Episodes
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Welcome to a chat with a physical therapist who is using their orthopaedic and sports skills outside the typical practice environment. Dr Patricia Weber shares her experience as a senior physical therapist in the shock trauma setting–a world that blends orthopedic, neurologic and multi-trauma in a challenging emotional and psychological environment.
Dr Weber is a senior physical therapist at the University of Maryland Medical Center. She primarily treats within the R. Adams Cowley Shock Trauma center in downtown Baltimore.
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In today's episode, Dr Nathan Vannatta outlines some ethical frameworks that the musculoskeletal rehabilitation clinician might use when working through clinical decisions, including about return to play.
Dr Vannatta outlines ethical theories and 4 approaches to bioethics. He explains how one might justify different decisions, depending on the ethical framing, illustrating the complexity of return to play decisions with the clinical example of 'Ellie', who is returning to soccer after ACL reconstruction.
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RESOURCES
More on ethics frameworks and return to sport decisions: https://www.jospt.org/doi/10.2519/jospt.2024.12310
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Missing episodes?
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Specialist shoulder physiotherapists, Marianne van Gastel and Karin Hekman, are back for the second part of their discussion on rehabilitation for peple with anterior shoulder dislocation and Bankart repair.
Marianne and Karin share how they use a psychologically-informed practice type of approach to support athletes and patients to work through and overcome anxiety and apprehension.
The chat focuses on supporting patients to return to high levels of function, including sport, after their shoulder surgery.
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RESOURCES
Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/
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Physiotherapists and clinician-researchers, Marianne van Gastel and Karin Hekman, share a new rehabilitation guideline on managing apprehension in people with anterior shoulder dislocation and Bankart repair.
Over the next 2 episodes of JOSPT Insights, Marianne and Karin will take us through the rehabilitation guideline, explain what's new in shoulder rehabilitation, and share their approaches to helping people feel confident to get back to the sports and recreation activities they love after shoulder dislocation.
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RESOURCES
Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106
Patients' perspectives after treatment for anterior instability: https://pubmed.ncbi.nlm.nih.gov/37811392/
To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/
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Musculoskeletal rehabilitation practitioners spend years honing our clinical skills—how much time do we spend thinking about and practicing skills like listening, working in teams, and making decisions?
Today, Dr Nicol van Dyk - physiotherapist and Assistant Professor at University College Dublin - is here to make the case for real skills as keys to expert musculoskeletal rehabilitation practice.
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RESOURCES
To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/
Essential skills for Physiotherapists led by David Clancy: https://www.us.elsevierhealth.com/essential-skills-for-physiotherapists-9780443111280.html
Seth Godin blog on real skills: https://itsyourturnblog.com/lets-stop-calling-them-soft-skills-9cc27ec09ecb and TED talk https://ideas.ted.com/soft-skills-and-real-skills/
Harvard Business Review - In praise of the incomplete leader: https://hbr.org/2007/02/in-praise-of-the-incomplete-leader
More on listening as a clinical skill: https://pubmed.ncbi.nlm.nih.gov/30279218/
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NICOL'S TOP BOOK RECOMMENDATIONS
How to win friends and influence people (Dale Carnegie): https://www.amazon.com/How-Win-Friends-Influence-People/dp/0671027034
Leaders eat last (Simon Sinek): https://simonsinek.com/books/leaders-eat-last/
Dare to lead (Brene Brown): https://brenebrown.com/book/dare-to-lead/
The 21 Irrefutable Laws of Leadership: Follow Them and People Will Follow You (John C Maxwell): https://www.amazon.com/21-Irrefutable-Laws-Leadership-Anniversary/dp/0785288376
Amazing discussion about vulnerability from Adam Grant with Brene Brown: https://www.youtube.com/watch?v=uXVhDSBiZCI
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The YAHiR (Young Athletes Hip Research) Collaborative takes over the JOSPT Insights podcast today. Tune in to learn about best practice in diagnosing and managing inguinal-related groin pain. Willem Heijboer, sports physiotherapist and clinical epidemiologist from the Amsterdam University Medical Centre, joins Dr Josh Heerey to share the latest research to inform your practice.
