Athletes First Performance Podcast: Recent Episodes
Athletes First Performance
The Athletes First Performance Podcast is focused on improving the knowledge of athletes and healthcare professionals in the topics of sports performance and rehabilitation. The co-hosts, James Zotto, PT, DPT, OCS, SCS, CSCS and Josh Fischer, PT, DPT, OCS, are both residency trained Physical Therapists who attended PT school together at the Medical University of South Carolina. We are by no means experts, but we do enjoy digging into the research in order to better our practice and improve patient outcomes. We are hoping this will be a great learning opportunity for all.
Griffin Zink, PT, DPT, CSCS joined the podcast to discuss psychological readiness for athletes returning to sport following ACL reconstruction.
We reviewed his residency research project as well as his recently published article in Sports Health: The Influence of Strength and Sport Exposure on Psychological Readiness After ACL Reconstruction
Topics Include:
- Why psychological readiness should be considered independently from strength and hop testing
- Screening psychological readiness via the ACL-RSI
- The Inverted U Theory and the criticaltimepoints and milestones during rehab that have fluctuations in emotions
- When to administer the ACL-RSI during the return to sport continuum
- How demographics such as age and gender impactpsychological readiness
- Potential interventions to addresspsychological readiness
Contact:
Instagram: @GriffinZink
Email: griffinzink1@gmail.com
Zink GP, Zwolski CM, Thomas SM, Paterno MV, Schmitt LC. The Influence of Strength and Sport Exposure on Psychological Readiness After ACL Reconstruction. Sports Health. 2024;16(2):239-246. doi:10.1177/19417381231223522
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us: Instagram: @athletes_first_physio
Run Time: 36:33 Released on 7April2024
Javy Ramirez, CSCS joined the podcast to discuss his journey from enlisting as a Navy Submariner, to making the rounds as a D1 football strength and conditioning coach, and ultimately finding his way back into the military setting to become a tactical strength and conditioning coach
Topics Include:
- Experiences in the Navy and lessons learned
- Gaining meaningful coaching experience while getting his degree
- The importance of networking and building relationships to get the jobs and experience that you want in life
- Leveraging his prior experience in the Navy to help connect, teach, and lead soldiers to higher levels of physical performance
Instagram: @Javy_RPerform
The Awakening Training Program on Train Heroic
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us: Instagram: @athletes_first_physio
Run Time: 58:21 Released on 26March2024
Orthopedic Surgeon Paul Inclan, MD joined the podcast to discuss ACL reconstruction, rehab, return to sport, and prevention programs.
Topics Include:
- Initial evaluation for athletes with an acute knee injury
- ACL graft type selection
- ACL rehab considerations for meniscus pathology
- Best ways that surgeons, PT's, and ATC's can come together for designing rehab protocols and return to sport testing
- How to maximize return to play and injury prevention programs for athletes recovering from ACL reconstruction
Paul Inclan, MD
Email: Inclanpm41@gmail.com
Twitter: Inclanpm
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us: Instagram: @athletes_first_physio
Run Time: 1:01:46 Released on September 10, 2023
Trevor Lomax joined the podcast to discuss performance nutrition for the injured athlete and soldier.
Topics Include:
- Key concepts that every athlete or soldier should know about nutrition and injury recovery
- The nutrition pyramid by Eric Helms
- Supplementation to enhance performance and recovery
- Nutrition protocols for common injury patterns seen in soldiers
- How to maximize nutrition during long term rehab post surgery
Trevor Lomax, MS, RD CSSD, CSCS
Instagram: @trevorlomax
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us: Instagram: @athletes_first_physio
Run Time: 1:12:43 Released on July 28, 2023
Matt Matau, CSCS joined the podcast to discuss his career as a strength and conditioning coach, moving from the university setting to working with the Army as part of a H2F team.
Topics Include:
- How to handle working with multiple teams as a college strength and conditioning coach
- The path to becoming a tactical strength and conditioning coach
- Building relationships with the soldiers that he works with
- Key considerations when working with the tactical population
- Advice for coaches who want to move into the tactical setting
Matt Matau
Instagram: @mathew_f_matau
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Instagram: @athletes_first_physio
Run Time: 35:34 Released on July 15, 2023
We had Nate Reynolds, PT, DPT, OCS on the podcast to discuss how he has transitioned his PT career from outpatient orthopedics to home health, and now creating a cash PT practice where he specializes in treating Crossfit athletes and baseball players.
