Episodes
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How do you approach assessing pain when you're working with athletes? What tools do you find most helpful?
Today, sports physiotherapist and researcher, Ciarán Purcell (University of Limerick, Ireland) describes the project he is leading to gather consensus from athletes and sports medicine & rehabilitation clinicians about how best to assess athletes' pain. Listen to the end to learn about how you can get involved in the consensus!
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RESOURCES
IOC consensus on managing pain in elite athletes: https://pubmed.ncbi.nlm.nih.gov/28827314/
Framework for assessing upper and lower limb pain in athletes: https://www.jospt.org/doi/10.2519/jospt.2024.12807
Scoping review of tools for assessing pain in athletes: https://pubmed.ncbi.nlm.nih.gov/36759138/
To get in touch with Ciarán about the consensus project, email [email protected]
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The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is hot off the presses!
Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice.
Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider.
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RESOURCES
Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall)
ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005
Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/
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Missing episodes?
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Did you know that only about 10% of the participants in sports medicine and sports physical therapy research are women?
When people are under-represented in research, it might mean that clinicians and researchers miss key concerns of women and girls when working with them to achieve the best outcomes of treatment.
Melissa Haberfield - physiotherapist and PhD candidate at the La Trobe Sports and Exercise Medicine Research Centre in Melbourne, Australia - shares the results of her work with women who have experienced serious knee injury, about what they wanted to know about managing knee health.
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RESOURCES
Systematic review of self-reported activity and knee-related outcomes after ACL injury (sex and gender differences): https://pubmed.ncbi.nlm.nih.gov/36889918/
Sex/gender equity in sport and exercise medicine/physical therapy publishing: https://pubmed.ncbi.nlm.nih.gov/36631242/
What do women (with serious knee injury) want to know about knee health (article): https://www.jospt.org/doi/10.2519/jospt.2025.12869
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You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees.
Maybe you've had someone in the clinic who worries that running will wear their joints out? Today's guest has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement.
Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy.
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RESOURCES
Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/
Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767
Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149
Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731
Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/
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In today's part 2 of an NMES masterclass from Dr Elanna Arhos (Northwestern University) and Dr Naoaki Ito (University of Wisconsin - Madison), we're getting into the nitty gritty of how to support patients to get the most out of a very beneficial intervention. Drs Arhos and Ito, and their team have tested a mix of common stimulators available on the market today, and are here to share the results with us. Let them help you make an informed decision about your next equipment purchase for your clinic.
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RESOURCES
Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028
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Neuromuscular electrical stimulation (NMES) hasn't quite had the coverage it deserves, especially when one considers the strength of evidence supporting NMES as a musculoskeletal rehabilitation intervention
Today, Drs Elanna Arhos (Northwestern University) and Naoaki Ito (University of Wisconsin - Madison) are re-visiting how NMES is applied in sports clinical practice. Get the low-down on why you need NMES in your sports rehabilitation toolkit, and how to figure out dose and intensity.
In part 2 we discuss how to support patients to get the most out of NMES, and which equipment is best for your clinic.
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RESOURCES
Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028
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Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy.
In part 2 of this series, Dr de Vos covers the multitude of options for treatment, outside of exercise therapy. Should you and the patient consider corticosteroid injections, PRP injections, heel lifts, shockwave, NSAIDs, or surgery? And when? What are the important clinical considerations when patients choose these options? Part 2 has it all!
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RESOURCES
Terminating corticosteroid injection in tendinopathy? https://www.jospt.org/doi/10.2519/jospt.2023.11875/
Dutch multidisciplinary guideline on Achilles tendinopathy: (https://pubmed.ncbi.nlm.nih.gov/34187784/
Platelet-rich plasma injection for chronic Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/20068208/
Time to put down the scalpel when treating tendinopathy? https://pubmed.ncbi.nlm.nih.gov/31653777/
Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/
Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/
Clinical tool for identifying spondyloarthropathy: http://tinyurl.com/3my87hma
More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/
Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/
Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/
Achilles Pain, Stiffness, and Muscle Power Deficits - 2024 updated clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2024.0302
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Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review.
In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy.
