Manual therapy (MT) comes in all shapes and sizes - mobilisation, manipulation, mobilisation with movement, soft tissue massage, instrument assisted massage, muscle energy techniques, pointy elbows pressed into flesh and more. Patients (often) love it, and it's a popular treatment modality with therapists. Debate rages, and myths and misconceptions surround MT. Could the time we spend performing MT be better spent elsewhere? How does MT work? Is it worth using if treatment effects are short lived? Is it just used as revenue raising by therapists, while creating reliance on passive therapies?

Is MT evidence-based? Is it worth including in our treatment? Which patients may benefit from MT, and which patients you should steer away from MT?

In this podcast, clinical researcher, physical therapist and Professor at Duke University, Dr Chad Cook, we discuss the evidence around MT, myths and misconceptions, how MT works, and using your clinical reasoning to decide when and how to utilise MT.

You'll discover:

• What are the arguments against manual therapy?
• Do the arguments against MT have merit?
• Does MT break up scar tissue or adhesions, correct alignment of joints, or put them back into place?
• Do we have evidence that MT creates reliance on passive therapies?
• Evidence for and against MT
• How to use clinical reasoning with MT
• How MT works - potential mechanisms
• What MT is NOT doing
• How to explain MT to your patients
• Clinical reasoning
• Identifying pain adaptive and non pain adaptive patients
• How MT can help identify patients with a better or worse prognosis
• How many sessions of MT should patients receive?
• How to select MT techniques
• Does MT cause harm and patient reliance?
• How to identify patient treatment expectations
• How to help change patient expectations

Links associated with this episode:

• Download and subscribe to the podcast on iTunes

• Listen to the podcast on Spotify

• Improve your confidence and plantar fasciopathy results with a free trial Clinical Edge membership, and get access to the 3 part webinar series on PHP with Henrik Riel

• Let David know what you liked about this podcast on Twitter

• Review the podcast on iTunes

• Like the podcast on Facebook

• Infographics by Clinical Edge

• Dr Chad Cook at Duke University

• Twitter - @ChadCookPT

• Book - Orthopaedic Manual Therapy

Articles associated with this episode:

Bialosky et al. 2009. The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model.

Bialosky JE, Bishop MD, Penza CW. Placebo mechanisms of manual therapy: a sheep in wolf's clothing?. journal of orthopaedic & sports physical therapy. 2017 May;47(5):301-4.

Cook et al. 2014. Is there preliminary value to a within- and/or between-session change for determining short-term outcomes of manual therapy on mechanical neck pain?

Cook et al. 2013. Early use of thrust manipulation versus non-thrust manipulation: a randomized clinical trial.

Cook et al. 2012. Can a within/between-session change in pain during reassessment predict outcome using a manual therapy intervention in patients with mechanical low back pain?

Cook. 2011. Immediate effects from manual therapy: much ado about nothing?

Deyle et al. 2005. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.

Goss et al. 2004. A Cochrane review of manipulation and mobilization for mechanical neck disorders.

Learmann et al. 2014. No Differences in Outcomes in People with Low Back Pain Who Met the Clinical Prediction Rule for Lumbar Spine Manipulation When a Pragmatic Non-thrust Manipulation Was Used as the Comparator.

Rubinstein et al. 2011. Spinal manipulation therapy for chronic low back pain.

Schneider et al. 2014. Derivation of a clinical decision guide in the diagnosis of cervical facet joint pain.

Traeger et al. 2018. Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain.

When your patient has heel pain with their first few steps in the morning, after sitting for a while or at the start of a run, a diagnosis of plantar heel pain (PHP) or plantar fasciopathy might jump straight to the top of your list. How will you treat your patients with PHP? How long will it take? How can you explain PHP, the rehab and recovery to your patients?

In this podcast with Henrik Riel (Physiotherapist, researcher and PhD candidate at Aalborg University) we take a deep dive into PHP, and how you can treat it, including:

• How to describe plantar heel pain to your patients
• How to explain to your patient why they developed PHP, recovery timeframes and rehab
• Plantar fasciitis, plantar fasciopathy, plantar heel pain? What's the most appropriate terminology?
• Differential diagnosis for PHP including
  • Neuropathic pain
  • Fat pad irritation, contusion or atrophy
  • Calcaneal stress fracture
  • Other diagnoses
• How to systematically perform an objective assessment and diagnose PHP
• Assessment tests to identify factors contributing to your patients pain
• Whether your patients require imaging
• How long PHP takes to recover
• What factors affect your patients prognosis and recovery times
• How to differentiate your treatment for active or sedentary patients
• Whether your patients can continue to run with PHP
• Factors that may hinder the recovery of your sedentary patients, and how to address these
• Whether your patients should include stretching in their rehab
• Types of strengthening to include in your rehab - isometric, isotonic or otherwise
• How many sets and reps should your patients perform of their strengthening exercises
• Whether orthotics are useful
• Corticosteroid injections - do they help or increase the risk of plantar fascia rupture?

Links associated with this episode:

• Download and subscribe to the podcast on iTunes

• Download the podcast now using my favourite podcast app - Overcast

• Improve your confidence and plantar fasciopathy results with a free trial Clinical Edge membership, and get access to the 3 part webinar series on PHP with Henrik Riel

• Let David know what you liked about this podcast on Twitter

• Review the podcast on iTunes

• Like the podcast on Facebook

• Infographics by Clinical Edge

• Twitter - @Henrik_Riel

• Research Gate - Henrik Riel

Articles associated with this episode:

Alshami et al. 2008. A review of plantar heel pain of neural origin: differential diagnosis and management.

Chimutengwende-Gordon et al. 2010. Magnetic resonance imaging in plantar heel pain.

Dakin et al. 2018. Chronic inflammation is a feature of Achilles tendinopathy and rupture.

David et al. 2017. Injected corticosteroids for treating plantar heel pain in adults.

Digiovanni et al. 2006. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up.

Hansen et al. 2018. Long-Term Prognosis of Plantar Fasciitis: A 5- to 15-Year Follow-up Study of 174 Patients With Ultrasound Examination.

Lemont et al. 2003. Plantar fasciitis: a degenerative process (fasciosis) without inflammation.

Rathleff et al. 2015. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.

Riel et al. 2017. Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on.

Riel et al. 2018. The effect of isometric exercise on pain in individuals with plantar fasciopathy: A randomized crossover trial.

Riel et al. 2019. Self-dosed and pre-determined progressive heavy-slow resistance training have similar effects in people with plantar fasciopathy: a randomised trial.

Other Episodes of Interest:

PE 062 - How to treat plantar fasciopathy in runners with Tom Goom

PE 061 - How to assess and diagnose plantar fasciopathy in runners with Tom Goom

PE 060 - Plantar fasciopathy in runners with Tom Goom

PE 038 - Plantar fasciopathy loading programs with Michael Rathleff

PE 012 - Plantar Fascia, Achilles Tendinopathy And Nerve Entrapments With Russell Wright

When you love running or any other sport or activity, having to take time off with an injury is really frustrating. Your patients with an injury limiting their running will feel frustrated and be keen to keep running or get back to running as quickly as possible. We can make a huge difference in helping them return to running, but how do we do it?

It would be pretty simple if we could hand all of our running injury patients a standard return to running table with a list of set running distances, and send them on their way to just follow the program. The trouble is, it doesn’t work that way in real life.

Each of your patients will have different goals, and respond differently to rehab and increases in running, depending on their injury, irritability of their symptoms, their load tolerance, and a lot of factors. Since recipe-based approaches won’t work for a lot of patients, how can you tailor your rehab and guide your running injury patients through their return to running?

In this podcast with Tom Goom, we’re going to help you return your patients to running as quickly as possible, know which factors you need to address in your rehab, and how to tailor your rehab to each of your patients. You will explore how to:

• Test whether your patient is ready to run
• Find your patients ‘run tolerance’
• Incorporate your athlete’s goals into their rehab
• Use their pathology to guide return to running eg stress fractures or plantar fasciopathy
• Use irritability to guide your load progression
• Vary your treatment depending on the stage of their competitive season
• Address strength, range of movement, control, muscle mass, power and plyometric impairments in their rehab program
• Choose the number of exercises you use
• Balance risk and reward to meet patients goals
• Four key steps to return your patient to running
• Use impact tests when assessing whether your patient is ready to run
• Plan training structure and progression
• Monitor return to running
• Identify acceptable pain levels while increasing running

We will take you through four real patient case study examples so you can apply the podcast in your clinical practice, including:

• Achilles tendon pain
• Medial tibial stress syndrome (MTSS)/Shin splints
• Calf pain
• High risk tibial stress fracture

CLICK HERE to download your podcast handout

 

Links associated with this episode:

• Free lateral hip pain video series with Tom Goom
• Download and subscribe to the podcast on iTunes
• Twitter - @tomgoom
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Other episodes of interest:

• Physio Edge 084 Running injury treatment - tendinopathy, MTSS, total hip replacement & high BMI patients. Q&A with Tom Goom
• Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom
• Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill
• Physio Edge 076 Footwear advice for running injuries with Tom Goom
• Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking
• Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras
• Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill
• Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang

Squeezing a stress ball and strengthening with 0.5kg dumbells will only get you so far with your treatment of hand and wrist injuries, and soon enough you'll hit a wall with treatment results. How are you going to smash through that wall, and help your patients keep working or playing, or get back to it? If you've felt limited with your hand and wrist treatment and exercises, you'll love the treatment approach and strengthening exercises from the third and final podcast in this series with Ian Gatt.

In the previous two podcasts with Ian we explored how you can take a great history, assess and diagnose wrist and hand injuries. You discovered types of grip strength and how to perform low and high tech grip strength assessment. In this new podcast with Ian Gatt you will discover how to use your assessment findings to develop a treatment plan, and how to develop your patients hand and wrist strength, plus:

• Strength exercises can you use in your rehab of hand and wrist injuries
• What pain level is acceptable during rehab exercises?
• How many sets and reps should your patients perform of each exercise?
• How can you reduce the pain your athlete experiences so they can perform their rehab exercises?
• What finger strengthening exercises can you use?
• Why is the proximal radio-ulnar joint (PRUJ) so important to treat with wrist and elbow injuries?
• How can you treat the PRUJ?
• How can you incorporate the kinetic chain into your hand and wrist rehab?
• How and why would you want to use vibration as part of rehab, even if you don't have a vibration plate?
• What manual therapy can you use with your hand patients?
• How can you maintain your athletes skill and performance while taking them through a rehab program?
• How should you adjust training volume or intensity with knuckle or Carpometacarpal joint (CMCJ) injuries?
• Can boxers with CMCJ injuries continue to hit the bag?
• What wrist positions and movements need to be limited during rehab and to prevent injury?
• Why is wrapping your boxers hands properly so important?
• How can you wrap your boxers hands?
• What gloves are recommended for boxers?

Ian works with GB Boxing, which involves helping boxers recover from hand, wrist and other injuries. This podcast is therefore boxer-centric, however there are a lot of specifics, exercises & principles in this podcast that you can use with your hand & wrist patients.

Dive into this podcast, and pick up a lot of great ideas for your hand & wrist injury treatment.

Links associated with this episode:

• Download and subscribe to the podcast on iTunes

• Listen to the podcast on Spotify

• Improve your confidence and patient results with a free trial Clinical Edge membership

• Let David know what you liked about this podcast on Twitter

• Review the podcast on iTunes

• Like the podcast on Facebook

• Infographics by Clinical Edge

• LinkedIn - Ian Gatt

• Twitter - @IanGattPhysio

• Instagram - @IanGattman

• Sheffield Hallam University - Ian Gatt

• Courses - HE Seminars

 

CLICK HERE for your spot on a free shoulder assessment webinar with Jo Gibson, available soon.

Resources associated with this episode:

• Video - How to wrap a boxer's hands with Ian Gatt

• Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

• PE089 - Combating hand & wrist injuries part 2 - Objective assessment with Ian Gatt

• PE 088 - Combating hand and wrist injuries part 1 with Ian Gatt

• PE 043 - Sporting Shoulder with Jo Gibson

• PE 027 - Sports Injury Management with Dr Nathan Gibbs

Your knuckles getting crushed in an overenthusiastic handshake by hands the size of watermelons isn't a fun experience. Do these knuckle-crushers know they're squeezing that hard, or do they just regularly snap pencils while taking notes, and wonder why pens and pencils are so fragile nowadays?

How much grip strength do you actually need, even if you're not planning on crushing any knuckles the next time you meet someone? How much grip strength do your patients need when recovering from a hand, wrist or upper limb injury?

Testing and building grip strength is a really important part of helping your hand, wrist, elbow pain and injury patients get back to work and day to day life. Gripping also pre-activates the rotator cuff, so you can use gripping as part of your patients shoulder rehab exercises.

Grip strength tests using handheld dynamometers (HHD)* test your "Power Grip", but this test doesn't assess thumb or pinch grip strength. There are two other grip strength tests that are pretty easy to perform, that are going to be better suited to some of your patients. What are they, and how can you test the different types of grip strength in your patients?

In this podcast with Physiotherapist (English Institute of Sport Boxing Technical Lead Physio) Ian Gatt, we discuss assessing and building grip strength, assessing hand and wrist injuries and more, including:

• 3 different types of grip strength you need to measure in your hand and wrist patients
• How grip strength measures help guide your assessment and prognosis
• What is the "Power grip" and how is it useful?
• How can you test thumb strength?
• Low-tech, simple grip strength tests you can use in your clinic
• The high-tech approach to grip strength testing
• How strong should wrist flexors and extensors be?
• How can you assess weight bearing tolerance of the hand and wrist?
• Why your patient can have a painfree grip and still be painful with weightbearing on the hand
• What exercises, weights and reps should you use following upper limb injury?
• How can you accurately measure wrist range of movement?
• How are the proximal radio-ulnar joint (PRUJ) and radio-humeral joint (RHJ) involved in hand and wrist injuries, and how can you assess these?

Like the tests demonstrated in the Clinical Edge online courses on Assessment & treatment of the elbow

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Download the podcast now using my favourite podcast app - Overcast
• Listen to the podcast on Spotify
• Improve your confidence and patient results with a free trial Clinical Edge membership
• Let David know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Linked In - Ian GattTwitter - @IanGattPhysio
• Instagram - @IanGattman
• Sheffield Hallam University - Ian Gatt
• Courses - HE Seminars

 

CLICK HERE for your spot on a free shoulder assessment webinar with Jo Gibson, available soon.

Resources associated with this episode:

Video - How to wrap a boxer's hands with Ian Gatt

Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

PE 088 - Combating hand and wrist injuries part 1 with Ian Gatt

PE 043 - Sporting Shoulder with Jo Gibson

PE 027 - Sports Injury Management with Dr Nathan Gibbs

Hand and wrist assessment and treatment can be overwhelming. There are a lot of tendons, ligaments and bones crammed into a small area, you need to worry about ligament and cartilage tears, rehabbing fine and gross motor control, strengthening, and then there are those fancy-looking splints you see. How would you like to get a better grip on hand and wrist injuries?

Physio Edge 088 Combating hand & wrist injuries part 1 with Ian Gatt

In this podcast with Physiotherapist (English Institute of Sport Boxing Technical Lead Physio) Ian Gatt, we discuss hand and wrist injuries in general, and dive into details on contact-related injuries encountered in boxing. If you treat patients that fall onto their hands and wrists, cop a blow to their fingers in ball sports, are boxers or martial artists, or just occasionally get involved in confrontations with walls or other immovable objects, you will enjoy this episode. You will explore:

• How to take a comprehensive subjective history for hand and wrist pain patients
• Questions you need to ask your hand and wrist patients
• Identify likely diagnoses for your patients injuries based on their pattern of symptoms
• When imaging is useful
• Figure out if your patient is likely to have a quick or slow recovery
• What is most important - pathology &structural diagnosis, biomechanics or function?
• Common boxing or contact-related hand and wrist injuries
• How to establish the severity of an injury
• Carpometacarpal (CMC) joint injury management
• Knuckle (Sagittal band) injuries
• Bone stress injuries of the hand and wrist
• Triangular fibrocartilage complex (TFCC) injuries, and why these are not as common now in contact sports

In the next two podcasts with Ian, we will explore how you can assess and treat these injuries

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Listen to the podcast on Spotify
• Improve your confidence and patient results with a free trial Clinical Edge membership
• Let David know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Linked In - Ian Gatt
• Twitter - @IanGattPhysio
• Instagram - @IanGattman
• Sheffield Hallam University - Ian Gatt
• Courses - HE Seminars

Resources associated with this episode:

Video - How to wrap a boxer's hands with Ian Gatt

Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

PE 043 - Sporting Shoulder with Jo Gibson

PE 027 - Sports Injury Management with Dr Nathan Gibbs

 

A crunching tackle, flying headfirst off the bike onto your shoulder, or falling onto an elbow will often be enough to injure an acromio-clavicular joint (ACJ). When your patient walks in supporting their arm, or wearing a collar-and-cuff to offload their ACJ, how will you accurately assess and grade their injury? What will you include in your ACJ patient rehab to help them get back to full shoulder function and return to sport?

In Physio Edge podcast episode 87 with Dr Ian Horsley, Physio with English Rugby, English Institute of Sport and Olympic Team GB, we explore ACJ and clavicular injuries, including:

• ACJ anatomy, and which ligaments are commonly injured
• How to grade an ACJ injury
• When to request imaging
• Clavicular osteolysis
• How to identify SLAP lesions that occur with ACJ injuries
• How to assess patients with ACJ injury
• Objective assessment tests to help your diagnosis
• The role of the scapula in ACJ rehab
• Common exercises you can use in rehab
• Progressing ACJ rehab to prepare for return to sport
• How to include return to contact in your rehab eg for rugby players
• How much pain is ok during rehabilitation
• Return to play timeframes with common
• What do do when rehab is not progressing to plan
• Clavicular fractures - conservative or surgical management
• Ways to stimulate osteoblastic activity post fracture

CLICK HERE to download your free handout on AC Joint injuries

Links associated with this episode:

• Download and subscribe to the podcast on iTunes

• Listen to the podcast on Spotify

• Improve your confidence and patient results with a free trial Clinical Edge membership

• Online course - Shoulder rehabilitation for contact sports and the rugby shoulder with Dr Ian Horsley

• Let David know what you liked about this podcast on Twitter

• Review the podcast on iTunes

• Like the podcast on Facebook

• Infographics by Clinical Edge

• Dr Ian Horsley on Twitter - @Back_in_action

• Back in Action Physiotherapy

• You Tube - Back in Action

• Facebook - Back in Action

• Research Gate - Dr Ian Horsley

Resources associated with this episode:

Jacob et al. 2017. Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations.

Robertson et al. 2016. Return to sport following clavicle factors: a systemic review.

Other Episodes of Interest:

PE 076 - Anterior shoulder pain, long head of biceps tendon pathology and SLAP tears with Jo Gibson

PE 067 - Shoulder special tests and the rotator cuff with Dr Chris Littlewood

PE 043 - Sporting Shoulder with Jo Gibson

PE 040 - Shoulder Simplified With Adam Meakins

PE 021 - Shoulder Pain With Dr Jeremy Lewis

How do you answer your patient when they ask why they still have back or neck pain more than 12 months after an injury? Shouldn't their body have healed by now? Why does their knee pain get worse every time they do their exercises, put tape on it, go for a walk or just climb the stairs?

What is going on? Why do they still have pain? How are you going to explain it, and how can you help them?

In this podcast with Dr Tim Mitchell and Dr Darren Beales, you'll discover:

• 4 types of pain, and how they change your assessment and treatment
• Why some patients become sensitised following an injury
• Questions you need to ask in your subjective
• How to identify red flags
• Is night pain and disturbed sleep a red flag?
• When your patient is sensitised to pain, can you differentiate between central and peripheral sensitisation?
• Important aspects to include in your objective assessment
• Assessing movement and function
• How hyperalgesia and allodynia affect your treatment
• Why it can backfire if you tell your patient they have central sensitisation and pain is in their brain
• How to challenge a patient's beliefs about their pain, like they "just need a massage" or their "pelvis is out" so that it won't backfire and make their faulty belief even stronger
• When should your patients return to work or have adjusted duties?
• How to use the Musculoskeletal clinical translation framework and apply it in your clinical practice

Download and subscribe to the Physio Edge podcast now to improve your treatment of musculoskeletal pain and sports injuries

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Increase your confidence and results with patients with a free trial Clinical Edge membership
• Discover a quick simple shoulder assessment in three free videos with Jo Gibson
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Musculoskeletal Clinical Translation Framework
• Dr Tim Mitchell
• Dr Darren Beales
• Twitter: @PeteOSullivanPT
• TWITTER: @hels_slater
• Curtin University - Master of Clinical Physiotherapy

Resources associated with this episode:

• BJSM Podcast - Lorimer Moseley
• Pain Options - Pain Resources
• Pain Health - Pain Self-checks
• Örebro Musculoskeletal Pain Questionnaire
• Örebro Musculoskeletal Pain Questionnaire Short Form
• Agency for Clinical Innovation - Best practice care for people with acute low back pain
• Pain-Ed

Other Episodes of Interest:

• PE 035 - Know pain with Mike Stewart Part 1
• PE 036 - Know pain with Mike Stewart Part 2

Have you had patients that developed groin pain after getting a bit carried away with situps or abdominal exercises in the gym? Or have your patients developed lower abdominal pain after running or training that is causing them pain into hip extension?

