BJSM Podcast

Return to exercise after ACL (anterior cruciate ligament) injury, with Dr Richard Frobell

Coming together at the UKSEM conference in London, Professor Lars Engebretsen (Oslo Sports Trauma Research Center and IOC medical commission) talks to Dr Richard Frobell (Lund University, Malmo, Sweden) about his work on return to exercise after ACL (anterior cruciate ligament) injury.Dr Frobell describes the evidence already on this issue, and his recently published randomized trial on whether surgery or rehabilitation improves pain, symptoms, function in sports and recreation, and knee-related quality of life post-injurySee also:A randomized trial of treatment for acute anterior cruciate ligament tears http://bit.ly/rrS51YThe BJSM Warm up about this injury http://bit.ly/tBNdiuOur 2010 interview with Richard Frobell and coauthors of the NEJM paper above http://bit.ly/99leZd

Biomechanical overload and lower limb injuries, with Andrew Franklyn-Miller

Diagnosing chronic exertional compartment syndrome relies on measuring intramuscular pressure, however Andrew Franklyn-Miller (Sports Surgery Clinic, Dublin; education director at BASEM) has shown the criteria for this are flawed (2.51). He talks to BJSM editor Karim Khan about what clinicians can do to get round this, his theory the condition is caused by biomechanical overload and his work looking at running re-education to alleviate symptoms (6.13).He also gives us his views on barefoot running (10.44) and talks about his research on orthotics (17.57).Finally, as UKsem’s director, Dr Franklyn-Miller gives us an update on the speakers and programme of the upcoming conference (21.04).See also:Foot Orthoses in the Prevention of Injury in Initial Military Training http://ajs.sagepub.com/content/39/1/30.abstractThe validity of the diagnostic criteria used in chronic exertional compartment syndrome: A systematic review http://bit.ly/10aEvc9Chronic exertional compartment syndrome testing: a minimalist approach http://bit.ly/ZkXNBcChronic exertional compartment syndrome http://bit.ly/oNUhJEBJSM podcast: July’s BJSM and the UKsem Congress, with Andrew Franklyn-MillerUKsem http://bit.ly/13rUCpJ

Treating tendinopathy with Professor Håkan Alfredson

Whether to opt for exercise treatment, new ‘biological therapies’ like platelet-rich plasma (PRP), or surgery is a clinical challenge. Sweden’s Professor Håkan Alfredson has unique experience in considering these options for patients with Achilles pain. He has 15 years experience as an international leader in sports and exercise medicine.In this podcast, he tells BJSM’s editor Karim Khan how to manage both straightforward (0.37) and complicated (7.34) Achilles tendinopathy. He shares novel insights into the contribution of the aberrant plantaris tendon to chronic medial leg pain (12.40).Prof Alfredson also provides a memorable clinical story to underscore the effectiveness of heavy loading eccentric training in one particularly stubborn patient (3.49). He argues against the use of PRP (17.37) and considers cortisone to be a short-term fix but long-term liability (15.24). The podcast concludes with discussion of both jumper’s knee (19.35) and lateral elbow tendinopathy (24.44).Related paper:Midportion Achilles tendinosis and the plantaris tendon http://bit.ly/11y79bcRelated podcasts:Robert Jan de Vos and Adam Weir on platelet rich plasma injections http://bit.ly/JdmFkJProfessor Jill Cook on managing tendinopathies in 2011 http://bit.ly/15DM8Qp

Celebrating the collaboration between BJSM and the VSG (in Dutch)

Zoals u weet heeft de VSG deze zomer een samenwerking gesloten met de British Journal of Sports Medicine.Door de samenwerking heeft sportarts Adam Weir een podcast opgenomen met directeur Anja Bruinsma van de Vereniging voor Sportgeneeskunde. Anja Bruinsma gaat in op: Samenwerking VSG en BJSM, erkenning sportgeneeskunde, wetenschapsdomein, centraal stellen van de sporter en de toekomst van de sportgeneeskunde. Voor meer informatie zie ook www.sportzorg.nl, www.sportgeneeskunde.com.

October’s BJSM and the VSG Annual Meeting, with Hans Tol and Adam Weir

VSG’s (the sports medicine society of the Netherlands) editor-in-chief Hans Tol and congress committee member Adam Weir highlight the October issue of BJSM and preview the VSG Annual Meeting on 1-2 December 2011.The first paper highlighted is from Collard et al [http://bit.ly/ZFQS3U], who have calculated the economic costs of organised sports, leisure time physical activities and physical education classes of 10-12 year old Dutch children (1.26). The outcomes are intriguing!A second paper of interest is from Malliaras and Cook [http://bit.ly/ZkULNj], who contend that the longitudinal changes in antero-posterior patellar diameter support a continuum of pathological changes (2.02).Two new theories on Achilles tendinopathy are presented in this issue. Firstly, Alfredson proposes [http://bit.ly/qyxi2W] there is an important role for the plantaris tendon (2.45). The second paper, presented by Andersson et al [http://bit.ly/15DwlRQ], highlights the role that substance P plays in tendinopathy (3.25). A must-read for those interested in tendon pathology and food for thought for all sport physicians!Visiting the VSG Annual Meeting in Kaatsheuvel, Netherlands, is a decision you won’t regret. Hans Tol and Adam Weir explain in their warm-up why this is a must-visit for sports medicine enthusiasts. However, the conference language is Dutch, so make sure you master this in time! Dr Weir discusses the main topics of interest in the second half of the podcast (5.44).

