Physio Edge podcast
Summary: Inspiring interviews with leading Physiotherapists, discussing real life assessment and treatment, clinical issues and ways to give you an edge in your Physiotherapy clinical practice. Pushing the boundaries of Physiotherapy to not only treat pain, but improve their own clinical performance.
A crunching tackle, flying headfirst off the bike onto your shoulder, or falling onto an elbow will often be enough to injure an acromio-clavicular joint (ACJ). When your patient walks in supporting their arm, or wearing a collar-and-cuff to offload their ACJ, how will you accurately assess and grade their injury? What will you include in your ACJ patient rehab to help them get back to full shoulder function and return to sport? In Physio Edge podcast episode 87 with Dr Ian Horsley, Physio with English Rugby, English Institute of Sport and Olympic Team GB, we explore ACJ and clavicular injuries, including: ACJ anatomy, and which ligaments are commonly injured How to grade an ACJ injury When to request imaging Clavicular osteolysis How to identify SLAP lesions that occur with ACJ injuries How to assess patients with ACJ injury Objective assessment tests to help your diagnosis The role of the scapula in ACJ rehab Common exercises you can use in rehab Progressing ACJ rehab to prepare for return to sport How to include return to contact in your rehab eg for rugby players How much pain is ok during rehabilitation Return to play timeframes with common What do do when rehab is not progressing to plan Clavicular fractures - conservative or surgical management Ways to stimulate osteoblastic activity post fracture CLICK HERE to download your free handout on AC Joint injuries Links associated with this episode: Download and subscribe to the podcast on iTunes Listen to the podcast on Spotify Improve your confidence and patient results with a free trial Clinical Edge membership Online course - Shoulder rehabilitation for contact sports and the rugby shoulder with Dr Ian Horsley Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Dr Ian Horsley on Twitter - @Back_in_action Back in Action Physiotherapy You Tube - Back in Action Facebook - Back in Action Research Gate - Dr Ian Horsley Resources associated with this episode: Jacob et al. 2017. Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations. Robertson et al. 2016. Return to sport following clavicle factors: a systemic review. Other Episodes of Interest: PE 076 - Anterior shoulder pain, long head of biceps tendon pathology and SLAP tears with Jo Gibson PE 067 - Shoulder special tests and the rotator cuff with Dr Chris Littlewood PE 043 - Sporting Shoulder with Jo Gibson PE 040 - Shoulder Simplified With Adam Meakins PE 021 - Shoulder Pain With Dr Jeremy Lewis
How do you answer your patient when they ask why they still have back or neck pain more than 12 months after an injury? Shouldn't their body have healed by now? Why does their knee pain get worse every time they do their exercises, put tape on it, go for a walk or just climb the stairs? What is going on? Why do they still have pain? How are you going to explain it, and how can you help them? In this podcast with Dr Tim Mitchell and Dr Darren Beales, you'll discover: 4 types of pain, and how they change your assessment and treatment Why some patients become sensitised following an injury Questions you need to ask in your subjective How to identify red flags Is night pain and disturbed sleep a red flag? When your patient is sensitised to pain, can you differentiate between central and peripheral sensitisation? Important aspects to include in your objective assessment Assessing movement and function How hyperalgesia and allodynia affect your treatment Why it can backfire if you tell your patient they have central sensitisation and pain is in their brain How to challenge a patient's beliefs about their pain, like they "just need a massage" or their "pelvis is out" so that it won't backfire and make their faulty belief even stronger When should your patients return to work or have adjusted duties? How to use the Musculoskeletal clinical translation framework and apply it in your clinical practice Download and subscribe to the Physio Edge podcast now to improve your treatment of musculoskeletal pain and sports injuries Links associated with this episode: Download and subscribe to the podcast on iTunes Increase your confidence and results with patients with a free trial Clinical Edge membership Discover a quick simple shoulder assessment in three free videos with Jo Gibson Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Musculoskeletal Clinical Translation Framework Dr Tim Mitchell Dr Darren Beales Twitter: @PeteOSullivanPT TWITTER: @hels_slater Curtin University - Master of Clinical Physiotherapy Resources associated with this episode: BJSM Podcast - Lorimer Moseley Pain Options - Pain Resources Pain Health - Pain Self-checks Örebro Musculoskeletal Pain Questionnaire Örebro Musculoskeletal Pain Questionnaire Short Form Agency for Clinical Innovation - Best practice care for people with acute low back pain Pain-Ed Other Episodes of Interest: PE 035 - Know pain with Mike Stewart Part 1 PE 036 - Know pain with Mike Stewart Part 2
