Physio Edge podcast (general)

Jo Gibson (Upper Limb Rehabilitation Specialist Physio) discusses the keys to successfully treat persistent anterior shoulder pain in two tennis players who had not recovered despite previous extensive rehab. In this podcast Jo explores what to include in your rehab of sportspeople who place large demands on their shoulders, elements commonly overlooked in shoulder rehab and how to address patients’ psychosocial factors, fears and beliefs to successfully treat persistent shoulder pain.

Click here for the free webinar with Jo Gibson “Rotator cuff revealed! Rehab & reasoning”. 

The handout for this podcast consists of a transcript and research articles referenced in this podcast.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Links associated with this episode:

Articles associated with this episode:

 

 

Podcast chapters:

 

  • 02:30 - Case studies: 2 tennis players
  • 03:14 - Kinetic chain definition 
  • 04:18 - When to consider the kinetic chain 
  • 07:07 - Screening tests 
  • 10:17 - Objective measures
Direct download: 161.mp3
Category:general -- posted at: 7:38am AEDT

Join David Pope (APA Titled Musculoskeletal and Sports & Exercise Physio) and Zoe Russell (Specialist Sports Physiotherapist, FACP; APA Titled Musculoskeletal Physio) in the Physio Edge podcast as they explore how to assess, treat, and manage patients suffering from ACL injuries or suspected ACL injuries.

You'll discover how to assess a patient with a suspected ACL injury, and criteria you can use to identify whether a patient may be suited to non-surgical management or is likely to require surgery. You'll also understand when immediate or delayed surgery is the best option, and how to guide patients through the decision-making process and different phases of rehab. Listen in to provide your ACL injury patients with the best treatment options. 

Free Achilles tendinopathy video series with Tom Goom available now

Links

Direct download: 160.mp3
Category:general -- posted at: 8:36am AEDT

Rotator cuff tear arthropathy (RCTA) is a pattern of glenohumeral joint degenerative changes following rotator cuff tears, causing shoulder pain and stiffness. Subscapularis tears can also be involved in RCTA, or a significant cause of shoulder pain and disability.

How can you identify RCTA and subscap tears in your shoulder pain patients? How can they be treated, and do these patients respond well to non-surgical management?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio).

Click here for the free webinar with Jo Gibson “Rotator cuff revealed! Rehab & reasoning”.

The handout for this podcast consists of a transcript and research articles referenced in this podcast.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Links associated with this episode:

Articles associated with this episode:

 

Chapters:

  • 03:25 - What is cuff arthropathy?
  • 05:35 - Contributing factors
  • 07:33 - Patient history
  • 08:37 - Subscapularis tendon tears
  • 12:29 - Common mechanisms of injury
  • 13:46 - Assessment tests
  • 16:51 - Rotator cuff related shoulder pain

 

Direct download: 159.mp3
Category:general -- posted at: 2:06pm AEDT

How can you successfully treat hip pain and instability associated with your patients’ hip dysplasia? Find out the eight critical steps to excellent results with hip dysplasia in this podcast, which is part 3 in this three-part podcast series with Tom Goom (Running Physio).

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Free video series: Achilles Tendinopathy from start to finish line! with Tom Goom

In this free Masterclass "Achilles tendinopathy: Assessment & rehab from start to finish line" presented by Tom Goom and hosted by Clinical Edge, you’ll discover:

  • 3 common conditions that cause Achilles pain.
  • How to assess patients with Achilles pain to get a clear diagnosis, and know where to start treatment.
  • Rehab exercises that will help your patients overcome their Achilles pain.
  • How to successfully return your patients to running or sport, and achieve their goals, without stirring up their pain.

CLICK HERE to register for your free access to this three-part video series with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Links associated with this episode:

Articles associated with this episode:

Chapters: 

  • 05:36 - Step 1: Assessment
  • 07:10 - Step 2: Investigations
  • 08:35 - Step 3: Patient education
  • 10:07 - Step 4: Settling symptoms
  • 16:25 - Step 5: Strength
  • 18:15 - Step 6: Control and proprioception
  • 20:08 - Step 7: Co-existing pathology
  • 21:09 - Step 8: General health
  • 22:32 - Key points

 

Direct download: 158.mp3
Category:general -- posted at: 2:58pm AEDT

When a patient presents with a potential frozen shoulder, what other differential diagnoses must be considered? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio), exploring the case study of a patient diagnosed with “frozen shoulder” with symptoms that don’t quite match a typical frozen shoulder. What’s the diagnosis of this patient’s stiff shoulder? You’ll also discover whether an X-ray or imaging is required when a patient presents with a stiff or frozen shoulder.

Click here for the free webinar with Jo Gibson “Rotator cuff revealed! Rehab & reasoning”.

The handout for this podcast is the transcript associated with this podcast.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Links associated with this episode:

Chapters: 

  • 04:03 - Case study
  • 07:23 - Frozen shoulder or misdiagnosis?
  • 10:21 - Screening tests
  • 10:58 - Risk factors
  • 17:14 - Key points
Direct download: 157.mp3
Category:general -- posted at: 4:17pm AEDT

Hip dysplasia is a commonly missed cause of hip and groin pain. In this podcast, which is part 2 in the 3 part series with Tom Goom (Running Physio), you’ll discover three types of hip dysplasia that will cause different symptoms and need different treatment (based on Wilkins et al. 2017), how to identify each type, and common exercises and a treatment approach that may be stirring up your patients hip and groin pain.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

Links associated with this episode:

Articles associated with this episode:

Chapters:

  • 03:12 - Signs & symptoms
  • 06:05 - Assessment
  • 08:05 - 3 types of hip dysplasia
  • 08:28 - Anterior instability
  • 09:58 - Posterior instability
  • 11:42 - Lateral/global instability
  • 13:29 - Key takeaways

 

Direct download: 156.mp3
Category:general -- posted at: 11:14am AEDT

Stingers or burners are a burning or stinging pain, often with some paraesthesia and occasionally weakness, often occurring in impact sports such as rugby or American football.

When your patients present with neck and arm symptoms, how can you differentiate a stinger or burner from a C/sp fracture, discogenic symptoms or nerve root compression, which all require very different treatment?

How should you manage patients with one-off or repeated stingers or burners?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio).

The handout for this podcast consists of a transcript and articles referenced in the podcast.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Links associated with this episode:

Articles associated with this episode:

 

Chapters:

  • 03:56 - What are stingers or burners?
  • 08:13 - 3 key mechanisms 
  • 14:36 - Signs & symptoms
  • 15:36 - Management guidelines
  • 18:46 - Shoulder instability treatment

 

Direct download: 155.mp3
Category:general -- posted at: 11:53am AEDT

Hip dysplasia is a commonly missed cause of hip and groin pain, catching, clicking, locking or popping, resulting from lack of coverage of the femoral head by the acetabulum.

How can you identify hip dysplasia in your hip or groin pain patients, and avoid misdiagnosing it as iliopsoas or adductor related groin pain? What signs and symptoms will your patients reveal in their subjective history that’ll help you identify this condition?

Find out the key signs and symptoms of hip dysplasia in this podcast with Tom Goom (Running Physio).

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

Articles associated with this episode:

 

Chapters:

  • 03:43 - Who develops hip dysplasia?
  • 06:35 - Objective tests
  • 09:11 - Hip dysplasia vs gluteal tendinopathy
  • 10:45 - Hip dysplasia vs femoral neck stress structure 
  • 14:13 - Key takeaways

 

Direct download: 154.mp3
Category:general -- posted at: 11:51am AEDT

Posterior shoulder instability can occur after a fall onto an outstretched arm, or diving and hitting the ground with your arm (like diving to score a try in rugby), injuring the posterior labrum and/or the glenohumeral joint. Unlike anterior shoulder instability, patients with posterior shoulder instability may not have have a feeling of instability, but may just experience pain, fatigue and weakness.

How can you identify posterior shoulder instability in your shoulder pain patients? What does your rehab for posterior shoulder instability need to include?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio).

The handout for this podcast consists of a transcript and articles referenced in the podcast.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:

 

Chapters:

  • 03:17 - Case study
  • 06:57 - Assessment tests
  • 13:17 - Rehab
  • 15:32 - Other treatment options
  • 16:10 - Recovery
  • 17:43 - Scapular dyskinesis
  • 21:59 - Barriers to recovery
Direct download: 153.mp3
Category:general -- posted at: 9:18am AEDT

After injury or surgery, a lot of runners are told to stop running for different reasons. How can you answer patients that ask if they need to give up running for good? When should patients consider permanently stopping running? Find out in this podcast with Tom Goom (Running Physio).

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

 

Chapters: 

03:25 - Stop running permanently

8:15 - Safe to continue running?

10:05 - Post ACL surgery

11:22 - Knee OA

13:27 - Running rehab plan 

16:44 - Key takeaways

Direct download: 152.mp3
Category:general -- posted at: 7:04pm AEDT

Will strength training help your patients reduce their risk of running injury and improve their running performance? Find out what the latest research reveals in this Physio Edge Track record: Running repairs podcast with Tom Goom (Running Physio), as you discover:

  • The latest research on whether strength training reduces running injury risk.
  • Which runners are more likely to develop a running injury, and which runners more successfully avoid running injury.
  • How to get runners to “buy in” and perform a strength program, when they’re short on time and motivation.
  • 3 key exercises your runners can do to improve their performance and reduce their running injury risk.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

Article associated with this episode:

Chapters:

02:22 - Research study

04:39 - Results

07:47 - Training program

Direct download: 151.mp3
Category:general -- posted at: 3:55pm AEDT

Marathon runners often come to us with pain, but also they need to build up their mileage in preparation for one of the most challenging events in endurance sport. They're trying to do more when their body may be telling them they need to be doing less.

How do we manage their symptoms, and guide them up to the marathon itself?

Find out in this podcast with Tom Goom (Running Physio).

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

 

 

Chapters:

00:02:40 - Marathon training phases

00:09:08 - Training priority

00:11:41 - Manageable goals

00:12:27 - Discussing risks

00:13:59 - Short and simple rehab

00:15:23 - Hands-on treatment

00:17:17 - Case study

Direct download: 150._Top_tips_for_treating_marathon_runners_with_Tom_Goom.mp3
Category:general -- posted at: 12:29pm AEDT

How can you settle symptoms and make progress with patients, when pain is a significant barrier to performing the rehab that will help them get back to the things they want to do?