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RESOURCES
Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/
Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/
Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf
More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/
Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/
Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/
Achilles Pain, Stiffness, and Muscle Power Deficits - updated clinical practice guideline from AOPT: https://www.jospt.org/doi/10.2519/jospt.2024.0302
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When patients improve following treatment, how much can be attributed to the intervention delivered, and how much is due to contextual factors and nonspecific effects that lie outside of the clinician's control?
Dr. Giacomo Rossettini joins the podcast again as a co-author of a paper (link below) that answers that very question.
Dr. Rossettini and his research colleagues tried to quantify the effect of contextual factors with a meta-analysis. They found non-specific effects play a big role in patients' outcomes. Today's discussion covers what these contextual factors are, how the researchers quantified them, and how musculoskeletal rehabilitation clinicians can harness non-specific effects to boost patients' outcomes.
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RESOURCES
Non-specific effects in musculoskeletal pain treatment outcomes (meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2024.12126
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Musicians and athletes might sometimes appear to exist in very different cultures. And yet, the single-minded focus, thousands of hours of practice, and high training loads on their musculoskeletal systems mean that musicians and athletes probably have more in common than they have differences. At least from a musculoskeletal rehabilitation perspective.
Today's guest is Marianne Roos - a former clarinetist and forever musician-at-heart, who now practices as a physiotherapist and conducts her PhD research from Laval University, Canada. Marianne explains the physical and psychological demands of orchestra performance on the musician's body, and shares the results of her PhD research in developing programmes to reduce musculoskeletal injuries among orchestra musicians.
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RESOURCES
Barriers and facilitators to implementing rehabilitation and wellness programs for orchestral musicians: https://pubmed.ncbi.nlm.nih.gov/33853373/
Workplace injury prevention and wellness program for orchestra musicians: https://www.jospt.org/doi/10.2519/jospt.2024.12277
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When it comes to serious injury, like an ACL tear, in college sport, how many young athletes return to their previous level of performance?
Today's guest led a team that has done the hard yards of synthesising all the available data to find an answer.
Dr Cortez Brown is a junior orthopaedic surgery resident at the University of Pittsburgh Medical Centre.
In today's episode, Dr Brown shares the results of his systematic review, and guides listeners through the complex factors that affect return to play outcomes for college athletes.
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RESOURCES
Return to college sport after ACL reconstruction systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12483
Systematic review of return to competitive sport (all levels) after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/
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Ballooning wait times, overworked and burnt out staff. No doubt you're only too familiar with the signs of a health system that's under serious strain. And not just since the Covid-19 pandemic.
Simon Lafrance, physiotherapist and researcher from the University of Montreal, explains musculoskeletal care models that flip the traditional medical model of the doctor as the first contact point a patient has with the health system, to a musculoskeletal specialist, like a physical therapist, leading instead.
Simon's clinical work and research work merge as he works to develop and evaluate advance practice physiotherapy models.
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RESOURCES
Trial of single vs. multiple sessions of advanced practice physiotherapy: https://www.jospt.org/doi/10.2519/jospt.2024.12618
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Musculoskeletal rehabilitation clinicians are well versed in the physical and mental benefits of regular physical activity. Unfortunately there is limited evidence to guide clinicians on how to best support return to sport and physical activity after childbirth. That's where today's guest comes in.
Dr Jenna Schulz (physiotherapist and postdoctoral researcher from Western University, Canada) specializes in pelvic health and sport, women’s health, and improving longevity in sport for females across the lifespan. Today, Jenna shares how she approaches supporting physical and mental readiness for sport postpartum, and when to refer to your colleagues in the multidisciplinary health care team.
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RESOURCES
Systematic review of exercise interventions for physical activity and cardiorespiratory fitness: https://www.jospt.org/doi/10.2519/jospt.2024.12666
Scoping review of guidelines for returning to physical activity and sport postpartum: https://pubmed.ncbi.nlm.nih.gov/37898507/
Relative Energy Deficiency in Sport (REDs) and the lactating athlete: https://pubmed.ncbi.nlm.nih.gov/37752008/
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Most people who pursue a career in health care do so because they want to help people. Depending on where you work, patients might find it easier or harder to access high-value musculoskeletal care, and you might run into barriers to providing the care you would like to provide.
Dr Roy Film is a physical therapist, educator and current President of APTA Maryland. In today's episode, Roy explains his work trying to make it easier for people to choose high-value musculoskeletal rehabilitation.