Have you had patients that developed groin pain after getting a bit carried away with situps or abdominal exercises in the gym? Or have your patients developed lower abdominal pain after running or training that is causing them pain into hip extension? In this podcast with Andrew Wallis, Sports Physiotherapist with the St Kilda AFL team, we explore how you can treat patients that were a little too exuberant with their abdominal training or running, including: The Doha Agreement on groin pain terminology Inguinal related groin pain Anatomy of the abdominal region and groin Rectus abdominus tendon overload Whether pelvic tilt contributes to abdominal overload How you can identify the cause of pain in this suprapubic region How to objectively assess patients, and key tests to perform How you can treat patients with an acute overload history Progressive abdominal loading, including exercises you can use How to progress running, interval training and hill running Adding in cutting, agility training and kicking How to help set your patient's expectations about recovery timeframes and progress Andrew Wallis is also presenting a webinar on how to treat athletes with the most common type of groin pain - adductor-related groin pain. It'll be held on Wednesday 25th October, so grab your spot on this webinar now! Links associated with this episode: Download and subscribe to the podcast on iTunes Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Andrew Wallis on Twitter @Andrewwallis15 Facebook - The Hip and Groin Clinic The Hip and Groin Clinic website Resources associated with this episode: Cook and Purdam. 2009. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy King et al. 2018. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes Other Episodes of Interest: Physio Edge 070 How to treat adductor related groin pain and complex cases with Dr Adam Weir Physio Edge 069 Adductor related groin pain, stress fractures and nerve entrapment assessment and diagnosis with Dr Adam Weir Physio Edge 054 Hip and groin part 2: Assessment and treatment with Benoy Mathew Physio Edge 053 Hip and groin part 1: Diagnosis, pathology and red flags with Benoy Mathew Physio Edge 028 Groin Injury Screening and Rehabilitation With Dr Kristian Thorborg Physio Edge 025 Groin Assessment With Dr Kristian Thorborg
How can you manage lower limb tendinopathy in your patients that like to run? Can runners with medial tibial stress syndrome (MTSS) continue to run? Can patients with high BMI or following total hip replacement run? Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries in this Q&A conducted live, including: How can you manage post-run morning stiffness? What are the important aspects when managing load? How can you treat Achilles tendinopathy patients with decreasing tolerance to running and walking, and increasing pain? Differential diagnosis for Achilles pain Proximal hamstring tendinopathy What exercises can be used? Is a feeling of tightness normal, and how can this be addressed? Are stretches helpful? When can deadlifts and Romanian deadlifts (RDL's) be used? Patellar tendinopathy - how can you manage a runner that is not willing to decrease running volume even temporarily? Peroneal tendinopathy Running vs rest in female distance runners with chronic hamstring origin injuries Patellar tendinopathy Medial tibial stress syndrome (MTSS)/Shin splints treatment Working at marathons or running events - How can you help your runners with ITBS or PFP finish a race? Can runners return to running following total hip replacement? Is running harmful for patients with high body mass index (BMI) when they want to reduce weight? To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes" Links associated with this episode: Submit questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
What are the key components when assessing and treating runners? Should your treatment of running injuries focus on glutes? How can your runners schedule their training to improve recovery? Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries, including: The key concepts when assessing and treating running injuries Gait retraining programs The best ways to change running technique Does gait retraining cause fatigue? Is gait retraining suitable in painfree runners? What are the most important elements to prevent injury in runners? Scheduling to improve recovery from injury. When should your runner run, and when should they rest? Can we increase leg stiffness when running? Does increasing leg stiffness reduce injury risk? Strengthening for runners Do glutes become underactive or "not fire properly"? Does improving glute strength improve running mechanics? Calf tears - how can you treat these? What tests can you perform for your runners calves? Do runners have "stiff hips", and does it matter? Can you help runners with meniscal tears? How can you treat ITB syndrome? Is barefoot running helpful or harmful? Should we run in only 1 shoe if we want to win a race? To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes" Links associated with this episode: Submit your running-injury related questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
