BJSM Podcast

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

Managing the PAINFUL hip and groin in sport – a focus on conservative Rx – Prof Mike Reiman (Part 2)

This podcast logically follows (Part 1) below but it stands alone as well. Painful hip and groin pain requires a careful history looking for aggravating factors and risk factors, as well as targeted physical examination including but not limited to the hip and groin. Duke University’s Associate Prof Mike Reiman shares specific tips for both assessing, and rehabilitating, the patient with hip and groin pain.
See also:
Jo Kemp, Kay Crossley, Ewa Roos. What fooled us in the knee may trip us up in the hip: lessons from arthroscopy: bit.ly/1pifElu
Per Holmich, Kristian Thorborg, Pedersen Nyvold. Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain?: bit.ly/1ic7PPu
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
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
Hip flexibility and strength measures: reliability and association with athletic groin pain: http://bjsm.bmj.com/content/43/10/739.abstract
Jon Patricios - Hip injuries in sport, in association with SASMA: https://soundcloud.com/bmjpodcasts/hip-injuries-in-sport-in-association-with-sasma
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

Duke University’s Assoc Prof Mike Reiman on managing the stiff hip in sport – is it FAI? (Part 1)

Managing the athlete with hip stiffness detected at a physical exam or in a PPE is one of the hottest topics of 2014. Some would argue that nothing needs to be done given that the patient is asymptomatic but on the other hand many orthopaedic papers argue for ‘preventive’ osteotomy. Is this ‘overdiagnosis’ and ‘overtreatment’? Mike Reiman is a highly respected clinician-academic and he has integrated the literature on this topic with his clinical expertise. A ‘must’ podcast for physiotherapists, ATCs and doctors who take care of active people.
See also:
Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis: bit.ly/1inIRfW
Physical examination tests for hip dysfunction and injury: bit.ly/1lHRoVP
Jo Kemp, Kay Crossley, Ewa Roos, What fooled us in the knee may trip us up in the hip: lessons from arthroscopy: bit.ly/1pifElu
Julianne Ryan, Neasa DeBurca, Karen McCreesh, Risk factors for groin/hip injuries in field-based sports: a systematic review: bit.ly/1sq5ip2
Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes: http://bjsm.bmj.com/content/48/14/1102.full
Jon Patricios - Hip injuries in sport, in association with SASMA: https://soundcloud.com/bmjpodcasts/hip-injuries-in-sport-in-association-with-sasma
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

Jennie Morton - Treating performing artists and musicians

Jennie Morton is a UCL Honorary Lecturer on the MSc in Performing Arts Medicine, and lectures for The British Association for Performing Arts Medicine, Dance UK and many performing arts schools and teaching organisations. She also co-runs a dance school in Tring, Hertfordshire, and is a faculty member of The Wells Summer School with Dancers of the Royal Ballet. She still performs as a professional singer with the Manhattan Music.
She speaks with James Walsh about the challenges of treating performing artists and musicians, her work with the British Association of Performing Arts Medicine(http://www.bapam.org.uk), and the crossover project with the american college of sports medicine (http://athletesandthearts.com/).
See also:
Fitness levels of middle aged martial art practitioners: http://bjsm.bmj.com/content/38/2/143.full
Risk of cervical injuries in mixed martial arts: http://bjsm.bmj.com/content/39/7/444.full
Dance training intensity at 11–14 years is associated with femoral torsion in classical ballet dancers: http://bjsm.bmj.com/content/40/4/299.full
Changes in hip and ankle range of motion and hip muscle strength in 8–11 year old novice female ballet dancers and controls: a 12 month follow up study: http://bjsm.bmj.com/content/35/1/54.full

