Dan Bastock speaks with the major players in the formation of this new College of Sport, Exercise and Musculoskeletal Medicine (CSEM). Professor Patrick Wheeler, Dr Julia Newton and Dr Natasha Jones.

They discuss the formation of the new college and what this means for BASEM and the Faculty of Sport and Exercise Medicine UK (FSEM), and SEM in the UK.

Link to FSEM relevant webpage: https://www.fsem.ac.uk/news/update-on-continued-progress-towards-establishing-csem/

Link to BASEM relevant webpage:https://basem.co.uk/update-on-significant-milestones-achieved-to-establish-the-college-of-sport-exercise-and-musculoskeletal-medicine-csem/

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Professor James Hull is joined by Dr Eric Harbour and Professor Hege Clemm to discuss the fast growing trend of “breathwork’ in athletes and whether this is a useful novel area of interest or if it is a potentially dangerous fad.

Listen in for a lively discussion!

Info:

Please find relevant references for further information below:

Dr Eric Harbour recommends:

Breath Tools review:

https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.813243/full

Breath tools website:

https://www.breathtools.com/

Lancet review mentioned:

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(25)00437-0/fulltext

Prof. Hege Clemm recommends:

IOC consensus BJSM:

https://bjsm.bmj.com/content/bjsports/56/19/1066.full.pdf

https://bjsm.bmj.com/content/bjsports/56/19/1089.full.pdf

Prof. James Hull has some resources in here:

www. breathetowin.co.uk

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In this episode, Dr. Jared Powell invites us to reflect on the mechanistic assumptions underlying exercise-based rehabilitation for musculoskeletal pain relief, based on his editorial recently published in BJSM.

It’s a great conversation that explores questions such as:

Why are these patients getting better?
How can we help those who do not respond to exercise?
What should be the next steps in research, and what should we be exploring in future clinical trials?
Should we offer exercise to all patients with musculoskeletal pain?
And how do we explain to patients that recovery may not be all about strength?

Press play and enjoy!

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In this episode, we focus on brain health and the evolution of the Premier League Head Injury Protocol, which is a key priority and area of focus within the Premier League.

Lynsey Hooper is joined first by Dr Matt Green (Head of Elite Performance), who outlines why brain health has become a central pillar of the Premier League’s player health strategy, and the breadth of activity currently underway to support players.

Following this introduction, Prof. Mark Gillett (Chief Medical Officer) and Dr Dominic Townsend (Brain Health Advisor) take us through the origins of the Head Injury Protocol in the Premier League. Outlining how it was developed, the implementation, and the principles that continue to shape its operation today.

Together, they also look ahead, covering how approaches to brain health may continue to evolve, and what the future could hold for clinical decision‑making.

This episode offers a detailed insight into how policy, medicine and elite sport intersect in practice at the highest level of the game.

Concussion in football: the case for temporary concussion substitutions

https://bjsm.bmj.com/content/59/23/1635

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In this episode, we’re joined by two of the most experienced and respected players in English football. James Milner and Steph Houghton join Lynsey Hooper in conversation.

Across more than two decades in the men’s and women’s professional game, James and Steph have lived through the evolution of elite football, where match demands have increased and a rapidly changing approach to player health and welfare has been observed.

In this conversation, they reflect candidly on life as an elite footballer, the realities of injury and recovery, changes in match load, and the importance of the multidisciplinary support teams around them.

This podcast expands on the themes explored in their joint ‘player voice’ editorial.

https://bjsm.bmj.com/content/59/23/1703

It’s a thoughtful, honest and highly insightful discussion from two players who have seen and been a part of the evolution of professional football.”

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In this podcast Brooke talks with Katherine Wilford, who earned her Bachelor of Science degree in Health and Exercise Science from Colorado State University (2006), her Doctorate in Physical Therapy (DPT) from Boston University (2009), and her Doctor of Science from Texas Tech University Health Sciences Center (2023). Kat has 16 years of clinical experience working with individuals with musculoskeletal pain. Her research interests include exploring the connection between sociocultural constructs and sensorimotor control as it pertains to musculoskeletal injury risk assessment.

In this episode, we discuss how Kat and her team synthesized existing literature to shed light on how cultural beliefs, gender roles, and societal expectations shape movement patterns.

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On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Jesse Cook, PhD, to discuss Building a Sleep Health Plan for Athletes.

In this conversation, which was recorded during the 2025 AMSSM Annual Meeting, Dr. Cook shares more information on his main stage lecture of the same name, which focused on best practices and essential principles.

Dr. Cook is a postdoctoral fellow with a doctoral degree in Clinical Psychology from the University of Wisconsin-Madison. His research focuses on the intersection of sleep and mental health, with his primary program of research purposed to advance the classification, assessment, and treatment of unexplained hypersomnolence.

He has additional research interests related to the strengths, limitations, and overall utility of wearable sleep tracking technology for research and clinical purposes, as well as the roles of sleep and circadian health in the performance and well-being of athletes. Clinically, he embraces an integrative orientation, drawing principally from CBT and third-wave therapy approaches (i.e., ACT and DBT).

Registration is now open for the 2026 AMSSM Annual Meeting. Visit the conference website to learn more: annualmeeting.amssm.org/

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In this podcast we are joined by Professor Alan McCall and Dr Tara Venkatesan, We talk about how music can be used in the clinical setting to improve outcomes in performance and recovery. We get into detail about styles of music and how they could be used in different scenarios.

Dr.Tara Venkatesan is the Senior Director of Cognitive Science Research at Universal Music Group. Her lab researches the impact of music on mental wellbeing and helps develop consumer products. She has a B.S. in Cognitive Science from Yale University and a Ph.D. in Experimental Psychology from Oxford University. Her research has been published in peer-reviewed journals and media, including The New York Times, BBC, Channel News Asia, and Health Magazine. She is an Honorary Fellow at the School of Advanced Study, University of London.

Professor Alan McCall is a practitioner and researcher with over 20 years of experience in elite sport. He spent 12 years embedded day to day inside professional and national teams, before moving into consultancy, where for the past decade he has worked alongside coaches, medical, and performance staff across different sports and countries. He is currently Consulting Head of Research & Development at Arsenal Football Club and supports clubs, federations, and governing bodies across European leagues, as well as FIFA, UEFA, the NBA, and the NFL. Alongside his applied work, he has published over 130 papers in sports performance and holds visiting research fellowships and editorial roles, with a focus on what actually works in real-world sporting environments—helping teams make better decisions under pressure by connecting research, data, and lived experience.

Links:

The soundtrack to success: can music enhance elite athlete’s health and performance?bjsm.bmj.com

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In this podcast we are discussing the use of low dose radiotherapy for musculoskeletal sports injury. We are joined by two experts in the field who give insight into the relatively unknown use of this modality.

Geoff Scott is an internationally experienced Physiotherapist who has worked at the highest levels of elite sport, including over eight seasons as Head of Medicine and Performance at Tottenham Hotspur Football Club. He has also held senior roles at Fulham FC and consulted across global football, Olympic sport, and the performing arts industry.

Dr Richard Shaffer is a global expert in the use of low-dose radiotherapy for benign (non-cancer conditions. He is co-founder of Reload Clinics (www.reloadclinics.com), which was set up to treat patients with tendonitis in a joint clinic with Geoff Scott.

Radiotherapy for osteoarthritis review -https://www.redjournal.org/article/S0360-3016(22)00357-1/fulltext

Plantar fasciitis: https://www.redjournal.org/article/S0360-3016(12)00848-6/fulltext

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In this episode of the SASMA Podcast, Dr. Minjon Ras speaks with Dr. Izzy Moore, Joanna Perkins, and Dr. Leigh Gordon about the newly released World Rugby Guidelines on returning to rugby after pregnancy.

Together they unpack the six-phase pathway designed to support female athletes, explore the physical and mental health considerations unique to postpartum recovery, and discuss the role of coaches, medical teams, and performance staff in creating a supportive environment.

The conversation blends evidence, personal experiences, and practical advice—empowering athletes and practitioners to ensure that returning to rugby postpartum is safe, individualised, and sustainable.

Please see link to the guidelines here : https://rfu.widen.net/s/nrjppzdnkv/postpartum-guidance---final

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On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Tom Cross, MBBS, DCH, to discuss the Cross Bracing Protocol.

In this conversation, Dr. Cross discusses the following:

Background on the Cross Bracing Protocol (CBP) and its origins
The selection criteria and the grading system for the CBP
The rehabilitation considerations for the CBP and potential complications
Future directions of research for the CBP

Dr. Tom Cross has practiced sports medicine for the past 28 years and during that time successfully completed 5 years of specialist post-graduate training in sport & exercise medicine. He has broad sports medicine experience caring for recreational athletes (adults and children), musculoskeletal injuries that occur at work or home, elite/professional athletes and also military personnel.

Resources:

Healing of Acute Anterior Cruciate Ligament Rupture on MRI and Outcomes Following Non-Surgical Management with the Cross Bracing Protocol https://bjsm.bmj.com/content/57/23/1490
Cross’s Website, including additional resources and information about the CBP: https://www.stadiumclinic.com.au/dr-tom-cross-sports-doctor-sydney.html

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In this BJSM podcast we are joined by Margie Davenport, lead author of the 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour, and Sleep throughout the First Year Postpartum. This podcast provides crucial insights health and exercise professionals guiding new mothers and their support network through the return to physical activity. It highlights the importance of movement, individualized recovery, and sleep hygiene, all while addressing the unique challenges of postpartum life.

Guidelines: https://bjsm.bmj.com/content/59/8/515

More about Margie’s research lab: https://www.ksr.ualberta.ca/exerciseandpregnancy/ourLab.php

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On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Irfan Asif, MD, FAMSSM, and Dr. Jonathan Finnoff, DO, FAMSSM, to discuss the multi-faceted topic of Paralympic Sports Medicine.

In this conversation, Dr. Asif and Dr. Finnoff discuss the following:

How they first got involved in USOPC and Paralympic team sports
The number of sports in Paralympic competition and the athlete classifications that aim to level the playing field for athletes of different abilities
What it’s like to take care of Paralympic athletes and their unique requirements
The planning process for delivering medical services for Team USA during the Paralympic Games
Current and future research efforts regarding Paralympic athletes
Overcoming the perceived barriers to entry when providing care for Paralympic athletes and ways to get more involved

Dr. Asif is the associate dean for primary care and rural health and professor and chair of the Department of Family and Community at the University of Alabama at Birmingham (UAB). He currently serves as the 2nd Vice President for AMSSM and is an Associate Editor for both the British Journal of Sports Medicine and Sports Health: A Multi-Disciplinary Approach.

Dr. Finnoff is the Chief Medical Officer for the United States Olympic and Paralympic Committee, a Clinical Professor in the Department of Physical Medicine and Rehabilitation, University of Colorado, and a Professor in the Department of Physical Medicine and Rehabilitation at Mayo Clinic College of Medicine and Science. He currently serves as the 1st Vice President for AMSSM.

Resources:

2025 USOPC Paralympic Sports Medicine Conference https://www.usopc.org/2025-paralympic-sports-medicine-conference

PARA-Wise Registry Screening Survey: https://redcap.link/PARAWISE

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In this insightful episode, Dr Daniel Tadmor hosts two leading voices in sports medicine—Prof Jon Patricios and Dr Leigh Gordon—for a debrief on the Concussion in Sports Group (CISG) conference. The trio unpacks major updates to concussion management, emerging research themes, and the clinical implications following the Amsterdam Consensus Statement. Whether you're a clinician, researcher, or simply passionate about athlete brain health, this episode offers a sharp and accessible overview of where the field is headed.

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In this episode, Dr. Roula Kotsifaki shares insights from her recent publication in the British Journal of Sports Medicine titled “Is 9 months the sweet spot for male athletes to return to sport after anterior cruciate ligament reconstruction?” She offers numerous clinical pearls on the key factors that influence a safe return to sport following ACL reconstruction. Dr. Kotsifaki is an experienced physiotherapist and biomechanist, currently serving as Head of the Assessment Lab at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Drawing on her research findings, she discusses which tests clinicians should use, optimal timing for return to sport, and the crucial role of treatment adherence.

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In this BJSM podcast, Dr Harvi Hart overview of the different types of body mass and body composition measurements, and they may impact common knee conditions, and what this means for clinicians, patients, and athletes. Harvi specializes in knee injuries and conditions, such as ACL injuries, patellofemoral pain, and osteoarthritis. Her research aims to develop targeted treatments that improve symptoms, mobility, and quality of life for individuals with knee conditions, using a combination of joint movement analysis, imaging, and clinical outcome measures.

Links:

Is body mass index associated with patellofemoral pain and patellofemoral osteoarthritis? A systematic review and meta-regression and analysis https://pubmed.ncbi.nlm.nih.gov/27927675/

Adiposity and cartilage lesions following ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/38631554/

Longitudinal changes in adiposity following anterior cruciate ligament reconstruction and associations with knee symptoms and function: https://pubmed.ncbi.nlm.nih.gov/38737984/

Obesity is related to incidence of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee (CHECK) study https://pubmed.ncbi.nlm.nih.gov/31705199/

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In this episode, Diogo Gomes interviews internationally renowned physiotherapist and researcher Dr. Alison Grimaldi for a focused discussion on gluteal tendinopathy. They explore common myths and misconceptions surrounding the condition, clarify the current evidence base, and share valuable clinical insights for effective assessment and management. With a clear and practical approach, Dr. Grimaldi offers take-home messages that clinicians can immediately apply in practice. Whether you manage this condition regularly or are looking to refine your approach, this episode is a must-listen.

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On this episode of the AMSSM Sports Medcast, host Dr. Jeremy Schroeder, DO, is joined by Dr. Jordan Lyons, MD, who delivered one of the Best Overall Case Presentations during the 2024 AMSSM Annual Meeting in Baltimore, MD.

In this conversation, Dr. Lyons discusses his award-winning case – Collapse of a Special Operator: Exertional Illness or More Than Meets the Eye? – and shares the findings and takeaways from this crucial medical diagnosis.

Resources:

2024 AMSSM Case Podium Presentations, published in the Clinical Journal of Sport Medicine

Exercise Collapse Associated with Sickle Cell Trait Practice Recommendation

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On this episode of the AMSSM Sports Medcast (X: @TheAMSSM), host Dr. Jeremy Schroeder, DO, is joined by Dr. Mike Uihlein, MD, to share a glimpse into his main stage presentation about Paralympic Sideline Emergencies during the 2025 AMSSM Annual Meeting.

Dr. Uihlein is the Associate Chief of Emergency Medicine for Education and Co-Director of the Adaptive Sports Medicine Clinic at the Clement J. Zablocki VA Medical Center. He also serves as an Assistant Professor in the Department of Emergency Medicine at the Medical College of Wisconsin.

He has served on teams that have claimed 11 titles, including three Paralympic gold medals (2014, 2018, 2022); four world championships (2015, 2019, 2021, 2023); five Para Hockey Cups (formerly World Sled Hockey Challenge) titles (2015, 2016 (Jan.), 2016 (Dec.), 2017, 2019) as well as the 2016 IPC Pan-Pacific Championship and 2018 Turin Para Ice Hockey International Tournament.

In-person and virtual attendance options are still available for the conference. Register to attend the 2025 AMSSM Annual Meeting at annualmeeting.amssm.org.

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On this episode of the AMSSM Sports Medcast (X: @TheAMSSM), host Dr. Jeremy Schroeder, DO, is joined by Dr. Margie Davenport, PhD, to provide a preview of her main stage presentation about Updates to Postpartum Return to Sport during the 2025 AMSSM Annual Meeting.

Dr. Davenport is an exercise physiologist and Professor in the Faculty of Kinesiology, Sport, and Recreation at the University of Alberta. She holds the Christenson Professorship in Active Healthy Living and is the Director of the Program for Pregnancy and Postpartum Health.

Over the last decade, Dr. Davenport has worked with numerous national and international organizations to support physical activity during and following pregnancy, and she is serving as a Featured International Speaker at this year’s Annual Meeting in Kansas City.

In-person and virtual attendance options are still available for the conference. Register to attend the 2025 AMSSM Annual Meeting at annualmeeting.amssm.org.

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On this episode of the AMSSM Sports Medcast (X: @TheAMSSM), host Dr. Jeremy Schroeder, MD, is joined by Dr. Ashwin Rao, MD, to provide a preview of his main stage presentation about Microsurgical Tendon Debridement vs. Orthobiologics for Tendinopathy during the 2025 AMSSM Annual Meeting.

Dr. Rao is board certified in family medicine and sports medicine, and is a Professor in UW School of Medicine's Department of Family Medicine. He is also a team physician for University of Washington Husky Athletics and a medical consultant for the Brooks Beast Middle Distance Track Club. He previously served as a team physician for the NFL’s Seattle Seahawks, Program Director of the UW Primary Care Sports Medicine Fellowship, and Co-Chair of the Education Committee on the Board of Directors of the American Medical Society for Sports Medicine (AMSSM).

In-person and virtual attendance options are still available for the conference. Register to attend the 2025 AMSSM Annual Meeting at annualmeeting.amssm.org.

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On this episode of the AMSSM Sports Medcast, host Dr. Jeremy Schroeder, DO, is joined by Dr. Erin Hammer, MD, MPH, who received the Best Overall Research Award at the 2024 AMSSM Annual Meeting in Baltimore, MD.

The study focused on the use of Guardian Caps and whether they were associated with a lower risk of sport-related concussion (SRC) during practices and games among high school football players.

In this conversation, Dr. Hammer discusses her award-winning research, which was recently published in the British Journal of Sports Medicine, and also shares her personal advice for those looking to get more involved in scholarly research.

Registration is now open for the 2025 AMSSM Annual Meeting in Kansas City, which takes place from April 22-27. Learn more and register now at annualmeeting.amssm.org.

Research Article Links

The Association Between Guardian Cap Use During Practices and Sport-related Concussion Risk in High School American Football Players bjsm.bmj.com/content/59/4/257

2024 AMSSM Annual Meeting Research Podium Presentations journals.lww.com/cjsportsmed/fulltext/2024/03000/2024_amssm_research_podium_presentations.11.aspx

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In this podcast James Walsh talks to Chris Macdonald and Professor Daniel Leiberman they dive into the lively discussion generated by this paper.

They discuss the reasons why exercise is not effective medicine from an evolutionary perspective, the differences between effective and efficacious interventions, and how clinicians can adapt their approach to help their patients get the most out of exercise.

Why exercise may never be effective medicine: an evolutionary perspective on the efficacy versus effectiveness of exercise in treating type 2 diabetes | British Journal of Sports Medicine

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In this episode, Dr Kyle Winik is joined by Adam Weir, Hans Tol, and Rod Whiteley, all actively involved in the Sport and exercise medicine field to discuss hamstring injuries and an approach to a challenging injury in practice.

This was recorded live from the IOC 15th Advanced Team Physician Course, in Rome, Italy.

Through the episode they discuss an approach to a patient with a hamstring injury but also tackle some important questions about if there are any ways to speed up or predict an accurate return to play.”

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In this episode, Dr Brooke Patterson is joined by Dr Bas Vanhooren, an applied sport scientist and strength and conditioning specialist, and a national level athlete. They discuss the BJSM Academy award winning PhD on “Innovative approaches to injury prevention and performance enhancement in running: insights from PhD research on hamstring strengthening, running biomechanics and energetics, and wearable technology”.

https://bjsm.bmj.com/content/early/2024/10/21/bjsports-2024-109159.long

This podcast forms a part of an ongoing series which aims to highlight the work of early career researchers, via the BJSM PhD Academy Awards, and in this series, we will also be asking the guests how they first got involved in research, why they decided to do a PhD, what they loved and what they found most challenging, and their career pathway or plans post-PhD. There are many ways to for clinicians to be involved in research, and we hope to highlight these along the way.

Brooke also highlights a new exciting initiative – The Training and Career Development Network developed by the IOC Research Centres.

https://ucalgary.ca/sport-injury-prevention-research-centre/ioc-research-centres-training-and-career-development-network

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In this episode Dr Kyle Winik is joined by Dr Lervasen Pillay, a Sport and Exercise Physician who has a keen interest in Exercise and Cancer.

Through the episode they discuss an approach to a patient battling cancer and try to give an approach to change the narrative that exercise can be used as a tool in cancer management.

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In this podcast, we are joined by Professor Lars Engebretson. After 17 years, Lars has stepped down as the Head of Scientific Activities of the Medical and Scientific Department for the International Olympic Committee. In this episode Lars reflects on his achievements, career, and the future of sport and exercise medicine research. You can follow Professor Engebretson on Twitter/X here

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New-generation running shoes are being developed with the aim of enhancing an athlete's stride length and propulsion force. But what do podiatrists think about these innovative "super shoes"?

In this podcast, Dr. Daniel Bastock explores this concept with Damir Metljak, a sports podiatrist based in Adelaide, South Australia. They discuss the biomechanical implications of these shoes, the potential for increased injury risk, and how to design the ideal orthotic to complement the unique characteristics of this footwear.

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In this episode we have a chat with this year’s American Medical Society for Sports Medicine(AMSSM) Global Exchange Program to South Africa candidate Dr Emily Sweeney. Doctor Sweeney is a Pediatric Sport Medicine Physician currently practising at Children’s Hospital Colorado in Denver. She will also be a speaker at the biannual SASMA Conference in October later this year.

Being a previous elite level gymnast who retired at a young age due to a back injury, Doctor Sweeney has a unique perspective to gymnastic medicine. Despite retiring as an athlete she remained very involved with the sport and now serves as a practitioner to many gymnasts suffering with gymnastics related injuries and pathology.

https://journals.lww.com/acsm-csmr/fulltext/2018/11000/returning_to_sport_after_gymnastics_injuries.7.aspx?WT.mc_id=EMxALLx20100222xxFRIEND

The discussion touches on numerous gymnastics medicine topics, like mental health, diversification of skills and lessons from the recent Paris Olympics. Some of the articles referred to in the episode:

-Returning to Sports After Gymnastics Injuries

-Health outcomes among former female collegiate gymnasts: the influence of sport specialization, concussion, and disordered eating

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Dr Richard Budgett has been the Medical and Science Director of the International Olympic Committee (IOC) for the last 12 years. He talks to Dr Georgia Cahill from the Paris 2024 Olympic Games about his role and reflects on how the IOC has focussed on athlete safety and health promotion as he prepares to step down in December 2024.

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Respiratory health in athletes, which is the most common system affected by illness in athletes, can often be tricky to manage or approach.

This SASMA podcast delves into a very engaging and robust discussion with two very knowledgeable guests.

Dr Kyle Winik chats with Dr Marcel Jooste and Dr Carolette Cloete, who are both Sports and Exercise physicians based at SEMLI, The Sport & Exercise Medicine Lifestyle Institute, in Pretoria, South Africa, under the leadership of Prof Martin Schwellnus.

They discuss important tools or concepts to adopt in clinical practice as well as updates to current knowledge in respiratory illness in athletes.

Attached are the Current IOC Guidelines in respiratory health as well as NB tips and tricks to get familiar with.

Jooste, Marcel & Schwellnus, Martin. (2024). Countermeasures to reduce the risk of infections at the 2024 Olympic and Paralympic Games—A balancing act. Journal of Sport and Health Science
Prevention of Infections in Track and Field Athletes - Top Tips - Aspetar Journal
Schwellnus M, Adami PE, Bougault V, et al International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 2: non-infective acute respiratory illness British Journal of Sports Medicine 20.22;56:1089-1103.

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On this episode of the AMSSM Sports Medcast (X: @TheAMSSM), host Dr. Devin McFadden, MD, is joined by Dr. Robert Bowers, DO, PhD (X: @TheDrROBO) and Dr. Jason Zaremski, MD (X: @DrZSportsDoc) to discuss their research related to overuse throwing injuries, weighted ball throwing programs and more.

For further discussion on this topic, check out a recent AMSSM webinar facilitated by Dr. Bowers and Dr. Zaremski on The Throwing Injury Epidemic in Baseball and Softball: What Science, Data and the Experts Say, featuring an international panels of experts.

Resources:

Pitching Restriction Policies in Adolescent and High-School Baseball Pitchers: Is It Time for an Updated Paradigm?
The Throwing Injury Epidemic in Baseball and Softball: What Science, Data and the Experts Say
Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates
Most high school baseball pitchers are using weighted ball throwing programs to increase ball velocity: crosssectional analysis of US high school pitchers

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Golf is played by over 100 million persons globally. But what injuries do they get and how can you help treat and even avoid injuries.

Dr Corey Cunningham hosts, and is joined by Dr Andrew Murray (@docandrewmurray) to look at a recent systematic review and meta-analysis of injuries in amateur and professional golfers,

https://bjsm.bmj.com/content/58/11/606.abstract

and look back at some resources in the popular BJSM e-edition

https://bjsm.bmj.com/pages/e-edition-golfmedicine

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In this podcast James Walsh speaks with Dr Dusty Narducci about ADHD in athletes. Dusty is one of the lead authors on the recent AMSSM ADHD position statement and is an expert in the treatment of ADHD in athletes.

They discuss the different types of ADHD, how they can manifest in athletes, treatment and the implications of stimulant medication for cardiac health and competition.

References and further reading:

https://www.docdusty.com/post/adhd-add-a-superpower-in-athletes

https://journals.lww.com/cjsportsmed/Fulltext/2023/05000/Athletes_With_Attention_Deficit_Hyperactivity.1.aspx

https://bjsm.bmj.com/content/53/12/741

Lakshaajeni Thevapalan, Martyna Stasiak, Lauren Harris, Anand S Pandit, Smart drugs among surgeons: future cause for concern?, British Journal of Surgery, Volume 110, Issue 8, August 2023, Pages 1000–1002,https://doi.org/10.1093/bjs/znad139

Cage S, Warner L, Cook A, Swindall R, Wadle C, Warner BJ. Prevalence of Self-Reported ADHD Symptoms Among Collegiate Athletes. The Internet Journal of Allied Health Sciences and Practice. 2023 Mar 20;21(2), Article 18.

Dikdan, S, Sun, M, Vyas, A. et al. MENTAL HEALTH AND THE YOUTH ATHLETE: AN ANALYSIS OF THE HEARTBYTES DATABASE. J Am Coll Cardiol. 2023 Mar, 81 (8_Supplement) 2173.

Zhang L, Yao H, Li L, et al. Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(11):e2243597. doi:10.1001/jamanetworkopen.2022.43597

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Physical activity and exercise is known to be beneficial for individuals with both Type 1 and Type 2 Diabetes. This podcast is another in the BJSM and PACC series which looks to help health care professionals who are looking to have more conversations with patients about physical activity in long term conditions.

Nusrat Kausar is a dietician who sits on the BDA specialist groups for Sports and Exercise Nutrition and Exercise in diabetes. She has a wealth of experience in discussion physical activity with this patient group and in providing education for others to do so. She joins Dr Dan Fitzpatrick, a Sport and Exercise Medicine Registrar, to discuss this crucial area.

The Physical Activity Clinical Champions or PACC programme is a national project delivering physical activity education to professionals working in healthcare to help get patients more physically active. It was previously being led by public health England as part of the moving healthcare professionals programme and funded by the national lottery & Sport England and is now being led by a consortium of The Faculty of Sport and Exercise Medicine, The Advance Wellbeing Research Centre at Sheffield Hallam University and Intelligent Health and is being re-designed with new resources. This podcast forms part of a series to support physical activity education for professionals working in healthcare. For anyone you would like to get involved with PACC project then please do email us at pacc@shu.ac.uk

Resources discussed

https://movingmedicine.ac.uk/pacc/

Type 1 -

Digibete - https://www.digibete.org/sports-page/

Team Type One Style - https://teamtypeonestyle.com/

JDRF - https://jdrf.org.uk/news-and-events/health-care-professional-events/

Diabetes UK - Type 1 events - https://www.diabetes.org.uk/how_we_help/type-1-events/healthcare-professional-volunteering

EXTOD - https://www.extod.org/

The Glucose Never Lies - https://theglucoseneverlies.com/

Diabetes Chat - https://www.diabeteschat.net/

Type 2 -

The 5s - https://www.leicesterdiabetescentre.org.uk/news-blog/ldc-highlights-five-important-health-behaviours-for-diabetes-management

Diabetes UK - https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise , https://www.diabetes.org.uk/node/1155 , https://www.diabetes.org.uk/for-professionals/supporting-your-patients/information-prescriptions/information-prescriptions-qa#download

NHS exercise links - https://www.nhs.uk/conditions/nhs-fitness-studio/, https://www.nhs.uk/live-well/exercise/

Other exercise videos -https://www.youtube.com/user/LWRFitnessChannel/videos?app=desktop

General education -

Updating general diabetes knowledge - https://pro.campus.sanofi/uk/type-2-diabetes/education , https://abcd.care/ , https://www.cdep.org.uk/

DSN forum - https://www.diabetesspecialistnurseforumuk.co.uk/hcp-resources

Diabetes NNF - https://www.diabetes-nnf.co.uk/

Diabetes Professional Conference - https://www.diabetesprofessionalcare.com/

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Mental Health problems are common and there is good evidence for physical activity as an important role to help prevent and treat mental health conditions. The BJSM has collaborated with the PACC programme to help develop this podcast and has invited Professor Brendon Stubbs, a global expert in this space. Brendon is a clinical-academic physiotherapist and has published more than 800 academic papers and has advised the WHO and the World Psychiatric Association.

“The Physical Activity Clinical Champions or PACC programme is a national project delivering physical activity education to professionals working in healthcare to help get patients more physically active. It was previously being led by public health England as part of the moving healthcare professionals programme and funded by the national lottery & Sport England and is now being led by a consortium of The Faculty of Sport and Exercise Medicine, The Advance Wellbeing Research Centre at Sheffield Hallam University and Intelligent Health and is being re-designed with new resources. This podcast forms part of a series to support physical activity education for professionals working in healthcare. For anyone you would like to get involved with PACC project then please do email us at pacc@shu.ac.uk

PAPERS MENTIONED

Physical activity Prevention of Mental Health Problems

Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies - PubMed (nih.gov)

Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies - PubMed (nih.gov)

Physical activity and sedentary behaviour:

The association between sedentary behaviour and indicators of stress: a systematic review - PubMed (nih.gov)

Testing the causal relationships of physical activity and sedentary behaviour with mental health and substance use disorders: a Mendelian randomisation study - PubMed (nih.gov)

Changes in sedentary time are associated with changes in mental wellbeing over 1 year in young adults - PMC (nih.gov)

Treatment of Mental Health conditions

Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up - PubMed (nih.gov)

Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders - PubMed (nih.gov)

Other resources mentioned:

https://movingmedicine.ac.uk

Home - Mind

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The Oxford Textbook of Children's Sport & Exercise Medicine released it's 4th edition in 2023. Dr. Liam West reached out on behalf of the BJSM community to the two editors, Prof. Neil Armstrong and Prof. Willem Van Mechelen, to discuss the journey that led to the 4th edition and get an insight into a few of the top tips inside the book that can help improve your clinical care for this population today!

Link to book - https://global.oup.com/academic/product/oxford-textbook-of-childrens-sport-and-exercise-medicine-9780192843968?cc=au⟨=en&

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Physiotherapist and Lead AHP Physical Activity Clinical Champion Sarah Dewhurst is joined by Dr Lucy Gossage, Clinical Oncologist and co-founder of ‘Move Against Cancer.

They discuss the importance of all healthcare professionals supporting people with cancer to be active through brief interventions in clinical settings. They summarise the evidence and share top tips to overcome some of the reported challenges which can make it difficult to bring up the topic to exercise in oncology. They also highlight some helpful resources to share with patients and promote further learning.

https://www.cancercaremap.org/

https://www.moveagainstcancer.org/5k-your-way/

https://www.canrehab.com/canrehab-trust/

https://www.macmillan.org.uk/in-your-area/choose-location.html

https://movingmedicine.ac.uk/

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Behaviour change theory and Motivational Interviewing (MI) principles are often an area cited by healthcare professionals as something they would like more training on. The BJSM has collaborated with the PACC programme to develop this podcast and has invited Dr Tim Anstiss, an expert in this area, to explain some key behaviour change theory and motivational interviewing concepts in this conversation. Tim is a medical doctor specialising in behaviour change and wellbeing improvement. He trained as a trainer in motivational interviewing in the mid 90’s and has trained thousands of health and care professionals, managers and coaches in Motivational Interviewing, health coaching, brief interventions and shared decision making.

For further information on behaviour change and MI please go to the moving medicine website:

https://movingmedicine.ac.uk

A great course run by Moving Medicine that you can sign up to improve understanding in behaviour change and up skill on principles of motivational interviewing is Active Conversations.

Books mentioned:

Motivational Interviewing in Health Care, Second Edition. Helping Patients Change Behaviour

By Stephen Rollnick, William R. Miller, Christopher C. Butler

Motivational Interviewing, Fourth Edition. Helping People Change and Grow. William R. Miller & Stephen Rollnick

Tiny Habits, Big Results: Your method for success, BJ Fogg

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On this episode of the AMSSM Sports Medcast (X: @TheAMSSM), host Dr. Jake Wessels, MD, is joined by Dr. Marcia Faustin (X: @FaustinMarcia) to discuss her main stage presentation about Mental Health and Shared Decision-Making during the 2024 AMSSM Annual Meeting.

Dr. Faustin is an Associate Professor in the Department of Family and Community Medicine and Physical Medicine & Rehabilitation at the University of California – Davis. She is the Associate Team Physician for the UC Davis Division I Collegiate Athletics team and the co-Head Team Physician for the USA Gymnastics Women's National Team.

In this conversation, Dr. Faustin discusses aspects of her upcoming talk in Baltimore, MD, and address the following topics:

Her journey to becoming a Division I athlete and working with elite level athletes
The factors that led her to work with the US Women’s Gymnastics Team
What shaped her shared decision-making process when caring for athletes – even at the highest levels of competition
How her personal experiences impact the way she practices medicine
The importance of mental health and why it should be a priority for providers
Trends she has noticed in mental health care for athletes

In-person and virtual attendance options are still available for the conference. Register to attend the 2024 AMSSM Annual Meeting at annualmeeting.amssm.org.

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On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Peter Brukner, MBBS, DSc (T: @DrPeterBrukner), to discuss his upcoming lectures on the placebo effect and fueling endurance athletes during the 2024 AMSSM Annual Meeting in Baltimore, MD.

In this conversation, Dr. Brukner shares some background on both of his upcoming main stage talks at the AMSSM Annual Meeting, which are titled:

Placebo Effect or Something More? How Nontangible Factors May Influence Perceived Outcomes with Injection Therapies
Fueling the Endurance Athlete

Dr. Brukner is a specialist sports and exercise physician and Professor of Sports Medicine at LaTrobe University. A former President of the Australasian College of Sports Physicians, he played a key role in establishing sports medicine as a medical specialty in Australia. He is the co-author of the widely used text book, Clinical Sports Medicine, and has been a team physician for professional football clubs as well as national athletics, swimming, soccer and cricket teams including Olympic and Commonwealth Games.

Learn more about his work and publications on his website (www.peterbrukner.com), and register to attend the 2024 AMSSM Annual Meeting in person or virtually at annualmeeting.amssm.org.

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This BJSM podcast discusses ACL reconstructions and when they may not meet the minimal important change (MIC) for the knee injury & osteoarthritis outcome score (KOOS) and quality of life (QoL).

Dr Janina Kaarre and Dr Eric Hamrin Senorski discuss their latest research of ACL reconstruction outcomes from the Swedish National Knee Ligament Registry database and explain who may not benefit from surgical ACL reconstruction intervention. Hosted by Dr Shona Kohlhardt.

Link to Paper: https://bjsm.bmj.com/content/57/9/528.abstract

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In this BJSM Podcast Dr Brooke Patterson hosts Dr Shefali Christopher and Dr Rita Deering. If you are a clinician who sees women runners this podcast is for you. Get up to date with the latest clinical and research recommendations for return to running post-partum. Dr Christopher led a recent consensus which combined expert opinion of a large range of clinical and exercise professionals with the current evidence. This is part 2 of a 2-part podcast, where we discuss developing a return to run program in more detail.

Links

Consensus (Christopher)https://bjsm.bmj.com/content/early/2023/12/26/bjsports-2023-107489

Return to running (Deering)https://bjsm.bmj.com/content/early/2024/01/08/bjsports-2023-107490

Other resources:

https://bjsm.bmj.com/content/57/17/1065

https://bjsm.bmj.com/content/57/18/1164

https://bjsm.bmj.com/content/55/22/1286

https://bjsm.bmj.com/content/57/20/1285

https://www.jospt.org/doi/full/10.2519/jospt.2020.0607

https://journals.lww.com/jwphpt/fulltext/2022/04000/rehabilitation_of_the_postpartum_runner__a_4_phase.3.aspx

https://journals.lww.com/jwphpt/fulltext/2022/07000/running_during_pregnancy_and_postpartum,_part_b_.3.aspx

https://journals.lww.com/jwphpt/fulltext/2022/07000/running_during_pregnancy_and_postpartum,_part_a_.2.aspx

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In this BJSM Podcast Dr Brooke Patterson hosts Dr Shefali Christopher and Dr Rita Deering. If you are a clinician who sees women runners this podcast is for you. Get up to date with the latest clinical and research recommendations for return to running post-partum. Dr Christopher led a recent consensus which combined expert opinion of a large range of clinical and exercise professionals with the current evidence. This is part 1 of a 2-part podcast, where we will focus on the consensus recommendations. In part 2 we will discuss developing a return to run program in more detail.

Links

Consensus (Christopher) https://bjsm.bmj.com/content/early/2023/12/26/bjsports-2023-107489

Return to running (Deering) https://bjsm.bmj.com/content/early/2024/01/08/bjsports-2023-107490

Other resources:

https://bjsm.bmj.com/content/57/17/1065

https://bjsm.bmj.com/content/57/18/1164

https://bjsm.bmj.com/content/55/22/1286

https://bjsm.bmj.com/content/57/20/1285

https://www.jospt.org/doi/full/10.2519/jospt.2020.0607

https://journals.lww.com/jwphpt/fulltext/2022/04000/rehabilitation_of_the_postpartum_runner__a_4_phase.3.aspx

https://journals.lww.com/jwphpt/fulltext/2022/07000/running_during_pregnancy_and_postpartum,_part_b_.3.aspx

https://journals.lww.com/jwphpt/fulltext/2022/07000/running_during_pregnancy_and_postpartum,_part_a_.2.aspx

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Prof Jon Drezner and Dr Nonhlanhla Mkumbuzi talk to Dr. Liam West about the important backstories to the BJSM achievements in 2023 and share with the listener the aims for 2024.

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In this podcast, we are joined by Professor Roald Bahr, a Professor of Sports Medicine and the Chair of the Oslo Sports Trauma Research Center at the Norwegian School of Sports Sciences. In addition, he is chair of the IOC Medical Commission Games Group, and has been overseeing the organisation of the 7th IOC World Conference on Prevention of Injury and Illness in Sport.

To find out more about the conference, check out this link or to follow Prof Bahr directly, you can follow him on Twitter/X here

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On this episode of the AMSSM Sports Medcast, hosts Dr. Corinne Rivard, DO, and Dr. Taryn Ryan, MD, are joined by three experts to discuss several key factors regarding mental health in athletes.

The panel of experts includes Chelsea Morales, PsyD; Samantha Morris, PsyD; and Andrew Toce, MEd, MBA, LPC, CMPC, and in this conversation, they address the following topics and questions about athlete mental health:

Explaining some of the roles and stressors that contribute to mental health injuries in athletes
How physicians can play a role in improving an athlete’s mental health
Who should be part of the mental health team supporting athletes?
What are some go-to mental health resources that student-athletes can utilize?
Examining the link between physiological response to physical injury or illness
What language can physicians use to address trauma and underfueling in athletes?
Beneficial advice on how to navigate the complex world of social media

Additional Resources

Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance and Prevention: AMSSM Position Statement—Executive Summary

Mental Health Best Practices from the NCAA Sport Science Institute

2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)

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In the last of this BJSM mini-series on the REDS (relative energy deficiency in sport) consensus statement, Dr Georgia Cahill hosts Monica Torstveit, a sports scientist who specialises in REDs and Dr. Kate Ackerman, sports medicine physician and director of the Female Athlete Program in Boston, USA. They discuss their paper, soon to be published in BJSM, regarding primary, secondary and tertiary prevention strategies for identifying and treating REDs. Kate provides tips for clinicians involved in athlete care while Monica outlines screening tools to identify at-risk athletes.

You can access their paper using the link below:

https://bjsm.bmj.com/content/57/17/1119

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Professor Margo Mountjoy and Dr Trent Stellingwerff discuss the latest clinical assessment tool for REDs. They introduce the new International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool - IOC REDs CAT2 – including how and when it is best to use it. Hosted by Dr Shona Kohlhardt, this podcast is part of the BJSM REDs Podcast Series.

https://bjsm.bmj.com/content/57/17/1068

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Prof. Sundgot-Borgen and Dr. Therese Mathisen draw on their personal and professional experiences to take the listener through the new consensus statement in body composition measurement in athletes. Packed full of clinical pearls, this podcast is part of the BJSM REDs Podcast Series.

https://bjsm.bmj.com/content/57/17/1148

https://bjsm.bmj.com/content/57/17/1073

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Relative Energy Deficiency in Sport (REDs) can cause various health and performance consequences for physically active individuals. BJSM’s Dr Liam West poses the questions to our topic expert Prof Margo Mountjoy to give you the overview of the changes to the recent IOC REDs Consensus Statement Papers. Margo has a wealth of knowledge in the area both in a clinical and research capacity so is perfectly placed to help guide you through the top take home points and how to improve the care you offer your patients!

https://bjsm.bmj.com/content/57/17/1073

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In this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Margot Putukian, MD (T: @MPutukian), and Dr. Siobhan Statuta, MD, to discuss the AMSSM Position Statement on Mononucleosis and Athletic Participation, which was published earlier this year.

This position statement updates the Evidence-Based Subject Review on Mononucleosis by the American Medical Society for Sports Medicine published in 2008 and reviews the epidemiology, clinical manifestations, laboratory assessment, and management including RTS for the athlete with IM. It also addresses complications, imaging, special considerations, diversity and equity considerations, and areas for future clinical research.

A Past President of AMSSM and the CMO of Major League Soccer, Dr. Putukian served as the co-lead author, and Dr. Statuta, sports medicine physician and team physician at the University of Virginia, was a co-author on the statement.

Additional Resources:

American Medical Society of Sports Medicine Position Statement: Mononucleosis and Athletic Participation https://journals.lww.com/cjsportsmed/Fulltext/2023/07000/American_Medical_Society_of_Sports_Medicine.1.aspx

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This BJSM podcast dives into the launch of 'Swimming as Medicine' with Dr Hussain Al-Zubaidi (GP, RCGP Lifestyle & Physical Activity Lead and Clinical Advisor for Swim England) and BJSM's host Dr Shona Kohlhardt.

This podcast explores the benefits and practicalities of the 'Swimming as Medicine' campaign and both how patients and clinical practitioners can benefit and get involved.

The following links are mentioned within the podcast:

https://www.swimming.org/swimengland/health-fact-sheets-relaunched/

https://www.swimming.org/poolfinder/

Coming in September 2023: The NHS England eLearning on Aquatic Activity and Swimming for Health - and burning questions can be sent to health@swimming.org

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In this episode of the AMSSM CRN Spotlight Podcast (T: @TheAMSSM) host Dr. Jeremy Schroeder, DO, (T: @thejschro) is joined by Dr. Dusty Narducci (T: @NarducciDusty) to discuss the updated AMSSM Position Statement regarding Athletes With Attention-Deficit/Hyperactivity Disorder.

Dr. Narducci served as a co-author on the position statement, and in this conversation, she addresses the following topics:

Why the position statement, which was originally published in 2011, was updated
The recommended approach for diagnosis and management of athletes with ADHD
Identifying the most common doppelgangers for ADHD and how to diagnose them
Some of the key points related to the new diversity, equity, and inclusivity section
Pharmacotherapy and the various medical treatment options for athletes with ADHD
The role of exercise in the treatment of ADHD
The relationship between ADHD and concussions
Regulatory issues

Resources:

Athletes With Attention-Deficit/Hyperactivity Disorder: Position Statement of the American Medical Society for Sports Medicine

Attention Deficit and Hyperactivity Disorder in Athletes: More Than Self-Rating Scales and Stimulants – Key Messages from the American Medical Society for Sports Medicine Position Statement

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This podcast is a part of a BJSM mini-series on concussion in sport following the release of the 6th International Consensus Statement. In this episode Brooke Patterson hosts Prof Grant Iverson and Prof Bob Cantu to discuss the systematic review which evaluated the later-in-life health risks associated with participation in collision sports, repeated head impacts and concussion. The podcast will help clinicians have evidence-informed conversations about the risks with athletes, coaches, parents, sporting, and community organisations.

https://bjsm.bmj.com/content/57/12/810

https://bjsm.bmj.com/content/57/12/822

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This podcast Brooke Patterson hosts Prof John Leddy and Dr Margot Putukian, as a part of a BJSM mini-series on concussion, following the release of the 6th international consensus statement. They discuss the latest evidence on risks and benefits of physical activity, rest, cognitive activity, and sleep after sports related concussion. It will help clinicians guide athletes to return to exercise, school, and sport following concussion.

Links to reviews

Rest and exercise https://bjsm.bmj.com/content/bjsports/57/12/762.full.pdf

Targeted interventions and their effect on recovery https://bjsm.bmj.com/content/57/12/771

Persisting symptoms and defining recovery https://bjsm.bmj.com/content/57/12/780

Defining recovery & role of technology https://bjsm.bmj.com/content/57/12/789

Clinical recovery from concussion: Return to school and sport https://bjsm.bmj.com/content/57/12/798

Social media posts

Tag: John Leddy and Margot Putukian, Jon Patricios, Kathryn Schneider

When can I exercise? Return to sport? Go back to school? How much rest? How can I progress physical activity? All the latest on the risks and benefits of physical activity, rest, cognitive activity, and sleep after sports related concussion.

