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

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

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

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

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

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

Links of Interest

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

Articles related to this episode:

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

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

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

We also explore:

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

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

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

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

Get your free access to videos on sports injury assessment and treatment.

Links mentioned in this episode

Enda King

Free sports injury assessment and treatment videos

Sports Injuries virtual conference

Free podcast handout on ACL and lateral knee injuries

Download or subscribe to the podcast on iTunes

Enda King on Twitter @enda_king

Sports Surgery Clinic Dublin

Free trial of clinical edge membership

David Pope on Twitter

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

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

• Sources of lateral knee pain
    - Lateral meniscus
    - Osteochondral defects
    - Lateral/Fibular collateral ligament
    - ACL
    - Postero lateral corner

• Mechanism of injury

• What your patients will report with LCL injury

• Questions you need to ask your patients with lateral knee pain

• Red flags

• Objective assessment

• Assessment tests you can use with lateral knee pain

• When imaging is useful and when it should be avoided

• Risk factors for injury

• Management of LCL injury

• When to commence strengthening

• How to maintain strength and cardiovascular fitness during rehabilitation

• How to explain the injury and rehabilitation to your patients

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

Links mentioned in this episode

Matt Konopinski

Free sports injury assessment and treatment videos

Free podcast handout on LCL and lateral knee injuries

Matt Konopinski on Twitter @Matt_Kono

LFC Liverpool football club

Article Impact of exercise selection on hamstring muscle activation

Free trial of clinical edge membership

David Pope on Twitter

Get your free access to videos on sports injury assessment and treatment.

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

In episode 50 of the Physio Edge podcast, Dr Stephen Shaffer and David Pope discuss TMD, structures that can be affected, and how you can assess and get great results treating TMD patients. We also explore:

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

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

Links mentioned in this episode

• Enrol free on the TMD webinar with Dr Stephen Shaffer by CLICKING HERE
• Download your podcast handout here
• Dr Stephen Shaffer on ResearchGate
• Cervical spine assessment and treatment online course with David Pope
• Free trial of Clinical Edge membership
• David Pope on Twitter

In Running from Injury part 2, Dr Rich Willy will help you assess and retrain running in your patients with achilles tendinopathy, patellofemoral joint pain, ITB Syndrome and stress fractures. We explore the latest evidence and how it will help you address pain and injuries related to running.

You will discover:

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

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

Links mentioned in this episode

• Physio Edge podcast 048 Running from injury part 2 with Dr Rich Willy
• Dr Rich Willy on Twitter
• Dr Rich Willy on ResearchGate
• RunCadence app for iOS and Android
• Bone stress injuries in runners webinar with Tom Goom
• Achilles tendinopathy in runners online course
• Free trial of Clinical Edge membership
• David Pope on Twitter

Other Physio Edge podcasts related to running injuries

• Physio Edge 048 Running from injury part 2 with Dr Rich Willy
• Physio Edge 046 Proximal hamstring tendinopathy with Tom Goom
• Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Seth O’Neill
• Physio Edge 039 Patellofemoral pain in adolescents with Dr Michael Rathleff
• Physio Edge 038 Plantar fasciopathy loading programs with Michael Rathleff
• Physio Edge 023 Lower limb tendinopathies with Dr Peter Malliaras
• Physio Edge 012 Plantar fascia, achilles tendinopathy & nerve entrapments with Russell Wright
• Physio Edge 010 Biomechanics Of Running With Blaise Dubois
• Physio Edge 005 Tendons And Tendinopathy with Dr Jill Cook

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

You will also discover:

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

I have an awesome freebie for you with this podcast! 

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

Links mentioned in this episode

Dr Rich Willy on Twitter

Dr Rich Willy at East Carolina University

Dr Rich Willy on ResearchGate

University of Delaware

Irene Davis - Harvard

Garmin 620

RunCadence app for iOS and Android

Run Scribe

Purchase a RunScribe

Article on polarised training approach

Bone stress injuries in runners webinar with Tom Goom

Achilles tendinopathy in runners online course

Free trial of Clinical Edge membership

David Pope on Twitter

Some papers of interest:

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

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

iii. Mirror gait retraining for the treatment of patellofemoral pain

Other Physio Edge podcasts related to running injuries

Physio Edge 046 Proximal hamstring tendinopathy with Tom Goom

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

Physio Edge 039 Patellofemoral pain in adolescents with Dr Michael Rathleff

Physio Edge 038 Plantar fasciopathy loading programs with Michael Rathleff

Physio Edge 023 Lower limb tendinopathies with Dr Peter Malliaras

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

Physio Edge 010 Biomechanics Of Running With Blaise Dubois

Physio Edge 005 Tendons And Tendinopathy with Dr Jill Cook

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

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

Links of interest

Enrol on the free webinar with Dr Chris Littlewood

Download the handout from this podcast

Subscribe to the podcast free on iTunes

Dr Chris Littlewood on Twitter

Dr Chris Littlewood

Webinar with Tom Goom on Bone stress injuries

Cervical spine assessment & treatment online course

Clinical Edge

Clinical Edge free trial

David Pope on Twitter

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

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

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

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

Free running injury assessment & treatment video series available now

Links

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

Tags: running, hamstring, tendinopathy, tom goom, podcast, proximal, peter malliaras, craig purdam, mike reiman, treatment, assessment

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

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

Discover:

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

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

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

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

Links of Interest

Dr Leanne Bisset

Dr Leanne Bisset on ResearchGate

Dr Leanne Bisset on Twitter

Download the Patient-Rated Tennis Elbow Evaluation (PRTEE)

Download the free podcast handout

Lateral Elbow Pain Part 1 with Dr Leanne Bisset

Review the podcast in iTunes

David Pope

Clinical Edge

Get your free trial of Clinical Edge online education

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

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

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

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

Links of Interest

Dr Leanne Bisset

Dr Leanne Bisset on ResearchGate

Dr Leanne Bisset on Twitter

Review the podcast in iTunes

David Pope

Clinical Edge

Get your free trial of Clinical Edge online education

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

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

Podcast handout

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

Links associated with this episode:

• Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson
• Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson
• Jo Gibson
• Download your free handout on the Sporting Shoulder
• Jo Gibson’s courses
• David Pope
• Clinical Edge
• Get your free trial of Clinical Edge online education
• Jo Gibson’s video - Gym ball rollout
• Jo Gibson’s video - Wall squat
• o Gibson’s video - Step up with V
• Physio Matters Podcast with Jo Gibson
• Skills for Communicating with Patients Book
• Key communication skills and how to acquire them - Article in BMJ by Peter Maguire, Carolyn Pitceathly
• EUSSER