Topics Include
- Transitioning to home health and starting a cash pay PT business
- Creating a niche with Crossfit athletes and baseball players
- How he is setting up his business to create the time and financial freedom for future success
Nate Reynolds
Instagram: @NRG.Health
Website: NRGhealth.fit
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: @athletes_first_physio
Run Time: 36:42 Released on November 3rd, 2022
In this episode we discuss the Patellofemoral Pain Clinical Practice Guidelines.
Topics Include:
- Differential Diagnosis
- Objective Exam Techniques
- Functional Tests and Measures
- Classification Systems
- Treatment
References:
- Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
Run Time: 58:36 Released on October 9, 2022
In this episode we discuss testing and profiling athletes following ALCR with Madi Franek and Brandon Surber.
Topics Include
- Important considerations for strength testing athletes during ACLR rehab
- Practical applications for assessing explosiveness and reactive strength in the clinic
- Horizontal deceleration and how it applies to ACL rehab
- Long term rehab frameworks
Madi Franek
twitter: madisonfranek
instagram: dr.madison.franek
Brandon Surber
twitter: @BSurberATPT
instagram: B_Surber4
brandoncsurber@gmail.com
References
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Essential guide to testing and profiling an athlete during rehabilitation and return to play following ACLR
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Harper DJ, McBurnie AJ, Santos TD, et al. Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports. Sports Med. 2022;52(10):2321-2354. doi:10.1007/s40279-022-01693-0
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Harper DJ, Cohen DD, Carling C, Kiely J. Can Countermovement Jump Neuromuscular Performance Qualities Differentiate Maximal Horizontal Deceleration Ability in Team Sport Athletes? Sports. 2020;8(6):76. doi:10.3390/sports8060076
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Harper DJ, Cohen DD, Rhodes D, Carling C, Kiely J. Drop jump neuromuscular performance qualities associated with maximal horizontal deceleration ability in team sport athletes. European Journal of Sport Science. 2022;22(7):1005-1016. doi:10.1080/17461391.2021.1930195
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: @athletes_first_physio
Run Time: 1:23:06 Released on September 24th, 2022
To start off season 2 of the podcast, we broke down the new Clinical Practice Guidelines: Hamstring Strain Injury in Athletes.
Topics Include
- Injury Incidence
- Pathoanatomical Features
- Risk Factors: Non-modifiable and Modifiable
- Evaluation Process
- Interventions
- Return to play
References
1.Hamstring Strain Injury in Athletes
RobRoy L. Martin, Michael T. Cibulka, Lori A. Bolgla, Thomas A. Koc, Jr., Janice K. Loudon, Robert C. Manske, Leigh Weiss, John J. Christoforetti, and Bryan C. Heiderscheit JOSPT Cases 0 0:0, CPG1-CPG44
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
Run Time: 41:41 Released on February 27th, 2022
In this episode, we discuss bone stress injuries in running athletes and military population.
Topics Include
- What is a bone stress injury (BSI)
- Basic pathophysiology of BSI and healing,
- Epidemiology and risk factors
- Clinical dx and low vs high risk BSI,
- Overarching treatment plan mobility, strength, and plyometrics for bone loading,
- When can athletes return to run and how to progress running program
References
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Warden SJ, Davis IS, Fredericson M. Management and Prevention of Bone Stress Injuries in Long-Distance Runners. J Orthop Sports Phys Ther. 2014;44(10):749-765. doi:10.2519/jospt.2014.5334
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Warden SJ, Edwards WB, Willy RW. Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning. J Orthop Sports Phys Ther. 2021;51(7):322-330. doi:10.2519/jospt.2021.9982
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Warden SJ, Edwards WB, Willy RW. Preventing Bone Stress Injuries in Runners with Optimal Workload. Curr Osteoporos Rep. 2021;19(3):298-307. doi:10.1007/s11914-021-00666-y
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
Run Time: 55:04 Released on November 4th, 2021
We break down the basics regarding blood flow restriction training in the clinic.
Topics Include:
- Proposed mechanisms of BFR
- Safety
- Determining proper limb occlusion pressure and what works best for developing muscle strength and hypertrophy
- Exercise volume and determining proper load
- What type of patients or athletes benefit from BFR
- Specifics regarding BFR with resistance exercise and aerobic exercise
- Pain Modulation
- Using BFR with post-op ACL
Resources:
1.Hughes L, Rosenblatt B, Haddad F, et al. Comparing the Effectiveness of Blood Flow Restriction and Traditional Heavy Load Resistance Training in the Post-Surgery Rehabilitation of Anterior Cruciate Ligament Reconstruction Patients: A UK National Health Service Randomised Controlled Trial. Sports Med. 2019;49(11):1787-1805. doi:10.1007/s40279-019-01137-2
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Patterson SD, Burr JF, Warmington S. Editorial: Blood Flow Restriction: Rehabilitation to Performance. Front Physiol. 2021;12:566421. doi:10.3389/fphys.2021.566421
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Owens Recovery Science
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
Run Time: 37:07 Released on October 4th, 2021
This episode is the last episode of our Pain Science Series. We discuss three different case studies on how to apply pain neuroscience education in the clinic.