Professor Lorimer Moseley on the brain and mind in chronic pain

Professor Lorimer Moseley holds the Inaugural Chair in Physiotherapy at the University of South Australia as well as being a Professor of Neurosciences. He completed his PhD in 2002 and has both learned and shared wisdom at the Universities of Queensland, Sydney and Oxford before settling in Adelaide. He leads the Body in Mind Research Group and coauthored the best-selling ‘Explain Pain’.
In this podcast he answers questions from Ebonie Rio, Department of Physiotherapy, Monash University, covering the important difference between pain and nociception, and sharing thoughts on how pain science can help clinicians working in sports medicine.
You’ll hear him share the best, and worst, ways to explain pain to patients. He predicts how low back pain management will look in 100 years’ time. As always with Lorimer Moseley. expect thoughtful reflections shared with big dob of humour and humility.
See also:
TEDx talk ‘Why things hurt’: http://www.youtube.com/watch?v=gwd-wLdIHjs
Acupuncture applied as a sensory discrimination training tool decreases movement-related pain in patients with chronic low back pain more than acupuncture alone: a randomised cross-over experiment http://goo.gl/zaNX8s
Are children who play a sport or a musical instrument better at motor imagery than children who do not? http://goo.gl/Xv9Qum
Exercise is medicine, for the body and the brain: http://bjsm.bmj.com/content/48/12/943.full
Chronic traumatic encephalopathy in sport: a systematic review: http://bjsm.bmj.com/content/48/2/84.full

Matthieu Sailly - Apophyseal injury in children and adolescents

Apophyseal injury in children and adolescents are common and usually respond to simple unloading interventions. But what is the underlying pathology and why do some children succumb and others not? And why do some apophyses become painful and others fail completely with a complete avulsion? Despite these questions it is an area that is under-researched and few people have a specific interest in this area.
Listen to the insights of Dr Matthieu Sailly, who is a French sports physician who has expertise and research interest in injuries in young athlete. He was the head of the Aspire Academy medical centre where he worked extensively with highly trained adolescent athletes and developed experience on growth related injuries and long term development strategies for immature athletes in various sports.
See also:
Physeal injuries in children’s and youth sports: reasons for concern?: http://bjsm.bmj.com/content/40/9/749.full
Sports-related acute and chronic avulsion injuries in children and adolescents with special emphasis on tennis: http://bjsm.bmj.com/content/41/11/827.full
“Goalkeeper’s hip”: acute haematogenous osteomyelitis secondary to apophyseal fractures: http://bjsm.bmj.com/content/40/9/808.full

‘Overdiagnosis’ in sports medicine? FAI for example? The great Ray Moynihan (‘Selling sickness’)

Over-diagnosis, over-treatment and industry influence. Surely not in sports medicine?
Ray Moynihan is an internationally renowned contributor in the battle to limit any inappropriate influence of pharmaceutical, diagnostic, and technology companies on good clinical practice.
He shares his concerns about the role of drug/implant companies but also argues that clinicians may well be contributing to suboptimal care – almost subconsciously. This is relevant for conditions such as femoroacetabular impingement (FAI). The issue of ‘preventive’ surgery to prevent future arthritis in currently pain-free hips is a massive issue in sports medicine of course. How do we know which patients need this treatment?
Enjoy this podcast from a voice outside BJSM’s traditional network of physiotherapists, physicians, massage therapists, clinicians working with active people.
When we planned the podcast, Ray Moynihan said he didn’t know about sport but I think you’ll agree that what he offers is hugely relevant to sport and exercise medicine. Thanks Ray!
And the 2nd ‘Preventing Overdiagosis’ conference is at Oxford from September 15-17 – just google ‘overdiagnosis conference’. Share your thoughts to @BJSM_BMJ - is this a problem in sports medicine?
See also:
Online First editorial about FAI: http://goo.gl/ziOLNz
In the June issue of BJSM we carry a review of PRP suggesting it isn’t helpful: http://goo.gl/xARb44
The authors of one of the key papers respond here:
http://goo.gl/B1hxqc
You can read several of Ray Moynihan’s papers in the BMJ including this one that summarises his thoughts on overdiagnosis:
http://goo.gl/8uxcGS
Repudiation of the ‘magic bullet’ approach to health improvement: a call to empower people to get moving and take charge: http://bjsm.bmj.com/content/46/5/303.full
‘Overdiagnosis’ / ‘overtreating’– relevant in sportsphysio/medicine? Professor Peter O’Sullivan: https://soundcloud.com/bmjpodcasts/overdiagnosis-overtreating-relevant-in-sportsphysiomedicine-peter-osullivan