Episodes
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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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Missing episodes?
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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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Ever wondered what a day in the life of a busy sports medicine clinic and research unit looks like?
Dr Enda King combines his roles as a sports physiotherapist, strength and conditioning coach, researcher, and educator through his work with individual athletes and elite teams across a spectrum of sports and disciplines.
Currently, he is the Head of Elite Performance and Development at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar.
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RESOURCES
For more on the Aspetar International Sports Medicine Conference - complete guide to thigh muscle injuries (November 2024): https://www.aspetar.com/en/professionals/our-events/complete-guide-to-thigh-muscle-injuries
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Today's episode is all about running load and injuries. Dr Rasmus Nielsen (Aarhus University, Denmark) leads the RUNSAFE research group, and today he provides an update on the latest research in running-related injuries.
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RESOURCES
Garmin-RUNSAFE Study (injury data from >7000 runners in 87 countries): https://www.jospt.org/doi/10.2519/jospt.2023.11959
Garmin-RUNSAFE Study protocol: https://pubmed.ncbi.nlm.nih.gov/31494626/
Changing distance and the association with injuries: https://www.jospt.org/doi/10.2519/jospt.2019.8541
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Andrew Mitchell (RB Leipzig) knows a thing or two about supporting athletes to return to play after injury, especially in professional football/soccer.
Today, Andrew explains his return to performance pathway, which is a criteria-based approach to help you and the athlete keep focused on the athlete's return to performance goal.
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RESOURCES
Andrew's return to performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240
Clinical pearls for supporting return to performance: https://www.jospt.org/doi/10.2519/josptcases.2021.0103
Control-chaos continuum for progressing rehabilitation: https://pubmed.ncbi.nlm.nih.gov/30737202/
On-field rehabilitation progression (part 1): https://www.jospt.org/doi/10.2519/jospt.2019.8954
On-field rehabilitation progression (part 2): https://www.jospt.org/doi/10.2519/jospt.2019.8952
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A thirty-year-old woman, who plays social basketball once each week and goes to the climbing gym at least twice each week, has been diagnosed with a traumatic medial meniscus tear.
The woman was told that surgery is the only way to 'fix' her knee so she can get back to basketball and climbing. But is that really what the research evidence says?
Professors Jonas Thorlund and Søren Skou (University of Southern Denmark) share the key findings of their DREAM trial, and its clinical implications for managing traumatic meniscal tears.
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RESOURCES
DREAM trial report: https://pubmed.ncbi.nlm.nih.gov/38319181/
STARR trial report: https://pubmed.ncbi.nlm.nih.gov/35676079/
Comparing treatment strategies for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245
Should symptom onset guide treatment choice for meniscus tears? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/
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Dr Kala Flagg of the Washington Mystics answers the classic Sports Corner questions for high-level women's basketball. She covers the demands of the sport, the most common injuries, and key things to plan for during injury rehabilitation.
Considering playing style, shoe fit, and physical fitness are all in a day's work when supporting high-level women's basketball athletes to perform at their best.
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Today's episode builds on last week's discussion of how changes in the way that the nervous system works after injury can compensate for impairments like joint instability, pain and muscle inhibition.
Dr Meredith Chaput (University of Central Florida) extends the 5 phases of the visual-cognitive control chaos continuum, to link the ways to assess for cognitive compensations and how to progressively load the visual-cognitive system during sports injury rehabilitation.
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RESOURCES
From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443
The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981
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Sports injury rehabilitation has moved well beyond simply focusing on physical function and recovery. There's various emphases on psychological responses to injury, mental readiness to return to sport, and now, the visual-cognitive components of recovery and return to sport.
Today, Dr Meredith Chaput (University of Central Florida) introduces the visual-cognitive control chaos continuum as a framework for sports injury rehabilitation. Her research uses functional MRI to evaluate neuroplasticity after knee injuries, focusing on understanding how people use visual attention to compensate for motor control, and how rehabilitation may better target these compensations.
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RESOURCES
From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443
The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981
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You don't have to go foar 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? My guest today 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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The relationship between musculoskeletal pain and mental distress is complex. Sometimes it can feel challenging to know where to start when supporting people to get their life back when they're struggling with chronic or persistent pain.
Today, Dr Pavlos Bobos (Western University, Canada) shares his own story of recovery from serious musculoskeletal injury, and how that experience drives the work he does now as a researcher. He discusses the results of a network meta-analysis of digital interventions for managing musculoskeletal pain and depression.
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RESOURCES
Network meta-analysis of digital interventions: https://www.jospt.org/doi/10.2519/jospt.2024.12216
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Were you someone who started delivering telerehabilitation for the first time during the pandemic? Or perhaps you're an early adopter?
Have you ever wondered how effective delivering rehabilitation via a screen is versus seeing the patient in the clinic?
Dr Belinda Lawford (The University of Melbourne) shares the latest research illustrating the benefits of telerehabilitation for managing chronic knee pain.
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RESOURCES
More on patients' perceptions of telerehabilitation/digital health: https://www.jospt.org/doi/10.2519/jospt.2024.12383
PEAK trial of telerehabilitation vs. in-person care for knee osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/38461844/
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What are the pros and cons of using AI chatbots in musculoskeletal rehabilitation? What are chatbot applications in education, clinical practice, and research?
How does the chatbot advice compare to the recommendations of trusted clinical practice guidelines? Dr Giacomo Rossettini shares the results of 2 new papers from his research team to answer these questions.
This episode is about the best ways clinicians can think about using AI chatbots to advance their clinical practice, while avoiding the pitfalls.
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RESOURCES
Pros and cons of AI chatbots in musculoskeletal rehabilitation practice: https://www.jospt.org/doi/10.2519/jospt.2023.12000
ChatGPT vs. CPGs for managing lumbosacral radicular pain: https://www.jospt.org/doi/10.2519/jospt.2024.12151
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Surveys of elite adult athletes reveal high use of analgesics, particularly non-steroidal anti-inflammatory drugs (NSAIDs). While medications like paracetamol have a generally low risk profile, certainly compared with NSAIDs or opioids, using pain medications to mask an injury or prevent pain might increase the risk of injury or make an existing injury worse.
Julie Pedersen - physiotherapist and PhD student (University of Southern Denmark) - is studying what, how, when and why youth athletes use pain medications. Today, Julie discusses how clinicians, coaches, parents and schools can support safe use of analgesics among youth athletes.
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RESOURCES
Prospective study of Danish youth analgesic use: https://www.jospt.org/doi/10.2519/jospt.2024.12407
Prevalence, frequency, adverse events data from youth athletes: https://pubmed.ncbi.nlm.nih.gov/36100523/
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There's plenty of work going into how AI can make health care better - including in recording consultation notes, or making early cancer diagnoses, or opening up low cost ways of doing musculoskeletal imaging.
The technology and applications of AI in healthcare changes just about every week. Today, we're exploring generative AI as a help, not a hindrance to musculoskeletal rehabilitation practice.
Physiotherapists Rebecca Fechner (Queensland Paediatric Persistent Pain Service), Dr Josh Pate (University of Technology Sydney) and Professor Mick Thacker (Royal College of Surgeons Ireland) talk about ways to use chatbots and generative AI to generate ideas and solve clinical problems.
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RESOURCES
The Prompt Engineering Guide is a deep dive into how to craft effective prompts for generative AI: https://www.promptingguide.ai/
More on the science of active inference: https://pubmed.ncbi.nlm.nih.gov/25563935/
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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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