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BJSM's Dr. Liam West talks to internationally renowned Sports Neuropsychologist Dr. Ruben Echemendia about the new concussion assessment tool - the SCAT6 and SCOAT6. They discuss areas that were highlighted as requiring improvement from the implementation of the SCAT5, how these were addressed and how best to use the SCAT6. The differences between the SCAT6 and SCOAT6 are discussed as well as top tips for those looking to diagnose and manage concussions.

SCAT6 Paper: https://bjsm.bmj.com/content/57/11/722

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In this BJSM Podcast, Brooke Patterson hosts Kathryn Schneider and Jon Patricios. This your one-stop-shop for the updates from the 6th International Concussion in Sport Consensus Statement. They summarise findings from 10 systematic reviews and five years of work on topics related to concussion prevention, assessment, management, return to learn and sport, later in life health risks, and retirement decisions. The rigour of the consensus process is very clear—with careful consideration of all stakeholders, medical ethics, all age groups and sports (including para-sport).

https://bjsm.bmj.com/content/57/11/695

https://bjsm.bmj.com/content/57/11/712

https://bjsm.bmj.com/content/57/11/617

https://bjsm.bmj.com/content/57/11/722

https://bjsm.bmj.com/content/57/11/737

https://bjsm.bmj.com/content/57/12/762

https://bjsm.bmj.com/content/57/12/771

https://bjsm.bmj.com/content/57/12/780

https://bjsm.bmj.com/content/57/12/789

https://bjsm.bmj.com/content/57/12/798

https://bjsm.bmj.com/content/57/12/810

https://bjsm.bmj.com/content/57/12/822

https://bjsm.bmj.com/content/57/12/749

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Dr Kerry Costello and Dr Deepak Kumar discuss a BSJM paper that investigated gait and physical activity predictors of cartilage worsening in people with knee osteoarthritis from the MOST study, using a machine learning model. Kerry and Deepak do a brilliant job of explaining the biomechanical variables, and the advantages of machine learning, and what these findings might mean for clinicians treating people with knee osteoarthritis.

Link to paper: bjsm.bmj.com/content/early/2023…sports-2022-106142 Connect with Kerry: mae.ufl.edu/people/faculty/prim…les/kerry-costello/

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On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Stacy Sims, MSc, PhD (Insta: @drstacysims), to discuss her upcoming lectures on how nutrition affects performance during the 2023 AMSSM Annual Meeting.Dr. Sims is an international exercise physiologist and nutrition scientist. She has directed research programs at Stanford, AUT University, and the University of Waikato, focusing on female athlete health and performance and pushed to improve research on all women. Her contributions to the international research environment and the sports nutrition industry has established a new niche in sports nutrition; and established her reputation as the expert in sex differences in training, nutrition and health. Dr. Sims has published over 70 peer-reviewed papers and several books.In this conversation, Dr. Sims addresses the following topics: How her athletic background impacted her journey into the field of nutrition and performance Sharing a starting point for medical professionals to think about optimizing nutrition for athletes Ways to encourage athletes to be aware of their nutrition and how to effectively structure training sessions and nutritional plans Her standard approach on supplementation and why less can often be moreLearn more about her work and publications on her website (drstacysims.com), and register to attend the 2023 AMSSM Annual Meeting in-person or virtually at annualmeeting.amssm.org.

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On this episode of the AMSSM Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Katie Rizzone, MD, MPH, and Dr. Megan Burleson, DO, to discuss the upcoming 2023 Collaborative Research Network (CRN) Research Summit on Justice, Equity and Inclusion.Dr. Burleson and Dr. Rizzone are members of Summit Planning Committee for the one-day conference, which takes place Friday, April 28, in Phoenix, AZ. This conference, will emphasize specific areas within sports and exercise medicine where health disparities have been previously identified or where they need to be further investigated. It will also highlight best practices for conducting meaningful research in the field of sports and exercise medicine through an equity lens.In this conversation, they address the following topics and questions: Origin and mission of the Collaborative Research Network The primary aims of the 2023 CRN Research Summit The current lack of available research regarding health disparities and how this conference seeks to explore those topics Some of the potential outcomes and future research directions of the Summit, and why they will be based on the conversations that happen during the conference The inclusive nature and applicability of the Research Summit, especially for clinicians who are not heavily involved in research Some of the biggest surprises the organizers have experienced while preparing for the Research Summit and the biggest highlights to look forward toIn-person and virtual attendance options are still available for the summit. Find complete details about the Research Summit and register here: https://annualmeeting.amssm.org/researchsummit.php

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In this podcast, Brooke Patterson hosts Dr Erik Denison (PhD, Research Fellow Monash University) and Neil Hay (Rugby Victoria President) about a trial published in the BJSM which tested the effectiveness of an education program delivered by professional rugby players designed to stop homophobic language. They discuss openly and honestly the challenges in changing behaviour in community sport. It is not too often we get to chat to sports administrators more broadly about what is needed to drive change – whether it be related to health, safety, inclusion, or diversity. Should we be using the carrot or stick? What other strategies might work? What is your role as a clinician in creating a safe environment? https://bjsm.bmj.com/content/early/2023/02/09/bjsports-2022-105916https://bjsm.bmj.com/content/early/2023/02/07/bjsports-2022-105917

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In this BJSM Podcast, we host Associate Professor Hanna Lindblom, who is a physiotherapist, researcher, and lecturer at Linkoping University in Sweden. We discuss Hanna’s paper, which evaluated the preventive efficacy of an extended version of the Knee Control injury prevention exercise program compared with an adductor strength program in amateur adolescent and adult male and female football (soccer) players. Coaches and player representatives received a printed and digital program material, and a practical workshop to show them how to use the programs. The novelty of this trial is they also compared the extended Knee Control to a second comparison group; where the teams were where the teams already used a self-selected program and did not receive workshop or program material. Many of these comparison teams (50%) said they were self-using the old Knee Control program, providing a “real world” comparison and proven benefits of the Extended Knee Control program. Hanna has hands-on experience designing and delivering injury prevention in a range of sports and has some great advice for clinicians looking to implement Knee Control and similar programs in amateur sports settings. Paper link: https://bjsm.bmj.com/content/57/2/83.abstract

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On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Devin McFadden, MD (T: @ArmySportsDoc), is joined by Dr. Adam Tenforde, MD (T: @AdamTenfordeMD), to discuss the a recently published manuscript titled “Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear.”In this conversation, Dr. Tenforde addresses the following topics related to the article:●Explanation of the use of Carbon Fiber Plate (CFP) technology in footwear and why it’s become so popular●Addressing the rapid changes and progression of record-breaking performance in the running community as a result of this footwear●Discussing his article featuring a case series of navicular bone stress injuries in runners using CFP footwear●Providing some general recommendations for safely using CFP footwear, as well as raising awareness on the possible health concerns of this new technologyAdditional Resources:Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear https://link.springer.com/article/10.1007/s40279-023-01818-zReturn to Sport Following Low-Risk and High-Risk Bone Stress Injuries: A Systematic Review and Meta-Analysishttps://bjsm.bmj.com/content/early/2023/01/24/bjsports-2022-106328

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BJSM’s Liam West talks to Dr. Richard Weiler about concussion in Para Sport. Dr. Weiler and colleagues have investigated concussion experiences of blind male footballers turning up some very interesting results. To ensure that these findings are accessible to visually impaired individuals, they have gone down the novel route of creating an audio file of the entire paper – the link for this can be found below.Links -"Concussion through my eyes" audio paperhttps://on.soundcloud.com/XQb2TConcussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group - https://bjsm.bmj.com/content/55/21/1187https://bjsm.bmj.com/content/early/2023/02/14/bjsports-2022-106256

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In this podcast, we host Dr Chloë Williamson (Twitter @Chlobobs). Chloë is a Postdoctoral Fellow in Physical Activity for Health based in the Physical Activity for Health Research Centre at the University of Edinburgh. Her research (including PhD) over the past 4 years or so has focused on physical activity communication and messaging. We all know that physical activity is important but it is equally important to consider how PA messaging is delivered. Chloë provides a great overview on the findings of her research to date and her work on the development of a translational tool to bring PA messaging research into practice. In this podcast, we discuss on:The framework of PA messaging and how to use itKey points to focus on and consider when delivering PA messagesHow we can use the framework findings to engage different partners and organisations How we can make PA attractive to our target audienceGet the Message? A scoping review of physical activity messaging. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00954-3A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01182-zPhysical Activity Messaging Framework (PAMF) and Checklist (PAMC): International consensus statement and user guide. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01230-8How can we better promote physical activity to the public through messaging? https://blogs.bmj.com/bjsm/2020/11/10/how-can-we-better-promote-physical-activity-to-the-public-through-messaging/Infographic: Walking on sunshine: scoping review of the evidence for walking and mental health: https://bjsm.bmj.com/content/53/14/903

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On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by Polly de Mille, RN, MA, RCEP, CSCS, USAT, to discuss the topic of Exercise Physiology and how it can help figure out the missing links in training programs.Polly de Mille is an exercise physiologist and the Director of Performance Services at Hospital for Special Surgery in New York. She will provide the American College of Sports Medicine (T: @ACSMNews) Exchange Lecture titled, “Inside the Running Lab:How to Evaluate Optimal Run Mechanics and Physiology” during the 2023 AMSSM Annual Meeting in Phoenix, AZ.In this 20-minute conversation, she addresses the following topics:·Sharing more information about her work as a certified exercise physiologist at HSS·How she and her team can help identify the causes of injuries and help athletes stay healthy in order to reach their goals·How her background as a critical care nurse and an avid marathoner led her into the field of exercise physiology·The ways she and her colleagues can help improve runner’s outcomes and how many different disciplines come together to play important roles to make that happen·The different types of tests used by exercise physiologists and how they use that information to improve performance·The possibilities of using nutrition to enhance physiologic training sessionsHSS Sports Rehabilitation and Performance Center: https://www.hss.edu/sports-rehabilitation-and-performance-center.asp

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In this podcast, Dr Brooke Patterson hosts ACL injury and post-traumatic osteoarthritis leading experts Ass. Prof Jackie Whittaker and Dr Stephanie Filbay in part 2 of an ACL myth busting series. Jackie and Steph provide tips about how you can integrate new evidence into daily practice that may challenge existing beliefs and practices. In today’s episode you will find out if the following statements are TRUE or FALSE….• ACL tears can heal • ACL tears only heal if patients are braced immediately • Open chain knee extension exercises are safe to perform in the first 4 weeks after ACLR• Returning to high impact sports increases the risk of PTOA after ACL injury• Having an early ACL reconstruction will reduce the risk of future structural OAWhittaker et al 2022 OPTIKNEE consensus statement https://www.ncbi.nlm.nih.gov/pubmed/36379676Whittaker et al 2022 OPTIKNEE review of risk factors http://bjsm.bmj.com/content/early/2022/10/05/bjsports-2022-105496.abstractFilbay et al 2022 ACL healing paper http://dx.doi.org/10.1136/bjsports-2022-105473OPTIKNEE website OPTIKNEE bit.ly https://bit.ly/OPTIKNEE

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In this podcast, Dr Brooke Patterson hosts ACL injury and post-traumatic osteoarthritis leading experts Ass. Prof Jackie Whittaker and Dr Stephanie Filbay in part 1 of an ACL myth busting series. In today’s episode you will find out if the following statements are TRUE or FALSE….●ACL reconstruction reduces the risk of osteoarthritis compared to non-surgical management ●Only patella tendon grafts get patellofemoral osteoarthritis after ACL reconstruction●Non-surgical management of an ACL injury increases the risk of future meniscal tears●Meniscal lesions at the time of ACL injury/surgery increases the risk osteoarthritis after ACL injury ●Higher BMI increases the risk of osteoarthritis after ACL injury●People can return to sport without having an ACL reconstruction for their ACL tear●Increased laxity increases the risk of osteoarthritis after ACL injury/surgeryWhittaker et al 2022 OPTIKNEE consensus statement https://www.ncbi.nlm.nih.gov/pubmed/36379676Whittaker et al 2022 OPTIKNEE review of risk factors http://bjsm.bmj.com/content/early/2022/10/05/bjsports-2022-105496.abstractOPTIKNEE website OPTIKNEE bit.ly https://bit.ly/OPTIKNEE

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In this BJSM podcast Jackie Whittaker discusses the OPTIKNEE consensus clinical and research recommendations. Jackie is an Associate Professor in the Department of Physical Therapy, at the University of British Columbia. The OPTIKNEE initiative aims to shine the light on post-traumatic osteoarthritis after traumatic knee injury – who is most at risk, what should we be measuring and how, and what interventions should we be using? Jackie encourages clinicians to think about knee and overall health beyond the short-game of injury rehab and return to sport. There are some great tips on how you can set up patients at risk of post-traumatic osteoarthritis with the knowledge, skills, and motivation to self-manage in the long-term. OPTIKNEE Consensus Statement https://www.ncbi.nlm.nih.gov/pubmed/36379676OPTIKNEE website and links to systematic reviews: bit.ly/OPTIKNEE

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Exercise Medicine and Physical Activity Promotion with Dr. Irfan Asif EP# 519 On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Irfan Asif, MD, to discuss the topic of Exercise Medicine and Physical Activity Promotion.

Dr. Asif, who is the Chair of the AMSSM Collaborative Research Network, helped lead the 2021 Research Summit, which produced several publications and educational resources related to Exercise Medicine and Physical Activity Promotion. In this conversation, he addresses the following topics and questions: • A refresher on the 2021 Research Summit and the significant outcomes from that event • How the Exercise Medicine and Physical Activity Promotion Core Curricula originated • More details about the interactive and freely available Exercise Medicine & Physical Activity Promotion Modules • How can physicians and other medical faculty integrate these resources into their clinical practices? • Providing information about the upcoming 2023 Research Summit on Justice, Equity and Inclusion, which takes place in April 2023 • Future publications, deliverables and other opportunities stemming from the 2021 Research Summit

Additional Resources Exercise Medicine & Physical Activity Promotion Modules tinyurl.com/exercisemodules

Exercise Medicine and Physical Activity Promotion: Core Curricula for US Medical Schools, Residencies and Sports Medicine Fellowships https://bjsm.bmj.com/content/bjsports/56/7/369.full.pdf

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BJSM’s Dr. Liam West talks to James Alexander about running related knee injuries and what options the current published literature support for managing & preventing these injuries. James & his colleagues have just published a systematic review in the area, and he gives the clinical relevance of his findings within the podcast. You can access their paper using the link below, in addition to other related content.

Review. Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials: https://bjsm.bmj.com/content/early/2022/09/23/bjsports-2022-105553.abstract

Infographic. Running Myth: recreational running causes knee osteoarthritis:https://bjsm.bmj.com/content/56/6/357

Infographic. Running myth: switching to a non-rearfoot strike reduces injury risk and improves running economy:https://bjsm.bmj.com/content/55/3/175

Infographic running myth: static stretching reduces injury risk in runners:https://bjsm.bmj.com/content/54/17/1058

Infographic. Running myth: strength training should be high repetition low load to improve running performance:https://bjsm.bmj.com/content/54/13/813

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In this BJSM podcast Brooke Patterson hosts Prof Lorimer Moseley AO and Dr Ebonie Rio, physiotherapists and international leaders in pain science. This is a fascinating discussion about how we increase our ability as clinicians and to “own the modern science” and explain pain to patients. We discuss the “warm-up phenomena” with painful tendons, the competing demands of self-protection and performance, and how we can help change the internal conversations that patients have about their pain.

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On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by Dr. Adam Tenforde, MD to discuss the topic of Exercise for Extracorporeal Shockwave Therapy (ESWT) in Musculoskeletal Medicine.

Dr. Tenforde recently published a research about best practices for ESWT, which is used in a variety of clinical applications including the management of musculoskeletal conditions. In this conversation, he addresses the following topics and questions about shockwave therapy: · What is ESWT? · The origins of shockwave therapy use and some of its additional applications · Describing the process of shockwave therapy and its effects · Some of the factors to consider when performing ESWT, especially to clinicians who have never used this treatment option before · Understanding the different types of shockwave therapy and how they can be used to treat injuries · What types of providers can administer ESWT, and what are the recommended treatment protocols for medical teams? · What is the reimbursement status of shockwave therapy for providers? · What are some of the medical conditions that are best treated by ESWT, in both the lower and upper extremities?

Additional Resources Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. PM&R 2022 May;14(5):611-619. doi: 10.1002/pmrj.12790. https://doi.org/10.1002/pmrj.12790 Bone stress injuries. Nat Rev Dis Primers. 2022 Apr 28;8(1):26. doi: 10.1038/s41572-022-00352-y. PMID: 3548413 A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life (Basel). 2021 Nov 24;11(12):1287. doi: 10.3390/life11121287.

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Kathryn Dane is a physiotherapist and is a professional Irish rugby union player, and PhD candidate at Trinity College Dublin. We discuss her first PhD publication on the physical, technical, tactical demands and preparatory strategies in female field collision sports. Kathryn draws on her experience as an athlete, clinician, and researcher, and what practitioners should consider when designing training programs for female field collision sports.

Physical and Technical Demands and Preparatory Strategies in Female Field Collision Sports: A Scoping Review: https://pubmed.ncbi.nlm.nih.gov/35767989/

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Dr. Joshua Heerey chats on this podcast to BJSM’s Dr. Liam West about hip joint imaging. Josh gives us a sneak peek into the findings from the “Femoroacetabular impingement & hip OsteoathRitis Cohort (FORCe) study & how they may help clinicians manage their patients with hip and groin pain. The podcast is heavily based around clinical scenarios that are commonly faced in the clinic or sports team settings.

Dr Heerey is a physiotherapist and Hip Osteoarthritis Research and Development Lead at La Trobe University’s Sport and Exercise Medicine Research Centre in Melbourne, Australia. Dr Heerey obtained his PhD in 2021, with his research programme focusing on understanding the relationship between hip joint imaging findings and pain, and risk factors for development of early hip osteoarthritis in football players. He has published numerous articles examining the diagnosis and treatment of intra-articular hip conditions and is a current member of the International Hip-Related Pain Research Network and Young Athlete’s Hip Research Collaboration, which are multi-disciplinary international research teams created to improve the care of people living with hip and groin conditions. Dr Heerey works clinically at Lifecare Prahran Sports Medicine Clinic. He has a particular interest in the management of longstanding hip and groin conditions

Relevant links: - Heerey et al. What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. Br J Sports Med. 2018;52(9):581-93. http://dx.doi.org/10.1136/bjsports-2017-098264 - Heerey et al. What is the prevalence of hip intra-articular pathologies and osteoarthritis in active athletes with hip and groin pain compared with those without? A systematic review and meta-analysis. Sports Med. 2019;49:951-972. https://doi.org/10.1007/s40279-019-01092-y - Heerey et al. Prevalence of early hip OA features in high- impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study. Osteoarthritis Cartilage. 2021; 29(3): 323-334. https://doi.org/10.1016/j.joca.2020.12.013 - Heerey et al. The size and prevalence of bony hip morphology do not differ between football players with and without hip and/or groin pain: Findings from the FORCe cohort. J Orthop Sports Phys Ther. 2021; 51(3): 115-125. https://www.jospt.org/doi/10.2519/jospt.2021.9622 - Heerey et al. Cam morphology is associated with MRI-defined cartilage defects and labral tears: a case–control study of 237 young adult football players with and without hip and groin pain. BMJ Open Sport & Exercise Medicine 2021;7:e001199. http://dx.doi.org/10.1136/bmjsem-2021-001199

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In this podcast we host Professor Benita Olivier (Twitter @BenitaOlivier). Benita is a lecturer in musculoskeletal physiotherapy at the University of the Witwatersrand and is the Director of the Wits Cricket Research Hub. Benita provides great practical tips for clinicians and researchers to create time and increase access to evidence-based information to bridge the gap between publication and the pitch. We also discuss some of the emerging research in African athletes, and what we can learn from Kenyan endurance runners.

Wits Cricket Research Hub https://www.youtube.com/channel/UCIenu_8XdRB7ttG3lGMLcMw Facebook: @witscricketresearchhub https://www.facebook.com/witscricketresearchhub Instagram: @witscricketresearchhub https://www.instagram.com/witscricketresearchhub/ Twitter: @WitsCricketRH https://twitter.com/WitsCricketRH LinkedIn: WITS Cricket Research Hub https://www.linkedin.com/company/wits-cricket-research-hub/

Knowledge and adherence towards evidence-based sports Physiotherapy standards among physiotherapists in Kenya https://www.ijmhr.org/IntJPhysiotherRes/IJPR.2020.171

A prevalence of running-related injuries among professional endurance runners in the Rift Valley, Kenya https://journals.assaf.org.za/index.php/sajsm/article/view/10690

Musculoskeletal predictors of non-contact injury in cricketers e Few and far between? A longitudinal cohort study https://linkinghub.elsevier.com/retrieve/pii/S1466853X1830021X

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On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by sports medicine researcher and past president of the American College of Sports Medicine, Dr. NiCole Keith, PhD to discuss the topic of Exercise for Post-Menopausal Women.

Dr. NiCole Keith (T: @nicolekeithphd) is a Professor from the Department of Kinesiology and associate dean of faculty affairs in the School of Health & Human Sciences at Indiana University-Purdue University Indianapolis. Her research interests include physical activity and health equity. In addition to serving as the current president of the ACSM she has previously served as the vice president of membership, communication, and policy and serves on both the Exercise is Medicine and American Fitness Index advisory boards.

In this 20 -minute conversation Dr. Keith addresses the following topics: · Discussing the different stages of menopause and the importance of physical activity during these stages · Creating effective exercise prescriptions, including the best physical activity recommendations and strategies · The best types of exercises for post-menopausal women and several alternatives, based on potential health and risk factors · Addressing health disparities between genders and communities, and making sure individuals can safely engage in physical activity

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The Women in Sport Congress, happening in Melbourne 17-19 August 2022, is looking to start conversations on how we can optimise women’s performance programmes and overall health within a sporting context. Dr. Rachel Harris is a Sport & Exercise Medicine Physician based in Perth, Australia, who is the project lead for the AIS Female Performance & Health Imitative (FPHI) and is co-organising the Women in Sport Congress. During the podcast she discusses strategies we need to employ to keep women and girls engaged in physical activity with some bonus content on tips to get involved in Para-Sport!

Links https://www.ais.gov.au/fphi https://womeninsportcongress.org.au/

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This BJSM podcast discusses how health care professionals can learn from the sports psychology world. Noting the similarities between athletes and health care professionals Dr Helen Church has put together a new PERFORM (Performance Enhancing Routine for Optimisation of Readiness using Metacognition) framework, using Performance Enhancing Routines to improve clinical performance. She provides practical advice on how you and your practise can benefit from simple sport psychology measures giving some fantastic examples for inspiration. Dr Helen Church is a GP trainee and academic clinical lecturer at the University of Nottingham, working as a clinical assistant professor in medical education. This podcast is hosted by Dr Shona Kohlhardt.

Links to useful papers further discussing sports psychology in clinical performance: 1. Using Insights From Sports Psychology to Improve Recently Qualified Doctors’ Self-Efficacy While Managing Acutely Unwell Patients (Church et al., 2021) https://journals.lww.com/academicmedicine/Fulltext/2021/05000/Using_Insights_From_Sports_Psychology_to_Improve.41.aspx

Applying sport psychology in health professions education: A systematic review of performance mental skills training (Sandars et al., 2021) https://www.tandfonline.com/doi/full/10.1080/0142159X.2021.196643
Applying sport psychology to improve clinical performance (Church et al., 2017) https://www.tandfonline.com/doi/full/10.1080/0142159X.2017.135953
What can medical educators learn from the Rio 2016 Olympic Games? (Church et al., 2017) https://www.tandfonline.com/doi/full/10.1080/0142159X.2016.127040

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One of the silver linings of COVID-19 pandemic is the increased adoption of telehealth in allied health and sports medicine services for people with musculoskeletal conditions. In this podcast we talk to Dr Allison Ezzat about the experiences and attitudes of patients and clinicians in using telehealth. Allison has led the creation of a telehealth toolkit for patients and clinicians and discusses the future of telehealth. Allison is a Canadian physiotherapist, and a current post-doctoral research fellow at La Trobe University, Australia. “It's second best”: A mixed-methods evaluation of the experiences and attitudes of people with musculoskeletal pain towards physiotherapist delivered telehealth during COVID-19 pandemic - https://www.sciencedirect.com/science/article/pii/S2468781221001843?via%3Dihub Canadian Physiotherapists Integrate Virtual Care during the COVID-19 Pandemic https://utpjournals.press/doi/10.3138/ptc-2022-0092 “Much better than I thought it was going to be - telehealth delivered group-based education and exercise was perceived as acceptable among people with knee osteoarthritis” https://www.sciencedirect.com/science/article/pii/S2665913122000395 Telehealth toolkit for clinicians: https://telehealth.trekeducation.org/

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In this podcast, we are joined by Dr James Robson and Professor Craig Ritchie to discuss all things ‘brain health’. We discuss what is meant by this term, why it is important, and what some of the steps people can take to optimise their brain health.

Related resources:

Lancet Commission https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext

Sport and Exercise for Brain Health MOOC https://www.futurelearn.com/admin/courses/sport-and-exercise-for-brain-health/1

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In this BJSM Podcast Dr Amy Dennett is hosted by Dr Brooke Patterson. Historically people with cancer have been told to rest, and patients and practitioners are often hesitant to get started with physical activity. Amy provides some great practical tips and resources - to support people with cancer exercise safely, safety and precautions, and tips for healthcare services and providers who want to get started with cancer exercise groups. Amy provides a huge array of resources available for healthcare services and clinicians.

Cancer exercise toolkit: https://cancerexercisetoolkit.trekeducation.org/ Cancer exercise toolkit paper: https://cancer.jmir.org/2022/2/e34903/authors Treatment protocols https://www.eviq.org.au/ International registry and handouts on exercise and cancer https://www.exerciseismedicine.org/eim-in-action/moving-through-cancer/ Patient and clinician resources https://www.petermac.org/cancersurvivorship

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On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Krystian Bigosinski, is joined by Dr. Matt Fedoruk, PhD, who works as the Chief Science Officer leading the Science & Research team at the U.S. Anti-Doping Agency (@usantidoping). Dr. Fedoruk served as a Featured National Speaker in the Doping in Sport session during the 2022 AMSSM Annual Meeting. In this conversation, he discusses some of the latest trends in doping science and testing and address the following topics: · His experience as a USADA Officer during the 2022 Olympic and Paralympics Games in China, and the new testing measures that were recently put in place. · How does WADA’s Athlete Biological Passport work, and what has its impact been on anti-doping? · How does he view orthobiologic treatments, such as PRP and stem cell therapies, through the lens of anti-doping? · Are gene doping technologies realistic from a physiological standpoint, or it is still the stuff of science fiction? · How does USADA balance respect for athlete autonomy and privacy, while also performing meaningful doping control? · How should sports medicine providers proceed when encountering athletes who might be coerced into doping programs? · How should physicians approach care of recreational athletes when it comes to the risks and benefits of substances that may be performance-enhancers, such as testosterone? · How does he approach being a fan of sport while working at USADA, where he often sees the best of worst of sport?

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In this podcast we are joined by Rachael Cowan and Professor Jill Cook. They provide an update on the evidence for management of greater trochanteric pain syndrome (GTPS) and discuss the results of a recent clinical trial evaluating the effect of menopausal hormone therapy, exercise, and education on tendon pain and function in post-menopausal women with GTPS. On the eve of retirement, Jill provides an opinion on what the next big breakthroughs in tendinopathy research should be!

Cowan et al. 2021 https://journals.sagepub.com/doi/full/10.1177/03635465211061142

Ganderton et al. 2018 https://www.liebertpub.com/doi/abs/10.1089/jwh.2017.6729

Mellor et al. 2018 https://www.bmj.com/content/361/bmj.k1662.long

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In this podcast with co-chair of the inaugural BJSM Live event on 25th May 2022, we chat about the event itself and some of the efforts to make it as diverse and inclusive as possible.

For tickets, please check out http://bjsmlive.bmj.com/

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On this week’s BJSM podcast, we are joined by Assistant Professor Margie Davenport, to talk about the latest evidence and experience around exercising and competing as an elite athlete whilst pregnant.

We discuss why this is such an important issue as well as some of the myths or misconceptions that exist in this space. Dr Davenport also provides a range of practical tips for team physicians, scientists and therapists to consider when it comes to advising athletes on planning pregnancies, training whilst pregnant, and shaping support networks and systems to support athletes that want to start a family?

Here is the key paper and some other notable resources discussed in the podcast:

Pushing for change: a qualitative study of the experiences of elite athletes during pregnancy https://bjsm.bmj.com/content/56/8/452 Why can’t I exercise during pregnancy? Time to revisit medical ‘absolute’ and ‘relative’ contraindications: systematic review of evidence of harm and a call to action https://bjsm.bmj.com/content/54/23/1395

Get Active Questionnaire for pregnancy checklist https://csep.ca/2021/05/27/get-active-questionnaire-for-pregnancy/

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On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Jacob Wessels, MD, is joined by Dr. Meredith Turner, MD, who is one of the speakers in the Race and Sport session during the 2022 AMSSM Annual Meeting.

In this conversation, Dr. Turner discusses her upcoming presentation in Austin, TX, on the Challenges of Exercise and Physical Activity in Minorities and address the following topics: · The definition of minority populations and how she first got interested in this topic · Identifying some of the primary barriers that minorities encounter regarding physical activity in their communities · How socioeconomic barriers that contribute to these health disparities in minorities · Ways that sports medicine professionals and healthcare providers can help recognize and address these factors in their communities

Resources: Oliver, E. J., Dodd-Reynolds, C., Kasim, A., & Vallis, D. (2021). Inequalities and Inclusion in Exercise Referral Schemes: A Mixed-Method Multi-Scheme Analysis. International journal of environmental research and public health, 18(6), 3033. https://doi.org/10.3390/ijerph18063033 https://pubmed.ncbi.nlm.nih.gov/33809451/

Hawes, A. M., Smith, G. S., McGinty, E., Bell, C., Bower, K., LaVeist, T. A., Gaskin, D. J., & Thorpe, R. J., Jr (2019). Disentangling Race, Poverty, and Place in Disparities in Physical Activity. International journal of environmental research and public health, 16(7), 1193. https://doi.org/10.3390/ijerph16071193 https://pubmed.ncbi.nlm.nih.gov/30987098/

Physical activity deserts: What they are and how to reduce them with Dr. NiCole Keith. Ep #468 https://soundcloud.com/bmjpodcasts/physical-activity-deserts-what-they-are-and-how-to-reduce-them-with-dr-nicole-keith-ep-468

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On this episode of the AMSSM CRN Spotlight Podcast (T: @TheAMSSM) host Dr. Jeremy Schroeder, DO, is joined by Dr. Monica Verduzco-Gutierrez (T: @MVGutierrezMD), who is serving as the AAPM&R Exchange Lecture Speaker during the 2022 AMSSM Annual Meeting. In this conversation, Dr. Verduzco-Gutierrez discusses her upcoming presentation in Austin, TX, on Post-COVID Syndrome in Athletes and address the following topics: • Defining Post-COVID Syndrome and its many potential impacts • How and why she developed a Post-COVID Recovery Clinic • Her contributions to multi-disciplinary collaborative consensus guidance statements for patients with PASC • How she generally approaches treating patients with Post-COVID Syndrome • The differences in rates and severity in Post-COVID Syndrome in athletes compared with other populations • Her advice for aspiring researchers in sport and exercise science Resources: Models of Care for Postacute COVID-19 Clinics: Experiences and a Practical Framework for Outpatient Physiatry Settings (https://pubmed.ncbi.nlm.nih.gov/34793373/) Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with post-acute sequelae of SARS-CoV-2 infection (PASC)(https://onlinelibrary.wiley.com/doi/10.1002/pmrj.12744) Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of fatigue in postacute sequelae of SARS-CoV-2 infection (PASC) patients (https://onlinelibrary.wiley.com/doi/full/10.1002/pmrj.12684)

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In BJSM’s 500th episode, we are joined by two of the current editors, Professor Jonathan Drezner and Dr Joanna Kemp, to look ahead as well as back at the specialty in general. We discuss hot topics, the direction in which the specialty as well as the journal is heading, and we get some top tips for early career researchers and clinicians too.

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On the podcast this week, we are thrilled to be joined by Associate Professor at the Centre for Health, Injury and Illness Prevention in Sport at the University of Bath, Dr Sheree Bekker.

We have all heard the term ‘knowledge translation’, but do we really know why it is important, what this process actually involves, and how can we all start embracing it in our professional lives?

Dr Bekker is a leader in this area, and we are thrilled that she has joined us to record the first in this ‘knowledge translation’ podcast series. You can find some of the resources that are mentioned in this podcast in the links below:

Dr Bekker’s twitter handle https://twitter.com/shereebekker

Dr Bekker’s #viral twitter thread https://twitter.com/shereebekker/status/1369972461014499331?lang=hi

Anterior cruciate ligament injury: towards a gendered environmental approach https://bjsm.bmj.com/content/55/17/984

We hope you enjoyed this podcast. Get in touch with us via social media if you have any feedback or suggestions for future guests.

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In this podcast Grainne Donnelly, Associate Prof Izzy Moore and Dr Brooke Patterson speak with Steph about her experience returning to sport post-partum using the 6Rs framework (https://pubmed.ncbi.nlm.nih.gov/34836883/).

Listen to Part 1 first: https://soundcloud.com/bmjpodcasts/bjsm-11022022-ep-497?in=bmjpodcasts/sets/bjsm-1&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing where Izzy and Grainne discuss the framework and the role of a musculoskeletal clinician.

Return to running BJSM infographic - https://bjsm.bmj.com/content/54/18/1114

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Associate Professor Izzy Moore and Grainne Donnelly discuss running during and after pregnancy and provide practical tips and great resources for clinicians treating pregnant and post-partum women. How can you ask about pelvic health? What is the role of a musculoskeletal clinician? How can we ensure less women suffer in silence?

Original research: Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women https://bjsm.bmj.com/content/55/22/1286.info

Editorial: Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women: https://pubmed.ncbi.nlm.nih.gov/34836883/

2019 return to running guideline https://doi.org/10.1016/j.physio.2020.03.276

Return to running BJSM infographic - https://bjsm.bmj.com/content/54/18/1114

Run ready post-partum BJSM blogs https://blogs.bmj.com/bjsm/2019/05/20/ready-steadygo-ensuring-postnatal-women-are-run-ready/ and https://blogs.bmj.com/bjsm/2021/08/22/return-to-running-following-childbirth-when-the-principles-of-sports-medicine-and-pelvic-health-collide/

Pelvic health impact questionnaire https://pubmed.ncbi.nlm.nih.gov/16021067/ Canadian guidelines - https://bjsm.bmj.com/content/52/21/1339

Clinical commentary considering the whole system readiness for running post-partum https://journals.lww.com/jwhpt/Abstract/2022/01000/Beyond_the_Musculoskeletal_System__Considering.7.aspx

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What is peripheral nerve hydrodissection and what conditions can it potentially treat? What is the data behind it’s practice? Has one injectate proven to be more efficacious than the others?

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by family medicine and sports medicine physicians Dr. Garry Ho.

Dr. Garry Ho is an Associate Professor from the Department of Family Medicine at the Virginia Commonwealth University School of Medicine, University of Vriginia School of Medicine, and the Georgetown University School of Medicine and has worked closely with athletes from several professional and collegiate organizations including the Washington Football Team, the D.C. Divas, the Washington Glory, the US Military Academy at West Point and the US Naval Academy in Annapolis.

In this 20 minute conversation Dr. Ho addresses the following topics: The definition of hydrodissection and theory behind its use? The current data supporting this procedure with respect to injectate utilized and anatomic location targeted. A discussion of the training required to become competent in this practice, and methods for assessing proficiency in learners?

2022 AMSSM Annual Meeting Information: https://annualmeeting.amssm.org

Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J Pain Res. 2020;13:1957-1968

https://www.dovepress.com/ultrasound-guided-nerve-hydrodissection-for-pain-management-rationale--peer-reviewed-fulltext-article-JPR

Cass, Shane P. DO Ultrasound-Guided Nerve Hydrodissection, Current Sports Medicine Reports: January/February 2016 - Volume 15 - Issue 1 - p 20-22

https://journals.lww.com/acsm-csmr/Fulltext/2016/01000/Ultrasound_Guided_Nerve_Hydrodissection__What_is.10.aspx

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In this episode host Dr Brooke Patterson, is joined by Associate Professor Shane Shapiro, to discuss the responsible use of orthobiologics and regenerative therapies in sports medicine. Professor Shapiro provides clinicians with practical considerations and tips for communicating with patients who may be considering the use of orthobiologics.

Links American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine https://journals.lww.com/cjsportsmed/Fulltext/2021/11000/American_Medical_Society_for_Sports_Medicine.10.aspx

Editorial - highlights from the American Medical Society for Sports Medicine position statement on responsible use of regenerative medicine and orthobiologics in sports medicine https://bjsm.bmj.com/content/early/2021/10/21/bjsports-2021-104887

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In this podcast with Dr James Hull and Dr Maarit Valtonen, we take a deep dive into a topic that affects athletes around the globe.

We cover: • The extent of the issue • A recommended approach to evaluating athletes • The value of point-of-case testing • Return to sport

For some further resources, the below links may well be useful

Papers: https://bjsm.bmj.com/content/early/2021/11/17/bjsports-2021-104719 https://bjsm.bmj.com/content/53/17/1093 https://bjsm.bmj.com/content/55/20/1144

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In part 2 of this podcast series Dr Adam Weir talks to Associate Professor Robert-Jan de Vos about the recently published Dutch multidisciplinary guideline on Achilles tendinopathy. They give a clinically focused overview that all practitioners will find invaluable.

They discuss: Conservative treatment The role of surgery Prognosis Secondary prevention

Links https://soundcloud.com/bmjpodcasts/sets/bjsm-1?si=ed9b271d1d7140ca81ecfbb201ec42ae&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing https://bjsm.bmj.com/content/55/20/1125

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In this podcast Dr Adam Weir talks to Associate Professor Robert-Jan de Vos about the recently published Dutch multidisciplinary guideline on Achilles tendinopathy. They give a clinically focused overview that all practitioners will find invaluable.

They discuss: · How the guideline was developed · Risk Factors · Prevention strategies · Clinical diagnosis · The role of imaging

Links https://bjsm.bmj.com/content/55/20/1125

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Similar to sports, overuse injuries are exceedingly common in the performing artist population. On this episode of the AMSSM Sports Medcast, host Dr. Stephen Luebbert, MD, is joined by Dr. Jeremy Stanek, MD, to discuss on the topic of performing arts medicine and his career journey from musician to sports medicine physician.

In this conversation Dr. Stanek addresses the following topics: · Dr. Stanek’s inspiration for becoming a performing arts physician as well as discuss the patient populations he typically sees and treats · The different components to physical exams to consider with dancers and musicians · The most common injury patterns in performing artists · The go-to resources to utilize for best practices, prevention, treatment and overall management of performing arts medicine · Recommend pathways to get started and more involved in this field

Resources I. Websites: 1. Performing Arts Medicine Association https://artsmed.org/ 2. International Association for Dance Medicine & Science- https://iadms.org/ 3. Stanford Performing Arts Medicine Program- https://pmr.stanford.edu/patients/performing-arts-orthopaedic-health.html 4. Texas Center for Performing Arts Health https://tcpah.unt.edu/home 5. Harkness Center for Dance Injuries- https://nyulangone.org/locations/harkness-center-for-dance-injuries 6. Washington University Medical Program for Performing Artists- https://www.ortho.wustl.edu/content/Patient-Care/2348/Services/Physical-Medicine-and-Rehabilitation-Musculoskeletal/Performing-Arts-Program.aspx 7. Performing Arts Medicine Fellowship at the Texas College of Osteopathic Medicine - https://www.unthsc.edu/texas-college-of-osteopathic-medicine/graduate-medical-education/performing-arts-medicine-fellowship/

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Professor Schipperijn is a Professor at the University of Southern Denmark & president of the International Society for Physical Activity and Health (ISPAH). He joins us on this BJSM podcast to outline the famous ‘8 investments’ for physical activity, that are now being translated into 12 languages.

We will be sharing the 8 investments, the translations and some associated resources through our social media channels over the coming weeks & months, but you can find out more information on the ISPAH website https://www.ispah.org/resources/key-resources/8-investments/

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Although early specialization in sport may pose a risk to some youth athletes, is it possible have success with specialized training? What is it about the workload-injury relationship and injury risk factors that practitioners must take in account when taking care of specialized athletes? On this episode of the AMSSM Sports Medcast, host Dr. Giorgio Negron, MD is joined by one of the leading experts on youth sports health Dr. Neeru Jayanthi, MD (Twitter: @neerujayanthi)to discuss on the topic of youth sports specialization.

In this conversation Dr. Jayanthi addresses the following topics: · Definition of youth sports specialization · What are the potential risks of injury for youth athletes pursuing sport specialization? · Are there any research regarding training guidelines or protocols for youth pursuing sport specialization?

References: Jayanthi N, Saffel H, Gabbett T. Training the specialised youth athlete: a supportive classification model to keep them playing. Br J Sports Med. 2021 Nov;55(22):1248-1249. doi: 10.1136/bjsports-2020-103880. Epub 2021 Aug 11. PMID: 34380644. Jayanthi N, Kliethermes SA, Côté J. Youth sport specialisation: the need for an evidence-based definition. Br J Sports Med. 2020 Feb;54(4):196-197. doi: 10.1136/bjsports-2019-101256. Epub 2019 Dec 19. PMID: 31857339. Myer GD, Jayanthi N, Difiori JP, Faigenbaum AD, Kiefer AW, Logerstedt D, Micheli LJ. Sport Specialization, Part I: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? Sports Health. 2015 Sep-Oct;7(5):437-42. doi: 10.1177/1941738115598747. Epub 2015 Aug 6. PMID: 26502420; PMCID: PMC4547120.

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This podcast discusses the new consensus statement on the risks of physical activity for people living with long term conditions. Shona Kohlhardt is joined by Dr Hamish Reid and Dr Natasha Jones, as they explain the latest findings and new recommendations from the consensus.

This conversation covers: New recommendations around patients being ‘fit for participation’ How to get patients to increase their physical activity levels How to practically overcome perceived risks and barriers to physical activity Who should be the judge of whether someone is safe enough to exercise The potential ramifications of this statement in the broader system, focusing on the physical activity sector

The consensus: Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions: https://bjsm.bmj.com/content/early/2021/11/03/bjsports-2021-104281

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In this podcast Brooke Patterson talks with Associate Professor Deirdre McGhee about breast injuries and breast health. Deirdre is a sports physiotherapist, and leads the breast research and education area of the Australian Institute of Sport Female Performance and Health Initiative (https://www.ais.gov.au/fphi).

She has been researching breast health biomechanics for the past 20 years, has written guidelines for Sports Medicine Australia on breast support and bra fit for female athletes (https://sma.org.au/resources-advice/injury-fact-sheets/exercise-and-breast-support/) and the freely accessible web-based App, “Sports Bra” (https://www.bra.edu.au/), to guide female athletes on breast support and bra fit.

The podcast covers practical tips for clinicians to check bra fit and why it is important, and the current evidence related to breast injuries, treatment, and breast protection for women playing contact sports.

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Today, AMSSM members Dr. Caitlyn Mooney hosts Dr. Katie Rizzone on the topic of sports bras. With more women athletes than ever, the sports bra has certainly grown in popularity in the last decades. This podcast will visit the history of breast support in sport and discuss how breast pain and discomfort effect sports participation in women as well as recent research by Dr. Rizzone and colleagues on their recent study on characteristics of sports bra preference in adolescent females.

More info: CHARACTERISTICS OF SPORTS BRA PREFERENCES IN ADOLESCENT FEMALES

Katherine H. Rizzone, MD MPH, Bianca Edison, MD MPH, Jane Chung, MD, Ingrid K. Ichesco, MD, Nailah Coleman, MD https://journals.sagepub.com/doi/abs/10.1177/2325967121S00110

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In this podcast, we’re joined by Dr Yetsa Tuakli-Wosornu, Lead Author of the BJSM #SportsEquity e-Edition and Dr Jane Thornton, one of the BJSM’s editors. We cover:

How this e-Edition came about The difference between equity and equality Why this issue is so important How people can use this e-edition in their personal and professional

Links: E-Edition: https://bjsm.bmj.com/pages/bjsm-e-edition-sportsequity/ Editorial: https://bjsm.bmj.com/content/early/2021/09/09/bjsports-2021-104874

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Today, Brooke Patterson hosts Annie Strauch and Catherine Etty-Leal, both experienced Australian physiotherapists with a Masters in Sports Physio and Musculoskeletal Physio. Annie’s passion for performance physiotherapy started in London’s West End where she managed performers in over 30 productions. After that, Performance Medicine (https://performancemedicine.com.au/) was born, a multidisciplinary clinic to provide singers, dancers and performers with tailored physiotherapy treatment. Annie and Catherine both specialise in vocal physiotherapy, and provide some tips for online public speaking. They discuss injury management and prevention for performing artists, and the cultural considerations. Sports medicine professionals have a big role to play in the performing arts industry, and Annie and Catherine share some tips for getting involved in the field.

Links International Association of Dance Medicine and Science (IADMS) - https://protect-au.mimecast.com/s/Cu1_CMwv0QUOKzGqCwWvfG?domain=iadms.org/

Australian Society of Performing Arts & Healthcare (ASPAH)-https://protect-au.mimecast.com/s/RieBCNLwP9UlKj10c4VDDt?domain=aspah.org.au/

Australian Voice Association (AVA)- https://protect-au.mimecast.com/s/7-noCOMxQyURVvopTkxo26?domain=australianvoiceassociation.com.au/

Medical Problems in Performing Artists (MPPA) - https://protect-au.mimecast.com/s/5dXICP7yRZiGY3qKSjiL2U?domain=sciandmed.com

RETURN TO DANCE post COVID - Webinar about how dance teachers, dance professionals and dance clinicians can assist their dance students return to the studio in a safe way. -https://protect-au.mimecast.com/s/-ILGCROAWocm958vSoFlgP?domain=performancemedicine.com.au/

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The mental health of athletes has been in the spotlight throughout this summer, as high-profile athletes such as Naomi Osaka and Simone Biles have spoken out about the importance of prioritizing their physical, and especially their mental, well-being.