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
Run Time: 43:42 Released on September 14th, 2021
This episode is the second of three episodes of our Pain Science Series. This week, we break down the drivers of persistent pain.
Topics Include:
- Cup Overflow Analogy
- Control of Stressors
- Sleep
- Mental Health
- Fear of Movement
- Graded Exposure
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
**Run Time: 36:34
Released on August 31st, 2021**
This episode is the first of three episodes of our Pain Science Series. This week, we break down pain biology and try to simplify the pain process.
Topics Include:
- Defining pain
- Breaking down the process of pain
- Pain modulation
- What causes odd pains?
- Central sensitization
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
More About Us:
Website: https://athletesfirstperformance.weebly.com/
Instagram: https://www.instagram.com/athletes_first_physio/
In episode 10 we discuses the evaluation and management of athletic low back pain. We talk about the differences between flexion and extension sensitive athletes and then take a deep dive into evaluation and treatment of spondylolysis in youth athletes.
Topics Include:
- Initial evaluation for athletic low back pain
- Specific tests to help identify spondylosis
- The importance of regional interdependence when dealing with athletes
- Trunk specific training and rehab progressions for athletes dealing with spondylosis
- Our thoughts on motor control exercises vs low back strengthening
Articles
1.Daniels JM, Pontius G, El-Amin S, Gabriel K. Evaluation of Low Back Pain in Athletes. Sports Health. 2011;3(4):336-345. doi:10.1177/1941738111410861
2.Purcell L, Micheli L. Low Back Pain in Young Athletes. Sports Health. 2009;1(3):212-222. doi:10.1177/1941738109334212
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Selhorst M, Allen M, McHugh R, MacDonald J. REHABILITATION CONSIDERATIONS FOR SPONDYLOLYSIS IN THE YOUTH ATHLETE. Intl J Sports Phys Ther. 2020;15(2):287-300. doi:10.26603/ijspt20200287
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Nambi G, Abdelbasset WK, Alqahtani BA, Alrawaili SM, Abodonya AM, Saleh AK. Isokinetic back training is more effective than core stabilization training on pain intensity and sports performances in football players with chronic low back pain: A randomized controlled trial. Medicine. 2020;99(21):e20418. doi:10.1097/MD.0000000000020418
Thanks for listening and as always if you have any questions feel free to reach out on social media or email!
In this episode we introduce the new clinical practice guidelines for managing lateral ankle sprains. We break down the CPG and discuss how we will be using the evidence to help improve our treatment for athletes/patients following a lateral ankle sprain. The flow of the podcast starts with defining a lateral ankle sprain and then identifying risk factors for primary and secondary injury. We then dive into our assessment of specific impairments for acute sprains then analyze a new framework for return to sport criteria. There is also discussion on prophylactic ankle bracing vs taping, stable and unstable surface balance training, and updated views on ankle special testing.
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
Articles
Caffrey E, Docherty CL, Schrader J, Klossnner J. The Ability of 4 Single-Limb Hopping Tests to Detect Functional Performance Deficits in Individuals With Functional Ankle Instability. J Orthop Sports Phys Ther. 2009;39(11):799-806. doi:10.2519/jospt.2009.3042
Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302
Smith MD, Vicenzino B, Bahr R, et al. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework—an international multidisciplinary consensus. Br J Sports Med. Published online June 22, 2021:bjsports-2021-104087. doi:10.1136/bjsports-2021-104087
Run Time: 1:08:12
Released on July 13th, 2021
In this week's episode, we discuss our principles of rehab. We start with the history and the importance of defining the situation and activity to give us a good foundation of where we need to take our objective exam. Next, we talk about our 6 principles of rehab to help develop systems based thinking for our evaluation and treatment. At last, we go over the Vermeil's Hierarchy, different phases of rehab, and criterion based vs timeline based thinking to help guid our treatment progressions.
Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover!
During this episode we provide an overview of hip femoroacetebular impingement syndrome evaluation and treatment.
Topics covered include:
Classifying different hip pathologies and defining FAI
The Funnel Approach to assessing the hip
Guiding principles for treatment General treatment options for improving hip mobility and strength
Articles
Reiman MP, Thorborg K, Sportsphysio M. CLINICAL EXAMINATION AND PHYSICAL ASSESSMENT OF HIP JOINT-RELATED PAIN IN ATHLETES.