Discover the five step process in this podcast with Tom Goom (Running Physio) to settle patients symptoms, overcome this barrier of pain, and help patients make progress with their rehab.

 

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

 
 
Chapters
  • 03:05 -  Screen for serious pathology
  • 04:13 - Analgesic review 
  • 05:13 - Discuss the pain
  • 06:09 - Identify and modify aggravating factors
  • 07:58 - Reduce irritation
  • 15:48 - Key takeaways
 

Zoe Russell discusses ankle sprain assessment and treatment, and how to return your patients to sport. You’ll discover how to help your ankle sprain patients fully recover as quickly as possible, and avoid long term issues, such as chronic ankle instability, osteoarthritis or other lower limb injuries. 

Zoe is a Specialist Sports Physiotherapist (FACP), APA Titled Musculoskeletal and Sports Physio, as well as a Clinical Edge Senior Educator and Presenter, and in this Physio Edge podcast hosted by David Pope, we discuss the latest evidence and practical strategies for ankle sprains, including: 

 

Assessment 

  • Common issues therapists face when rehabilitating ankle sprain patients. 
  • Questions you need to ask your ankle sprain patients. 
  • How a previous history of ankle sprains impacts your assessment & treatment.
  • Why patients with inversion injuries may have medial ankle pain.
  • How to avoid stirring up patients pain during your assessment.

 

Diagnosis

  • Common mechanisms of injury, and how this guides your diagnosis. 
  • Structures that are likely to be injured with different ankle injuries.

 

Treatment 

  • 10 key elements to include in your assessment & treatment.
  • How to help reduce swelling quickly after an ankle sprain, and why this is important.
  • Immediate sideline management for ankle sprains at sporting events.
  • Whether manual therapy has a role in acute ankle injuries or persistent ankle pain and swelling. 
  • How to explain ankle sprains, recovery & rehab to your patient.
  • What you’re looking to achieve with your early rehab. 
  • How to set rehab targets or goals with your patients.
  • The role of taping in ankle rehab.
  • Taping compared to bracing.
  • Whether long term taping or bracing is a useful long term injury prevention strategy. 
  • The latest surgical procedures for patients with chronic ankle instability (CAI).

 

References

 
 

Chapters:

  • 03:47 - Untreated ankle sprains
  • 05:27 - Latest evidence
  • 07:04 - Subjective questions
  • 09:45 - Common mechanisms of injury
  • 11:47 - Plantarflexion/inversion injury with medial ankle pain
  • 15:22 - Dorsiflexion eversion injuries
  • 15:54 - Swelling
  • 21:11 - Objective tests
  • 26:32 - Irritability
  • 26:47 - Figure of 8 taping technique
  • 28:56 - Inferior and superior tib-fib joint assessment
  • 32:14 - Treatment
  • 42:41 - Change of direction
  • 43:17 - Tape or brace?
  • 50:06 - Mobilise or immobilise?



Direct download: 148.mp3
Category:general -- posted at: 12:02pm AEDT

Patients with knee osteoarthritis (OA) often have a sensitive and painful knee, and are reluctant to use or exercise it, feeling that it’ll just further “wear out” the joint.

In this podcast with Dr JP Caneiro (Specialist Sports Physiotherapist, PhD) you’ll discover how to assess and rehabilitate knee OA patients, including:

  • Subjective questions you need to ask knee OA patients.
  • How to use your subjective assessment to identify tests to perform in your objective assessment.
  • How to identify patient fears and negative beliefs that will interfere with rehab and limit progress.
  • Objective assessment tests you need to perform.
  • How to differentially diagnose knee OA from other causes of knee pain.
  • How to assess patients’ functional ability.
  • How to use palpation in your assessment of knee OA.
  • Where to start your treatment.
  • What to do if your patient is performing knee exercises and their pain is not improving, or getting worse.
  • How to break through negative patient beliefs so you can get your patient on the road to better knee health, movement and pain.

Enjoy this podcast with Dr JP Caneiro, hosted by David Pope and Clinical Edge now to improve your treatment of knee OA.

 

Chapters:

  • 09:04 - Knee OA myths & misconceptions
  • 14:07 - Subjective questions
  • 15:33 - Patient fears & beliefs
  • 24:07 - Subjective follow up questions
  • 30:44 - Objective assessment
  • 41:40 - Functional assessment
  • 42:09 - Palpation
  • 50:45 - Where to start treatment
Direct download: 147_with_Dr_JP_Caneiro.mp3
Category:general -- posted at: 5:10pm AEDT

Patients with knee osteoarthritis (OA) often believe their knee is “bone on bone”, exercises will wear out their knee more and they just need a knee replacement. This narrative can make it difficult to motivate your patients to perform knee rehab exercises that have the potential to improve their pain, function and quality of life.

How can you shift the narrative, educate your patients with knee OA so they “buy in” and perform an effective knee rehab program, and get better results with your treatment?

In this podcast with Dr JP Caneiro you’ll discover:

  • How to start your patient on a rehab program when they have fear avoidance, and don’t want to exercise.
  • How to help patients have a positive response to your treatment, experiencing better movement, function or pain with exercise and movement.
  • How to encourage your patient to share their narrative and perspective, so you can start addressing this with your treatment.
  • How to accurately describe OA to your patients and provide a positive narrative.
  • How to help patients recognise load and lifestyle factors that are influencing their pain and movement.
  • How to modify patients’ unhelpful behaviours and integrate new movement strategies into daily activities.
  • How to manage flareups and provide patients with self-management strategies.

Enjoy this podcast with Dr JP Caneiro and hosted by David Pope and Clinical Edge now to improve your treatment of knee OA.

Direct download: 146.mp3
Category:general -- posted at: 12:27pm AEDT

Exercise is a vital component in our rehabilitation of patients with musculoskeletal pain and injuries.

How can you, as a Physiotherapist, Physical therapist or health professional, choose exercises for your patients that improve their pain, strength, control, confidence and the ability to reach their goals, without stirring up their pain?

Find out in this podcast with David Pope (APA Titled Sports & Musculoskeletal Physio) and David Toomey (NZ Titled Musculoskeletal Physio & PhD Candidate) from the Clinical Edge education & presentation team.

Direct download: 145_How_to_choose_exercises_that_improve_patients_pain_with_David_Toomey.mp3
Category:general -- posted at: 10:21am AEDT

Do we need to target “proprioception” in shoulder rehab with flexible or vibratory, blade-like rehab tools or water-filled pipes? Does the evidence support the use of these proprioceptive tools to improve patients shoulder pain, or are there different exercises that provide better results?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio) and discover whether to include proprioceptive treatment tools in your patients shoulder rehabilitation programs.

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:

Direct download: 144_Proprioceptive_rehab_tools_for_shoulder_pain_with_Jo_Gibson.mp3
Category:general -- posted at: 10:52am AEDT

What strategies can you recommend to your patients that are recovering from injury or increasing their training to help improve physical recovery? Athletes often use various recovery strategies such as ice baths, compression stockings, massage and more to improve their recovery, but are they actually effective? What key strategies are evidence-based and useful?

Patients experiencing pain or a flareup may feel distressed or anxious. What mental recovery strategies can your patients use to help with these feelings of distress or anxiety?

Find out in this podcast with Tom Goom (Running Physio), as you discover the key recovery strategies for physical and mental health.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

Direct download: 143_Key_recovery_strategies_for_physical_and_mental_health_with_Tom_Goom.mp3
Category:general -- posted at: 10:46am AEDT

Traumatic superior labrum anterior to posterior (SLAP) tears can occur in contact athletes and other patients that land on their arm or shoulder, and in throwers and other athletes. Initial assessment and even MRI often miss or misdiagnose these injuries, leading to ongoing shoulder, long head of biceps tendon (LHBT) or ACJ pain.

In this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio) you’ll discover how to identify patients with SLAP tears. You’ll explore which assessment tests can be used to diagnose and differentiate SLAP tears from other causes of shoulder pain, and which imaging modalities will actually identify SLAP tears.

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Article associated with this episode:


Patients with anterior knee pain may have pain with activities that load the patellofemoral joint (PFJ), such as squatting, going up or down stairs, and running. When is it important to offload patients PFJ during your rehab, to help settle their symptoms? How can you design a rehab program to improve your patients' knee pain?

Find out in this podcast with Tom Goom (Running Physio) as you discover how to effectively offload and treat patellofemoral joint pain, exercises to include in rehab, and activities and exercises to reduce during your initial phases of treatment.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

Article associated with this episode:

Direct download: 141_How_to_reduce_patellofemoral_pain_and_load_with_Tom_Goom.mp3
Category:general -- posted at: 2:39pm AEDT

When things don’t go well in a treatment session, what will help you identify the potential reasons and clues?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio), and discover how to use non-verbal communication to improve the success of your treatment sessions.

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:


Can shockwave improve pain and function in Achilles tendinopathy patients that fail to improve with rehab?

Find out in this podcast as Tom Goom (Running Physio) reveals whether the latest research supports the use of shockwave in Achilles tendinopathy patients, and how to successfully return patients to running and rehab.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom.

Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge.

Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain.

Get your free access to this video series now.

CLICK HERE for your access to three free videos with Tom Goom

CLICK HERE for your access to three free videos with Tom Goom

Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Article associated with this episode:

Direct download: 139_Shockwave_for_Achilles_tendinopathy_with_Tom_Goom.mp3
Category:general -- posted at: 12:39pm AEDT

How can you treat patients with an achilles or patellar tendinopathy while they’re in the middle of a season or training for an event? Successful treatment often includes loading and strengthening the tendon, but how can you quickly identify the best exercises and load for each patient?

Find out in this Physio Edge podcast as David Pope and Daniel Silvan (Head Physiotherapist at Aspire Academy, Aspetar) discuss how to choose the most effective exercises for your patients to successfully treat lower limb tendinopathy.