In this episode, host Dr. Giselle Aerni, MD is joined by AMSSM Past Presidents Dr. Cindy Chang, MD and Dr. Margot Putukian, MD to discuss the AMSSM Position Statement on Mental Health Issues and Psychological Factors in Athletes, which Dr. Aerni also co-authored.

In this 33-minute conversation, they address the following topics: The importance of a position statement on the mental health of athletes and the novel aspects addressed in the document The team-based approach to mental health care and why it’s a crucial component for the well-being of athletes How the acceptance of mental health issues has evolved in recent years and the impact social media has on those perceptions The impact of the COVID-19 pandemic on athletes’ mental health and how it reinforces the need for conversations about this vital issue

Resources: Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement (https://bjsm.bmj.com/content/54/4/216.full) Madam Athlete Podcast (https://madamathlete.com/)

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Dan is a podiatrist and a senior lecturer at La Trobe University. He completed a PhD in 2019, where he investigated the use of foot orthoses for the prevention of injury in military recruits. In this episode, Brooke Patterson discusses with Dan the key considerations for clinicians when helping athletes make footwear choices. They discuss the role of performance and sponsorship, and Dan provides his opinion on Nike’s super spike in the lead up to the Tokyo Olympics. The role of injury, comfort, gender, and foot shape, and research in footwear design is discussed. Twitter: @DanielRBonanno

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What is a weighted ball velocity throwing program? Do they work, and what is the evidence of benefit? What are the risks involved and common injury patterns seen? Host Dr. Devin McFadden, MD is joined by Dr. Jason Zaremski, MD to explore these topics and more on the AMSSM Sports Medcast.

Dr. Zaremski is a clinical associate professor holding a joint appointment from the Departments of Physical Medicine and Rehabilitation and the, Department of Orthopaedics and Rehabilitation at the University of Florida. In addition he is the Co-Medical Director of the Adolescent and High School Outreach Program at the University of Florida. He is a past participant in the AMSSM International Travelling Fellowship program, is a Co-Chair of the AMSSM Fellowship Committee and currently serves on the Board of Directors for the AMSSM.

In this 17 minute conversation Dr. Zaremski addressed the following topics: Defining a weighted ball velocity program Considering the risks and benefits of their use Determining what populations should not use these programs and how to safely implement them if athletes decide to pursue one.

Zaremski JL. Weighted Ball Velocity Throwing Programs Are Effective. Are the Benefits Worth the Risk? Clin J Sport Med. 2020 Mar 11. doi: 10.1097/JSM.0000000000000822. Epub ahead of print. PMID: 33914497. Caldwell JE, Alexander FJ, Ahmad CS. Weighted-Ball Velocity Enhancement Programs for Baseball Pitchers: A Systematic Review. Orthop J Sports Med. 2019 Feb 12;7(2):2325967118825469. doi: 10.1177/2325967118825469. PMID: 30800693; PMCID: PMC6378453. Melugin HP, Smart A, Verhoeven M, Dines JS, Camp CL. The Evidence Behind Weighted Ball Throwing Programs for the Baseball Player: Do They Work and Are They Safe? Curr Rev Musculoskelet Med. 2021 Feb;14(1):88-94. doi: 10.1007/s12178-020-09686-0. Epub 2021 Jan 6. PMID: 33403626; PMCID: PMC7930148.

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Today Brooke Patterson (@Knee_Howells) speaks with Dr Nonhlanhla Mkumbuzi (@DrNoeMkumbuzi). Dr Mkumbuzi is a physiotherapist, and completed her PhD in 2020 on the association of genetic risk factors with nociception and pain in chronic painful achilles and patellar tendinopathies. She is a post-doctoral research fellow at the University of Cape Town. Dr Mkumbuzi shares some eye-opening experiences as head physiotherapist for Zimbabwe National Rugby Teams. We discuss her recent editorial (https://bjsm.bmj.com/content/early/2021/05/10/bjsports-2021-104202) and the broad consideration of race, culture, gender, and economics in sport and exercise medicine. She shares some personal experience and advice for marginalised athletes, clinicians, and academics. Brooke discusses the opportunity to get involved in the BJSM global mentoring program (https://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2021/03/BJSM-Global-SEM-Mentoring-Program.pdf). Mentors can submit a short statement of interest with your areas of expertise to bjsmglobalmentoring@bmj.com. Mentees can submit a short description of the proposed study, and the specific areas you could use assistance.

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On this episode of the AMSSM CRN Spotlight Podcast (T: @TheAMSSM) host Dr. Jeremy Schroeder, DO, is joined by BJSM Editor-in-Chief Dr. Jonathan Drezner, MD, and Kimberly Harmon, MD, who are both Past Presidents of AMSSM.

In this 23-minute conversation, Drs. Drezner and Harmon discuss the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA) national registry and address the following topics:

· Details about the ORCCA registry, what makes it unique and why it was created · The early findings of the registry and what they mean for team physicians and athletic trainers · How this study and others are impacting return-to-play decisions after COVID · The current recommendations regarding cardiac imaging in athletes · Finding the right balance in our professional and personal lives

Resources:

SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes (https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054824)

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Dr Joanne Parsons (@J_ParsonsUofM) is a physical therapist and an associate professor at the University of Manitoba. Dr Stephanie Coen (@steph_coen) is a health geographer and assistant professor at the University of Nottingham in the UK.

To date, ACL injury prevention and management has been approached from a sex-based biological point of view. In this episode, Dr Brooke Patterson (@Knee_Howells) discusses with Joanne and Stephanie how the traditional sex-based approach does not take into account the growing recognition of how sex and gender (a social construct) are ‘entangled’ and influence each other. They discuss their recent review (co-authored with Sheree Bekker), (https://bjsm.bmj.com/content/early/2021/03/09/bjsports-2020-103173) and how clinicians can take a gendered approach to inform more effective approaches to injury prevention and management.

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In this podcast, Dr. Jane Thornton hosts Dr. Fiona Wilson and Kellie Wilkie to discuss their 2021 consensus statement for preventing and managing low back pain in elite and subelite adult rowers.

Dr. Fiona Wilson is an associate professor and physiotherapist in the School of Medicine Trinity College Dublin where she is head of the physiotherapy programme. She was lead physiotherapist for Rowing Ireland for 10 years and still practices clinically focusing on managing low back pain.

Kellie Wilkie is a Sport & Exercise Physiotherapist with her own private practice in Hobart, Tasmania. She was an Australian Rowing Team Physiotherapist from 2008-2016 and the Lead Physiotherapist in the Rio Olympic cycle.

We cover: · What is rowing-related low back pain and how prevalent is it? · What causes rowing-related low back pain, and can it be prevented? · How should rowing-related low back pain be managed? · What this means for rowers, coaches and medical staff

Links:

https://bjsm.bmj.com/content/early/2021/03/11/bjsports-2020-103385.abstract

World Rowing site: https://worldrowing.com/2021/05/11/guide-for-managing-low-back-pain-in-rowers/

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Did you know that being on the International Space Station for a few months can have the same effect on bone density loss as a decade or more of aging here on earth? In this episode, Dr. Erin Macri asks Drs. Leigh Gabel and Kate Ackerman about a recent publication about predictors of bone loss on long-duration space flights – it’s not what you might think! – and how this new information might change how we approach bone health in sports medicine here on earth.

Links and resources:

https://twitter.com/AstroVicGlover/status/1337434468244746240

Gabel L, Liphardt AM, Hulme PA, Heer M, Zwart SR, Sibonga JD, Smith SM, Boyd S. Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight. British Journal of Sports Medicine. Published Online First: 17 February 2021. http://dx.doi.org/10.1136/bjsports-2020-103602

Ackerman KE, Popp KL, Bouxsein ML. Rocket science: what spaceflight can tell us about skeletal health on Earth. British Journal of Sports Medicine Published Online First: 21 April 2021. http://dx.doi.org/10.1136/bjsports-2021-104164

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On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Ashwin Rao, MD is joined by Dr. Crystal Wong, MD, a family medicine physician at the University of Washington and an Associate Medical Director at UW Neighborhood Clinics. She was instrumental in developing and implementing telemedicine services at the University of Washington during the COVID-19 pandemic, when UW saw a 29,000 percent increase of in telemedicine visits.

In this 22-minute conversation, Dr. Wong discusses her experience with telehealth services and addresses the following topics:

What do you see as the benefits of telemedicine in primary care and how might translate to other disciplines? What are some of the challenges and barriers of telemedicine? What types of visits are most amendable to the telehealth format? What about efforts to replicate a physical exam virtually? What are the challenges of administering telemedicine across state lines? Will telemedicine continue to have a prominent role in practice after the pandemic? What advice does she have for sports medicine providers interested in pursuing telemedicine services?

Resources:

Telemedicine Management of Musculoskeletal Issues - American Family Physician (aafp.org)

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Professor Vicki Anderson is a paediatric neuropsychologist in Melbourne, Australia, with over 25 years of experience across clinical, research and academic sectors. She is the Director of Psychology at The Royal Children's Hospital, and Director of Clinical Sciences Research at Murdoch Children's Research Institute. Her research aims to better diagnose, manage and treat child concussion. In this episode, Brooke Patterson asks Vicki about who is most at risk of persistent symptoms after concussion, evidence-based intervention strategies, and digital health tools for monitoring child with post-concussion symptoms.

Twitter:

@bivianoanders Website https://www.mcri.edu.au/users/professor-vicki-anderson

Resources:

Raising Children Network - https://raisingchildren.net.au/guides/a-z-health-reference/concussion HeadCheck App - https://www.headcheck.com.au/

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The Black Biomechanists Association (BBA) was recently cofounded by Associate Professor Matthew McCullough from North Carolina A&T State University, Kayla Seymore, PhD student at the University of Delaware, and Dr. Erica Bell, Postdoctoral fellow at the Mayo Clinic. In this episode, Dr. Erin Macri inquires about the need for organizations like this in our global scientific communities, and learns more about how the BBA is positioned to lead the charge in changing how we think about diversity, representation and anti-racism in biomechanics research.

Twitter: @BlackBiomechs @Erin_Macri

Links to articles and references: Become a member (allies welcome): bit.ly/BBA-member Contact us: blackbiomechanics@gmail.com Follow us: @BlackBiomechs on Twitter/Instagram Dr. Karl Zelik, Vanderbilt University: https://theconversation.com/chadwick-bosemans-black-panther-gives-a-boost-to-diversity-in-stem-a-black-engineers-take-on-personal-and-professional-inspiration-151983 Dr. Cherice Hill, Clemson University/Medical University of South Carolina: Hill CN, Reed W, Schmitt D, Sands LP, Queen RM. Racial differences in gait mechanics. Journal of biomechanics. 2020;112:110070 https://doi.org/10.1016/j.jbiomech.2020.110070

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Are concussions in para-sport a big issue? What are some of the challenges in this setting? Where do you start, when it comes to assessing para-athletes?

In this 20-minute podcast with SEM consultant Dr Richard Weiler, you will learn the answers to all of the above, and know where to find some practical tips & tricks.

Links: Link to paper https://bjsm.bmj.com/content/early/2021/04/08/bjsports-2020-103696

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Dr Simon Kemp is a Sport and Exercise Medicine consultant, and Medical Services Director at the Rugby Football Union. He is a leading researcher in Rugby Medicine, with a wide and high-impact research portfolio. Dr Patrick O’Halloran is a Sport and Exercise Medicine Registrar in the UK who is undertaking a PhD at the University of Birmingham. He also works as a senior medical advisor to Marker. They both join us in this podcast to talk about their recently published paper on the diagnostic signatures of concussion in the saliva of male athletes.

In this 15-minute chat, we talk about the importance of developing objective measures in diagnosing concussions, how they went about their ground-breaking trial and much more.

You can find their paper ‘Unique diagnostic signatures of concussion in the saliva of male athletes: the Study of Concussion in Rugby Union through MicroRNAs (SCRUM)’, via the link below: https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-103274

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The benefits of physical activity are unquestioned, but many health care providers still do a poor job of activity counseling and prescription. Frequently cited reasons for this apparent disconnect include a lack of time, poor reimbursement, and lack of training on how to incorporate exercise prescription into clinical practice. The AMSSM has assembled a team of international experts to help address these gaps and share best practices for incorporating exercise medicine into both clinical practice and academic medicine.

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by Dr. Irfan Asif, MD is a Professor and Chair of the Department of Family and Community Medicine at the University of Alabama-Birmingham School of Medicine. He also serves on the AMSSM board of directors and is an associate editor for both the BJSM and Sports Health.

In this 10-minute conversation Dr. Asif addresses the following topics:

What is the focus of the upcoming AMSSM Collaborative Research Summit? What are the aims and anticipated outputs of the summit? Is this summit relevant to a clinician not currently engaged in multi-site research?

The Virtual AMSSM Annual Meeting takes place from April 13-18, 2021. Registration is still open for both the main meeting and CRN Research Summit. More information can be found at https://annualmeeting.amssm.org/

Exercise is Medicine connects physical activity to healthcare: https://www.exerciseismedicine.org/

Joy E (L), Blair SN, McBride P, et al. Physical activity counseling in sports medicine: a call to action. Br J Sports Med. 2013;47:49-53. https://bjsm.bmj.com/content/bjsports/47/1/49.full.pdf

Hebert ET, Caughy MO, Shuval K. Primary care providers’ perceptions of physical activity counseling in a clinical setting: a systematic review. Br J Sports Med. 2012;46:625-31. https://bjsm.bmj.com/content/bjsports/46/9/625.full.pdf

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Linda Truong is a physical therapist and PhD trainee at the University of British Columbia, in Vancouver. Her research aims to understand how social support can improve recovery outcomes and delay post-traumatic osteoarthritis after a traumatic knee injury. In this episode, Brooke Patterson asks Linda about her recent scoping review and editorial regarding the need to embrace non-physical factors in the treatment of sports-related injury. Linda provides practical suggestions as to how to assess and treat social and contextual factors after sports-related knee injury.

Twitter: @LKTphysio

Resources: Multidimensional Scale of Perceived Social Support (MSPSS)- https://www.researchgate.net/publication/311534896_Multidimensional_Scale_of_Perceived_Social_Support_MSPSS_-_Scale_Items_and_Scoring_Information

The PASS-Q: The Perceived Available Support in Sport Questionnaire - https://www.researchgate.net/publication/50936606_The_PASS-Q_The_Perceived_Available_Support_in_Sport_Questionnaire

The ARSQ: The Athletes' Received Support Questionnaire - https://www.researchgate.net/publication/261256629_The_ARSQ_The_Athletes%27_Received_Support_Questionnaire

Truong LK, Bekker S, Whittaker JL, Removing the training wheels: embracing the social, contextual and psychological in sports medicine, BJSM, Published Online First: 12 November 2020. - https://bjsm.bmj.com/content/early/2020/11/11/bjsports-2020-102679.abstract

Truong LK, Mosewich AD, Holt CJ, Le CY, Miciak M, Whittaker JL. Psychological, social and contextual factors across recovery stages following a sport-related knee injury: a scoping review. BJSM, 2020. - https://bjsm.bmj.com/content/54/19/1149

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We all know the benefits of physical activity, but have you ever considered the ways the area you live in influences your ability to and options for exercise? Many Americans live in areas that discourage rather than promote an active lifestyle. Lack of access to areas to safely exercise creates physical activity deserts, which like food deserts, where fresh produce is not readily available, have deleterious effects on the health and well-being of the population living there.

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by sports medicine researcher and president of the American College of Sports Medicine, Dr. NiCole Keith, PhD.

In this 20-minute conversation Dr. Keith addresses the following topics:

What are physical activity deserts? Who is a risk of these deserts and what are the consequences? What can we do to advocate for improved access to safe areas to be physically active on the local and national levels?

Physical Activity Alliance: https://paamovewithus.org/

The American Fitness Index ranks America’s top 100 healthiest cities: https://americanfitnessindex.org/

Exercise is Medicine connects physical activity to healthcare: https://www.exerciseismedicine.org/

ActivEarth seeks to improve communities through physical activity and active transportation: https://www.acsm.org/acsm-membership/strategic-initiatives/activearth-(active-transportation)

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Joining us on this podcast to discuss this crucial topic are Dr Adam Gledhill, Dr Dale Forsdyke and Tom Goom.

Adam is Course Director for Sport, Exercise and Health Sciences at Leeds Beckett University. He is also chair of the British Association of Sport and Exercise Science Division of Psychology.

Dale is a Senior Lecturer in Sports Injury Management at York St John University, and Head of Science and Medicine at York City Tier 1 Regional Talent Club.

Tom (probably known to many as ‘the running physio’) is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course.

In this podcast we cover:

The inspiration behind the editorial and why is it such an important topic Patients’ basic psychological needs and how they relate back to rehab? A number of practical suggestions on how to enhance adherence.

Links:

‘I’m asking you to believe—not in my ability to create change, but in yours’: four strategies to enhance patients’ rehabilitation adherence https://bjsm.bmj.com/content/early/2020/11/03/bjsports-2020-102245?hwshib2=authn%3A1611998232%3A20210129%253A76cf0ccf-1d2e-4e4c-8ced-6c1e1766754f%3A0%3A0%3A0%3AikkQGUelivZ4k1xUJsCLFQ%3D%3D Blog on the running-physio website https://www.running-physio.com/adherence/

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Childhood obesity is a prevalent problem but perhaps not as commonly addressed in doctors’ appointments due to a variety of reasons. In part two of their conversation, Dr. Dusty Marie Narducci, MD speaks with Dr. Caitlyn Mooney, MD about childhood obesity, including the following questions:

· At what point would you recommend intervening? · Once a weight loss goal is determined, how do you move forward? · How exactly does diet play a role in obesity? · What is the role of physical activity, and what are the current activity recommendations? · What’s the evidence regarding interventions for childhood obesity? · Is there a role for pharmacological therapy in treatment? And what about surgical intervention? · Is there a role for counseling in certain populations?

Related Articles and Links:

BMI Z-Score and Percentile Calculator: https://www.bcm.edu/bodycomplab/BMIapp/BMI-calculator-kids.html BMI Percentile Calculator for Child and Teen https://www.cdc.gov/healthyweight/bmi/calculator.html

Boutelle KN, Rhee KE, Liang J, et al. Effect of Attendance of the Child on Body Weight, Energy Intake, and Physical Activity in Childhood Obesity Treatment: A Randomized Clinical Trial. JAMA Pediatr 2017; 171:622.

US Preventive Services Task Force, Grossman DC, Bibbins-Domingo K, et al. Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA 2017; 317:2417.

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128 Suppl 5:S213

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In this podcast, we’re joined by Professor Ben Jones, to discuss his recently published paper on the risk of COVID-19 transmission in sport.

Ben is a Professor at the Carnegie School of Sport at Leeds Beckett University, with a background in Sport and Exercise Physiology. He is also Head of Performance for England Rugby League and the Pathway Performance Director for Leeds Rhinos.

We cover: · The sports the research relates to · The methods involved · What this means for players, for medical staff, and for sport in general

Link: https://bjsm.bmj.com/content/early/2021/02/10/bjsports-2020-103714

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Twitter: @GBruinvels, @JaneSThornton, @Erin_Macri

Dr. Georgie Bruinvels is a Research Associate at St. Mary’s University in Twickenham in the UK, and also works as a Senior Sports Scientist and Research Scientist at Orreco. Her research focuses on the female athlete and female physiology.

In this episode, Dr. Erin Macri, Dr. Jane Thornton, and our guest Dr. Georgie Bruinvels discuss menstrual symptoms and sports performance, and explore the technology and ethics around normalizing period talk in sports medicine.

Bruinvels G, Goldsmith E, Blagrove R, Simpkin A, Lewis N, Morton K, Suppiah A, Rogers JP, Ackerman KE, Newell J, Pedlar C. Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete: a study of 6812 exercising women recruited using the Strava exercise app. British Journal of Sports Medicine. 2020. http://dx.doi.org/10.1136/bjsports-2020-102792

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Brooke Patterson is a physiotherapist who is currently completing her PhD at the La Trobe Sport and Exercise Medicine Research Centre, investigating the impact of ACL injuries on the lives of young adults. Brooke played several seasons in the Australian Football League national women’s competition (WAFL), and has recently transitioned to becoming a coach. You will be hearing more from Brooke, who will be hosting some BJSM podcasts over the coming months, so we thought we’d take this opportunity to get to know Brooke and her research.

In this podcast we discuss:

The latest ACL injury prevention & early-onset osteoarthritis research

The next big breakthroughs to expect in the next decade from a research perspective do

Advice for people wanting to/working in elite women’s sport

Links:

Making football safer for women with Brooke Patterson and Dr Ben Mentiplay. Episode #445 https://soundcloud.com/bmjpodcasts/making-football-safer-for-women-with-brooke-patterson-and-dr-ben-mentiplay-episode-445
Building on a BJSM podcast – and celebrating good news! #WomensFootball https://blogs.bmj.com/bjsm/2020/10/22/building-on-a-bjsm-podcast-and-celebrating-good-news-womensfootball/
Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players https://bjsm.bmj.com/content/54/18/1089

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In this podcast, you can hear from James Collins – a leading performance nutritionist and one of the leads on the recent UEFA expert group statement on nutrition in elite football. James has worked with a range of elite sporting organisations, and is also the founder of the Intra Performance Group.

In this podcast, we cover: - how the statement came about, and where it fits into the existing literature - nutritional considerations for training and match-day - the importance of body composition - nutritional considerations in the rehabbing athlete - next steps

For more, please check out the links below:

UEFA expert group statement: https://bjsm.bmj.com/content/early/2020/11/08/bjsports-2019-101961

Importance of nutrition in football: the coach’s perspective https://bjsm.bmj.com/content/early/2020/10/22/bjsports-2019-101972

The importance of nutrition in football: perspective of a national team’s doctor https://bjsm.bmj.com/content/early/2020/10/22/bjsports-2020-103318

James’ twitter profile: https://twitter.com/JamesCollinsPN

James’ company profile: https://www.intraperformancegroup.com/team

Informed Sport https://www.informed-sport.com/

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On this week’s podcast, Dr. Dusty Marie Narducci, MD speaks with Dr. Ben Krainin, MD on the AMSSM Sports Medcast about the use of bioinformatics and wearable technology in female athletes.

In this conversation, Dr. Narducci focuses the following topics:

· A general overview of bioinformatics, including the three main wearable technology product categories · Injury Prevention in Volleyball Players · Menstrual Tracking for Female Athletes · Fitness Trackers for the “General Consumer”

This lecture features multiple key points and takeaways about bioinformatics and was originally scheduled to be presented during the 2020 AMSSM Annual Meeting.

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Join us for a 15-minute chat with Prof Jon Drezner, the new Editor-in-Chief of the BJSM. We cover his journey to the job, his hopes for the future, and the role he sees the journal playing for the international sport and exercise medicine community over the coming years. In this, the last podcast of 2020, we discuss the challenges of 2020, and also pay tribute to the outgoing editor-in-chief, Professor Karim Khan, for his mentorship and for his incredible contribution to both the BJSM, and the wider Sport and Exercise Medicine community. For more, you can check out Jon's editorial in the latest edition of the BJSM

https://bjsm.bmj.com/content/55/1/1

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In this week’s podcast, we are joined by Dr Mahmood to discuss how we can support the mental health of elite cricketers. Dr Mahmood is a psychiatrist based in Birmingham, England, who recently authored a chapter about mental health emergencies in cricket in a new textbook, Case Studies in Sports Psychiatry. In this 15-minute podcast, Dr Mahmood explores mental health screening, the difference between sports psychologists and psychiatrists, and how cricket can learn from other sports to improve the wellbeing of all athletes.

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Dr. Kirsty Elliott-Sale. Dr. Elliott-Sale is an Associate Professor of female physiology at Nottingham Trent University in Nottingham, England, where she is Head of the Musculoskeletal Physiology Research Group. For over 20 years she has been focussed on elite women athletes and maternal populations, primarily in the areas of endocrinology and musculoskeletal and exercise physiology.

In this episode, Dr. Erin Macri talks to Dr. Elliott-Sale about menstruation and oral contraception, and their effects on sports performance. This is an important listen for all men and women who work with women athletes of all levels.

Twitter: @ElliottSale @Erin_Macri

Resources and references Menstruation is not a taboo in women’s sport, period. https://theconversation.com/menstruation-is-not-a-taboo-in-womens-sport-period-92378

The BASES Expert Statement on Conducting and Implementing Female Athlete-Based Research https://www.bases.org.uk/imgs/0000_bas_tses___autumn_2020_online_pg6_7237.pdf

McNulty, K.L., Elliott-Sale, K.J., Dolan, E. et al. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med 50, 1813–1827 (2020). https://doi.org/10.1007/s40279-020-01319-3

Elliott-Sale, K.J., McNulty, K.L., Ansdell, P. et al. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Med 50, 1785–1812 (2020). https://doi.org/10.1007/s40279-020-01317-5

Martin, D., Sale, C., Cooper, S. B., & Elliott-Sale, K. J. (2018). Period Prevalence and Perceived Side Effects of Hormonal Contraceptive Use and the Menstrual Cycle in Elite Athletes, International Journal of Sports Physiology and Performance, 13(7), 926-932. Retrieved Dec 2, 2020, from https://journals-humankinetics-com.ezproxy.library.ubc.ca/view/journals/ijspp/13/7/article-p926.xml

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On this week's episode, we are joined by the WHO's Prof Fiona Bull and Dr Juana Willumsen to launch the new WHO 2020 Guidelines on Physical Activity and Sedentary Behaviour. In this 20-minute podcast, Prof Bull and Dr Willumsen discuss the new global recommendations in depth, explain what has changed since the 2010 guidelines, and outline the next steps forward to creating more active people for a healthier world.

Want to learn more? Check out the BJSM WHO Guidelines special issue (open access!) as well as the WHO website for all the resources.

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On this week’s episode, we are joined by Prof Christa Janse van Rensburg to discuss the do’s and don’ts of mask wearing during exercise. Prof Janse van Rensburg is a Sport and Exercise Physician who is the Head of Department of the Section Sports Medicine at the University of Pretoria in South Africa.

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As a three-time Major winner and the current European Ryder Cup team captain, Padraig Harrington is uniquely placed to consider the cultural changes in golf with respect to medicine and performance.

During this two-part conversation with Dr Sean Carmody and Padraig's longtime fitness coach, Dr Liam Hennessey, Padraig provides an insight into his experiences of injury, what he believes contributes to injury, and how a willingness to innovate has helped him to continue playing at the highest level over so many years.

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As a three-time Major winner and the current European Ryder Cup team captain, Padraig Harrington is uniquely placed to consider the cultural changes in golf with respect to medicine and performance.

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Serenna Williams, Alysson Felix, Kerry Walsh Jennings, Lisa Leslie. Mothers and champions. In this AMSSM Sportsmedcast sports medicine specialist Dr. Rathna Nuti hosts Dr. Ellen Casey, @EllenCaseyMD, Associate Attending Physiatrist in the Department of Physiatry and the Women's Sports Medicine Center at the Hospital for Special Surgery in New York. Dr Casey who works with US Gymnastics, is also an Associate Professor of Clinical Rehabilitation Medicine at Weill Cornell Medical College.

Dr. Casey addresses the following topics: • What are some things to consider when caring for a pregnant athlete? • Should a pregnant athlete be exercising or training? • What are some misconceptions surrounding a pregnant athlete and exercise? • What exercises are recommended? • What exercises are prohibited? • Is there any point in time that a pregnant athlete should stop exercising? If so, when can she safely resume? • Is there any medications or supplements that a pregnant athlete should be taking during her pregnancy? • Any special medical evaluations that should be assessed by either the OB/GYN or Sports Medicine physician besides to the overall care of the pregnancy? • What are some common barriers to exercise in pregnant athletes (lumbopelvic pain, fatigue) • What are some things to consider when returning to sports/exercise after delivery? What are some of the barriers to exercise in postpartum women? • What is diastasis rectus abdominis? Can anything be done about it? • What are some of the reasons postpartum women develop urinary incontinence during sports/exercise? Can anything be done about it? • What do we know about breast feeding and sports participation?

References Mottola et al. Br J Sports Med 2019 PMID: 30337460 Prather et al. PMR 2012 PMID: 23174548 Bø et al. Br J Sports Med 2016 PMID: 28642221 Meah et al. BJSM 2020 PMID: 32513676

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On this week’s podcast, Dr. Douglas Casa PhD, ATC and Dr. Francis O’Connor MD, MPH, FAMSSM join Dr. Seth Smith MD, PharmD on AMSSM’s Sports Medcast to discuss exertional heat illness with an emphasis on exertional heat stroke.

In this conversation, Dr. Casa and Dr. O’Connor will address the following topics: · What is the basic paradigm for the prehospital care of exertional heat stroke (EHS)? · How to develop a thorough emergency action plan (EAP) for recognition and management of EHS? · What steps can be taken to help reduce the occurrence of EHS? · What future items may be used to help guide return to activity for patients who have suffered an EHS?

Listen to an extended version of this conversation on the AMSSM podcast feed, beginning at the 17-minute mark: https://amssm.podbean.com/e/an-in-depth-discussion-on-exertional-heat-illness-with-dr-doug-casa-and-dr-fran-o-connor/

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A dive into female athlete health with Dr Nicky Keay. Dr Keay is a Sports and Dance Endocrinologist and Honorary Fellow at the Department of Sport and Exercise Sciences at Durham University. Many of our listeners will know Nicky from some of her publications in BJSM relating to female athlete health, which we cover in two rich podcasts. For some of the resources mentioned, please see the links below, or check out the BJSM blog homepage, where they will be collated into an interactive blog.

Links: BASEM website www.health4performance.co.uk (in houses the IOC consensus statements and other published studies in RED-S)

BJSM blogs “Of Mice and Men” https://blogs.bmj.com/bjsm/2019/11/21/of-mice-and-men-and-women/ and summary of IOC 2018 RED-S update https://blogs.bmj.com/bjsm/2018/05/30/2018-update-relative-energy-deficiency-in-sport-red-s/

Dr Keay's website nickykeayfitness.com

BJSM infographics on RED-S https://bjsm.bmj.com/content/53/20/1310 and cycling study https://bmjopensem.bmj.com/content/4/1/e000424

Course for coaches working with female athletes endorsed by BASEM https://sport-ready-academy.teachable.com/p/working-with-high-performing-female-athletes

Blood tests for athletes/dancers (including female hormone profiling) in UK https://www.forthedge.co.uk/

Menstrual monitoring alongside training metrics used at Sottish Ballet as mentioned in podcast https://www.athletemonitoring.com/menstrual-cycle-tracker/

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Links: BASEM website www.health4performance.co.uk (in houses the IOC consensus statements and other published studies in RED-S)

Dr Keay's website nickykeayfitness.com BJSM infographics on RED-S https://bjsm.bmj.com/content/53/20/1310 and cycling study https://bmjopensem.bmj.com/content/4/1/e000424

Course for coaches working with female athletes endorsed by BASEM https://sport-ready-academy.teachable.com/p/working-with-high-performing-female-athletes

Blood tests for athletes/dancers (including female hormone profiling) in UK https://www.forthedge.co.uk/

Menstrual monitoring alongside training metrics used at Sottish Ballet as mentioned in podcast https://www.athletemonitoring.com/menstrual-cycle-tracker/

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On this week’s episode, crowd favourite Dr Alex Hutchinson PhD returns to discuss the difference between effort and pain in the world of endurance. A former Canadian national team middle- and long-distance runner and Cambridge-trained physicist, Alex is an award winning author and columnist who writes for Outside magazine and The Toronto Globe and Mail. Want to learn more about the science of suffering? Follow @Sweat Science on Twitter and check out his book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

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Dr. Harvi Hart is a postdoctoral researcher at Western University in London, Ontario, funded by the Canadian Institutes of Health Research. Dr. Hart’s research focuses on identifying risk factors for knee osteoarthritis, both non-traumatic and post-traumatic osteoarthritis. Through better understanding these risk factors, Dr. Hart aims to develop new treatment approaches for managing knee OA. In this episode, Dr. Erin Macri asks Dr. Hart about her most recent studies looking at cadence and its possible role in joint loading and knee osteoarthritis.

Twitter: @HarviHart @Erin_Macri

Resources and references Hart HF, Birmingham TB, Primeau CA, et al. Associations between cadence and knee loading in patients with knee osteoarthritis. Arthritis Care Res (Hoboken) 2020. Published online first doi:10.1002/acr.24400 Hart HF, Gross KD, Crossley KM, et al. Is step rate associated with worsening of patellofemoral and tibiofemoral joint osteoarthritis in women and men? The Multicenter Osteoarthritis Study. Arthritis Care Res (Hoboken) 2019. Published online first doi: 10.1002/acr.23864 Lenhart RL, Thelen DG, Wille CM, Chumanov ES, Heiderscheit BC. Increasing running step rate reduces patellofemoral joint forces. Med Sci Sports Exerc 2014; 46: 557-564. Willy RW, Meardon SA, Schmidt A, Blaylock NR, Hadding SA, Willson JD. Changes in tibiofemoral contact forces during running in response to in-field gait retraining. J Sports Sci 2016; 34: 1602-1611. Bramah C, Preece SJ, Gill N, Herrington L. A 10% increase in step rate improves running kinematics and clinical outcomes in runners with patellofemoral pain at 4 weeks and 3 months. Am J Sports Med 2019 7:3406-3413.

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As long haul domestic & international travel for athletic competition slowly begins to resume post the restrictive COVID period, it will be more imperative than ever to keep these athletes healthy. This travel places significant risks of infection transmission and an aeroplane has unique challenges to overcome. BJSM's Liam West poses the questions to Prof. Wayne Derman who gives golden practical tips on how to commute safely. This podcast was recorded in March - since then the learning curve has been steep and behaviour regarding travel of both athletes and non-athletes changed substantially. Face masks are mandatory on flights, deep cleans of the aircraft pre-flight are routine replacing the need to clean your own tray table. Head over to the fantastic resource from the World Health Organisation (WHO) - https://www.who.int/news-room/q-a-detail/air-travel-advice

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Why are females more at risk of ACL injuries in football? What can we do to reduce the risk for our athletes? On this week’s episode, we are joined by Brooke Patterson and Dr Ben Mentiplay to discuss their latest review of injury prevention programmes reducing the risk of injury in women’s football. Brooke (T: @Knee_Howells) is a physiotherapist who is currently completing her PhD at the La Trobe Sport and Exercise Medicine Research Centre, investigating the impact of ACL injuries on the lives of young adults. Brooke played several seasons in the Australian Football League national women’s competition (WAFL), and has recently transitioned to becoming a coach. Dr Mentiplay (@MentiplayB) has a background in sport and exercise science and completed his PhD in 2017. Ben is currently a lecturer and research Fellow at La Trobe, with a strong interest in biomechanics.

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On this week’s episode, we are joined by Dr Mary O’Keeffe (T: @MaryOKeeffe007) to discuss how clinicians can better manage patients with low back pain. Mary is a physiotherapist and a Marie Skłodowska-Curie Postdoctoral Fellow. Mary was awarded her PhD in 2017, in which she examined multidimensional rehabilitation for the individual with chronic back pain. Mary’s research now focuses on changing clinicians’ behaviour, improving diagnostic labels of low back pain, and communicating healthcare messages in the media. In this 20-min podcast, Mary explores clinicians’ common misconceptions about low back pain and how we can better address psychosocial aspects of care.

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On this week’s episode, we are joined by A/Prof Daniel Belavy (T: @BelavySpine) from the Institute of Physical Activity and Nutrition at Deakin University in Melbourne. A/Prof Belavy is a back pain and spine researcher, and Leader of the Spine Research Group at Deakin. In this 17-min podcast, A/Prof Belavy discusses: • the most effective exercises to improve pain, physical function and mental in adults with non-specific chronic low back pain • how running and cycling affect spine health • how sitting and sedentary behaviour affect spine health

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Dr. Mark Matthews (@Mark_MatthewsNZ) is a Lecturer at Ulster University in Belfast, Northern Ireland. Prof. Bill Vicenzino (@Bill_Vicenzino) is Chair in Sports Physiotherapy and Director of Sports Injuries Rehabilitation and Prevention for Health (SIRPH) research unit at the University of Queensland in Brisbane, Australia. In this episode, Dr. Erin Macri (@Erin_Macri) asks these clinician-researchers about their recent trial comparing foot orthoses to hip exercises, and how their results change what we think we know about managing patellofemoral pain. Part 1 – The FOHX trial for patellofemoral pain: webinar https://espace.library.uq.edu.au/view/UQ:cc0ee60 Part 2 – Patellofemoral pain panel discussion https://espace.library.uq.edu.au/view/UQ:c813701

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What is COVID myocarditis and how strong is the data to create a link between COVID and potential arrhythmias? Was COVID myocarditis the leading factor in the recent decisions of some American athletic conferences to shut-down the fall sports season? What are the criteria to start participation again?

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by sports medicine physicians and internationally renowned experts on Sports Cardiology Dr. Jonathan Drezner and Dr. Michael Ackerman, who have both been influential in the debate on whether a Collegiate Athletic season can safely occur in the midst of the ongoing COVID-19 Pandemic.

Dr. Jonathan Drezner is a Professor from the Department of Family Medicine and Director of the University of Washington Center for Sports Cardiology, past president of the AMSSM, team physician for the Seattle Seahawks, UW Huskies, and OL Reign and deputy editor of the BJSM.

Dr. Michael Ackerman is a Professor of Medicine, Pediatrics, and Pharmacology at the Mayo Clinic College of Medicine and Science. He is the Director of the Windland Smith Rice Genetic Heart Rhythm Clinic and Windland Smith Rice Sudden Death Genomics Laboratory, as well as the president of the Sudden Arrhythmia Death Syndromes (SADS) Foundation.

In this 40 minute conversation Drs. Drezner and Ackerman addressed the following topics: What is COVID myocarditis and why is it so concerning? How strong is the link between COVID-19 and was this a driving factor in the cancelling of the FALL sports season by some collegiate conferences? What metrics need to be satisfied in order to safely return to play, and will that occur this year.

Health and Well Being Considerations for PAC-12 Institutions: Guidance for Local Planning for Return to Sporting Activity

https://xs.pac-12.com/2020-08/Pac-12%20Covid-19%20Return%20to%20Play%20Considerations%2008.10.2020.pdf

Puntmann VO, Carerj ML, Weiters I. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916 Baggish A, Drezner JA, Kim J, et al. Resurgence of sport in the wake of COVID-19: cardiac considerations in competitive athletes https://bjsm.bmj.com/content/early/2020/06/18/bjsports-2020-102516 Maron BJ, Zipes DP, Kovacs RJ, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and the American College of Cardiology. Copublished in Circulation and the Journal of the American College of Cardiology 2015. https://www.acc.org/~/media/fb92803045d249ae91b715650dd0ebe4.pdf Pelliccia A, Solberg EE, Papadakis M, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). European Heart Journal 2019;40:19. https://academic.oup.com/eurheartj/article/40/1/19/5248228

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There has been a huge shift in golfers over the last 10 to 15 years with many more golfers at the top of the game such as Tiger Woods, Rory Mcllroy and Brooks Koepka focusing on Strength and Conditioning (S&C) to improve performance. COVID-19 has stopped many sporting events and has provided some a unique opportunity to focus on S&C. Bryson DeChambeau took full advantage of this putting on large amounts of muscle and is the latest golfer to demonstrate the benefits of S&C in golf performance. In this podcast Dan Coughlan explains to Will Wynter Bee the shift in S&C in golf and how the different S&C programmes used by tour players can improve performance while minimising injury risk. He also discusses the S&C set up on the European tour. Additional information. https://bjsm.bmj.com/content/bjsports/53/1/13.full.pdf?casa_token=SP73J6k2B4AAAAAA:EmiTi99T9da2ALJWIbVB350UmxsyeNLtkCz43HLNyVAGaDqzP9F1bJZC6_ReinWhYHzI8TLCTvA

https://shapeamerica.tandfonline.com/doi/abs/10.1080/02640414.2018.1559972#.Xw8soZNKhTY

https://sportperfsci.com/strength-and-conditioning-in-golf-probability-of-performance-impact/

Dan’s Twitter and Instagram accounts

https://twitter.com/etpi?lang=en

https://www.instagram.com/etpi_performanceunit/

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Are injury recurrences due to a return to sport prior to adequate biological healing? Can we accurately measure stages healing with imaging or blood tests? Professor Erik Witvrouw discusses the importance of respecting biological healing in sports musculoskeletal injuries with BJSM’s Liam West.

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Language, and how we use it, has a powerful influence on driving performance and clinical outcomes. Nick Winkelman, Head of Athletic Performance & Science for the Irish Rugby Football Union, has spent considerable time studying how effective communication can enhance performance. During this podcast with Dr Sean Carmody, Nick draws on the content from his book The Language of Coaching: The Art & Science of Teaching Movement to assess how visual cues and metaphors can be applied to improve your clinical or coaching practice.

The Language of Coaching: The Art & Science of Teaching Movement

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Dr. Andrea Mosler is a specialist sports physiotherapist and research fellow at La Trobe University, Melbourne. In this podcast, Liam West poses the questions that see Dr. Mosler explain how you should approach the prevention and management of hip and groin pain in athletes. She describes findings from her PhD and gives you the listener some clinical pearls to add to your “hip and groin” treatment toolbox!

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Dr Mackenzie Herzog (@MackenzieHerzog) has a PhD in Sports Injury and Orthopaedic Epidemiology from the University of North Carolina at Chapel Hill. She is currently a Lead Epidemiologist on the Injury Surveillance and Analytics team at IQVIA. She was part of a team assessing the risks of sustaining an ankle sprain whilst playing in the NBA across four seasons. In this podcast we explore the findings from the paper (published in AJSM), the need to collect robust data to inform injury prevention strategies, how data science and sports epidemiology is evolving and her insights on working with teams in the NBA and NFL.

https://www.iqvia.com/

Herzog et al. Ankle Sprains in the National Basketball Association, 2013-2014 Through 2016-2017. American Journal of Sports Medicine, 2020. 47;11: 2651-2658. https://journals.sagepub.com/doi/10.1177/0363546519864678

Bahr R, et al. International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS)). British Journal of Sports Medicine, 2020;54:372-389. https://bjsm.bmj.com/content/54/7/372.info

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Dr. Dan Rhon (T: @danrhon) is an active researcher for the US Department of Defence, a consultant and assistant professor at both Duke (North Carolina) and Baylor (Texas) Universities. He attended a manual therapy clinical fellowship at Brooke Army Medical Center in Texas, is a fellow in the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT), and an orthopaedic clinical specialist (OCS). He completed a postdoc research fellowship through the University of Utah and has a strong research interest in the effectiveness of clinical care pathways for musculoskeletal disease, both at primary and specialty care levels, and the intersection of these two. He was recently part of the investigating team who published a study on the effects of corticosteroid vs physiotherapy for managing knee osteoarthritis, published by the prestigious New England Journal of Medicine. In this discussion with associate editor Paul Blazey (T: @blazey85), he focuses on the findings of the study and the implications for the effective management of one of the most prevalent conditions seen in MSK clinics across the world.

References Deyle, GD., Allen, CS., Allison, SC., et al. Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee. N Engl J Med 2020; 382:1420-1429 DOI: 10.1056/NEJMoa1905877 https://www-nejm-org.ezproxy.library.ubc.ca/doi/10.1056/NEJMoa1905877

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Twitter: @Happysport_dk According to the literature, a substantial reduction in injury rates in youth sport is achievable. So why isn’t this translating into meaningful injury prevention in the real world? And what can we do about it? In this episode, Dr. Erin Macri asks Dr. Merete Møller to share her powerful insights on this topic and to introduce a novel research project (the HAPPY project) that aims to bridge the gap from injury prevention trials to real-world results on the field.

Related Articles and Links Soomro N, Sanders R, Hackett D, et al. The Efficacy of Injury Prevention Programs in Adolescent Team Sports: A Meta-analysis. Am J Sports Med. 2016;44(9):2415‐2424. doi:10.1177/0363546515618372 Owoeye OBA, Palacios-Derflingher LM, Emery CA. Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors. Clin J Sport Med. 2018;28(4):325‐331. doi:10.1097/JSM.0000000000000462 Emery CA, van den Berg C, Richmond SA, et al. Implementing a junior high school-based programme to reduce sports injuries through neuromuscular training (iSPRINT): a cluster randomised controlled trial (RCT) [published online ahead of print, 2019 Dec 10]. Br J Sports Med. 2019;bjsports-2019-101117. Sakata J, Nakamura E, Suzuki T, et al. Throwing Injuries in Youth Baseball Players: Can a Prevention Program Help? A Randomized Controlled Trial. Am J Sports Med. 2019;47(11):2709‐2716. doi:10.1177/0363546519861378 Bekker, S., Paliadelis, P. & Finch, C.F. The translation of sports injury prevention and safety promotion knowledge: insights from key intermediary organisations. Health Res Policy Sys 15, 25 (2017). https://doi.org/10.1186/s12961-017-0189-5 O'Brien J, Finch CF. The implementation of musculoskeletal injury-prevention exercise programmes in team ball sports: a systematic review employing the RE-AIM framework. Sports Med. 2014;44(9):1305‐1318. doi:10.1007/s40279-014-0208-4 Lindblom H, Carlfjord S, Hägglund M. Adoption and use of an injury prevention exercise program in female football: A qualitative study among coaches. Scand J Med Sci Sports. 2018;28(3):1295‐1303. doi:10.1111/sms.13012 Ageberg E, Bunke S, Lucander K, Nilsen P, Donaldson A. Facilitators to support the implementation of injury prevention training in youth handball: A concept mapping approach. Scand J Med Sci Sports. 2019;29(2):275‐285. doi:10.1111/sms.13323 Richmond SA, Donaldson A, Macpherson A, et al. Facilitators and Barriers to the Implementation of iSPRINT: A Sport Injury Prevention Program in Junior High Schools. Clin J Sport Med. 2020;30(3):231‐238. doi:10.1097/JSM.0000000000000579

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On this week’s episode, we chat with BJSM Deputy Editor Dr Jane Thornton MD PhD about how clinicians can support athlete mental health during COVID-19. As a World Champion and former Olympic rower for Canada, Dr Thornton has been supporting Canadian athletes experiencing mental health issues related to COVID-19. In partnership with sports psychiatrist Dr Carla Edwards, Dr Thornton has also produced a range of mental health resources to help athletes combat COVID-19 anxiety. In this 25–minute podcast, Dr Thornton discusses her own experiences as an Olympic athlete, how to prepare for adversity, manage fear, and reset training and competition goals.