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RESOURCES
Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir
The next Young Athlete's Hip Symposium is on 25-27 September, 2024, at Worcester College, Oxford University
The YAHiR Collaborative, La Trobe University and JOSPT are co-hosting a webinar mini series in May and June 2024. In these webinars, you'll hear more from experienced clinician-researchers Drs Josh Heerey, Jo Kemp, Kate Jochimsen and Mike Reiman. Dr Lindsey Plass and Luke Kearney, who both have lived experience of hip pain limiting their sporting careers, bring the athlete's perspective. For more information, and to register: https://semrc.blogs.latrobe.edu.au/events/yahir/
More on the terminology of inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36111127/
Reliability and accuracy of clinical tests for diagnosing inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36643406/
Rehabilitation and return to sport after surgery for inguinal-related groin pain: https://www.sciencedirect.com/science/article/abs/pii/S1060187217300382
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There's an app for just about everything these days, including in musculoskeletal rehabilitation and exercises therapy. Have you been scrolling the app store wondering if there's anything worthwhile to recommend to patients?
Today, we're uncovering what makes a quality app for monitoring and promoting physical activity in chronic conditions, including musculoskeletal pain. Dr Alessio Bricca (Assistant Professor, University of Southern Denmark) and physiotherapist, Nikolaj Nøhr, share their latest research and discuss how to apply it in practice.
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RESOURCES
World Health Organization's global strategy on digital health (2020-2025): https://www.who.int/publications/i/item/9789240020924
More on the quality of health apps available in major app stores: https://pubmed.ncbi.nlm.nih.gov/35119367/
Research waste in musculoskeletal pain apps: https://pubmed.ncbi.nlm.nih.gov/30324177/
Benefits and harms of digital health interventions for promoting physical activity: https://pubmed.ncbi.nlm.nih.gov/37410534/
International consensus on research priorities for telehealth in musculoskeletal pain: https://pubmed.ncbi.nlm.nih.gov/37789304/
Making sense of digital health data in primary care: https://pubmed.ncbi.nlm.nih.gov/37096688/
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If you're looking for a guide to testing function and readiness to return to sport after injury, you're in the right place! Dr Eric Hamrin Senorski (PT, PhD; University of Gothenburg, Sweden) shares how he blends his research training with his clinical skills to help athletes and active people with ACL injury.
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RESOURCES
Project ACL ("Project Korsband") registry: https://projektkorsband.se/
Quadriceps and hamstrings strength reference values for soccer/football, basketball and handball: https://www.jospt.org/doi/10.2519/jospt.2022.10693
Hop and jump test reference values for soccer/football, and basketball: https://www.jospt.org/doi/10.2519/jospt.2024.12374
Knee injuries after returning to sport following ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/27162233/
Return to sport rates after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/
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Dr Carrie Cooper does the lead climbing and helps you belay (see what we did there?) into the world of climbing. From bouldering to sport climbing—there's no need to go free solo (ok, ok...we'll stop now) if you don't know much about climbing. JOSPT Insights has you covered.
Dr Cooper discusses how climbing is like gymnastics, baseball, and rugby, with their shared hand, shoulder, and knee injuries. Some other key take aways from the episode are how to identify weakness that climbers are so good at hiding, and how to progress a return to climb program. Hang on; it’s good one!
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RESOURCES
Knee injuries in bouldering and rock climbing: https://pubmed.ncbi.nlm.nih.gov/32004071/
Classifying and managing flexor pulley injuries: https://pubmed.ncbi.nlm.nih.gov/30904240/
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Health care practice is slowly transitioning from a paternalistic way of delivering care (doing to the patient) to a shared decision-making model (doing with the patient). Health systems, clinical professions and individual clinicians are at different points along the transition.
As a process, shared decision-making provides a scaffold for the patient's values, preferences and circumstances to receive primacy when discussing options, benefits and risks. As a mindset, shared decision-making is a standard of excellence in clinical practice - it ensures your are focused supporting the patient to authentically engage in decisions about their health.
Today, Diane Slater, physiotherapist and educator from Aalborg University, Denmark is helping you self-diagnose your shared decision-making practice. Diane shares tips for staying up-to-date with the best information to support quality shared decision-making, which she has honed through her work as a coach and mentor to musculoskeletal health practitioners.
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Nick Kane, the head physio at Essendon Football Club in Australia, brings our attention back to Australian Rules Football. Like in all Sports Corner episodes, he reviews the demands of the sport, the common injuries, and key things to keep in mind when designing and progressing rehabilitation programs with Australian football athletes.
In today’s episode, we take a deep dive into the hard preseason work that goes into preventing injuries, as Nick shares the specific primary and secondary strategies his team uses to keep athletes healthy and performing at their best.