Achilles tendinopathy treatment - what is the latest research, and how can it help your treatment? What is the best way to treat Achilles tendinopathy (AT)? Over the years our treatment of tendinopathy has evolved significantly. You may remember rubbing tendons with ultrasound or our thumbs in years gone past, and stretching the painful area or muscle-tendon complex. If you did, you may also remember the number of people that didn't really improve or develop the load tolerance to return to activity with this approach, supported by research demonstrating the lack of effectiveness of this approach. We progressed to the golden era of loading, initially using eccentric training. Additional research emerged on the benefits of heavy slow resistance in tendinopathy treatment, closely followed by the importance of load management demonstrated in research on soft tissue injuries. In 2015 and 2016 Rio et al. released promising preliminary research utilising isometric holds in patellar tendinopathy patients, and we have extrapolated and used isometric holds with many different types of tendinopathy. In Physio Edge podcast episode 82 with Dr Seth O'Neill, you will discover: Are isometric holds effective with Achilles tendinopathy patients? What is the most effective treatment for AT? What does the latest research on the treatment of AT reveal? Is relief of pain with isometric holds necessary to make a diagnosis of tendinopathy? What assessment tests can you perform to diagnose AT? How can you assess patient calf strength? How can you differentially diagnose other conditions including Plantaris involvement, insertional AT, talocrural impingement or neural irritation? How can you explain AT to your patients? What exercises can you include in your treatment? Exercise progressions you can use When are eccentrics a useful addition to a treatment program? When can patients start, continue or progress a walking or running program? How can you incorporate the biopsychosocial model into your treatment? Is dorsiflexion range of movement important? Is stretching an effective treatment for tendinopathy? Are ice, massage or ESWT useful? When is imaging useful? How can you treat insertional Achilles tendinopathy? Download this podcast now to improve your results with Achilles tendinopathy Dr Seth O'Neill completed a MSc in Musculoskeletal Physiotherapy, followed by a PhD focused on Achilles tendon disorders. Seth is a lecturer in Physiotherapy at the Universities of Leicester and Coventry, and has a Physio private practice in Nottingham, UK. Click here to download your FREE podcast handout Click here to register for this FREE webinar "Anterior knee pain and the impact of load" with Lee Herrington Click here to register for this FREE webinar "Accelerated conservative management of medial knee injuries" with Chris Morgan Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @Seth0Neill Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode: Beyer R, Kongsgaard M, Hougs Kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. The American journal of sports medicine. 2015 Jul;43(7):1704-11. O’Neill S, Radia J, Bird K, Rathleff MS, Bandholm T, Jorgensen M, Thorborg K. Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy. 2018:1-9. Rio E, Kidgell D, Purdam C, Gaida J, Moseley GL, Pearce AJ, Cook J. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015 May 15:bjsports-2014. Other episodes of interest: Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
Ankle syndesmosis injuries following forced ankle dorsiflexion and lateral rotation of the foot require very specific management and rehabilitation to achieve great treatment outcomes. If you approach management of ankle syndesmosis injuries in the same manner as a lateral ankle ligament injury it will likely result in long term pain and dysfunction for your patients. In the previous episode of the Physio Edge podcast - How to assess ankle syndesmosis injuries, Chris Morgan and David Pope explored how to assess and diagnose ankle syndesmosis injuries (ASI). In this new Physio Edge podcast - "How to treat ankle syndesmosis injuries with Chris Morgan (Arsenal 1st Team Physiotherapist in the English Premier League), you will discover how to manage different grades of ASI, including: Grade 1 syndesmosis injury management Initial injury management How long should you immobilise a Grade 1 injury for? What weight bearing should be allowed in the initial stages? Taping techniques that can be utilised during return to running, training and play Rehab - initial exercises and progressions How much pain is acceptable during return to training? Return to sport timeframes & how you and your athlete can decide when RTP is appropriate When can contact be initiated? Grade 2 syndesmosis injuries Grade 2 injury management and immobilisation Which players are likely to require arthroscopy to confirm instability, and subsequent stabilisation surgery? Why rehabilitation of stable grade 2 injuries is different from grade 1 injuries Which movements you need to restrict How to maintain lower limb musculature and minimise muscle atrophy should be performed Additional general conditioning your patient should perform during the early phase of rehab How to incorporate an Alter G treadmill into rehab Occlusion training for lower limb conditioning How to modify rehab if you do not have access to an Alter G Timeframes and criteria to assess when your patient