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Associate Editor Paul Blazey (T: @blazey85) talks with Professor Chad Cook from Duke University (North Carolina, USA). Chad is a Professor in the Orthopaedic Surgery Division of Physical Therapy, with an interest in the effective diagnosis, intervention, and outcomes assessment of conservative and surgical treatment of orthopedic-related conditions.

Today we focus on Chad’s experience with orthopaedic testing, especially when applied to femoroacetabular impingement syndrome, and the ability to effectively assess this condition over telehealth.

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The global COVID-19 Pandemic has changed the way we practice medicine and live our daily lives. Things we traditionally have taken for granted now pose major challenges, and among those is the challenge of remaining active. On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by sports medicine physician and fitness enthusiast Dr. Jordan Metzl to discuss strategies for continuing to encourage physical activity even during “social distancing.” Dr. Metzl is a pediatrician with subspecialty training in sports medicine whose goal is to help patients and athletes maintain physically active lifestyles and recover from injuries to return to their chosen forms of activity. He has written multiple books and is well known for his Iron Strength workout series. To learn more about Dr. Metzl’s work, or sign-up for his listserv to be notified of future classes please visit his website at https://drjordanmetzl.com

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Dr. Ben Sporer (T: @ben_sporer) is the current director of performance strategy, research and innovation at the Vancouver Whitecaps (MLS). He trained as an exercise physiologist and worked with the Canadian Sport Institute, supporting multisport, cycling and snowboarding athletes across three full Olympic cycles (summer and winter games). He brings a wealth of knowledge about developing elite athlete performance and wellbeing, as well as what it takes to build a performance team. Today in the discussion with associate editor Paul Blazey (T: @blazey85), we dive into:  what impact Ben’s exercise physiology background had on his management of the medical arm of his performance team  how the Whitecaps use data science to support medical and team decisions  what Ben looks for in developing a high performance medical and support team  how the team has managed the lockdown and the challenges of return to play in elite sport post covid-19

Resources Catapult Sport Data Capture Systems - https://www.catapultsports.com/

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On this week's episode, we are joined again by Prof Fiona Bull to discuss why and how we should stay active in self-isolation. Prof Bull is the Programme Manager in the Department of Prevention of NCDs at the WHO in Geneva. She leads the WHO’s global work on physical activity. In this 15-minute podcast, Prof Bull explains what the WHO is doing to support countries increase physical activity in times of COVID-19 and outlines physical activity research priorities at a global level. #HealthyAtHome @WHO https://www.who.int/news-room/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---physical-activity

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In this cutting-edge podcast with Dr James Hull – a leading authority on respiratory health in athletes - we discuss the challenges facing athletes and healthcare professionals following infection with the novel coronavirus. We cover a few case-studies, and practical points for all SEM professionals to consider.

Additional Links: Link to the published article in the Lancet Respiratory Medicine journal https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30175-2/fulltext#.XrHWOYDlNMw.twitter Dr James Hull’s twitter page: https://twitter.com/Breathe_to_win Link to Book: https://www.amazon.co.uk/Complete-Guide-Respiratory-Care-Athletes/dp/1138588350/ref=redir_mobile_desktop?ie=UTF8&qid=1586959229&ref_=tmm_pap_title_0&sr=8-1 BJSM Education Review on EILO https://bjsm.bmj.com/content/52/18/1211 BJSM podcast on EILO https://soundcloud.com/bmjpodcasts/do-you-know-athletes-who-have-a-wheeze-and-get-short-of-breath-easily-surely-asthma-right?in=bmjpodcasts%2Fsets%2Fbjsm-1&fbclid=IwAR3tViVFdNwqKZ04hU43y57HeuPcskYQ5OPuGoCJCF4hIlLd-BlL3k2SXVU

Complete Guide to Respiratory Care in Athletes

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Are you involved in the care of athletes, and now planning their return to sport? Have you fully considered their cardiac health, especially in those with suspected/confirmed novel coronavirus infection? In this 15-minute podcast with Prof Jon Drezner, one of the world’s leading Sports Cardiologists & Team Physicians, we dive into some case-studies and some of the emerging evidence in this interesting area. Please get in touch with us if you have any questions! Additional resources: Link to BJSM blog: https://blogs.bmj.com/bjsm/2020/04/24/the-resurgence-of-sport-in-the-wake-of-covid-19-cardiac-considerations-in-competitive-athletes/ Link to free ECG e-Academy https://uwsportscardiology.org/e-academy/ecg-modules/

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Host Dr. Giorgio Negron, MD is joined by Dr. Kenneth Mautner, MD on the AMSSM Sports Medcast to discuss orthobiologics, specifically PRP and stem cell treatments, and the current evidence for their use. Dr. Mautner is an associate professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedics Surgery at Emory University in Atlanta, GA. In this 20-minute conversation Dr. Mautner addresses the following topics: What is PRP and how did it become so popular in the musculoskeletal world? What the variabilities that are important to know in PRP? What is a stem cell? How do we obtain stem cells? How can it help with musculoskeletal conditions? What are these “pop-up” stem cell clinics and their products they are advertising? What research are you currently working on?

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In this Podcast, Dr Phil Hopley explains to Dr Will Wynter Bee the impact of the COVID crisis on athletes' mental health as well as discussing his role in setting up mental health services for the European tour. He also provides insights into how, clinically, he assesses and manages mental health conditions in elite athletes. Georgia Hopley discusses her research providing valuable insights into the prevalence of common mental health conditions in elite golfers. Useful links we discuss: Mental health in elite athletes: International Olympic Committee consensus statement (2019)- https://bjsm.bmj.com/content/53/11/667 Cognacity - https://www.cognacity.co.uk/ National institute of mental health - https://www.nimh.nih.gov/index.shtml Mind - https://www.mind.org.uk/information-support/tips-for-everyday-living/ Sane - http://www.sane.org.uk/ Calm - https://www.thecalmzone.net/

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Can we learn more from our patients than you might think? Do they hold the answers to the clinical question that you face? Dr. Osman Ahmed is an Associate Editor at BJSM, co-leading the “Patient Voices” section of the journal alongside Dr. Tracey Blake. Osman discusses how we can engage our patients/athletes to improve the clinical applicability of our research, and highlights some areas of medicine that have already benefited from this approach. Links of articles discussed on the podcast: https://bjsm.bmj.com/content/52/24/1547 https://www.jospt.org/doi/full/10.2519/jospt.2019.0106

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On the heels of a global pandemic, we have all been asked to quickly adapt to our new surroundings – in most cases our living room – and to carry on with delivering quality education. For many of us, this means scrambling to make our once classroom-based educational materials online-ready for the first time.

Where do we begin?

Dr. Erin Macri joins Dr. Jackie Whittaker in this BJSM episode to share tips and tricks for both delivering and receiving effective, high quality online education. Dr. Whittaker has delivered online university-level education for over six years, and her experience and insight are invaluable during these difficult times.

For a list of resources please visit the BJSM blog:

https://blogs.bmj.com/bjsm/2020/04/05/educators-in-a-dangerous-time-effective-online-healthcare-education-with-dr-jackie-whittaker/

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Runners are constantly trying to find the perfect shoe that will combine increased performance with decreased injury risk. In this podcast, Dr. Liam West poses the questions to Dr. Laurent Malisoux to explore whether the current body of research is able to guide the clinician as to which shoe type is perfect for which foot type. Dr. Malisoux is a key researcher at the Sports Medicine Research Laboratory at the Luxembourg Institute of Health. His area of research and expertise centres on running shoes and potential risk factors for injury.

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Assistant Dean at McMaster University, member of the FINA (World Swimming) and the IOC Working Group on Mental Health in Athletes, Dr Margo Mountoy (MD, Dip Sport Med [CASEM], PhD) shares practical insights. What 4 things should a team physician do to help an athlete who has mental health symptoms or a diagnosed mental health disorder. You’ll hear the FREE 2019 consensus paper referred to: http://ow.ly/hTpS50yKx7K

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Football is the world's most popular sport, captivating the hearts and minds of millions of people every day. Supporting our national team or local club evokes a deep sense of pride, and provides a consistent source of entertainment. How could something so addictive be so good for you? Football has been found to be an effective adjunct for the treatment and prevention of a wide variety of conditions such as depression, some cancers and type 2 diabetes. In this podcast, Dr Daniel Parnell explains to Dr Sean Carmody the emerging research behind the broad spectrum health benefits attached to participating in football.

Dr Daniel Parnell is a Senior Lecturer in Sports Business at the University of Liverpool and co-author of Football as Medicine: Prescribing Football for Global Health Promotion.

Dr Sean Carmody is a doctor based in London.

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Dr Imran Sajid is a frontline clinician, health policy maker, educator and researcher with a keen interest in behavioural economics. This podcast takes a 30,000-foot view of some of our daily clinical approaches—and dives down into specific cases to make important points. How do you get the right care to the right patient at the right time. Is there overdiagnosis and overtreatment in our field—the field of musculoskeletal care? Fee-for-service underpins a great deal of treatment in MSK medicine. Are our diagnoses (such as ‘locked knee’) really as solid as we may have been taught in the early 2000s? Do very common surgical procedures such as knee and shoulder arthroscopy add value for the patient? Dr Sajid gives 3 tips to improve the value of care for patients: 1) We need system change so the right care is provided at the right place. This generally requires a shift towards shared care in the community setting. 2) There needs to be a culture change away from the structural model—most health care burden does not derive from structures that can be fixed simply with a pill or a screw. 3) Clinicians need to be healthy skeptics about what works and what doesn’t. Humility helps! Don’t fall prey to those powerful cognitive biases. Just because we know about them doesn’t make them go away. Think of your favourite optical illusion! It’s hard to ‘see’ the truth!

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Dr. Rachel Lampert, MD joins host Devin McFadden, MD on AMSSM’s Sports Medcast (T: @TheAMSSM) to discuss athletic participation in athletes with cardioverter-defibrilators for known cardiac abnormalities. In this 20 minute conversation Dr. Lampert addresses the following topics: - What are the common causes of sudden cardiac death in athletes? - What is the data to support disqualifying patients with known cardiac disease (cardiomyopathies and channelopathies) from sports, and could they potentially participate safely? - How will future studies impact the way we practice further?

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Has the principle of shared decision making in athletes with known cardiac abnormalities placed our athletes, teams, and medical system at risk? Are there situations where accepted medical standards and risk management trump patient autonomy? What further steps can we take to generate the data needed to ensure that the athletes we clear in the future are safe to participate? On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Devin McFadden, MD is joined by internationally recognized expert Dr. Sanjay Sharma, MD to discuss the risks and benefits encountered while making clearance decisions in athletes with known cardiac abnormalities.

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Nanette is a Chartered Psychologist and a Fellow of the British Association of Sport and Exercise Sciences. She took a break from writing the 4th edition of ‘Psychology of Physical Activity” to speak with BJSM’s outgoing Editor-in-Chief Karim Khan (@BJSM_BMJ)

In podcast 2 of 2 she discusses: The revolutionary physical activity and weight control intervention for men—Football Fans in Training. http://ow.ly/zOIv50yfYd0. She revisits the topic of too much sitting—which is different to physical inactivity. Prof Mutrie argues that we promote the short-term benefits of walking to the public. “You will get a boost in your mood and you will sleep better by just having a 10-minute walk.” That’s how Coke promotes their product—it’s not about promising long-term health benefits. What do you think about that? And she discusses ‘outrunning a bad diet’, weekend warriors and The Daily Mile. You’ll love this episode as much as the record-breaking first of this duet. If you missed that one here’s the link: http://ow.ly/NNtg50yfYk3

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Nanette Mutrie (@NanetteMutrie) has been Chair of Physical Activity for Health at the University of Edinburgh since July 2012. She directs the Physical Activity for Health Research Centre (PAHRC) in the Institute for Sport, Physical Education and Health Sciences. In January 2015 Nanette was awarded an MBE in the New Year's Honours list for services to physical activity for health in Scotland. Nanette is a Chartered Psychologist and a Fellow of the British Association of Sport and Exercise Sciences—hence the expertise in behavioural interventions. She took a break from writing the 4th edition of ‘Psychology of physical activity” to speak with BJSM Editor in Chief Karim Khan (@BJSM_BMJ) This podcast (part 1 of 2) will help you; appreciate the power for walking for health and mental health even more than previously, realise why ‘brisk’ may not be the ideal adverb to associate with walking for certain populations. The chat swings from practical tips about which technology to consider to capture walking, to tips for physios in the clinic and to Prof Mutrie explaining that walking is one factor that can contribute to addressing the Climate Crisis.

Enjoy!

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Did you know that water can stop bullets? Dr. Erin Macri caught up with Dr. Ben Waller to learn more about the untapped and under-recognized power of water and its potential applications in everything from rehabilitation to high level athletic conditioning. Dr. Ben Waller is the Scientific Chair of the Finnish Sport physiotherapy association; Adjunct Professor at Reykjavik University, and Lecturer for the International Aquatic Therapy Faculty. Prior to this he was Senior Researcher at the University of Jyväskylä in Finland, where he also completed his PhD and postdoctoral work, all focused on aquatics. Ben’s current research is focused on quantifying and optimizing the prescription of aquatic exercise in the PAPESH research group in Reykjavik University (https://en.ru.is/papesh/).

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Are passive therapies making patients worse? Does stretching help? Where do the bio, psycho and social components fit into patient management? This week Tom Goom joins us to chat about how to avoid the common pitfalls all clinicians can make. Known to many in the SEM community as the ‘Running Physio’, Tom is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course.

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In our first episode of 2020, Associate Professor Shona Halson PhD joins us to chat about why our new year’s resolution should be to get more sleep!

Shona is an Associate Professor in the School of Behavioural and Health Sciences at Australian Catholic University. Shona has a PhD in Exercise Physiology, recently finished up close to 16 years working at the Australian Institute of Sport as a senior recovery physiologist, and has been the Director of the Australian Olympic Committee Recovery Centre for the last three summer Olympic games.

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At the 6 th International Patellofemoral Pain Research Retreat held in Milwaukee in October 2019, Erin Macri pulled four clinician-scientists (Dr. Simon Lack, Dr. David M. Bazett-Jones, Dr. Gretchen Salsich, Dr. Christian Barton) into the ring, with a goal of teasing out key concepts and providing guidance on how to incorporate dynamic knee valgus into the evaluation and treatment of individuals with patellofemoral pain. Should dynamic knee valgus always be treated? Find out in this episode.

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This podcast features the heavily in-demand Dr Enda King. Enda is Head of Performance Rehabilitation at the Sports Surgery Clinic in Dublin, and world-leading authority on Hip, Groin and ACL injuries. In this 20-minute masterclass, Enda provides cutting-edge insight on a number of topics including: - The role of biomechanical factors in injury prevention and rehabilitation - Key biomechanical and clinical milestones in the rehabilitation process - How to identify and address common biomechanical patterns following ACL injury - Assessing biomechanical factors in the field You can find Enda on twitter: https://twitter.com/enda_king If you would like to keep up to date with the 10 th Arsenal SEMS conference, you can find all the details here: https://www.arsenal.com/semsconference

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This week, Prof Lorimer Moseley joins us to explore how we can better apply contemporary understanding of pain in clinical practice. Lorimer is Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy at the University of South Australia. Prof Moseley’s research group - Body in Mind - investigates the role of the brain and mind in chronic pain. He has over 25 years of clinical experience and has authored hundreds of articles, as well as five books.

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What are the keys to good running form? Is there a magical number for step rate? Should we all be changing the way we run?

This week Tom Goom joins us to chat about gait retraining and its role in helping injured runners. Known to many in the SEM community as the ‘Running Physio’, Tom is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course.

In this 20-minute episode, Tom discusses the rationale for gait retraining, who needs it, how to assess the injured runner and his comprehensive gait retraining management plan.

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On this week’s episode, we are joined by Dr Louise Tulloh to dive into the biopsychosocial realm of patient management in sport and exercise medicine. Dr Tulloh was recently elected as President of The Australasian College of Sport and Exercise Physicians (ACSEP) and has been practicing sport and exercise medicine for over 20 years. In this 20-minute podcast, we discuss: · Why we should all take a more biopsychosocial approach in SEM · How to explore a patient’s individual psychosocial factors · How to ask about a patient’s motivation to get better · Tips for shared decision making · How to discuss weight loss with patients · What makes a patient ‘complex’

Don’t miss out on ACSEP’s 2020 Annual Conference 2020 (Feb 7-9) https://www.acsep.org.au/page/events/conference-2020

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One of the most important aspects of athletic performance is something we all do for a third of our lives, but until recently, had rarely been discussed. In the second of this two-part episode, Dr. Krys Bigosinski and Dr. Cindy Chang converse about the role of sleep in sports medicine. They cover topics including the role of sleep in sports performance, the challenges of travel for the elite athlete, the impact of a busy schedule on sleep for collegiate athletes, and the role of sleep in concussion care.

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One of the most important aspects of athletic performance is something we all do for a third of our lives, but until recently, had rarely been discussed. In the first of this two-part episode, Dr. Krys Bigosinski and Dr. Cindy Chang converse about the role of sleep in sports medicine. They cover topics including the role of sleep in sports performance, the challenges of travel for the elite athlete, the impact of a busy schedule on sleep for collegiate athletes, and the role of sleep in concussion care. Dr. Chang is currently a Clinical Professor in the Departments of Orthopaedics and Family & Community Medicine at UCSF. Prior to this, she has served as president of AMSSM, was the head team physician for UC-Berkeley, and has published many papers and textbook chapters in sports medicine, including co-authoring a chapter titled The Role of Sleep in the Psychological Well Being of Athletes in the book Mental Health in the Athlete: Modern Perspectives and Novel Challenges For The Sports Medicine Provider. She was also active in writing the section on the effect of sleep on mental health in the upcoming AMSSM position statement on Psychological Issues in Athletes.

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Dr Alex Hutchsinon PhD chats about the historic breakthrough that was equated to humans setting foot on the moon. Alex is an award-winning journalist, author and athlete who has a keen interest in exploring the science of endurance, fitness, and health.

In this 20-minute podcast, Alex discusses: - The significance of Eliud Kipchoge’s unofficial record and its impact on our beliefs about the limits of human performance - Factors limiting and facilitating endurance performance in running - Kipchoge’s shoes - Regulating footwear in road running - What we can learn from Kipchoge’s fueling strategy - The next big psychological barriers in sport

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In this special Athlete Voice edition of the podcast, we chat with Olympic and World Champion rifle shooter Abhinav Bindra about managing the mental pressures of elite sport. Abhinav is a 5 x Olympian, entrepreneur and active member of the IOC Athlete’s Commission. In this 20-minute podcast, Abhinav discusses: · How he found the sport of rifle shooting · Celebrating the ‘process’ throughout his decorated 22-year career · The importance of prevention, prehab and physical awareness · His current charitable work in India to prioritise athlete wellbeing and grow sport at the grassroots level Don’t miss out on the IOC World Conference Prevention of Injury & Illness in Sport (March 2020) https://ioc-preventionconference.org/

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On this week’s episode, we chat with Dr Louise Tulloh about overcoming barriers for women in medical leadership. Dr Tulloh was recently elected as President of The Australasian College of Sport and Exercise Physicians (ACSEP) and has been practicing sport and exercise medicine for over 20 years. In this 20-minute podcast, we discuss: · Dr Tulloh’s new role as president of ACSEP · Barriers to women attaining leadership positions in medicine and how we can overcome them - Gender stereotypes within leadership - Changing sports culture and creating equity within organisations Don’t miss out on ACSEP’s 2020 annual conference 2020 (Feb 7-9) https://www.acsep.org.au/page/events/conference-2020

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Welcome to this BJSM podcast with Elaine Wyllie MBE, a former headteacher in Stirling, Scotland who launched the hugely popular ‘Daily Mile’ initiative. She will be speaking at the BASEM conference in Glasgow on 21st November, but in advance we thought we’d get a few sneaky glimpses into what she will be discussing.

For tickets to the BASEM conference in Glasgow: you can find them on the link here: https://basem.co.uk/event/basem-2019-annual-conference/

For some of the research behind the Daily Mile, follow this link: https://thedailymile.co.uk/research/

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For our 400th episode, we chat with Amelia Boone--four-time Obstacle Racing World Champion, ultrarunner and attorney--about her battle with anorexia for the past 20 years. In July 2019, Amelia wrote publicly about her eating disorder, shining a light on RED-S, athlete mental health and recovery. In this 20-minute podcast, we discuss: · Amelia’s motivation for sharing her story · The impact of success on perception of food and body image · Common myths about athletes and eating disorders · What treatments did (and didn’t) work well with different clinicians · How clinicians should change the way we are talking about eating disorders

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In this BJSM podcast, we hear from Associate Professor Jon Patricios, a South African Sport & Exercise Medicine physician who has extensive experience of working in Rugby Union. He has an interest in concussion, having written the concussion protocols for the BokSmart injury prevention programme and he is a member of the World Rugby Concussion Advisory Group. In this discussion, we discuss (among various things) - How things have changes from an immediate care point of view - How the HIA works at present? - The tools available that could help pick up a concussion at the professional level - What happens after match-day in terms of follow-up/advice - Clinical tips in terms of communicate the protocol to players/staff - Common pitfalls do you encounter when it comes to RTP after a concussion

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Dr Martin Raftery and Dr Ross Tucker join the BJSM to discuss World Rugby’s injury prevention journey, and most recent player welfare initiatives. We also hear from World Rugby chairman Sir Bill Beaumont on how rugby has evolved in this regard. All links can be found in the e-Edition.

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In this podcast, we are joined by Dr Stephen West to discuss all things load. Stephen recently completed his PhD at the University of Bath, looking into the Epidemiology of injury and associated risk factors in Professional Rugby Union.

Topics covered include: - Athlete monitoring - The way we capture data - Practical tips for those working in sport - Where are the next big gains likely to be found?

Resources: https://www.semanticscholar.org/paper/Athlete-Monitoring-in-Rugby-Union%3A-Is-Heterogeneity-West-Williams/b8e39759a7f83fb57c9c571d1212db8ea16bf406 https://researchportal.bath.ac.uk/en/publications/patterns-of-training-volume-and-injury-risk-in-elite-rugby-union- https://researchportal.bath.ac.uk/en/publications/better-way-to-determine-the-acute-chronic-workload-ratio

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Should we still be using ice and cryotherapy? Do we need to foam roll before or after working out? Are we wasting our money on compression gear? On this week’s BJSM podcast, award-winning science writer and best-selling author Christie Aschwanden (T: @cragcrest) joins BJSM’s Daniel Friedman (T: @ddfriedman) to cut through all the hype and explain what works and what doesn’t when it comes to recovery. Christie Aschwanden is the author of New York Times bestseller GOOD TO GO: What the Athlete in All of Us Can Learn From the Strange Science of Recovery and co-host of EMERGING FORM, a podcast about the creative process. She’s the former lead science writer at FiveThirtyEight and was previously a health columnist for The Washington Post. Christie is a frequent contributor to The New York Times. She’s also been a contributing editor for Runner’s World. https://christieaschwanden.com/ In this podcast, Christie dissects the evidence for common recovery methods and discusses: - The changing definition of recovery and how we measure it - Ice and cryotherapy - Massage and foam rolling - Which recovery methods actually work and how to optimise them - The best indicators of recovery - How to improve the quality of recovery research

Mentioned in this podcast: Good to Go - https://www.goodtogobook.com/ Methodology problems in sport science - https://fivethirtyeight.com/features/sports-science-is-finally-talking-about-its-methodology-problems/

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Predicting and preventing injuries is seen as the ‘holy grail’ of sports medicine. The literature is brimming with efforts to understand injury prevention, and popular buzzwords such as ‘artificial intelligence’ has seen the emergence of questionable methods to predict sports injuries. In this podcast, Dr Nicol van Dyk speaks to Dr Sean Carmody about current concepts in injury prevention and the validity of the evidence underpinning them. Nicol draws on the experience of his PhD investigating risk factors for hamstring injuries in professional football to forecast the future for preventive efforts in elite sport. Key resources discussed in the podcast have been included below, and if you want to hear more on the topic, Nicol will be presenting at the South African Sports Medicine Association Conference in October 2019. Key Resources: Why screening tests to predict injury do not work—and probably never will…: a critical review Do not throw the baby out with the bathwater; screening can identify meaningful risk factors for sports injuries Risk factors for hamstring in football - thinking fast and slow by Nicol van Dyk Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study The quadrant of doom and hamstring injuries: sexy but too easy? The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players The acute-chronic workload ratio: a critical appraisal Aspetar – Hamstring Issue The training—injury prevention paradox: should athletes be training smarter and harder?

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Joining Dr Steffan Griffin in the studio this week are Drs Martin Raftery and Ross Tucker, Chief Medical Officer and one of the lead Research Scientists at World Rugby respectively. Following on from their debut podcast two years ago, we dive into rugby’s complex relationship with concussion, and the journey that World Rugby have been on over the last few years to tackle the issue. Much of the resources discussed will be in the special #RugbyMedicine e-Edition, that will be launched in time for #RWC2019. In this podcast we cover: - The concussion journey rugby has been through, and the interventions that have been trialled/implemented - The high tackles sanction framework - Recent law trials - Advice to other governing bodies looking to prioritise player welfare

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Is iliotibial band pain a friction problem? Or a load problem? On this week’s BJSM podcast, Dr Rich Willy (T: @rwilly2003) and BJSM’s Daniel Friedman (T: @ddfriedman) discuss the clinical management of iliotibial band pain. Dr. Richard Willy PT, PhD, is an Assistant Professor in the School of Physical Therapy, University of Montana (Missoula, MT, USA). He received his PhD in Biomechanics and Movement Science from the University of Delaware and his master of physical therapy from Ohio University. In addition to his research, Dr. Willy has been a clinician for 18 years specialising in the treatment of the injured runner. His research aims to develop clinically effective treatments for patellofemoral pain syndrome, Achilles tendon injuries and tibial stress fractures. In this podcast, Dr Willy discusses: · How to assess the injured runner with ITB pain · Misconceptions about ITB pain – it’s not a friction problem and you need some tightness! · How to progress the rehabilitation in managing ITB pain · Is there a role for stretching and foam rolling? The case study used in this podcast was originally from Pegrum James, Self Alex, Hall Nick. Iliotibial band syndrome BMJ 2019; 364 :l980 https://www.bmj.com/content/364/bmj.l980

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CrossFit: dangerous fad or fitness panacea? The AMSSM talks safety with Drs Sean Rockett and Robert Oh.

Few topics in sports draw such universally strong opinions from medical providers as that of CrossFit. Most seem to love or hate it, but are their strong opinions justified? Does current data back-up the concerns many of us have regarding the safety of this sport? What are the common injury patterns that are found? Host Dr. Devin McFadden, MD is joined by Dr. Sean Rockett, MD and Dr. Robert Oh, MD to explore these topics and more on the AMSSM Sports Medcast.

Dr. Sean Rockett is an Associate Professor of Orthopedic Surgery at Tufts University School of Medicine, president of Orthopedics New England and author of 321GoMD.com an injury prevention website for CrossFitters. He is head of the Orthopedic division for the Medical team for The CrossFit Games. Dr. Robert Oh, Sports Medicine physician and CrossFitter for 12 years. He’s the Chief of the Family Medicine Dept at Madigan Army Medical Center and Fellowship director for the Leader and Faculty Development at Madigan.

References: 1. Sport Med - open. 2018;4(1):11. doi:10.1186/s40798-018-0124-5. 2. J Sports Med Phys Fitness. 2017;57(9):1147-1153. doi:10.23736/S0022-4707.16.06827-4 3. Orthop J Sport Med. 2018;6(10):2325967118803100. doi:10.1177/2325967118803100 4. J Sport Rehabil. 2018;27(3):295-299. doi:10.1123/jsr.2016-0040. 5. Sport Med. 2017;47(3):479-501. doi:10.1007/s40279-016-0575-0 6. Annals of epidemiology 2006; 16(9):712-719.) 7. Work Heal Saf. 2017. doi:10.1177/2165079916685568. 8. Mil Med. 2016;181(7):627-637. doi:10.7205/MILMED-D-15-00273 9. US Army Med Dep J.:36-47. http://www.ncbi.nlm.nih.gov/pubmed/24146241. Accessed August 5, 2018.

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“Only by speaking out can we create lasting change” On this week’s BJSM podcast, Prof Margo Mountjoy (T:@margomountjoy) joins BJSM’s Daniel Friedman (T:@ddfriedman) to discuss harassment and abuse in sport. Prof Mountjoy is an Associate Clinical Professor in the Department of Family Medicine at McMaster University Medical School and Regional Assistant Dean of the Michael G. DeGroote School of Medicine, McMaster University. She is also a clinician scientist – sports medicine physician practicing at the Health + Performance Centre at the University of Guelph, as the Clinical + Academic Director. Prof Mountjoy works for several International Sports organizations in the field of sports medicine including the International Olympic Committee (Games Group), the International Federation for aquatics (FINA), the Association of Summer Olympic International Federations and for the World Anti-Doping Agency. In this episode, Prof Mountjoy discusses: · The Larry Nassar case · Sexual abuse in sport · MeToo movement’s impact on sport · Types of abuse and harassment and the impact on the athlete vs organisation · The Olympic Athlete Welfare Programme · Tips for clinicians to help prevent abuse and harassment in sport Mentioned in this podcast: Mountjoy M ‘Only by speaking out can we create lasting change’: what can we learn from the Dr Larry Nassar tragedy? British Journal of Sports Medicine 2019;53:57-60. https://bjsm.bmj.com/content/53/1/57 The Larry Nasser Tragey – BMJ https://blogs.bmj.com/bmj/2018/03/29/margo-mountjoy-on-the-larry-nassar-tragedy-never-again/ Reardon CL, Hainline B, Aron CM, et al Mental health in elite athletes: International Olympic Committee consensus statement (2019) British Journal of Sports Medicine 2019;53:667-699. https://bjsm.bmj.com/content/53/11/667 Safeguarding athletes from harassment and abuse in sport IOC toolkit https://www.iwf.net/wp-content/uploads/downloads/2018/10/IOC_Safeguarding_Toolkit_ENG.pdf You can find two of Professor Mountjoy’s previous podcasts here: Relative energy deficiency syndrome (RED-S): http://ow.ly/VCZK50v2A7f Psychological abuse in sport (2017) http://ow.ly/ljJt50v2Amt (Harrassment, abuse, bullying)

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Jonathan Hanson is a Sports Medicine consultant with a background in emergency medicine. He works as team doctor for the Glasgow Warriors rugby union team, has worked as an Emergency care advisor to the FA and worked on Head injury systems and immediate care with the Senior men at the 2018 FIFA World Cup. Given his background, he has a particular interest in the human factors associated with working in SEM, especially in a pitch-side/pre-hospital setting. In this podcast, we discuss:  What is meant by the term ‘human factors’?  How do we develop these? Can they be developed at an individual level, or do they need to be embraced more broadly by a team/department as a whole?  Examples of how human factors have affected practice  Getting people to ‘buy-in’ to the importance of human factors? For listeners, you can follow Jonathan @SportsDocSkye – and the links to the resources we mentioned can be found below: BJSM Three-Part Blog Series: https://blogs.bmj.com/bjsm/2019/04/30/human-factors-in-sports-medicine-part-1/ https://blogs.bmj.com/bjsm/2019/05/17/human-factors-in-sports-medicine-part-2/ https://blogs.bmj.com/bjsm/2019/05/25/human-factors-part-3/ Just a routine operation: https://www.youtube.com/watch?v=JzlvgtPIof4 13 minutes to the moon: https://www.bbc.co.uk/programmes/w27vq4km

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On this week’s BJSM podcast, BJSM deputy editor Dr Jane Thornton (T: @JaneSThornton) joins Daniel Friedman (T: @ddfriedman) to discuss physical activity counselling. Dr Jane Thornton MD PhD is a sports medicine physician and researcher currently based in London, Canada, and is an international advocate for physical activity. She has a wealth of international experience in the field of preventative medicine, with a particular passion for promoting physical activity as both prevention and treatment of chronic disease. Alongside a super impressive medical career, Dr Thornton is also a World Champion and former Olympic rower for Canada.

In Part 2 of this 2-part podcast, Dr Thornton discusses: · Her efforts leading the Canadian Medical Education Strategy · Physical activity resources for clinicians and patients · Examples for successful physical activity counselling initiatives around the world · What SEM clinicians can start doing today to help their patients become more physically active

Mentioned in this podcast: Make Your Day Harder http://www.makeyourdayharder.com/ PAPRICA (Switzerland) https://www.paprica.ch/ WHO Global Action Plan on Physical Activity https://www.who.int/ncds/prevention/physical-activity/gappa In-bed cycling for patients https://www.cbc.ca/news/canada/hamilton/biking-in-bed-is-good-for-icu-patients-says-new-mcmaster-study-1.3915472 Park Run https://www.parkrun.com/ PA prescription in Luxembourg http://www.sport-sante.lu/

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In this week’s BJSM podcast, BJSM deputy editor Dr Jane Thornton (T: @JaneSThornton) joins Daniel Friedman (T: @ddfriedman) to discuss physical activity counselling. Dr Jane Thornton MD PhD is a sports medicine physician and researcher currently based in London, Canada, and is an international advocate for physical activity. She has a wealth of international experience in the field of preventative medicine, with a particular passion for promoting physical activity as both prevention and treatment of chronic disease. Alongside a super impressive medical career, Dr Thornton is also a World Champion and former Olympic rower for Canada. In Part 1 of this 2-part podcast, Dr Thornton discusses: · Why physical activity is the single best thing we can do for our health · The evidence for physical activity prescription in primary care · The shared decision making of how to prescribe physical activity to patients · How to talk about physical activity intensity with patients

Mentioned in this podcast: 23 and a half hours YouTube video: https://www.youtube.com/watch?v=aUaInS6HIGo Make Your Day Harder http://www.makeyourdayharder.com/ PA Prescription Position Statement https://bjsm.bmj.com/content/50/18/1109 Naci et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. BJSM 2019. https://bjsm.bmj.com/content/53/14/859

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On this week’s BJSM podcast, Dr Celeste Geertsema joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the imbalance between men’s and women’s football medicine research and what needs to be done to move towards equality. Dr Geertsema is is a Sports Medicine Physician at Aspetar with her main interests being in football, skiing, snowboarding and athletes traveling. She has extensive experience working alongside FIFA in various World Cups. She was the first ever female Team Physician at the FIFA world Cup (in South Africa 2010) and also worked as FIFA Medical Officer at the Women’s Football World Cup and U17 Women’s World Cup, as well as Medical Officer at the Winter Olympic Games and Commonwealth Games. https://www.aspetar.com/person-profile.aspx?id=12⟨=en

In this 20-minute conversation, Dr Geertsema discusses: • Her current role at the Women’s FIFA World Cup in France • The medical requirements of men vs women at the World Cup • Why men and women footballers should be studied separately • The gaps in women’s football medicine research • What the SEM community can do to help out

Disclaimer: This is a personal interview for BJSM. Dr Geertsema is not speaking on the behalf of FIFA.

Pele in a skirt: https://www.cbc.ca/sports/2.720/marta-pele-in-skirts-1.731293

Germany Women’s FIFA World Cup Ad: https://www.youtube.com/watch?v=layoVXL5mnw

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It has been another big year for tennis, and for British Tennis in particular with further successes in the Fed Cup and a number of exciting juniors making an impact on the world stage. In the run up to Wimbledon, we thought we’d catch up with some of the practitioners tasked with not only caring for these athletes, but responsible for the medical provision at some of the biggest sporting events in the international calendar. In this podcast we hear from Dr Jo Larkin and Dr Wing Chu. Jo is a Sport & Exercise Medicine consultant and Lead Doctor for British Tennis, with Wing an SEM registrar and qualified GP who works with Jo at the Lawn Tennis Association. In this podcast, you can hear about everything from the challenges of working in tennis, to some of the often under-appreciated public health benefits linked to the sport.  Patients needing advice & input across multiple continents at the same time  Policy-making as well as ‘pitch-side’ care  Population health – what role does tennis have? Do you know someone who could benefit from a healthier heart, reduced stress and a leaner body? Or, does this sound like a personal target for you? We would implore the #SEM community to share the podcast, infographics, papers and animations widely in order to try and spread the knowledge not only of #TennisMedicine, but tennis AS medicine https://www.youtube.com/watch?v=X4UHmZ6PL30

Seminal Papers Health Benefits of tennis infographics: https://bjsm.bmj.com/content/52/3/201 Health Benefits of tennis paper: https://bjsm.bmj.com/content/41/11/760 Associations of specific types of sports and exercise with all-cause and cardiovascular- disease mortality https://bjsm.bmj.com/content/51/10/812.long Leisure-Time Physical Activity & Life-Expectancy https://www.mayoclinicproceedings.org/article/S0025-6196(18)30538-X/fulltext

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What is like working at one of the biggest clubs in the world? How do you manage the intense workload of the English premier league? What happens when players retire? In this hard hitting BJSM podcast, we are joined by Dr Andy Massey, physiotherapist and doctor who currently works as head of medical services at Liverpool FC. Topics discussed include:

● Managing the load of the premier league footballer ● Looking at the whole squad; substitutes and non-playing members ● The £177 million conundrum; the cost of injured players to the league ● Managing a rectus femoris injury; how to approach it? ● 1%ers- what is their place in football? ● Transitioning into retirement- do we do enough? ● Top tips for early career professionals wanting to work in football

Links to some of the papers mentioned: Bye Bye MRI? https://bit.ly/2KfChKQ POLICE principle for treating injuries : https://bit.ly/2EHcS9C

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Have we been thinking about Osgood Schlatter Disease (OSD) all wrong? To answer this question, Dr. Erin Macri interviewed Prof. Jens Lykkegaard Oleson and Dr. Sinead Holden from Aalborg University on a recent visit to Denmark. Prof. Olesen is a rheumatologist and sports medicine physician, currently located at the Center for Almen Medicine at Aalborg University. His research focuses on tendon and fascia tissue adaption to loading, and the use of ultrasound examination in tendon and fascia pathology. Dr. Holden is a Senior Researcher at the Center for General Practice in Aalborg, where she is co-founder and research co-ordinator for the OptiYouth Research Group focused on ‘optimising physical health in youth’. Her research aims to increase understanding of musculoskeletal injuries and pain in youth, to identify those at increased risk for developing chronic MSK problems. In this episode, we delve into some recent evidence suggesting the OSD may not be the self-limiting condition we have typically believed it to be. In fact, OSD may be more akin to a tendonopathy in its presentation, which lends itself to exploring some novel treatment approaches that may change OSD management in clinical practice.

Related Articles and Links OSD table: http://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2019/06/OSD-table.pdf Cairns G, Owen T, Kluzek S, Thurley N, Holden S, Rathleff MS, Dean BJ. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med. 2018 Aug 13;4(1):e000383. doi: 10.1136/bmjsem-2018-000383 https://bmjopensem.bmj.com/content/4/1/e000383 Holden S, Winiarski L, Krommes K, Thorborg K, Olesen JL, Hölmich P & Rathleff MS. Prognosis of Osgood-Schlatter - poorer than anticipated? A prospective cohort study with 24-month follow-up. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Vad, CG; Rathleff, MS; Jensen, HP; Holden S. Osgood Schlatter is associated with significant impairments in knee function and quality of life 4 years after diagnosis: a retrospective study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Lyng K, Rathleff MS, Dean B, Kluzek S, Holden S. Current Management Strategies in Osgood Schlatter: A quantitative study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Kaya DO, Toprak U, Baltaci G, et al. Long-term functional and sonographic outcomes in Osgood-Schlatter disease. Knee Surg Sports Traumatol Arthrosc 2013;21(5):1131-9. Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop 1990;10(1):65-8.

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On this week’s BJSM podcast, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) EIC elect Dr Clare Ardern PhD (T: @clare_ardern) joins BJSM EIC Prof Karim Khan to answer the difficult questions about return to play. Dr Clare Ardern is a physiotherapist and clinical researcher who completed her award-winning PhD on return to play in 2013. Since then, Clare has worked as a clinical researcher at the Aspetar Orthopaedic & Sports Medicine Hospital (Qatar) and Linköping University (Sweden). Clare led the 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. She has a particular interest in the psychological aspect of returning to play and how the return to play transition can be improved with specific clinical interventions and superior clinical decision making. We here at BJSM would like to thank Clare for her tireless work as BJSM Deputy Editor and wish her all the best for her upcoming role as EIC at JOSPT! In this 30-minute conversation, Clare discusses: · Tips for clinicians when approaching RTP with athletes · The psychological aspects of RTP and the importance of shared decision making · Athletes’ biggest fears when RTP · Non-operative management of ACL injuries · Paediatric ACL injuries On Oct 4-5, Clare will be speaking at the The IFSPT Third World Congress of Sports Physical Therapy in Vancouver, Canada. She will be presenting alongside a world-class line up of local and international experts exploring the theme “High performance to clinical practice”. https://www.sportphysio.ca/calendar-of-upcoming-events/spc2019/

Mentioned in this episode: Ardern CL, Ekås G, Grindem H, et al. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018;doi:10.1136/bjsports-2018-099060 (article co-published by Knee Surgery Sports Traumatology Arthroscopy, Journal of ISAKOS and Orthopaedic Journal of Sports Medicine). https://bjsm.bmj.com/content/52/7/422 Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med 2016;50:853-864. https://bjsm.bmj.com/content/50/14/853 Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med 2014;48:1543-1552. Grindem H, Snyder-Mackler L, Moksnes H, et al Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study British Journal of Sports Medicine 2016;50:804-808. https://bjsm.bmj.com/content/50/13/804 Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine. 2010 Jul 22;363(4):331-42. Headspace App: https://www.headspace.com/headspace-meditation-app

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What are the most effective strategies for preventing sport-related concussions in youth? What role do clinicians have in this arena? Dr. Erin Macri took advantage of Prof. Emery’s recent visit to the Netherlands to get caught up on the latest evidence in concussion prevention.

Prof. Emery is a physiotherapist and epidemiologist. She currently holds an appointment in the Faculty of Kinesiology at the University of Calgary, with joint appointments in Pediatrics and Community Health Sciences, Cumming School of Medicine, and is Chair of the Sport Injury Prevention Research Centre at the University of Calgary. Her research focuses on injury prevention in youth sport and recreation, concussion, and pediatric rehabilitation.

In this episode, Prof. Emery discusses over a decade of work aimed at preventing sport-related concussion in ice hockey in Canada.

Related Articles and Links Emery CA, Black AM. Are rule changes the low-hanging fruit for concussion prevention in youth sport? JAMA pediatrics 2019. E-pub ahead of print doi:10.1001/jamapediatrics.2018.5498 Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med 2017;51(12):978-84 Kolstad A, Nadeau L, Eliason P, Palacios-Derflingher L, Goulet C, Emery CA. The Effect Of Body Checking Policy Change On Offensive Game Skill Performance In 13–14 Year Old Ice Hockey Players. Br J Sports Med 2017;51(4):345-45 McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun 1;51(11):838-47. Concussion: prevention, detection and management (online course): https://www.ucalgary.ca/knes/online-concussion-course Concussion Awareness Training Tool: https://cattonline.com/ Canadian Concussion Guidelines and other resources, Parachute Canada: http://www.parachutecanada.org/injury-topics/item/concussion

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On this week’s BJSM podcast, Kathrine Switzer (T: @KVSwitzer) joins BJSM’s Daniel Friedman (T: @ddfriedman) to chat about empowering female athletes and the changing face of women’s sport in 2019. In 1967, 20-year-old Kathrine Switzer became the first woman to complete the all-male Boston Marathon as an official entrant. She managed to fight off a race official who tried to force her from the course after only several kilometres, and made history as she crossed the finish line four hours later. Empowered by her experience, Kathrine became determined to create change for all women and has dedicated her career to advancing women’s sport, health and equality. https://kathrineswitzer.com/ In this 25-minute conversation, Kathrine discusses: · The story of her historic 1967 Boston Marathon · Her activism in advancing women’s running · 261 Fearless – a global supportive social running network http://www.261fearless.org/ · The biggest barriers to female participation in sport today · What SEM clinicians can do to help out On June 6-8, Kathrine will be speaking at the 4th biennial Female Athlete Conference in Boston. She will be presenting alongside a world-class line up of local and international experts on women’s sport and exercise medicine, coaching, leadership and culture. https://bostonchildrens.cloud-cme.com/default.aspx?P=1&EID=910 Learn more about NZ’s Green Rx: https://www.health.govt.nz/our-work/preventative-health-wellness/physical-activity/green-prescriptions

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What venue are we at today? Which half is it now? Who scored last in this match? The Maddocks questions are a key part of immediate or on-field assessment of concussion. But do you have an easy way of remembering what else needs to be done? On this week’s episode, Dr Jim Bovard joins BJSM’s Daniel Friedman (T: @ddfriedman) to share his ABC concussion tool for rapid on-field assessment. Dr Bovard is the team physician for the Vancouver Canucks and Vancouver Whitecaps. He currently consults for Canada Snowboard and Tennis Canada.