In this podcast with Andrew Wallis, Sports Physiotherapist with the St Kilda AFL team, we explore how you can treat patients that were a little too exuberant with their abdominal training or running, including:

• The Doha Agreement on groin pain terminology
• Inguinal related groin pain
• Anatomy of the abdominal region and groin
• Rectus abdominus tendon overload
• Whether pelvic tilt contributes to abdominal overload
• How you can identify the cause of pain in this suprapubic region
• How to objectively assess patients, and key tests to perform
• How you can treat patients with an acute overload history
• Progressive abdominal loading, including exercises you can use
• How to progress running, interval training and hill running
• Adding in cutting, agility training and kicking
• How to help set your patient's expectations about recovery timeframes and progress

Andrew Wallis is also presenting a webinar on how to treat athletes with the most common type of groin pain - adductor-related groin pain. It'll be held on Wednesday 25th October, so grab your spot on this webinar now!

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Andrew Wallis on Twitter @Andrewwallis15
• Facebook - The Hip and Groin Clinic
• The Hip and Groin Clinic website

Resources associated with this episode:

• Cook and Purdam. 2009. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy
• King et al. 2018. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients
• Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes

Other Episodes of Interest:

• Physio Edge 070 How to treat adductor related groin pain and complex cases with Dr Adam Weir
• Physio Edge 069 Adductor related groin pain, stress fractures and nerve entrapment assessment and diagnosis with Dr Adam Weir
• Physio Edge 054 Hip and groin part 2: Assessment and treatment with Benoy Mathew
• Physio Edge 053 Hip and groin part 1: Diagnosis, pathology and red flags with Benoy Mathew
• Physio Edge 028 Groin Injury Screening and Rehabilitation With Dr Kristian Thorborg
• Physio Edge 025 Groin Assessment With Dr Kristian Thorborg

How can you manage lower limb tendinopathy in your patients that like to run? Can runners with medial tibial stress syndrome (MTSS) continue to run? Can patients with high BMI or following total hip replacement run?

Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries in this Q&A conducted live, including:

• How can you manage post-run morning stiffness?
• What are the important aspects when managing load?
• How can you treat Achilles tendinopathy patients with decreasing tolerance to running and walking, and increasing pain?
• Differential diagnosis for Achilles pain
• Proximal hamstring tendinopathy
  • What exercises can be used?
  • Is a feeling of tightness normal, and how can this be addressed?
  • Are stretches helpful?
  • When can deadlifts and Romanian deadlifts (RDL's) be used?
• Patellar tendinopathy - how can you manage a runner that is not willing to decrease running volume even temporarily?
• Peroneal tendinopathy
• Running vs rest in female distance runners with chronic hamstring origin injuries
• Patellar tendinopathy
• Medial tibial stress syndrome (MTSS)/Shin splints treatment
• Working at marathons or running events - How can you help your runners with ITBS or PFP finish a race?
• Can runners return to running following total hip replacement?
• Is running harmful for patients with high body mass index (BMI) when they want to reduce weight?

To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes"

Links associated with this episode:

• Submit questions for the Physio Edge podcast
• Download and subscribe to the podcast on iTunes
• Twitter - @tomgoom
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Other episodes of interest:

• Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom
• Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill
• Physio Edge 076 Footwear advice for running injuries with Tom Goom
• Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking
• Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras
• Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill
• Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang

What are the key components when assessing and treating runners? Should your treatment of running injuries focus on glutes? How can your runners schedule their training to improve recovery?

Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries, including:

• The key concepts when assessing and treating running injuries
• Gait retraining programs
• The best ways to change running technique
• Does gait retraining cause fatigue?
• Is gait retraining suitable in painfree runners?
• What are the most important elements to prevent injury in runners?
• Scheduling to improve recovery from injury. When should your runner run, and when should they rest?
• Can we increase leg stiffness when running? Does increasing leg stiffness reduce injury risk?
• Strengthening for runners
• Do glutes become underactive or "not fire properly"?
• Does improving glute strength improve running mechanics?
• Calf tears - how can you treat these?
• What tests can you perform for your runners calves?
• Do runners have "stiff hips", and does it matter?
• Can you help runners with meniscal tears?
• How can you treat ITB syndrome?
• Is barefoot running helpful or harmful?
• Should we run in only 1 shoe if we want to win a race?

To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes"

Links associated with this episode:

• Submit your running-injury related questions for the Physio Edge podcast
• Download and subscribe to the podcast on iTunes
• Twitter - @tomgoom
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Other episodes of interest:

• Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill
• Physio Edge 076 Footwear advice for running injuries with Tom Goom
• Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking
• Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras
• Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill
• Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang

Achilles tendinopathy treatment - what is the latest research, and how can it help your treatment? What is the best way to treat Achilles tendinopathy (AT)?

Over the years our treatment of tendinopathy has evolved significantly. You may remember rubbing tendons with ultrasound or our thumbs in years gone past, and stretching the painful area or muscle-tendon complex. If you did, you may also remember the number of people that didn't really improve or develop the load tolerance to return to activity with this approach, supported by research demonstrating the lack of effectiveness of this approach.

We progressed to the golden era of loading, initially using eccentric training. Additional research emerged on the benefits of heavy slow resistance in tendinopathy treatment, closely followed by the importance of load management demonstrated in research on soft tissue injuries. In 2015 and 2016 Rio et al. released promising preliminary research utilising isometric holds in patellar tendinopathy patients, and we have extrapolated and used isometric holds with many different types of tendinopathy.

In Physio Edge podcast episode 82 with Dr Seth O'Neill, you will discover:

• Are isometric holds effective with Achilles tendinopathy patients?
• What is the most effective treatment for AT?
• What does the latest research on the treatment of AT reveal?
• Is relief of pain with isometric holds necessary to make a diagnosis of tendinopathy?
• What assessment tests can you perform to diagnose AT?
• How can you assess patient calf strength?
• How can you differentially diagnose other conditions including Plantaris involvement, insertional AT, talocrural impingement or neural irritation?
• How can you explain AT to your patients?
• What exercises can you include in your treatment?
• Exercise progressions you can use
• When are eccentrics a useful addition to a treatment program?
• When can patients start, continue or progress a walking or running program?
• How can you incorporate the biopsychosocial model into your treatment?
• Is dorsiflexion range of movement important?
• Is stretching an effective treatment for tendinopathy?
• Are ice, massage or ESWT useful?
• When is imaging useful?
• How can you treat insertional Achilles tendinopathy?

Download this podcast now to improve your results with Achilles tendinopathy

Dr Seth O'Neill completed a MSc in Musculoskeletal Physiotherapy, followed by a PhD focused on Achilles tendon disorders. Seth is a lecturer in Physiotherapy at the Universities of Leicester and Coventry, and has a Physio private practice in Nottingham, UK.

Click here to download your FREE podcast handout

Click here to register for this FREE webinar "Anterior knee pain and the impact of load" with Lee Herrington

Click here to register for this FREE webinar "Accelerated conservative management of medial knee injuries" with Chris Morgan

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Twitter - @Seth0Neill
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Articles associated with this episode:

• Beyer R, Kongsgaard M, Hougs Kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. The American journal of sports medicine. 2015 Jul;43(7):1704-11.

• O’Neill S, Radia J, Bird K, Rathleff MS, Bandholm T, Jorgensen M, Thorborg K. Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy. 2018:1-9.

• Rio E, Kidgell D, Purdam C, Gaida J, Moseley GL, Pearce AJ, Cook J. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015 May 15:bjsports-2014.

Other episodes of interest:

• Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras
• Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking
• Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill
• Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang

Ankle syndesmosis injuries following forced ankle dorsiflexion and lateral rotation of the foot require very specific management and rehabilitation to achieve great treatment outcomes. If you approach management of ankle syndesmosis injuries in the same manner as a lateral ankle ligament injury it will likely result in long term pain and dysfunction for your patients.

In the previous episode of the Physio Edge podcast - How to assess ankle syndesmosis injuries, Chris Morgan and David Pope explored how to assess and diagnose ankle syndesmosis injuries (ASI).

In this new Physio Edge podcast - "How to treat ankle syndesmosis injuries with Chris Morgan (Arsenal 1st Team Physiotherapist in the English Premier League), you will discover how to manage different grades of ASI, including:

Grade 1 syndesmosis injury management

• Initial injury management
• How long should you immobilise a Grade 1 injury for?
• What weight bearing should be allowed in the initial stages?
• Taping techniques that can be utilised during return to running, training and play
  • Rehab - initial exercises and progressions
• How much pain is acceptable during return to training?
• Return to sport timeframes & how you and your athlete can decide when RTP is appropriate
• When can contact be initiated?

Grade 2 syndesmosis injuries

• Grade 2 injury management and immobilisation
• Which players are likely to require arthroscopy to confirm instability, and subsequent stabilisation surgery?
• Why rehabilitation of stable grade 2 injuries is different from grade 1 injuries
• Which movements you need to restrict
• How to maintain lower limb musculature and minimise muscle atrophy should be performed
• Additional general conditioning your patient should perform during the early phase of rehab
• How to incorporate an Alter G treadmill into rehab
• Occlusion training for lower limb conditioning
• How to modify rehab if you do not have access to an Alter G
• Timeframes and criteria to assess when your patient can remove their immobilisation boot
• Tests to perform at each stage of rehab
• When and how should dorsiflexion range be improved?
• Timeframes and criteria to meet prior to return to running
• Exercise progressions and variations
• Return to play markers and tests you can use
• What to do when a player still reports a ‘nipping’ at the front of the ankle after 6 weeks and is having difficultly achieving full dorsiflexion

Unstable injuries - Grades 2b, 3 and 4

• Management of unstable injuries
• Post-surgical immobilisation and management
• Common return to play timeframes

Click here to download your podcast handout

To accurately grade your patients ASI and prescribe the most appropriate rehab I strongly recommend listening to Physio Edge podcast episode 80 – How to assess ankle syndesmosis injuries with Chris Morgan prior to this podcast

CLICK HERE to register for the free webinar - Medial knee injuries with Chris Morgan

Medial knee injuries often occur in snow sports, or other sports when landing or being tackled. Different areas of the medial knee can be injured, including the deep, superficial, proximal or distal fibres of the MCL and medial knee. Depending on the injured structures, patients will either cope with a more aggressive treatment approach and early return to sport, or require a more conservative approach. How can you know the rehab approach your individual patient requires?

In this free webinar with Chris Morgan (1st Team Physiotherapist with Arsenal FC), you will explore:

• Applied anatomy of the medial knee
• Mechanism of injury, presentation and diagnosis of medial knee injuries
• How you can differentiate between deep, superficial, proximal, distal and Grade 1, 2 and 3 clinical injuries
• How imaging findings correlate with your clinical findings
• MRI grading (radiological versus clinical)
• How you can perform an objective assessment
• How function, pain and instability impact your treatment
• Accelerated vs more conservative treatment - how can you choose the ideal approach for your patient?
• Are PRP injections appropriate?
• Rehabilitation principles you can use with your medial knee injury patients
• Ligament loading
• Which bracing and weight bearing regime should you utilise?
• What should you do when your patient has joint laxity?
• Is pain during rehab acceptable?
• Should you overload OR "under load to overcome"?

You can CLICK HERE to access this free webinar

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Twitter - @ChrisMorgan10
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Articles associated with this episode:

• Calder et al. 2016. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports

• Latham et al. 2017. Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report

• Morgan et al. 2014. Conservative management of syndesmosis injuries in elite football

• Sikka RS, Fetzer GB, Sugarman E, Wright RW, Fritts H, Boyd JL, Fischer DA. Correlating MRI findings with disability in syndesmotic sprains of NFL players. Foot & ankle international. 2012 May;33(5):371-8.

• Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med. 2015 Mar 1;49(5):323-9.

Other episodes of interest:

• PE 051 - Lateral knee and LCL injuries with Matt Konopinski
• PE 052 - Conservative or surgical management of ACL injuries with Enda King

Ankle syndesmosis injuries, also known as a high ankle sprain, commonly occur during high impact tackles or collisions that involve forced lateral rotation of the foot in ankle dorsiflexion. Syndesmosis injuries can be missed in the early stages as the degree of pain and swelling may not reflect the severity of the injury. Early diagnosis of syndesmosis injuries is key in preventing persistent pain, disability and limited ability to return to play or activity.

In Physio Edge podcast episode 80, English Premier League Physiotherapist Chris Morgan, and David Pope explore how to assess and diagnose ankle syndesmosis injuries (ASI), including:

• Questions you need to ask when your patient has had an ankle injury
• What is an ASI?
• What symptoms will your patient report following ASI?
• Ligaments and structures that are often involved in an ASI
• What is a "peeling injury", and how does this influence the structures that are injured?
• Common mechanism of injury
• How to assess, diagnose, classify and grade ASI
• How to differentiate between stable and unstable ASI
• Which tests can you perform to accurately diagnose ASI?
• Differential diagnosis
• Which injuries are likely to require surgical intervention, and which injuries may be managed conservatively?
• When imaging is useful
• What type of imaging to perform
• Identifying underlying chondral lesions
• Early management strategies

CLICK HERE to download your podcast handout

Upcoming podcast - How to treat ankle syndesmosis injuries with Chris Morgan

A subsequent podcast with Chris Morgan will discuss in detail how to treat ankle syndesmosis injuries . Download this podcast now to improve your assessment and diagnosis of ankle syndesmosis injuries.

Free webinar - Medial knee injuries with Chris Morgan

Chris Morgan's Physiotherapy roles in English Premier League with Liverpool and Crystal Palace have provided him with a lot of experience treating acute injuries, including the ankle and knee. To help you take advantage of this experience, Chris is presenting a Clinical Edge webinar on medial knee injuries. In his webinar Chris will discuss:

• Presentation of medial knee injuries
• How imaging findings correlate with clinical findings
• How to progress your rehabilitation and return players to performance
• Incorporating change of direction and trunk control into rehabilitation

You can CLICK HERE to access this free webinar

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Twitter - @ChrisMorgan10
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Articles associated with this episode:

Morgan et al. 2014. Conservative management of syndesmosis injuries in elite football

Sikka RS, Fetzer GB, Sugarman E, Wright RW, Fritts H, Boyd JL, Fischer DA. Correlating MRI findings with disability in syndesmotic sprains of NFL players. Foot & ankle international. 2012 May;33(5):371-8.

Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med. 2015 Mar 1;49(5):323-9.

Other episodes of interest:

PE 017 - Injury reduction with Dr Peter Brukner

PE 027 - Sports injury management with Dr Nathan Gibbs

Following ACL injury, patients can have a smooth recovery with full return to sport and activity, or end up with ongoing knee symptoms and limited ability to perform the activities they love. How can you help your ACL injured patients have a great outcome?

In Physio Edge podcast episode 079, Dr Lee Herrington and David Pope explore how to make your ACL injury rehab successful, and provide you with a comprehensive guide to rehabilitate ACL injuries. You will understand how to take your patients from initial injury to return to sport, and develop the knowledge to help inform your patients decide with your patient whether surgical repair or conservative management is their best option.

You will discover:

• Do ACL injuries require surgical management?
• Which factors commonly affect whether people with ACL-deficient knees require surgery?
• Common diagnostic errors in ACL injury patients
• What are the key elements you need to include in your rehab of ACL injuries?
• Conservative vs surgical management
• Should your rehab focus on movement control, strength or skills?
• How you should objectively assess your patients rehab progress?
• What valid measurement tools can you use when assessing patient progress?
• Are open-chain exercises safe, and should they be used in your rehab?
• Most effective types of movement control and skill training
• How to know when your patient should progress their exercises?
• Which strength measures are important?
• Which strength training exercises can you include?
• When can running be commenced?
• Running progressions you can use
• What pain measures should you monitor throughout rehab?
• Is pain during rehab ok?
• How to return your patient to training and sport
• What maintenance exercises should your patient continue after completing their rehab?

Related online courses

Advanced ACL rehab with Andrew Ryan

Other episodes of interest:

• Physio Edge 052 Conservative or surgical management for ACL injuries with Enda King
• Physio Edge 051 Lateral knee and LCL injuries with Matt Konopinski
• Physio Edge 034 - Advanced ACL rehab with Enda King

 

Click here to download the podcast handout

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Twitter - @LeeHphysio
• MSc Sports injury rehabilitation - University of Salford

• Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership

• Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino

• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Articles associated with this episode:

• Bollen et al. 1996. Rupture of the anterior cruciate ligament - a quiet epidemic?
• Comfort et al. 2011. Kinetic comparisons during variations of the power clean
• Frobell et al. 2010. A randomised trial of treatment for acute anterior cruciate ligament tears
• Gabbett. 2016. The training - injury prevention paradox: should athletes be training smarter and harder?
• Harris et al. 2017. Tibiofemoral osteoarthritis after surgical or nonsurgical treatment of anterior cruciate ligament rupture: a systematic review
• Herrington et al. 2013. Task based rehabilitation protocol for elite athletes following Anterior Cruciate ligament reconstruction: a clinical commentary
• Hewett et at. 2010. Understanding and Preventing ACL injuries: current biomechanical and epidemiological considerations
• Mikkelsen et al. 2000. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study
• Weiler et al. 2015. Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football plater with return to play in less that 8 weeks: applying common sense in the absence of evidence

How can you incorporate high performance elements into your sports injury rehab, to help your injured players and athletes become strong, fit, powerful and fast? How can you rehab a player to perform at a high level when they return to sport following injury?

In Physio Edge podcast episode 78, David Joyce shares how you can improve the performance aspects of your rehabilitation. You will discover some of the key elements when managing high performance athletes and sporting teams. If you work with injured athletes at an elite, recreational or junior level, or would like to work with a sports team, you will love this podcast.

In this podcast, David Joyce and David Pope discuss:

• How to help athletes move from being a junior player to performing at an elite level
• How to help players build tolerance and resilience to cope with high level sport
• How to create "elite level people", not just "elite level players"
• What makes a player likely to succeed?
• Schedules and weekly programs you can use to prepare junior players
• What load should a junior player perform during preseason relative to a senior player?
• When players need to be exposed to higher loads
• How to schedule training and running to prevent bony and soft tissue injuries
• How many running sessions per week should players perform?
• "Earning the right" to run at full speed
• How to structure strength sessions do players perform
• Incorporating plyometrics
• What load measures are actually important
• Important screening questions to ask your players
• How to return injured players to high level sport
• How many weeks of full training do ACL injured players require before return to play
• Key tests to perform for your players
• Tips when objectively testing athletes

CLICK HERE to download your podcast handout

Get your access to Sports Injury Assessment and Treatment FREE videos

Links associated with this episode:

• David Joyce at Greater Western Sydney Giants
• David Joyce on Twitter - @DavidGJoyce
• Twitter - Giants Athletic Performance Unit @Giants_APU
• Book - Sports injury prevention and rehabilitation
• Book - High performance training for sports
• Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership
• Download and subscribe to the podcast on iTunes
• Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge

Other episodes of interest:

• PE 003 - Rugby, rehab and return to sport with the Australian Wallabies Physio
• PE 027 - Sports injury management with Dr Nathan Gibbs
• PE 034 - Advanced ACL rehab with Enda King

The long head of biceps tendon and superior labrum can get a hard time in throwing athletes and patients that fall on their arm or shoulder. This can result in long head of biceps tendon pathology or SLAP tears, and cause ongoing shoulder pain.

A lot of our shoulder tests are non-specific, and are unable to identify particular structures that are irritated or painful in the shoulder. In the case of the long head of biceps (LHB) tendon and slap tears, there are a few useful tests that in combination with a good history can help you identify when the structures are involved in your patient's shoulder pain.