can remove their immobilisation boot Tests to perform at each stage of rehab When and how should dorsiflexion range be improved? Timeframes and criteria to meet prior to return to running Exercise progressions and variations Return to play markers and tests you can use What to do when a player still reports a ‘nipping’ at the front of the ankle after 6 weeks and is having difficultly achieving full dorsiflexion Unstable injuries - Grades 2b, 3 and 4 Management of unstable injuries Post-surgical immobilisation and management Common return to play timeframes Click here to download your podcast handout To accurately grade your patients ASI and prescribe the most appropriate rehab I strongly recommend listening to Physio Edge podcast episode 80 – How to assess ankle syndesmosis injuries with Chris Morgan prior to this podcast CLICK HERE to register for the free webinar - Medial knee injuries with Chris Morgan Medial knee injuries often occur in snow sports, or other sports when landing or being tackled. Different areas of the medial knee can be injured, including the deep, superficial, proximal or distal fibres of the MCL and medial knee. Depending on the injured structures, patients will either cope with a more aggressive treatment approach and early return to sport, or require a more conservative approach. How can you know the rehab approach your individual patient requires? In this free webinar with Chris Morgan (1st Team Physiotherapist with Arsenal FC), you will explore: Applied anatomy of the medial knee Mechanism of injury, presentation and diagnosis of medial knee injuries How you can differentiate between deep, superficial, proximal, distal and Grade 1, 2 and 3 clinical injuries How imaging findings correlate with your clinical findings MRI grading (radiological versus clinical) How you can perform an objective assessment How function, pain and instability impact your treatment Accelerated vs more conservative treatment - how can you choose the ideal approach for your patient? Are PRP injections appropriate? Rehabilitation principles you can use with your medial knee injury patients Ligament loading Which bracing and weight bearing regime should you utilise? What should you do when your patient has joint laxity? Is pain during rehab acceptable? Should you overload OR "under load to overcome"? You can CLICK HERE to access this free webinar Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @ChrisMorgan10 Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode: Calder et al. 2016. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports Latham et al. 2017. Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report Morgan et al. 2014. Conservative management of syndesmosis injuries in elite football Sikka RS, Fetzer GB, Sugarman E, Wright RW, Fritts H, Boyd JL, Fischer DA. Correlating MRI findings with disability in syndesmotic sprains of NFL players. Foot & ankle international. 2012 May;33(5):371-8. Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med. 2015 Mar 1;49(5):323-9. Other episodes of interest: PE 051 - Lateral knee and LCL injuries with Matt Konopinski PE 052 - Conservative or surgical management of ACL injuries with Enda King
Ankle syndesmosis injuries, also known as a high ankle sprain, commonly occur during high impact tackles or collisions that involve forced lateral rotation of the foot in ankle dorsiflexion. Syndesmosis injuries can be missed in the early stages as the degree of pain and swelling may not reflect the severity of the injury. Early diagnosis of syndesmosis injuries is key in preventing persistent pain, disability and limited ability to return to play or activity. In Physio Edge podcast episode 80, English Premier League Physiotherapist Chris Morgan, and David Pope explore how to assess and diagnose ankle syndesmosis injuries (ASI), including: Questions you need to ask when your patient has had an ankle injury What is an ASI? What symptoms will your patient report following ASI? Ligaments and structures that are often involved in an ASI What is a "peeling injury", and how does this influence the structures that are injured? Common mechanism of injury How to assess, diagnose, classify and grade ASI How to differentiate between stable and unstable ASI Which tests can you perform to accurately diagnose ASI? Differential diagnosis Which injuries are likely to require surgical intervention, and which injuries may be managed conservatively? When imaging is useful What type of imaging to perform Identifying underlying chondral lesions Early management strategies CLICK HERE to download your podcast handout Upcoming podcast - How to treat ankle syndesmosis injuries with Chris Morgan A subsequent podcast with Chris Morgan will discuss in detail how to treat ankle syndesmosis injuries . Download this podcast now to improve your assessment and diagnosis of ankle syndesmosis injuries. Free webinar - Medial knee injuries with Chris Morgan Chris Morgan's Physiotherapy roles in English Premier League with Liverpool and Crystal Palace have provided him with a lot of experience treating acute injuries, including the ankle and knee. To help you take advantage of this experience, Chris is presenting a Clinical Edge webinar on medial knee injuries. In his webinar Chris will discuss: • Presentation of medial knee injuries • How imaging findings correlate with clinical findings • How to progress your rehabilitation and return players to performance • Incorporating change of direction and trunk control into rehabilitation You can CLICK HERE to access this free webinar Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @ChrisMorgan10 Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode: Morgan et al. 2014. Conservative management of syndesmosis injuries in elite football Sikka RS, Fetzer GB, Sugarman E, Wright RW, Fritts H, Boyd JL, Fischer DA. Correlating MRI findings with disability in syndesmotic sprains of NFL players. Foot & ankle international. 