In this 20 minute conversation, Dr. Bovard discusses: · Clinical reasoning for approaching the collapsed athlete · His own ABC concussion tool for on field assessment · Tips for coaches and parents for managing concussion · The difference between caring for elite athletes vs general population

Further reading: Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenbogen RG, Echemendia RJ, Makdissi M, Sills A, Iverson GL. The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). Br J Sports Med. 2017 Apr 26:bjsports-2017. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

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What are your favourite sports medicine research articles from 2018? This week, we are excited to share an AMSSM Sport Medcast hosted by Drs Scott Young and Dr. Meghan Raleigh In this abbreviated episode, learn about the latest research regarding: · Treatment of Achilles tendinopathy · Effect of NSAIDs on bone healing rates · Management of lateral hip pain · Exercise as medicine for concussion · Physiotherapy vs surgery for meniscal tears To listen to the full episode and learn about all ten studies, please visit the AMSSM’s website: https://www.amssm.org/E-Learning.php Further reading: Johannsen F, Jensen S, Wetke E. 10-year follow-up after standardised treatment for Achilles tendinopathy. BMJ open sport & exercise medicine. 2018 Oct 1;4(1):e000415. Wheatley BM, Nappo KE, Christensen DL, Holman AM, Brooks DI, Potter BK. Effect of NSAIDs on Bone Healing Rates: A Meta-analysis. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2019 Apr 1;27(7):e330-6. Nissen MJ, Brulhart L, Faundez A, Finckh A, Courvoisier DS, Genevay S. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clinical rheumatology. 2019 Mar 14;38(3):647-55. Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is medicine for concussion. Current sports medicine reports. 2018 Aug 1;17(8):262-70. van de Graaf VA, Noorduyn JC, Willigenburg NW, Butter IK, de Gast A, Mol BW, Saris DB, Twisk JW, Poolman RW. Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the ESCAPE randomized clinical trial. Jama. 2018 Oct 2;320(13):1328-37.

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Farooq Mohammed was a football fan who discovered that he has heart disease. In this BJSM podcast, we focus on the patient voice and hear from Farooq who shares his own lived experience with the disease and, importantly, how football became part of his rehabilitation. Farooq shows that by empowering patients to take control of their own health, rehabilitation can become a fun activity, not a boring ‘must do’ where the individual is counting down the minutes until it’s over. If you want to learn more about the “friendly group of ‘Heart Patients’ from #EastLondon” who make up Two Touch Athletic Football Club, connect with them on Twitter (@TwoTouchAFC) or Linked In (TwoTouchAthleticAFC). The conference that Farooq refers to was the 2019 Football is Medicine conference, University of Southern Denmark, Odense. It was led by Professor Peter Krustrup: http://ow.ly/7Xxn30oxFFR You can find another BJSM patient podcast here: http://ow.ly/rXis30oxFMJ Christina Le shares her lived experience of suffering an ACL injury in 2017.

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In this podcast Dr Katie Marino interviews Dr Rebecca Robinson about physical activity & cancer. Dr Robinson is a Sport and Exercise Medicine Consultant in Sheffield who has clinics at Weston Park Hospital in Sheffield working directly with cancer patients. During the podcast she gives a great insight into our current understanding of the use of physical activity in cancer patients. As Macmillan quote that by 2020 almost half the population will develop some form of cancer in their lifetime, it is important that we increase our understanding of how physical activity can be used to improve quality of life in this patient group. As mentioned in the podcast, please visit the following link for more information: https://movingmedicine.ac.uk/disease/cancer/#start

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Drop and give us 20.

On this week’s BJSM podcast, Dr Alex Hutchinson PhD (T:@sweatscience) joins BJSM’s Daniel Friedman (T: @ddfriedman) to make sense of all of the click-bait headlines and explore whether push-up prowess is the secret to long life.

Alex writes Outside’s Sweat Science column, about the science of endurance and adventure. He started out as a Cambridge-trained physicist and long-distance runner on the Canadian national team. As a journalist, he earned a National Magazine Award for his energy reporting with Popular Mechanics, covered adventure travel for The New York Times, and wrote a training column for Runner’s World. His latest book, out in February 2018, is ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance. He lives in Toronto, where he runs fast, climbs poorly, and gets outside as much as possible with his wife and daughters.

In this 17-minute conversation, Alex discusses: · If push-ups can predict your likelihood of future cardiovascular events · What we can learn from functional tests that aim to assess different health outcomes · New data on the cardio vs weights debate

Further reading: Yang J, Christophi CA, Farioli A, Baur DM, Moffatt S, Zollinger TW, Kales SN. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA network open. 2019 Feb 1;2(2):e188341-. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778 Stamatakis E, Williamson C, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH. Infographic. Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts. Br J Sports Med. 2019 Mar 1:bjsports-2018. https://bjsm.bmj.com/content/early/2019/03/01/bjsports-2018-100468.abstract Harb SC, Cremer PC, Wu Y, Xu B, Cho L, Menon V, Jaber WA. Estimated age based on exercise stress testing performance outperforms chronological age in predicting mortality. European journal of preventive cardiology. 2019 Feb 13:2047487319826400. https://journals.sagepub.com/doi/10.1177/2047487319826400

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Seth is a physiotherapy lecturer at the University of Leicester with a special interest in calf & Achilles injuries, having completed his PhD on Achilles Tendinopathy. He joins us to answer some of these questions · What are the biggest risk factors for Achilles tendinopathy (AT)? · What would be your biggest bang-for-buck treatments for AT? · What would you say were the most useful markers for progression? · Where do you think people are going wrong in the treatment of AT in general – what are the most common misconceptions/mistakes? · How important is the role of the soleus in ankle/calf function, and sporting performance in general? · In terms of managing soleus injuries, what tips would you have for clinicians out there?

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What comes first—the robust athlete or the high training load? What is the role of moderating factors in training load? And is the ‘10% rule’ a myth? On this episode, Dr. Tim Gabbett PhD x2 (T: @TimGabbett) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss all things training load and debunk some common misconceptions. Tim has over 20 years of experience working as an applied sport scientist with elite athletes, coaches, and high performance teams from around the world. He holds a PhD in Human Physiology (2000) and has completed a second PhD in the Applied Science of Professional Football (2011), with special reference to physical demands, injury prevention, and skill acquisition. www.gabbettperformance.com In this 20 minute conversation, Tim discusses: · The definition of training load and its different components · The Acute:Chronic Workload Ratio (ACWR) and its limitations · What separates robust from fragile athletes · The 10% rule ‘myth’ · How to design a rehabilitation training program for an injured athlete

Further reading: Gabbett TJ, Nielsen RO, Bertelsen ML, Bittencourt NF, Fonseca ST, Malone S, Møller M, Oetter E, Verhagen E, Windt J. In pursuit of the ‘Unbreakable’Athlete: what is the role of moderating factors and circular causation? https://bjsm.bmj.com/content/early/2018/11/13/bjsports-2018-099995 Gabbett TJ. Debunking the myths about training load, injury and performance: empirical evidence, hot topics and recommendations for practitioners. Br J Sports Med. 2018 Oct 26:bjsports-2018. https://bjsm.bmj.com/content/early/2018/10/26/bjsports-2018-099784 Gabbett TJ. The training—injury prevention paradox: should athletes be training smarter and harder?. Br J Sports Med. 2016 Mar 1;50(5):273-80. https://bjsm.bmj.com/content/50/5/273 Hulin BT, Gabbett TJ, Lawson DW, Caputi P, Sampson JA. The acute: chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med. 2016 Feb 1;50(4):231-6. https://bjsm.bmj.com/content/50/4/231 Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett T, Gleeson M, Hägglund M, Hutchinson MR, Van Rensburg CJ. How much is too much?(Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016 Sep 1;50(17):1030-41. https://bjsm.bmj.com/content/50/17/1030

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What common injury patterns do adolescent overhead throwing athletes face? What are the current pitch count recommendations and evidence for their use? How can we best monitor and encourage compliance with these recommendations? Host Dr. Devin McFadden, MD is joined by Dr. Jason Zaremski to explore these topics and more on the AMSSM Sports Medcast. Dr. Zaremski is an assistant professor from the Division of Physical Medicine and Research, Department of Orthopaedics and Rehabilitation and Co-Medical Director of the Adolescent and High School Outreach Program at the University of Florida College of Medicine in Gainesville, Florida. He is also a past participant in the AMSSM International Travelling Fellowship program, having recently travelled to Scandinavia where he shared insights on the above topics and learned how the Scandinavians deal with similar injuries. In this 30 minute conversation Dr. Zaremski addressed the following topics: What are common injury patterns in adolescent overhead throwing athletes? What injury prevention strategies have been enacted and what is the evidence for their use? When to consider operative rather than conservative treatments.

Mechanisms and Treatment of Throwing Injuries- https://journals.lww.com/acsm-csmr/fulltext/2017/05000/Mechanisms_and_Treatments_for_Shoulder_Injuries_in.17.aspx

Zaremski ZL, Wasser JG, Vincent HK. Mechanisms and Treatments for Shoulder Injury in Overhead Throwing Athletes. Current Sports Medicine Reports. 2017;16(3):179-188

Unaccounted Workload in Pitch Counts- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894908/

Zaremski JL, Zeppieri G, Jones DL, et al. Unaccounted workload factor: game-day pitch counts in high school baseball pitchers- an observational study. Orthop J Sports Med. 2018;6(4):1-7

The Thrower’s Ten Exercises- https://insights.ovid.com/pubmed?pmid=28498227

Wilke KE, Yenchak AJ, Arrigo CA, et al. The advanced throwers ten exercise program: a new exercise series for enhanced dynamic shoulder control in the overhead throwing athlete. Phys Sportsmed. 2011;39(4):90-97.

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Breakneck speeds. Scorching heat. Extreme g-forces. Motor racing is one of the most challenging of all sports - not only for drivers themselves, but also for the teams that play an integral role in the performance of the driver and car. As the 2019 Formula One World Championship Season launches into action this weekend in Melbourne, F1 physiotherapist Kim Keedle takes a pit stop with BJSM’s Daniel Friedman (T: @ddfriedman) to share insights into the physically and mentally demanding world of motor racing. Kim graduated from Melbourne University in 2012 with a Bachelors of Physiotherapy, and completed a Masters in Strength & Conditioning at Edith Cowan University in 2016. He is currently working full time as a physiotherapist and high performance coach for the Haas F1 Team, based in Geneva. In this 17 minute conversation, Kim explains: · His pathway into F1 · The role of the physiotherapist within the broader F1 medical team · The physical and mental demands of F1 racing · The importance of neck and trunk strength for drivers · Cervical loading programs and conditioning during the off season

Further reading: https://blogs.bmj.com/bjsm/2013/03/26/the-fast-and-the-furiousand-physiotherapy-training-for-extreme-g-force-loads-on-the-neck/ Contact Kim: kkeedle@gmail.com

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Following their recent editorial (https://bjsm.bmj.com/content/early/2018/11/09/bjsports-2018-099457) in the BJSM, and the publication of the reliability paper in the #BMJOpenSEM https://t.co/lCFcZNi5Tu - we managed to get this international team of collaborators around the table at BMA House, to discuss the applicability of the ASH test in guiding the return to play process following shoulder injuries. Steffan Griffin had the pleasure of hosting Ben Ashworth, Laura Tulloch, Nav Singh & Daniel Cohen, who take us through the journey behind the test, and how it can be used within the clinical setting. Some great examples & case-studies for anyone who sees upper limb injuries in sport! If you’re interested in the paper & the group’s work, you can follow them here: https://twitter.com/AthleteShoulder https://twitter.com/benashworth https://twitter.com/lt_physio https://twitter.com/paddhog https://twitter.com/danielcohen1971 https://twitter.com/i/status/1021381112378155009

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Since 1996, the Football Association has mandated that every young professional footballer in England undergoes cardiac screening. In this podcast, Dr Aneil Malhotra, lead author on the recent NEJM paper which reported the outcomes of the FA’s screening programme, discusses the implications of the research and what it means for screening in the future. In this conversation with Dr Sean Carmody, he also discusses other measures support staff can take to minimise the risk of sudden cardiac deaths in athletes.

Related Articles: Outcomes of Cardiac Screening in Adolescent Soccer Players Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England

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NCAA athletes face the realization of career ending injuries, whether they are acute/catastrophic or cumulative. As team physicians and athletic trainers it is imperative that we have our athletes' long- term health as a priority in their care. Presenters of this podcast are Pierre Rouzier, MD, head team physician of the University of Massachusetts, Jennifer Brodeur, ATC, director of Sports Medicine and Jeff Smith, ATC, senior associate Athletic Director for Internal Operations at UMass. This presentation will discuss various medical categories considered career ending and disqualifying; some of these are clear-cut, some may be more nebulous. Athletes facing 'retirement due to injury' are known to have significant psycho-social issues in their transition; we will discuss important institutional resources to help our athletes. We will present cases and outcomes from data collected at the University of Massachusetts. At the conclusion of the podcast, listeners will have learned various NCAA definitions, such as 'medical disqualification', 'medical hardship', 'medical red-shirt' and changes new to 2018. Program participants will know the consequences and implications of being 'medically disqualified' from an NCAA sport, and the impact on the athletes' financial assistance and what this means to their team's scholarship numbers. Listeners will be able to learn the process of medically disqualifying an athlete and how to provide the support and care they need to transition out of their sport.

Hayley Marks, Daniel R. Czech, Brandonn S. Harris, Trey Burdette, David D. Biber, An Examination of Coping with Career Ending Injuries: An NCAA Division I and NCAA Division III Comparison, International Journal of Sports Science, Vol. 5 No. 2, 2015, pp. 87-92. https://doi.org/10.5923/j.sports.20150502.07 Leena Ristolainen, Jyrki A. Kettunen, Urho M. Kujala & Ari Heinonen (2011): Sport injuries as the main cause of sport career termination among Finnish top-level athletes, European Journal of Sport Science, https://doi.org/10.1080/17461391.2011.566365 2017-18 NCAA Division 1 Manual https://www.ncaapublications.com/p-4511-2017-2018-ncaa-division-i-manual-august-version- available-august-2017.aspx 2014-15 NCAA Sports Medicine Handbook https://www.ncaapublications.com/p-4374-2014-15-ncaa-sports-medicine-handbook.aspx

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Did you know that worldwide, more than one in four adults (28% or 1.4 billion) are physically inactive? In some countries, it’s as high as one in three! How many more times do we need to be reminded that physical inactivity is one of the leading risk factors for global mortality before we finally decide to get off the couch? On this week’s episode, Prof Fiona Bull MBE (T: @fiona_bull) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the latest physical activity trend data and explain how clinicians can play their part to increase levels of physical activity for a more active world. Prof Bull is the Programme Manager in the Department of Prevention of Noncommunicable Diseases (NCD) at the World Health Organization based in Geneva, Switzerland. She leads the WHO’s global work on physical inactivity, healthy eating and the prevention of obesity, and provides leadership for global monitoring and surveillance of NCDs and their risk factors. Bull joined WHO in 2017 after 25 years in applied research in Australia, the UK and the USA. Her recent positions include Professor of Public Health and Director of the Centre for Built Environment and Health at the University of Western Australia and Professor of Sports Science and Director of National Centre of Physical Activity at Loughborough University in the UK. Bull has co-authored over 180 scientific publications and reports. Her interest is in bridging the knowledge-policy-practice gap, and she has been actively involved in civil society. She is immediate past President of the International Society of Physical Activity. In 2014, Bull was awarded a Member of the British Empire (MBE) for her services to public health. In this 15 minute conversation, Prof Bull addresses: · Physical inactivity trends over the past 16 years · The causes of physical inactivity · What the WHO is doing to support countries increase physical activity · What clinicians can do to play their part

Further reading: Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. The Lancet Global Health. 2018 Oct 1;6(10):e1077-86. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30357-7/fulltext World Health Organization. (‎2018)‎. ACTIVE: a technical package for increasing physical activity. World Health Organization. http://www.who.int/iris/handle/10665/275415 Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018. http://apps.who.int/iris/bitstream/handle/10665/272722/9789241514187-eng.pdf Global action plan on physical activity 2018-2030: At a glance http://apps.who.int/iris/bitstream/handle/10665/272721/WHO-NMH-PND-18.5-eng.pdf

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Our guest for this podcast is Professor Greg Whyte, one of the world’s most respected and renowned Sport & Exercise Scientists. Greg combines his academic position at Liverpool John Moores University with both public & private work around the UK, and is a hugely respected scientist and voice, with expertise in a wide range of domains. Not content with overseeing breathtaking Sport Relief challenges and helping to raise >£30m for charity, he has recently published a book titled ‘Bump It Up’, focused on advice for pregnant women.

In this podcast, Greg covers: - The current consensus - Common misconceptions - Common barriers and how to overcome them - Safety & contraindications - The importance of physical activity at every life-stage

Further resources: Greg’s Book: https://www.penguin.co.uk/books/111/1111959/bump-it-up/9780593077481.html BJSM Special Edition on Pregnancy: https://bjsm.bmj.com/content/52/21 2019 Canadian guideline for physical activity throughout pregnancy https://bjsm.bmj.com/content/52/21/1339

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Did you know that up to 3.8 million sports-related concussions occur in the USA annually? As the largest membership organisation representing sports medicine physicians in North America, the AMSSM is perfectly placed to provide advice and guidance to clinicians who are expected to manage every stage of the concussion spectrum. On this week’s episode, Prof Kimberly Harmon (T: @DrKimHarmon) returns for another podcast and joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the upcoming updated 2019 AMSSM position statement on managing concussion in sport. Prof Harmon is a Professor in the Department of Family Practice and Departments of Family Medicine and Orthopaedics and Sports Medicine at the University of Washington, as well as a past president of the AMSSM. She has over 20 years of experience as a team physician for the University of Washington, and is currently the head physician for the university’s American football team. In this 20 minute conversation, Prof Harmon discusses: · Our current understanding of concussion · The 2019 updated AMSSM Concussion in Sport position statement vs the 2013 statement · Managing concussed athletes and return to play at the collegiate level · Efforts to prevent concussion and reduce its severity in college football Prof Harmon will be speaking at the upcoming 2019 ACSEP conference (https://bit.ly/2HkQsi5) in Queenstown, NZ, and at the 2019 AMSSM Annual Meeting (https://bit.ly/2U573rD) in Houston, USA. Don't miss out!

Further reading: Harmon KG, Drezner JA, Gammons M Endorsed by the National Trainers’ Athletic Association and the American College of Sports Medicine, et al. American Medical Society for Sports Medicine position statement: concussion in sport Br J Sports Med 2013;47:15-26. https://bjsm.bmj.com/content/47/1/15.short Turner M Happy Birthday Concussion! Br J Sports Med Published Online First: 01 December 2018. doi: 10.1136/bjsports-2018-100316 McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017;51:838-847

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Traditionally, sports medicine may have focussed on joints and tendons and muscles, but, as with medicine more widely, nutrition is now being properly recognised as an essential aspect of health. Food is a very strong lever to improve human health and environmental sustainability on earth. However, food is currently threatening both people and planet. The food we eat, the ways we produce it, and the amounts wasted or lost affect us all – athletes, patients and clinicians. On this BJSM podcast Prof Jess Fanzo (T: @jessfanzo) from Johns Hopkins (full bio below) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the recently published report Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems that is making headlines around the world. The report is also creating much controversy. Not everyone will agree with the commission, just as not everyone agrees with all nutrition advice. At BJSM, our job is to share major views from the scientific world with our community and here you can listen to a major player in this report.

In this 15-minute conversation, Prof Fanzo shares the report’s key takeaways (!) and how sport and exercise medicine clinicians can contribute to “the great food transformation".

Prof Jess Fanzo PhD is the Bloomberg Distinguished Associate Professor of Ethics and Global Food & Agriculture at the Johns Hopkins Berman Institute of Bioethics, the School of Advanced International Studies, and the Bloomberg School of Public Health, Department of International Health. She also serves as the Director of the Global Food Ethics and Policy Program. Prof Fanzo received her PhD in Nutrition at the University of Arizona, and was the Stephen I. Morse Postdoctoral Fellow in Immunology in the Department of Molecular Medicine at Columbia University. https://eatforum.org/contributor/dr-jessica-fanzo/

Have something to say about the commission or the podcast? Let us know your thoughts by leaving us a comment via social media or wherever you get your podcasts!

Sportsuisse2018 https://sportsuisse2018.ch/

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Type 2 diabetes is a complex systems disease, caused by interactions between lifestyle and genes. It is an illusion to believe that it can be cured by medication. Lifestyle change should always be at the heart of treatment. Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care. Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology.

In our 20 min conversation we discuss Dietary advice for people with type 2 diabetes The importance of other lifestyle measures Effects of lifestyle intervention in clinical practice Patient preferences

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Do I really need this test, treatment or procedure? What are the downsides? What happens if I do nothing? And are there simpler, safer alternatives? Dr. Ray Moynihan (@raymoynihan) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the growing problem of overdiagnosis and overtreatment, and what is being done to wind back the harms of too much medicine. Ray is an Australian academic, author and award-winning health journalist who completed his PhD on overdiagnosis in 2015 at the Centre for Research in Evidence-Based Practice at Bond University in Australia, where he is also a senior research fellow. Having reported across print, radio, television and social media, Dr Moynihan has worked at the ABC TV’s investigative program, Four Corners and the 7:30 Report, and The Australian Financial Review. He has also developed an impressive body of academic work published in the Lancet, the New England Journal of Medicine, PLOS ONE and the BMJ. Dr. Moynihan has won several awards for his investigative journalism, and his book ‘Selling Sickness’ (2005) was described in the New York Times as a “compelling case” and has been translated into a dozen languages. His fourth book, ‘Sex, Lies & Pharmaceuticals’ was released globally in 2010 and generated widespread interest internationally. Dr Moynihan hosts the very popular podcast, ‘The Recommended Dose’, that is produced by Cochrane Australia and co-published by the BMJ. https://soundcloud.com/therecodo In this 25 minute conversation, Dr Moynihan explains the drivers of too much medicine and addresses: embracing healthy scepticism in healthcare the threat of too much medicine to our health the problem with diagnostic labels his ground-breaking discovery of a dangerous new disease what clinicians should do to practice ‘just the right amount’ of medicine (Goldilocks Principle)

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We were thrilled to catch up again with Dr Andrew Murray, the recently appointed Chief Medical Officer to the PGA European Tour, European Tour Performance Institute, and Ryder Cup Europe. He is universally known for his work promoting physical activity for health, his ultra-endurance challenges, and for leading the ‘Golf and Health project’. In this podcast he covers everything from the health benefits of golf, how to produce a consensus statement, the WHO’s GAPPA, to how to overcome various factors affecting knowledge translation #Gold

Various papers/resources are referred to throughout the podcast, links to which can be found below:

http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099509 http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099771

The relationships between golf and health: a scoping review https://bjsm.bmj.com/content/51/1/12 Previous BJSM podcast on Golf & Health: https://soundcloud.com/bmjpodcasts/andrew-murray-1 The World Health Organization’s Global Action Plan for Physical Activity: Prof Fiona Bull https://soundcloud.com/bmjpodcasts/the-world-health-organizations-global- action-plan-for-physical-activity-prof-fiona-bull?in=bmjpodcasts/sets/bjsm-1 It is time to replace publish or perish with get visible or vanish: opportunities where digital and social media can reshape knowledge translation https://bjsm.bmj.com/content/early/2017/11/17/bjsports-2017-098367

We hope you enjoyed the podcast – get in touch with us via social media if you have any questions for @docandrewmurray

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Contrary to the long held contention that low fat diets are best for people with type 2 diabetes (DM2), the totality of current evidence suggests that low carb diets are at least as effective in ameliorating metabolic health in DM2. In fact, low carb seems to be somewhat better, particularly in the short to medium term, although the evidence is of moderate certainty. On this week’s episode Prof Hanno Pijl (@HannoPijl) and dr Esther van Zuuren (@Ezzoef) join Dr Aseem Malhotra (@DrAseemMalhotra) to discuss the most appropriate diet for people with DM2 Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care. Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology In our 20 min conversation we discuss Efficacy of low fat versus low carb diets in the treatment of type 2 diabetes The method of weighing the certainty of evidence we used in our systematic review of the literature Dietary recommendations for people with type 2 diabetes

https://academic.oup.com/ajcn/article-abstract/108/2/300/5051863

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Did you know that the worldwide prevalence of obesity nearly tripled between 1975 and 2016? In 2016, more than 1.9 billion adults and more than 340 million children were classified as overweight or obese. At the individual level and in our modern, obesogenic world, weight gain has become the norm—the biological and social path of least resistance. On this week’s podcast, Dr Sandro Demaio (@SandroDemaio) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss childhood obesity and public health nutrition policy. After recently leaving his role as the WHO’s medical officer for NCDs and Nutrition, Sandro was appointed the CEO of EAT , a non-profit startup focused on food and sustainability. Formerly an Assistant Professor and Course Director at the University of Copenhagen’s School of Global Health, and a postdoctoral fellow at Harvard, Sandro regularly shares his knowledge and ideas at international conferences, universities and public events. He founded the PLOS Global Health Blog, NCDFREE and festival21, and is currently a bestselling author and TV host. http://sandrodemaio.com/about In this conversation, Sandro addresses the following topics:  Our current state of obesity  Policies needed to address childhood obesity  Sugar-sweetened disease and the sugar tax  Role of the clinician in addressing the obesity pandemic Further reading: Renzella, Jessica A., and Alessandro R. Demaio. "It’s time we paved a healthier path of least resistance." (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/03/07/bjsports-2017-098805 Murphy, Lisa, and Alessandro R. Demaio. "Understanding and removing barriers to physical activity: one key in addressing child obesity." (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/01/18/bjsports-2017-098546 Demaio, Alessandro. "A lifeSPANS approach: Addressing child obesity in Australia." Health Promotion Journal of Australia (2018). https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.44 Demaio, Alessandro, and Alexandra Jones. "The true price of sugar-sweetened disease: political inertia requires renewed, strategic action." The Medical Journal of Australia 209.2 (2018): 1. https://www.mja.com.au/journal/2018/209/2/true-price-sugar-sweetened-disease-political-inertia-requires-renewed-strategic Beale, Anna L., and Alessandro R. Demaio. "Non-communicable disease risk factors: a call for primary care clinicians to act and to refer. Brief intervention, not silent abdication." (2017): bjsports-2017. https://bjsm.bmj.com/content/early/2017/10/05/bjsports-2017-098475

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Is saturated fat good or bad? But doesn’t it cause cardiovascular disease? And what about the guidelines?

On this week’s episode, Dr. Zoë Harcombe (@zoeharcombe) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the takeaways from The BMJ’s Food For Thought conference 2018 (https://www.bmj.com/food-for-thought) and the demonisation of dietary fats. Zoë has a PhD in public health nutrition. The full title of her thesis is: “An examination of the randomised controlled trial and epidemiological evidence for the introduction of dietary fat recommendations in 1977 and 1983: A Systematic Review and Meta-analysis“. She researches in the fields of nutrition, diet, dietary advice, diet-related health and obesity and writes and talks about these topics daily - http://www.zoeharcombe.com/

In this 30 minute conversation, Zoë discusses: The strength of evidence in nutrition research Facts about dietary fats Our current understanding of saturated fat Does saturated fat cause cardiovascular disease? Are universal dietary guidelines feasible? Further reading: Forouhi, Nita G., et al. "Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance." BMJ361 (2018): k2139. https://www.bmj.com/content/361/bmj.k2139 Harcombe, Zoë. "Dietary fat guidelines have no evidence base: where next for public health nutritional advice?." Br J Sports Med 51.10 (2017): 769-774. https://bjsm.bmj.com/content/51/10/769 Harcombe, Zoë, Julien S. Baker, and Bruce Davies. "Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis." Br J Sports Med 51.24 (2017): 1743-1749. https://bjsm.bmj.com/content/51/24/1743.info Harcombe, Zoë, et al. "Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis." Open Heart 3.2 (2016): e000409. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985840/ Harcombe Z US dietary guidelines: is saturated fat a nutrient of concern? Br J Sports Med Published Online First: 14 August 2018. doi: 10.1136/bjsports-2018-099420 https://bjsm.bmj.com/content/early/2018/08/14/bjsports-2018-099420 Malhotra, Aseem, Rita F. Redberg, and Pascal Meier. "Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions." (2017): bjsports-2016. https://bjsm.bmj.com/content/51/15/1111

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Did you know that a regular bottle of Gatorade contains 34g of sugar? That’s over 8 teaspoons of sugar! The WHO recommends that <10% of our daily energy should come from free sugars. For an adult consuming 2000 calories daily, this equates to a recommended limit of roughly 50 grams, or 12 teaspoons. On this week’s episode, Dr. Deborah Cohen (@deb_cohen) joins BJSM’s Daniel Friedman(@ddfriedman) to reveal the shocking truth behind sports drinks and the industry’s ties to sporting organisations, academia and schools. Deborah is an award winning television, print and radio reporter and academic journal editor. After training as a doctor in the UK and France, she became an editor of The BMJ working on both academics and journalistic sections. Deborah became the first investigations editor of The BMJ and has reported and co-produced documentaries for BBC Panorama and Newsnight, Channel 4 News and Dispatches, The Telegraph, as well has having worked with the Cochrane Collaboration. In this 20 minute conversation, Deborah discusses: the history of sports drinks the science of hydration industry’s enlistment of academics industry’s infiltration of schools hydration guidelines

You can read Deborah's latest BBC investigative piece here: https://www.bbc.co.uk/news/resources/idt-sh/the_struck_off_doctor

Further reading: Cohen, Deborah. "The truth about sports drinks." Bmj 345 (2012): e4737. https://www.bmj.com/content/345/bmj.e4737 Robert Cade: Scientist who invented Gatorade, the world’s first and biggest-selling sports drink. Times 2007 Nov 29. https://www.nytimes.com/2007/11/28/business/28cade.html Kays, Joe, and Arline Phillips-Han. "Gatorade: The idea that launched an industry." Explore: Research at the University of Florida 8.1 (2003). http://www.research.ufl.edu/publications/explore/v08n1/gatorade.html Noakes, Timothy David. "Is drinking to thirst optimum?." Annals of Nutrition and Metabolism 57.Suppl. 2 (2010): 9-17. https://www.ncbi.nlm.nih.gov/pubmed/21346332 Cordrey, Kyla, et al. "Adolescent Consumption of Sports Drinks." Pediatrics (2018): e20172784. https://www.ncbi.nlm.nih.gov/pubmed/29735573

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This heavyweight podcast is sure to be a knockout! On this week’s episode, sports medicine physician Dr. John Neidecker (@DrJohnNeidecker) joins BJSM’s Daniel Friedman (@ddfriedman) in the ring to discuss the hot topics in combat sports today. Dr. Neidecker is a physician for USA Boxing and USA Taekwondo, and is the vice president for the Association of Ringside Physicians (ARP) (http://www.ringsidearp.org/), an international non-profit organisation dedicated to the health and protection of boxers and mixed martial artists. He serves as the ARP certification committee chair, enabling physicians to become certified in ringside medicine, and currently practices at Orthopedic Specialists of North Carolina. Dr. Neidecker is also the lead author of the ARPs Consensus Statement on concussion in combat sports that was recently published in the BJSM. In this 20 minute conversation, Dr. Neidecker explains the current medical practices and controversies in combat sports, and addresses the following topics:  concussion management in combats sports  return to fighting protocol  common injuries in combats sports  weight cutting  ethics of combats sports Further reading: Neidecker, John, et al. "Concussion management in combat sports: consensus statement from the Association of Ringside Physicians." Br J Sports Med (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/07/26/bjsports-2017-098799 McCrory, Paul, et al. "Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016." Br J Sports Med (2017): bjsports-2017. https://bjsm.bmj.com/content/51/11/838 Crighton, Ben, Graeme L. Close, and James P. Morton. "Alarming weight cutting behaviours in mixed martial arts: a cause for concern and a call for action." (2015): bjsports-2015. https://bjsm.bmj.com/content/50/8/446 Association of Ringside Physicians Releases Consensus Statement On Weight Management in Professional Combat Sports (2014) http://www.ringsidearp.org/resources/Documents/Position%20Statements/Weight%20Management% 20in%20Professional%20Combat%20Sports.pdf

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Fresh off ‘BJSM Podcast World Cup’ victory, superstar physiotherapist Dr. Alison Grimaldi returns for what is sure to be another chart-topping podcast. On this week’s episode, Dr. Alison Grimaldi (@alisongrimaldi) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the results from her latest clinical trial – the LEAP trial - that was recently published in the BMJ. https://www.bmj.com/content/361/bmj.k1662 With 25 years of clinical experience and particular expertise in the management of hip, groin and lumbo-pelvic pain and dysfunction, Alison is Principal Physiotherapist at Physiotec in Brisbane, Australia, and an Adjunct Research Fellow at the University of Queensland. Alison also has a special interest in the assessment and optimisation of lumbo-pelvic and lower limb biomechanics for running, change of direction and all weight bearing sports. She is currently involved with research studies through the University of Queensland and University of Melbourne. https://dralisongrimaldi.com/ Alison explains the clinical significance of the findings from the LEAP trial and shares some practical physiotherapy tips for clinicians helping patients manage gluteal tendinopathy pain. She discusses: Treatment options for managing gluteal tendinopathy pain Load management for gluteal tendinopathy Specific exercises for gluteal tendinopathy Alison continues to publish, present and provide practical workshops for other health professionals, and will be coming to Vancouver in September 2018 for her hip and groin pain masterclass! https://www.eply.com/DrGrimaldi-2018

You can listen to Dr. Grimaldi’s previous BJSM podcast on treating lateral hip pain here: https://soundcloud.com/bmjpodcasts/dr-alison-grimaldi-with-practical-physiotherapy-tips-on-treating-lateralhippain?in=bmjpodcasts/sets/bjsm-1

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After listening to this one, you may want to think twice before reaching for that next bottle of kombucha! On this week’s podcast, microbiome expert Dr Patrick Hanaway joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the implications of the gut microbiome for athlete health and performance. Dr Hanaway is a family physician who has served as the Director of Medical Education for the Institute for Functional Medicine, as well as the Medical Director at the Cleveland Clinic Center for Functional Medicine. He is also a past president of The American Board of Integrative Holistic Medicine. He is currently the Director of Research at the Cleveland Clinic Center for Functional Medicine (https://my.clevelandclinic.org/departments/functional-medicine), and practices at his clinic (http://www.familytofamily.org) in Asheville, North Carolina. In this 20 minute conversation, Dr Hanaway shares how clinicians can apply our current understanding of the gut microbiome in their clinical practice, and addresses the following topics: · What is the gut microbiome? · Microbial diversity throughout the life cycle and its relationship with different disease states · The relationship between different diets/foods/macronutrients and the gut microbiome · The effects of different types of physical activity on the gut microbiome · The role of probiotics in sport

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In this podcast Katie Marino speaks to Jack Forsyth. Jacky Forsyth (@JackyForsyth) is a senior lecturer at Staffordshire University. She is a lead organiser of the Women in Sport and Exercise Conference. In this podcast Katie Marino (@krmarino1) speaks to Jacky about the difference in the amount of research done on exercise in women compared to exercise in men, and why we need to correct this imbalance. The research community needs to strengthen and promote research on women in sport and exercise, with the goal of optimising women’s athletic success and increase their participation rates. The Women in Sport and Exercise Academic Network (WISEAN) is mentioned in the podcast. It is a research-orientated interdisciplinary group that focuses on: Generating high quality, impactful research into women in sport and exercise (WISE); Collaborating and sharing resources; Increasing the visibility of WISE issues and Research mentoring. If you would like to join this network, please email claire-marie.roberts@uwe.ac.uk or J.J.Forsyth@staffs.ac.uk To keep up to date on WISEAN and the Women in Sport and Exercise Conference follow WISEAN on Twitter (@WISE_AN)

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Thanks to BJSM editorial board member Daniel Friedman (@DDFriedman), who has also served as in intern at the World Health Organization, for hosting this podcast. The BJSM’s guest is Professor Fiona Bull, MBE – Program Manager of WHO Prevention of Noncommunicable Diseases Management Team, Geneva, Switzerland. @fiona_bull

The conversation gives the listener a 20-minute gem that covers the following points What is the global action plan? How was it developed? Why was this needed? How does it differ from the 7 investments? What is the overall goal? (15% reduction in physical inactivity by 2030) What can the BJSM community and how can we follow progress?

The answer to the last question is via the WHO ‘Let’s be active’ page: http://www.who.int/ncds/prevention/physical-activity/gappa Here is the link for the ‘’7 investments” document: https://bjsm.bmj.com/content/46/10/709 Here is the link for the Bangkok Declaration on Physical Activity: https://bjsm.bmj.com/content/bjsports/51/19/1389.full.pdf If you are interested in physical activity, see the 2018 BJSM special issue on walking here: https://bjsm.bmj.com/content/52/12

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Thanks to Professor Lorimer Moseley for his 4th BJSM podcast over the last 4 years. Here he chats with final year medical student Daniel Friedman who is at the coalface (@DDFriedman). How are the terms pain, nociception and central sensitisation used? Are they taught accurately or poorly? All of us can learn from Lorimer as he clarifies these concepts.

You can find his patient-focused website ‘Tame the Beast’ here: www.tamethebeast.org/#home You can find his academic/health professional website ‘Body in Mind’ here: www.bodyinmind.org/ Lorimer’s 2014 BJSM podcast was on tendons. Still worth listening to. It has had 20K listens: ow.ly/5OGN30gkaD7. The 2017 podcast on pain was on pain (some overlap): http://ow.ly/XgNi30kaQax His 2018 update, focusing particularly on knowledge translation – helping the community become aware of, and benefit from contemporary pain science, is here: http://ow.ly/q3b230kIf4R

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BJSM is one of very few channels that comments on food but doesn’t receive any funds from any food-related stakeholder. The BMJ doesn’t receive funds from food companies (as far as I know) and the new BMJ Open journal on nutrition doesn’t either. What about the ‘British Nutrition Foundation’ – sounds pretty helpful right? Well, it may be, but if you know where to click 5 times you can find that about 1/3 of its funding from corporate sponsors. The Academy of Nutrition and Dietetics has food sponsors too. That’s perfectly legal.

What about Government Food Guidelines – surely they are based on health evidence? Well, they may be, but governments run the food guidelines past their Departments of Agriculture before finalizing them. And that is OK too – I can understand why that would happen – of course that Department has to have input. Government requires balancing competing interests.

I don’t recommend people following national food guidelines (personal opinion – k2). I wouldn’t follow most nations’ food guidelines if I were given the food for free and paid $100 per day. Not for $500 per day – sorry. I’m fortunate as I’m on stable financial footing (touch wood). And what I eat may be ‘wrong’. This podcast is shared with the BJSM community in a spirit of humility and to provide data for folks to make up their own minds.

Nina Teicholz is a journalist (let’s get than in early to save the critics from bringing it up – pre-empting the ad hominem attack) and she has a fascinating book that argues fats have been unfairly demonized. Since that book was published the news that Harvard scientists were paid for a report suggesting that fats, not sugar, caused obesity. http://ow.ly/j1Bc30kCvqx. Nina Teicholz tweets from @bigfatsurprise.

Thanks to Dr Mark Hyman (@MarkHymanMD) for allowing us to edit his conversation with Nina Teicholz. Link to a recent Nina Teicholz comment in The BMJ: https://www.bmj.com/content/360/bmj.k822/rr-13 Here’s a link to the book that documents the case for healthy fats: https://thebigfatsurprise.com/ The original (full version) of Dr Mark Hyman’s podcast with Nina Teicholz on YouTube https://youtu.be/Zc_e5ME_5Cg

Thanks again to Dr Mark Hyman and Nina Teicholz.

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Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Here’s a link to his personal website: http://www.hiparthroscopyclinic.co.uk/ He was the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302. He has published a major paper in the field of hip pain in one of the top sports medicine journals – The Lancet. Published @TheLancet on June 2nd. http://ow.ly/4LhQ30kvJ1u BJSM fortunate to have chatted with @DamianGriffin courtesy of @footballmed. Podcast about it with the BJSM community in two weeks - 15th June (all 2018). Previous podcast with Damian Griffin: About the FAI syndrome: http://ow.ly/oo7530kvJB5. Two years ago. Griffin DR, Dickenson EJ, O'Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med2016;50:1169-1176. http://bjsm.bmj.com/content/50/19/1169 You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk

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Dr Marcos Agostinho (@MarcMedMD) asks Professor Peter Krustrup (http://ow.ly/9slg30koLv1) about the history of football fitness. What is it? Does it involve games/competition? Who are the main beneficiaries? And what of ‘walking football’ – what does that entail? This short podcast is a celebration of the health benefits of football and it provides powerful practical examples of what can be done. Kudos!

The 2nd International Football and Medicine Conference will be held in Odense, Denmark, on 25-26th January 2019.

Here is a 2018 systematic review: Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis. http://ow.ly/oGBs30koLzT

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Have you ever felt frustrated that research doesn’t get into the public domain? It’s stuck in journals, on shelves. But Lorimer is tackling that head on with community based engagement in his characteristic quirky way.

Listen to the story of the ‘Pain Revolution’ – a movement that engages local communities by having trained pain educators share contemporary pain science in accessible ways. Ignore the massive bike ride that Lorimer and friends undertake to spread the message and raise the funds (for now!). Listen to the story that underpins ‘Tame the Beast’ and watch it. Share it widely.

Part 2 next week!

Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. people.unisa.edu.au/lorimer.moseley He combines Oxford rigour with a laconic and very popular Australian style of communication. You can find his patient website ‘Tame the Beast’ here: www.tamethebeast.org/#home You can find his academic/health professional website ‘Body in Mind’ here:www.bodyinmind.org/ Lorimer’s 2014 BJSM podcast was on tendons. Still worth listening to. It has had 20K listens:ow.ly/5OGN30gkaD7. The 2017 podcast on pain was on pain (some overlap): http://ow.ly/XgNi30kaQax

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How do we assess running biomechanics? Does it translate to practice? BJSM editor Tej Pandya chats with Chris Bramah (@chrisbramah), England Athletics physiotherapist and biomechanist based at the Manchester Institute of Health and Performance. Chris is completing a PhD dissertation on the links between running gaits and running injuries.

They discuss: - Biomechanics of elite running athletes - Applying biomechanics to produce clinically relevant outcomes - A case of ITB syndrome in runners: What’s the role of biomechanical assessment? - Advances biomechanics technology - How the clinician can use biomechanics to assess athletes

Links to some of the papers mentioned in the podcast: - How to estimate centre of mass in running? https://bit.ly/2k4KbbV - Movement of the spine and pelvis during running. https://bit.ly/2La501S

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A great conversation between the fascinating Dr Alex Hutchinson and sports physiotherapist Chris Napier. Alex Hutchinson will be known to many because of his sports writing for Runners World (in the past) and Outside Magazine (now). He spent 9 years asking the question that is the title of this podcast – you get the answers in 20 minutes!

In addition to the discussion of limits of performance, they share practical tips on how to improve your own running times! Here’s a link to Alex’s website https://alexhutchinson.net/about.htm and his twitter handle is @SweatScience. Here’s the link to Alex’s book ‘Endure’: http://ow.ly/oqlF30jWuiw The insightful interviewer is also a runner - the Vancouver sports physiotherapist and near PhD graduate – Chris Napier @RunnerPhysio. Chris heads the Scientific Committee for the World Congress in Sports Physiotherapy (2019). That conference, which builds on previous World Congresses in Bern and Belfast will be held in Vancouver, Canada, October 4-5, 2019. http://ow.ly/Y1Qj30jWutO. The World Congress is being hosted by Sports Physio Canada @SportPhysio_ON.

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Dr. Cheri Blauwet is a leading and inspiring voice in sport and exercise medicine (SEM). She is a former Paralympic athlete in the sport of wheelchair racing, competing for the United States Team in three Paralypmic Games (Sydney '00, Athens '04, Beijing '08) and bringing home a total of seven Paralympic medals. She is also a two-time winner of the Boston Marathon.

After an elite sporting career, she turned her attentions to medicine. Dr. Blauwet completed her residency training in Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital/Harvard Medical School and followed this by a Sports Medicine Fellowship at the Rehabilitation Institute of Chicago. A successful and influential career in SEM has so far culminated in Cheri acting as the Chairperson of the International Paralympic Committee’s Medical Commission. She also serves on the Board of Directors for the United States Anti-Doping Agency (USADA), promoting clean competition in sports.

BJSM’s Liam West talks to Dr. Blauwet to highlight top learning points from her journey into SEM and the must know topics in disability sport.

You can hear Cheri talk further on this topic at the Canadian Academy of SEM 2018 conference in New Halifax in June - https://bit.ly/2rif5S0

Similar Podcasts; Cerebral Palsy Soccer - https://soundcloud.com/bmjpodcasts/cerebral-palsy-football-1?in=bmjpodcasts/sets/bjsm-1

Further Reading; Webborn N, et al. Heads up on concussion in para sport. Br J Sports Med 2017 doi:10.1136/bjsports-2016-097236

Derman W, et al. Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-097962

Mountjoy M, et al. The IOC Consensus Statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med 2016 doi:10.1136/bjsports-2016-096121

Derman W, et al. High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-098039

Blauwet CA, et al. Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline A Prospective Cohort Study at the London 2012 Paralympic Games. Am J Sports Med 2016;44:6

Blauwet CA, et al. Low Energy Availability, Menstrual Dysfunction, and Low Bone Mineral Density in Individuals with a Disability: Implications for the Para Athlete Population. Sports Med 2017;47(9):1697-1708

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Thanks to Christina Le for providing the first ‘patient voices’ podcast for BJSM. Christina is speaking as a 31-year old patient who is dealing with a common scenario – non-contact ACL rupture while playing soccer. You can follow her patient journey and obtain advice from a top sports physio at @YEGphysio. Christina chatted with BJSM editor-in-chief Karim Khan.

Christina addresses these common questions:

How did the injury occur? Did you feel any pain later? How did you decide whether to opt for surgery or no surgery? What lifestyle changes are you prepared to make after this injury? With whom did you discuss further options? How do you know when to return to sport?

Links: Return to play: 2016 Consensus statement link - http://bjsm.bmj.com/content/50/14/853

Dr Stepanie Filbay on return to sport factors post ACL reconstruction. https://www.ncbi.nlm.nih.gov/pubmed/27167588

Patient voices: Thanks to Osman Ahmed and Tracy Blake for launching the BJSM series. Read the blog here. http://ow.ly/1s4H30jHO1U.

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Managing stress fractures in any athlete can be difficult. Liam West discussed the topic with international expert Dr. Kathryn Ackerman, to find out clinical management gems.