In episode 77 of the Physio Edge podcast, Jo Gibson, Shoulder Specialist Physio and David Pope discuss anterior shoulder pain, LHB pathology and SLAP tears. You will discover:

• Anatomy of the long head of biceps tendon and superior labrum
• Why the anatomy is important, and may be different to what you learnt at university around the biceps tendon and bicipital groove
• The clinical presentation and relevant history of patients with SLAP lesions and LHB tendon pathology
• Which patients are more likely to get SLAP tears following trauma
• Special tests that may help you identify LHB pathology and SLAP tears
• What information imaging gives us
• When to request imaging for your shoulder pain patients
• Different groups of patients that develop LHB pathology
• Rehabilitation of LHB tendon pathology and SLAP tears
• When to specifically target the LHB tendon, and when to target the surrounding structures for best results
• Other areas to consider in your rehab beyond the shoulder
• How the kinetic chain can impact shoulder pain
• How someone's hop distance can influence their shoulder pain
• How to start treatment of someone with an irritable LHB tendon
• Important education components to include in your treatment
• Time frames - How long do these injuries take to recover?
• Which patients are suitable for surgical management?
• Different types of surgery for LHB tendon pathology
• Which SLAP tear patients should have conservative treatment?
• How suprascapular nerve involvement can present following traumatic shoulder injury, and how to identify patients with suprascapular nerve compression

Links of Interest

• Free Shoulder assessment videos with Jo Gibson - a series of three evidence-based videos to get you great results with shoulder pain

• Free sports injuries videos including the AC joint with Jo Gibson

• Download and subscribe to the podcast on iTunes

• Jo Gibson on Twitter - @ShoulderGeek1

• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Courses - Steps to Success

Articles associated with this episode:

• Hendy et al. 2012. Cross education and immobilisation: mechanisms and implications for injury rehabilitation
• Kibler et al. 2009. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder
• McCreesh et al. 2017. Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy
• Parle et al. 2017. Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect?
• Saithna et al. 2016. Shoulder Arthroscopy Does Not Adequately Visualize Pathology of the Long Head of Biceps Tendon
• Schroder et al. 2017. Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial
• Taylor et al. 2017. The "3-Pack" Examination Is Critical for Comprehensive Evaluation of the Biceps-Labrum Complex and the Bicipital Tunnel: A Prospective Study

Exercise videos

• Thoracic rotation exercise
• Dynamic rotation exercise

Other episodes of interest:

• PE 043 - Sporting Shoulder with Jo Gibson
• PE 031 - Unruly scapular assessment and retraining with Ann Cools

There are a lot of myths around footwear, and your patients with running injuries will often blame an "incorrect shoe" choice for their injury, or believe that getting the "right shoe" will help resolve an injury. Are running shoes the cause of, and solution to running injuries?

What advice should you give your patients when they ask that inevitable question "Do you think I need to get new shoes?", closely followed by "What shoe do you think I should run in?"

In Physio Edge podcast episode 76 with Tom Goom, you will also discover:

• What footwear should your runners and injured runners wear?
• Footwear questions you need to ask your running injury patients
• Does footwear change gait patterns?
• Can footwear contribute to injury?
• What footwear may contribute to or help in your treatment of Achilles tendinopathy
• What is heel-toe drop and how is this important?
• Does footwear affect ground reaction forces, and how does this relate to bone stress injuries and plantar fasciopathy?
• Is minimalist or barefoot running helpful or harmful?
• Can runners safely transition to barefoot or minimalist running?
• Is footwear the key to resolving running injuries?
• Shoe prescription
• Recommendations when buying new shoes
• Footwear considerations for specific pathologies
• When should runners change their shoes?

If you would love to get better results with running injuries, the podcast handout contains the key take-home messages for you. You can download it here.

To complement this podcast and improve your treatment of runners, Tom Goom and I have created three awesome free Achilles tendinopathy rehab videos. This is a series of three evidence-based videos to help you master Achilles treatment. CLICK HERE to get your free access to these videos

Links of Interest

• Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

• Download and subscribe to the podcast on iTunes

• Download your free podcast handout on treatment of calf pain in runners
• Tom Goom on Twitter
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

Related posts

• Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom
• Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom
• Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom
• Infographic - How to treat plantar fasciopathy in runners with Tom Goom
• Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Physio Edge 060 Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy imaging & education with Tom Goom

Research associated with this episode

• Esculier et al. 2015. A consensus definition and rating scale for minimalist shoes.
• Fuller et al. 2017. Six week transition to minimalist shoes improves running economy and time-trial performance.
• Kong et al. 2009. Running in new and worn shoes: a comparison of three types of cushioning footwear.
• Mallisoux et al. 2015. Influence of heel to toe drop of standard cushioned running shoes on injury risk in leisure time runners: a randomised controlled trial with 6 month follow up.
• Nigg et al. 2015. Running shoe and running injuries: myth busting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’.
• Salzier et al. 2016. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.

Tendinopathy patients may present for treatment with an ultrasound or MRI report in hand, unsure how you can help them, or how they can possibly recover when they have so much tendon pathology. To add insult to injury, they may even have a partial tendon tear on their imaging report thrown into the mix. How do imaging results impact your treatment and your patient's recovery? Are the imaging findings relevant to their pain?

In this Physio Edge podcast with Dr Sean Docking (Physiotherapist, PhD), you will explore what information imaging actually provides in your tendinopathy patients, how to explain imaging to your patients, and whether partial tendon tears identified on imaging will effect your treatment. You will also discover:

• Who develops tendon pathology
• If patients have tendon pathology on imaging, is this responsible for their symptoms, or will it cause future tendon pain
• Asymptomatic tendon pathology in sports people
• How tendon pathology can actually be linked to better performance
• Can we prevent tendon pathology
• The advantages and disadvantages of different imaging types, including
• MRI
• Ultrasound
• Ultrasound tissue characterisation (UTC)
• Why a thickened tendon may actually be helpful in recovery
• How can we actually diagnose tendinopathy
• When is imaging useful
• Differential diagnosis of Achilles pain, including
  • Achilles tendinopathy
  • Paratenonitis
  • Plantaris associated tendinopathy
• Partial tendon tears, the accuracy of identification, and how they impact your treatment

Sports injuries virtual conference

As mentioned in this episode Sean presented at the 2017 Sports Injuries virtual conference. His main conference presentation on tendinopathy and imaging discusses:

• The research around the use for imaging
• A framework for when and when not to use imaging
• How to explain imaging findings to patients

You can get immediate access to his presentation, and presentations from 13 of the leaders in sports injuries by CLICKING HERE

Download this podcast and subscribe on iTunes

 

Links associated with this episode:

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Enrol on the 2017 Sports Injuries virtual conference
• Twitter - @SIDocking
• Sean Docking - La Trobe University website
• Sean Docking - Research gate
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership

Articles associated with this episode:

Alfredson. 2011. Midportion achilles tendinosis and the plantaris tendon

Brown et al. 2011. The COL5A1 gene, ultra-marathon running performance and range of motion

Docking et al. 2016. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC).

Docking et al. 2015. Tendinopathy: Is imaging telling us the entire story?

Lieberthal et al. 2014. Asymptomatic achilles tendinopathy in male distance runners

McAuliffe et al. 2016. Can ultrasound imaging predict the development of Achilles and patellar tendinopathy? A systematic review and meta-analysis

Simpson et al. 2016. At What Age Do Children and Adolescents Develop Lower Limb Tendon Pathology or Tendinopathy? A Systematic Review and Meta-analysis

Other episodes of interest:

PE 068 - Lower limb tendinopathy loading, running and rehab with Dr Pete Malliaris

PE 042 - Treatment of Plantaris and achilles tedninopathy with Seth O’Neil

PE041 - Plantaris involvement in achilles tendinopathy with Dr Christoph Spang

Femoroacetabular impingement (FAI) may contribute to hip and groin pain, buttock pain, pelvic or low back pain and referred pain into the thigh. Is conservative management effective in patients with FAI, or is surgery required? If we can treat FAI conservatively, what is the best treatment, and how can you tailor your treatment to your individual patients?

In episode 74 of the Physio Edge podcast with Dr Joanne Kemp you will discover:

• What is FAI, and how can you identify it?
• Common clinical presentations
• Key subjective questions to ask
• Types of FAI morphology and how they are identified
• Is FAI just a normal finding?
• How you can perform an objective assessment in patients with FAI
• Differential diagnosis
• Components you need to include in your conservative treatment for FAI
• Which objective markers to use when treating FAI
• How to address common impairments in your rehabilitation, including strength, functional tasks, cardiovascular training and range of movement
• When to refer for a surgical opinion
• Outcomes of surgical treatment
• Future risk of developing OA in presence of FAI

Sports Injuries virtual conference presentation

As mentioned in this episode Joanne will be part of the Sports Injury virtual conference. Her pre conference presentation will discuss FAI and the diagnostic process in more detail. Her subsequent conference presentation will be available on 9-10 December 2017, with access for up to 12 months following the conference, and will discuss:

• Conservative management of FAI
• Specific exercise progressions you can use
• Return to sport for athletes

Enrol on the 2017 Sports Injuries virtual conference by CLICKING HERE

Download this podcast and subscribe on iTunes

Links associated with this episode:

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Enrol on the 2017 Sports Injuries virtual conference
• Twitter - @JoannaLKemp
• Joanna Kemp - Research gate
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• LaTrobe Sports and Exercise Medicine Research Blog
• Twitter - @LaTrobeSEM
• GLA:D Australia
• Lake Health Group

Articles associated with this episode:

Griffin et al. 2016. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.

Articola et al. 2014. A Cam Deformity Is Gradually Acquired During Skeletal Maturation in Adolescent and Young Male Soccer Players. A Prospective Study With Minimum 2-Year Follow-up.

Other episodes of interest:

• Physio Edge 054 - Hip and groin pain part 2 with Benoy Matthew
• Physio Edge 053 - Hip and groin pain part 1 with Benoy Matthew
• Physio Edge 009 - Lateral hip pain with Dr Alison Grimaldi
• Physio Edge 004 - Hip injuries and labral tears with Nicole Hamilton

Strengthening is not commonly used in neck pain treatment and rehabilitation, however athletes may place large demands on their neck during training and play that require a high level of strength or endurance.

When should you include strength training in your rehabilitation? What patients will benefit from strength training? How can you incorporate strengthening into your treatment?

In episode 73 of the Physio Edge podcast, we explore the role of neck strengthening with Kay Robinson, Physiotherapist working with Australian sailing, and previously with the British Olympic Skeleton team.

In the podcast you will discover:

• Objective assessment of patients with neck pain
• Range of movement and strength tests you can use with your neck pain patients
• How to assess neck strength in your patients
• Indications for strength training
• Is strength training suitable in the early stages of neck pain rehabilitation?
• Early-stage cervical spine rehabilitation exercises you can use
• Exercise progressions to improve neck strength
• Neck strengthening in concussion
• Is neck strength training suitable for whiplash patients?
• Aspects incorporated into a typical neck strengthening program

Kay Robinson will also be presenting at the 2017 Sports Injury virtual conference. Her conference presentation on neck strengthening will discuss:

• How to incorporate neck training into rehabilitation post injury
• Neck strengthening for injury prevention
• How to make exercise patient or sport specific
• Other consideration with neck training
• Case studies

Download this podcast and subscribe on iTunes

 

Links associated with this episode:

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Enrol on the 2017 Sports Injuries virtual conference
• Kay Robinson on Twitter - @kaylourob
• Kay Robinson at Total Physiotherapy
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• Book - Sports Injury Prevention and Rehabilitation: Integrating Medicine and Science for Performance Solutions
• High-Performance Training for Sports

Articles associated with this episode:

Durall. 2012. Therapeutic Exercise for Athletes With Nonspecific Neck Pain: A Current Concepts Review.

Falla et al. 2003. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion.

Falla et al. 2007. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting.

Jull et al. 2009. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain.

Other episodes of interest:

PE 013 - Cervical Spine Artery and VBI Testing with Roger Kerry

5 Minute Physio tip - Manual therapy for the cervical spine - Is there any evidence?

5 Minute Physio tip - Contraindications and red flags to cervical spine manual therapy.

Injured athletes like to recover and return to play as quickly as possible, and we need to balance return to play against impaired strength, performance and risk of reinjury. Initial injury rehabilitation often commences with isometric exercises, progressing into concentric/eccentric style exercises when isometric tests are pain-free. Finally high load eccentric exercises such as the Nordic hamstring are introduced for their positive effects of increased strength, fascicle length and reduced injury risk.

High level and eccentric exercises are often avoided in the early stages of rehab, for fear of aggravating the injury. What if we could commence higher-level and eccentric exercises safely at an earlier stage? Would this impair or accelerate your patients' recovery?

In this podcast with Jack Hickey, currently completing a PhD with the QUT/ACU hamstring injury research group, we explore an accelerated hamstring injury rehabilitation program, and how this can be implemented with your patients. You will discover:

• The limitations of traditional rehabilitation
• What is the evidence for only using isometric exercises in the early stages of rehab
• Why eccentric exercises are commonly thought of as too high a load for initial rehab
• More modern rehabilitation programs for hamstring strain injuries, including the Askling (2013), Aspetar (2017) and Mendiguchia (2017) programs
• An accelerated rehab program, introducing higher-level and eccentric exercises at an early stage
• How often high-level exercises need to be performed
• Which exercises you can use with your hamstring injury patients
• How to know when to progress your patient's exercises
• When you can start your patient's rehabilitation
• When your patients can return to running
• How to progress your patience through a return to running program
• When your patients are suitable for return to sport

Download this podcast and subscribe on iTunes

 

Links associated with this episode:

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Jack Hickey
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• ACU open access hamstring journal repository
• Dr David Opar on Twitter
• Dr Anthony Shield
• Dr Morgan Williams
• Dr Matthew Bourne
• Nicol van Dyk
• Rod Whiteley
• Nirav Maniar
• Ryan Timmins

• Dr Steve Duhig

• Sliding discs to use in hamstring slider exercises in your clinic - available in Australia. Use the code "clinicaledge" to get 20% off your order (at the above link, not applicable on Amazon)

• Amazon (outside Australia)- Sliding discs to use in hamstring slider exercises

 

Other episodes of interest:

• PE 071 - Hamstring strengthening, lengthening and injury prevention with Dr David Opar
• PE 019 - Hamstring strength, flexibility and injury reduction with Dr Kieran O’Sullivan
• PE016 - Preventing hamstring injuries with Dr Kristian Thorborg

Articles associated with this episode:

• Askling et al. 2013. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols
• Aspetar Hamstring Protocol
• Hickey et al. 2016. Criteria for Progressing Rehabilitation and Determining Return-to-Play Clearance Following Hamstring Strain Injury: A Systematic Review
• Jacobsen et al. 2016. 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.
• Järvinen et al. 2007. Muscle injuries: optimising recovery.
• Mendiguchia et al. 2017. Hamstring rehab for football players.
• Silder et al. 2013. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial

Hamstring injuries are the most common injury in football and AFL, and we can help our patients strengthen their hamstrings while significantly reducing their risk of injury with the right exercise program. What are the best exercises to use to strengthen and lengthen the hamstrings, and to prevent hamstring injury?

In this Physio Edge podcast with Dr David Opar, we discuss hamstring injury prevention, which athletes will benefit, which exercises to use, the most important aspects of each exercise and how to incorporate these with your athletes. You will discover:

• What does the latest research around hamstring exercises and injury reveal?
• Which players are most at risk of hamstring injury?
• How can we prevent hamstring injuries?
• How does hamstring muscle architecture adapt to training, and how does this relate to your exercise selection or prescription?
• How can we increase hamstring muscle fascicle length?
• How can we tailor our patients hamstring program based on whether they are preseason, in-season, uninjured or previously injured?
• Which exercises are important in hamstring rehabilitation and prehabilitation?
• How can you start and progress a hamstring injury prevention program?
• How quickly do patients lose their hamstring gains, and how much maintenance do they need to perform?
• What happens to hamstring muscle strength and flexibility following injury?
• What neuromuscular inhibition happens following hamstring injuries, and how can we address this in our rehab?

There has been a lot of great research performed recently on hamstring injuries, and to share this and help you with your hamstring injury patients, we have invited Dr David Opar to present at the upcoming Sports Injuries virtual conference in December 2017. You can access six free preconference sports injury presentations by CLICKING HERE.

Links

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• ACU open access hamstring journal repository
• Dr David Opar on Twitter
• Dr Anthony Shield
• Dr Morgan Williams
• Dr Matthew Bourne
• Nicol van Dyk
• Rod Whiteley
• Nirav Maniar
• Jack Hickey
• Ryan Timmins
• Dr Steve Duhig

Articles associated with this episode:

• Bourne et al. 2017. Impact of exercise selection on hamstring muscle activation.
• Opar et al. 2015. Eccentric hamstring strength and hamstring injury risk in Australian footballers.
• Petersen et al. 2011. Preventive Effect of Eccentric Training on Acute Hamstring Injuries in Men’s Soccer.
• Timmins et al. 2015. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study.
• Timmins et al. 2016. Architectural Changes of the Biceps Femoris Long Head after Concentric or Eccentric Training.
• van Dyk et al. 2016. Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries: A 4-Year Cohort Study.

Athletes with groin pain will commonly play with pain until the end of the season, and rest during the off-season in the hopes this will aid in their recovery. Unfortunately this offseason rest period rarely results in recovery, and athletes head into the preseason with long-standing groin pain and an extended recovery period.

In this episode of the Physio Edge podcast with Dr Adam Weir , you will discover how to treat adductor related groin pain (ARGP) and complex patient presentations with multiple areas of pathology or pain.

This podcast follows on from the Physio Edge podcast episode 69, where Dr Adam Weir and I discussed in detail how to assess and diagnose adductor related groin pain, identify or exclude differential diagnosis including stress fractures, hip joint involvement, inguinal related groin pain and nerve entrapment.

You will explore:

• Treatment of acute adductor strains
• Long term adductor related groin pain (ARGP)
• Is rest during the off season helpful or harmful for groin pain
• What pain level is ok during rehab exercises
• How can you describe ARGP to decrease patient fear
• Is ARGP a tendinopathy or different pathology?
• How to answer your patients when they ask how long until they can return to training (RTT) or return to play (RTP)?
• What is and how can you incorporate the Copenhagen Adductor exercise?
• Is there a role for passive treatment?
• Is hand held dynamometry useful during recovery?
• Treatment for adductor related groin pain (ARGP)
• Starting treatment
• Exercise progressions
• What criteria can you utilise for treatment progressions?
• What criteria can you use prior to allowing your patients to return to running, change of direction and RTP
• How to progress running and change of direction training
• Adductor to abductor strength ratios your athletes can achieve prior to RTP

Complex presentations

• How can you make a diagnosis and tailor your rehab when a patient has multiple areas of pain and positive tests eg ARGP plus Psoas related groin pain or Inguinal related groin pain?

• How your treatment program may evolve as your patient progresses through their rehab

Dr Adam Weir will be presenting at the upcoming Sports Injuries virtual conference on the assessment and treatment of Inguinal related groin pain. You can access his free preconference presentation, along with other free sports injury assessment and treatment videos AT THIS LINK

Links associated with this episode:

• Get your access to free Sports Injuries presentations
• Download your free podcast handout
• Dr Adam Weir on Twitter - @adamweirsports
• Aspetar – Sports groin pain centre
• Get your free trial Clinical Edge membership
• David Pope on Twitter
• Clinical Edge on Facebook
• Adductor protocol on Mobile devices
• Adductor protocol videos on Youtube

Articles associated with this episode:

• Branci et al. 2014. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls.

• Drew et al. 2017. Experimental pain in the groin may refer into the lower abdomen: implications to clinical assessment.

• Drew. 2017. PhD Thesis - Beyond the pathoanatomical explanation of long-standing groin pain in athletes

• Mosler et al. 2015. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis.

• Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes.

• Whittaker et al. 2015. Risk factors for groin injury in sport: an updated systematic review.

Physio Edge 069 Adductor related groin pain, stress fractures and nerve entrapment assessment & diagnosis with Dr Adam Weir

Adductor related groin pain is the most common diagnosis for athletes with groin pain. In this episode of the Physio Edge podcast you will discover how to assess and diagnose adductor related groin pain, identify or exclude differential diagnosis including stress fractures, hip joint involvement, inguinal related groin pain and nerve entrapment.

Dr Adam Weir is a Sports Physician with a PhD on groin pain, the lead author for the Doha agreement meeting on terminology and definitions in groin pain in athletes, who currently shares his time between the Aspetar sports groin pain centre and the Erasmus University Hospital Academic Centre for Groin Injuries in Holland. Adam will take you through exactly how to perform an assessment around the hip and groin, how to interpret your findings and how to explain your diagnosis to your patients. You will explore:

• The common presentation and symptoms of someone with adductor related groin pain
• Structures that are commonly involved
• Aggravating and easing activities
• Area of pain, and new research highlighting unexpected pain referral areas from the adductor tendons
• Differential diagnosis
• Bone stress injuries around the hip and pubic bone
• Genitofemoral nerve entrapments - symptoms, diagnosis and treatment
• Red flags
• Acute versus chronic presentations
• Adductor related versus pubic related groin pain
• How to perform an assessment, including screening tests
• Tests you need to incorporate into your assessment
• Identifying and diagnosing all the structures contributing to a patient's symptoms
• What is the value of imaging and when should it be performed?

Links associated with this episode:

• Get your access to free Sports Injuries presentations
• Download your free podcast handout
• Dr Adam Weir on Twitter - @adamweirsports
• Aspetar – Sports groin pain centre
• Erasmus University Hospital Academic Centre for Groin Injuries
• Get your free trial Clinical Edge membership
• David Pope on Twitter
• Clinical Edge on Facebook

Articles associated with this episode:

• Branci et al. 2014. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls.