2012 May;33(5):371-8. Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med. 2015 Mar 1;49(5):323-9. Other episodes of interest: PE 017 - Injury reduction with Dr Peter Brukner PE 027 - Sports injury management with Dr Nathan Gibbs
Following ACL injury, patients can have a smooth recovery with full return to sport and activity, or end up with ongoing knee symptoms and limited ability to perform the activities they love. How can you help your ACL injured patients have a great outcome? In Physio Edge podcast episode 079, Dr Lee Herrington and David Pope explore how to make your ACL injury rehab successful, and provide you with a comprehensive guide to rehabilitate ACL injuries. You will understand how to take your patients from initial injury to return to sport, and develop the knowledge to help inform your patients decide with your patient whether surgical repair or conservative management is their best option. You will discover: Do ACL injuries require surgical management? Which factors commonly affect whether people with ACL-deficient knees require surgery? Common diagnostic errors in ACL injury patients What are the key elements you need to include in your rehab of ACL injuries? Conservative vs surgical management Should your rehab focus on movement control, strength or skills? How you should objectively assess your patients rehab progress? What valid measurement tools can you use when assessing patient progress? Are open-chain exercises safe, and should they be used in your rehab? Most effective types of movement control and skill training How to know when your patient should progress their exercises? Which strength measures are important? Which strength training exercises can you include? When can running be commenced? Running progressions you can use What pain measures should you monitor throughout rehab? Is pain during rehab ok? How to return your patient to training and sport What maintenance exercises should your patient continue after completing their rehab? Related online courses Advanced ACL rehab with Andrew Ryan Other episodes of interest: Physio Edge 052 Conservative or surgical management for ACL injuries with Enda King Physio Edge 051 Lateral knee and LCL injuries with Matt Konopinski Physio Edge 034 - Advanced ACL rehab with Enda King Click here to download the podcast handout Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @LeeHphysio MSc Sports injury rehabilitation - University of Salford Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode: Bollen et al. 1996. Rupture of the anterior cruciate ligament - a quiet epidemic? Comfort et al. 2011. Kinetic comparisons during variations of the power clean Frobell et al. 2010. A randomised trial of treatment for acute anterior cruciate ligament tears Gabbett. 2016. The training - injury prevention paradox: should athletes be training smarter and harder? Harris et al. 2017. Tibiofemoral osteoarthritis after surgical or nonsurgical treatment of anterior cruciate ligament rupture: a systematic review Herrington et al. 2013. Task based rehabilitation protocol for elite athletes following Anterior Cruciate ligament reconstruction: a clinical commentary Hewett et at. 2010. Understanding and Preventing ACL injuries: current biomechanical and epidemiological considerations Mikkelsen et al. 2000. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study Weiler et al. 2015. Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football plater with return to play in less that 8 weeks: applying common sense in the absence of evidence
How can you incorporate high performance elements into your sports injury rehab, to help your injured players and athletes become strong, fit, powerful and fast? How can you rehab a player to perform at a high level when they return to sport following injury? In Physio Edge podcast episode 78, David Joyce shares how you can improve the performance aspects of your rehabilitation. You will discover some of the key elements when managing high performance athletes and sporting teams. If you work with injured athletes at an elite, recreational or junior level, or would like to work with a sports team, you will love this podcast. In this podcast, David Joyce and David Pope discuss: How to help athletes move from being a junior player to performing at an elite level How to help players build tolerance and resilience to cope with high level sport How to create "elite level people", not just "elite level players" What makes a player likely to succeed? Schedules and weekly programs you can use to prepare junior players What load should a