Dr. Ackerman has specialist training in Internal Medicine, Sports Medicine and Endocrinology, Diabetes & Metabolism. This training has cumulated in positions as Medical Director of the Female Athlete Program at Boston Children's Hospital, Associate Director of the Sports Endocrine Research Lab at Massachusetts General Hospital, and Assistant Professor of Medicine at Harvard Medical School. She has focused research efforts on hormonal treatments to improve bone density and fracture healing, as well as various imaging modalities for assessing bone quality.

Related Articles Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. bjsm.bmj.com/content/49/6/370.long

IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491

Associated Podcasts Management of difficult stress fractures in sport - http://bit.ly/2EVorIM

Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04

Podcast Quotes “There is a transient osteopenia during adolescenece that predisposes them to stress fractures”

“Amenorrhic athletes have wider but weaker bones”

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Machine learning. One of the buzz expressions currently being bandied around healthcare. But how can it be applied in sports medicine? In this BJSM podcast, we discuss it with two scientists currently applying machine learning to their practice, Chris Kelly and Dr Tommy Wood from nourishbalancethrive, a US-based performance optimization company. We discuss the applications of machine learning and its potential implications for healthcare.

Topics include: - How to go about creating a machine learning model - What have they managed to predict so far - Limitations of using machine learning - Where do they see this technology moving forward to the future? - How can clinicians in sports use machine learning in practice? - How can anyone learn about machine learning?

Link to nourishbalancethrive: https://bit.ly/2q3Yyk4 Link to an easy way to getting into coding: https://bit.ly/2EjQM9Y

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We all know that exercise is medicine’s polypill. On this podcast, Dr. Blaise Williams discusses how to help older patient’s get active again. BJSM’s Liam West provides the questions that see Dr. Williams cover how the aged runner differs both in biomechanics and physiology, how this effects the forces through various areas of their bodies and finally the top clinical pearls you can use in your office today to help these older patients get moving again. If you haven’t listened to the first BJSM podcast with Blaise on his readiness to run scale, make sure you check that out too!

Dr. Williams is an Associate Professor in the Department of Physical Therapy and the Director of the Virginia Commonwealth University (VCU) RUN LAB. Blaise teaches students at VCU within the orthopaedic and sports curriculum. Alongside this, he continues to treat athletes of all levels at the VCU Sports Medicine Clinic.

Related Reading Paquette MR, DeVita P, Williams DSB 3rd. Biomechanical Implications of Training Volume and Intensity in Aging Runners. Med Sci Sports Exerc. 2017. Epub ahead of print. Powell DW, Williams DS. Changes in Vertical and Joint Stiffness in Runners with Advancing Age. J Strength Cond Res. 2017. Epub ahead of print. Devita P, Fellin RE, Seay JF, Ip E, Stavro N, Messier SP. The Relationships between Age and Running Biomechanics. Med Sci Sports Exerc. 2016. 48:98-106. Bus SA. Ground reaction forces and kinematics in distance running in older-aged men. Med Sci Sports Exerc. 2003, 35:1167-75.

Similar Podcasts ▪ From the AMSSM: Drilling down into running injuries – what they don’t teach in medical school http://bit.ly/2EvQbCP ▪ From the AMSSM: 3 sports medicine legends on running injuries, illness and footwear http://bit.ly/2mfG7pM ▪ Gait retraining to reduce leg pain with Dr Andy Franklyn-Miller http://bit.ly/1iTsOWb ▪ Keeping runners running: the secrets of running assessment - advice and exercise progressions http://bit.ly/2EuGrIH

Quotes “These changes occur as early as in our 40s, and in females even earlier”

“Our physiology changes way before we see changes in our biomechanics”

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Retired professional footballers are at a significantly increased risk of several health problems including osteoarthritis, mental health conditions, and difficulties pertaining to suboptimal lifestyle choices. During this podcast, Sean Carmody talks to Dr Vincent Gouttebarge, a retired professional footballer and current Chief Medical Officer of FIFPro (World Players’ Union), about what can be done to reduce the risk of health issues for footballers in retirement. Dr Gouttebarge has led several initiatives to improve outcomes for footballers in retirement, including a pilot ‘exit health examination’ study in collaboration with the Dutch Football Association and Dutch Players’ Union.

Related Articles: Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in the general population: a cross-sectional study - http://bjsm.bmj.com/content/early/2017/10/25/bjsports-2017-097503 Perceptions of retired professional soccer players about the provision of support services before and after retirement - http://bjsm.bmj.com/content/bjsports/36/1/33 Prevalence and determinants of symptoms related to mental disorders in retired male professional footballers - https://www.ncbi.nlm.nih.gov/pubmed/27285354 Lower extremity osteoarthritis is associated with lower health-related quality of life among retired professional footballers - https://www.tandfonline.com/doi/abs/10.1080/00913847.2018.1451718

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“There is no real optimal exercise program. There’s no such thing it doesn’t really exist.” LIVE from Copenhagen at the 14th Scandinavian Congress of Medicine & Science in Sports, Dr. Karen Litzy, PT, DPT, with the Healthy, Wealthy and Smart Podcast, interviews Dr. Peter Malliaras about exercise principles for patellar and Achilles tendinopathy. Peter Malliaras is an Associate Professor at Monash University in the Department of Physiotherapy. His research focus is musculoskeletal disorders, sports medicine and tendinopathy. In 2006 he completed his PhD in tendinopathy identifying novel risk factors, and since has undertaken post-doctoral research in the UK and Australia. Peter maintains a strong clinical focus, specializing in difficult tendinopathy cases and delivering clinical postgraduate education for clinicians in Australia and internationally. In this podcast, Peter discusses different loading programs, pain responses and the value of imaging for patellar and Achilles tendinopathy. Resources Peter Malliaras Twitter - http://bit.ly/2ESwPch Scandinavian Congress of Medicine & Science in Sports - http://bit.ly/2nHdZ0h Peter Malliaras Research Gate Profile - http://bit.ly/2G3K61c Tendinopathy Rehabilitation - http://bit.ly/2C94T0H Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness - http://bit.ly/2Bn2d34 Monash University Peter Malliaras Profile - http://bit.ly/2Ey1sGg

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Professor Lars Engebretsen, MD, PhD, Head of Medicine & Science at the IOC’s Scientific and Medical Department discusses the massive problem that is ACL injuries in children under 12 years of age.

Kids’ ACL ruptures are becoming more prevalent, the condition seems to affect boys and girls equally, and the management is controversial. There is universal agreement that preserving the meniscus (which can include meniscal suture) is critical. See the full consensus statement here - http://bit.ly/2FwQMF6

Links: Link to the FREE 2018 consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. http://bjsm.bmj.com/content/early/2018/03/07/bjsports-2018-099060

Editorial by Professor Nick Mohtadi, Dr Clare Ardern and Professor Lars Engebetsen on the need to preserve the meniscus. http://bjsm.bmj.com/content/early/2018/03/09/bjsports-2018-099169

Podcast: Lars Engebretsen on adult knee injuries (2016 podcast, 10K listens) https://soundcloud.com/bmjpodcasts/professor-lars-engebretsen-on-management-of-young-adult-and-older-patients-with-knee-injuries

Podcast: Dr Ben Clarsen on elite athlete screening and monitoring https://soundcloud.com/bmjpodcasts/nipping-injuries-in-the-bud-practical-tips-for-injuryillness-care-in-elite-athletes

Website: IOC Sports Physiotherapy Diploma – What is it? http://www.sportsoracle.com/Sports+Physical+Therapies/Home/

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Dr. Tasha Stanton’s background in physiotherapy and pain science means her research is very clinically relevant. BJSM’s Liam West discusses with Dr. Stanton the pain experienced by patients with osteoarthritis, how fear and emotions can alter this pain and where the future of osteoarthritis pain management might lie.

Related Articles: Evidence of central sensitisation, impaired pain inhibition, enhanced pain facilitation in OA: Edwards et al. BMC Musculoskeletal Disorders 2016; 17:284 Perception of harm influences pain: Wiech et al J Neurosci 2010; 30:16324-31 What people with OA think about exercise/harm: Holden MA, et al. Role of exercise for knee pain: what do older adults in the community think? Arthritis Care Res. 2012;64:1554-64. Somers et al. J Pain Symptom Manage. 2009;37:863-72. Pouli N, et al. The experience of living with knee OA. Disabil Rehabil. 2014;36:600-7 Modulation of pain by vision: Longo et al. J Neurosci 2009; 29: 12125-30; Longo et al. J Neurosci 2012; 32: 2601-7 Alterations in body perception in people with OA: Nishigami et al. PLoS ONE 2017; 12:e0179225 Gilpin et al. Rheumatology 2015; 54:678-82 Body illusions in people with pain: Bosch et al. PAIN 2016; 157:519-29. Altering sounds alters feelings of back stiffness: Stanton et al. Scientific reports 2017; 7: 9861.

Associated Podcasts: Prof Hunter on OA and exercise - http://bit.ly/2DQAd9z OA in the spotlight - http://bit.ly/1Frwnxt Prof Moseley on the brain and mind in chronic pain - http://bit.ly/1u33pPY Pain coach and first patient contact for pain management - http://bit.ly/2DHCaGa

Am I safe to move? Prof Moseley on understanding pain and focusing on the patient - http://bit.ly/2nmCAqu

Podcast Quotes: “Give your patient the locus of control” “Knowledge helps you frame what is happening in your world” “People with osteoarthritis often hold beliefs that movement is harmful”

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Understanding and managing your patient’s pain can be extremely difficult. Liam West spoke to Dr. Tasha Stanton to tap into her vast expertise in the area of pain science. Dr. Stanton is a Senior Research Fellow for the “Body in Mind” group in Australia and has a background in physiotherapy, spinal biomechanics and pain neuroscience. Her work to date has led to several prestigious pain science awards. In this podcast she explains the disconnect between tissue damage and the pain experience, why people experience different levels of pain to the same stimulus and shares how to explain pain to a patient within a clinic setting.

Discordance between findings on scans (i.e., tissue damage) and pain Hannan MT, Felson DT, and Pincus T. 2000. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatology 27:1513-1517. Brinjikji et al American Journal of Neuroradiology 2015;36:811-16

Central sensitisation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/ http://www.noigroup.com/en/Product/EPBII

Things that fire together, wire together: http://www.noigroup.com/en/Product/EPSB

Explaining the neurobiology of pain: Moseley GL, Butler DS. Fifteen years of Explaining Pain. J Pain. 2015;16:807-13

Our sensations (including pain) are based on the believable, credible evidence that is available to us: Expectations of pain can be important: Bingle et al. Sci Transl Med 2011;3:70ra14 Other sensory input can change pain – the stinky smell study: Bartolo et al PAIN 2013 Our sensations are influence by the meaning that we attach to information: Moseley, Arntz. PAIN 2007;133:64-71

People with chronic pain are not good at learning safety (extinguishing fear to what was painful movement): https://www.ncbi.nlm.nih.gov/pubmed/27776989

A feeling of control and pain: http://psycnet.apa.org/doiLanding?doi=10.1037%2F0033-2909.90.1.89

Associated Podcasts Prof Moseley on the brain and mind in chronic pain - http://bit.ly/1u33pPY

Pain coach and first patient contact for pain management - http://bit.ly/2DHCaGa

Am I safe to move? Prof Moseley on understanding pain and focusing on the patient - http://bit.ly/2nmCAqu

Podcast Quotes “Things that fire together, wire together” “Things that change the ‘need to protect’ your body changes pain”

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Research so often includes ‘education’ in the comparison arm of clinical trials as though it is a universal, standardized, or perhaps even inert component of intervention. But what if education IS a key ingredient in managing patellofemoral pain? Erin Macri met up with Dr. Michael Rathleff after hearing some impressive presentations from him and his team members at the 5th International Patellofemoral Pain Research Retreat in Gold Coast, Australia.

Dr. Rathleff works at the Research Unit for General Practice in Aalborg. He is an associate professor and head of the OptiYouth research group that works towards improving musculoskeletal health in adolescents.

In this podcast, Dr. Rathleff shares some innovative and evidence-based approaches to optimizing outcomes for patellofemoral pain using strategic, targeted education.

Related Articles Rathleff MS, Roos E, Olesen J, Rasmussen S. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial. Br J Sports Med 2015;49(6):406-12

Associated Materials for upload Educational slides for use with patients (attached)

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Listen to leading physiotherapists continue their conversation on common ground when treating patients with disabling pain. (Link to Part 1 here http://ow.ly/mi3c30iqGSI)

In this episode the focus is treatment - what can you do to provide an all-around programme that respects the biopsychosocial model.

· How to assess the patient given the history you have obtained · Common ground they have discovered in treating backs and knees – there are many shared experiences and lessons from them · Exercise is the most powerful treatment – which ones, when, how to promote adherence with a programme.

Links to papers: 1. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. bjsm.bmj.com/content/50/14/839

2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) bjsm.bmj.com/content/50/14/844
Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. bjsm.bmj.com/content/51/24/1713.long

The link to Part 1 of the conversation: http://ow.ly/mi3c30iqGSI

The link to previous podcasts by these experts: Prof Kay Crossley’s previous BJSM podcast on treatment of patellofemoral pain (2015) http://ow.ly/PnHl30iqNlJ (10,000 listens)

Prof Peter O’Sullivan on treatment of back pain (2014) http://ow.ly/Ws2Y30iqNyD

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Join BJSM editor in chief Karim Khan eavesdropping on Professors Kay Crossley (La Trobe University, Melbourne) and Peter O’Sullivan (Curtin University, Perth) as they discuss the assessment and management of typical patients who present with long-standing knee pain and/or back pain. In podcast 1 (episode 320), they discuss: · The context from which to begin the consultation. What is the physio’s goal when taking the history? · What to ask about · How to frame the assessment when discussing the patient’s fears · What NOT to do or say! Links to papers: 1. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. bjsm.bmj.com/content/50/14/839 2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) bjsm.bmj.com/content/50/14/844 3. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. bjsm.bmj.com/content/51/24/1713.long Links to podcasts: Prof Kay Crossley’s previous BJSM podcast on treatment of patellofemoral pain (2015) https://soundcloud.com/bmjpodcasts/assoc-prof-kay-crossley-on-procedures-for-patellofemoral-pain Prof Peter O’Sullivan on treatment of back pain (2014) https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-curtin-walks-you-through-two-cases-of-low-back-pain

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Dr. Blaise Williams has a passion for helping people to get active and especially to get running. He is an Associate Professor in the Department of Physical Therapy and the Director of the Virginia Commonwealth University (VCU) RUN LAB. Blaise teaches students at VCU within the orthopaedic and sports curriculum. Alongside this, he continues to treat athletes of all levels at the VCU Sports Medicine Clinic. His research interests are in the areas of biomechanics and pathomechanics of running injuries, dynamic balance after injury and limb coordination during functional tasks.

On this podcast he discusses his readiness to run scale with BJSM’s Liam West.

Related Reading Roelofs EJ, Smith-Ryan AE, Melvin MN, Wingfield HL, Trexler ET, Walker N. Muscle size, quality, and body composition: characteristics of division I cross-country runners. J Strength Cond Res. 2015, 29:290-6. Paquette MR, Peel SA, Schilling BK, Melcher DA, Bloomer RJ. Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise. Eur J Sport Sci. 2017, 17:546-554. Kuhman D, Melcher D, Paquette MR. Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners. Eur J Sport Sci. 2016;16:433-40. Raabe ME, Chaudhari AMW. Biomechanical consequences of running with deep core muscle weakness. J Biomech. 2018;67:98-105. Luedke LE, Heiderscheit BC, Williams DS, Rauh MJ. Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Med Sci Sports Exerc. 2016;48:1244-50.

Quotes “I always try to get them to work on distance slowly, before they work on speed or intensity”

“Injured athletes need to be able to land before they are able to go back running”

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From the University of Queensland, Australia, physiotherapist and PhD candidate Liam McLachlan and Professor of Sports Physiotherapy Bill Vicenzino share clinical pearls relating to the patient with patellofemoral pain.

Dr Erin Macri, physiotherapist and BJSM editorial board member doing her postdoctoral studies at the University of Delaware leads the conversation.

• Why is it important to consider psychological factors in patellofemoral pain? • Which instruments should I use in the clinic (clue, google “Startback tool”) • Which comes first, the psychological distress or the pain? • Can explanation and reassurance contribute to reducing pain and improving function? • Bottom line – time to rethink from the narrow mechanical (only) perspective.

Here are some key links: Systematic review: The psychological features of patellofemoral pain: a systematic review. First author: Liam Maclachlan. http://bjsm.bmj.com/content/51/9/732 FREE Be sure to check the 3 BJSM Patellofemoral consensus statements (all free):

2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. http://bjsm.bmj.com/content/50/14/839
2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) http://bjsm.bmj.com/content/50/14/844
Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. http://bjsm.bmj.com/content/51/24/1713.long

*The STarT Back Screening Tool (SBST): Home page. https://www.keele.ac.uk/sbst/startbacktool/

Twitter: @Bill_Vicenzino: https://twitter.com/Bill_Vicenzino @PaulWHodges: https://twitter.com/PaulWHodges (coauthor)

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In this Podcast, Heart Digital Media Editor Dr. James Rudd is joined by Dr. Aseem Malhotra from Lister Hospital, Stevenage, UK. They discuss what we should tell our patients about diet and exercise - high fat, low fat or something else?

Link to published paper: bjsm.bmj.com/content/51/15/1111

Further Listening Management of mature athletes with cardiovascular conditions - https://soundcloud.com/bmjpodcasts/management-of-mature-athletes-with-cardiovascular-conditions?in=bmjpodcasts/sets/heart-podcast

Physical activity for the prevention of heart disease - https://soundcloud.com/bmjpodcasts/physical-activity-in-the-prevention-of-coronary-heart-disease-implications-for-the-clinician?in=bmjpodcasts/sets/heart-podcast

Aseem Malhotra on the impact of diet on heart disease https://soundcloud.com/bmjpodcasts/aseem-malhotra-dont-fear-the-fat

Fearless cardiologist author, Dr Aseem Malhotra, busts myths and shares Pioppi health secrets https://soundcloud.com/bmjpodcasts/fearless-cardiologist-author-dr-aseem-malhotra-busts-myths-and-shares-pioppi-health-secrets

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Dr. Kathryn Ackerman talks in this podcast to Dr. Liam West about the hot topic of energy availability in sport giving us clinical tips to manage athletes we suspect might be at risk of the consequences of low energy availability.

Dr. Ackerman has undertaken board certification in Internal Medicine, Sports Medicine and Endocrinology, Diabetes & Metabolism. This training has cumulated in positions as Medical Director of the Female Athlete Program at Boston Children's Hospital, Associate Director of the Sports Endocrine Research Lab at Massachusetts General Hospital, and Assistant Professor of Medicine at Harvard Medical School. Kathryn’s research focuses on the Female Athlete Triad and the various aspects of Relative Energy in Deficiency in Sport.

Related Articles IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491 Misunderstanding the FAT - http://bjsm.bmj.com/content/48/20/1461 IOC RED-S Clinical Assessment Tool - http://bjsm.bmj.com/content/49/21/1354

Associated Podcasts AMSSM Sports Medcast- Female Athlete triad - http://bit.ly/2lBP7WJ Thoughts from the England Football CMO - http://bit.ly/2CpV6Zp Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04

Podcast Quote Low energy availability happens to others, it can happen to men, it can happen to disabled athletes.

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For the 2nd time on the BJSM podcast, Sean Carmody is joined by David Dunne to discuss practical considerations for the travelling athlete. During his time with Orreco, David has worked closely with athletes from professional golf and the NBA, most of whom face gruelling travel demands during competition. David and Sean delve into the strategies the practitioner can employ to help reduce the risk of illness, minimise the effects of jet lag, improve sleep and optimise performance. These strategies are complimented by lessons David has learnt during his PhD in Behaviour Change at Liverpool John Moores University. Key research linked below: Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2–3-fold increased risk of illness: http://bjsm.bmj.com/content/46/11/816.

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In this podcast, Dr Sean Carmody speaks to Dr Nick van der Horst, who has recently published a paper on decision-making and medical criteria for return to play following hamstring strain injuries. Nick, who is First team physiotherapist at the Go Ahead Eagles in the Dutch Eerst Divisie and holds a PhD in football medicine, provides his thoughts on the controversies around the role of MRI and eccentric strength in determining return to play, and also shares his beliefs about why hamstring strain injuries continue to rise. Finally, Nick closes the podcast with his key tips for clinicians managing hamstring strain injuries.

There is lots of research referred to during the podcast, and these are linked below:

Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making: http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-097206

Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study: http://bjsm.bmj.com/content/early/2016/01/08/bjsports-2015-095359

Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey: http://bjsm.bmj.com/content/early/2015/05/20/bjsports-2015-094826

Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making: http://bjsm.bmj.com/content/early/2015/06/02/bjsports-2014-094569.short?rss=1

Hamstring injuries and predicting return to play: ‘bye-bye MRI?’ http://bjsm.bmj.com/content/49/18/1162

MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes: http://bjsm.bmj.com/content/early/2015/08/24/bjsports-2015-094892

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Over the last few years, rugby medicine has been somewhat mired with controversy. From ‘Bloodgate’, to concussion, there have been many back-page features in the press, often calling for quite sensationalist measures.

Against this backdrop, and away from the gaze of the press, World Rugby have been busy synthesising an evidence base, and adapting the game to try and maximise player welfare. Such efforts have often flown under the radar, and today on the podcast we hear from its Chief Medical Officer & Senior Scientific Advisor, who address a variety of topics including: -The process behind the recent law changes -Trying to optimise the prevention and management of concussion -Injury prevention -Trying to build an evidence-informed player welfare initiative

Some resources that you may find useful, and are mentioned in the podcast include: -World Rugby Medical website http://playerwelfare.worldrugby.org/ -The evidence underpinning the tackle laws -Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies http://bjsm.bmj.com/content/51/15/1152 -Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review http://bjsm.bmj.com/content/50/15/921 -Tackle technique and body position of the tackler and ball carrier significantly influences head injury risk in rugby union http://bjsm.bmj.com/content/51/11/A70.2 -Berlin Concussion Consensus http://bjsm.bmj.com/content/51/11/838

Let us know your thoughts on what is discussed via the normal social media channels – we look forward to hearing from you!

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Embedding physical activity in the undergraduate healthcare curriculum is an important step to building capacity in the future workforce to promote physical activity, every contact. This podcast features two UK medical schools and schools of health describing their approaches to upskilling tomorrow’s healthcare professionals, in physical activity, for tomorrow’s patients using the #MovementForMovement educational resources and a community of practice approach. More about Ann Gates here: http://www.exercise-works.org/. And here is the BJSM 2015 podcast with Ann Gates and Ian Ritchie on this topic - https://soundcloud.com/bmjpodcasts/training-tomorrows- doctors-in- exercise-medicine-for-tomorrows- patients. 6,000 listens already.

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Professor Stanley Herring is a clinical professor at the University of Washington (UW) in the Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine, and Neurological Surgery. He is director of the UW Medicine Sports Health & Safety Institute, medical director of Sports, Spine and Orthopedic Health for UW Medicine, and co-medical director of the Sports Concussion Program, a partnership between UW Medicine and Seattle Children's.

Dr. Herring's clinical interests include non-operative musculoskeletal and sports medicine with a particular interest in disorders of the spine and sports concussion. He is a team physician for the Seattle Mariners and a consultant to the UW Sports Medicine Program.

In this podcast he talks to BJSM’s Liam West about an important cause of low back pain in our adolescent sporting population – spondylolysis. They discuss common presentations, examination techniques, imaging protocols and clinical pearls for treatment.

References Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis - http://bjsm.bmj.com/content/40/11/940.info

Nonoperative treatment of active spondylolysis in elite athletes with normal X-ray findings: literature review and results of conservative treatment - https://www.ncbi.nlm.nih.gov/pubmed/11806390

Union of defects in the pars interarticularis of the lumbar spine in children and adolescents - http://bjj.boneandjoint.org.uk/content/86-B/2/225

Nonoperative treatment in lumbar spondylolysis and spondylolisthesis: a systematic review - https://www.ncbi.nlm.nih.gov/m/pubmed/24427393/

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Die Evidenz basierte Medizin ist ein Grundpfeiler medizinischen Handelns und ist im täglichen Leben des Arztes und Physiotherapeuten nicht mehr wegzudenken.

Dr Andreas Waltering (IQWIQ) gibt uns eine Einführung in die Evidenz basierte Medizin (EBM). Anfangen mit der Entstehungsgeschichte der EBM. Die EBM wurde im Gegensatz zu Deutschland von der Ärzteschafft selber gefordert. Im deutschsprachigen Raum wurde die EBM primär eingeführt um der Fehlversorgung entgegen zu wirken. Dr Markus Laupheimer (@swisssportscare) stellt die Fragen.

Wieso ist EBM wichtig?

Sollen wir den Vorlieben der Chef oder Oberärzte folgen? Oder sollen wir Patientenbezogen die EBM einsetzten?

EBZ ist für ein Gesundheitssystem wichtig um Therapien die nachweislich was Bewirken zu fördern und zu bezahlen. Im Gegensatz dazu sollten Therapien die Nachweislich keinen Nutzen haben nicht von der Solidargemeinschaft bezahlt werden.

Systematische Übersichtsarbeiten helfen Verzerrungen von einzelnen Studien zu vermeiden um den größten Aussagewert zu erhalten. Hierarchie der Evidenz: http://canberra.libguides.com/c.php?g=599346&p=4149721

Praktisches Beispiel in der Sportmedizin gibt es viele, jedoch eines der meisten untersuchten Therapien ist die Arthroskopie bei Gonarthrose, welche keinen Vorteil zu Placebo zeigt.

Bewegungsmedizin #Evidenzbasiert

Dabei sollten wir nicht vergessen “Bewegung bringt Heilung” (https://soundcloud.com/bmjpodcasts/einfuhrung-in-die-bewegungsmedizin-bewegung-bringt-heilung-mit-dr-boris-gojanovic?in=bmjpodcasts/sets/bjsm-1)

Weitere links zur Evidenzbasierten Medizin:

Deutsches Netzwerk Evidenzbasierten Medizin e.V. http://www.ebm-netzwerk.de/

Center of evidence-based medicine University of Oxford

IQWIQ : Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen https://www.iqwig.de/

Euch einen aktiven und bewegungsreichen Tag!

Nun viel Spaß mit diesem Podcast des BJSM. Und vergesst nicht uns auf Twitter @BJSM_BMJ, Facebook oder google+ zu folgen. Da gibt es regelmäßig neue updates. Für feedback oder Anregungen für neue Podcasts schreibt mir einfach eine mail markus@swisssportscare.com

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Dr. Michael Makdissi is a Sports & Exercise Medicine (SEM) Physician based in Melbourne. He has pursued a career that blends both clinical and research roles. His research is mainly based around concussion and it is this area where he has become a globally respected voice.

Liam West poses the questions in this podcast that sees Dr. Makdissi discuss the new Sports Concussion Assessment Tool (SCAT) 5, common mistakes made when managing athletes with concussion, updates within the SCAT5 and tips on how to use it.

To read the full paper related to the new SCAT5 please follow the link, The Consensus Statement - http://bjsm.bmj.com/content/51/11/838. Or head to the BJSM website to find further related papers: The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale - http://bjsm.bmj.com/content/51/11/848; Sport concussion assessment tool - 5th edition - http://bjsm.bmj.com/content/51/11/851.

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Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. http://people.unisa.edu.au/lorimer.moseley He combines Oxford rigour with a laconic and very popular Australian style of communication. In this podcast he addresses the questions: What’s new in our understanding of the spinal cord? What should we be telling patients? Is the ‘hands on, hands off’ debate a useful one? How do you feel the profession is performing right now? On the subject of what should we be telling patients, he argues we should train them to ask clinicians 3 questions. 1. How do I know my pain system is over-protective? 2. What can I do to retrain my system to be less protective? 3. Am I safe to move? You can find his patient website ‘Tame the Beast’ here: https://www.tamethebeast.org/#home And is previous BJSM podcast was on tendons. It has had >17K listens: http://ow.ly/5OGN30gkaD7. And here is a link to the Pain Revolution website: https://www.painrevolution.org/

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Allyson M Pollock is professor of public health and Director of Institute of Health and Society in the Medical Faculty of Newcastle University. She is a public health doctor and has been researching injuries and rugby injuries for more than ten years.

She takes what she describes as the ‘child’s perspective’ and asks – Do children know the risks of playing school rugby? Do all schools have appropriate risk mitigation? She reminds us that the health benefits of physical activity are well proven – but if one critically reviews the literature those benefits have not been proven for school rugby. This is a controversial position that is strongly countered by others. BJSM doesn’t have a position in this debate – our job is to highlight that there is a respectful debate and to encourage scrutiny of the existing evidence. We encourage researchers to add new data to this question and similar ones in sport.

Links: University of Newcastle Press Release: Prof Pollock’s letter to all 4 Chief Medical officers of the UK: http://www.ncl.ac.uk/press/news/2017/09/banrugbytackleforkids/

World Rugby’s reply to above call. From The Guardian. https://www.theguardian.com/sport/2017/sep/26/ban-harmful-contact-from-school-rugby-games-to-reduce-injury-risk-say-experts

Professor Pollock’s call to ban tackling in rugby in the BMJ: http://blogs.bmj.com/bmj/2017/09/25/allyson-pollock-and-graham-kirkwood-tackle-and-scrum-should-be-banned-in-school-rugby/

A reply to Prof Pollock by Dr Ross Tucker and colleagues: http://bjsm.bmj.com/content/50/15/921

Prof Pollock’s reply to World Rugby: http://bjsm.bmj.com/content/51/15/1113

The BMJ profile of Prof Pollock – “BMJ Confidential” (must have BMJ subscription): http://www.bmj.com/content/359/bmj.j4625

Prof Pollock’s Wikipedia page: https://en.wikipedia.org/wiki/Allyson_Pollock

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Why are groin injuries so difficult to manage? How has rehabilitation advanced over the years? In this BJSM podcast, we interview Professor Michael Callaghan, Professor of Physiotherapy at Manchester Metropolitan University and Head of Physical Therapies at MUFC. We discuss the pressures of dealing with groin injuries in a team environment, the use of 1%ers, and surgical options for dealing with the groin.

Michael is involved with the organisation of the inaugural MUFC Conference starring experts in the field such as Damian Griffin, details of which can be found here: www.manutd.com/medicalconference

Another key BJSM podcast focusing on the biomechanics of groin injury can be here: https://goo.gl/GWeQ62

Adam Weir, vastly experienced physiotherapists, also shares his pearls on groin treatment here: https://tinyurl.com/y88zplkb

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This episode takes place from Surrey Sports Park, the training base of Harlequins Rugby Union. During the podcast, performance nutritionist David Dunne delves into the following topics with Dr Sean Carmody:

-Managing weight loss safely in weight dependent sports (eg boxing, MMA) -Developing muscle mass appropriately in rugby union players -Nutritional considerations in the professional golfer

In addition to his work with Harlequins, David has worked in several sports including Queens Park Rangers FC (football), Team Wiggins (cycling), GB Canoeing and professional boxing. David also holds a position with data analytics and sport science company, Orreco.

Links to the research discussed during the podcast are listed below:

https://www.researchgate.net/publication/304529333_Acute_Weight_Loss_Strategies_for_Combat_Sports_and_Applications_to_Olympic_Success

https://www.researchgate.net/project/Waterloading-in-combat-sport-athletes-as-means-to-manipulate-body-mass

http://www.tandfonline.com/doi/abs/10.1080/17461391.2017.1297489?scroll=top&needAccess=true&journalCode=tejs20

The Liverpool John Moores University observational MMA case study discussed is still currently in press. To keep up to date on this research follow the below profiles on researchgate:

https://www.researchgate.net/profile/Carl_Langan-Evans

https://www.researchgate.net/profile/Ben_Crighton

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Michele Verroken is the founding director of Sporting Integrity, a consultancy which advises governing bodies about identifying, adopting and managing best practice procedures relating to risk, ethical and integrity standards and issues in sport.

Formerly Director of Ethics and Anti-Doping at UK Sport, Michele has worked in elite sport for over thirty years. She currently works as an Anti-Doping advisor to the PGA European Tour and is Secretary of the Commonwealth Games Federation Medical Commission.

Here, in conversation with Sean Carmody, Michele outlines her anti-doping efforts in golf, the problems with the TUE system, and the three key things that any clinician working in golf must consider in order to prevent doping.

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Respiratory conditions are often neglected in the world of sports medicine, so we’ve got two world leaders on a podcast, recorded at the famous Centre for Health & Human Performance in London, to enlighten us on respiratory conditions in sport.

Our guests Dr James Hull is Consultant Respiratory Physician with a specialist expertise in assessing athletes with unexplained breathlessness. He is an invited member of the American Thoracic Society expert committee for Exercise Induced Bronchoconstriction and is widely published in this field. Dr. John Dickinson is an Exercise Respiratory Physiologist with a specialist in assessing exercise respiratory symptoms in athletes. He has tested over 1,000 elite athletes from a range of sports including all Olympic and many professional sports, such as rugby and Premier League football.

In this podcast we discuss: What are the common respiratory conditions that every sport & exercise medicine clinician should be comfortable with? What work-up do these athletes need? What is the gold-standard management of exercise-induced bronchoconstriction in athletes? What is EILO – and why is it important we know about it? Check out the BJSM social media channels for further resources!

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Professor Jon Drezner is a family medicine physician from Seattle, USA with expertise in sports medicine and sports cardiology. He shares the new international criteria for electrocardiogram (ECG) interpretation in athletes - these lead to a lower false positive rate while maintaining sensitivity. He clearly defines the key changes and what to look out for on an ECG.

You can access the International ECG Criteria paper below and also check out the conference Prof. Drezner is organising in Seattle 2-3 November 2017.

International ECG Interpretation Criteria - http://bjsm.bmj.com/content/early/2017/03/03/bjsports-2016-097331. Conference: “Prevention of Sudden Cardiac Death in Athletes: Sports Cardiology for the Team Physician and Cardiology Consultant” - https://uw.cloud-cme.com/Ap2.aspx?EID=4649&P=5.

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Angela Smith is an attending orthopaedist at Nemours/Alfred I duPont Hospital for children, and Clinical Professor of Orthopaedics and Paediatrics at Sidney Kimmel Medical College of Thomas Jefferson University. She is the past president of the American College of Sports Medicine, and acts as a member of the Executive Committee of FIMS.

She draws upon her extensive clinical experience of working with youth athletes to discuss with BJSM’s Liam West the hotly debated topic of early sports specialisation. Is this needed in order for athletes to be success? Or are we causing a higher injury risk in these kids? All this and more inside the podcast…

Further Reading: Caring for the young athlete: past, present and future - http://bjsm.bmj.com/content/51/3/141

Debunking early single sport specialisation and reshaping the youth sport experience: an NBA perspective - http://bjsm.bmj.com/content/51/3/142

Early sport specialisation, does it lead to long-term problems? - http://bjsm.bmj.com/content/47/17/1060

Youth sports injury prevention: keep calm and play on - http://bjsm.bmj.com/content/51/3/145

Sports specialised risks for re-injury in young athletes: A 2+ year clinical prospective evaluation - http://bjsm.bmj.com/content/51/4/334.2

Promoting the athlete in every child: physical activity assessment and promotion in healthcare - http://bjsm.bmj.com/content/51/3/143

Similar Podcasts: Injuries in kids: Why do they occur? Is specialisation a problem? Sam Blanchard - http://bit.ly/1HqnXsf

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AMSSM Podcast host Dr. Krystian Bigosinski is joined by Dr. Alessio Fasano, the W. Allan Walker Chair in Pediatric Gastroenterology and Nutrition and Director of the Center for Celiac Research and Treatment at Massachusetts General Hospital, as well as Dana Lis, RD, PhD, owner of Summit Sports Nutrition in Vancouver, British Columbia. Topics of conversation include the definition of gluten and FODMAPs and their potential role in leading to both gastrointestinal and constitutional symptoms in athletes, a practical diagnostic approach to evaluate an athlete manifesting GI symptoms, recognition of the spectrum of disease from gluten sensitivity to true celiac disease, when to consider initiating a restrictive diet and subsequently how to reintroduce foods, and the potential risks of athletes restricting their diets without a formal pathological diagnosis.

Links: Noakes T, Volek JS, Phinney SD. Low-carbohydrate diets for athletes: what evidence?. Br J Sports Med 2014;48:1077-1078. http://bjsm.bmj.com/content/48/14/1077

Collins J, McCall A, Bilsborough J, et al. Football nutrition: time for a new consensus?. Br J Sports Med Published Online First: 02 March 2017. doi: 10.1136/bjsports-2016-097260 http://bjsm.bmj.com/content/early/2017/03/02/bjsports-2016-097260

Lis DM, Fell JW, Ahuja KDK, Kitic CM, Stellingwerff T. Commercial Hype Versus Reality: Our Current Scientific Understanding of Gluten and Athletic Performance. Current sports medicine reports. 2016;15(4):262-268. doi:10.1249/JSR.0000000000000282. http://journals.lww.com/acsm-csmr/fulltext/2016/07000/Commercial_Hype_Versus_Reality___Our_Current.11.aspx

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A respected global voice within Sports Physiotherapy, Phil Glasgow returns to the BJSM podcast to share his thoughts and expertise on loading for injury prevention and treatment. Phil has worked at numerous major international sporting events and was the Chief Physiotherapy Officer for Team GB at the Rio 2016 Olympics. As Former Head of Sports Medicine at Sports Institute, Northern Ireland, he has amassed extensive experience in high performance sport working with elite athletes from a wide range of sports learning their best loading patterns amongst the way.

BJSM’s Liam West poses the questions that see Phil take you through the fundamental principles of loading, when to start loading after injury, different loading patterns based on tissue type and loading pattern variations during rehabilitation.

Want to hear more on loading? Check out these two conferences below that Phil and other great speakers will be discussing loading patterns more in depth;

Second World Congress of Sports Physical Therapy in Belfast, Northern Ireland on 6th-7th October 2017 (http://www.opload2017.com)
New Zealand Sports Physiotherapy Conference in Auckland, 14th-15th October 2017 (http://bit.ly/2vudQmN).

Some further reading:

PRICE needs updating, should we call the POLICE? - http://bjsm.bmj.com/content/46/4/220

Optimal loading: key variables and mechanisms - http://bjsm.bmj.com/content/49/5/278

Optimising load to optimise outcomes - http://bjsm.bmj.com/content/51/13/985

A view from New Zealand and an invitation to Sports Physiotherapy New Zealand’s Symposium (14–15 October 2017) - http://bjsm.bmj.com/content/51/5/413

Training – injury prevention paradox. Should athletes be training smarter AND harder bjsm.bmj.com/content/early/2016…sports-2015-095788

Related Podcasts: Dream Team of training load management: How training influences injury and performance - http://bit.ly/29gPxxg

Putting load management evidence into practice: Sometimes you can’t! Dr Darren Burgess - http://bit.ly/2el00rR

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One of the most influential cardiologists in Britain and a world leading expert in the prevention, diagnosis and treatment of heart disease, Dr Aseem Malhotra is a brave advocate for public health initiatives. An award-winning NHS cardiologist, Dr Malhotra has successfully motivated leading academics, the media and politicians to make sugar reduction a health priority in the UK. His academic publications can be found in the BMJ and BJSM (see links below) and he is prominent in mainstream media.

He recently published what is already a best-seller, “the Pioppi Diet: A 21 day lifestyle plan”. https://www.penguin.co.uk/books/305991/the-pioppi-diet/

Links:

Dr Malhotra explains that if folks want to lose weight they need address eating habits and food choices: http://bjsm.bmj.com/content/49/15/967 “You can’t outrun a bad diet”

Dr Malhotra on saturated fat - it does not clog the arteries. Coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced by healthy lifestyle interventions: http://bjsm.bmj.com/content/51/15/1111.

Interesting in low-carb eating and the rationale for real food? Here is obesity warrior, Dr Sarah Hallberg on TEDx. She explains how to reverse Type 2 diabetes (‘sugar diabetes’). >2million views! https://www.youtube.com/watch?v=da1vvigy5tQ

Previous related podcasts:

Dr Aseem Malhotra: You cannot outrun a bad diet. https://soundcloud.com/bmjpodcasts/you-cant-outrun-a-bad-diet-draseemmalhotra-on-weight-loss-strategies

Professor Tim Noakes: Time to revisit real food choices. https://soundcloud.com/bmjpodcasts/prof-tim-noakes-time-to-revisit-food-choices-the-real-meal-revolution-lchf-summit-for-health

Dr Sarah Hallberg: Why we get fat. https://soundcloud.com/bmjpodcasts/why-we-get-fat-insulin-is-a-fat-storing-hormone-dr-sarah-hallberg-renowned-obesity-doctor

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Ian Needleman is a Professor of Restorative Dentistry at the Centre of Oral Health and Performance, University College London (UCL) Eastman Dental Institute. Prof Needleman is on a mission to combat poor oral health in athletes. Alongside his research team, he has proven oral healthcare at the elite level to be poor, that this leads to a decrease in performance and has suggested that oral health screening should be routine for athletes (link to these papers below). You can also check out, download and use an infographic on oral healthcare published in the BJSM (link below).

BJSM's Medical Editor Dr. Liam West caught up with Prof. Needleman at the 2017 IOC Injury and Illness Prevention Conference (Monaco) to discuss why athletes should care about their oral healthcare.

You can find out more from Ian and his team on their website - www.ucl.ac.uk/cohp -

Extra Links Poor Oral Health in Professional Football Study - http://bjsm.bmj.com/content/50/1/41

Oral health screening should be routine in professional football: a call to action for SEM clinicians - http://bjsm.bmj.com/content/50/21/1295

Oral Healthcare Infographic - http://bjsm.bmj.com/content/51/9/757

London 2012 paper: http://bjsm.bmj.com/content/47/16/1054

Systematic review: http://bjsm.bmj.com/content/48/7/561.3

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The American Medical Society for Sports Medicine (AMSSM) podcast is hosted by Dr Devin McFadden (Sports Medicine Fellow, Washington D.C) is your host. He chats with Dr Bert Fields (Sports Medicine Physician, Greensborough, North Carolina), Dr Robert Oh (Sports M edicine, Fort Benning, Georgia) and Dr Chad Asplund (Athletic Sports Medicine, Georgia Southern University).

In this podcast (part 2 of 2), the experts on running injuries discuss: • What is the role of motion control shoes? • What factors unrelated to footwear do you look for in an injured runner? • What’s the role of the core? • Can nutrition contribute to obesity, metabolic syndrome even in distance runners? • What are the greatest risks to failing to meet your running goals?

Link to Laurent Malisoux’s RCT on injury risk in motion control shoes vs standard shoes: http://bjsm.bmj.com/content/50/8/481 (Free)

Link to part 1 of this podcast: https://soundcloud.com/bmjpodcasts/from-the-amssm-3-sportsmedicine-legends-on-running-injuries-illness-and-footwear

The next AMSSM Annual meeting will be in Orlando, Florida, April 24-29, 2018.

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Dr Boris Gojanovic (@DrSportSante) is a specialist sports medicine physician and a board member of the Swiss Sports Medicine Society. In addition to his Sports Medicine training, he is certified in Internal Medicine (General Medicine).

In this chat about paediatric sports development, training and injuries he shares tips on interdisciplinary management of concussion, knee injuries. He tackles hip pain including that related to femoroacetabular impingement. He reveals his lessons from working as the lead doctor for national teams in the sports of gymnastics and youth triathlon.

The Young Athletes Forum conference is in Montreux, September 21, 22, 2017. http://yaf2017.org/, Twitter @YAFfoundation

Links to related podcasts:

Lars Engebretsen on whether or not to reconstruct the ACL in children: http://ow.ly/1Hzr30e9Fu6

Ben Clarsen on monitoring workload in team settings: http://ow.ly/q6iL30e9FDw

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Andy Nicholettos @sportinjuryandy is co-founder and head of sports medicine at Prevail Golf Performance, a specialist academy that blends golf coaching, sports medicine and strength and conditioning practice. Andy is also the author of “a movement in golf performance”.

Aside from golf, Andy is the clinical lead at the Pain Clinic Oxford. He has lectured nationally and internationally on the application of pain science to sports performance, and has contributed to literature spanning exercise physiology, and orthopedics

The discussion includes: • The Tiger Woods effect • What is golf fitness? • Marrying research and clinical practice. • Back pain in the golfer • How to get patients off the treatment merry-go-round • Myths in golf practice

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New York physiotherapist Dr Karen Litzy @KarenLitzyNYC, host of physio podcast 'Healthy Wealth and Smart' poses the practical questions to Dublin’s Dr Marie-Elaine Grant. Dr Grant has been Ireland’s Olympic Team Chief Physiotherapist since 1992 and Chief Physiotherapist with the IOC Medical Commission for the London 2012 Games.

The discussion includes:

• Whether to tape or brace or not • For how long should an athlete use tape or brace? • If the athlete is superstitious? Is it OK to keep taping for luck • The K-tape question • Tape falling off – re-tape or not? • Any adverse events? Contraindications • How long do the properties of the tape last? • Bracing vs. neuromuscular training

Download the ‘BJSM’ mobile app to your phone, tablet or desktop computer if you want to benefit from over 200 experts sharing their tips.

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Prof. Roald Bahr is the Head of the Aspetar Sports Injury & Illness Prevention Programme, Chair of the Oslo Sports Trauma Research Center and a member of the IOC medical committee. Prof. Bahr’s main research area is the prevention of injury and illness in athletes, and has published more than 200 papers and book chapters.

In this podcast he talks to BJSM's Dr. Liam West about his views on musculoskeletal screening - why it doesn't work and probably never will.

You can access his review paper on this topic using the link below:

Bahr - Why screening tests to predict do not work - http://bjsm.bmj.com/content/50/13/776

Clarsen - Screening is dead. Long live screening! - http://bit.ly/2tPJ5Hu

If you want to catch Prof. Bahr and other keynote speakers get along to the Dutch annual sports medicine scientific conference in Holland on the 23rd and 24th November 2017.

http://www.sportmedischwetenschappelijkjaarcongres.nl/pg-31582-7-113164/pagina/home.html

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Jo Gibson is a Clinical Physiotherapy Specialist at the Liverpool Upper Limb Unit based at the Royal Liverpool Hospital, UK. She lectures both nationally and internationally about rehabilitation of the shoulder. Her research interests are shoulder instability and motor learning. Jo is currently Squad Physiotherapist for the Great Britain Endurance riding Team.