Direct download: 138._How_to_treat_patellar__Achilles_tendinopathy_with_Daniel_Silvan.mp3
Category:general -- posted at: 12:15pm AEDT

Do your acute ACJ injury patients require surgery, or can they be managed conservatively with a rehab program? Find out in this podcast as Jo Gibson (Upper Limb Rehabilitation Specialist Physio) reveals how to grade patients’ acute ACJ injuries, help patients decide on surgery or conservative management, and rehab your patients effectively.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Direct download: 137._Acute_AC_joint_injury_imaging_rehab__recovery_with_Jo_Gibson.mp3
Category:general -- posted at: 12:18pm AEDT

Shoulder pain & frozen shoulder can be extremely debilitating for patients, impacting their ability to sleep, fulfill their normal work and family role or have fun. How can you as a therapist understand your patients pain experience, help them feel supported and meet your patients needs throughout their journey to recovery from shoulder pain or frozen shoulder?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio), hosted by Clinical Edge, as you explore how the latest research can help improve your shoulder pain treatment.

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:


Calf strains are common in runners, footballers, dancers and other athletes. Discover how to assess, differentially diagnose and tailor your treatment of calf strains using the latest evidence in this podcast with Tom Goom (Running Physio).

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Article associated with this episode:


When you’re treating patients that feel like their scapulae are asymmetrical, a rib is “out of place”, or they feel neck or thoracic stiffness without any restriction in movement, they may expect you to perform treatment that is unlikely to help, like joint mobilisation, manipulation or massage.

How can you use the latest pain science in your treatment to help patients overcome the experience of asymmetry, stiffness or something being out of place?

Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio).

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:


Calcaneal bony stress injuries or fractures are often misdiagnosed and incorrectly treated as insertional Achilles tendinopathy or plantar heel pain, leading to worsening pain and poor recovery.

In this podcast with Tom Goom (Running Physio), hosted by Clinical Edge, discover how to accurately assess and effectively treat patients with calcaneal bony stress injuries or fractures.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Article associated with this episode:


Why do some rotator cuff (RC) repair patients progress really slowly post-operatively and experience high levels of pain and sleep disturbance for long periods?

Find out in this case study and exploration of the latest evidence in this podcast with Jo Gibson (Shoulder Rehabilitation Specialist) as she reveals:

Quick or slow recovery?

  • Which patients are likely to improve quickly, and which patients are likely to take longer to improve.
  • How soon after arthroscopic RC repair your patients will experience significant improvements in pain.
  • When patients sleep is likely to improve.

Objective assessment tests

  • How to identify post-op nerve injury, red flags and infection.
  • Objective tests you can safely perform without overstressing the rotator cuff.
  • How to identify patients developing post-op frozen shoulder.

Expectations, education & reassurance

  • How to help set patient expectations for recovery before and after surgery.
  • Questions to ask patients after surgery that will help guide your treatment.
  • How to reassure patients that are experiencing pain.
  • How to explain post-op recovery to patients that are unhappy with their progress, even when their recovery is on track.

Treatment & resources

  • Activities your patients may be performing that slow their post-op recovery.
  • Positions and postures you can show patients to improve their pain in the day, and sleep at night.
  • Resources to give your post-op patients.

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

 

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Improve your frozen shoulder assessment and treatment now with Jo Gibson’s free video series at clinicaledge.co/shoulder 

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Articles associated with this episode:


We’re heading into the holiday season, when your patients will either keep progressing with their rehab program, or give their exercises a miss for a while and risk an increase in symptoms, skip appointments in the new year, and disappear off your list.

How can you prepare & motivate your patients for the holiday period, or effectively hand over care of your patients to another therapist, so their pain and strength keep improving?

In this live mentoring session, the Clinical Edge presentation team of Specialist and Titled Physiotherapists will reveal to you:

  1. How to keep your patients engaged and progressing over the holiday period.
  2. If you’re going away, how to effectively keep in contact with patients or hand patients over to other therapists, and avoid losing them over the Christmas period.
  3. How to help kids and young athletes stay active and manage load over the holidays, to stay strong and healthy and avoid overuse injuries early next year.

Prepare your patients now, and set yourself up for a successful holiday season and new year with this free mentoring session.

 


How can you thoroughly assess your neck pain patients, and use the information from your assessment to guide your treatment? What treatments are effective in helping patients overcome their neck pain?

In the first podcast with Specialist Musculoskeletal Physiotherapist, researcher and Emeritus Prof. Gwen Jull 121. Neck pain assessment, clinical reasoning & rehab. Physio Edge podcast with Prof Gwendolen Jull, we discussed questions to ask during your subjective history that help guide your neck pain assessment and clinical reasoning.

In this followup podcast, discover how to accurately assess and effectively treat neck pain with Emeritus Prof. Gwen Jull, including:

Objective examination (OE)

  • How to perform a thorough OE.
  • What information a skilled manual assessment provides.
  • What we can actually identify & diagnose.
  • How to use your OE to guide your Rx.
  • Whether posture is relevant to neck pain.
  • When and how to assess posture.
  • How to assess physical impairments, and identify if they’re relevant to a patients neck pain.
  • Common impairments that exist in neck pain patients
  • Which tests are valuable for:
    • ROM
    • Strength
    • Endurance

Treatment

  • How to decide where to start with your treatment.
  • Whether manual therapy (MT) is useful in the treatment of neck pain.
  • How to decide whether to use
    • MT.
    • Postural changes.
    • Strength exercises.
    • Control exercises.
    • Neurodynamic treatment.
    • General strength and endurance training.
    • Exercises for flexibility and range of motion.
    • Graded activity.
    • Motor control.
    • Aerobic exercise for general fitness.
  • How to use symptom modification to help decide on your treatment.
  • How to target our treatment to what your patient needs and will get the most benefit from.
  • Neck exercises and treatment progressions.
  • How do you decide on the treatment progression to use.
  • Whether there is evidence to include shoulder strength in neck pain patients.
  • Craniocervical flexion test - when do you use this?
  • Whether the biofeedback cuff is essential to use with neck pain patients.
  • How craniocervical flexion exercises compare to cervical spine physiological flexion.
  • When to have a strength focus in your treatment.
  • How to incorporate strength training in treatment.
  • How to improve the likelihood of successful neck pain treatment.

CLICK HERE to get access to Cervical spine assessment & treatment for neck pain & upper limb symptoms

CLICK HERE to get access to Cervical radiculopathy assessment & treatment case study


When patients have a running injury, such as knee pain or Achilles tendinopathy, do we need to include strength training in their rehab? Discover when strength training is an important part of comprehensive running injury rehab in this podcast with Tom Goom (Running Physio), and explore:

  • Whether strength is important in runners.
  • Whether patients that are stronger are less likely to develop running injuries.
  • Why recent research found higher levels of strength in recently injured runners compared to uninjured runners.
  • When we need to improve patients' strength in running injury rehab.
  • Can strength training reduce the risk of running injuries?
  • How strength training fits into a comprehensive rehab program.
  • When strength is relevant to pain and pathology.
  • When rehab does NOT need to include strength training.
  • How to know what to focus on during rehab.
  • Which patients don’t require exercises or strength training.
  • How to identify when strength goals are a barrier to recovery and return to running.
  • Additional benefits of strength training, beyond improved strength.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs


Patients may develop stiffness following rotator cuff repair or other shoulder surgery, particularly with longer periods of immobilisation. On the other hand, some patients may fail rehab without sufficient immobilisation. How can you identify which patients are likely to develop stiffness and will benefit from early mobilisation? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

  • Which patients are likely to benefit from rotator cuff or other surgical repair.
  • How to plan post-op surgical rehab.
  • Whether patients should have a period of immobilisation or not.
  • How to predict patients that are likely to develop post-op shoulder stiffness.
  • Metabolic, genetic, age-related and psychosocial factors that influence development of stiffness.
  • Pre-operative and surgical factors that influence development of stiffness.
  • How to reduce the likelihood of stiffness developing.
  • Comparison between early post-op shoulder mobilisation and six weeks in a sling.
  • Patients more likely to fail a RC repair, who may need more of a conservative approach to early mobilisation.
  • How to explain mobilisation vs immobilisation to patients.
  • Short and long term outcomes when patients develop stiffness.
  • Frozen shoulder
    • If and when corticosteroid injections are helpful.
    • The role of P. acnes in development of frozen shoulder.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess


Can you solve this case of a badminton player with a five year history of posterior shoulder pain and shoulder fatigue with overhead movements? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist). Discover the diagnosis and why the patient hasn’t improved with rehabilitation, as Jo reveals the case study and:

  • Subjective clues to help diagnose this condition.
  • Questions to ask in the subjective history.
  • Differential diagnoses to keep in mind.
  • How to identify and rule out red flags.
  • Clinical tests to use to rule this condition in and out.
  • What medical tests and MRI reveal.
  • Common causes of this condition.
  • Conservative, medical and surgical management and results.
  • Ideal treatment pathways for this condition.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess


When your patient with Achilles tendon pain isn’t progressing as well as you hoped, could Plantaris be implicated in their pain? Find out in this latest Physio Edge Track record: Running repairs podcast with Tom Goom, where you’ll discover:

  • Plantaris anatomy and relationship to the Achilles tendon.
  • Common symptoms when Plantaris is causing Achilles tendon pain.
  • How to differentiate Achilles tendinopathy from Plantaris involvement.
  • Why patients with Plantaris involvement may not progress with a tendon loading program.
  • How to adjust treatment when you suspect Plantaris involvement.
  • When Plantaris patients can return to running and hill running.
  • Additional medical and surgical management when Plantaris conservative treatment doesn’t resolve symptoms.

Enjoy this new podcast with Tom Goom now to improve your treatment of Achilles tendon pain.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs


Immobilisation following a humeral fracture or shoulder surgery quickly results in muscle atrophy and decreased shoulder strength and proprioception. How can you limit strength deficits that develop while patients are in a sling?

During this period of immobilisation, cross education (CE) can help retain shoulder strength. This improved shoulder strength and proprioception after the immobilisation period concludes may enable a faster return to work, high load activities or sport. What is CE, and how can you use it in your treatment? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

  • What is cross education (CE)?
  • What the latest research reveals about the effectiveness of CE?
  • Which patients benefit most from CE.
  • Common strength and proprioceptive deficits after shoulder stabilisation surgery.
  • How CE improves strength and proprioception.
  • Recommendations for CE exercise intensity and dosage.
  • Whether to use eccentric, concentric or isometric exercises.
  • How to amplify the strength and cortical effects of CE.
  • How to target the rotator cuff with CE.
  • How to incorporate proprioception into CE.
  • How to use CE in rehab for instability, movement apprehension & kinesiophobia.
  • When to include CE in MRCT post-op rehab.