Musculoskeletal ultrasound with Kim Harmon and Sean Martin

Ultrasound is rapidly revolutionising point-of-care medicine in many specialties. The last few years have seen technological advances make musculoskeletal ultrasound more practical, opening up opportunities for diagnostic and therapeutic interventions.In this podcast, BJSM’s editor Karim Khan investigates the value of musculoskeletal ultrasound and how to integrate it into practice, with Kim Harmon, director of the Sports Medicine Fellowship at the University of Washington, US, and Sean Martin, Clinical Faculty at Eglin Airforce Base, US.They discuss their experiences of the technique in clinical practice (0.44), which procedures it’s useful for (4.22), how to get started (12.03), using musculoskeletal ultrasound in the training room (13.33), the value of collaborating with radiologists and orthopaedics (15.58) and credentialing (17.46).See also:Musculoskeletal ultrasound education for sports medicine fellows: a suggested/potential curriculum by AMSSM http://bit.ly/XSYhwiAmerican Institute of Ultrasound in Medicine (AIUM) http://www.aium.org/BJSM podcast: What is the future in sports imaging? Bruce Forster, David Hancock and John Orchard http://bit.ly/ZM6Q8C

The JUMP-ACL study with Anthony Beutler

In this BJSM podcast, Karim Khan talks to Anthony Beutler (Injury Prevention Research Lab, Uniformed Services University, Bethesda, Maryland) about the JUMP-ACL study http://www.iprc.unc.edu/jumpacl/. It is a large prospective cohort study which investigates risk factors for ACL injury - results will be published soon.They discuss the mechanism of ACL injury in different athletes, the risk of recurrence, and plans to turn the results into practical steps to prevent this injury.Related articles in BJSM include:the IOC current concepts statement on ACL injuries http://bit.ly/ZkTHJ4Roald Bahr’s editorial - ACL injuries - problem solved? http://bit.ly/13TDrBmas well as previous podcasts if you missed them - Tim Hewett and Lars Engebretsen/Liza Arendt.Topic timecodesMain findings - 02.35Frequency of occurrence - 07.45Prevention - 11.30Link with BMI - 18.00

Managing whiplash with Professor Michele Sterling

Karim Khan catches up with associate professor Michele Sterling (Centre for National Research on Disability and Rehabilitation Medicine (CONROD), University of Queenstown, Australia) at the Canadian Physiotherapy Association Congress. As an international expert on neck pain, Michele explains what we currently do and don’t know about whiplash, and advises on managing the condition.She talks us through the importance of early pain management, the link with post traumatic stress disorder and what to do if you suspect this, manual and physical therapies, and treating chronic pain.Resources:Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury http://bit.ly/Mod4ooCONROD’s whiplash evidence based information resource http://bit.ly/11A6xkg

Mike Loosemore - how to prescribe exercise

Dr Mike Loosemore is a consultant in sports and exercise medicine who works at the English Institute of Sport and the University College London Hospital.In this podcast he emphasises the importance of clinicians taking an exercise/activity history. (See link Developing healthcare systems to support exercise: exercise as the fifth vital sign http://bit.ly/17Uhlyc). He provides practical tips for clinicians and highlights major health benefits from physical activity in a wide range of settings as diverse as patients with mental illness, breast cancer [2 links below], and those undergoing renal dialysis.See also:Physical activity interventions for cancer survivors http://bit.ly/ZFQ5jDPhysical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects http://bit.ly/ZJHPfb

FIFA’s Professor Jiri Dvorak on ‘Medicine for Football’ and ‘Football for Health’

Professor Jiri Dvorak, one of BJSM’s senior associate editors, shares his 17 years experience as the FIFA chief medical officer. He discusses How FIFA have reduced injuries in football [1], The evidence for football being a great medicine [2 a ,b] ‘Football for Health’ – FIFA’s successful foray into public health education in schools [3].This is a terrific story of research turning into action – improved health for football players and football players contributing to improve the health of their society.See also:[1] Injuries and illness of football players during the 2010 FIFA world Cup http://bit.ly/11gDgdG[2a] Executive summary: The health and fitness benefits of regular participation in small-sided football games http://bit.ly/17Mntpu[2b] Give Hippocrates a jersey: promoting health through football/sport http://bit.ly/15DIc21[3] ‘11 for Health’, a football-based health education programme for children: a two-cohort study in Mauritius and Zimbabwe http://bit.ly/13rSMVR