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Dr. Jeremy Lewis is a Consultant Physiotherapist and Professor of Musculoskeletal Research (University of Limerick, Ireland). Originally born in New Zealand, he trained in Australia before moving to England where he now works in both the Public (NHS) and Private sectors.

Dr. Lewis has distinguished himself and become a globally respected voice in the area complex shoulder issues in both clinical and research capacities.

This podcast has been adapted from one originally published by our friends Kinetic Labs (https://kineticlabs.ca/ - where you can find the full version). Dr. Lewis shares his thoughts with the listeners on;

• Shoulder Impingement • Rotator Cuff tears • Shoulder special tests and why they aren't that special • Shoulder Surgery • Shoulder Symptom Modification Procedures and how they help treat patients • What mistakes we commonly make when treating shoulder pain

For extra podcast resources on shoulder issues in SEM, check out; • Practical Clinical Shoulder Pearls with Adam Meakins - https://soundcloud.com/bmjpodcasts/shoulder-focus-with-leading-sports-physiotherapist-adam-meakins-practical-clinical-pearls?in=bmjpodcasts/sets/bjsm-1 • Prof McCormack on whether to operate on Shoulder Dislocations - https://soundcloud.com/bmjpodcasts/shoulder-dislocation-to-operate-or-rehabilitate-prof-bob-mccormack-olympic-physician?in=bmjpodcasts/sets/bjsm-1 • Scapular Summit with Ben Kibler - https://soundcloud.com/bmjpodcasts/scapular-summit-2013?in=bmjpodcasts/sets/bjsm-1 • 5 Clinical shoulder tips with Dr. Mark Hutchinson - https://soundcloud.com/bmjpodcasts/five-clinical-tips-for?in=bmjpodcasts/sets/bjsm-1 • Prof Jeremy Lewis on Rotator Cuff Tendinopathy - https://soundcloud.com/bmjpodcasts/prof-jeremy-lewis-rotator-cuff?in=bmjpodcasts/sets/bjsm-1 • Shoulder Injuries with Ann Cools - https://soundcloud.com/bmjpodcasts/shoulder-injuries-with-ann?in=bmjpodcasts/sets/bjsm-1 • The Shoulder in Sport with Ben Kibler - https://soundcloud.com/bmjpodcasts/the-shoulder-in-sport-with-ben?in=bmjpodcasts/sets/bjsm-1 • Clinical assessment of the Tennis Shoulder with Ben Kibler - https://soundcloud.com/bmjpodcasts/dr-ben-kibler-examination-and-diagnosis-of-the-tennis-player-part-one?in=bmjpodcasts/sets/bjsm-1

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Assistant Professor Dr Fiona Wilson is a Chartered Physiotherapist in the discipline of Physiotherapy, Trinity College, Ireland. She has over 25 years of clinical experience in the UK, South Africa and Ireland. She has worked with elite and international athletes throughout her career and was Lead Physiotherapist for Rowing Ireland for 10 years.

Her research has focused on sport and exercise medicine with a special focus on rowing and back pain and recently in rugby and concussion. She is editorial board member for BJSM and was awarded the prestigious Cochrane Fellowship in 2012.

In this podcast Dr Wilson shares wisdom on topics such as: • Managing back pain in the mature rower • 3 common pitfalls / stroke issues to assess • How to assess the rowing athlete • How rowers monitor load / or not • How you can use technology and apps to monitor rowers • How to apply lessons from rowing to managing back pain in all sports and among the general public • Debate on stability and mobility – are planks associated with increased incidence of back pain?

3 previous BJSM podcasts on back pain in sport include the very popular: • Tiger Woods – soon after his 2014 spinal surgery, @PeteOSullivanPT (Prof Peter O’Sullivan) feared for the worst. Was surgery a good idea? Remember this conversation predated Tiger Woods’ plunging down the world ranking. https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-peteosullivanpt-on-tiger-woods-back-and-core-strength • Tiger Woods – 2015 update. With @PeteOSullivanPT after a 2nd operation a year later. How helpful is the postoperative MRI scan? https://soundcloud.com/bmjpodcasts/test • Dr Kieran O’Sullivan (no relation to Peter above) shares 7 habits of highly effective clinicians who manage back pain. It’s had 23K listens! https://soundcloud.com/bmjpodcasts/dr-kieran-osullivan-on-managing-back-pain-7-habits-of-highly-effective-clinicians-part-2-2016

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Struggling with swimmers and their shoulders? It’s something we clinicians struggle with, and have been for a long time. Today we’re gonna take this head on, how we can move the model from external impingement to anterior superior internal impingement (ASII).

We are joined on this BJSM podcast with Andrew Delbridge and Craig Boetcher from Australia. Craig completed his PhD through Sydney University examining shoulder EMG back in 2010. He’s been the physiotherapist for the Australian swim team for the last 8 years, and offers a unique perspective to this issue, having been an elite swimmer himself.

Craig is currently supervising Kylie Holt who is completing her PhD on Shoulder pain and pathology in elite swimmers. Kylie is a senior sport physio at the Australian institute of sport, and has been looking after the swimming programme since 2009.

Our second guest is Andrew Delbridge, who has been working with Craig at Regent St Physiotherapy for the last 17 years. Andrew has been working in elite sport with throwing athletes, and has found a fresh way of looking at the swimmer’s shoulder.

1:25 What is swimmer’s shoulder? External impingement model from the 70s outdated

2:00 Difference between primary and secondary impingement

3:40 We’ve got swimmer’s shoulder wrong. Andrew explains some of the reasons.

5:10 Spoiler alert - you guessed it, its internal impingement. ASII- Anterior superior internal impingement

6:00 Clinical background that initially drove the reason for the new ASII approach

8:20 What can baseball teach us about swimming? The loads don’t make sense! Buhrkart influenced throwing shoulder which led to applying that in swimmers

9:25 3 questions to understand the swimmer’s shoulder: 1) What is the unique position for swimmers in their stroke, 2) what is the anatomical relations in that position, 3) can we reconcile pathology we see?

10:00 Unique position for the demands of swimming - elevation and internal rotation while in large amount of elevation

10:30 Literature also looks at this position (classic Hawkins & Kennedy) investigating the anatomy in this position.

11:30 Position vs load - which causes the pain? It’s mix of tensile and compressive load

12:00 ASSI explained Swimmers are super overhead workers

13:15 The data are building, but it’s still early. 60 swimmers included in large MRI study

15:00 Does this only apply to elite swimmers? No.

16:25 Key differences in ASII model: Internal not external, tendinopathy (anterior or posterior). Mix loading (compressive load in ASII) which might apply to the whole cuff, Broad term of swimmer’s shoulder to vague, sub-classification needed to differentiate treatment

18:15 3 practical tips for the clinician: 1) Shift in thinking, apply your tendinopathy theory 2) Use dynamometry to assess cuff health 3) Monitor training load.

Full text now available here: https://goo.gl/rQ4EMF

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Joining us for this BJSM podcast is the vastly experienced, Dr Roger Hawkes. We chat to him about a wide range of issues, from his role as CMO to the European Golf Tour - where he has built an incredible service, and provided incredible quality of care to the world’s best golfers – to common golfing injuries, and how to assess them.

We also touch on the innovative work being done that is looking into the health benefits of golf, and the challenges of working in such a dynamic, and multi-disciplinary environment. So if you want to get better at assessing & managing the golfers that walk through your clinic door, or want to know more about the benefits of golf (so you can further justify next weekend’s round), look no further!

Extra Resources

Andrew Murray Golf & Health podcast: https://soundcloud.com/bmjpodcasts/andrew-murray-1

ETPI twitter account: https://twitter.com/ETPI_Physiounit

Golf & Health Infographic: http://bjsm.bmj.com/content/51/1/20

The relationships between golf and health: a scoping review: http://bjsm.bmj.com/content/51/1/12

Pictorial review of wrist injuries in the elite golfer: http://bjsm.bmj.com/content/50/17/1053

Hip morphology in elite golfers: asymmetry between lead and trail hips: http://bjsm.bmj.com/content/50/17/1081

The prevalence, variety and impact of wrist problems in elite professional golfers on the European Tour: http://bjsm.bmj.com/content/47/17/1075

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Are you confused about healthy nutrition, the role of insulin, this concept of ‘insulin resistance’? Can one largely ignore a macronutrient (i.e. carbohydrates) and not drop dead within a few days?

Karim Khan, the Editor in Chief of the BJSM vouches for this podcast personally and describes Dr Hallberg as one of the people that has most influenced his understanding of a key medical concept.

In addition to Dr Hallberg’s popular (nearing 2 million views!) TEDx talk https://youtu.be/da1vvigy5tQ

Here are her further credentials. https://www.virtahealth.com/about/hallberg

When Dr Hallberg refers to blood glucose being ‘100’ she is referring to the US convention – using mg/dL which is 5.6 mmol/L in many countries (Europe, UK, Australia, Canada etc.)

Highlights include:

Dr Hallberg has great training for exercise prescription from her undergraduate and Master’s degrees in Kinesiology. She’s a medical doctor who runs a clinic for obese patients – that’s a better place to speak from than a lot of theorists in the field.

Dr. Sarah Hallberg is the Medical Director at Virta Health, a specialty medical clinic that reverses type 2 diabetes safely and sustainably, without the risks, costs, or side effects of medications or surgery.

As a physician and exercise physiologist with a passion for helping people be healthy through diet and exercise, she is responsible for providing medical supervision to Virta’s expert team of physicians and oversees the clinical strategy for Virta Clinic participants.

Dr. Hallberg is also the executive director of The Nutrition Coalition, a nonprofit organization that aims to educate the public and policymakers about the need to strengthen national nutrition policy so that it is founded upon a comprehensive body of science.

Link to Dr Hallberg’s paper:

Recent trial she refers to: http://diabetes.jmir.org/2017/1/e5/ A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes

Link to other podcasts on BJSM relating to this topic:

Professor Timothy Noakes: “High-fat for health” (11k listens) https://soundcloud.com/bmjpodcasts/high-fat-for-health

Professor Stephen Phinney “Science behind lo-carb for performance” (9K listens) https://soundcloud.com/bmjpodcasts/prof-stephen-phinney-on-the-science-behind-low-carb-diets-for-athletes-a-rational-approach

Professor Jason Fung: “Diet and obesity and diabetes” (6K listens) https://soundcloud.com/bmjpodcasts/dr-jason-fung-on-the-impact-of-diet-on-obesity-and-type-2-diabetes-mellitus

Link to Dr Hallberg’s nearly 2 million view TEDx talk: “Reversing Type 2 diabetes starts with ignoring the guidelines” https://youtu.be/da1vvigy5tQ

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Whilst at the 2017 IOC Prevention of Injury & Illness Conference, BJSM’s Liam West spoke to a key figure within the concussion research world, Associate Professor Kathryn Schneider. Kathryn is a Clinical Specialist in Musculoskeletal Physiotherapy working at the Sport Injury Prevention Research Centre located at the University of Calgary, Canada.

She was the lead author in the landmark RCT look at cervicovestibular rehabilitation in sport-related concussion in 2014 (link below). Her most recent research is discussed in this podcast and formed part of the discussion in the 2016 Berlin Concussion in Sport Meeting.

Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial (2014) http://bjsm.bmj.com/content/48/17/1294.long

Rest and treatment/rehabilitation following sport-related concussion: a systematic review (2017) http://bjsm.bmj.com/content/early/2017/03/24/bjsports-2016-097475

What strategies can be used to effectively reduce the risk of concussion in sport? (2017) http://bjsm.bmj.com/content/early/2017/03/01/bjsports-2016-097452

Remember to check out the literature on the new Sports Concussion Assessment Tool (SCAT5) here: http://bjsm.bmj.com/content/early/2017/04/28/bjsports-2017-097699

The new tool can be found here: http://bjsm.bmj.com/content/early/2017/04/28/bjsports-2017-097506SCAT5

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Ahead of the Finnish Sports Physiotherapy Congress (June 9 and 10, 2017), BJSM editor in chief Karim Khan, chats with the senior author of a study that proved that partial removal of a degenerative torn meniscus does not alleviate mechanical symptoms when compared with sham surgery. That was Teppo Järvinen (http://bit.ly/2rlfW5I), professor of orthopaedics and traumatology at the University of Helsinki and a speaker at the Finnish Congress in June.

Before that study (link below), orthopaedists were confident of the benefits of arthroscopic surgery on patients suffering from mechanical symptoms. However, “scientific proof of the benefits had been based entirely on uncontrolled follow-up studies,” said Dr Raine Sihvonen, specialist in orthopaedics at the Hatanpää Hospital in Tampere and first author of the study.

Here is the link to the study in the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMoa1305189#t=article

In the podcast we cover:

A bird’s eye view of Bruce Moseley’s seminal sham surgery study – arthroscopy was no more helpful for knee arthroscopy in older people than sham surgery http://www.nejm.org/doi/full/10.1056/NEJMoa013259#t=article
The fact that MRI is not a good predictor of who will benefit from knee arthroscopy. Here’s Dr Martin Englund’s NEJM paper. http://www.nejm.org/doi/full/10.1056/NEJMoa0800777#t=article
Ewa Roos’ and Nina Kise’s study showing that exercise provides as good results as arthroscopic meniscectomy. Remember – the patients who fail rehab also fail surgery. Look for other solutions – not arthroscopy – to cure that patient. http://www.bmj.com/content/354/bmj.i3740

Links: Here’s a YouTube video summarizing the FIDELITY study in 4 minutes. https://www.youtube.com/watch?v=RaDWkJHmEB0

Here the link to the Finnish Sports Physiotherapy Congress – June 9 & 10, 2017. http://fspa-congress.com/

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Doping ist immer ein heisses Thema, besonders in Jahren der Olympischen und Paralympischen Spiele.

Dr Markus Laupheimer (London/Zürich) stellt die Fragen in deutscher Sprache an Prof. Dr. Patrick Diel. Patrick ist Professor an der Deutschen Sporthochschule Köln am Institut für Kreislaufforschung und Sportmedizin, Abteilung Molekulare und Zelluläre Sportmedizin. Er hat ein spezielles Interesse an präventiver Dopingforschung und beantwortet uns einige interessante Fragen:

Was ist Doping?
Wo liegen die Nutzen und Risiken von Nahrungsergänzungsmitteln?
Was ist Gen-Doping?
Was ist eine Medizinisch Therapeutische Ausnahmegenehmigung (TUE)?
Wie können wir unsere Athleten vor Doping schützen?

Weitere Informationen zum Thema Doping findet Ihr unter:

https://www.nada.de/de/nationale-anti-doping-agentur-deutschland/

http://www.doping-prevention.com/

https://www.dshs-koeln.de/visitenkarte/einrichtung/zepraedo/

Für weiter englischsprachige und deutschsprachige Inhalte folgen Sie uns gerne auf Twitter @BJSM_BMJ

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Britain's leading anti-sugar campaigner and one of the most prolific doctors in the world influencing obesity thinking and highlighting the harms of too much medicine.

In addition to being a Consultant Cardiologist, Dr Malhotra is a member of the board of trustees of UK health think tank, The King’s Fund and a member of the Academy of Medical Royal Colleges Choosing Wisely Steering Group

Here’s the link to his website: http://doctoraseem.com/biography/

Topics covered include:

No association of saturated fats and heart disease in primary or secondary prevention studies.

Focus on sugar - • CVD mortality has come via reduction in smoking & trans fats with better acute AMI management.

• Statins have a number needed to treat of 1 in 83 for mortality in secondary prevention in men

• Stents save lives during heart attacks but not for 'stable' coronary disease

• PREDIMED and Lyon heart study

• Cholesterol is not the mechanism of action of how diet studies work

• Practical explanation-of frying vegetable oils and dangerous omega 6 (high omega 6 to omega 3 is bad)

• Butter and coconut oils have saturated fatty acids and are stable in cooking.

• Criticism from the Centre for evidence based medicine (Oxford).

Here is the editorial (Free) in BJSM:

http://bjsm.bmj.com/content/early/2017/03/31/bjsports-2016-097285

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What is rhabdomyolysis? Can it sneak under a clincian’s radar? What the key clinical features?

When to be alert for rhabdomyolysis

Problems when coaches are too aggressive with a new load

Two cases – clinical scenarios

When sickle cell trait complicates matters

Which athlete with sickle cell trait is at increased risk?

Can clinicians identify the athlete with sickle cell trait who is at risk of death?

To screen or not to screen. Ethics and science.

Who is ready to return to play?

Who is at risk of recurrence? It applies to athletes and war fighters.

Role of genetics – the genetic markers that clinicians can test for in a tertiary care centre

Links to a previous podcast by Fran O’Connor – Exertional leg pain http://ow.ly/j9IU30bs1oe

Links to papers: Sickle Cell paper in Medicine and Science in Sports and Exercise: https://www.ncbi.nlm.nih.gov/pubmed/?term=harmon+and+Med+Sci+Sports+Exerc

Pathophysiology of exertional death associated with sickle cell trait: can we make a parallel with vaso-occlusion mechanisms in sickle cell disease? Connes P, Harmon KG, Bergeron MF. http://bjsm.bmj.com/content/47/4/190.long

Sickle cell trait associated with a RR of death of 37 times in National Collegiate Athletic Association football athletes: a database with 2 million athlete-years as the denominator. Harmon KG, Drezner JA, Klossner D, Asif IM. http://bjsm.bmj.com/content/46/5/325.long

To screen or not to screen for sickle cell trait in American football? Harmon KG, Drezner JA, Casa DJ. http://bjsm.bmj.com/content/46/3/158.long

Return to Physical Activity After Exertional Rhabdomyolysis O'Connor FG; Brennan FH, et al. http://journals.lww.com/acsm-csmr/Fulltext/2008/11000/Return_to_Physical_Activity_After_Exertional.8.aspx

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Dr Jonathan Finnoff, DO, is the Medical Director for Mayo Clinic Square, Sports Medicine Center, Minneapolis, Minnesota. He is a specialist in Physical Medicine and Rehabilitation and Sports Medicine. He benefits from his experience as a former professional athlete in his work as the Team Physician for professional basketball teams -- the Minnesota Timberwolves and Lynx.

Dr Finnoff addresses the case of a 24 year old basketball player who has calf pain that stops her from playing but responds relatively quickly when she stops running.

Timeline • The differential diagnoses include chronic exertional compartment syndrome, vascular problems such as popliteal artery entrapment, as well as neurological causes • Physical examination is critical and there are some key tests to distinguish those different pathologies • The role of investigations including imaging • How does one make the compartment pressure diagnosis? • Treatment for chronic exertional compartment syndrome including gait retraining • More aggressive treatment including use of the meniscotome, botox injection and surgery • Outcomes of treatment including botox and surgery

Link to previous podcasts: This podcast is complemented by one with Professor Francis O’Connor: https://soundcloud.com/bmjpodcasts/professor-francis-oconnor-from-the-amssm-challenging-leg-paincalf-pain-and-military-injuries?in=bmjpodcasts/sets/bjsm-1

Andy Franklin-Miller’s BJSM podcast on exertional compartment syndrome and gait retraining: https://soundcloud.com/bmjpodcasts/running-injuries-with-andy

Andy Cornelius on how to assess a runner and what to do when you see abnormalities: https://soundcloud.com/bmjpodcasts/keeping-runnners-running-the-secrets-of-running-assessment-advice-and-exercise-progressions

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BJSM’s good friend Fran O’Connor is Director of Emergency Medicine and Sports Medicine at Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland. He is a former President of the American Medical Society for Sports Medicine (AMSSM, @theAMSSM). He also held leadership positions in the American College of Sports Medicine and the American Medical Athletic Association. He is a prolific researcher with more than 60 scientific journal publications, 25 book chapters and numerous national and international presentations.

In the podcast he addresses the following questions: • What are the main challenges seen by clinicians who work in military settings? • What is the differential diagnosis to consider in the patient with calf pain, leg pain? • How does one make the compartment pressure diagnosis? • What are the challenges of measuring compartment syndrome? • What is the conservative management for compartment syndrome? (Prof O’Connor touches on gait retraining first and foremost, Pose running technique, botox injection) • Is there a role for surgery, and if so, which surgery? What are the outcomes? • What is the role of orthoses?

Link to previous podcasts: This podcast is complemented by one with Dr Jonathan Finnoff: https://soundcloud.com/bmjpodcasts/mayo-clinic-and-amssm-sports-medicine-specialist-dr-jon-finnoff-on-managing-leg-pain-in-sport?in=bmjpodcasts/sets/bjsm-1

Andy Franklin-Miller’s BJSM podcast on exertional compartment syndrome and gait retraining: https://soundcloud.com/bmjpodcasts/running-injuries-with-andy

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How has football medicine changed in the past 10 years? What is its future?

Mike Davison, managing director of Isokinetic Medical Group in London, one of the FIFA medical centers of excellence, gives us an excellent overview of football medicine: past, present and future. In this hard-hitting podcast we also preview the upcoming Isokinetic Conference in Barcelona, where representatives from over 88 countries are attending.

Topics discussed in this podcast include: -Where has football medicine come from? What is the state of play now? -The challenges in managing re-injury and long-term rehab -Is there too much over medicine in sport? How has this come about? -What can we expect from the Isokinetic Conference? -Practical tips to break into the field for aspiring clinicians

For articles on this topic, visit http://bjsm.bmj.com/

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The American Medical Society for Sports Medicine (AMSSM) has its Annual Meeting come up (May 8-13, 2017) so we celebrate with this podcast. Dr Devin McFadden (Sports Medicine Fellow, Washington D.C) is your host. He chats with Dr Bert Fields (Sports Medicine Physician, North Carolina), Dr Robert Oh (Sports medicine, Fort Benning, Georgia) and Dr Chad Asplund (Athletic Sports Medicine, Georgia Southern University)

Topics discussed include: • Common mistakes made by amateur running athletes – training errors and hip abduction weakness get a mention • Is one type of exercise best for reducing the risk of cardiovascular disease? The trade-off between health benefits and injury risk. • Non-MSK running injuries- which ones do we need to think about? • Biomechanics of running and types of shoes • Minimalist and barefoot running- evidence supporting a different running style?

Link to JAMA study that mentioned the ‘weekend warrior’ promoting health: https://www.ncbi.nlm.nih.gov/pubmed/?term=JAMA+internal+medicine+and+weekend+warriors and the BJSM editorial commenting on it (FREE this weekend!) http://bjsm.bmj.com/content/early/2017/02/23/bjsports-2017-097538

Link to BJSM paper suggesting you can’t run to your way to health weight http://bjsm.bmj.com/content/49/15/967.long (FREE)

Link to 2016 BJSM paper where 1 in 13 runners had illness in the lead up to an event http://bjsm.bmj.com/content/50/15/939.long

Link to BJSM RED-S consensus statement: Relative Energy Deficiency (Sport) http://bjsm.bmj.com/content/48/7/491.long (FREE)

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What is abuse and how does it manifest itself in sport? In this hard-hitting podcast, Karen Litzy hosts Dr Margo Mountjoy, IOC medical commission, FINA executive board member, and associate clinical professor at McMaster University. Dr Mountjoy explores the various types of harassment, how it can occur, and what safeguards can be put in place to help athletes report abuse.

Highlights include: -What does it mean when we talk about abuse and harassment? -Youth sport and why we need to be especially careful in our younger athlete - Top tips to recognizing abuse: when is the athlete trying to tell us something? -Putting in safeguarding mechanisms to protect athletes and report abuse -The impact of social media in sport especially among “millennials” -Take home messages for working in practice

Dr Mountjoy is a Senior Associate Editor at BJSM and here’s the link for her previous podcast about energy deficiency among sportspeople (RED-S) http://ow.ly/w6w430aBmKJ

Link to the open access (FREE) IOC consensus statement on non-accidental violence in sport: http://ow.ly/YzMd30aBmA2

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In part 1 of two podcasts, Dr Ben Kibler, international shoulder authority, shares top tips on examination and diagnosis of the tennis player. (Part 2 will focus on baseball pitchers)

Dr Ben Kibler, orthopaedic surgeon and medical director of Lexington Clinic in Kentucky is a world expert on management of shoulder injuries with a particular focus on the role of the scapula (scapular dyskinesis). He has held regular ‘scapular summit’ meetings of experts in his hometown of Lexington, Kentucky, USA. The most recent summary of that meeting can be read here: http://bjsm.bmj.com/content/47/14/877

In this podcast, we discuss:

• Briefly how Dr Kibler, a surgeon, learned about biomechanics • Examination of the tennis player’s shoulder including how to perform a biomechanical analysis • Simple tests to recognize abnormal asymmetry in the tennis player • Diagnosis of injury in tennis players; search for culprit (the real cause) – don’t just incriminate the victim • The rise in the double-handed backhand in tennis and how it has increased the incidence of ulnar wrist injuries • Role of communication within the multidisciplinary team: how much should the physician know about the biomechanics? • Two tests commonly used to assess shoulder function – the Scapular Assistance Test (SAT) and the Scapular Retraction Test (SRT).

Remember to keep an eye out for Part 2 – management of the overhead throwing athlete. You can meet with Dr Kibler in person at the AMSSM annual conference. May 9-13, 2017, San Diego. It’s a prime spot on the sports medicine calendar. https://www.amssm.org/Content/pdf%20files/BROCHURES/2017_Annual_Meeting.pdf

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The Society of Sports Therapists was established in the UK in 1990 to address the growing demands from sport and leisure on everyone involved in the management and care of injured participants.

In this 2nd podcast with BJSM, Professor Smith highlights hot topics such as: (i) readiness to return to play and how it differs from return to competition, (ii) training load and contribution of new data in the training-injury field. I summarise the program for the 2017 conference “From Pain to Performance” (May 20th, 2017) that features Peter Brukner, Bill Knowles, and Susan Alexander.

The Society of Sports Therapists is one of 25 member societies that partners with BJSM:

Links: Home page for the Society of Sport Therapists http://www.society-of-sports-therapists.org/index.php

Where to study Sports Therapy (BSc Hons) http://www.society-of-sports-therapists.org/index.php/public/degree_courses_BSc

Where to study Sports Therapy if you already have a relevant degree (MSc) http://www.society-of-sports-therapists.org/index.php/public/degree_courses_MSc

Previous podcast: 2016 https://soundcloud.com/bmjpodcasts/focus-on-sports-therapists-and-students-considering-sports-therapy-professor-graham-smith

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What are the odds? Understanding Risk and Uncertainty.

Today we welcome Dr. Rod Whiteley for the first time ever to the BJSM podcast. Rod has done a bunch of work in shoulder injuries (measuring load and strength long before it got sexy). And the rumour is he’s still got a pretty good curve ball. A clinician for well over 20 years, He is the current assistant director of the Rehab department here at Aspetar Orthopaedic and Sports Medicine Hospital, and he has also contributed heavily in the area of hamstring rehabilitation and groin injuries. Look out for him on twitter @RodWhiteley, where’s he’s happy to be unpopular to point out the obvious.

Rod is a clinical researcher, interested in how practitioners can understand statistics better, and integrate that in their daily practice. In this podcast, Rod and I talk about how we understand risk, in particular percentages and odds. And no, they’re not the same thing.

2:45 The difference between odds, ratios, and percentages.

3:20 An example: ACL and hamstring injuries as an example, looking at the base rate for how often these injuries happen (ACL infrequently, and hamstrings quite frequent), and then adding a likelihood ratio and how does that change the odds.

5:20 Chad Cook and Erik Hegedus really turned our ideas around interpreting risk around. Clinicians need to understand pre- and post-test odds. Find the related articles here (http://bmj.co/2m65v43) and in the links below.

6:30 Mladen Jovanovic (@Physical_Prep) - heuristics and uncertainty, published recently here (http://bmj.co/2nrRUUX) in the Aspetar journal. We have to get more comfortable with the uncertainty of these tests.

7:46 Understand base rates, and using tests that have large likelihood ratios in our clinical assessment. Pre-test odds will influence how you interpret your clinical test, which then changes your post-test odds.

10:14 Can we do the same for prevention, and identifying risk? IOC world conference prevention of injury and illness in sport (http://bmj.co/2m64AR8) in Monaco will focus this year on the value of screening. Screening allows us to identify modifiers and change potential interventions at a group level.

10:31 The importance of population level studies, looking for associations with subsequent injury. Screening is useful for injury prevention. “But if you’re doing a test to tell someone they are or aren’t gonna get injuried, you’re gonna make a monkey of yourself in open court pretty quickly.”

12:27 WHO report on risk of cancer risk associated with eating bacon/processed meat. If we ignore the base rate, we might be fooled by the actual change in risk. And then you still need to interpret that for the individual.

14:00 Absolute vs Relative risk, and what is the actual event happening. We don’t think of delayed onset of muscle soreness (DOMS) and sudden cardiac death the same.

14:15 Two players with the same risk of injury, but totally different interpretation of their result.

15:12 Predicting vs Forecasting - “An experiment that only happens once.” You only get one season and and you either get an injury or you don’t. We have to be more comfortable with that kind of uncertainty.

16:35 Predicting return to play with clinical outcome measures.

18:30 How do we interpret and incorporate percentages and odds into our clinical setting.

Links:

IOC world conference prevention injury and illness in sport (http://bmj.co/2m64AR8)

Available for FREE from BJSM (http://bjsm.bmj.com/)

Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests (http://bmj.co/2mwMP90)

A combination of initial and follow-up physiotherapist examination predicts physician-determined time to return to play after hamstring injury, with no added value of MRI (http://bmj.co/2mx0r3Z)

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Screening is one of the hottest topics in Sports Medicine, and a topic which is constantly evolving. The BJSM has provided a platform for much of the academic literature concerning screening, but what actually happens at the coalface? In part one of this special podcast with Arsenal FC giants Colin Lewin, and Dr Gary O’Driscoll, we heard about the role of screening in professional sport, and how it ties in with player medicals, which is further elaborated on in this podcast. Other topics that are touched upon include the role of technology in predicting injury, the pressure of the jobs, and some tips for anyone working in football medicine/hoping to do so one day!

This podcast is bound to generate some deal of controversy, and if you’re looking for a platform to voice your opinion, you shouldn’t miss the Arsenal SEMS conference, with insights from the likes of Professor Roald Bahr, Adam Meakins, and Des Ryan amongst other influential names. The link to the event can be found at http://www.arsenal.com/semsconference - it’s bound to be one of the most insightful conferences of 2017!

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Bruce Forster is the Head of Radiology at the University of British Columbia. He was previously the director of diagnostic imaging at the Vancouver Winter Olympics and has authored over 80 peer-reviewed publications. In this podcast, we discuss:

The role of MSK ultrasound in sports medicine and how to learn
Structures that can be imaged and their challenges
What to look for when purchasing an ultrasound machine?
Ultrasound guided injections, including evidence behind PRP, stem cells and cortisone
Pain science and the role of radiology in treating chronic pain
Imaging for prognosis and RTP -when to image?

Bruce is presenting a workshop at the IOC Prevention Conference- details can be found here : http://ow.ly/SFcJ309KUve

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Screening is one of the hottest topics in Sports Medicine, and a topic which is constantly evolving. The BJSM has provided a platform for much of the academic literature concerning screening, but what actually happens at the coalface? BJSM Associate Editor Steffan Griffin chats to two giants of the football (and sports) medicine world – Colin Lewin, and Dr Gary O’Driscoll, who both head up the medical department at Arsenal Football Club – about the practical aspect of screening, and what role it plays in elite sport.

This podcast serves as a little taster to the Arsenal SEMS conference, which this year focuses on the role of screening, with insights from the likes of Professor Roald Bahr, Adam Meakins, and Des Ryan amongst other influential names. The link to the event can be found at http://www.arsenal.com/semsconference

Topics covered in this part one include: What is involved with a player ‘medical’? Who is involved with a player’s ‘medical’? Is there a role for screening in elite sport?

Look out for the upcoming Part Two – where screening and player medicals are discussed in further detail.

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Professor Tim Caulfield (@CaulfieldTim) is a best-selling author in the health and popular science domain. He has published over 300 articles into the ethical, legal and health policy of a broad range of topics including stem cell therapies, genetic testing, obesity treatment and the prevention of chronic disease. In this podcast, we discuss:

• Genetic testing and its predictive value- what place does it have in sports medicine? • Stem cell therapies- evidence behind it and how it is portrayed by the media • PRP- therapeutic benefits or another health fad? • The role of athletes as celebrities in advocating new treatments • 6 simple ways to maintain a healthy lifestyle.

Links to Tim’s hugely successful books can be found here http://ow.ly/TEfJ309ise8

David Epstein (@DavidEpstein) book The Sports Gene here: http://thesportsgene.com/

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Professor David Hunter is a leading rheumatologist and researcher working at the University of Sydney. David has over 350 publications in rheumatology and has co-authored several books providing self-management strategies for patients with osteoarthritis. In this podcast, we discuss:

• Treatments of OA, what does and doesn’t work • How to take a detailed history and examination from a patient with OA • Cornerstones of patient care: behavioral change, self management and weight loss • Weight loss strategies and how to maintain it • Physiology behind how exercise improves symptoms • Pharmacological and surgical treatments for OA

David caught up with Karim Khan after the 2017 Australasian College of Sport and Exercise Physicians (ACSEP) conference in the Gold Coast. The next event is February 2018 and is sure to be a huge success! http://ow.ly/t20j3093yZq

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Eamonn is a wonderful clinician-scientist who graduated with a 1st Class Honours Degree from the University College Dublin (UCD) School of Physiotherapy in 2003 placing first in his class. Eamonn received a prestigious Irish Research Council for Science Engineering and Technology (IRCSET) post-graduate research scholarship. He was awarded his PhD from the UCD School of Physiotherapy and Performance Science in 2006, In this podcast that combines science with clinical application topics include:

• The high prevalence of ankle injuries and the high risk of the development of chronic residual symptoms. • The characteristic features of CAI. • How to manage the young soccer player who sustains an ankle injury. • Detailed discussion of (1) modified Ottawa Ankle Rules; (2) determination of lateral ligament laxity; (3) syndesmosis assessment. • How to assess for chronic ankle instability • Mechanical insufficiencies including: (1) pathological laxity; (2) arthrokinematic restrictions; (3) synovial changes; (4) degenerative changes. • Functional insufficiencies including: (1) impaired proprioception; (2) impaired neuromuscular control; (3) impaired postural control/postural balance; (4) impaired strength. • Assessment of laxity and the use of taping and bracing. • Patient-reported outcome measures clinicians can use including the FAAM, CAIT & idFAI

Associated papers and tools:

Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis http://bjsm.bmj.com/content/early/2016/11/24/bjsports-2016-096858.long

Cumberland ankle instability tool (<24/30)

idFAI – > 11 – chronic ankle instability (>11)

Foot and ankle ability scale: FAN ADL(21 items) and FAN sport (8 minutes)

Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. http://bjsm.bmj.com/content/48/13/1014

2016 consensus statement the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. http://bjsm.bmj.com/content/50/24/1493.long

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You want the big names on BJSM podcasts and Twitter asked for Dr Graeme Close. Fresh from the UK undergraduate student conference, Graeme shares pearl after pearl on this top podcast. What do you do in a first consultation? How does nutrition in team sport vary from individual sport? What’s the key to a successful pre-game routine? How should nutrition change when an athlete is injured? Supplements? Coffee? Sleep? Take home tips – all in this 16 minute gem.

Graeme has a great CV for his role in top sport. He is (i) a former professional rugby league player (clips here https://youtu.be/1mHljSGlQwA) (ii) a sports science PhD and now faculty at Liverpool John Moores University (iii) rumored to be the only person in the UK accredited with the official bodies for sports science (BASES), sports nutrition (SENr) and strength & conditioning (UKSCA). We call that the ‘triple crown’.

Kudos to medical student Tej Pandya for organizing the conference and for a great debut as a podcast host. BJSM’s podcasts have been hosted by 23 different interviewers and there are podcasts in 5 languages. Feel free to submit a podcast for our consideration. (info.bjsm@bmj.com)

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A world leader in sportsphysiotherapy, Associate Professor Dr Kristian Thorborg is from Copenhagen University. He is renowned for his studies and clinical workshops related to patients with hip, groin, hamstring and knee related injuries.

Here he outlines:

the paradigm shift for the use of exercise to treat conditions such as tendinopathy and hamstring strains. He addresses questions such as ‘What is the ideal type of exercise?’ and ‘Does the body know if the exercise is concentric or eccentric?’
cheap technology that can be used to help patients measure the load they are using and to check compliance
the challenge of treating patients in season
the concept of progression and the different stage of rehab that is preparation for ‘return to play’
prevention – it needs monitoring of the players – waiting until they show up with pain is too late

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How does a leading shoulder physiotherapist approach patients in the clinic? What are 3 fundamental principles that guide every consultation? Hear from extended scope practitioner Adam Meakins on how his approach to the patient with shoulder pain has changed over the past years.

Learn how you can provide exercises for your patient without needing sophisticated video equipment or cameras. Listen to tips on how to tell if the patient is fearful, perhaps at greater risk for a central contribution to pain.

Timeline 0:40 - Adam makes the case for 3 principles that guide every consultation 2:30 - Encouraging movement – both for health and to exercise injured parts (e.g. the shoulder) 4:00 - The need for patient education and advice. And how to do it. 8:35 - How much pain is OK? 10:30 - Treating the patient as an individual – the whole patient 12:40 - Is there a central component of pain? 13:19 - Which exercises to choose

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The Berlin Concussion in Sport Consensus Meeting was held in October 2016 and the experts are currently writing the systematic reviews and agreeing on the final statement from this event. In the meantime, various panel members are sharing some key messages the world over. The knowledge translation needed from event such as this is extensive.

The experts are Dr Jon Patricios, sports physician and former President of the South African Sports Medicine Association (SASMA) and Paul McCrory, Associate Professor and neurologist at the Florey Institute of Neuroscience and Mental Health, Australia. Both attended the Berlin meeting.

Timeline: 0:45 Immediate management of concussion

2:54 Differences and common ground from elite level competition to the community setting

5:00 Balance and visual disturbances

8:26 Concussion in the developing brain

14:34 The update on CTE – chronic traumatic encephalopathy

16:40 Take home messages

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Rugby is often maligned in the press for its inevitable relationship with concussion, with numerous high-profile incidents only compounding the issue. If your reading is restricted to the newspapers, you’d be forgiven for thinking that a culture of denial is in place, however when you delve deeper, there are numerous examples of innovative and powerful research, all of which is already leading to law and policy changes. One leading light in the sport is the Rugby Football Union (RFU), who are actively conducting policy-informing research, and using this to shape the game in order to maximise player welfare. Steffan Griffin, of the BJSM, caught up with Dr Simon Kemp (Chief Medical Officer), Dr Matt Cross (Professional Rugby Medical Research Officer), and Dr Mike England (RFU’s Community Rugby Medical Director), who provide an insight into their work, which is not only shaping the way the game is played, but provides a fantastic blueprint for other sports to follow. Here is Part 2!

Timeline: 0.35: Is there a relationship between when players are removed & their subsequent recovery?

5.13: What else is the RFU doing around concussion?

8.36: Will we ever prevent concussions in rugby?

16.45: What are we hoping to hear about at the Berlin Consensus Conference?

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Professor Lars Engebretsen is the Head of Scientific Activities in the Department of Medicine and Science at the International Olympic Committee. An orthopaedic surgeon, he is a strong advocate of the multidisciplinary approach to patient care. Among his many awards are the Nordic Prize in Medicine and the American Orthopaedic Society of Sports Medicine Hall of Fame. He is the Editor of the BJSM’s Olympic-supported issues (4 per year, usually numbers 1, 7, 11 and 17).

Timeline: 0:40 mins - Surgical management of the patient with the acute ACL rupture – emphasis on early rehabilitation

1.44 mins - Prehabilitation – a definite focus

5.54 mins - The locked knee – what is it and how does finding one affect management?

8.00 mins - Is surgery indicated for meniscal injuries or not?

9.12 mins - The paediatric ACL (age 8-12 years). What’s the best management?

13.50 mins - IOC education courses with a focus on the 2-year online diploma.

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Do you consider the first 10 seconds of a consultation to be important? Have you looked at your clinic space and how that might affect your patients? In this podcast Steve Aspinall (BASRaT) speaks to Richmond Stace @painphysio about the importance of compassion and active listening in the treatment of pain.

Richmond is presenting at the BASRaT symposium on the 18th of November in London.

Our Symposium this year will focus on pain; with unmissable keynote speeches from experts in the field and presentations and workshops that will enrich your knowledge. Focussing exclusively on pain and all its forms and manifestations it will be vital for practitioners to help manage and manipulate pain and help people from all walks of life.

Our unmissable range of speakers includes Richmond Stace who is leading advances in understanding and treating pain and has created the pain coach programme.

Richmond will look into the importance of the first point of contact, how we can gain information from the first few words.

We have a range of workshops including "Gold from Rio"- BASRaT Sport Rehabilitator, Hannah Crowley helped Ed Clancy on his road to recovery from a back injury and to his gold medal win at Rio.

Our closing keynote "Pain, the Brain and a little bit of Magic" will be presented by Professor Anthony Jones. Professor Jones is an MSK pain specialist and leads the Human Pain Research Group.

This one day event on Friday 18th November will be packed full of essential speeches, presentations and seminars, enriching your knowledge and aiding your work. BOOK NOW. Visit basrat.eventbrite.co.uk.

Timeline: 1:03 How big is the problem of pain?

2:39 What does good communication mean?

8:00 What are the key points in an interview about pain?

12:11 How to pain the patients journey?

16:44 Is neuroscience education important?

18:59 Key messages for the clinician

Links: http://basrat.org/ http://www.eventbrite.co.uk/o/british-association-of-sport-rehabilitators-and-trainers-6930299875

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Over the last 20 years across the western world the increasing toll of sedentary behaviour on young peoples physical and mental wellbeing is a well-documented phenomenon. Many different piecemeal policy initiatives have failed to tackle the problem. In this podcast Steve Aspinall (BASRAT) speaks to head teacher Elaine Wyllie about the daily mile initiative. This simple game changing initiative provides massive public health benefits though a simple philosophy of non-competitive outdoor fun that is accessible to all children regardless of age, gender, ability or socioeconomic background. Listen to Steve and Elaine discuss this inspirational initiative and find out how you can get involved:

Timeline: 1:03 What is the daily mile? 1:49 How is the daily mile implemented in schools what are examples of best practice? 4:54 Does the daily mile work for all children? 8:56 How does the weather impact participation? 11:43 Local and national level support 15:04 Preliminary results of a large scale study 17:00 How to get involved

Links: http://thedailymile.co.uk/ http://basrat.org/ http://www.eventbrite.co.uk/o/british-association-of-sport-rehabilitators-and-trainers-6930299875

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Rugby is often maligned in the press for its inevitable relationship with concussion, with numerous high-profile incidents only compounding the issue. If your reading is restricted to the newspapers, you’d be forgiven for thinking that a culture of denial is in place, however when you delve deeper, there are numerous examples of innovative and powerful research, all of which is already leading to law & policy changes. One leading light in the sport is the Rugby Football Union (RFU), who are actively conducting policy-informing research, and using this to shape the game in order to maximise player welfare. Steffan Griffin, of the BJSM, caught up with Dr Simon Kemp (CMO), Dr Matt Cross (Professional Rugby Medical Research Officer), and Dr Mike England (RFU’s Community Rugby Medical Director), who provide an insight into their work, which is not only shaping the way the game is played, but provides a fantastic blueprint for other sports to follow. This is Part 1: in the build up to the Berlin Consensus Conference.

Timeline: 01:15: Can you give us some insight into the scale of concussion in Rugby Union?

04:00: Are the rising rates due to increased incidence or due to people being more likely to recognise and report it nowadays?

06:45: What is the RFU’s general approach to the management of Concussion?

08:45: Can you tell us a little about the ‘recognise, remove, recover and return’ campaign?

14:00: So the aim is to remove as many concussed players from the pitch as soon as possible: what else is the RFU doing to try and ensure this?

19:15: you have published a number of papers in the BJSM – one of which showed a relationship between concussion and subsequent musculoskeletal injuries – could you please elaborate?

21:50: What does this mean about the return to sport following concussion? How could this influence practice?

Links Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015 http://bjsm.bmj.com/content/early/2016/09/01/bjsports-2016-096461.abstract

The accuracy and reproducibility of video assessment in the pitch-side management of concussion in elite rugby http://www.jsams.org/article/S1440-2440(16)30142-6/abstract

Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes http://bjsm.bmj.com/content/early/2015/12/01/bjsports-2015-094982.full

BJSM Podcast with the Heath Brothers & Mike Evans: https://soundcloud.com/bmjpodcasts/23-5-hours-to-switch-behaviour?in=bmjpodcasts/sets/bjsm-1

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Phil Glasgow is the head of sports medicine at the Sports Institute, Northern Ireland. A vastly experienced physiotherapist, he has worked at 3 Olympic Games, and has just returned from Rio. In this podcast, we discuss a case history of a football player with hip pain, from assessment to RTP. We look at the sensitivity vs. specificity of various tests, how to explain the symptoms to patients, and any co-existing pathologies there may be in the athlete. Finally, the discussion moves to treatment, the role of manual therapy, and exercises the patients can do to increase strength in the tissue.

The 2nd World Conference of Sports Physiotherapy will be held in Belfast, 2017- details can be found here: http://bit.ly/2dP2HjH

Timeline 0.40 - Hip pain: a case history and when is it reported to the physio? 3.08 - Ruling things out in the hip is easy: how do we rule things in? 7.30 - Things to consider when treating the hip 10.30 - Prescribing exercise for the patient - how do we go about it? 13.00 - How to increase the load in the injured athlete 18.26 - Bridging exercises for the hip 22.50 - Building a model for the pain and tips from the top

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“A few years ago, like most doctors, I was pretty ignorant on the topic of food and medicine” is how Peter Brukner, Professor at Latrobe University’s Sport and Exercise Medicine Research Centre opens this podcast. He summarises 4 years of engaging seriously with nutrition for health and in sport. His comments apply to the general public, the recreational athlete and he shares his experience from elite level sport. Peter has been involved in an international nutrition educational leadership group that includes Professor Timothy Noakes, Dr Aseem Malhotra, Dr Sarah Hallberg, Dr Jason Fung, Nina Teicholz and Gary Taubes. Recent reports that the sugar industry paid two Harvard professors to write a piece for the New England Journal of Medicine https://www.statnews.com/2016/09/12/sugar-industry-harvard-research/ makes the opinion of unbiased academic clinicians like Peter Brukner even more timely.