junior player perform during preseason relative to a senior player? When players need to be exposed to higher loads How to schedule training and running to prevent bony and soft tissue injuries How many running sessions per week should players perform? "Earning the right" to run at full speed How to structure strength sessions do players perform Incorporating plyometrics What load measures are actually important Important screening questions to ask your players How to return injured players to high level sport How many weeks of full training do ACL injured players require before return to play Key tests to perform for your players Tips when objectively testing athletes CLICK HERE to download your podcast handout Get your access to Sports Injury Assessment and Treatment FREE videos Links associated with this episode: David Joyce at Greater Western Sydney Giants David Joyce on Twitter - @DavidGJoyce Twitter - Giants Athletic Performance Unit @Giants_APU Book - Sports injury prevention and rehabilitation Book - High performance training for sports Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership Download and subscribe to the podcast on iTunes Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: PE 003 - Rugby, rehab and return to sport with the Australian Wallabies Physio PE 027 - Sports injury management with Dr Nathan Gibbs PE 034 - Advanced ACL rehab with Enda King
The long head of biceps tendon and superior labrum can get a hard time in throwing athletes and patients that fall on their arm or shoulder. This can result in long head of biceps tendon pathology or SLAP tears, and cause ongoing shoulder pain. A lot of our shoulder tests are non-specific, and are unable to identify particular structures that are irritated or painful in the shoulder. In the case of the long head of biceps (LHB) tendon and slap tears, there are a few useful tests that in combination with a good history can help you identify when the structures are involved in your patient's shoulder pain. In episode 77 of the Physio Edge podcast, Jo Gibson, Shoulder Specialist Physio and David Pope discuss anterior shoulder pain, LHB pathology and SLAP tears. You will discover: Anatomy of the long head of biceps tendon and superior labrum Why the anatomy is important, and may be different to what you learnt at university around the biceps tendon and bicipital groove The clinical presentation and relevant history of patients with SLAP lesions and LHB tendon pathology Which patients are more likely to get SLAP tears following trauma Special tests that may help you identify LHB pathology and SLAP tears What information imaging gives us When to request imaging for your shoulder pain patients Different groups of patients that develop LHB pathology Rehabilitation of LHB tendon pathology and SLAP tears When to specifically target the LHB tendon, and when to target the surrounding structures for best results Other areas to consider in your rehab beyond the shoulder How the kinetic chain can impact shoulder pain How someone's hop distance can influence their shoulder pain How to start treatment of someone with an irritable LHB tendon Important education components to include in your treatment Time frames - How long do these injuries take to recover? Which patients are suitable for surgical management? Different types of surgery for LHB tendon pathology Which SLAP tear patients should have conservative treatment? How suprascapular nerve involvement can present following traumatic shoulder injury, and how to identify patients with suprascapular nerve compression Links of Interest Free Shoulder assessment videos with Jo Gibson - a series of three evidence-based videos to get you great results with shoulder pain Free sports injuries videos including the AC joint with Jo Gibson Download and subscribe to the podcast on iTunes Jo Gibson on Twitter - @ShoulderGeek1 Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Courses - Steps to Success Articles associated with this episode: Hendy et al. 2012. Cross education and immobilisation: mechanisms and implications for injury rehabilitation Kibler et al. 2009. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder McCreesh et al. 2017. Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy Parle et al. 2017. Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect? Saithna et al. 2016. Shoulder Arthroscopy Does Not Adequately Visualize Pathology of the Long Head of Biceps Tendon Schroder et al. 2017. Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial Taylor et al. 2017. The "3-Pack" Examination Is Critical for Comprehensive Evaluation of the Biceps-Labrum Complex and the Bicipital Tunnel: A Prospective Study Exercise videos Thoracic rotation exercise Dynamic rotation exercise Other episodes of interest: PE 043 - Sporting Shoulder with Jo Gibson PE 031 - Unruly scapular assessment and retraining with Ann Cools