Get free access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson at clinicaledge.co/shoulder

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess


What do foam rolling and stretching do to the ITB? Are they effective in the treatment of ITB syndrome? Find out in this podcast with Tom Goom (Running Physio).

 

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom


Is subscapularis the forgotten part of the rotator cuff? Do we ever need to target it individually? If we do what are the best options for exercises?

Find out which patients with torn or painful shoulders benefit from targeted subscapularis rehab in this episode of the Physio Edge Shoulder success podcast with Jo Gibson. You’ll discover:

Rotator cuff & subscapularis anatomy & function.

  • Role and function of subscapularis with shoulder movement.
  • How subscapularis works with the posterior cuff and larger shoulder muscles.

Subscapularis pain & injury

  • Subscapularis tears - mechanism of injury.
  • Whether subscapularis is implicated in swimmers’ shoulder pain.

Objective assessment

  • Objective tests to assess subscapularis strength.
  • The role of special tests to identify subscap tears.

Targeted subscapularis rehabilitation

  • Which shoulder pain patients require targeted subscapularis rehab.
  • When to target subscap in post-op rehab.
  • Why and how to start subscap rehab in patients with massive rotator cuff tears
  • Exercises to target subscap.
  • How incorporating the kinetic chain can help your subscap rehab.
  • How to improve subscap recruitment with altered speed of exercise.
  • Plyometrics for subscapularis.

Subscapularis rehab in other patients

  • Stiff shoulders - using eccentric subscap exercises to improve range of movement.
  • Whether subscap should be targeted post long head of biceps (LHB) rupture.

Improve your rehab of painful and torn shoulders now with this podcast.

Get free access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson at clinicaledge.co/frozenshoulder

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess


Are vaccinations associated with shoulder pain? Shoulder injury related to vaccine administration (SIRVA) has received a lot of attention on social media as vaccination levels have increased. If your patient has shoulder pain after a vaccine, what does this mean for treatment?

Also in this podcast, how can you identify non-musculoskeletal causes of shoulder pain related to NSAID use or viscera?

Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist).

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson at clinicaledge.co/frozenshoulder

Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson at clinicaledge.co/shoulder

Articles associated with this episode:


How can you accurately assess neck pain patients and choose the most effective treatment to help resolve their pain and prevent recurrence? Find out in part 1 of this two part podcast series with Emeritus Professor Gwendolen Jull, and explore:

  • How to accurately assess patients movements, muscular control, strength, posture, and palpate the cervical spine to identify the source of neck symptoms and contributing factors.
  • Which questions and assessment tests will help you choose treatment that resolves symptoms, fully rehabilitates patients and helps to prevents future episodes of neck pain?
  • How to use clinical reasoning to target your rehab, and decide if your treatment should include neck strengthening, manual therapy, sensory motor control, postural or work position changes?

Download this podcast now to improve your assessment and treatment of neck pain.

The next podcast with Prof Gwen Jull, available soon, will build on the knowledge you gain from part 1, and provide you with additional neck pain treatment strategies.

CLICK HERE to get access to Cervical spine assessment & treatment for neck pain & upper limb symptoms

CLICK HERE to get access to Cervical radiculopathy assessment & treatment case study


Pec minor cops the blame for shoulder pain, scapular dyskinesia and all sorts of upper limb pain and “dysfunction”. Is pec minor shortness or “tightness” really responsible for shoulder pain?

In this podcast with Jo Gibson (Clinical Physiotherapy Specialist), you’ll discover whether the latest evidence supports pec minor as a major cause of shoulder pain, or whether pec minor is an innocent victim. You’ll also explore:

  • Is pec minor responsible for shoulder pain?
  • Does pec minor truly become “shortened”?
  • Is there a link between a shortened pec minor, scapular dyskinesia and risk of developing shoulder pain?
  • Should the Pectoralis minor be stretched in patients with shoulder pain?
  • Review of pec minor attachments & anatomy
  • Measurement of pec minor length has been shown in the literature to be reliable, but do we need to measure it?
  • What is the most effective way of increasing length in pec minor? Stretching, self release, taping or strengthening the rotator cuff?
  • Does pec minor stretching help to improve shoulder function, mechanics or prevent injury in overhead athletes?
  • How long do ROM improvements following pec minor stretching last?
  • If patients have a clear history of trauma, is pec minor shortness relevant?
  • Is pec minor shortness relevant in thoracic outlet syndrome (TOS)?
  • Can weightlifters develop pec minor tendinopathy?
  • Is it worth assessing pec minor length in shoulder pain patients?
  • Does the evidence support treating PM shortness in shoulder pain patients?

The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available.

Article associated with this episode:


Stress fractures and bone stress injuries in running patients need to be identified early, to allow recovery before the injury worsens and requires extensive time away from running. When should you suspect a stress fracture or a bone stress injury (BSI) in your running patients? Find out in the podcast with Tom Goom (Running Physio), and explore:

  • How to identify stress fractures & BSI’s in your patients.
  • Which patients are at greater risk of developing BSI or stress fractures?
  • Features in your patient history, including past & medical history, onset & aggravating factors that increase your suspicion of a stress fracture.
  • Which BSI’s are “high risk”?
  • Common training errors that lead to a stress fracture.
  • What tests can be performed in your objective assessment to help diagnose stress fractures?
  • How to differentiate tendon pain from bone stress injuries
  • Will bruising or swelling appear with bone stress fractures?
  • How palpation can help your diagnosis
  • Why common assessment tests are often painfree in bone stress injuries.
  • When imaging is important.
  • Which imaging modalities to request when you suspect a stress fracture or BSI.

Improve your identification and assessment of stress fractures and bone stress injuries now with this podcast.

 

Your comprehensive guide to ITB assessment & treatment with Tom Goom

If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB).

What causes ITB syndrome? How can you assess, diagnose and successfully treat it?

CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering:

  • Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid.

  • Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now.

  • Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients.

CLICK HERE to get immediate access to this free ITB video series with Tom Goom.

 

Lateral hip pain assessment, diagnosis & treatment video series

To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom


Patients with atraumatic sternoclavicular joint (SCJ) instability may have pain during overhead activities, throwing or playing sport. How can you diagnose and successfully rehabilitate SCJ instability? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and explore:

Assessment & diagnosis

  • Which bony surfaces, ligaments and muscles provide stability at the SCJ.
  • Why do patients develop SCJ instability, and what are the risk factors?
  • What the research reveals about SCJ instability.
  • Common symptoms that help you identify SCJ instability.
  • Questions you need to ask that help with diagnosis.
  • Posterior instability - Common symptoms & anatomical structures that can be impacted.
  • How to identify clavicular epiphyseal plate injuries in young athletes.
  • When closing of the proximal clavicular epiphyseal plate occurs, and why this is important to know.

Rehab & recovery

  • Rehab exercises you can use to develop muscular support for the SCJ.
  • How and why you can add C/Sp exercises into SCJ rehab.
  • How long recovery will take your patients.
  • When patients are likely to start noticing improvements in symptoms.
  • Will SCJ instability patients continue to experience instability and pain after rehab?
  • Is this condition self-limiting?
  • How can involvement of the SCJ disc be identified?
  • What imaging can be helpful?
  • When should you request SCJ imaging?
  • When is SCJ surgery indicated?

Jo also answered these questions from FB Live listeners:

  • Does hypermobility change with age?
  • Can asymptomatic SCJ instability occur in weightlifters that do not have hypermobility, and do we need to treat it?
  • Which SCJ patients benefit from injections?
  • When should SCJ injections be avoided?
  • What autoimmune inflammatory conditions may result in SCJ swelling?

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Articles associated with this episode:


How can you rehab patients with an acromioclavicular joint (ACJ) injury, or end of range elevation shoulder pain, long term shoulder pain, clavicular osteolysis, or osteoarthritis? What exercises and manual therapy can you use in your rehab program? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

  • Common ACJ mechanisms of injury
  • A recap of ACJ injury classification and treatment pathways for different grades of injury.
  • How useful is X-ray in ACJ injuries, and what is the best imaging for this injury?
  • What imaging should ACJ injury patients have?
  • What are the long term risks for ACJ patients?
  • What factors correlate with worsening ACJ pain?
  • Can atraumatic instability occur at the ACJ?
  • What movements should be assessed in ACJ injury patients?
  • Why is symptom modification helpful in shoulder pain and ACJ patients?
  • What compensatory movement patterns do patients adapt that may contribute to ongoing pain?
  • How can we help to break the cycle of ACJ pain?
  • What tests can be performed to identify the best treatment for individual ACJ patients?
  • What muscles help to improve stability around the ACJ, and how can these be targeted in ACJ injury patients?
  • What exercises can be used in initial ACJ rehab?
  • How can ACJ rehab be progressed?
  • How can end range pain (ERP) be improved in ACJ patients?
  • How to identify when scapular mechanics affect the ACJ.
  • Exercises that improve scapular mechanics in ACJ patients?
  • When is manual therapy useful in ACJ patients?
  • What combination of manual therapy or mobilisation with movement and exercises can be used in ACJ patients?
  • What role can the ACJ play in shoulder pain?
  • Does the ACJ need to be symptomatic to cause shoulder pain?
  • What common symptoms make you suspect the ACJ is involved in shoulder pain?

Answers to live listener questions:
What humeral fractures or bone stress injuries occur in throwing athletes?
Who develops humeral spiral fractures or stress fractures?
Are recreational or high level athletes more likely to develop humeral fractures?
Are players more or less likely to have a fracture after having a 6 week break from training?
How can players prevent humeral stress fractures?

Direct download: 117._ACJ_rehab._Physio_Edge_Shoulder_success_podcast_with_Jo_Gibson.mp3
Category:general -- posted at: 12:00pm AEDT

How can you diagnose posterior shoulder, neck and supraclavicular pain in your weightlifting patients and throwing athletes? Could a bone stress injury be responsible for your patients pain?