Reiman MP, Agricola R, Kemp JL, et al. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018. Br J Sports Med. 2020;54(11):631-641. doi:10.1136/bjsports-2019-101453
Thanks for listening and as always please let us know if you have any questions, recommendations, or topics you would like us to cover!
In this episode we cover the control-chaos continuum and how it relates to late stage ACLR rehabilitation with Dr. Madi Franek.
twitter: madisonfranek
instagram: dr.madison.franek
Topics Covered Include:
° Describing the Control to Chaos Model and how we can utilize this approach in our program design during on field rehab
° Objectively breaking down the athletes capacity to perform a task such as double or single leg squatting
° Discussing his rehab and reconditioning process for athletes returning to sport following ACL injury
°Energy system development and discussing the differences between intensive and extensive training
° Specific criteria that he looks at in order to progress throughout the rehab process for running, plyometrics, return to on field training, and return to play
Article Links:
Taberner M, Dyk NV, Allen T, et al. Physical preparation and return to performance of an elite female football player following ACL reconstruction : a journey to the FIFA Women ’ s World Cup. Published online 2020. doi:10.1136/bmjsem-2020-000843
For our fifth episode, we are joined by Dr. Wesley Talley to talk about the examination and treatment of the shoulder in baseball players. Wesley has a background in working with overhead athletes both during his time in the ATI Sports Residency and in his current position with ATI in Spartanburg, SC.
We cover the subjective and objective portions of the examination as it relates to baseball players and then go into specific education and treatment strategies that Wesley uses to maximize the athlete's ability to recover and then return to sport. There are a lot of specifics that go into working with this population and we greatly appreciate Wesley's expertise on the subject.
Thanks for listening and as always please let us know if you have any questions, recommendations, or topics you would like us to cover!
Article Links:
Wilk KE, Bagwell MS, Davies GJ, Arrigo CA. RETURN TO SPORT PARTICIPATION CRITERIA FOLLOWING SHOULDER INJURY: A CLINICAL COMMENTARY. Intl J Sports Phys Ther. 2020;15(4):624-642. doi:10.26603/ijspt20200624
Matsel KA, Butler RJ, Malone TR, Hoch MC, Westgate PM, Uhl TL. Current Concepts in Arm Care Exercise Programs and Injury Risk Reduction in Adolescent Baseball Players: A Clinical Review. Sports Health. 2021;13(3):245-250. doi:10.1177/1941738120976384
Reinold MM, Macrina LC, Fleisig GS, Aune K, Andrews JR. Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates. Sports Health. 2018;10(4):327-333. doi:10.1177/1941738118779909
Run Time: 58:24
Released on May 19th, 2021
During this episode we provide a general overview of how we examine and treat the shoulder. We are planning to have more in depth discussions on the shoulder coming up, so this just lays the foundation for those conversations.
Topics covered include:
The history
Traditional vs. Current examination process
Special Tests
Our opinion our anatomical vs. movement diagnoses
General treatment overview
Thanks for listening and as always please let us know if you have any questions, recommendations, or topics you would like us to cover!
During this episode we discuss our orthopedic (University of Wisconsin) and sports residency (University of North Dakota) experiences and how it has impacted our careers. If you’re interested in learning more about the residency process or taking the OCS/SCS board exams, this is the podcast for you!
Topics covered include:
Why we decided to do a residency
What we looked for when applying
Interview process
What a typical day looked like
Mentoring and clinical reasoning
Career opportunities that residency provided
OCS and SCS board exam prep
Continuing education and staying up to date on the research
Thanks for listening and as always please let us know if you have any questions, recommendations, or topics you would like us to cover!
Our second episode covers pre-operative and early stage rehabilitation after and ACL tear/reconstruction. We start by going into the preoperative phase speaking to evaluation, treatment, and education with a patient immediately after injury and in preparation for surgery. We then move into the management of the patient in the immediate post-operative phase (phase 1) and the early rehabilitation phase (phase 2).
Some other special topics we cover include copers vs. non-copers, the state of the evidence in regards to open-chain exercises early after ACLR, and our ideal equipment if we had our choice when rehabbing a patient after ACLR
Look for 1-2 follow-up episodes on the mid to later stages of ACLR rehab in the future.
Thanks for listening and as always please let us know if you have any questions, recommendations, or topics you would like us to cover!
For our first episode, we talk all things Achilles Tendinopathy. We go into the anatomy and physiology of the tendon and of tendinopathies, we then cover the history/exam, and, finally, we discuss the various management strategies for this condition. We hope you are able to take something from this talk and apply it to your practice and/or training. Thanks for listening!