• Drew et al. 2017. Experimental pain in the groin may refer into the lower abdomen: implications to clinical assessment.

• Drew. 2017. PhD Thesis - Beyond the pathoanatomical explanation of long-standing groin pain in athletes

• Mosler et al. 2015. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis.

• Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes.

• Whittaker et al. 2015. Risk factors for groin injury in sport: an updated systematic review.

There are a range of tendinopathy presentations, from easily diagnosed with a local area of pain and clear pain response to tissue overload; through to patients with trickier presentations and multiple contributors to pain e.g. long term proximal hamstring or gluteal tendinopathy with a lumbar spine radiculopathy.

How can you diagnose and treat patients with complex tendinopathy presentations? How does the latest research around tendinopathy help us? I explore these issues and more with Dr Peter Malliaras in episode 68 of the Physio Edge podcast. We also explore:

• Do tendinopathy patients always present with a small area of pain, or can they have pain in larger, more diffuse areas?
• How will you identify tendinopathy or other structures that may be contributing to your patients symptoms?
• Clues in your patients' history to help you identify and differentiate tendinopathies, lumbar and SIJ referral
• Symptoms and how your treatment will differ in patients with paratenon and fat pad involvement
• How can you measure your patients load tolerance?
• What categories of tendinopathy patients can you use to help differentiate your treatment?
• How can you rehabilitate patients with tendinopathy?
• What role does biomechanics have?
• What advice can you provide to your patients about load management, symptoms and flareups?
• When is it ok for your patients to continue or return to running?
• What strength tests should your patients be able to complete before returning to running?
• If your patients are not tolerating running, which aspects should you modify first - frequency, intensity, type or duration?
• When are isometrics useful in your treatment?
• When can you start isotonic and plyometric exercises?
• How can you incorporate tendon neuroplastic training (TNT)?

Links associated with this episode

• Download your podcast handout
• Dr Peter Malliaras on Twitter
• Tendinopathy rehab blog with Dr Peter Malliaras
• Get your free trial Clinical Edge membership
• David Pope on Twitter
• Clinical Edge on Facebook

Other episodes of interest:

• PE 046 - Proximal hamstring tendinopathy with Tom Goom
• PE 042 – Treatment of plantaris and Achilles tendinopaty with Seth O’Neil
• PE 023 – Lower limb tendinopathies with Dr Pete Malliaras

Articles associated with this episode:

• Coombes et at. 2016. Isometric exercise above but not below an individuals pain threshold influences pain perception in people with lateral epicondylalgia

• Rio et al. 2015. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy

• Silbernagel et al. 2007a. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled trial.

• Silbernagel et al. 2007. Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy.

Shoulder pain can involve the rotator cuff, scapula, cervical spine, thorax, and other structures in this area. Recent research has also explored the role of patient beliefs and expectations on the outcomes of Physiotherapy for shoulder pain. Which factors are important in your shoulder pain patients? Can we identify the contributing factors to your patients shoulder pain? What information will you get from orthopaedic special tests during a shoulder examination? How can you improve your treatment results with your patient education?

In this episode of the Physio Edge podcast, Dr Chris Littlewood and David Pope discuss shoulder pain, including:

• Classification of shoulder pathology
• How to identify painful vs stiff vs unstable shoulder pain vs cervical spine referred pain
• Questions to ask in your subjective assessment
• Does subacromial impingement exist, and how does a diagnosis of subacromial impingement effect outcomes
• Patient expectations of treatment outcomes
• How to perform an objective assessment
• What information special tests provide
• Is scapular dyskinesis pathological or normal movement variation
• Are painful or non-painful exercises most helipful in chronic shoulder pain
• What role does imaging have in shoulder pain

This podcast adds to Physio Edge podcast 47 - Rotator cuff tendinopathy with Dr Chris Littlewood .

Links of interest

Webinar - "Exercise for rotator cuff tendinopathy: Does it work as we think it should, and can we do better? with Dr Chris Littlewood

Download the handout from this podcast

Cervical spine assessment & treatment online course

Get your free trial Clinical Edge membership

David Pope on Twitter

Clinical Edge on Facebook

Dr Chris Littlewood at Keele University

Dr Chris Littlewood on Twitter

Dr Chris Littlewood on ResearchGate

Experiencing increasing calf pain with running can be an incredibly frustrating experience for your running patients, especially when it is severely limiting or stopping them from being able to run. You can have a lot of success in helping your runners overcome running related calf pain, and in episode 66 of the Physio Edge podcast, we give you practical strategies and exercises you can use in your treatment.

Tom Goom and David Pope helped you explain the causes of calf pain to your running patients, differential diagnosis and red flags, and what you need to assess in episode 64 and episode 65, and in Episode 66 you will explore:

• How to strengthen the calf complex
• Strengthening for local ankle and foot muscles
• Benefits and how to incorporate strengthening for the kinetic chain
• Incorporating neural mobility into your treatment
• Adjusting and progressing training loads
• The role of gait retraining in the treatment of calf pain

If you would love to get better results with calf pain in runners, the podcast handout contains the key takehome messages for you. You can download it here.

To complement this podcast and improve your treatment of runners, Tom Goom and I have created three awesome free Achilles tendinopathy rehab videos. This is a series of three evidence-based videos to help you master Achilles treatment. CLICK HERE to get your free access to these videos

Links of Interest

• Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

• Download and subscribe to the podcast on iTunes

• Download your free podcast handout on treatment of calf pain in runners
• Tom Goom on Twitter
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

 

Related posts

• Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom
• Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom
• Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom
• Infographic - How to treat plantar fasciopathy in runners with Tom Goom
• Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Physio Edge 060 Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy imaging & education with Tom Goom

Research associated with this episode

• Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series
• Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis
• Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery
• Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis

When your patients present with calf pain, do you have a clear understanding of the likely causes and potential differential diagnosis? Do they have any red flags that require urgent medical attention? What other issues besides a calf tear could be causing their calf pain?

It's time to brush off those diagnostic skills, to understand the types of calf pain you can treat, and which patients you need to refer on immediately.

In this podcast with Tom Goom and David Pope, we are going to break it down for you, so you are confident in assessing and diagnosing the different types of calf pain. You will understand:

• How to identify calf muscle pathology or tears
• When symptoms are due to neural irritation or pathology
• Different types of vascular pathology, including popliteal artery entrapment
• Red flags such as deep vein thrombosis (DVT)
• What information imaging can provide

You can download a free handout containing a summary of the podcast info on differential diagnosis, which you can download here.

Tom Goom and I are really excited to share three free evidence-based Achilles tendinopathy rehabilitation videos - to help you master the treatment of achilles tendinopathy. These will be out soon, so join us for these free masterclasses

 

Links of Interest

• Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

• Download and subscribe to the podcast on iTunes

• Download your free podcast handout on differential diagnosis of calf pain in runners
• Tom Goom on Twitter
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

 

 

Related posts

• Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom
• Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom
• Infographic - How to treat plantar fasciopathy in runners with Tom Goom
• Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Physio Edge 060 Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy imaging & education with Tom Goom

 

Research associated with this episode

• Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series
• Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis
• Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery
• Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis

One of the most popular blogposts of all time on Tom Goom's website running-physio.com is on how to manage calf tears in runners. Is this because it is a really common problem, or because Tom wrote such a great blogpost? It's a bit hard to tell, and most likely it's a bit of both, but it begs the question "Why is calf pain one of the issues so many runners face? "

In episode 64 of the Physio Edge podcast, David Pope and Tom Goom discuss the latest research around calf pain in runners and what is actually going on. We want to give you all the tools you need to assess runners that present with calf pain, so we have included this in the episode as well.

We also created a free handout with the info and assessment tests from this podcast, which you can download here.

If you would like to up your game on calf pain, here are some of the highlights from the podcast:

• What is responsible for calf pain in runners?
• What are the common symptoms?
• What will imaging show (or not show)?
• What happened to chronic exertional compartment syndrome (CECS)? Does it still exist?
• What is biomechanical overload syndrome, and how is it different to CECS?
• Who are the most likely culprits to experience calf pain?
• How can you assess runners with calf pain?
• What tests should you perform?
• How can you perform a calf capacity test?

Tom Goom and I are releasing free Achilles running rehab videos - a series of three evidence-based videos to get you great results with achilles tendinopathy. These will be out soon, so join us to master Achilles treatment

Links of Interest

• Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy
• Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries
• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on calf pain in runners
• Tom Goom on Twitter
• Let David Pope know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

Related posts

• Physio Edge 060 Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy imaging & education with Tom Goom
• Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom
• Infographic - How to treat plantar fasciopathy in runners with Tom Goom

Research associated with this episode

• Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis
• Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series

Posterior hip pain can have a number of causes, with referral from the lumbar spine, SIJ and hip, along with local structures such as the hip joint, gluteals, glute tendons, proximal hamstring tendons. How can you identify the structures involved in your patient's posterior hip pain? What tests can you perform in your objective assessment to assist your treatment? What is the best way to treat the glutes if they are the involved in your patient's pain?

In episode 63 of the Physio Edge podcast, Benoy Mathew and David Pope explore how you can improve your diagnosis and results with posterior hip pain.

You will discover:

• What are some of the common causes of posterior hip pain?

• Gluteal tendinopathy (GT)

  • What area of symptoms will patients with GT report?
  • What are the pattern of symptoms for GT?
  • What tests can we perform to make GT more or less likely
  • How can we treat GT?

• Deep gluteal syndrome (DGS)

  • What is deep gluteal syndrome?
  • What muscles can be involved in DGS?
  • How can we differentiate it from Gluteal tendinopathy?
  • What tests can you perform to confirm or exclude DGS?
  • How does the treatment for DGS differ to GT?

Benoy is presenting a free webinar with Clinical Edge on "How to assess & diagnose posterior hip and gluteal pain, that complements this podcast, and takes you through the common sources of hip pain, how to identify hip and lumbar spine red flags, and demonstrates exactly how you can perform an assessment to test and differentially diagnose the structures involved in your patients pain.

CLICK HERE to enrol on this free webinar with Benoy Mathew

Ben also presented a webinar with Clinical Edge on how to rehabilitate adductor and psoas related groin pain. The webinar helps you discover:

• Rehabilitation of adductor and psoas related groin pain
• Practical tips
• Common presentations
• Osteitis pubis, sports hernia, hip impingement
• Rehabilitation from initial stages to plyometrics

CLICK HERE to watch the webinar "Rehab of adductor and iliopsoas related groin pain" with Benoy Mathew with a free trial Clinical Edge membership

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on how to assess and treat posterior hip pain
• Physio Edge podcast 053 Hip and groin pain part 1 - diagnosis, pathology and red flags with Benoy Mathew
• Physio Edge 054 Hip and groin part 2 - assessment and treatment with Benoy Mathew
• Download the free podcast handout for Physio Edge 054 Hip & Groin pain Part 2
• Webinar on groin pain rehabilitation with Benoy
• Benoy Mathew on Twitter
• Benoy Mathew's website and courses
• Access to Ben's webinar on rehabilitation of hip and groin pain, along with all of the Clinical Edge webinars and videos with a free trial membership
• David on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Free sports injury videos

 

Articles related to this episode:

1. Franklyn-Miller et al (2009)- The Gluteal Triangle: a clinical patho-anatomical approach to the diagnosis of gluteal pain in athletes , BJSM. Open Access Link
2. Grimaldi & Fearon (2015)- Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Management, JOSPT. Open Access Link
3. Hernando et al (2016)- Evaluation and management of ischio-femoral impingement: a pathophysiologc, radiolgic and therapeutic approach to a complex diagnosis, Skeletal Radiol
4. Martin et al (2016)- Deep Gluteal Syndrome, JHPS, Open Access Link
5. Martin et al (2016)- Ishiofemoral Impingement and Hamstrings Syndrome, Distal Causes of Deep Gluteal Syndrome. Where do we go next? Clin Sports Med. Open Access Link
6. Michel et al (2013)- Piriformis muscle syndrome: Diagnostic criteria and treatment of a mono centricseries of 250 patients, Annals of Physical and Rehabilitation Medicine
7. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist
8. Physical Examination of the Hip by Dr. Hal D. Martin

How can you treat plantar fasciopathy? How can you return your plantar fasciopathy patients to activity and running? When can they run without aggravating their pain?

In episode 62 of the Physio Edge podcast, Tom Goom and David Pope help you discover exactly how you can get great treatment outcomes with plantar fasciopathy.

You will discover:

• How can you treat plantar fasciopathy (PF)?
• How can you help reduce plantar fascia pain during the "pain-dominant" phase?
• How can you improve load capacity during the "load-dominant" phase?
• When do your patients need relative rest?
• What cross training options are suitable for runners with PF?
• When and how can you incorporate strengthening into your treatment?
• What other impairments should you address in your treatment?
• How do you adapt strengthening if your patients pain is irritable vs non-irritable
• Is stretching helpful?
• Should you include other treatment, eg taping, orthotics, gel heel cup
• When can your patients return to running?
• How long is the average recovery from PF?
• A PF case study with exercise progressions and return to running.

Download Physio Edge podcast episode 62 now to find out all of this and more

This podcast follows on from Physio Edge 060 Plantar fasciopathy in runners with Tom Goom and Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom

Links of Interest

• Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries
• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on plantar fasciopathy in runners
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

 

Related posts

• Physio Edge 060 Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy in runners with Tom Goom
• Infographic - Plantar fasciopathy imaging & education with Tom Goom
• Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom
• Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom

 

Research associated with this episode

Rathleff et al. 2014. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.

Assessment and diagnosis is vital in planning your plantar fasciopathy treatment program, and successfully returning your patients to activity and running. Structures in the vicinity of the plantar fascia insertion may contribute to plantar heel pain, but require a very different treatment approach. How can you identify other structures that are involved? What questions do you need to ask in the history? How can you perform an examination, and what tests should you perform on patients with plantar fasciopathy?

In episode 61 of the Physio Edge podcast, Tom Goom and David Pope help you discover exactly how you can assess and differentially diagnose plantar fasciopathy.

You will discover:

• Plantar fasciopathy clinical presentation
• How to identify fat pad irritation
• Patterns of calcaneal and navicular bony stress injuries
• How you can identify nerve entrapment and radiculopathy
• Red flags such as spondyloarthropathy
• Questions to ask in your subjective that will guide your diagnosis and treatment
• How to perform an objective assessment
• Tests you need to perform
• Identifying impairments to address during rehabilitation
• When you should perform a running assessment

Download Physio Edge podcast episode 61 now to find out all of this and more

This podcast follows on from Physio Edge 060 Plantar fasciopathy in runners with Tom Goom

Links of Interest

• Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries
• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on plantar fasciopathy in runners
• Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live
• Enrol on the free webinar "How to treat persistent pain, and use the latest pain education strategies in your treatment" with Mike Stewart
• Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy

Research associated with this episode

• Rathleff et al. 2014. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.
• Riel H, et al Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on

Plantar fasciopathy is one of the most common causes of foot pain in runners and non-athletes alike. Our understanding of plantar fasciopathy (PF) pathology and treatment has progressed significantly over recent years. In episode 60 of the Physio Edge podcast, Tom Goom and David Pope explore PF, what we know about it, and how you can explain the condition, treatment and recovery process to your patients.

You will discover:

• What we know about plantar fasciopathy
• What pathology is present
• What information imaging provides
• Which forms of imaging are the most useful
• What are the risk factors for developing PF
• Which aspects of running may be related or contribute to developing PF?
• How can you explain PF the condition, treatment and recovery process to your patients

Download this podcast now to find out all of this and more

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on plantar fasciopathy in runners
• Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live
• Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy

 

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

 

Research associated with this episode

• Sullivan et al. 2015. Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain

• Nielsen et al. 2013. Predictors of Running-Related Injuries Among 930 Novice Runners

• van Leeuwen, et al. 2015. Higher body mass index is associated with plantar fasciopathy/‘plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors

• Riel H, et al Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on

How can you identify the most important factors involved in your patients running injuries? During your rehabilitation of runners, which is most important to address - load, gait pattern, strength, foot strike, pelvic position, footwear, range of movement or other factors?

I wanted to discuss and debate these issues with a number of Physiotherapists that treat and research running injuries, so I have a very different format for you on this episode of the Physio Edge podcast - a group podcast.

On this podcast, we have Tom Goom, Greg Lehman and Dr Christian Barton all in one virtual room discussing and debating the merits of the various approaches to running injuries.

In this episode of the Physio Edge podcast David Pope and the group discuss:

• When is it ok for your runners to continue running, and when do they need to stop
• Common myths around running retraining
• When is it important to change your patients foot strike?
• Which patient presentations and pathologies will be assisted with running retraining?
• How can you identify a suitable running load during rehab
• How can you incorporate running retraining into your rehab
• Which areas are important to running assessment
• How can you manage training load strength and conditioning
• When are plyometrics appropriate during rehabilitation
• Other factors that impact injury prognosis and duration
• What advice can you give new runners
• Which footwear should runners wear?

Download this podcast now to find out all of this and more

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on running injuries
• Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Get your free trial Clinical Edge membership

 

Tom Goom - Running Physio website - Tom on Twitter - Tom Goom's website & courses - Tom on Facebook Live

Greg Lehman - Greg Lehman's website - Twitter - Facebook

Dr Christian Barton - Twitter - LaTrobe Sport and Exercise Medicine Research Blog

 

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

 

Papers mentioned in this episode

Is there an economical running technique? A review of modifiable biomechanical factors affecting running economy

Influence of step length and landing pattern on patellofemoral joint kinetics during running

The training-injury prevention paradox: should athletes be training smarter and harder?

Optimizing strength training for running and cycling endurance performance: A review

A negative life event impairs psychosocial stress, recovery and running economy of runner

Running shoes and running injuries: mythbusting and a proposal for two new paradigms: preferred movement path and comfort filter

The effectiveness of exercise interventions to prevent sports injuries: a syatematic review and meta-analysis of randomized controlled trials

Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period

Frontal plane kinematics of the hip during running: Are they related to hip anatomy and strength?

High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self structured running program: a 1 year observational study

Your athletes workload consists of the amount of running, training and matches performed. Their current workload can be compared to previous workload to identify periods where they may be at risk of injury or setting back their rehabilitation (Gabbett 2016). Balancing your athletes workload during rehabilitation and afterwards is vital to allow recovery from injury, improved performance while avoiding further injury.

What do you need to monitor, and how can you monitor workload in an easy and efficient manner? Find out in this episode of the Physio Edge podcast with Tom Goom and David Pope.

You will also discover:

• What is athlete monitoring?
• What is the aim?
• What do we want to monitor?
• What are external training loads?
• What are internal training loads?
• How might we monitor athletes?
• What do we do with the data we get?

Download this podcast now to find out all of this and more

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on athlete monitoring 
• Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

Reference: Gabbett, TJ. The training—injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 2016;50:273-280

Helping our running patients recover and return to running following injury is our primary rehab priority, however we may also have the opportunity to help improve their running performance. Runners are often motivated by improving their speed, performance and times, and incorporating these goals into their rehab can increase motivation and exercise compliance. How then can we help our patients to improve their performance when returning from an injury? Find out in this episode of the Physio Edge podcast with Tom Goom.

You will also discover:

• Why consider performance?
• How might we assess performance in a more scientific way?
• What are the benefits of performance tests?
• How can we link it to other aspects e.g. gait analysis?
• How does performance influence training structure and progression?
• How do we optimise performance in injured athletes?

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on advanced performance tests & optimising performance in runners
• Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Get your free trial Clinical Edge membership
• Tom Goom's website & courses
• Tom on Facebook Live

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

Identifying how much running each of your patients can perform (their load capacity) during their rehabilitation is a skill. This podcast will help you develop your load management skills, and know how much running your individual patients should perform at each stage of their rehabilitation.

In this podcast with Tom Goom, you will discover:

• What is load capacity?
• How do we identify your patient’s running capacity?
• How are your patient’s progressing in their rehabilitation, relative to where they want to be?
• How can you identify what your patients goals are, so that you can help tie this into a rehab program?
• What questions can you ask your patients to assess load capacity and identify the right amount of load?
• What objective tests can you use to help identify your patient’s load capacity?
• How should you adapt your testing with different pathology?
• What tests can you perform to identify your patient’s load capacity if your patient has an Achilles Tendinopathy?
• What measures can we use to identify your patient’s running performance?

This podcast is the first in a series of podcasts over the next few months with Tom Goom, where we will help to develop your assessment and treatment skills, while improving your results with runners.

 

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download your free podcast handout on load capacity in runners
• Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy
• Tom Goom on Twitter
• Connect with David Pope on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Get your free trial Clinical Edge membership
• Tom Goom’s website & courses
• Tom on Facebook Live

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

 

Related articles

Cook J, Docking S. “Rehabilitation will increase the ‘capacity’ of your …insert musculoskeletal tissue here….” Defining ‘tissue capacity’: a core concept for clinicians. BJSM 2015

Physio Edge 055 Patellofemoral pain in runners with Brad Neal

Runners regularly present for treatment of anterior knee pain. Accurate diagnosis is vital in guiding your treatment, and helping your patients return to painfree running.