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RESOURCES
For more on the Sports MAP Network: https://sportsmap.com.au/
Normative isometric plantarflexion strength values: https://www.sciencedirect.com/science/article/pii/S1466853X23000469?via%3Dihub
More on the relationship between fascicle length and hamstring strength: https://bjsm.bmj.com/content/50/24/1524
JOSPT Insights episode 138 with Melissa Haberfield: https://open.spotify.com/episode/0qizZvG0ESHDfvWhOxq1Nd?si=c052ab2987e141f8 or https://podcasts.apple.com/us/podcast/ep-138-sports-corner-footy-the-game-they-play-in/id1522929437?i=1000619109573
JOSPT Insights episode 124 with Dr Seth O'Neill: https://open.spotify.com/episode/4n4wkxGK1hwBykR1MZyzJm?si=be616b82cc9542d6 or https://podcasts.apple.com/us/podcast/ep-124-caring-for-the-calf-with-dr-seth-oneill/id1522929437?i=1000604944985
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How do you approach evaluating psychological health factors when working with people in pain? Do you have an established process for screening? How about an approach to managing the psychological aspects of injury and health?
Athletes say they would like psychological support, while many musculoskeletal rehabilitation clinicians feel ill-equipped to provide appropriate support. What to do?!
Fortunately, Dr Kate Jochimsen (ATC, PhD; Massachusetts General Hospital) is leading a research program geared towards developing and evaluating mind-body interventions for chronic hip pain, and she addresses some of the clinical challenges in today's episode.
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RESOURCES
Psychologically-informed practice when managing sports injuries: https://pubmed.ncbi.nlm.nih.gov/37647239/
More on the prevalence of hip morphology in athletes: https://www.jospt.org/doi/10.2519/jospt.2021.9622
Physiotherapist-led treatment for hip-related pain: https://pubmed.ncbi.nlm.nih.gov/31732651/
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Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh
Direct links for each of the North American Pain Science in Practice courses:
Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley
San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/
New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/
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In today's part 2 of an NMES masterclass from Dr Elanna Arhos and Dr Naoaki Ito, 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
Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh
Direct links for each of the North American Pain Science in Practice courses:
Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley
San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/
New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/
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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 (Ohio State 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
Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh
Direct links for each of the North American Pain Science in Practice courses:
Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley
San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/
New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/
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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/
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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/
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Sports Corner is back for 2024! Today, we revisit ice hockey, and focus on acute injuries—preventing and managing them.
Dr Joe Robinson is the head physical therapist for the National Hockey League’s Boston Bruins. He skates into Sports Corner to explain the physical demands of hockey, the typical acute injuries he sees and how to prevent them, and runs through how the medical team responds during emergency scenarios.
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Does the thought of managing elbow pain leave you reaching for your orthopaedics textbook? Maybe you've got lateral elbow tendinopathy sorted, but how confident do you feel about managing elbow fractures and dislocations?
Today, Val Jones, Clinical Lead Physiotherapist at the Sheffield Shoulder and Elbow Unit at the Sheffield Teaching Hospital Foundation Trust, shares practical advice to help you feel confident about managing elbow pain.
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RESOURCES
CT versus MRI for assessing osteochonritis dissecans of the capitellum: https://pubmed.ncbi.nlm.nih.gov/36342019/
Shoulder arm return to sport test battery: https://pubmed.ncbi.nlm.nih.gov/31203142/
Lateral elbow pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2022.0302
2022 Bern shoulder consensus: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952
JOSPT Insights episode 136 (lateral elbow pain with Drs Lucado and Day): https://podcasts.apple.com/us/podcast/ep-136-lateral-elbow-pain-2022-clinical-practice-guideline/id1522929437?i=1000617533681
JOSPT Insights episode 103 (baseball pitching biomechanics with Wake Forest Pitching Lab): https://podcasts.apple.com/us/podcast/ep-103-baseball-pitching-biomechanics-with-the-wake/id1522929437?i=1000581372250
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Did you know that calf injuries are one of the most common soft tissue injuries in team sports? How comfortable do you feel assessing and managing calf pain, especially designing and progressing a program to help someone get back to their sport?
Today, Dr Seth O'Neill from the University of Leicester, joins us to blend the latest science in calf injury with high-level clinical reasoning. You'll get something out of today's chat whether you're beginning in your clinical career or whether you're looking for suggestions for advanced clinical practice.
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Two (gentle) giants of physiotherapy/physical therapy research and practice join JOSPT Insights today.
Associate Professor Peter Kent and Professor Peter O'Sullivan (Curtin University, Perth, Australia) share, on behalf of the whole trial team, the results of their RESTORE trial. Does cognitive functional therapy herald a revolution in how clinicians can support people to live well with back pain? Let's find out.
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RESOURCES
For the published trial: https://pubmed.ncbi.nlm.nih.gov/37146623/
Find out lots more about the RESTORE trial, including how patients and clinicians feel about cognitive functional therapy: https://www.restorebackpain.com/
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