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RESOURCES
Racial disparities in outpatient PT use: https://www.jospt.org/doi/10.2519/jospt.2024.12641
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The complex world of clinical practice in musculoskeletal rehabilitation brings many challenges. Some you might feel prepared for, while others...not so much.
Musculoskeletal physiotherapist and shoulder specialist, Jared Powell, is here to reassure us that no-one expects you to have all the answers, encourage us all to think carefully and critically when evaluating information, and to embrace a work-related niche that resonates with your passions and strengths.
Jared shares ideas on how to succeed as a compassionate and effective musculoskeletal rehabilitation specialist.
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RESOURCES
"Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676
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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.
Registration and information: https://tinyurl.com/3xkcrtu2
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Today brings a refresher on best practice in managing non-traumatic shoulder pain.
Professor Karen McCreesh (University of Limerick) guides the listener to the best available clinical practice guidelines and runs the ruler over different approaches to exercise therapy.
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RESOURCES
Diagnosing, managing and supporting return to work for people with rotator cuff disorders (practice guideline): https://www.jospt.org/doi/10.2519/jospt.2022.11306
Efficacy of exercise therapy - systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12453
GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34382931/
JOSPT Insights episode 173 (shared decision making): https://podcasts.apple.com/ca/podcast/ep-173-shared-decision-making-what-it-is-and-what-it/id1522929437?i=1000651049481 orhttps://open.spotify.com/episode/6CCh5FRTGAsz54bdpWbYGB?si=c40b2c227eb94a12
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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.
Registration and information: https://tinyurl.com/3xkcrtu2
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If you consult a clinical practice guideline for any musculoskeletal condition, you'll probably see advice and education included as part of the recommendations for helping someone manage their musculoskeletal pain.
How well do the recommendations in clinical practice guidelines about what topics advice and education should cover align with the main concerns of people with back pain?
Dr Giovanni Ferreira (University of Sydney) joins JOSPT Insights to explain.
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RESOURCES
Concerns of people with acute back pain: https://www.jospt.org/doi/10.2519/jospt.2024.12571
AI chatbots answering questions about low back pain: https://pubmed.ncbi.nlm.nih.gov/39299722/
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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.
Registration and information: https://tinyurl.com/3xkcrtu2
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Today's episode takes the spirit of our popular SPORTS CORNER series, and flips it to learning about playing a leading role in the world of sports medicine and rehabilitation.
Dr Ciara Burgi has worked across collegiate, professional men's, and professional women's sport, and has a ton of wisdom to share.
From building rapport with athletes and patients, to valuing your work in the present without looking too far ahead to what might (or might not) come next, and doing what you can with the resources at your disposal, are among the topics Dr Burgi covers.
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RESOURCES
The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the extended early-bird price and the opportunity for up to 13 continuing education contact hours.
Registration and information: https://tinyurl.com/3xkcrtu2
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In this episode, we throw ourselves into the world of team handball with Dr Martin Asker (Sophiahemmet University, Sweden).
If your exposure to handball is every 4 years at the Olympic Games, we've got you covered with a review of the game and the demands of the sport.
Martin's shoulder expertise shines as he covers the common injuries and key things to keep in mind while treating these tricky, well-rounded athletes.
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RESOURCES
Handball Medicine & Science website: https://www.handballmedicine.com/
Bern consensus on managing shoulder injuries in athletes: https://www.jospt.org/doi/10.2519/jospt.2022.10952
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Muscle strength is a core focus of many sports injury rehabilitation programmes, and often a prominent discharge criterion. Today's guest has an important message about the uninjured limb in ACL rehabilitation: "beware the moving target of strength".
Olivia Barbosa is a sports physiotherapist with over a decade of experience in soccer and rugby. She currently works at the Aspetar Orthopaedic & Sports Medicine Hospital where she contributes to the concussion and the ACL clinical teams, and does research focused on muscle activation and strength recovery in ACL rehabilitation.
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RESOURCES
More on changes in quadriceps and hamstrings muscle strength over rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2023.11961
Aspetar ACL rehabilitation clinical practice guideline: https://www.aspetar.com/en/professionals/aspetar-clinical-guidelines/recommendations-on-rehabilitation-after-aclr
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