In episode 53 of the Physio Edge podcast Brad Neal and David Pope discuss the different patient presentations with anterior knee pain, along with the subjective clues and objective tests that will help guide successful treatment.

We also explore:
• Sources of anterior knee pain
- Patellofemoral pain
- Acute synovitis
- Fat pad irritation
- Osteochondral defects
• The role of imaging
• How to perform an objective assessment in patients with anterior knee pain, including key special tests
• Red flags
• Saphenous nerve involvement
• How to assess if the patient will benefit from an orthotic intervention
• Treatment of patellofemoral pain, synovitis, and fat pad irritation
• Taping techniques

’

Links of Interest

• Download and subscribe to the podcast on iTunes
  
• Download your free podcast handout on patellofemoral pain in runners with Brad Neal
  
• Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy
  
• Brad Neal on Twitter
  
• Connect with David Pope on Twitter
  
• Brad Neal on ResearchGate
  
• Brad Neal on Google Scholar
  
• Pure Sports Medicine
  
• Team PFP
  
• TREK – Translation of research education and knowledge
  
• Review the podcast on iTunes
  
• Like the podcast on Facebook
  
• Free sports injury videos
  

Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy

Articles related to this episode:

• Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anaesthesia
  
• Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: a systematic review and meta-analysis
  

Related resources

Infographic - Running retraining with Dr Rich Willy

Hip and groin pain part 1 - diagnosis, pathology and red flags with Benoy Mathew

In this second podcast on hip and groin pain with Physiotherapist and Extended Scope Practitioner Benoy Mathew, we explore:

• How you can assess the hip and groin
• How to assess the lumbar spine, SIJ and the lower limb for factors contributing to your patient’s groin pain
• Tests you can perform to identify the source of your patient’s hip and groin pain
• Identifying hip joint involvement
• How to start your patient’s hip and groin exercises
• When to incorporate exercises for local hip stabilising muscles
• When you need to utilise and progress hip strengthening exercises
• Exercise progressions you can use
• How to strengthen while you lengthen the hip flexors
• When and which plyometric exercises your patients can perform
• When speed and agility work can be incorporated

In the first podcast with Ben Mathew “Hip and groin pain part 1 - diagnosis, pathology and red flags” with Benoy Mathew", we explored pathology around the hip and groin and when pathology relates to symptoms, knowledge of potential red flags, along with patterns and symptoms associated with each diagnosis is vital in guiding your treatment of hip and groin pain.

`

As mentioned in this episode Benoy presented a webinar with Clinical Edge. The webinar helps you discover:
• Rehabilitation of adductor and iliopsoas related groin pain
• Practical tips
• Common presentations
• Osteitis pubis, sports hernia, hip impingement
• Rehabilitation from initial stages to plyometrics

CLICK HERE to watch the webinar “Rehab of adductor and iliopsoas related groin pain” with Benoy Mathew with a free trial Clinical Edge membership

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download the free podcast handout for Physio Edge 054 Hip & Groin pain Part 2
• Download the free podcast handout for Physio Edge 053 Hip & Groin pain part 1, including an additional summary and pictures by Ben Mathew
• Webinar on groin pain rehabilitation with Benoy
• Webinar on How to perform a running assessment with Dr Rich Willy
• Benoy Mathew on Twitter
• Benoy Mathew’s website and courses
• Access to Ben’s webinar on rehabilitation of hip and groin pain, along with all of the Clinical Edge webinars and videos with a free trial membership
• David on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Free sports injury videos

Articles related to this episode: 

• Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population
• The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment
• Rehabilitation following Hip Arthroscopy: An evolving process
• Iliopsoas: Pathology, Diagnosis and Treatment
• The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist
• How much arthritis is too much for hip arthroscopy: a systematic review
• Video – Hip special tests

Hip and groin pain part 1 - diagnosis, pathology and red flags with Benoy Mathew

Acute and chronic groin pain is common in sports, however diagnosis can be challenging. A thorough understanding of pathology around the hip and groin and when pathology relates to symptoms, knowledge of potential red flags, along with patterns and symptoms associated with each diagnosis is vital in guiding your treatment of hip and groin pain.

In the first of two podcasts on hip and groin pain with Physiotherapist and Extended Scope Practitioner Benoy Mathew, we explore:

• How you can use the patient history to help your diagnosis and treatment
• Important questions you NEED to ask all of your hip and groin pain patients
• Sources of hip and groin pain - intra and extra-articular
• How you can identify referred pain from the lumbar spine and SIJ
• How you can identify important red flags around the hip and groin
• When you should refer your patients for further investigations, medical assessment and surgical opinion
• How you can identify osteoarthritis in younger patients
• Differentiating hip impingement, labral pathology and hip dysplasia
• When to request X-ray or MRI
• Identifying and understanding iliopsoas pain and pathology

This is a vital podcast for anyone that treats hip and groin pain, and is highly recommended listening before Hip & groin pain part 2 - Assessment & Treatment with Benoy Mathew coming soon.

`

As mentioned in this episode Benoy is presenting a webinar with Clinical Edge. The webinar will discuss:
• Rehabilitation of adductor and iliopsoas related groin pain
• Practical tips
• Common presentations
• Osteitis pubis, sports hernia, hip impingement
• Rehabilitation from initial stages to plyometrics

CLICK HERE to enrol on the free webinar “Rehab of adductor and iliopsoas related groin pain” with Benoy Mathew

Links of Interest

• Download and subscribe to the podcast on iTunes
• Download the free podcast handout
• Benoy Mathew on Twitter
• Benoy Mathew’s website and courses
• Free webinar on groin pain rehabilitation with Benoy
• Access to Ben’s webinar on rehabilitation of hip and groin pain, along with all of the Clinical Edge webinars and videos with a free trial membership
• David on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Free sports injury videos

Articles related to this episode:

• Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population
• The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment
• Rehabilitation following Hip Arthroscopy: An evolving process
• Iliopsoas: Pathology, Diagnosis and Treatment
• The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist
• How much arthritis is too much for hip arthroscopy: a systematic review
• Video – Hip special tests

ACL injuries commonly occur during pivoting and change of direction sports. What is the best way to manage these injuries? Are your patients suitable for conservative managment or will they require surgery?

In Physio Edge podcast 052, David Pope and Enda King discuss acute management of ACL injuries, and how you can help your patient decide whether to have conservative or surgical management.

We also explore:

• What is the latest research around ACL injury
• What leads to an ACL injury, and how is this important in your rehab?
• What are the outcomes following ACL injury
• How can you make clear decisions on when your patient is ready for return to training and return to sport
• What biomechanics lead to ACL injury
• What role does trunk control have in ACL injury
• A patient example with an ACL injury
• Conservative vs surgical management
• Post injury management
• Timeframe for surgery
• Who is suitable for conservative management
• How to prepare your patient for the extended rehab process following ACL injury
• Strength and power training in ACL rehab
• Youth and adolescent ACL injury management
• How to manage concomitant chondral and meniscal injury
• When can your patient return to running

You can download the free podcast handout that will take you through lateral knee and LCL injury assessment and rehabilitation by clicking here.

Get your free access to videos on sports injury assessment and treatment, including accelerated rehabilitation of LCL injuries with Matt Konopinski.

Enda King will also be presenting at the Sports Injury Virtual Conference hosted by Clinical Edge along with the world leaders in sports injury management.

How can you manage ACL injuries conservatively? What are the important components of ACL rehab to help your players return to sport? Enda’s presentation will take you through ACL rehab to address common strength and biomechanical issues found in athletes with ACL injuries. Discover exactly how to progress your conservative management of ACL injuries, and when your players can return to running and sport.

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Links mentioned in this episode

Enda King

Free sports injury assessment and treatment videos

Sports Injuries virtual conference

Free podcast handout on ACL and lateral knee injuries

Enda King on Twitter @enda_king

Sports Surgery Clinic Dublin

Free trial of clinical edge membership

David Pope on Twitter

Lateral knee injuries are common in football with landing from a jump or header, or during tackles when the tibia is forced into external rotation. This mechanism of injury often affects the Lateral/Fibular collateral ligament (LCL), however LCL injury is not always obvious from the patient’s history, and can be misdiagnosed.

In this podcast with Liverpool FC Physiotherapist Matt Konopinski, we discuss LCL and lateral knee injuries, and how you can identify and treat these. LCL injuries can often respond extremely well to an accelerated rehabilitation approach, and in this podcast you will discover:

Sources of lateral knee pain
- Lateral meniscus
- Osteochondral defects
- Lateral/Fibular collateral ligament
- ACL
- Postero lateral corner
Mechanism of injury
What your patients will report with LCL injury
Questions you need to ask your patients with lateral knee pain
Red flags
Objective assessment
Assessment tests you can use with lateral knee pain
When imaging is useful and when it should be avoided
Risk factors for injury
Management of LCL injury
When to commence strengthening
How to maintain strength and cardiovascular fitness during rehabilitation
How to explain the injury and rehabilitation to your patients

You can download the free podcast handout that will take you through lateral knee and LCL injury assessment and rehabilitation by clicking here.

Get your free access to videos on sports injury assessment and treatment, including accelerated rehabilitation of LCL injuries with Matt Konopinski.

 

Links mentioned in this episode

Matt Konopinski

Free sports injury assessment and treatment videos

Free podcast handout on LCL and lateral knee injuries

Matt Konopinski on Twitter @Matt_Kono

LFC Liverpool football club

Article Impact of exercise selection on hamstring muscle activation

Free trial of clinical edge membership

David Pope on Twitter

Temporomandibular joint pain and dysfunction can significantly impact your patients life, limiting their ability to enjoy eating and talking. Temporomandibular dysfunction (TMD) has a lot of musculoskeletal contributors that physiotherapists are perfectly positioned to treat and help improve patient’s lives.

In episode 50 of the Physio Edge podcast, Dr Stephen Shaffer and

 

David Pope discuss TMD, structures that can be affected, and how you can assess and get great results treating TMD patients. We also explore:

• Structures involved in TMD
• Involvement of the cervical spine
• Common presentations of TMD
• Questions to ask in your subjective assessment
• Red flags
• How to perform an objective assessment
• Normal TMJ movement
• How you can treat TMD
• Manual therapy
• Education
• Exercise therapy
• Are the Rocabado 6x6 the best exercises to provide your patients

Dr Stephen Shaffer is presenting a webinar on TMD, hosted by Clinical Edge, and you can enrol free on this webinar by CLICKING HERE

Links mentioned in this episode

Enrol free on the TMD webinar with Dr Stephen Shaffer by CLICKING HERE

Download your podcast handout here

Dr Stephen Shaffer on ResearchGate

Cervical spine assessment and treatment online course with David Pope

Free trial of Clinical Edge membership

David Pope on Twitter

Physio Edge 049 Running from injury part 2 with Dr Rich Willy

In Running from Injury Part 2, Dr Rich Willy will help you perform a running assessment and tie this into running retraining for patients with achilles tendinopathy, patellofemoral joint pain, ITB Syndrome and stress fractures. We explore the latest evidence and how it will help you address your running patients pain and injuries.

You will discover:

• Treadmill or overground running assessments?
• Gait retraining for particular musculoskeletal conditions
• How to provide your patients with the individual running cue they need
• What cadence should we be aiming at for runners (hint: it may not be what you expect!)
• Is heel strike important to assess
• Running assessment from the side
• Important factors when treating runners with PFJP
• Running assessment & retraining for achilles tendinopathy
• Factors involved in ITB Syndrom
• When are orthotics useful

You can download the handout to go along with this podcast to help you perform a running assessment, retrain runners and address achilles tendinopathy, knee pain and tibial stress injuries.

Download your free handout by clicking here

Links mentioned in this episode

Physio Edge podcast 048 Running from injury part 2 with Dr Rich Willy

Dr Rich Willy on Twitter

Dr Rich Willy on ResearchGate

RunCadence app for iOS and Android

Bone stress injuries in runners webinar with Tom Goom

Achilles tendinopathy in runners online course

Free trial of Clinical Edge membership

David Pope on Twitter

Other Physio Edge podcasts related to running injuries

Physio Edge podcast 048 Running from injury part 2 with Dr Rich Willy

Physio Edge 046 Proximal hamstring tendinopathy with Tom Goom

Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Seth O’Neill

Physio Edge 039 Patellofemoral pain in adolescents with Dr Michael Rathleff

Physio Edge 038 Plantar fasciopathy loading programs with Michael Rathleff

Physio Edge 023 Lower limb tendinopathies with Dr Peter Malliaras

Physio Edge 012 Plantar fascia, achilles tendinopathy & nerve entrapments with Russell Wright

Physio Edge 010 Biomechanics Of Running With Blaise Dubois

Physio Edge 005 Tendons And Tendinopathy with Dr Jill Cook

Are you looking to improve your assessment & treatment of runners? Would you like to know exactly what to look for in a running assessment? What are the most important factors to treat when your running patients have achilles tendinopathy? How is that different when they have patellofemoral joint pain (PFJP)? The research around running is evolving quickly, and with Dr Rich Willy we explore the latest evidence and how it will help you address the most important factors with different musculoskeletal issues.

You will also discover:

• How to perform a running gait analysis
• Key communication points with runners
• How to explain your gait analysis & running injuries to your patients
• Important questions to ask runners
• Intensity runners should train at to avoid illness and injury
• Technology you can incorporate in your running assessment and retraining
• Important factors when treating runners with PFJP and achilles tendinopathy
• Does pronation & foot mechanics matter?

I have an awesome freebie for you with this podcast!

You can download free the podcast handout that will take you through the 8 essential areas to analyse when performing a running assessment, communication tips, advice to give your running patients during their recovery and much more.

Links mentioned in this episode

Dr Rich Willy on Twitter

Dr Rich Willy at East Carolina University

Dr Rich Willy on ResearchGate

Some papers of interest:

i. Patellofemoral Joint and Achilles Tendon Loads During Overground and Treadmill Running

ii. In-field gait retraining and mobile monitoring to address running biomechanics associated with tibial stress fracture: In-field gait retraining and monitoring

iii. Mirror gait retraining for the treatment of patellofemoral pain

University of Delaware

Irene Davis - Harvard

Garmin 620

RunCadence app for iOS and Android

Run Scribe

Purchase a RunScribe

Article on polarised training approach

Bone stress injuries in runners webinar with Tom Goom

Achilles tendinopathy in runners online course

Free trial of Clinical Edge membership

David Pope on Twitter

Other Physio Edge podcasts related to running injuries

Physio Edge 046 Proximal hamstring tendinopathy with Tom Goom

Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Seth O’Neill

Physio Edge 039 Patellofemoral pain in adolescents with Dr Michael Rathleff

Physio Edge 038 Plantar fasciopathy loading programs with Michael Rathleff

Physio Edge 023 Lower limb tendinopathies with Dr Peter Malliaras

Physio Edge 012 Plantar fascia, achilles tendinopathy & nerve entrapments with Russell Wright

Physio Edge 010 Biomechanics Of Running With Blaise Dubois

Physio Edge 005 Tendons And Tendinopathy with Dr Jill Cook

The rotator cuff and rotator cuff tendons are often involved in shoulder pain, and targeted with our treatment. Dr Chris Littlewood is a Physio and senior research fellow at the University of Sheffield, and spends a large portion of his time studying and treating shoulder pain, including rotator cuff tendinopathy. In this episode, Chris and I discuss how to identify rotator cuff tendinopathy and other types of shoulder pain, and how you can direct your treatment for rotator cuff tendinopathy. We also explore:

• Other sources of shoulder pain
• Clues that the cervical spine could be referring pain to the shoulder
• Unstable shoulder
• Red flags
• When to image the shoulder
• When bursal thickness or effusion is or isn’t a problem
• Shoulder assessment
• Stiff painful shoulders
• Treatment for rotator cuff tendinopathy
• Improving exercise adherence
• When to perform special orthopaedic tests
• Injections
• Surgery
• Is there really a rotator cuff exercise, compared to a scapular muscle exercise?
• Do exercises isolate the rotator cuff?

Download your free handout “Rotator cuff tendinopathy”

 

Links of interest

Webinar with Dr Chris Littlewood

Download the handout from this podcast

Webinar with Tom Goom on Bone stress injuries

Cervical spine assessment & treatment online course

Clinical Edge

Clinical Edge free trial

David Pope on Twitter

David on Facebook Live video

Proximal hamstring tendinopathy (PHT) occurs in athletes, runners, weightlifters, and other athletes, as well as more sedentary patients, causing pain at the hamstring origin and limiting your patients ability to sit, run and continue to be active.

There are a number of structures that can contribute to pain in this area, and in this podcast, Tom Goom and David Pope discuss how to clearly identify PHT and differentiate it from lumbar spine referred pain, hip pain, sciatic nerve pain and other conditions.

Tom recently released an article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management with Peter Malliaras, Mike Reiman and Craig Purdam. We explore this article, and the research around PHT, and cover in detail:

• Subjective clues to guide you towards diagnosis
• Aggravating factors and 24 hour pain patterns
• Differential diagnosis
• Lumbar spine pain
• How the lumbar spine could contribute to development of PHT
• Hip pain
• SIJ pain
• Sciatic nerve pain
• Development of PHT
• Central sensitisation
• Diagnostic tests for PHT
• Hamstring tests
• Other assessment tests
• Functional tests
• The value of palpation
• Tests for involvement of the rest of the kinetic chain
• Running assessment/gait analysis
• Testing load tolerance
• Biopsychosocial aspects of tendon recovery
• Other advice for patients
• Whether stretching is helpful
• When your patient can return to running
• Cross training
• Does manual therapy have a role in the treatment of PHT?
• Starting treatment (Stage 1)
• When and how to progress rehabilitation (Stage 2)
• Further rehabilitation progressions (Stage 3)
• Advanced exercise progressions for high load sports
• Exercises you can incorporate during the various stages
• How long recovery will take

Links

• Free webinar with Tom Goom
• Download the free handout summary of this podcast
• Tom’s website - Running Physio
• Tom on Twitter
• Running Repairs courses with Tom
• Article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management
• JOSPT
• Peter Malliaras
• Mike Reiman
• Craig Purdam
• VISA-H
• Become a Clinical Edge member to access Tom’s webinar and other great online education

How can you treat your patient’s lateral elbow pain (lateral epicondylalgia (LE)/tennis elbow)? How and when should you progress your patient’s exercise program? Is pain during their exercise program ok?

In this episode, which is Part 2 of Lateral Elbow pain with Dr Leanne Bisset, we explore in detail how you can differentially diagnose LE from other causes of lateral elbow pain, and treat it successfully.

Discover:

• Diagnosis and differential diagnosis of LE
• How to get the best outcomes for your patients when treating LE
• Do isometrics work?
• How can you commence strengthening?
• Should your patient experience any pain during their exercise program?
• When and how can you incorporate Mobilisation with Movement into your treatment program?
• How to perform MWM’s for LE
• How to progress your treatment
• Identifying and treating radial nerve involvement
• Incorporating strengthening for the upper limb
• High level athletes and weightlifters with lateral elbow pain - is this likely to be LE or another condition?
• Identifying nerve root irritation with pain over the lateral elbow
• Taping methods to deload the lateral elbow when there is nerve involvement
• Clinical reasoning of your treatment
• Predictors of poor treatment prognosis
• When to order imaging
• Evidence for and against other treatment strategies including the Cyriax approach, massage, laser, ESWT, corticosteroids and PRP
• Validated screening tools for LE, including the PRTEE

In this episode, Leanne answers a lot of your questions on LE, asked via Twitter and the Clinical Edge newsletter. 

Dr Leanne Bisset is a Physiotherapist, Physiotherapy lecturer and researcher at Griffith University in Queensland, Australia who has extensively researched and published on lateral elbow pain, and spends a large proportion of her clinical time treating the upper limb and lateral elbow.

This is a two part podcast, followup up Lateral Elbow Pain Part 1, episode 44 of the Physio Edge podcast, David Pope and Dr Leanne Bisset.

 

Download your free handout "Treatment of Lateral Elbow Pain 2"

 

Download the podcast here

Subscribe free to the Physio Edge podcast in iTunes

Download the podcast from Stitcher

Download and listen to the podcast on Soundcloud

Download your free podcast handout

Links of Interest

Dr Leanne Bisset

Dr Leanne Bisset on ResearchGate

Dr Leanne Bisset on Twitter

Download the Patient-Rated Tennis Elbow Evaluation (PRTEE)

Download the free podcast handout

Lateral Elbow Pain Part 1 with Dr Leanne Bisset

Review the podcast in iTunes

David Pope

Clinical Edge

Get your free trial of Clinical Edge online education

Lateral elbow pain (lateral epicondylalgia/tennis elbow) affects , and can respond fantastically to Physiotherapy treatment, or in other patients with a similar presentation, not at all. 