Explore how to assess, diagnose and rehab shoulder pain from bone stress injuries in weightlifters or throwing athletes in this podcast with Jo Gibson (Clinical Physiotherapy Specialist). Discover:

  • Bone stress injuries in the upper limb and ribcage that cause shoulder pain.
  • What causes first rib stress fractures?
  • Which patients develop first rib bone stress injuries - common populations and activities.
  • Common areas of pain with first rib stress fractures.
  • How to assess & diagnose first rib bone stress injuries.
  • Common painful and restricted movements that help with diagnosis.
  • How to differentiate between a rotator cuff injury and first rib bone stress injuries.
  • Cervical spine & shoulder strength and control assessment tests that help identify where to target your rehab.
  • Do biomechanics in weightlifting matter?
  • How to assess and address weightlifting biomechanics to allow healing and return to sport.
  • Imaging
    • Why imaging is vital in patients with this injury.
    • Common imaging that misses 1st rib bone stress fracture, and what imaging to request that actually identifies it.
  • Why non-healing with the formation of pseudoarthrosis may lead to better outcomes than bony callous formation.
  • Whether patients can return to sport if rib stress fractures don’t heal.
  • How can you rehab patients with 1st rib stress fracture?
  • How to progress rehab exercises.
  • Treatment when 1st rib callus formation is causing thoracic outlet syndrome.

Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist) at clinicaledge.co/shoulder

Improve acute shoulder pain diagnosis with 3 free videos from Jo Gibson clinicaledge.co/shoulder

Improve clinical skills, confidence and reasoning for all other areas of the body with a free trial Clinical Edge membership clinicaledge.co/freetrial

The handout for this podcast consists of an article referenced in the podcast. There is no additional transcript or handout available.

Article associated with this episode:


Time for some detective work - can you diagnose the cause of this man’s shoulder pain? Listen out for the clues in this interesting case study.

When your shoulder pain patient has bilateral shoulder pain after starting a gym program, difficulty lifting their arms overhead due to weakness, significant bilateral scapular winging and muscle atrophy, what are your potential diagnoses?

Find out in this case study with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

  • When patients have uncommon shoulder pain presentations, what potential diagnoses can you keep in mind?
  • How does it impact your diagnosis if your patient has difficulty smiling, whistling and drinking through a straw?
  • What’s this patients’ diagnosis?
  • What tests can be performed to confirm the diagnosis?
  • Which muscles are commonly affected?
  • How much muscle weakness commonly occurs?
  • What is the long term prognosis for this condition?
  • What treatment is supported by the evidence?
  • Are braces helpful?
  • Which medical specialists are important to include in diagnosis & management?

Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist) at clinicaledge.co/shoulder

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Articles associated with this episode:


When paediatric or skeletally immature patients have shoulder pain, what diagnoses should be kept in mind? What are the potential diagnoses following trauma, in overuse injuries or “little leaguers shoulder”? What assessment and imaging is required in these patients?

Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and explore:

  • What growth plate injuries may occur in skeletally immature athletes?
  • The case study of a young athlete with misdiagnosed pain over the acromioclavicular joint (ACJ)
  • A recap of acromial apophylysis and distal clavicular osteolysis.
  • What are the common mechanisms of injury for ACJ?
  • How are ACJ injuries classified?
  • What are the limitations of ACJ injury classifications?
  • Why are there often differences in ACJ injury classification between X-ray and MRI?
  • How can ACJ imaging lead to incorrect return to play timeframes in mature athletes?
  • In paediatric patients, what differential diagnosis do you need to keep in mind with an apparent ACJ injury?
  • How does imaging help guide prognosis and treatment in younger athletes with ACJ injuries?
  • How can growth plate injuries be identified?
  • Can patients have a slipped humeral epiphysis?
  • What are the most common humeral fractures
  • What are humeral Salter-Harris fractures?
  • Which fractures may impact future growth in the humerus?
  • When is imaging absolutely required in paediatric shoulder injuries?
  • What is “little leaguers shoulder” and why is it important to identify this early?
  • When is glenohumeral internal rotation deficit (GIRD) relevant in lateral humeral pain?
  • What are the risk factors for shoulder pain in young athletes?
  • What causes GIRD in paediatric and skeletally mature athletes?
  • What tests help with diagnosis in stiff shoulders?
  • When is GIRD relevant?
  • Why should the term “shoulder impingement” be avoided?
  • How can you describe shoulder pain to patients?
  • Can osteolysis of the whole scapula occur?

Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist) at clinicaledge.co/shoulder

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Articles associated with this episode:


What are the best rehab options for patients with an irreparable rotator cuff tear? Can we predict which patients will do well and how long rehab will take?

Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), discussing rehab options, a patient case study and the latest evidence for massive rotator cuff tear (MRCT) rehab. Discover:

  • When patients are unable to have surgery, what rehab options are available to rehab MRCT?
  • What is classified as a MRCT?
  • What common issues do patients with MRCT face?
  • What proprioceptive deficits exist in MRCT patients functionally and on fMRI?
  • Is the “Anterior deltoid program” really the best rehab program for MRCT patients?
  • What MRCT rehab exercises & programs are supported by the latest research?
  • Which MRCT patients are likely to respond to rehab?
  • Is scapular dyskinesis important to target in MRCT rehab?
  • When patients are unable to lie supine, and are therefore unable to complete the anterior deltoid program, what options are available for rehab?
  • How do rotator cuff imaging results help guide treatment?
  • Which rotator cuff tendons need to be intact for successful rehab?
  • Specific exercise ideas and progressions that can be used in rehab.
  • How long is recovery likely to take?
  • What key messages are important to convey to patients?
  • What is the evidence for injections in MRCT, including prolotherapy, PRP?
  • How can rehab programs target subscapularis strength?
  • Is humeral head depression an important component in rehab?

Get free access to video series on assessment & diagnosis of acute shoulder pain and stiff shoulders at clinicaledge.co/shoulder

For improved clinical skills, knowledge and treatment results with all other areas of the body, get a free trial Clinical Edge membership at clinicaledge.co/freetrial

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Articles associated with this episode:


When swimmers and overhead athletes have superior & anterior shoulder pain, what are your likely diagnoses? How can you successfully treat shoulder pain that improves with rest from sport, then comes back each time they return to training or sport? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), where you’ll discover:

  • What are your likely diagnoses?
  • Distal clavicular osteolysis (DCO) - what is it?
  • How to differentially diagnose acromial apophysitis/apophylysis (AA) in young overhead athletes.
  • What are common areas of pain and aggravating movements in DCO patients?
  • Common training errors and weight training exercises that can cause or aggravate symptoms.
  • Which athletes are likely to develop DCO, and common mechanisms of injury.
  • Imaging you need to order.
  • What Xray and other imaging reveals in DCO.
  • What are potential long term issues following DCO, and how can this be avoided?
  • The MOST important treatment for patients with DCO and AA.
  • How can DCO be successfully managed?
  • How to modify work activities in DCO patients.
  • How long recovery takes.
  • Why asymptomatic stress tests and palpation doesn’t mean your patient is safe to return to sport.
  • How to work with coaches when your patients are experiencing DCO.
  • How to successfully return DCO patients to sport.

Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist) at clinicaledge.co/shoulder

 


When your female patient has shoulder pain, how can you identify if the cause is musculoskeletal, or related to women’s health issues? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist). You’ll explore two separate case studies of female shoulder pain patients with different diagnoses, that’ll help you discover:

  • Which female reproductive issues can cause shoulder pain?
  • How can you differentiate musculoskeletal and non-musculoskeletal causes of shoulder pain?
  • Is pain at different stages of the menstrual cycle really just “hormones”?
  • What questions can you ask your patients to help guide your diagnosis?
  • What is the typical history of patients with shoulder pain related to women’s health?
  • If patients wake with acute shoulder pain, what are the potential musculoskeletal and non-musculoskeletal diagnoses?

For free video series covering assessment & diagnosis of acute shoulder pain and stiff shoulders head over to clinicaledge.co/shoulder


Are eccentric exercises useful in subacromial shoulder pain rehab? When shoulder pain rehab has stalled, and patients aren’t improving, will eccentric exercises help? Are eccentric exercises the missing component in successful rehab programs for recalcitrant shoulder pain?

Find out in this discussion with Jo Gibson (Clinical Physiotherapy Specialist). Also discover:

  • Should eccentric exercises be included in shoulder rehab programs?
  • What does the research reveal about eccentric shoulder exercises?
  • How can the research be applied and adapted clinically with shoulder pain patients?
  • If eccentric exercises are helpful, which exercises should patients use?
  • When and how often should eccentric exercises be performed?
  • Are eccentric exercises helpful in acute shoulder pain?
  • How long does shoulder pain normally take to recover from?
  • How can gym programs be adapted to allow shoulder pain to recover while patients continue training or exercising?
  • How many exercises should be included in shoulder pain rehab programs?

Get free access to the stiff shoulder & acute shoulder pain assessment & diagnosis video series with Jo Gibson at clinicaledge.co/shoulder


An unusual cause of shoulder pain - what's the diagnosis? Solve this patient case study with Jo Gibson (Clinical Physiotherapy Specialist) and discover musculoskeletal and non-musculoskeletal causes of shoulder pain that are important to keep in mind when features don't fit.

Get free access to the free webinar series on how to assess & diagnose shoulder pain and stiff shoulders with Jo Gibson at clinicaledge.co/shoulder


When is shoulder pain from the C/sp? When a patient presents with shoulder pain and stiffness, how can C/Sp referral be identified? If a patient has full neck range of movement, and neck movements don’t reproduce shoulder pain, can their pain still be from the C/sp?

Recent research shows that including treatment of the C/sp can improve results in up to ⅓ of shoulder pain patients. In this video with Jo Gibson (Clinical Physiotherapy Specialist) discover how to identify, assess and treat patients with cervical referral, including:

  • What history and pain features will patients with cervical referred shoulder pain report?
  • What assessment tests can be performed to diagnose or rule out the C/Sp involvement in shoulder pain?
  • What information does palpation and repeated movements in the objective assessment provide?
  • What does the research reveal about cervical referred shoulder pain?
  • What biopsychosocial factors may be involved in cervical referred shoulder pain?
  • How can manual therapy to the C/Sp improve shoulder range of movement?
  • What education can be provided to patients with cervical spine referral?
  • What exercises and exercise variations may be used to improve cervical referred shoulder pain?
  • Are upper muscle fibres of trapezius “overactive” or are these muscles actually weak?
  • What exercises can be used for upper traps in C/sp referred shoulder pain?
  • What manual therapy can be used for C/sp referred shoulder pain?
  • Does the thorax get “stiff”, and what exercises help improve thoracic range of movement?