Relevant links: Peter Brukner on the other side of the mike interviewing Professor Timothy Noakes: https://soundcloud.com/bmjpodcasts/high-fat-for-health

Dr Jason Fung on the impact of diet on obesity and type 2 diabetes mellitus: https://soundcloud.com/bmjpodcasts/dr-jason-fung-on-the-impact-of-diet-on-obesity-and-type-2-diabetes-mellitus

Prof Stephen Phinney on the science behind low carb diets for athletes: A rational approach: https://soundcloud.com/bmjpodcasts/prof-stephen-phinney-on-the-science-behind-low-carb-diets-for-athletes-a-rational-approach?in=bmjpodcasts/sets/bjsm-1

If you think that BJSM is only sharing one side of the story please use our various channels to contribute. Papers, blogs, podcasts, Twitter, Facebook - we’d love to hear from you. We haven’t rejected any papers saying that hi-carb is good for you!

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In this podcast, Steffan Griffin of the BJSM speaks to Dr Andrew Murray – SEM consultant & adventurer (amongst other things!), who is currently undertaking a PhD looking into ‘Golf and Health’. We talk about how the Golf and Health project was born, and some of the notable findings from his recently published scoping review. This is a must-listen for any SEM professional/student, not only due to some of the clinical pearls, but due to the fact that this is a shining light of what other sports could also be doing!

Contents 1.00: Andrew tells us about the Golf and Health project

2.30: What are the main findings from the scoping review?

5.30: Deeper dive into the potential benefits

6.45: What about mental health?

7.30: Could spectators also be reaping some of the health rewards associated with playing?

9.45: What lessons are there for other sports?

Links Scoping Review http://bjsm.bmj.com/content/early/2016/09/26/bjsports-2016-096625.full

Infographic http://bjsm.bmj.com/content/early/2016/09/20/bjsports-2016-096866.full.pdf+html

Golf and Health website http://www.golfandhealth.org/

Golf and Health twitter https://twitter.com/GolfAndHealth

Golf and Health facebook https://www.facebook.com/GolfAndHealth/?fref=ts

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Dr Clare Ardern is a sports physiotherapy researcher at Linkoping University in Sweden. She carries Australia’s prestigious NHMRC’s top scholarship for clinician researchers – the 4-year Fellowship Award. You may know of her publications that highlight the relatively low return to play rates after ACL reconstruction. In this podcast, she addresses return to play more broadly. From 12-15th October this year she will be a keynote speaker at Sports Medicine Australia’s conference. You can follow that via BJSM Twitter #SMAConf16 and Facebook.

She was interviewed by Dr Christian Barton, who is a well-published physiotherapist PhD as well. He serves as BJSM Deputy Editor and the Editor responsible for Social Media (small job! easy!).

Timeline: 1:00m - Where did the Return To Play Consensus come from?

2:00m - Defining Return to Play; what does it mean in different settings

3:00m - The difference in RTP for o/c acute – removal from play?

4: 10 - Decision making – how should the return to play decision be made?

3:30m - Return to Play is a continuum that requires meticulous planning

4:00m - When can the athlete return to a pre-injury (or better) level of performance?

4:30m - What is the evidence for return to play decisions? Spoiler alert! – It’s limited.

5:20m - Taking the emphasis of the ‘one day’ that players focus on to be back at sport. The concept of a continuum (from when you first see the athlete).

6:45 - Return to play and returning to perform at the previous level. Are there important differences? What can clinicians do to help players get back to that level?

8:30m - Does ‘Return to Play’ end? It’s very different for different athletes.

10:10m - Should athletes have ACL reconstruction after ACL injury? What does the research show?

11:40 - Clare’s perspective on the return to play data after ACL reconstruction in the non-elite players.

12:15 - An example of a player in the English Premier League who was ACL deficient.

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Professor Peter O’Sullivan is among the top 3 most popular physiotherapy voices on podcasts and here he focuses on myths and harmful beliefs about back pain. He takes a swing at clinicians who rely excessively on imaging findings to attempt to explain the source of pain. He shares the story of a clinician who told a patient his spine was ‘shredded’.

Prof O’Sullivan emphasizes the importance of history taking, finding factors that can sensitize neural tissue and gives an overview of treatment. He will be the keynote Refshauge Lecturer at Sports Medicine Australia’s 2016 Conference (#SMAConf16, @SMA_Events).

Timeline: 0.35 m - A sneak preview of the Refshaughe lecture plan – back pain is a big problem and those in sport can learn from what is known in back pain in the general population

2.17 m - Patients respond well to a combination of explanation, being shown ways they can get back to the things they love to do, and appropriate progressive exercises

4.21 m - A case where a patient could have been treated with early investigation, aggressive medical intervention, potentially surgery. An alternative approach to management

6.48 m - How junior clinicians can approach the patient who presents with a bag of images or a medical note that may not reflect current best practice for managing back pain

9.45 m - The biology of how neural tissue can be sensitized by lack of sleep, stress. Fascinating neuroimmunology

10.55 m - You do treat the back don’t you? It’s not just explaining pain, counseling?

12.30 m - Parallels with work of other physiotherapists such as Prof Jill Cook (@ProfJillCook) and Dr Alison Grimaldi (@alisongrimaldi) who advocate for progressive loading as a stimulus for healing. “Backs love movement”

13.55 m - A 30-second summary!

Related podcasts: Please consider downloading the mobile app “BJSM’ from iStore or GooglePlay. There are over 250 to choose from and the 10 most recent are very easy to get via the app.

Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’ http://ow.ly/uNgj304udUI
Dr Kieran O’Sullivan (@KieranOSull) on how top clinicians approach back pain http://ow.ly/18Ru304ue96

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Professor Damian Griffin talks about the Warwick Agreement, an international consensus on the management of femoroacetabular impingement syndrome. This podcast brings you right up to date on the most current thinking about hip impingement or FAI.

0.38 Aim of the consensus 1.36 Consensus methodology 2.26 What is FAI syndrome? Symptoms, clinical signs, and imaging findings. 3.40 How should FAI syndrome be diagnosed? 6.26 What is the appropriate treatment for FAI syndrome? 8.26 What is the prognosis of FAI syndrome? 10.23 How should someone with an asymptomatic hip, with cam or pincer morphology, be managed? 11.53 What research is now needed? 14.15 How is this new definition of FAI syndrome going to influence clinical care?

@DamianGriffin #WarwickAgreement

Damian’s passion is the diagnosis and treatment of hip and groin pain in young adults. His clinical practice and research focus on joint-preserving surgery for early arthritis, hip arthroscopy, the management of femoroacetabular impingement and sport injuries of the hip. He runs the largest national referral service for young and active people with hip pain in the UK, based at the University Hospital of Coventry and Warwickshire NHS Trust, and for private patients and elite athletes in London and Coventry (www.hiparthroscopyclinic.co.uk).

Damian leads a research team based at the University of Warwick, with a portfolio of hip research. In particular he is the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302

You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk

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Leicester City’s league title was widely seen as one of the biggest upsets in sporting history. But was it really that surprising? Christian Barton (La Trobe University) talks to Dr Paul Balsom, the Head of Sports Science at Leicester City and analyst with the Swedish National Football Team.

In this podcast, Paul explains how teamwork and culture led to players avoiding the medical room. We then go on to discuss the role of evidence-based medicine in sports, and how the ideas employed by Leicester can be transitioned between sports. Lastly, the conversation moves on to the ongoing season, which will see an increased number of matches for the team and how to manage this load.

Link to the upcoming SMA Conference where you can see Dr Balsom: http://tinyurl.com/jx739en

And a podcast with one of the other keynote speakers: http://tinyurl.com/zaoncqq

Timeline: 0.40 - The key factors behind the success of Leicester. 2.00 - How do you achieve good communication in a football club? 3.55 - Keeping all the players fit - by putting responsibility onto them! 5.40 - Optimising performance - what role does EBM have in sport? 7.22 - What medical teams can learn from each other. 9.02 - How to manage an injury free rate with increased load - looking at the new season. 10.45 - The principles behind measuring load in players.

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ACL injuries are some of the most common and debilitating injuries in athletes. In this podcast, Tim Hewett and Kate Webster talk about the biomechanical risk factors for ACL injury, the role and potential of screening, and the use of ACL prevention programmes.

Tim Hewett is an expert in biomedical engineering work at the Mayo Clinic and Kate Webster is an associate professor at La Trobe University. They are both speaking at the upcoming Sports Medicine Australia Conference-more details can be found here-http://tinyurl.com/h4ndfy2

Timeline: 0.40 - What is the biggest risk factor for ACL injury? 2.10 - How are ACL injuries preventable? 4.10 - Can we screen for injury risk? 6.00 - Key criteria for RTS. 9:40 - The high risk of re-injury following ACL damage. 13.00 - Are we returning athletes too soon post injury?

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Often tendinopathy will be resistant to even the best traditional rehabilitation methods. Liam West chats to Dr Ebonie Rio, a PostDoctoral Fellow at La Trobe University’s Sports and Exercise Medicine Research Centre in Melbourne. Dr Rio’s research aims to explain the role of the primary motor cortex in tendinopathy. She discusses tendon neuroplastic training (TNT) and how it might help your tendinopathy patients regain pain free function in the clinic.

Timeline 0.40 – Why traditional rehabilitation for tendinopathy might be unsuccessful 1.40 - Changes in primary motor cortex and motor control in tendinopathy 2.35 – What is TNT & how to utilise it? 5.30 – How long does it take for TNT to help patients? 6.30 – Cross education for tendinopathy

Further Reading Tendon neuroplastic training: changing the way we think about tendon rehabilitation – OPEN ACCESS - http://bit.ly/29ergE3

Revisiting the continuum model of tendon pathology - http://bit.ly/29rSDPK

Related Podcasts Prof Jill Cook revisits Tendon Pathology - http://bit.ly/1UR3tvL

Prof Michael Kjaer on the pathogenesis of tendinopathy and tendon healing - http://bit.ly/29pOZol

Defining tissue capacity - http://bit.ly/29iVSKc

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Dr Kieran O’Sullivan, PT, PhD, was one of the first podcast guests to crack 9,000 listens! From the University of Limerick, Ireland, he has vast clinical experience and he completed a PhD on the role of sitting in back pain. In this 18-minute podcast he reviews his 2015 podcast in the first 3 minutes and then rattles off at least 7 practical tips.

Kieran was a guest of PhysioFirst (UK) when BJSM interviewed him in April 2015. The 2017 PhysioFirst conference is on April 1-2 (2017!) in Nottingham (UK) and guest speakers include Professor Paul Hodges, Dr Tania Pizzari and Dr Igor Tak.

Timeline: 1.00 m Back pain is neither explained by what patients and clinicians see on scans nor just by load

2.00 m When treating, you need to assess the various factors that could be playing a role, such as load, posture, stress, and address the right one.

4.00 m Should we try to prevent all back pain? Listen to Dr O’Sullivan challenge the belief that it’s important to never have back pain. He likens back pain to conditions like sadness, constipation – not great but not a major problem as long as it doesn’t persist. Athletes need to load their bodies and adapt rather than avoid load and become vulnerable (See Gabbett papers and podcast, below). Don’t pass on fear (of back pain coming on or persisting) to athletes.

5.00 m Screen for red flags of course, if the clinical picture warrants it – but most long-term back pain is NOT due to something listed as a red flag.

6.00 m Reassurance – being empathetic without inducing fear.

7.00 m Think through. What precipitated the pain? Too much load, too much stress, bad posture, movement patterns? If unknown, have patient create a pain diary. Look for trends. Examine all the dimensions of the biopsychosocial model.

9:00 m Don’t just make the diagnosis but be practical. Patient sad? Don’t just say ‘You are sad, your back pain will go away’. Provide specific treatment for the specific threat.

10:00 m Empower the patient to choose the exercises he or she wants and what he or she will do! Exercise has benefits across systems.

11:00 m Don’t give up. Here Kieran walks us through a challenging real life case. A simple tissue diagnosis would not have helped this person at the centre of the case

12:00 m Explain! Explain the pain! (HT to Professor Lorimer Moseley and Dr David Butler).

13:00 m The period at 4-6 weeks of pain can be difficult – patient has not adapted to the contemporary model and may still be on waiting list for imaging.

14:00 m What is the evidence for this approach? How does the evidence compare, with, for example Hamstring injuries?

Links to previous podcast: 2015 – Dr O’Sullivan on “Effective treatments for back pain: Kieran O'Sullivan’s practical tips within a guiding framework” http://ow.ly/4nepGu

BJSM paper: O'Sullivan K, O'Sullivan P. The ineffectiveness of paracetamol for spinal pain provides opportunities to better manage low back pain. Br J Sports Med. 2016 Feb;50(4):197-8. http://ow.ly/4neqbS (Members Only/subscribers)

Manual Therapy paper: Hurley J, …., O'Sullivan K. Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials. Man Ther. 2016 Mar 10. pii: S1356-689X(16)00017-5. doi: 10.1016/j.math.2016.02.009. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/27026111

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All clinicians aim to classify muscle injury classifications to guide treatment and predict return – it’s a hot topic. The British Athletics Muscle Injury Classification is one helpful classification system and Dr Noel Pollock explains to Dr Markus Laupheimer (BJSM) how and why the Classification developed, as well as why the (older) Munich classification was not ideal. Listen for tips on how this classification adds something special and is of practical value for treating your athletes with muscle injuries.

Timeline: 01:01m – Why a new muscle injury classification?

03:50m – Limitations of the Munich consensus Open access Munich Paper: http://bjsm.bmj.com/content/47/6/342.full.pdf+html

05:18m – British Athletics classification explained Open access British athletics paper: http://bjsm.bmj.com/content/48/18/1347.full

09:15m – Clinical application, follow up papers

12:00m – Discussion: MRI or not? http://bjsm.bmj.com/content/49/24/1579.full

14:05m – Future Development of muscle injury classification

Links: British athletics muscle injury classification: a new grading system http://bjsm.bmj.com/content/48/18/1347.long (Open Access)

Time to return to full training is delayed and recurrence rate is higher in intratendinous (‘c’) acute hamstring injury in elite track and field athletes: clinical application of the British Athletics Muscle Injury Classification http://bmj.co/1lWvDdy

Previous podcast: The Munich muscle classification: Using it for more accurate diagnosis and treatment https://soundcloud.com/bmjpodcasts/the-munich-muscle-classification-using-it-for-more-accurate-diagnosis-and-treatment?in=bmjpodcasts/sets/bjsm-1

Range of BJSM podcast: http://bjsm.bmj.com/site/podcasts/

You can readily access BJSM podcasts via our Mobile App (BJSM). Latest sports medicine updates are posted via Twitter (@BJSM_BMJ)

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In this 2nd of 2 podcasts for 2015 (link to previous one here http://ow.ly/V8h97) Professor Jill Cook from the La Trobe University Centre for Sports and Exercise Medicine Research (Australia) introduces the term ‘capacity’ for physical therapy / physiotherapy.

‘Capacity’ is a very practical concept that underpins successful tendon rehabilitation. Prof. Cook discusses how to use the figure from the linked paper to list exercises a patient should do. Practical stuff. 13 minutes of gold!

Timeline: 1:00m - Why do we need the term ‘capacity’ in clinical practice?

1:30m - Definition – What is tissue ‘capacity’?

2:15m - The difference between ‘capacity’ and ‘function’ – capacity is tissue-specific

3:15m - Practical example: Hamstring muscle strain

5:30m - How to use this in the clinical setting – sitting with a patient and explaining the rehab programme

7:00m - The ‘Capacity’ figure – how to use it with patients to get buy-in to their rehabilitation

8:30m - ‘Building a bridge’ from what patients can do now to what they want to return to

9:00m - Practical tips including examples of (i) strength, (ii) energy storage, (iii) energy storage & release exercises

12:00m - Summary (30 seconds!)

Previous podcast: How tendons fail, how to treat in season/out of season http://ow.ly/V8h97

Related papers: The Continuum model of tendinopathy http://ow.ly/V8hLr

The challenge of managing tendinopathy during the season http://ow.ly/V8oTl

Capacity – the paper (with Figure!) that underpins this podcast! http://bmj.co/1MIaBrx

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Dr. Mark Hutchinson is professor of orthopaedics and head of the sports medicine services at the University of Illinois College of Medicine. He has been a team physician for the WNBA Chicago Sky, USA gymnastics, USA Field Hockey, USA Basketball and Team USA at two World University Games and the Paralympics Games.

In this second of a two-part set, he discusses management of the patient who presents with recent onset of acute knee pain. You might be surprised by some of what this orthopaedic surgeon says!

Timeline: 1:30m - Does everybody who ruptures an ACL need a knee reconstruction?

2:00m - How do you advise the person who wants to play soccer?

3:00m - How can you tell whether someone will make a good recovery or not with exercise therapy (not surgery)?

4:00m - OK for patients to go through a trial of physio to see if they are going to be stable or not

5:30m - Management of children who rupture their ACL. It’s a hot topic. On the one hand kids may be less compliant with ACL-risky behaviours than adults; on the other hand, operating and crossing growth plates can cause significant problems

7:30m - The key study by Håvard Moksnes and Lars Engebretsen – ACL injuries in kids (http://www.ncbi.nlm.nih.gov/pubmed/26025937) (not open access)

7:45m - How to discuss ACL management options with patients directly – ‘Tell us what you say to the patient Hutch’ (An introduction to shared decision-making)

9:15m - Non-operative, quality physiotherapy for ACL deficient patients

10:15m - Does ACL reconstruction prevent osteoarthritis?

11:15m - The elephant in the room – what about management of the patient whose ACL reconstruction has reruptured?

12:45m - Injuring the other knee – a disaster that occurs all too often!

13:30m - Psychological factors: a neglected part of the equation? http://bjsm.bmj.com/content/48/21/1543.abstract

14:30m - Return to play after reconstruction: the mind matters too! What is the optimal time for collagen healing? Coordination training, functional tests.

16:45m - Return to play with an unoperated knee: with a focus on neuromuscular training exercises

Links:

Previous BJSM podcasts: Pearls on knee examination: http://ow.ly/UBy3v

Pearls on treating shoulder conditions and one wrist bonus: http://ow.ly/UBym

YouTube videos on Physical Examination have been viewed more than 5 million times! https://www.youtube.com/user/BJSMVideos

YouTube video: 39-minute lecture by Associate Editor Dr Clare Ardern on similar issues – return to play after ACL injury https://youtu.be/P_JJf0h6rhU

Want a replay from last week? (1st podcast in this set) A 40-year old patient presents with an acute exacerbation of knee pain – Professor Hutchinson discusses whether arthroscopy is helpful in the arthritic knee. Which ones need orthopaedic referral? https://soundcloud.com/bmjpodcasts/mark-hutchinson?in=bmjpodcasts/sets/bjsm-1

Return to Play conference 2016: April 9-11, London (UK). The immensely successful annual Football Medicine Strategies conference focuses on Return to Play for all football injuries – not just ACL. Give this one serious consideration – top programme with over 100 invited speakers, terrific international audience (you will feel at home), friendly atmosphere and convenient venue. All the benefits of London without the need to own an expensive home there! http://www.footballmedicinestrategies.com/en/

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Sports physiotherapists provide evidence-based treatment for back pain. Unfortunately surgery for back pain has rather poor outomes. Tiger Woods has spinal surgery on March 31, 2014 and did not return to his previous level of play. He went under the knife again on September 16, 2015. In this podcast, Curtin University’s Professor Peter O’Sullivan comments on the risks and possible benefits of surgery in an elite golfer.

Previous podcast (>10,000 listens): Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’ http://ow.ly/TK6uo

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Do you treat patients with neck pain? Do you have neck pain? Stop reading and start listening to the podcast. Professor Gwen Jull is one of the most lauded health professionals in the world right now and she shares pearls every minute of this podcast.

Here's the link to the second part of the podcast: https://soundcloud.com/bmjpodcasts/managing-cervicogenic-headache-and-other-pearls-professor-gwen-jull-second-of-two-podcasts?in=bmjpodcasts/sets/bjsm-1

Timeline 0:00m - How do you approach the patient aged in the prime of life who complains of neck pain and bad cervical posture?

2:00m - “Big development in physiotherapy is the assessment /examination which then forms the basis of our treatment” - movement and also how the movement is performed. Facet joint tests, muscle coordination.

3:10m - Detailed specific assessment of posture in the patient with neck pain. Have the patient adopt the work positions. Aim to correct the posture to see if pain changes.

5:10m - How to distinguish the superficial and deep neck extensors

8:30m - 3 trajectories in whiplash patients; folks who get better fairly rapidly (50%), those who suffer persistent mild pain (> 2years, 30%), and ‘the major worry’ of those who have persistent moderate to high levels of pain for many months and sometimes going on for years. What predicts these trajectories? “The last group is a real stumbling block for all professions”.

11:00m - Predictors of the poor outcomes.

12:00m - See the link to the Jull and Sterling booklet for patients - ow.ly/Soyma.

13:00m - Treatment of a patient with uncomplicated whiplash - “Hurry slowly”.

14:00m - Contribution of post-traumatic stress disorder

14:30m - Management of the complicated case of whiplash. Multiprofessional approach. Multimodal care. Instruments to assess severity and to look for particular elements.

16:20m - Providing overall management of the patient. Avoiding the medical merry-go-round

17:00m - Exercise is important (this will appeal to you Adam!)!

17:30m - “My emphasis is on treating multimodally”

18:00m - Manual therapy in the context of multimodal programme

19:00m - Explaining imaging findings to the patient

19:33m - Trigger points and dry needling?

Remember the 2nd part of this conversation (about Headache and more) will be available on the BJSM podcast site on 2nd October, 2015.

Links: Grieve’s Modern Manual Physiotherapy (4th edition): Book review here http://ow.ly/Sj4cn Gwen Jill is the lead author of this physiotherapy bible

Related podcast: Professor Michele Sterling: ‘Managing Whiplash’ (2013). Very practical management of Whiplash that held up over the 2 years. http://ow.ly/Sj4Jz

Is the neck pain related to concussion? A related paper in BJSM: Schneider KJ, et al. Br J Sports Med. 2014 Sep;48(17):1294-8. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. http://bjsm.bmj.com/content/48/17/1294.abstract

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Mo Farah has great running technique. You see it, you know it. But what are the elements of Mo Farah’s running style? Can we assess running patients and guide them to improve their technique? Might gait education prove more effective than medication to treat symptoms?

Andy Cornelius has the answers. He’s a Graduate Sport Rehabilitator and head running coach who works in private clinics, premiership football and with high profile clubs and athletes. Posing the questions is Stephen Aspinall, Chairman of the British Association of Sports Rehabilitators and Trainers (BASRaT - http://www.basrat.org) and Lecturer in Sport Rehabilitation at the University of Salford, England.

Timeline 1:20m - What are the key elements of running assessment?

2:45m - What you can learn by watching the runner from behind (frontal plane) and the side (sagittal plane) on the track and on the treadmill.

4:08m - The runner with injuries related to overstriding. What is overstriding? What can the clinician advise?

6:00m - Assessing cadence and helping the athlete to make a change of between 5-10% in cadence.

7:00m - Role of hip extension, angle of trunk lean.

7:40m - Treatment of the runner who over-strides. Exercises for rehabilitation: split stride, triple extension position, mat sliding exercise, TRX device, verbal queues.

10:20m - Stride width: consider this in conditions like ITB friction syndrome, medial tibial stress syndrome (overloading one side).

12:00m - Risk of knee pain with widening stride.

12:20m - Detailed exercise progression to adjust stride width.

14:30m - How to couple pelvic stability with hip mobility – the need to balance stability and mobility.

15:15m - Mo Farah as an example - what he does right.

16:00m - Exercise progressions to address limitations around the hip and pelvis. Strive for Mo Farah’s stride!

17:00m - When to introduce bounding, hopping drills.

17:40m - Learn more at running workshops organised by BASRaT, including at the BASRaT Annual Symposium - Manchester City’s Etihad Stadium, November 20, 2015. http://www.basrat.org/

Links Paul Hodges on the balance between mobility and stability – http://ow.ly/S4UKE

The Telegraph on Mo Farah in 2013 - http://ow.ly/S4UQh

Andy Franklyn Miller et al. Biomechanical overload syndrome: defining a new diagnosis. Br J Sports Med. 2014 Mar;48(6):415-6. (OPEN ACCESS) (@AndyFranklynMiller) http://www.ncbi.nlm.nih.gov/pubmed/22983122

Andy Franklyn Miller’s related podcast - biomechanics and running injuries - http://ow.ly/S4VBF (@AndyFranklynMiller)

Christopher Napier’s Systematic Review gait retraining - http://ow.ly/S4V29 (ONLINE FIRST, live October 1st 2015)

BASRaT Annual Conference – Friday November 20th, Manchester - http://www.basrat.org/

Please feel free to suggest links via @BJSM_BMJ or email karim.khan@ubc.ca

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Dr. Joanne Kemp, research fellow at ACRISP (Australian Centre for Research into Injury in Sport and its Prevention) Federation University Australia, discusses Femoral Acetabular Impingement (FAI) and the overall health of the hip joint. Dr. Kemp completed her PhD at the University of Queensland in 2013. She remains very much involved in clinical physio practice as an APA sports physiotherapist and director of Bodysystem®. (@JoanneLKemp)

An emerging voice in sports medicine, she explores some of the difficult questions regarding hip pathology. Do we know when surgery is appropriate for FAI, or when to opt for conservative treatment? Which outcomes should guide our clinical decision to treat patients with hip pathology? What are the long term implications for joint health after sports-related hip injury?

Links to 3 of Dr Kemp’s papers here:

Hip arthroscopy for intra-articular pathology: a systematic review of outcomes with and without femoral osteoplasty - http://bjsm.bmj.com/content/46/9/632.abstract

Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes - http://bjsm.bmj.com/content/48/14/1102.abstract

What fooled us in the knee may trip us up in the hip: lessons from arthroscopy - http://bjsm.bmj.com/content/48/16/1200.extract

Follow @JoanneLKemp on Twitter

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Kelly Starrett is a coach-physical therapist whose 2013 book, Becoming a Supple Leopard, is a New York Times and Wall Street Journal bestseller. He received his Doctor of Physical Therapy (DPT) degree in 2007 from Samuel Merritt College in California. He runs his own physical therapy practice that emphasises returning athletes to elite level sport and performance.

In the podcast, Kelly enthusiastically draws on his background as an elite athlete and national level coach to suggest that sport physiotherapists should consider being very well trained in the practical aspects of strength and conditioning coaching. He argues that including the ‘coach’ element in the physiotherapist’s scope of practice will provide better results for patients. He calls for physios to be able to understand, and communicate, in ‘actionable language’ for customers – potentially elite athletes. He refers to the physio-coach as someone who is ideally poised to treat musculoskeletal conditions.

Plenty of practical tips on how to get there.

Primary link to Kelly’s resources: MobilityWOD.com

Jump on to the Google+ Sports Clinicians Community page to add your comment: https://plus.google.com/u/0/communities/101520200531074507996

Become a Supple Leopard on Amazon: http://www.amazon.com/Becoming-Supple-Leopard-Preventing-Performance/dp/1936608588

Competing interest: Neither BJSM nor Karim Khan has any financial interest in the MobilityWOD company. Kelly Starrett’s role in MobilityWOD and ‘Becoming a supple leopard’ is self-evident.

Becoming a Supple Leopard: Movement, Mobility, and Maintenance of the Human Animal

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Do you want to get your athletes with an acute hamstring injury back to play as quickly as possible, without the risk of a recurrence? Should you include lengthening exercises, trunk stabilisation, Nordic curls or PRP injections? Are you searching for a comprehensive, evidence-based update?

This 10-minute podcast will answer all your questions. BOOM!

Eminent sports physician Johannes Tol asks the hard questions. Sports physician Haiko Pas provides answers based on his recent systematic review & meta-analysis on hamstring rehab programs and PRP injections.

Time codes: Optimal treatment for a quick return to play (2.30 min), re-injury reduction (3.50min) and the added value of PRP injections (6.20min). The podcast finishes with three evidence based take home messages for the clinician dealing with acute hamstring injuries (8.20 min).

Links:

Pas H, Reurink G, Tol JL, Weir A, Winters M, Moen M. Br J Sports Med 2015 (BJSM issue 18) Efficacy of rehabilitation (lengthening) exercises, platelet rich plasma injections and other conservative interventions in acute hamstring injuries: An updated systematic review and meta-analysis. http://bjsm.bmj.com/content/early/2015/07/21/bjsports-2015-094879.abstract

Brukner P. Hamstring injuries: prevention and treatment—an update. Br J Sports Med. 2015 Jun 23. pii: bjsports-2014-094427. doi: 10.1136/bjsports-2014-094427. [Epub ahead of print] http://bjsm.bmj.com/content/early/2015/06/23/bjsports-2014-094427.long

Hamilton B, Tol JL, Almusa E, Boukarroum S, Eirale C, Farooq A, Whiteley R, Chalabi H. Platelet-rich plasma does not enhance return to play in hamstring injuries: a randomised controlled trial. Br J Sports Med. 2015 Jul;49(14):943-50. doi: 10.1136/bjsports-2015-094603. http://bjsm.bmj.com/content/49/14/943.long

Bahr R, Thorborg K, Ekstrand J. Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey. Br J Sports Med. 2015 May 20. pii: bjsports-2015-094826. doi: 10.1136/bjsports-2015-094826. [online first and issue 22] http://bjsm.bmj.com/content/early/2015/05/20/bjsports-2015-094826.long

Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JA, Bierma-Zeinstra SM, Maas M, Tol JL; Dutch HIT-study Investigators. Rationale, secondary outcome scores and 1-year follow-up of a randomised trial of platelet-rich plasma injections in acute hamstring muscle injury: the Dutch Hamstring Injection Therapy study. Br J Sports Med. 2015 May 4. pii: bjsports-2014-094250. doi: 10.1136/bjsports-2014-094250. [Epub ahead of print] http://bjsm.bmj.com/content/early/2015/05/03/bjsports-2014-094250.long

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High performance demands heavy workloads but loading increases the risk of ‘overuse’ injury. How can clinicians and strength & conditioning (S&C) coaches find the happy medium? Or is it time to take a different view? Perhaps INCREASING training load will make tissues more resilient and injury LESS likely.

Dr Tim Gabbett (www.gabbettperformance.com) bridges sports medicine and S&C as a performance consultant and a recognized applied researcher. In the BJSM spotlight he shares what physiotherapists can learn from S&C coaches and argues for the concept of the ‘performance physiotherapist’. Similarly, he translates S&C secrets for physios – insights to progressing sport specific game demands within the rehabilitation program using a rugby example. We ask him about the high-tech and low-tech equipment to gauge how much players are doing and how to titrate their training dose.

The latter part of the podcast focuses on how greater training loads can make players less likely to suffer injury but match demands must be considered. “High training loads are not necessarily the problem, it is how you get there that can damage players”. The internationally-recognized Gabbett closes by outlining the concept of ‘training stress balance’ – the net difference between fitness (long-term training load) and fatigue (short-term training load). When the player is in ‘positive’ balance, (i.e, the short-term load is lower than the longer term level of load the player is adapted to) injury is very unlikely. However, when this pattern is reversed, such as when a player is attempting to rapidly ‘gain fitness’ after a layoff, injury is almost inevitable. Cricket fast bowling data provides compelling evidence for this novel concept.

Link to Dr Tim Gabbett’s home page: www.gabbettperformance.com

In case you don’t get to check Dr Gabbett’s bio, he is in that rare group of individuals with two PhDs – one in human physiology (2000), the other in the applied science of professional football (2011). He has worked with players in many Olympic Games cycles and published over 150 papers. http://gabbettperformance.com.au/profile/

The BJSM paper relating to ‘training stress balance’: Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Hulin BT, Gabbett TJ, ….Orchard JW. Br J Sports Med. 2014 Apr;48(8):708-12 http://www.ncbi.nlm.nih.gov/pubmed/23962877

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Physical rehab (physiotherapy), behavioural rehab and combinations of these have been mainstays of back pain treatment. Dr Kieran O’Sullivan shares his expertise on what to do and what not to do – lessons from 15 years of providing specialised clinical care and engaging in top level research.

Specifically, what is the role of patient advice, targeted exercises, and novel therapies including injections?

You can link to Dr O’Sullivan’s home page at the University of Limerick here: http://www.ul.ie/clinicaltherapies/node/443

Interested in back pain? Related resources:

Editorial: Common misconceptions about back pain in sport: Tiger Woods’ case brings five fundamental questions into sharp focus http://bjsm.bmj.com/content/early/2015/02/08/bjsports-2014-094542.extract

Podcast: Professor Peter O’Sullivan on Tiger Woods’ back and ‘core strength’ https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-peteosullivanpt-on-tiger-woods-back-and-core-strength?in=bmjpodcasts/sets/bjsm-1

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Dr David Opar joins us for this BJSM podcast. David is a lecturer at the Australian Catholic University in Melbourne and one of the emerging voices in the field of hamstring strain injuries, having done work on the possible mechanism of injury as well as prospective studies aimed at better understanding eccentric strength as a risk factor for these injuries.

His work also investigates the Nordic Hamstring Device, developed by the Queensland University of Technology Hamstring Group, looking into the potential of this device in prevention, treatment and rehabilitation of hamstring injuries.

Nicol van Dyk, a physiotherapist in the Rehabilitation Department at Aspetar Sports Medicine & Orthopaedic Hospital in Qatar, leads the discussion around nordic hamstring exercises, the role of eccentric strength in hamstring strain injuries and the seeing the big picture in prevention and rehabilitation.

With hamstring strain injuries continuing to receive much attention in the literature and mainstream media, David Opar elucidates some significant features of this common injury.

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With over twenty years' experience, accreditation in Sports Physiotherapy, and a recent PhD in the topic of lateral hip pain, Alison Grimaldi (@AlisonGrimaldi) was invited to this podcast by BJSM’s Twitter community.

She is a popular conference speaker internationally. Here she walks you through each step of the assessment and treatment of an older patient with right hip pain. She then shares how to assess and treat a younger sportsperson.

In both cases, Dr Grimaldi emphasizes that compression is bad for tendons that run over bony prominences (trochanter in this case) and indicates how this can be addressed.

Enjoy one of our most practical podcasts. Recorded at the Physiotherapy New Zealand Conference, Auckland (September 2014) with thanks to the NZ Sports Physiotherapy Interest Group (@SportsPhysioNZ).

Links: 1) JL Cook, C Purdam Is compressive load a factor in the development of tendinopathy? Br J Sports Med 46(3):163-8. 2012 http://bjsm.bmj.com/content/46/3/163.abstract

2) Fearon A, Stephens S, Cook J, et al. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study. Br J Sports Med. 2012 http://bjsm.bmj.com/content/46/12/888.long

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This is a podcast by Dr Robert-Jan de Vos, sports physician in the Erasmus Medical Centre in the Netherlands, with Guustaaf Reurink, who is a registrar in Sports medicine in the Netherlands and is currently finishing his thesis on diagnosis and treatment of acute hamstring injuries. Recently, he published a paper in the New England Journal of Medicine about the role of Platelet-rich Plasma (PRP) treatment for acute hamstring injuries (http://www.nejm.org/doi/full/10.1056/NEJMc1402340).

We start with discussing this interesting study, which did not show a benefit of PRP injections in acute hamstring injuries. Dr Reurink expresses the methods and results of this study and possible explanations for these findings are debated.

Dr Reurink also performed a number of studies on the value of clinical tests and Magnetic Resonance Imaging (MRI) in acute hamstring injuries. Previously, he already showed that most MRIs are still abnormal when the athlete already returned to gameplay (http://bjsm.bmj.com/content/early/2013/11/19/bjsports-2013-092450.abstract?eaf).

We close by discussing the role of MRI and standardised clinical tests as a predictor of time to return to play and re-injury.

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Peter O’Sullivan has two recent BJSM podcasts (see below). In this podcast he shares his thoughts on the recent media attention around Tiger Woods' obvious back pain while playing in the US PGA.

He discusses what the pathology might be, why the media suggested that Mr Woods’ ‘sacrum went out’. He contends that ‘core strengthening’ may not be the panacea.

The lessons apply to the management of low back pain, and other pain, in a myriad of settings.

See also Read Professor O'Sullivan's blog on Tiger Wood's back pain: http://bit.ly/1zaISGz

Listen to his podcast on lower back pain: http://goo.gl/jrQxSe

Listen to his podcast on overtreatment and overdiagnosis in sports medicine: http://goo.gl/vPZ3g8

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Professor Michael Kjaer is Professor in Sports Medicine at the Institute of Sports Medicine and Centre for Healthy Ageing in Copenhagen, Denmark. He has published articles in the areas of Sports Medicine and muscle and tendon adaptation at the structural and mechanical levels as well as at the cellular and molecular level. Michael is interested in mechanisms of adaptations to muscle and tendon following exercise, disuse, disease and ageing.

In this podcast on tendon and tendon pathology he gives a synthesis of seven models of tendinopathy, explains the difference between mid-tendon and insertional tendinopathy, presents his views on the healing capacity of tendons, talks about the (absence of a) link between tendinopathy and tendon rupture, and discusses the various interventions that are used in an attempt to promote tendon healing, including eccentric and concentric exercises.

Links to articles: Heinemeier KM, Schjerling P, Heinemeier J, Magnusson SP, and Kjaer M. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C. FASEB Journal 2013;27:2074–9. http://goo.gl/MRmulq

Kjaer M. Role of extracellular matrix in adaptation of tendon and skeletal muscle to machanical loading. Physiol Rev 2004;84:649-8. http://goo.gl/tEiirg

Magnusson SP, Langberg H, Kjaer M. The pathogenesis of tendinopathy: balancing the response to loading. Nat Rev Rheumatol 2010;6:262-8. http://goo.gl/s1dpDc

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Did you listen to Ray Moynihan’s podcast on ‘’Overdiagnosis in sports medicine”? That’s a ‘gold’ podcast (>5000 listens) and Peter O’Sullivan now extends those ideas into the realm of sports physiotherapy.

“We can massively create health problems” warns Prof O’Sullivan speaking about the way clinicians may explain pathology to patients. If not explained appropriately, MRI and other imaging can have a negative effect on a patient’s perception of injury.

Pete refers to this free paper in RADIOLOGY: McCullough et al. Lumbar MR imaging and reporting epidemiology: do epidemiologic data in reports affect clinical management? Radiology. 2012 Mar;262(3):941-6. doi: 10.1148/radiol.11110618.

If you missed Ray Moynihan’s podcast, here’s the link: http://bit.ly/1oA45UC

See also:

Listen to Prof O'Sullivan discussing low back pain: http://goo.gl/WgseGQ

It's time for change with the management of non-specific chronic low back pain: http://bjsm.bmj.com/content/46/4/224.full

Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/

Professor Peter O’Sullivan (Curtin) walks you through two cases of low back pain: https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-curtin-walks-you-through-two-cases-of-low-back-pain

‘Overdiagnosis’ in sports medicine? FAI for example? The great Ray Moynihan (‘Selling sickness’: https://soundcloud.com/bmjpodcasts/overdiagnosis-in-sports-medicine-fai-for-example-the-great-ray-moynihan-selling-sickness

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Who are the biggest names in the back pain world? Correct – Peter O’Sullivan is one of them.

He's provocative, clinically-relevant, and vastly experienced. He’s desperate to help patients, that’s obvious! But not everyone has to agree. Listen to his take on management of both chronic, and acute, back pains – does it make sense to you?

Peter O’Sullivan is Professor of Musculoskeletal Physiotherapy at Curtin University, Perth, (http://goo.gl/Dk6beV)and a Specialist Musculoskeletal Physiotherapist who consults at bodylogicphysiotherapy.com.

See also:

It’s time for change with the management of non-specific chronic low back pain (2012) http://bit.ly/1nY6YxK

Professor O’Sullivan discusses the risk of clinicians ‘overservicing’ or ‘overdiagnosing’ various conditions in another BJSM podcast: http://goo.gl/7HYDiX

‘Overdiagnosis’ / ‘overtreating’– relevant in sportsphysio/medicine? Professor Peter O’Sullivan: https://soundcloud.com/bmjpodcasts/overdiagnosis-overtreating-relevant-in-sportsphysiomedicine-peter-osullivan

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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

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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

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Here’s the podcast that over 12,000 listeners have been demanding – physiotherapist Adam Meakins (@TheSportsPhysio)on a number of controversial topics, including: Is diagnostic palpation accurate? Can the sacroiliac joint really be ‘unstable’? How does ‘touch’ in physiotherapy have its therapeutic effect?

Adam provides great value on Twitter and on his blog – here you can listen to him in your favourite podcast setting.

Adam shares his way of explaining neural pain to patients and that alone is worth the price.

He also discusses his popular blogs on ‘5 Least Favourite Shoulder Rehab Exercises’ as well as ‘Top 5 Shoulder Rehab Exercises’.

He argues that the key to managing some knee conditions is to manage load and he refers to Scott Dye’s classic ‘envelope of function’ concept.

And we close by discussing a couple of figures that have gained great traction in the Twittersphere. You might find them useful in your clinical practice. But it’s a risk on radio – I get that! Enjoy and comment via @BJSM_BMJ or on Facebook.

See also:

Why does my shoulder hurt? A review of the neuroanatomical and biochemical basis of shoulder pain: http://bjsm.bmj.com/content/47/17/1095.full

Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis: http://bjsm.bmj.com/content/48/16/1216.full

Rehabilitation for shoulder instability: http://bjsm.bmj.com/content/44/5/333.full

Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury: http://bjsm.bmj.com/content/45/4/245.full

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After a patient has undergone ACL surgery, rehabilitation is bread and butter in many physiotherapy/sports medicine clinics. Many BJSM podcast listeners will be expert in this role. If you are less expert and wondering if there is an ‘optimum’ way to guide the patient back to sport, Dr Andy Franklyn-Miller provides some food for thought.

He discusses some novel ways of assessing a patient’s progress after ACL reconstruction, advocates for the use of video in the clinic, and shares the dynamic tests he uses before allowing a player to return to sport. He shares exercises that both test, and help rehabilitate athletes in this setting.

Dr Franklyn-Miller is a sports physician at the Sports Surgery Clinic in Dublin, Ireland. He has published widely in sports medicine and his book, Clinical Sports Anatomy (2011), co-authored with Eanna Falvey and Peter Brukner, is an international best-seller. You can follow him on Twitter @AFranklynMiller and his blog provides great resources (www.drAndyFranklyMiller.com) including a further series of podcasts.

See also: His previous podcasts on BJSM relating to running injuries (http://bit.ly/1bqMh8C) and groin pain (http://bit.ly/1fo2TAW).

Consensus criteria for defining ‘successful outcome’ after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation: http://bjsm.bmj.com/content/early/2013/07/23/bjsports-2013-092299.full

Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years: http://bjsm.bmj.com/content/47/15/980.full

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If you have wondered about the connection between pain and pathology in tendons, this podcast is for you.

In this new forum, a BJSM reader takes the hard questions to the experts, Chris Littlewood, who has expertise as a clinician and researcher in the rotator cuff, asks questions of Craig Purdam, who needs little introduction to you, and Ebonie Rio, who has expertise as a clinician in tendons and as a researcher in tendon pain.

Listen to the answers on the complex nature of tendons and the relationship between pain and pathology, and let us know via bjsm@bmjgroup.com if you have a pressing desire to ask an expert yourself about a clinical issue in a podcast. We are always open to suggestions.

See also:

Greater glycosaminoglycan content in human patellar tendon biopsies is associated with more pain and a lower VISA score: http://bjsm.bmj.com/content/48/6/469.full

Prospective study of change in patellar tendon abnormality on imaging and pain over a volleyball season: http://bjsm.bmj.com/content/40/3/272.full

Tendinopathy – rehab progression – part 1: http://blogs.bmj.com/bjsm/2013/07/23/tendinopathy-rehab-progression-part-1/

Achilles Tendinopathy: is foot strike important?: http://blogs.bmj.com/bjsm/2014/01/22/achilles-tendinopathy-is-foot-strike-important/

Australian football players’ Achilles tendons respond to game loads within 2 days: an ultrasound tissue characterisation (UTC) study: http://bjsm.bmj.com/content/early/2014/06/26/bjsports-2013-092713.full

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Karim Khan calls mechanotherapy “the most important fundamental concept that underpins rehabilitation exercises”.

Listen to Karim explain that all exercise-based rehabilitation relies on the cells of the injured tissue sensing the exercise stimulus, converting that signal to protein synthesis, and repairing tissue. He explains why ‘rest doesn’t work’ and argues that mechanotherapy has substantial evidence in its favour. The process applies to all body tissues – to injuries / pathology in bone, muscle, tendon and cartilage.

Read the review article, which has had over 32,000 full-page views since 2009:

Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair - http://bjsm.bmj.com/content/43/4/247.full

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Dr Peter Brukner has been looking at nutrition for health, both of athletes and in the wider population. In this podcast he speaks to Professor Tim Noakes, author of The Lore of Running, originator of the central governor theory, and a strong exponent of the low carbohyrate-high fat diet.

Tim talks about his views on carbohydrate, and how his experience of a very low carb diet has changed the way he views the decades old advice of low-fat intake - particularly when it comes to treatment of patients with type-2 diabetes and cardiovascular disease. They discuss this diet in the specific setting of sport - long distance and football codes. Professor Noakes has over 21,000 followers on Twitter (https://twitter.com/ProfTimNoakes) and his most recent book, Challenging Beliefs, includes an introduction to his thoughts on this topic.

Peter Brukner's editorial on this topic is in the July 2013 issue of BJSM - http://bjsm.bmj.com/content/47/11/663.full

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