Dr Leanne Bisset is a Physiotherapist, Physiotherapy lecturer and researcher at [Griffith University][GU] in Queensland, Australia that has extensively researched and published on lateral elbow pain, and spends the majority of her clinical time treating the upper limb and lateral elbow.

This is a two part podcast, and in Part 1, episode 44 of the Physio Edge podcast, David Pope and Dr Leanne Bisset discuss:

• Why is Lateral Epicondylalgia (LE) difficult to treat?
• What tissue pathology exists in LE
• Pain pattern for LE
• Patient reports that will help your diagnosis of LE
• Important aspects to communicate with your patients regarding their LE
• Objective tests that you can perform
• Patient advice
• Should you rest your patients or provide exercises?
• How is tendinopathy in the Upper Limb different to the Lower Limb?
• Commencing treatment
• How to incorporate manual therapy into your treatment
• Exercises you can start your treatment with
• Should you include isometric exercises for lateral elbow pain
• How often should your patients perform their exercises
• Exercise into pain, or avoid pain?

Download the podcast from iTunes

Subscribe free to the Physio Edge podcast in iTunes

Download the podcast from Stitcher

Download and listen to the podcast on Soundcloud

 

Download your free handout and Podcast Summary on Lateral Elbow Pain Part 1

 

Links of Interest

Dr Leanne Bisset

Dr Leanne Bisset on ResearchGate

Dr Leanne Bisset on Twitter

Download the free podcast handout

Review the podcast in iTunes

David Pope

Clinical Edge

Get your free trial of Clinical Edge online education

 

Shoulder pain and injury in overhead athletes is very common and has a high recurrence rate. In this podcast with Jo Gibson we discuss sporting shoulder injuries and rehabilitation, including:

• The role of the Rotator Cuff
• Train strength or efficiency in the Rotator Cuff?
• Rotator Cuff muscle balance
• When is (and when isn’t) surgery necessary for Rotator Cuff or SLAP tears
• Assessment of shoulder stiffness
• Bursal involvement
• Imaging of the shoulder
• How you can help improve Rotator Cuff activation
• What role does manual therapy have in shoulder treatment?
• The importance of the postero-superior cuff
• What stretches can you perform for the postero-superior Rotator Cuff
• Treating pain in loaded and overhead activities
• Exercises you can use in shoulder treatment with your athletes
• Incorporating the kinetic chain in shoulder rehabilitation
• Managing shoulder load
• Central sensitisation
• Treating throwing athletes
• The role of the thoracic spine in shoulder pain
• Communication tips with your shoulder pain patients

 

Download the podcast from iTunes

Review the Physio Edge podcast in iTunes

Download the podcast from Stitcher

Download and listen to the podcast on Soundcloud

Links of Interest

Jo Gibson

Download the free podcast handout

Subscribe free to the podcast in iTunes

Jo Gibson’s courses

David Pope

Clinical Edge

Get your free trial of Clinical Edge online education

Jo Gibson’s video - Gym ball rollout

Jo Gibson’s video - Wall squat

Jo Gibson’s video - Step up with V

Physio Matters Podcast with Jo Gibson

Skills for Communicating with Patients Book

Key communication skills and how to acquire them - Article in BMJ by Peter Maguire, Carolyn Pitceathly

EUSSER

Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Seth O’Neill

Treatment of your patients’ Achilles Tendinopathy may be slowed by involvement of Plantaris.

In Episode 41 of the Physio Edge podcast, Dr Christoph Spang and I discussed how Plantaris may play a role in Achilles tendinopathy. In this episode of the Physio Edge podcast, I discuss with Seth O’Neill how you can identify Plantaris involvement in your patients, and adjust and progress your conservative treatment of Achilles pain and tendinopathy with Plantaris involvement. 

We discuss: 

• What indicates Plantaris involvement and helps you differentiate from mid portion Achilles Tendinopathy
• Where do patients have pain with Plantaris tendinopathy
• What history do patients with Plantaris involvement or tendinopathy present with
• Objective tests and findings for Plantaris tendinopathy and involvement
• Biomechanics contributing to Plantaris tendinopathy
• Is treatment successful for Plantaris
• How to treat Plantaris tendinopathy and involvement in midportion Achilles
• How to perform a loading program
• Running adjustments
• Taping
• Manual therapy

Links of Interest

Download your podcast handout by CLICKING HERE

Access to the Lower Limb Tendinopathy free videos, including Seth’s presentation on Achilles Tendinopathy

Lower Limb Tendinopathy Virtual Conference with detailed, practical presentations:

• Dr Jill Cook will cover “Structure, function and pain in tendinopathy”
• Dr Sean Docking is then going to take us through “The role of imaging in the diagnosis and monitoring of tendinopathy”.
• Dr Peter Malliaras is presenting “Staged rehabilitation of Patellar Tendinopathy”.
• Craig Purdam takes you through “Staged rehabilitation of Hamstring Tendinopathy”
• Seth O’Neill will help you understand “Achilles Tendinopathy Exercise & rehab progressions. Risk factors and the importance of Soleus in Achilles tendinopathy”
• Dr Ebonie Rio will conclude the Virtual Conference with “Tendon pain and the brain – what do we know and can we change it?”

CLICK HERE for more information on the Lower Limb Tendinopathy Virtual Conference

Seth on Twitter

Seth’s website on Achilles Tendon Research

David on Twitter

Subscribe to the podcast on iTunes

Physio Edge podcast episode 41 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang

 

PE041 The role of Plantaris in mid portion Achilles Tendinopathy

Plantaris tendinopathy and compression of Plantaris on the Achilles has been shown to play a role in some cases of Achilles Tendinopathy, slowing down their rate of rehabilitation progress.

Dr Christoph Spang is a Biologist and Sports Scientist, and completed a PhD on “The plantaris tendon in relation to the Achilles tendon in midportion Achilles tendinopathy”. In this podcast we discuss the interaction of Plantaris in patients with midportion Achilles Tendinopathy, including:

Why consider Plantaris in Achilles Tendinopathy patients?

How can Plantaris cause or be involved in Achilles pain?

Anatomy, function and role of Plantaris

What interaction does Plantaris have with the Achilles and calf?

Do patients with Plantaris involvement respond to a loading program?

What is the clinical presentation of a patient with Plantaris involvement?

How can Ultrasound or Ultrasound Tissue Characterisation (UTC) be utilised to identify Plantaris?

The role of injection therapy

Surgical treatment

Links of Interest

Free videos on Lower Limb Tendinopathy

Dr Christoph Spang at UMU

Dr Christoph Spang’s PhD Thesis

Dr Christoph Spang on Research Gate

David Pope on Twitter

Out very soon…. Conservative management of Plantaris involvement in Achilles Tendinopathy with Seth O’Neill

achilles, plantaris, tendinopathy, christoph, spang, utc, physioedge, physio, clinical edge

 

PE040 Shoulder simplified with Adam Meakins

How complex does your shoulder assessment need to be? How can you can simplify your shoulder assessment and treatment?

Find out in episode 40 of the Physio Edge podcast with Adam Meakins, where Adam and I discuss:

• Common mistakes Physio’s make in assessment and treatment of the shoulder
• Adam’s classification of shoulder pain
• Subjective clues to guide your objective and treatment
• How to identify weak and painful shoulders
• Red flags with shoulder pain
• Frozen shoulders
• Objective assessment
• Subacromial impingement
• GIRD (Glenohumeral Internal Rotation Deficit)
• The use of US in shoulder pain
• Surgical treatment for shoulder pain
• Treatment for weak and painful shoulders
• Loading the rotator cuff for pain relief and strength
• Gym junkie shoulder pain and how to adapt their weight training programs

Links of Interest

Download your free handout on The Shoulder Simplified

Follow Adam Meakins on Twitter

Adam’s website

Adam’s Shoulder courses

Adam’s presentation on “When is a GIRD not a GIRD”

Shoulder Pain Virtual Conference

Follow David on Twitter

Access practical Online Courses for Physiotherapists with a Free Membership Trial of Clinical Edge

Download your free handout on the Shoulder Simplified

 

 

 

PE #037 Pilates for shoulder and knee pain with Lana Johnson

Pilates is commonly known and used for rehabilitation of persistent low back pain, however Pilates principles and equipment can also be used for assessment and treatment of pain beyond the pelvis and lumbar spine.

In episode 37 of the Physio Edge podcast, Lana Johnson, a Physiotherapist and former dancer, from BPS Tensegrity in Sydney and I discuss how you can use Pilates for knee and shoulder pain, as well as:

• Common misconceptions about Pilates
• Functional vs non-functional exercises
• Common errors made in Pilates training and rehabilitation
• Pilates for hip and knee pain
• Case studies using Pilates with shoulder and knee pain patients
• Patient progression
• Cues you can use with your patients for hip and shoulder retraining
• Exercise progressions
• Exercises to stay away from

Links of Interest

• Lana Johnson
• BPS Tensegrity
• Clinical Edge
• Clinical Edge Online Education
• Virtual conferences with Physio Edge and Clinical Edge
• Physioedge on Facebook
• David on Twitter

 

Tags: Lana Johnson, Pilates, BPS, BPS Tensegrity, Low back pain, shoulder pain, knee pain, rehabilitation, strengthening, retraining, Clinical Edge, online education, Physio Edge, podcast, case studies, exercise progression, functional exercise, hip

 

Mike Stewart and further explore persistent pain, helpful language you can use with your persistent pain patients, how you can use group sessions, as well as:

• How the bio fits into biopsychosocial
• How you can develop an educational toolkit
• Case study of a patient with persistent peripheral pain
• Language & communication recommendations.
• Misconceptions about persistent pain education
• And much more.

Links of Interest

Physio Edge podcast episode 35 - Know Pain part 1 with Mike Stewart

Mike Stewart

Know Pain

Courses with Mike Stewart

Mike Stewart on Twitter

Virtual conferences with Physio Edge and Clinical Edge

Clinical Edge discounts for Undergraduate Physio students available by emailing verification of your student status to info at clinicaledge.com.au

Clinical Edge online education

Free Sports Medicine articles in the Aspetar Journal

Headspace

“Living in the moment” by Anna Black

“Rainy brain, Sunny brain” by Elaine Fox

Free video on Metatarsal head padding with Nick Torrance

Free video on soft metatarsal domes for acute metatarsalgia

Free video on firmer metatarsal domes for metatarsalgia

Facebook

David on Twitter

Tags: Pain, persistent pain, chronic pain, complex pain, know pain, mike stewart, physiotherapy, physio, podcast, physio edge, clinical edge, courses, virtual conference, conference, understanding, biopsychosocial, communication

PE035 - Know Pain with Mike Stewart Part 1

Persistent pain can be a challenge, but also enjoyable to treat. In this episode of the Physio Edge podcast, Mike Stewart and I focus on specific examples and case studies of patients with complex or persistent pain, how you may approach persistent pain patients, explain their pain, use metaphors and explanations so they understand it, and help guide them through the recovery process. 

Mike and I get into the details on:

• Why Physios need a deep understanding of pain science
• How does the “bio” part come into bio-pscyho-social
• How can we identify if the patient needs pain education, further investigations, a biological approach eg specific exercise
• How can you incorporate pain science into the treatment of patients with acute pain
• Mike’s top tips when working with persistent pain
• Specific case studies of patients with persistent and complex back pain, and how Mike has worked with these patients, including their presentation, beliefs, Mike’s language used in their session, activity modification and results achieved with these patients
• How to develop our teaching skills to achieve the best results with our patients

Links of Interest

Mike Stewart

Know Pain

Courses with Mike Stewart

Mike Stewart on Twitter

Virtual conferences with Physio Edge and Clinical Edge

Clinical Edge discounts for Undergraduate Physio students available by emailing verification of your student status to info at clinicaledge.com.au

Clinical Edge online education

Free video on Metatarsal head padding with Nick Torrance

Free video on soft metatarsal domes for acute metatarsalgia

Free video on firmer metatarsal domes for metatarsalgia

Facebook

David on Twitter

 

The advanced stages of ACL rehabilitation are enjoyable to progress your patients through, and at the same time challenging to find the right exercises, and optimise the rate of progression through to return to training (RTT) and return to play (RTP). In this episode, Enda King from the Sports Surgery Clinic Dublin and David Pope discuss these later stages of rehabilitating your patients following an ACL Reconstruction.

We discussed the prehabilitation and early stage ACL Rehab in the Physio Edge podcast episode 32, and episode 34 Enda and I cover in detail:

• Return to straight line running and change of direction

• Advanced Exercise Programming

• What exercises to choose

• Proprioception and motor control training

• Strength and power programming

• Periodisation

• Sports specific conditioning

• Plyometrics - readiness, what to use and timing of these in the training schedule

• Multi-directional performance

• Strength testing - what Enda uses, indicators of strength

• Decisions on return to training

• Return to contact

• Decision making on Return to play

• Bridging the gap between the gym and the field

• Advice for Physios rehabilitating athletes recovering from an ACL reconstruction

• When to discharge an ACL athlete

• And much more

Links of interest

Physio Edge podcast episode 32 - How to rehabilitate ACL Injuries with Enda King

Enda King

Enda on Twitter @enda_king

Sports Surgery Clinic, Dublin

SSC Research Foundation

David Pope on Twitter

Clinical Edge Webinar program - register your interest

Clinical Edge

Review the podcast in iTunes

David Pope

Tags: ACL, knee, injury, anterior cruciate ligament, surgery, rehabilitation, soccer, football, strengthening, movement, non-contact, physiotherapy, physio edge, podcast, enda king, SSC, sports surgery clinic, david pope, clinical edge, advanced, strengthening, proprioception

How to treat anterior knee pain with Kurt Lisle

Anterior knee pain can occur in your elite sports patients right through to office workers and weekend warriors. In this podcast with Kurt Lisle, we discuss anterior knee pain, the causes, how to diagnose the source of the pain, and the best ways to treat and rehabilitate these patients.

Kurt Lisle is the Australian Socceroos Physio and co-owner of The Knee Joint Physio in Queensland. Kurt and I discussed acute knee injuries on the Physio Edge podcast in episode 29, and I really wanted to get Kurt back on the podcast to discuss the anterior knee.

In this fantastic, detailed episode of the Physio Edge podcast, Kurt and I explore:

• Subjective clues that give you ideas about differential diagnosis
• Fat pad - location of pain, activities that irritate
• Patellofemoral joint - aggravating activities and DDx
• Patellar tendon - subjective clues, location of pain
• Objective examination of the anterior knee
• Tests for PFJ
• Functional tests first or examination on the treatment table?
• Palpation of the anterior knee
• Fat pad palpation and tests
• Is the fat pad tender medial and laterally, or can it be tender only on one aspect
• Neuromuscular patterning
• Squat and one leg squat examination
• What causes “catching” pain on movement
• Chondral defects - identifying
• Is there value in the grind test
• When to refer for MRI and other imaging
• Important factors that may contribute to AKP
• Gait contributors to AKP
• Treatment of PFJ pain
• Modifying PFJ aggravating activities
• Using EMG
• Quadricep rehabilitation and strengthening
• When to incorporate squats into your rehabilitation program
• The role of taping for PFJ or fat pad irritation
• Red flags causing knee pain

You can download this episode from iTunes or Soundcloud.

If you enjoy the Physio Edge podcast, we would love you to take a couple of minutes write us a review on iTunes. Please take a screenshot of your review before posting it, and email it to info@physioedge.com.au so I can give you a shoutout in the next podcast

Links of Interest

Kurt Lisle

The Knee Joint Physiotherapy, Bokarina, QLD

Socceroos

Review the Physio Edge podcast in iTunes

Download the Physio Edge podcast from iTunes

Clinical Edge

20% off your first month’s membership to Clinical Edge with the code PHYSIOEDGE

Review the Physio Edge podcast in iTunes

Download the Physio Edge podcast from iTunes

Clinical Edge

20% off your first month’s membership to Clinical Edge with the code PHYSIOEDGE

 

Tags: anterior knee, pain, knee, knee injuries, socceroos, patellofemoral joint, fat pad, impingement, patellar tendon, knee joint, imaging, strengthening, examination, rehabilitation, return to play, graft, tendon, conservative, football, soccer, physio edge, physiotherapist, physio, edge, clinical edge, podcast, online education, kurt lisle, socceroos, the knee joint

ACL injuries can be career ending, or they can be an opportunity to sort out movement efficiency, motor control and and technical skills, coming back from the rehabilitation process with more power, speed and efficiency than your patients had before they injured their ACL.

In this podcast, Enda King from the Sports Surgery Clinic in Dublin currently completing his PhD in 3D biomechanical analysis after ACL reconstruction, with the aim to assist in RTP decision making and identifying fully rehabilitated athletes, and David Pope discuss ACL injuries, and the most important factors in pre-operative management and post-operative exercise programming to get your patients back to sport with improved sporting performance.

Going deep on the details involved in ACL Rehabilitation, including:

01:20 Enda King and SSC, and working with ACL athletes PhD in 3D biomechanical analysis after ACL reconstruction, aim to assist in RTP decision making and what a fully rehabilitated athlete looks like

• What does a fully rehabilitated athlete look like?
• Incorporating performance goals into the rehab process
• Can athletes achieve better performance post ACL rehab than they were pre-injury
• Types of ACL grafts
• Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery
• Preoperative education
• Restoring knee extension, balancing pain and improved range of movement, empowering your patient
• Guidelines for pain, swelling when restoring range of movement
• Restoring quadriceps activation, normalising gait patterns
• Clinical Edge
• Clinical Edge’s free webinar program
• Preoperative length of time
• Post-op - initial management
• To use or not use co-contraction exercises of quads and hamstrings
• Should you use squatting style exercises Week 1 post op
• Activating quadriceps - internal quadriceps cues or external exercise focus
• How much pain should a patient experience during or after an exercise
• Week 2 post-op
• When can heavy gym training commence
• Changing movement patterns throughout the kinetic chain
• Advice for patients in the early stages of rehab
• Frequency of exercise
• Week 2 onwards - exercises incorporating balance and proprioception
• Open vs closed chain exercises
• Advice for patients in weeks 2–6
• Nutrition and dietary advice for patients
• Gym based rehabilitation
• Choosing and modifying exercises for middle stages of the rehabilitation process
• Various types of squatting movement, and progressing the types of squats
• Goblet squats
• Retraining ideal squat patterns
• Progressing squats, deadlifts and lunges
• Front squats
• Front squats and trap bar deadlifts vs back squats during rehabilitation
• When can an athlete start cycling
• Disadvantages of using cycling as the main part of a rehabilitation program
• Hamstring rehabilitation after semitendinosis/gracilis graft
• Strength and power development
• Strength testing - mid thigh pull, leg press
• Should we use open chain strength tests
• When to perform strength tests
• Strength vs power and rate of force development
• Running - incorporating into the program. When can your patient start running?
• Preparation for running
• Running drills
• Ideal movement patterns in running
• Enda King and SSC, and working with ACL athletes

Podcast timeline

3:35 What does a fully rehabilitated athlete look like?

5:40 Incorporating performance goals into the rehab process

6:50 Can athletes achieve better performance post ACL rehab than they were pre-injury

8:20 Types of ACL grafts

11:10 Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery - an opportunity to prepare your patients knee, ROM, strength and educate them on the rehabilitation process

14:20 Preoperative education

14:40 Restoring knee extension, balancing pain and improved range of movement, empowering your patient with

15:40 Guidelines for pain, swelling when restoring range of movement

16:15 Restoring quadriceps activation, normalising gait patterns

17:10 Clinical Edge

18:45 Clinical Edge’s free webinar program

19:30 Preoperative length of time

20:35 Post-op - initial management

23:20 To use or not use co-contraction exercises of quads and hamstrings

24:50 Should you use squatting style exercises Week 1 post op

25:25 Activating quadriceps - internal quadriceps cues or external exercise focus

26:30 How much pain should a patient experience during or after an exercise

27:30 Week 2 post-op

28:30 When can heavy gym training commence

29:30 Changing movement patterns throughout the kinetic chain

31:00 Advice for patients in the early stages of rehab

32:10 Frequency of exercise

32:55 Week 2 onwards - exercises incorporating balance and proprioception

34:10 Open vs closed chain exercises

35:40 Advice for patients in weeks 2–6

37:15 Nutrition and dietary advice for patients

37:45 Gym based rehabilitation

38:50 Choosing and modifying exercises for middle stages of the rehabilitation process

41:00 Various types of squatting movement, and progressing the types of squats

41:45 Goblet squats

42:30 Retraining ideal squat patterns

43:25 Progressing squats, deadlifts and lunges

44:00 Front squats

46:00 Front squats and trap bar deadlifts vs back squats during rehabilitation

47:25 When can an athlete start cycling

48:00 Disadvantages of using cycling as the main part of a rehabilitation program

48:30 Hamstring rehabilitation after semitendinosis/gracilis graft

49:45 Strength and power development

51:00 Strength testing - mid thigh pull, leg press

53:15 Should we use open chain strength tests

54:20 When to perform strength tests

55:00 Strength vs power and rate of force development

55:50 Running - incorporating into the program. When can your patient start running?