Get your access to free videos with Jo Gibson on acute shoulder pain & stiff shoulder assessment & diagnosis at clinicaledge.co/shoulder.

 

Articles associated with this episode:


When your patient has neck and arm pain, or low back and leg pain from neural tissue pain disorders (NTPD) such as peripheral nerve sensitisation (PNS), how will you treat them? Pain associated with PNS can occasionally be mild and non-irritable, but more often than not, it’s severe, highly irritable, and easy to stir up.

How can you provide treatment that settles their pain, without stirring them up? What advice, education, manual therapy and exercise will you provide to help improve symptoms and speed up recovery? What are the keys to success with PNS patients?

In Physio Edge podcast 104Dr Toby Hall and I discussed PNS, common symptoms, causes, questions to ask, and how to assess and diagnose PNS in your patients. In this followup podcast, the second in our two-part series, Dr Toby Hall and I take you through the next phase - how to treat PNS. You’ll discover:

  • The 7 keys to success with PNS
  • How to successfully treat PNS in the neck and upper limb, AND the low back and lower limb.
  • What education and advice should you provide to your patient about activities to avoid or reduce, and which activities should they increase?
  • What are the most effective exercises for patients with PNS?
  • Should exercise be painful or painless?
  • When is neural mobilisation an effective treatment?
  • When should you avoid using neural mobilisation as a treatment?
  • Is manual therapy effective in PNS?
  • Which manual therapy techniques can you use to improve symptoms and range of movement (ROM) immediately?
  • How to perform effective manual therapy techniques that reduce pain without stirring up your patients.
  • How can you combine neural mobilisation with manual therapy?
  • If you use manual therapy to improve symptoms, what home exercises should patients perform after each treatment session?
Direct download: 107._Treatment_of_peripheral_nerve_sensitisation_with_Dr_Toby_Hall.mp3
Category:general -- posted at: 2:05pm AEDT

Explore cervical radiculopathy, central sensitisation, achilles tendinopathy, hip & groin pain, & strength tests for athletes with Simon Olivotto, Dave Toomey, Paula Peralta & Nick Kendrick.
In this Clinical Edge member Q&A, the Clinical Edge Senior Physio Education & Presentation team discussed:


Cervical radiculopathy patients with an irritable presentation

  • Do imaging findings such as modic changes, alter our management
  • How can you approach treatment of cervical radiculopathy?
  • Are medications indicated?
  • Red flags you need to rule out
  • Are sliders and gliders a useful treatment?

 

Sensitivity to cold or ice

  • How can you use tests to identify sensitivity to cold or ice to guide your treatment?
  • Does ice sensitivity indicate central sensitisation?
  • How does this impact management?
  • If your whiplash patients have sensitivity to cold or ice, how does this impact treatment & prognosis?
  • Which research articles cover this topic?

 

Calf & achilles strengthening

  • When is it best to perform calf raises into dorsiflexion (DF)?
  • When should you avoid strengthening the calf into end of range (EOR) DF?
  • What ankle issues may lead you to avoid strengthening or stretching into EOR DF?

 

Hip joint pain and the acetabular labrum

  • Can we identify when the labrum is responsible for hip or groin pain?
  • What tests are important to perform in patients with hip or groin pain?
  • If deep structures such as the hip joint are painful or injured, does this mean more superficial structures such as the acetabular labrum are also pain generators?

 

Strength assessment & screening of athletes

  • What strength screening tests can you perform in athletes with large demands such as motorcross?
  • Which areas do you need to assess?
  • What are simple and more complex ways to assess strength in different regions of the body?
  • What are important considerations when designing a S&C program for a motocross athlete?
  • Making sense of pain

 

How can you make sense of pain? How can you describe pain to your patients in a way that makes sense, and doesn’t tell them “it’s all in your head”? Find out how to improve your confidence with acute and persistent pain in the upcoming “Making sense of pain” module.

Warning: Contains swearing

 

 

Articles associated with this episode:

 


When you assess your patients shoulder movements, and notice a winging scapula, altered resting position or timing of scapula movement, do you need to treat it? Can we diagnose “Scapular dyskinesis”, and does it matter? How can you simplify your scapular assessment?

In this podcast, Jo Gibson (Clinical Physiotherapy Specialist) explores common beliefs and myths around the scapula, including:

  1. Abnormal scapular kinematics cause pain
  2. We can predict patients that are going to get shoulder pain
  3. Upper traps should be retrained to decrease their activation
  4. Scapular-based interventions are superior to rotator cuff based treatment
  5. There are reliable and valid ways to assess scapular movement

Alongside this mythbusting, you’ll explore:

  • Is there any point assessing the scapula?
  • Is scapular asymmetry normal or abnormal?
  • Is scapular dyskinesis a normal response to exercise or loading?
  • How accurate are we at identifying scapular dyskinesis compared to findings in laboratory studies of scapula movement?
  • What scapular findings will you commonly observe in patients with massive rotator cuff tears, nerve injuries & stiffness?
  • How does rotator cuff fatigue impact scapular movement?
  • How does fear avoidance and worry about particular movements impact muscle activity and movement?
  • When is increased upper traps activity helpful and beneficial?
  • Should we try to decrease upper traps activity in patients with C/Sp driven shoulder pain?
  • Can we preferentially target the scapular or rotator cuff with our exercises?
  • Do improvements in shoulder pain correlate with changes or “improvements” in scapular movement?
  • How do scapular assessment test (SAT) results impact your treatment and exercise prescription?
  • If the SAT improves pain, does that mean we should perform scapular based exercises?
  • Can we use scapular dyskinesia classification to stratify patients or guide our treatment?
  • Is there any reliability in scapular assessment?
  • Does the SAT simply identify those that have a favourable natural history ie are going to get better on their own regardless?
  • Do scapular treatments increase the subacromial space, and does this matter?
  • Is winging post-surgery (posterior stabilisation + labral repair) a product of surgery or does this need to be addressed?
  • How does incorporating the kinetic chain into rehab impact patient movement strategies, scapular and rotator cuff recruitment?
  • Are scapulothoracic bursae relevant to shoulder pain?
  • How can you address patient beliefs and fear avoidance around their shoulder pain?

Articles associated with this episode:

Direct download: 105._Scapular_dyskinesis_-_Does_it_really_matter_with_Jo_Gibson.mp3
Category:general -- posted at: 4:25pm AEDT

When your patient has leg, shoulder or arm pain, how can you identify if their pain is due to neural tissue compression, sensitisation or irritation? How can you differentiate whether pain is from neural tissue or local structures like nearby joints, tendons or muscles? What questions and objective tests will help you diagnose a neural tissue pain disorder (NTPD)?

In this podcast with Dr Toby Hall (Specialist Musculoskeletal Physiotherapist, FACP, PhD), you’ll discover:

  • Three types of neural tissue pain disorders, and how to identify each one
  • What is Peripheral nerve sensitisation (PNS)?
  • What clues in your subjective examination will help you identify PNS?
  • Why do nerves become inflamed or irritated?
  • How to identify & differentiate radiculopathy and radicular pain in patients with radiating limb pain.
  • Do all patients with NTPD have obvious neuro symptoms such as pins and needles, numbness or weakness?
  • Quick screening tests you can use in your assessment to identify PNS.
  • How to identify if your patients shoulder and arm pain is from neural tissue or from local shoulder structures.
  • How to diagnose a NTPD in patients with hip or leg pain.
  • How to perform passive neurodynamic tests such as the straight leg raise (SLR), upper limb neurodynamic test (ULNT), slump test and femoral nerve slump test.
  • What information does a positive or negative neurodynamic test provide?
  • Can we identify the location of a nerve lesion or irritation with our passive neurodynamic tests or palpation?
  • Initial PNS treatment options
  • Is exercise helpful or harmful in patients with PNS?
  • How can you palpate over neural tissue, and what information does this provide?
  • Do opioids provide pain relief, or prolong recovery in patients with NTPD?

This podcast is the first part in a two part series on neural tissue pain disorders with Dr Toby Hall. Part 1 (this podcast) guides you through the types of NTPD, and how to assess and diagnose NTPD. Part 2 (available soon) will take you through how to treat PNS.

I highly recommend listening to this episode (part 1) prior to part 2, to have a thorough understanding of when and how to treat PNS.


A young male patient woke with an acute onset of constant, shooting shoulder pain, is painful into abduction, reluctant to lift his arm, and feels like he’s losing shoulder strength. He has no recent history of injury. 

Can you diagnose this unusual cause of shoulder pain, based on this patient's symptoms and physical tests? What are your differential diagnoses and red flags to keep in mind with this patient? 

In this podcast, Jo Gibson puts your knowledge of shoulder pain and diagnostic skills to the test, and explores how you can treat patients with this diagnosis.

Articles associated with this episode:

Get access to free videos with Jo Gibson on diagnosis of shoulder pain at clinicaledge.co/shoulder

Direct download: 103._An_unusual_cause_of_shoulder_pain_with_Jo_Gibson.mp3
Category:general -- posted at: 1:24pm AEDT

Do you include stretches in your treatment of shoulder pain? Have you ever identified a glenohumeral internal rotation deficit (GIRD) and used the "Sleeper stretch" to help improve internal rotation? Do stretches have any value for shoulder pain, or are there better treatment options?

In this podcast, Jo Gibson (Clinical Physiotherapy Specialist) discusses how to differentiate true capsular stiffness from muscle stiffness, what information GIRD provides, and whether sleeper stretches for shoulder pain are a useful treatment.