There are a lot of myths around footwear, and your patients with running injuries will often blame an "incorrect shoe" choice for their injury, or believe that getting the "right shoe" will help resolve an injury. Are running shoes the cause of, and solution to running injuries? What advice should you give your patients when they ask that inevitable question "Do you think I need to get new shoes?", closely followed by "What shoe do you think I should run in?" In Physio Edge podcast episode 76 with Tom Goom, you will also discover: What footwear should your runners and injured runners wear? Footwear questions you need to ask your running injury patients Does footwear change gait patterns? Can footwear contribute to injury? What footwear may contribute to or help in your treatment of Achilles tendinopathy What is heel-toe drop and how is this important? Does footwear affect ground reaction forces, and how does this relate to bone stress injuries and plantar fasciopathy? Is minimalist or barefoot running helpful or harmful? Can runners safely transition to barefoot or minimalist running? Is footwear the key to resolving running injuries? Shoe prescription Recommendations when buying new shoes Footwear considerations for specific pathologies When should runners change their shoes? If you would love to get better results with running injuries, the podcast handout contains the key take-home messages for you. You can download it here. To complement this podcast and improve your treatment of runners, Tom Goom and I have created three awesome free Achilles tendinopathy rehab videos. This is a series of three evidence-based videos to help you master Achilles treatment. CLICK HERE to get your free access to these videos Links of Interest Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Download and subscribe to the podcast on iTunes Download your free podcast handout on treatment of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Research associated with this episode Esculier et al. 2015. A consensus definition and rating scale for minimalist shoes. Fuller et al. 2017. Six week transition to minimalist shoes improves running economy and time-trial performance. Kong et al. 2009. Running in new and worn shoes: a comparison of three types of cushioning footwear. Mallisoux et al. 2015. Influence of heel to toe drop of standard cushioned running shoes on injury risk in leisure time runners: a randomised controlled trial with 6 month follow up. Nigg et al. 2015. Running shoe and running injuries: myth busting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’. Salzier et al. 2016. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.
Tendinopathy patients may present for treatment with an ultrasound or MRI report in hand, unsure how you can help them, or how they can possibly recover when they have so much tendon pathology. To add insult to injury, they may even have a partial tendon tear on their imaging report thrown into the mix. How do imaging results impact your treatment and your patient's recovery? Are the imaging findings relevant to their pain? In this Physio Edge podcast with Dr Sean Docking (Physiotherapist, PhD), you will explore what information imaging actually provides in your tendinopathy patients, how to explain imaging to your patients, and whether partial tendon tears identified on imaging will effect your treatment. You will also discover: Who develops tendon pathology If patients have tendon pathology on imaging, is this responsible for their symptoms, or will it cause future tendon pain Asymptomatic tendon pathology in sports people How tendon pathology can actually be linked to better performance Can we prevent tendon pathology The advantages and disadvantages of different imaging types, including MRI Ultrasound Ultrasound tissue characterisation (UTC) Why a thickened tendon may actually be helpful in recovery How can we actually diagnose tendinopathy When is imaging useful Differential diagnosis of Achilles pain, including Achilles tendinopathy Paratenonitis Plantaris associated tendinopathy Partial tendon tears, the accuracy of identification, and how they impact your treatment Sports injuries virtual conference As mentioned in this episode Sean presented at the 2017 Sports Injuries virtual conference. His main conference presentation on tendinopathy and imaging discusses: The research around the use for imaging A framework for when and when not to use imaging How to explain imaging findings to patients You can get immediate access to his presentation, and presentations from 13 of the leaders in sports injuries by CLICKING HERE Download this podcast and subscribe on iTunes Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Twitter - @SIDocking Sean Docking - La Trobe University website Sean Docking - Research gate David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership Articles associated with this episode: Alfredson. 2011. Midportion achilles tendinosis and the plantaris tendon Brown et al. 2011. The COL5A1 gene, ultra-marathon running performance and range of motion Docking et al. 2016. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Docking et al. 2015. Tendinopathy: Is imaging telling us the entire story? Lieberthal et al. 2014. Asymptomatic achilles tendinopathy in male distance runners McAuliffe et al. 2016. Can ultrasound imaging predict the development of Achilles and patellar tendinopathy? A systematic review and meta-analysis Simpson et al. 2016. At What Age Do Children and Adolescents Develop Lower Limb Tendon Pathology or Tendinopathy? A Systematic Review and Meta-analysis Other episodes of interest: PE 068 - Lower limb tendinopathy loading, running and rehab with Dr Pete Malliaris PE 042 - Treatment of Plantaris and achilles tedninopathy with Seth O’Neil PE041 - Plantaris involvement in achilles tendinopathy with Dr Christoph Spang
