain syndrome? Consider orthoses or more comfortable shoes!: http://blogs.bmj.com/bjsm/2011/02/24/patellofemoral-pain-syndrome-consider-orthoses-or-more-comfortable-shoes/
Professor Irene Davis - Does the concept of the abdominal ‘core’ apply to the foot too?: https://soundcloud.com/bmjpodcasts/does-the-concept-of-the-abdominal-core-apply-to-the-foot-too-professor-irene-davis-harvard

Shabaaz Mughal - Working in elite football

Dr Shabaaz Mughal and Geoff Scott from Tottenham Hotspurs join James Walsh to talk about how to get into working in elite football, the multi-disciplinary team working environment in elite sport, concussion, Fabrice Muamba and cardiac arrest, as well as the Fifa 11+ and injury prevention.
See also:
A pilot study examining injuries in elite gaelic footballers: http://bjsm.bmj.com/content/34/2/104.full
The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care: http://bjsm.bmj.com/content/47/18/1199.full

Jon Patricios - Hip injuries in sport, in association with SASMA

Jon Patricios, President of the South African Sports Medicine Association (SASMA) and editor of BJSM July 2014, Volume 48, Issue 14, chats to Dr Josep "Chuck" Cakic, a renowned Croatian-born South African Hip Arthroscopist, chair of the South African Society for Hip Arthroscopy (SASHA) and an executive member of the International Society of Hip Arthroscopy (ISHA).
They discuss key issues regarding hip injuries in sport, accurate diagnosis and selecting patients for surgery.
See also:
Hip Stage Screening Protocol: http://goo.gl/7BNrY2
Hip Joint Screening Initiative: http://goo.gl/kkEkvQ
Risk factors for groin/hip injuries in field-based sports: a systematic review: http://bjsm.bmj.com/content/48/14/1089.full
The association between hip and groin injuries in the elite junior football years and injuries sustained during elite senior competition: http://bjsm.bmj.com/content/44/11/799.full
UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons: http://bjsm.bmj.com/content/43/13/1036.full
Hip flexibility and strength measures: reliability and association with athletic groin pain: http://bjsm.bmj.com/content/43/10/739.abstract
Managing the PAINFUL hip and groin in sport – a focus on conservative Rx – Prof Mike Reiman (Part 2): https://soundcloud.com/bmjpodcasts/managing-the-painful-hip-and-groin-in-sport-a-focus-on-conservative-rx-mike-reiman-part-2
Duke University’s Assoc Prof Mike Reiman on managing the stiff hip in sport – is it FAI? (Part 1): https://soundcloud.com/bmjpodcasts/duke-universitys-assoc-prof-mike-reiman-on-managing-the-stiff-hip-in-sport-is-it-fai-part-1