Jo explores the current research and clinical implications on your treatment, including:

  • What is the driver of decreased range of movement (ROM)?
  • If we get immediate changes in ROM with a sleeper stretch, does that mean we should use this as a treatment?
  • Is stretching an effective, efficient and evidence-based treatment?
  • Can we use strengthening movements to improve range and cuff recruitment?
  • What exercises can you use with patients with GIRD to improve ROM and cuff recruitment?
  • Humeral retroversion and how torsional load from throwing sports at a young age impact your ROM assessment.
  • If you have a patient with GIRD, what does this tell you?
  • In patients with true capsular stiffness, does stretching in combination with damp heat have a role?
  • Does eccentric strengthening have a role in improving GIRD in patients with true capsular stiffness or fibrosis?
  • How can you use GIRD to monitor your athletes fatigue and recovery?

Links associated with this episode:

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Shoulder surgery in athletes is common following dislocation. Accelerated post-op shoulder stabilisation rehab protocols include early mobilisation to reduce movement, proprioceptive and strength deficits. This has allowed earlier return to play (RTP), however athletes often still have significant proprioceptive and strength deficits up to 2 years post surgery. Despite getting back to play, athletes may struggle to get back to performance.

Following surgery, contact athletes such as rugby players, throwing athletes and young players have additional RTP challenges. Redislocation risks in contact sports such as rugby are high, leading to poor outcomes. Younger athletes are not skeletally mature, and with early RTP following stabilisation surgery may have higher failure rates. How can you identify and address these challenges?

Which tests and features in a patients history help you determine whether a patient is suitable for an early RTP? In this podcast with Jo Gibson (Clinical Physiotherapy Specialist), you’ll explore:

  • Which shoulder tests are most valuable with your patients?
  • How has emerging evidence challenged our previous approach to RTP testing?
  • What are the risks associated with early RTP following shoulder surgery?
  • How can you help identify athletes at risk of redislocation?
  • Which psychosocial factors impact RTP?
  • How does fear of reinjury and levels of anxiety about their shoulder affect RTP?
  • How does your patient’s sport of choice affects dislocation risks?
  • How is RTP impacted by patients age?
  • How do daily stressors impact RTP and predict outcomes?
  • Which psychosocial factors impact RTP?
  • What is the biggest factor in whether an athlete gets back to play?
  • Which question are key to ask your patients?
  • Which questionnaires can you use with your post-op shoulder patients?
  • Which tests and combinations of tests have been validated and are evidence-based?
  • How can you assess range of movement (ROM)?
  • How can you measure patients strength?
  • How is rate of force development (RFD) affected following shoulder injury?
  • How can you assess RFD?
  • How does fatigue impact strength testing eg testing at the start of training compared to the after training?
  • How does the kinetic chain impact RTP testing for throwers?
  • How can you assess shoulder endurance?
  • RTP tests for swimmers
  • What role does manual therapy have in shoulder rehab?

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Direct download: 101._Return_to_play_testing_after_shoulder_surgery_with_Jo_Gibson.mp3
Category:general -- posted at: 10:48am AEDT

100 Physio Edge podcast episodes since I discovered a love of podcasts, and created the Physio Edge podcast to help Physio’s, Physical Therapists and other health professionals in their clinical practice with practical information from the leaders in different musculoskeletal and sports injuries. I really enjoy recording each podcast, helping you with your clinical challenges and hearing how the podcast has helped you with your patients.

While recording each of these podcasts, I’ve noticed that one area Physiotherapy experts & leaders have in common is their well developed clinical reasoning. They use effective & efficient clinical problem solving to assess and treat their patients. How can you improve your clinical reasoning to more effectively assess and treat your patients?

In this podcast with the new Clinical Edge Senior Physio education & presentation team - David Toomey (NZ based Musculoskeletal Physio), Jordan Craig (APA Titled Musculoskeletal & Sports Physio) and Simon Olivotto (Specialist Musculoskeletal Physiotherapist, FACP), you’ll explore:

  • Five practical strategies you can use immediately to improve your clinical reasoning and treatment results.
  • Clinical reasoning - what is it and how will it help you with your patients?
  • How to effectively & efficiently assess and treat in short treatment sessions
  • How to create a rehabilitation or training plan for a patient to suit their individual needs.
  • Low back pain patients - How to use clinical reasoning to target your questioning, objective assessment and treatment to your patients needs

Download this podcast now to improve your clinical reasoning and treatment results with these five practical strategies.

Download and subscribe to the podcast on iTunes
Download the podcast now using the best podcast app currently in existence - Overcast
Listen to the podcast on Spotify
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Patients with shoulder pain, rotator cuff tears and nerve injuries can often be seen shrugging their shoulder while they lift their arm, appearing to overuse their upper fibres of trapezius. Surface EMG research has shown increased activity in UFT in shoulder pain and whiplash patients. To add to this, patients get sore upper traps, and can be adamant that they need regular massage of their upper fibres of trapezius (UFT).

We seem to have plenty of evidence that we need to decrease UFT muscle activity, and help this by providing exercises to target the middle and lower traps.

Is this really the case? Are the upper traps really a bad guy, or a victim caught in the spotlight? Do we need to decrease upper traps muscle activity to help our patients shoulder or neck pain? Or perhaps counter-intuitively, do we need to strengthen upper traps and help them to work together with the surrounding muscles?

In this podcast, Jo Gibson (Clinical Specialist Physio) explores the evidence around the upper fibres of trapezius, and implications on your clinical practice. You’ll discover:

  • What are the myths around upper traps?
  • Are upper fibres of trapezius a bad guy or a victim?
  • Why do upper traps sometimes seem to be overactive?
  • Should we aim to increase the activity in middle and lower traps?
  • What information does surface EMG really provide?
  • Can taping of the scapula change recruitment of the trapezius?
  • Should we strengthen UFT?
  • Why is initial activation of the UFT important in shoulder elevation movements?
  • Why should patients with rotator cuff tears or stiff & painful shoulders use upper traps more with their movements?
  • How can we incorporate UFT strengthening into our shoulder strengthening?
  • What exercises can we use to strengthen UFT without increasing activity in levator scapulae?
  • Why is UFT strengthening important in ACJ injury rehab?
  • In gym goers, what scapula setting errors are commonly used?
  • How do nerve injuries that affect the upper traps impact movement?
  • Do trigger points or soreness indicate that our patients need massage or exercises to decrease UFT activity?

Download this episode now to improve your treatment of shoulder and neck pain.

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Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast
Lee JH, Cynn HS, Choi WJ, Jeong HJ, Yoon TL. Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome. Human movement science. 2016 Feb 1;45:119-29.
Pizzari T, Wickham J, Balster S, Ganderton C, Watson L. Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Clinical Biomechanics. 2014 Feb 1;29(2):201-5.

Direct download: Physio_Edge_099_Upper_traps_-_are_they_really_a_bad_guy_with_Jo_Gibson.mp3
Category:general -- posted at: 2:19pm AEDT

Strength training can be used in your treatment and rehab programs to improve your patients strength, load capacity, function & pain, so they can get back into work and the activities they enjoy. In your athletic patients, strength training can be used to help restore power and speed, which are vital for sporting performance.

Would you like to include more strength training in your treatment, but aren’t completely sure about the most effective ways to build strength? Which exercises can you use? How many sets and reps should your patients perform? Will 3 sets of 10 reps build strength effectively? What is power training, when should you focus on improving power, and how can you incorporate power training?

In this podcast with David Joyce - Sports Physiotherapist, S&C expert and co-author of High performance training for sports, and Sports injury prevention and rehabilitation, you will discover:

  • How to use strength training with your patients
  • The most effective ways to help your patients develop strength
  • Set and rep ranges for strength improvements
  • Recent developments in S&C
  • What is power & power training, and how does this compare to strength?
  • When should your patients work on improving power vs strength
  • How to improve power using different areas on the force/velocity curve
  • Power development using bodyweight and barbell exercises
  • Calf strengthening
  • How to incorporate velocity/explosiveness training
  • When are higher reps useful?
  • Does endurance training with higher reps carryover to improved running or cycling
  • When your patients are performing deadlifts or squats, what elements should you monitor?
  • Do biomechanics in a deadlift or squat matter?
  • What rest periods should be used to help develop strength, while maintaining an efficient training routine
  • What is strength training vs conditioning?
  • How can patients perform conditioning for improved fitness?
  • Should conditioning be incorporated into strength training sessions for maximum improvements in strength?
  • Should exercises and sets be performed to temporary muscular failure (when the bar is unable to be lifted for another repetition)
  • Resources to help improve your strength & conditioning

 

 

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Long head of biceps (LHB) tendinopathy and associated anterior shoulder pain can develop in patients that increase their lifting load eg moving house, overhead activities, activities that involve loaded shoulder extension and in throwing athletes. Patients may also develop long head of biceps tendon pain after a traumatic ACJ injury or SLAP tear.

How can you identify and treat LHB tendinopathy? In this podcast with Jo Gibson, you’ll explore:

What causes LHB tendinopathy?

  • What mechanisms of injury commonly cause LHB pain, ACJ injury or SLAP tears?
  • Key traumas you need to keep an eye out for that impact LHB
  • Why do patients with ACJ injuries develop LHB pain?
  • Why do patients with SLAP lesions develop LHB pain?
  • What causes LHB reactive tendinopathy?

LHB Anatomy & function

  • What activities does LHB help with?
  • Long head of biceps (LHB) anatomy
  • Variance in proximal biceps attachment and how traumatic LHB injuries impact different structures
  • How the LHB is stabilised anatomically in the bicipital groove
  • Does the transverse ligament exist?

Patient features that help your diagnosis

  • Which patients are likely to present with LHB pain?
  • Which structures are more likely to be affected with traumatic shoulder injuries in younger vs older patients?
  • Why do young patients with LHB instability develop pain?

Subjective history features that help your diagnosis

  • Where do patients with LHB tendinopathy experience pain?
  • Which movements are likely to be painful in LHB tendinopathy patients?

Objective testing & diagnosis

  • Which tests or combinations of tests help diagnose LHB pain?
  • Which special tests help your diagnosis?
  • Does palpation have any value in LHB diagnosis?
  • How can you exclude intra-articular pathology with your testing?
  • How can you rule in or rule out rotator cuff pathology?

Rotator cuff tears & involvement in LHB

  • How does LHB muscle activity vary in painful vs painfree massive rotator cuff tear patients?
  • How do traumatic rotator cuff tears, particularly subscapularis, impact LHB?
  • If patients have rotator cuff surgery, what details in the operation notes will help you identify if they are at risk of persistent post-op pain and stiffness?
  • Why do subscapularis tears cause LHB pain?