57:30 Preparation for running

58:35 Running drills

1:00:30 Ideal movement patterns in running

Links:

Enda King

Enda on Twitter @enda_king

Sports Surgery Clinic, Dublin

SSC Research Foundation

David Pope on Twitter

Clinical Edge Webinar program - register your interest

Clinical Edge

Review the podcast in iTunes

 

Tags: ACL, knee, injury, anterior cruciate ligament, surgery, rehabilitation, soccer, football, strengthening, movement, non-contact, physiotherapy, physio edge, podcast, enda king, SSC, sports surgery clinic, david pope, clinical edge, webinar

CrossFit is a very popular form of improving strength and fitness, and CrossFit athletes have a variety of common injuries. Training errors and the athlete’s biomechanics often contribute to these injuries, and identifying incorrect biomechanics and other contributing elements in their training is often the key to helping your patients recover from injury, train pain free and importantly for your patients, ultimately get stronger and fitter.

In episode 30 of the Physio Edge podcast, David Pope discusses CrossFit injuries, training, biomechanics and injury recovery with Antony Lo. Antony is a Musculoskeletal Physiotherapist with a number of clinics within CrossFit gyms across Sydney, and a large proportion of his patient population are CrossFit athletes.

In this podcast Antony and David explore:

• The most common injuries in CrossFit
• Factors that contribute to injuries in the Shoulders, Neck, Back, Knees, and lower limb
• Specific exercises performed in CrossFit
• Squats
• Pullups/Chinups
• Pushups
• Overhead exercises
• Double unders
• Overhead squats
• Snatch
• Running
• Ideal biomechanics for each of these movement
• Common movement errors and ways to assess each movement
• Rest from training vs continue training
• Manual therapy on cross fit athletes
• Modifying training loads
• Rhabdomyolisis
• Urinary continence while training
• Advice for Physios treating CrossFit athletes

Links of Interest

Subscribe to the podcast in iTunes

Review the podcast in iTunes

Listen to the podcast on Soundcloud

Antony Lo

Antony’s Website - physiodetective.com

Antony on Twitter

 

CrossFit

 

Shoulder pain patients often have poor scapula control. Is their shoulder pain caused by poor scapula control, or is their scapula dysfunction caused by shoulder pain? When your patients present with shoulder pain, should your focus be on scapula control, glenohumeral control, or treatment of the neck and thorax? 

In this podcast, David Pope talks to Ann Cools, a Physiotherapist and Head of Education for Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium, and is also the founding member and president (2010–2012) of EUSSER - European Society of Shoulder and Elbow Rehabilitation. We discuss in detail assessment of the scapula, the role of the scapula in shoulder pain and how to retrain unruly scapulae.

Other topics covered in this podcast include:

• Research by Ann Cools

• What we currently know from the research about the role, movement and control of 

• the scapula

• Scapula dyskinesis - what is it

• Static vs dynamic assessment of the scapula

• Altering muscle balance and timing with specific exercises

• How altering scapula mechanics effects muscle balance around the shoulder

• Important parts of the subjective history

• Scapula vs glenohumeral joint

• How subjective will guide your objective assessment and treatment

• Red flags around the shoulder, nerve pathology and frozen shoulder

• Frozen shoulder imaging

• Nerve injuries - symptoms, objective examination and treatment

• Assessment of the scapula, Type 1 scapula dyskinesis

• Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula)

• Testing GHJ IR

• Clinical Edge and online education on the shoulder

• Stretching and shoulder joint mobilisation

• Palpation, stretching and manual therapy for pec minor

• Type 2 scapula dysfunction

• Handheld dynamometry - serratus

• Handheld dynamometry - middle and lower traps

• Pain when strength testing

• Type 3 scapula dysfunction

• Dynamic assessment of the scapula

• To retract and depress the scapula or not?

• Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis

• Special tests around the shoulder

• Laxity tests for the GH joint

• Posterior GHJ laxity

• Anterior GHJ laxity

• Explanations of scapula dysfunction to your patients

• Information on Ann Cools 

• EUSSER

Timeline:

0:30 Research by Ann Cools

4:20 What we currently know from the research about the scapula

6:30 Scapula dyskinesis - what is it

8:30 Static vs dynamic assessment of the scapula

11:45 Altering muscle balance and timing with specific exercises

13:15 How altering scapula mechanics effects muscle balance around the shoulder

14:10 Important parts of the subjective history

16:20 Scapula vs glenohumeral joint

18:20 How subjective will guide your objective assessment and treatment

18:55 Red flags around the shoulder, nerve pathology and frozen shoulder

21:15 Frozen shoulder imaging

21:45 Nerve injuries - symptoms, objective examination and treatment

30:30 Assessment of the scapula, Type 1 scapula dyskinesis

35:00 Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula)

36:10 Testing GHJ IR

42:00 Clinical Edge

44:00 Stretching and shoulder joint mobilisation

51:45 Palpation, stretching and manual therapy for pec minor

55:40 Type 2 scapula dysfunction

59:20 Handheld dynamometry - serratus

1:00:51 Handheld dynamometry - middle and lower traps

1:03:54 Pain when strength testing

1:04:50 Type 3 scapula dysfunction

1:10:03 Dynamic assessment of the scapula

1:15:00 To retract and depress the scapula or not?

1:16:23 Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis

1:17:50 Special tests around the shoulder

1:20:35 Laxity tests for the GH joint

1:23:00 Posterior GHJ laxity

1:24:30 Anterior GHJ laxity

1:26:20 Explanations of scapula dysfunction to your patients

1:31:00 Information on Ann Cools 

1:32:20 EUSSER

1:33:00 Wrap up

Links of Interest

Anne Cools on Linked In

Ann Cools’ Research

Ann Cools at Ghent University

Ann on Twitter

Clinical Edge

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Tags: shoulder, scapula, Ann Cools, physio, physioedge, podcast, shoulder pain, scapula dysfunction, EUSSER, glenohumeral joint, dynamic assessment, static assessment, nerve, red flags, subjective, diagnosis, strength testing, objective examination

Acute Knee Injuries with Kurt Lisle

Topics - Acute Ligament injury, ACL injuries, Postero-lateral corner (PLC) Injuries, Knee Surgery and return to sport. On Episode 29 of the Physio Edge podcast, David Pope is joined by the Australian Socceroos Physio Kurt Lisle, a Specialist Sports Physiotherapist to discuss assessment and management of Acute knee injuries. On this podcast, David and Kurt discuss:

• Acute Ligament Injuries - Initial management

• When to refer for Orthopaedic consult

• Bracing/not bracing

• Adolescent knee injuries - when to refer for XR to check for an avulsion injury

• Swelling during and after treatment

• ACL injury - when to trial conservative management and when to refer for surgery

• Timeframes for surgery following ACL injury

• Different types of ACL grafts - pros and cons

• LARS

• Hamstring vs ITB tendon vs Patella tendon

• Open chain X’s eg leg extensions to restore quads and patellar tendon load capacity?

• Important aspects of post op rehab

• Return to training/change of direction criteria

• RTP criteria

• PLC

• Details of PLC injuries

• Mechanism

• Structures normally injured

• Symptoms

• Testing for PLC injuries

• Conservative vs surgical

• Rehab guidelines

• RTP timeframes

Links of Interest

Kurt Lisle

The Knee Joint Physiotherapy, Bokarina, QLD

Socceroos

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Tags: knee, knee injuries, socceroos, ACL, MCL, knee joint, posterolateral corner, PLC, surgery, rehabilitation, return to play, graft, tendon, conservative, football, soccer, physio edge, physiotherapist, physio, edge, clinical edge, podcast, online education

PE028 Groin Screening, Injury and Rehabilitation with Dr Kristian Thorborg

David Pope and Dr Kristian Thorborg (Physiotherapist, PhD) discuss screening and rehabilitation of groin injuries. Find out in this podcast:

• Which tests to use when screening for potential groin injuries
• Prevention tactics
• Acute groin injuries - initial management and exercise progressions
• Rehabilitation of adductor related groin pain
• Rehabilitation of hip flexor related groin pain
• Rehabilitation of long standing groin pain
• Conservative management of hip related groin pain and FAI
• Pubic symphysis
• Management of acute compared to long standing groin pain
• Role of manual therapy in the treatment of groin pain
• Stretching
• Adductor tendinopathy
• Load management for groin pain
• and much more!

This episode follows on from Episode 25 of the Physio Edge podcast on Groin Assessment with Dr Kristian Thororg. I hope you enjoy Kristian sharing his experience, research and knowledge of the evidence with us on the treatment of groin pain.

Links of Interest

Case Study of Adductor tear rehabilitation

Dr Kristian Thorborg

Dr Kristian Thorborg on Twitter

HAGOS

Studies that Dr Kristian Thorborg has completed or been involved in

PE #025 Groin Assessment with Dr Kristian Thorborg

PE #016 Preventing hamstring injuries with Dr Kristian Thorborg

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Kristian Thorborg’s editorial on BJSM

Kristian Thorborg’s PhD Thesis

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Tags: groin, groin pain, groin assessment, kristian thorborg, dr kristian thorborg, HAGOS, strength testing, adductors, inguinal, hip flexor, hip joint, acetabular labrum, hip strength, function assessment, pubic symphysis, sports hernias, physio edge, physiotherapist, physio, edge, clinical edge, podcast, online education

 

http://traffic.libsyn.com/physioedge/PE_025_Groin_Assessment_with_Dr_Kristian_Thorborg.mp3

 

PE#027 Managing Sports Injuries with Dr Nathan Gibbs

In one of the most controversial Physio Edge podcasts to date, Dr Nathan Gibbs and I discuss managing sports injuries in a team setting. Dr Nathan Gibbs has worked with many professional sports teams, including the Sydney Swans for 15 years, 10 years with South Sydney Rugby League Football club and is one of the owners of South Sydney Sports Medicine, and in episode 27 of the Physio Edge podcast, we discuss:

• Ideal working relationships between Physiotherapists and Sports Physicians
• The role of a Sports Physician
• Hamstring injury - common factors involved, imaging and return to play
• Injections - cortisone, PRP
• Use of PRP in ligament injury, with chondroplasty and OA

Links of Interest

Dr Nathan Gibbs

Sydney Swans

South Sydney Rugby League Football club

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Gymnastics places some fairly unique demands on fairly young bodies. In episode 26 of the Physio Edge podcast, I discuss these demands with Kingsley Gibson, a Sports Titled Physiotherapist that has worked with Australian Diving, Synchronised Swimming, Shooting and Hockey teams at a number of Commonwealth and Olympic games, and works with elite gymnasts on a daily basis. For his services to gymnastics, in 2000 the Commonwealth awarded Kingsley with a Sports Services Medal. So Kingsley has a lot of experience to draw on, and we got into detail on a number of topics.

In this podcast we discuss:

* Common injury patterns in the various gymnastic disciplines

* Important factors to consider when returning gymnasts to training and competition

* Factors that can influence your gymnasts treatment outcome

* Communication with parents and coaches

* How to best implement load management strategies

* Various motor control patterns in gymnasts that contribute to injuries

* Screening gymnasts

* Designing specific upper limb rehab programs

* Lower limb and lumbar spine rehab programs

* Management of acute vs chronic injuries

* Stress reactions in the Lumbar spine

* Apophyseal injuries - hip flexors, hamstrings, calcaneus (Sever’s) and Osgood-Schlatter’s

* Management of apophyseal injuries compared to tendinopathy

* Motor control/“stability” patterns in gymnasts

* When to order imaging

* Growth plate injury management - particularly in the wrist

* The effect of other factors such as training surfaces and equipment on injury

Links of Interest

 

Become incredibly flexible by subscribing to the Physio Edge podcast or giving it a review on iTunes

Kingsley Gibson Sydney Sports Medicine Centre at Homebush

Sydney Wests Sports Medicine at Rooty Hill

Clinical Edge

Available online education with Clinical Edge

 

PE025 Groin assessment with Dr Kristian Thorborg

How can you identify the reason your patient has groin pain and the structures that may be causing it? Groin pain is one of the most common issues in a lot of sports, particularly the football codes, and in episode 25 of the Physio Edge podcast, David Pope talks to Dr Kristian Thorborg about assessment of the groin.

Some of the topics we discuss on this podcast include:

Types of groin injuries Identifying and diagnosing groin pain and injury Groin vs hip pain Tests you can perform to identify the irritated or painful structures The relevance of diagnostic imaging, and when to refer for this Hip and Groin Outcome Score (HAGOS) Using the HAGOS in your clinic Adductor related groin pain Hip flexor related groin pain Abdominal related groin pain The hip joint Pubic symphysis Sports Hernias Testing hip strength Assessment of function And much more!

I had Kristian on the Physio Edge podcast for episode 21 discussing hamstring injury prevention, and wanted to get him back to discuss his other area of special interest - the groin. I am sure you will get as much out of this episode with Kristian as I did, and you will be all over diagnosis of groin pain by the end of the episode. Enjoy!

Links of interest

Dr Kristian Thorborg

Dr Kristian Thorborg on Twitter

HAGOS

Studies that Dr Kristian Thorborg has completed or been involved in

Review the Physio Edge podcast in iTunes

Download the Physio Edge podcast from iTunes

Clinical Edge

20% off your first month’s membership to Clinical Edge with the code PHYSIOEDGE

Kristian Thorborg’s editorial on BJSM

Kristian Thorborg’s PhD Thesis

PE 024 Thoracic Ring Approach with Dr Linda-Joy (LJ) Lee

The thorax is often considered stiff and stable by Physiotherapists and manual therapists, and precious little of our undergrad or postgrad training incorporating or seeing the need for motor control of this area.

In episode 24 of the Physio Edge podcast, LJ Lee and David Pope explore the function of the thorax, the impact the thorax can have, not only on thoracic pain, but also on other parts of the body. We discuss the Thoracic Ring Approach (TRA) created by LJ, which incorporates manual techniques to assess and treat the thoracic rings, and integrates motor control training for this area. In this podcast you will learn:

What bones and joints make up a “Thoracic ring”

Is the thorax inherently stiff?

What is ideal motor control of the thorax?

How can listeners identify non-optimal control of the thorax in their patients

How can motor control of the thorax be trained?

Identifying articular/joint restriction vs neuromuscular factors interfering with normal thorax movement

How can the thorax impact on other areas of the body eg the hip

When is manipulation of the thorax ideal?

What are some guidelines for manipulation of the thorax?

and much more. Download this podcast free from iTunes, or listen on the link below

Links of Interest

Have an awesome holiday, and review the Physio Edge podcast on iTunes

LJ Lee

The Sports Thorax course with LJ Lee

The Sports Pelvis course with LJ Lee

Videos on the Thoracic Ring Approach with LJ Lee via Clinical Edge

Physio Edge podcast episode 2 - “Analysing movement, and clinical expertise or research” with LJ

Physio Edge Podcast episode 6 - TA, “Core Stability”, Drivers and going beyond the pain experience" with LJ Lee

Tags: Thorax, Thoracic ring, Thoracic Ring Approach, ribs, thoracic spine, Integrated Systems Model, stiffness, motor control, mobilisation, manipulation, driver, articular, joint, neuromuscular, stability, bones, joint, hip, vertebrae, LJ, Linda-Joy Lee, ISM, Integrated Systems Model, Physio Edge, podcast, physiotherapy, physiotherapist, clinical practice

Lower limb tendinopathies with Dr Peter Malliaras

Tendinopathies are a hot topic, and there are lots of new developments in research and treatment. Dr Peter Malliaras, a Physiotherapist with a PhD studying tendinopathy, has a special interest in the treatment of tendinopathy, and treats elite basketball and volleyball, EPL football, rugby, and cricket players, the Royal Ballet and track and field athletes. Peter has also published numerous studies on tendinopathy.

In this episode of the Physio Edge podcast, Peter and David Pope discuss

• The latest research on tendinopathy
• Different types of loading programs for tendinopathy
• Outcomes for various types of loading
• Tendinopathy on Doppler Ultrasound or other imaging, and what changes with a loading program
• The tendon pathology continuum by Dr Jill Cook and Craig Purdham
• Mid portion Achilles tendinopathy
• Insertional Achilles treatment
• Patellar tendinopathy treatment, and a loading program for this that may challenge your preconceptions!
• Tenosynovitis
• Biomechanics contributing to tendinopathy
• Return to sport following tendinopathy
• Injury reduction/prevention
• Injections

Peter shared so much great info on tendinopathy, check it out now on episode 23 of the Physio Edge podcast

Show your love for the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

Links of Interest

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Dr Peter Malliaras

Studies with Dr Peter Malliaras as one of the authors

Physio Edge podcast episode 5 with Dr Jill Cook

Clinical Edge

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Tags: tendinopathy, tendinitis, tendinosis, malliaras, dr peter malliaras, tendon pathology, continuum, dr jill cook, craig purdham, physiotherapy, movement, research, podcast, injuries, rehabilitation, physio edge, clinical edge

Dr Kieran O’Sullivan is back on the Physio Edge podcast after talking about hamstring injuries, this time discussing his other big area of interest and expertise - chronic low back pain (CLBP). In this episode, Kieran and David Pope discuss

• Recent research on CLBP
• Central vs peripheral contributions to CLBP
• Sitting postures and behaviours, and the relationship of this to pain
• Is there an ideal sitting posture, and does changing sitting behaviour change CLBP?
• Manual therapy in CLBP
• Lumbar kyhposis/lordosis
• Physical and psychological interventions for CLBP
• The effect of exercise on CLBP
• Movement patterns and retraining in chronic pain states
• The challenges of talking to patients about chronic pain states

 

Enjoy this episode, brought to you by the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

 

Links of Interest

Show your love of feeling great, and also the podcast by writing a review on iTunes

Kieran O’Sullivan

Pain Education website with Peter O’Sullivan, Kieran O’Sullivan, Wim Dankaerts, Kjartan Vibe Fersum

University of Limerick

The role of muscle strength in hamstring injury. Kieran O Sullivan and Cian McGinley. 2010. Nova Publications

Clinical Edge

 

Tags: physiotherapy, low back pain, chronic, chronic low back pain, sitting, posture, movement, research, podcast, injuries, rehabilitation, physio edge, Kieran O’Sullivan, clinical edge

Shoulder pain - what are the causes, and how can you treat it? Are your special tests around the shoulder really isolating and identifying pathology? How can the rotator cuff still function with small and large tears?

In Episode 22 of the Physio Edge podcast, Jeremy Lewis and David Pope discuss these questions and more including:

What is the value of special tests around the shoulder? What diagnosis can you provide your patients for their shoulder pain How can you identify if you need to focus your treatment on the scapula, glenohumeral joint, cervical spine or thorax? How can you identify a rotator cuff tendinopathy? What is the Rotator Cable, and how is it important in rotator cuff tears? Is the acromion really the cause of “impingement” or subacromial pain? If a patient has a biceps tendinopathy and a rotator cuff tendinopathy, which should be treated first? What contributes to biceps tendinopathy? Theraband - valuable? When imaging of the shoulder is valuable, and when it is a waste of time Frozen shoulder - what treatments work well

And much more.

Podcast links

Dr Jeremy Lewis

London Shoulder Clinic

Courses with Jeremy Lewis

Clinical Edge

Become a Clinical Edge member

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Tags: Dr Jeremy Lewis, Shoulder, shoulder pain, subacromial pain syndrome, acromion, impingement, rotator cuff, tendinopathy, theraband, SSMP, pathology, frozen shoulder, muscle tear, rotator cable, physio, physio edge, podcast

What are the best ways to avoid hamstring injuries? What are the main factors to consider in hamstring rehabilitation? How does muscle strength relate to hamstring injury? How can we screen for or predict hamstring injuries?

In episode 19 of the Physio Edge podcast, Kieran O’Sullivan, PhD of the University of Limerick, Physiotherapist and co-author of the book “The role of muscle strength in hamstring injury.” Kieran O Sullivan and Cian McGinley. 2010. Nova Publications and David Pope get stuck into hamstrings and the many facets of this important muscle group, including:

• Injury reduction
• Rehabilitation - early stages, and return to sport
• Return to Sport
• Flexibility
• Eccentric training
• Predicting hamstring injury
• Assessing readiness of return to sport
• Stretching - Static vs Dynamic vs PNF etc, and the clinical implications

Enjoy this episode, brought to you by the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

Links of Interest

Love the podcast by writing a review on iTunes

Kieran O’Sullivan

Pain Education website with Peter O’Sullivan, Kieran O’Sullivan, Wim Dankaerts, Kjartan Vibe Fersum

University of Limerick

The role of muscle strength in hamstring injury. Kieran O Sullivan and Cian McGinley. 2010. Nova Publications

Clinical Edge

Tags: Physio, Hamstrings, Podcast, Flexibility, Strength, Injuries, Hamstring Injury, Rehabilitation, Physio Edge, Eccentric training, Return to sport, Clinical Edge 

How can the pelvis contribute to pain and dysfunction? Is the SIJ the main pain producer around the pelvis, or what is? What is the state of current research around the pelvis? Is it possible to feel “unlocking” of the SIJ? Do Pelvic Upslips exist?