Femoroacetabular impingement (FAI) may contribute to hip and groin pain, buttock pain, pelvic or low back pain and referred pain into the thigh. Is conservative management effective in patients with FAI, or is surgery required? If we can treat FAI conservatively, what is the best treatment, and how can you tailor your treatment to your individual patients? In episode 74 of the Physio Edge podcast with Dr Joanne Kemp you will discover: What is FAI, and how can you identify it? Common clinical presentations Key subjective questions to ask Types of FAI morphology and how they are identified Is FAI just a normal finding? How you can perform an objective assessment in patients with FAI Differential diagnosis Components you need to include in your conservative treatment for FAI Which objective markers to use when treating FAI How to address common impairments in your rehabilitation, including strength, functional tasks, cardiovascular training and range of movement When to refer for a surgical opinion Outcomes of surgical treatment Future risk of developing OA in presence of FAI Sports Injuries virtual conference presentation As mentioned in this episode Joanne will be part of the Sports Injury virtual conference. Her pre conference presentation will discuss FAI and the diagnostic process in more detail. Her subsequent conference presentation will be available on 9-10 December 2017, with access for up to 12 months following the conference, and will discuss: • Conservative management of FAI • Specific exercise progressions you can use • Return to sport for athletes Enrol on the 2017 Sports Injuries virtual conference by CLICKING HERE Download this podcast and subscribe on iTunes Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Twitter - @JoannaLKemp Joanna Kemp - Research gate David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership LaTrobe Sports and Exercise Medicine Research Blog Twitter - @LaTrobeSEM GLA:D Australia Lake Health Group Articles associated with this episode: Griffin et al. 2016. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Articola et al. 2014. A Cam Deformity Is Gradually Acquired During Skeletal Maturation in Adolescent and Young Male Soccer Players. A Prospective Study With Minimum 2-Year Follow-up. Other episodes of interest: Physio Edge 054 - Hip and groin pain part 2 with Benoy Matthew Physio Edge 053 - Hip and groin pain part 1 with Benoy Matthew Physio Edge 009 - Lateral hip pain with Dr Alison Grimaldi Physio Edge 004 - Hip injuries and labral tears with Nicole Hamilton
Strengthening is not commonly used in neck pain treatment and rehabilitation, however athletes may place large demands on their neck during training and play that require a high level of strength or endurance. When should you include strength training in your rehabilitation? What patients will benefit from strength training? How can you incorporate strengthening into your treatment? In episode 73 of the Physio Edge podcast, we explore the role of neck strengthening with Kay Robinson, Physiotherapist working with Australian sailing, and previously with the British Olympic Skeleton team. In the podcast you will discover: Objective assessment of patients with neck pain Range of movement and strength tests you can use with your neck pain patients How to assess neck strength in your patients Indications for strength training Is strength training suitable in the early stages of neck pain rehabilitation? Early-stage cervical spine rehabilitation exercises you can use Exercise progressions to improve neck strength Neck strengthening in concussion Is neck strength training suitable for whiplash patients? Aspects incorporated into a typical neck strengthening program Kay Robinson will also be presenting at the 2017 Sports Injury virtual conference. Her conference presentation on neck strengthening will discuss: How to incorporate neck training into rehabilitation post injury Neck strengthening for injury prevention How to make exercise patient or sport specific Other consideration with neck training Case studies Download this podcast and subscribe on iTunes Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Kay Robinson on Twitter - @kaylourob Kay Robinson at Total Physiotherapy David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership Book - Sports Injury Prevention and Rehabilitation: Integrating Medicine and Science for Performance Solutions High-Performance Training for Sports Articles associated with this episode: Durall. 2012. Therapeutic Exercise for Athletes With Nonspecific Neck Pain: A Current Concepts Review. Falla et al. 2003. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Falla et al. 2007. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Jull et al. 2009. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Other episodes of interest: PE 013 - Cervical Spine Artery and VBI Testing with Roger Kerry 5 Minute Physio tip - Manual therapy for the cervical spine - Is there any evidence? 5 Minute Physio tip - Contraindications and red flags to cervical spine manual therapy.