Imaging

  • What information does imaging of LHB provide?
  • What imaging can you use if your patient is not progressing?
  • MRI vs MRA vs US for different pain & injuries

How to treat LHB

  • What is the best way to treat LHB tendon pain?
  • Are isometrics helpful with LHB, and how do these help?
  • What surgery is used for LHB pain?

Additional questions covered

  • How are results after rotator cuff tears impacted by the rotator interval?

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Patients with thoracic outlet syndrome (TOS) may have undiagnosed pain and symptoms into their shoulder, arm, hand, scapula, head, face, upper back, axilla, chest and anterior clavicle.

With a number of potential sources of pain in these areas, TOS patients commonly have a delayed or incorrect diagnosis, followed by unnecessary and unsuccessful surgery. Further complicating matters, imaging and nerve conduction studies are often clear or inconclusive. Studies show that on average, patients with TOS have an average of 5 years of symptoms and see 6 doctors before receiving an accurate diagnosis.

What tests and questionnaires will help guide your diagnosis and intervention? When are patients suitable for Physiotherapy and conservative management? When should you refer on for a surgical opinion?

In this podcast with Jo Gibson (Clinical Physiotherapy Specialist), you will discover:

  • What is Thoracic outlet syndrome (TOS)?
  • Commonly reported symptoms of TOS
  • Three different types of TOS
  • The most common type of TOS with around 80% of all TOS patients
  • Why imaging and investigations are often clear, and don’t match up with symptoms
  • 3 key causes of TOS
  • The relationship between TOS and hypermobility syndrome
  • Criteria for diagnosis in the latest TOS diagnostic consensus statement
  • Differential diagnosis (DDx) - Cervical NR compression, and peripheral nerve entrapment
  • Common subjective findings that guide you towards a diagnosis of TOS
  • A questionnaire you can use to assist cervicobrachial diagnosis
  • What information is gained from imaging, including MRI and MR Neurography & nerve conduction studies
  • What are the limitations of imaging?
  • What is the difference between small nerve fibre and large nerve fibres, and how this impacts diagnosis
  • QST - Quantitative sensory testing - Pin prick (Neurotip) and Thermal testing - warm and cold
  • Simple QST test using a coin
  • Objective testing
    • What tests do you need to perform in patients with suspected TOS?
    • What is the elevated stress test (EST)?
    • What information does an upper limb tension test (ULTT) provide?
    • Does a negative ULTT test exclude TOS?
  • How are nerve blocks used?
  • What is the best way to perform a nerve block?
  • How effective are nerve blocks in assisting diagnosis?
  • Who should we refer on for early medical or surgical management?
  • When should you get an early surgical opinion?
  • Which patients are likely to benefit from conservative management?

Download and subscribe to the podcast on iTunes
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Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast

Direct download: Physio_Edge_096_Thoracic_outlet_syndrome_with_Jo_Gibson.mp3
Category:general -- posted at: 11:34am AEDT

The sternoclavicular joint (SCJ) can cause pain locally, or refer into the neck and shoulder. With a relatively high incidence of serious and potentially life-threatening pathology at the SCJ, it’s important to diagnose the source of SCJ pain. In this (Facebook live/video/podcast) with Jo Gibson (Clinical Physiotherapy Specialist ), you’ll discover:

  • How to identify and diagnose the SCJ as the source of pain
  • Where does the SCJ commonly refer pain to?
  • What pathologies cause SCJ pain
  • What activities & movements commonly reproduce pain in the SCJ?
  • Who develops SCJ pain?
  • Which differential diagnosis (DDx) are important to identify, including
    • localised osteoarthritis (OA)
    • rheumatoid arthritis
    • septic arthritis
    • atraumatic subluxation
    • seronegative spondyloarthropathies
    • gout, pseudogout
    • SC hyperostosis
    • condensing osteitis
    • Friedrich’s disease/avascular necrosis
    • condensing arthritis
    • Friedrich’s disease and
    • ‘SAPHO’ (Synovitis Acne Pustulosis Hyperostosis Osteitis) syndrome
  • How does DDx impact prognosis?
  • What role does imaging have with the SCJ?
  • SCJ Imaging - MRI vs CT vs Xray.
  • If pain refers down to the anterior chest, what other structures may be involved?
  • Tietze syndrome at the costochondral junction.
  • Costochondritis - who develops it, is there a mechanism of injury?
  • Red flags you need to be aware of around the SCJ
  • Case study of an SCJ patient where a potentially life-threatening illness was identified
  • Other red flags - infection, HIV, septic arthritis, diabetes, ankylosing spondylitis, gout
  • What investigations are important for SCJ pain patients?
  • What are realistic expectations for prognosis and resolution of SCJ symptoms?
  • How can you rehab patients with SCJ pain?
  • Costochondral joint pain
  • Rehab following clavicular ORIF
  • When is arthroscopic release suitable in frozen shoulder patients

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Have you ever wanted to improve your patients strength, but weren't sure about the best way to go about it? What exercises should you use? How many sets, reps and sessions per week should you ask your patients to complete? Strength levels often start to decline with pain or after an injury, from neuromuscular inhibition, swelling, inflammation or joint laxity (Hopkins & Ingersoll, 2000; Rice & McNair, 2010). Unfortunately strength doesn't always return as quickly as it disappears, and neuromuscular inhibition can carry on (Roy et al, 2017).

In this podcast with Dr Claire Minshull, we dive into the role of strength and conditioning in rehab, and explore:

  • Why building strength is an important part of rehab
  • How can you build strength effectively and efficiently?
  • Do 8-12 rep sets or 3-5 rep sets build greater strength?
  • How many sets of an exercise should your patient perform?
  • How frequently do patients need to perform their exercises?
  • Is maximal loading necessary in rehab?
  • Which patients should use lower load exercises?
  • Will strength training make endurance athletes slow and muscular, or improve running economy?
  • "Functional exercises" vs strength exercises
  • When should exercises target strength, and when can you use "functional exercises"?
  • What is power training, and what exercises help to develop power?
  • When should power training be used?
  • What lifting cues can you use with beginning lifters e.g. in deadlifts?
  • Patients with knee osteoarthritis:
    • What is an effective exercise strategy for patients with knee osteoarthritis (OA)?
    • What important factors do you need to incorporate in your pain education?
    • How can you start a strengthening program?
    • What exercises can you use?
    • What pain levels are acceptable during exercise?
    • How can you know if your exercises are appropriate for each patient?
    • What braces or supports can you use to make unicompartmental knee OA more comfortable and able to exercise?

 

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Dr Claire Minshull also presented two online courses for Clinical Edge members to further develop your strength & conditioning skills and confidence. You can get access to these online courses with your free trial membership.

What is in Dr Claire Minshull's webinar?

  • How to incorporate strength development in your rehab programs
  • How to progress strength in rehab
  • Exercise progressions and regressions to maintain a strength focus
  • Case study examples taking you through how to apply S&C principles with your patients

Download and subscribe to the podcast on iTunes
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Website - Get Back to Sport
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Versus Arthritis

Articles associated with this episode:

Campos et al. 2002. Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones.

Hall et al. 2018. Knee extensor strength gains mediate symptom improvement in knee osteoarthritis: secondary analysis of a randomised controlled trial.

Jorge et al. 2015. Progressive resistance exercise in women with osteoarthritis of the knee: a randomized controlled trial.

Latham et al. 2010. Strength training in older adults: the benefits for osteoarthritis.

Teixeira et al. 2018. Effect of resistance training set volume on upper body muscle hypertrophy: are more sets really better than less?

Uusi-Rasi et al. 2017. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial.


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

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?

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

 

Other episodes of interest:


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.

 

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

Resources associated with this episode:

Other Episodes of Interest:


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

 

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

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

 

Direct download: Physio_Edge_088_Combating_hand__wrist_injuries_part_1_with_Ian_Gatt.mp3
Category:general -- posted at: 1:16pm AEDT

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

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

Direct download: Physio_Edge_087_AC_Joint_injuries_with_Dr_Ian_Horsley.mp3
Category:general -- posted at: 5:08pm AEDT

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

Resources associated with this episode:

Other Episodes of Interest:


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!

Resources associated with this episode:

Other Episodes of Interest:


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"

Other episodes of interest:


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"

Other episodes of interest:


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

Articles associated with this episode:

Other episodes of interest:


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 injuriesChris 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

Articles associated with this episode:

Other episodes of interest:

Direct download: Physio_Edge_081_How_to_treat_ankle_syndesmosis_injuries_with_Chris_Morgan.mp3
Category:general -- posted at: 12:15pm AEDT

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

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:

 

Click here to download the podcast handout

Articles associated with this episode:

Direct download: Physio_Edge_079_How_to_rehabilitate_ACL_injuries_with_Dr_Lee_Herrington.mp3
Category:general -- posted at: 6:29pm AEDT

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

Other episodes of interest:

Direct download: Physio_Edge_078_High_performance_athlete_management_with_David_Joyce.mp3
Category:general -- posted at: 4:10pm AEDT

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

Articles associated with this episode:

Exercise videos

Other episodes of interest:


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

Related posts

Research associated with this episode

Direct download: Physio_Edge_076_Footwear_advice_for_running_injuries_with_Tom_Goom.mp3
Category:general -- posted at: 8:13pm AEDT

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

 

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

Direct download: Physio_Edge_075_Tendinopathy_imaging_and_diagnosis_with_Dr_Sean_Docking.mp3
Category:general -- posted at: 5:13pm AEDT

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

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:


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

 

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

 

 

Other episodes of interest:

Articles associated with this episode:


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

Articles associated with this episode:


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:

Articles associated with this episode:


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:

Articles associated with this episode:


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

Other episodes of interest:

Articles associated with this episode:


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 .

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

 

Related posts

Research associated with this episode

Direct download: Physio_Edge_066_How_to_treat_calf_pain_in_runners_with_Tom_Goom.mp3
Category:general -- posted at: 3:22pm AEDT

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

 

 

Related posts

 

Research associated with this episode


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

Related posts

Research associated with this episode


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

 

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

 

Related posts

 

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.