In episode 18 of the Physio Edge podcast Diane Lee of Discover Physio and David Pope discuss the pelvis and SIJ in detail, including:

• palpation around the pelvis
• how can you palpate for unlocking of the SIJ
• what role the pelvis has in low back pain
• how the pelvis can be affected by other areas of the body
• does the current research support unlocking of the pelvis
• how can the thorax affect the pelvis
• when should you perform deep abdominal or multifidus training

And then we dive into Paediatric musculoskeletal development, including

• footwear for kids
• sporting activities for kids
• should kids sit in chairs or on the floor
• is a simple ankle sprain all that simple
• advice for parents
• children’s furniture
• and lots of other great info that will help you when treating or bringing up kids

Enjoy this episode, brought to you by the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

Links of Interest

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Diane Lee

Diane Lee on Twitter

The Pelvic Girdle, 4th Edition by Diane Lee

Discover Physio

Linda-Joy Lee

Discover the Sports Pelvis with LJ Lee

Clinical Edge

How can you reduce the chance of sporting injury? What are the most useful recovery aids from games and training? When are injections helpful in injury recovery?

In episode 17 of the Physio Edge podcast, Dr Peter Brukner, fresh from working with Liverpool Football Club in the EPL, co-author of Clinical Sports Medicine with Dr Karim Khan, and author of many other publications discusses with David Pope the management of sporting teams, injury reduction, prevention, recovery and a multitude of other topics, including:

• ACL Injury Prevention
• Hamstring Injury Prevention
• Strength training vs Specific strengthening
• Player load management
• Recovery from tendinopathy
• The role of injections, including PRP, Cortisone and Orthokine
• Player screening
• Player game recovery

and more. Enjoy this episode, brought to you by the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

Hamstrings are one of the most common acute muscular injuries in athletics and team sports. In this episode of the Physio Edge podcast I discuss recent research with promising results preventing hamstring injuries with Dr Kristian Thorborg, a Specialist Sports Physiotherapist in Copenhagen, Denmark.

Tags: hamstring injuries, hamstrings, acute, eccentric, strengthening, BJSM, british journal of sports medicine david pope, physioedge, podcast, assessment, treatment

Links of Interest

Get incredible legs by subscribing to the podcast in iTunes

Review the Physio Edge podcast in iTunes

Clinical Edge

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Kristian Thorborg’s editorial on BJSM

Kristian Thorborg’s PhD Thesis

Contact Kristian Thorborg

Carl Askling

H-test

Classification of hamstring injuries by Carl Askling on BJSM

Carl Askling on BJSM podcast

Acute Hamstring Injuries with Andrew Ryan, and Rehabilitation of Hamstring Injuries with Merryn Aldridge - Online education for Physiotherapists for Clinical Edge members

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Contact David

David on Twitter

How can you recognise when the cervical spine is involved in a patients headache? How can you treat headaches caused by cervical dysfunction? What role does manual therapy play in their treatment? When and how should you treat their cervical motor control?

In this podcast, Ken Niere and David Pope discuss cervicogenic headaches, effective physio treatment, and how to recognise the difference between cervicogenic headaches, tension type headaches and migraine.

Ken Niere is a Specialist Musculoskeletal Physiotherapist with over 25 years’ clinical experience in the assessment and treatment of spinal disorders. He is a senior lecturer in the School of Physiotherapy at La Trobe University, where he has taught spinal musculoskeletal physiotherapy at undergraduate and postgraduate levels since 1989.

Ken is an examiner for the Australian College of Physiotherapists and he recently contributed to and co-edited a book on headache, orofacial pain and bruxism. His special interests include the diagnosis and management of headaches and neck disorders, and he has lectured on these topics in Australia and overseas.

Tags: Cervicogenic headache, cervical spine, headache, tension type headaches, migraine, physiotherapy, ken niere, physio, differential diagnosis, la trobe university, australian college of physiotherapists, david pope, physioedge, podcast, assessment, treatment

Links of Interest

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Ken Niere

Ken Niere at La Trobe University

The essential role of the thorax in whole body function and the “Thoracic ring approach” with LJ Lee - Online education for Physiotherapists for Clinical Edge members

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David on Twitter

What is contributing to your patients low back pain? How do you know when to use manual therapy, education, exercise, motor control programs, CBT or any other approach for chronic LBP? In episode 14 of the Physio Edge podcast, Peter O’Sullivan and David Pope discuss chronic low back pain and Peter’s approach to getting past it. Some of the topics we dug into include:

• Causes, classification and treatment of chronic low back pain (CLBP)
• Common treatment errors
• Identifying mechanical contributors
• When manual therapy is helpful
• Myths around “core stability”
• What is the current evidence base for CLBP classification and treatment
• Tips for treatment of CLBP
• A lot of other great treatment advice for CLBP….

Listen to it now, and subscribe free to the podcast in iTunes

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Peter O’Sullivan

Peter O’Sullivan at Curtin University

The essential role of the thorax in whole body function and the “Thoracic ring approach” with LJ Lee - Online education for Physiotherapists for Clinical Edge members

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Contact David

David on Twitter

Tags: physio, physio edge, physiotherapist, podcast, courses, evidence based practice, online education, peter o’sullivan, curtin university, bodylogic physiotherapy, low back pain, chronic low back pain, treatment, assessment, classification, clinical edge

Treatment of the cervical spine often involves some degree of manual therapy or manipulation, and VBI testing is generally encouraged or required prior to this. In this episode of the Physio Edge podcast, Roger Kerry and David Pope discuss Cervical Arterial Dysfunction (CAD), the accuracy and limitations of VBI testing, and a lot of other good stuff, including:

• Cervical Arterial Dysfunction (CAD), and VBI
• Why is it important for clinicians to know about CAD
• The limitations of VBI testing
• Clues within the history to alert you to the possibility of CAD
• Symptoms of CAD
• 2 types/causes of dizziness and differentiation
• The 5 Ds and 3 N’s - what are the limitations of this approach
• Signs & Symptoms of Cerebral and retinal ischaemia
• Aetiology
• Upper cervical instability
• As clinicians, where should CAD and VBI testing lead our assessment, treatment and investigations?
• When can we conservatively treat someone with these symptoms
• Monitoring - during and post rx
• Contraindications to Rx

Listen to it now, and subscribe to the podcast in iTunes

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Roger Kerry on Twitter @rogerkerry1

Roger Kerry’s profile at Nottingham University - Physiotherapy

Roger Kerry’s profile at Nottingham University - Philosophy

Courses with Roger Kerry

IFOMPT Conference 2012

Hamstring Rehab for Elite Sprinters - Online education for Physiotherapists for Clinical Edge members

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David on Twitter

Tags: physio, physio edge, physiotherapist, podcast, courses, cervical spine, CAD, cervical arterial dysfunction, VBI, vertebrobasilar insufficiency, spine, artery, manipulation, IFOMPT, Nottingham University, evidence based practice, health education seminars, online education, verterbral artery, dizziness

PE #012 Plantar Fascia, Achilles and Nerve Entrapments with Russell Wright

David Pope and Russell Wright talk about everything to do with feet and ankles. Plantar Fascia and Achilles Tendinopathy are conditions that need good differential diagnosis and specific tailored treatment programs, especially in runners, and in this episode we chat about how you can get the best results with these patients. We cover:

• causes of plantar fasciosis
• strengthening of the plantar fascia
• what exercises work with plantar fasciosis, and which ones are a waste of time
• nerve entrapments that can be involved in plantar fasciosis, and how to identify * these
• the role of taping and orthotics
• achilles tendinopathy
• eccentric programs and progressions
• ankle sprain rehab - keeping it functional

Listen to it now, and subscribe to the podcast in iTunes

(Warning: this podcast has occasional explicit language)

Links of interest

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Russell Wright

Ocean View Physio

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Acute Hamstring Tears - Online education for Physiotherapists for Clinical Edge members

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David on Twitter

Tags: physio, physio edge, physiotherapist, podcast, courses, achilles, plantar fascia, nerve entrapments, russell wright, ocean view physio, tendinopathy, treatment, eccentric, strengthening, fasciopathy, feet, ankle, runners, running, barefoot running, ankle sprain, rehabilitation

PE #011 Lateral Hip Pain with Dr Alison Grimaldi

Hamstrings are one of the more frequently injured muscles in sportspeople, and in this episode, Alison and I discuss hamstring tendinopathy, symptoms, assessment and treatment of this common condition.

Some of the aspects we explore in this podcast are:

• Subjective clues that someone may have a Hamstring Tendinopathy
• Differentiating Hamstring Tendinopathy from pain of Lumbar origin
• Assessment of the hamstring
• Tests to confirm or rule out a Hamstring Tendinopathy
• Causes
• Advice for patients
• Rehabilitation
• Deep hip muscle activation
• Keys to a successful treatment program
• a whole lot more

There is currently limited research around the area of hamstring tendinopathy, and Alison’s tips and insights are based on this evidence base as well as her clinical experience.

I hope you enjoy it!

Links of interest

Get great legs by subscribing to the podcast in iTunes

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Clinical Edge

Dr Alison Grimaldi

Dr Alison Grimaldi’s Publications

PhysioTec

University of Queensland

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Tags: physiotherapist, Clinical Edge, physio edge, physio edge podcast, courses, physio courses, hamstring, posterior thigh pain, tendinopathy, runners, rugby, sprinters, lumbar spine, dr alison grimaldi, physiotec

Barefoot running has been sweeping the globe in the last few years, and as a Physio, which of your patients are best suited to this type of running technique. How does running technique relate to a runner’s pain and dysfunction, and really, what is the ideal running technique?

In this podcast with Blaise Dubois - a Physiotherapist with a clinic, website and courses devoted to helping runners and Physiotherapists that treat runners, we chat about these topics, as well as:

• Running assessment
• Biomechanics of running
• Improving running technique and performance
• Which patients should change their running technique
• Barefoot running
• Heelstrike and landing
• Current evidence on running technique
• Injury prevention in runners
• Downhill running technique
• Footwear for running
• Improving running in patients with pathology eg Achilles Tendinopathy

Blaise has also been kind enough to provide a PDF handout to go along with this podcast, which is available for free download -

Download the PDF handout

Links of interest

Get more (or less) hair on your chest by subscribing to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Clinical Edge

Blaise Dubois

PDF Handout to go with the podcast

The Running Clinic

Blaise Footwear Reviews

Big bulky shoes to avoid

Blaise’ course - New Trends in the Prevention of Running Injuries - Newcastle, March 2012

Blaise’ course - New Trends in the Prevention of Running Injuries - Melbourne, March 2012

Have you subscribed to the Podcast in iTunes yet?

Online education for Physiotherapists for Clinical Edge members

MBT Footwear

Vibram 5 Fingers

Become a Clinical Edge member

Next time on the Physio Edge Podcast: The Thorax and Biomechanics of the Thoracic Rings with LJ Lee

Contact David

Tags: physiotherapist, Clinical Edge, physio edge, physio edge podcast, courses, physio courses, running, biomechanics, achilles, tendinopathy, blaise dubois, the running clinic, assessment, barefoot running, injuries, injury prevention, downhill, Vibram 5 fingers, MBT, big bulky shoes, footwear, evidence, heelstrike

PE #009 Lateral Hip Pain with Dr Alison Grimaldi

Lateral hip pain is a condition patients present with regularly to Physiotherapists, with pain walking or standing, sleeping on their side, stretching of the posterior hip, and sitting, amongst other symptoms, and can often mimic lumbar spine pathology. In this episode, Alison and I discuss symptoms, assessment and treatment of an extremely common cause of lateral hip pain - Glute Med Tendinopathy (GMT), that is often incorrectly diagnosed as “trochanteric bursitis”.

Some of the aspects we explore in this podcast are:

• Subjective clues that someone may have a Glute Med Tendinopathy
• “Trochanteric Bursitis”
• Differentiating Glute Med Tendinopathy from pain of Lumbar origin
• Assessment of the hip
• Tests to confirm or rule out a Glute Med Tendinopathy
• Causes of a Glute Med Tendinopathy
• Advice for patients
• Treatment of Glute Med Tendinopathy
• Deep hip muscle activation
• How to design a treatment program to make the difference between it working and failing
• much more

I also want to take this moment to wish you and your family a very Happy New Year.

Links of interest

Become incredibly sexy by subscribing to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Clinical Edge

Dr Alison Grimaldi

Dr Alison Grimaldi’s Publications

PhysioTec

University of Queensland

Have you subscribed to the Podcast in iTunes yet?

Online education for Physiotherapists for Clinical Edge members

Become a Clinical Edge member

Next time on the Physio Edge Podcast: The Biomechanics of Running

Contact David

Tags: physiotherapist, Clinical Edge, physio edge, physio edge podcast, courses, physio courses, hip, lateral hip pain, tendinopathy, glute med tendinopathy, lumbar spine, dr alison grimaldi, physiotec,

All golfers want to hit as far as Tiger Woods, but without the injuries. How can you treat the injuries in your golfing patients, prevent further injury and improve their “coachability” and performance?

Golfers regularly need Physio treatment for injuries like tendinopathy around the elbow, low back and neck pain, and plenty of other injuries. In episode 8 of the Physio Edge podcast, I chat with Matt Green of High Performance Golf about

• Common golf injuries
• How to assess and treat golfers
• Technique errors that contribute to injury
• Tendinopathy around the elbow
• Assessing the golf swing
• Strengthening and motor control
• Advice to give your golfers and
• plenty more.

If you treat golfers, or would like to treat more golfers, get stuck into this episode free on iTunes, and brought to you by the podcast sponsor Clinical Edge.

Links of interest

Become incredibly sexy by subscribing to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Clinical Edge

High Performance Golf

Ramsay McMaster

Have you subscribed to the Podcast in iTunes yet?

Online education for Physiotherapists for Clinical Edge members

Become a Clinical Edge member

Next time on the Physio Edge Podcast: Glute Med Tendinopathy

Contact David

Tags: physiotherapist, Clinical Edge, physio edge, physio edge podcast, courses, physio courses, golf, golf injuries, golf performance, high performance golf, matt green, ramsay mcmaster,

PE007 Dry Needling with Andrew Hutton

Dry Needling has become incredibly popular in Physiotherapy recently. Is dry needling really the way forward for Physios?

In this podcast I chat with Andrew Hutton of Dry Needling Plus, presenter of the Dry Needling Plus courses for Clinical Edge, and we discuss dry needling and whether it complements regular Physio treatment. Some of the topics we cover include

• What are the different styles of dry needling?
• How can dry needling be used in sporting populations?
• How to know immediately if your needling has been effective
• What is the evidence for dry needling
• Studies show decreased ROM with needling, is it possible to improve ROM with dry needling
• How does changing ROM actually relate to a patient’s pain?
• Some clinical scenarios where dry needling could be incorporated

Links of interest

Become better looking by subscribing to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Dry Needling Plus"

Dry Needling Plus courses with Clinical Edge

Clinical Edge

IMS

Have you subscribed to the Podcast in iTunes yet?

“Treatment of Acute Lateral Ankle Sprains” with Russell Wright for Clinical Edge members

Become a Clinical Edge member

Next time on the Physio Edge Podcast: Golf Injuries and Performance

Contact David

Podcast 6 - LJ Lee - TA, “Core Stability”, Drivers and going beyond the pain experience

When should Transversus (TA) be included in your patient rehab? When is TA retraining a waste of time? Is planking good for anything other than entertaining your mates? How can we go beyond just treating the pain experience to connect with your patient and improve their performance.

In Episode 6 of the Physio Edge podcast, I chat again with LJ Lee, this time covering TA, “Core Stability”, and more including:

• Retraining TA in your treatment
• Planks
• Running like a block of wood with legs
• McGill’s Big 3 exercises
• Body “flow” and agility Vs stiffness and rigidity
• Specificity of exercise
• How can the Cervical Spine affect knee pain in a squat?
• The Discover Physio Series
• “Salsa in your ribcage” and breathing
• The impact of intra-thoracic pressure on the pelvic floor

Links of interest

Subscribe to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Linda-Joy Lee

Clinical Edge

Discover the Sports Thorax

Discover the Sports Pelvis

Discover Physio Series

Canadian Academy of Manual and Manipulative Therapy

Diane Lee

Discover Physio

University of Queensland

Prof Paul Hodges

Sackett

Stuart McGill

“See What I’m Saying” by Rosenblum

“Mindsight” by Dan Siegel

Subscribe to the Podcast in iTunes

“Assessment of the Pelvis” online education for Clinical Edge members

Become a Clinical Edge member

Contact David

PE #005: Tendons and tendinopathy with Jill Cook

What causes tendon breakdown? What are the stages of tendinopathy, and how do they effect your treatment? Is it just about eccentric training for tendinopathy? When should NSAID’s be used?

This is part of the great discussion I had with Jill Cook about tendons and tendinopathy. We also chatted about some other aspects of tendinopathy, including

• Factors that contribute to tendinopathy beyond biomechanics
• Eccentrics - what is the future of training to rebuild tendons
• Return to sport or running after tendinopathy
• Avoiding tendinopathy
• Treatment at each stage of tendinopathy
• Rehabing achilles tendinopathy
• Rehab for hamstring tendinopathy

plus we related all of these to clinical scenarios. Enjoy!

Links of interest

Subscribe to the podcast in iTunes

Give the Physio Edge podcast a review in iTunes

Jill Cook

Craig Purdam

Monash University

“Achilles Tendinosis in Runners” online education for Clinical Edge members

Become a Clinical Edge member

BJSM Podcast

Contact David

PE004 Hip Injuries and Labral tears. An interview with Nichole Hamilton

Acetabular Labral tears in the hip are becoming more commonly diagnosed and operated on. In this episode, I chat to Nichole Hamilton, a Physio with a lot of experience treating hips, designing post-op arthroscopic hip protocols and lecturing about the hip. Some nice insights into hip injuries and diagnosing and treating labral tears.

This week we talk about all sorts of issues around the hip, including:

Diagnosing labral tears Labral tear symptoms What causes a labral tear? Activities that contribute to labral tears When is surgery required for labral tears When is conservative treatment a good option Kicking sports - what muscle control is required What is the role of psoas Dancers - what activities and positions load the labrum How can maximum hip range of movement be attained safely Posterior pelvic tilt or tuck - how does this relate to the hip Progressing exercises to incorporate functional positions

Links of interest

Subscribe to the Podcast in iTunes

Nichole Hamilton

Synergy Physio

Clinical Edge

Free videos with Nichole Hamilton

Thoracic Outlet Syndrome video for Clinical Edge members

Standing Posture Assessment video for Clinical Edge members

The Irritable Hip course with Nichole Hamilton

Shirley Sahrmann

APA Dance Course

Andrew Ryan is a Sports Physio with the Australian Qantas Wallabies, and in this weeks episode Andrew and I chat about acute injury management, player screening, on-season treatment, corks, and adductors. Some great insights into elite sports management.

Links of interest

Subscribe to the Podcast in iTunes

Andrew Ryan

Clinical Edge

Australian Qantas Wallabies

Adductors (I would provide a link, but if you don’t know what these are you should probably be reading a textbook about now)

Impact Injuries to the Shoulder video for Clinical Edge members

Discover Physio Series with LJ Lee

Linda-Joy Lee

James Sutherland

James Sutherland’s interview on The Sports Physiotherapist podcast

PE 002: LJ Lee - “Analysing movement, and clinical expertise research”

Analyse movement using your manual skills and palpation, plus insights into what clinical expertise and “Evidence Based Practice” really means - an interview with LJ Lee.

This podcast is brought to you by Physio Edge, your host David Pope, and the podcast sponsor, Clinical Edge.

Links of Interest

Linda-Joy Lee

Clinical Edge

Discover the Sports Thorax

Discover the Sports Pelvis

Discover Physio Series

Florence Kendall

IFOMPT

Canadian Academy of Manual and Manipulative Therapy

Diane Lee

Discover Physio

University of Queensland

Prof Paul Hodges

Physio First

Sackett

David Sackett on YouTube

“See What I’m Saying” by Rosenblum

“Mindsight” by Dan Siegel

PE#1 - An interview with David Butler. Fascinating insights into pain, painful experiences, and neurodynamics from one of the world's leading neuroscience and pain experts. Learn why we (and out patients) experience pain, the latest research in pain and pain management. Learn how to talk to your patients to reduce their pain experience, when pain is more from joints or the periphery, and how to use neural glides.

Brought to you by Physio Edge - www.physioedge.com.au and your host, David Pope