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Physio Edge podcast

Physio Edge podcast

Inspiring interviews with leading Physiotherapists, discussing real life assessment and treatment, clinical issues and ways to give you an edge in your Physiotherapy clinical practice.

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108. Cervical spine referred shoulder pain assessment, diagnosis & treatment with Jo Gibson

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 ? 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.

Links associated with this episode: 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 Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter

 

Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast Alonso-Perez JL, Lopez-Lopez A, La Touche R, Lerma-Lara S, Suarez E, Rojas J, Bishop MD, Villafañe JH, Fernández-Carnero J. Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial. Journal of Bodywork and Movement Therapies. 2017 Oct 1;21(4):798-803. Hauswirth J, Ernst MJ, Preusser ML, Meichtry A, Kool J, Crawford RJ. Immediate effects of cervical unilateral anterior-posterior mobilisation on shoulder pain and impairment in post-operative arthroscopy patients. Journal of back and musculoskeletal rehabilitation. 2017 Jan 1;30(3):615-23. Katsuura Y, Bruce J, Taylor S, Gullota L, Kim HJ. Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review. Global Spine Journal. 2020 Apr;10(2):195-208. Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation. Journal of manipulative and physiological therapeutics. 1998 Sep 1;21(7):448-53.
2020-12-07
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107. Treatment of peripheral nerve sensitisation with Dr Toby Hall

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? Links associated with this episode: Physio Edge podcast 104 - Peripheral nerve sensitisation & neural tissue pain disorders with Dr Toby Hall Comprehensive, practical training to improve your skills, clinical reasoning, treatment results & confidence with a free trial Clinical Edge membership The new ?Making sense of pain? module available with a free trial Clinical Edge membership 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 Sherlock Holmes & the Sign of the Four Hypotheses case study with Nick Kendrick Comprehensive, practical training to improve your skills, clinical reasoning, treatment results & confidence with a free trial Clinical Edge membership Dr Toby Hall on Twitter Manual Concepts Dr Annina Schmid Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Join live Q&A podcasts on Facebook Infographics by Clinical Edge
2020-10-23
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Cervical radiculopathy, central sensitisation, achilles tendinopathy, hip & groin pain, and strength testing with Paula Peralta, Simon Olivotto, Nick Kendrick & David Toomey

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

 

Links associated with this episode: 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 Improve your clinical reasoning, assessment and treatment effectiveness, efficiency and results with a free trial Clinical Edge membership Clinical reasoning module - simplify complex patients, clarify your assessment and get great results with clinically reasoned treatment ?Making sense of pain? module Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Clinical Edge Education & presentation team Simon Olivotto Paula Peralta David Toomey Nick Kendrick   Articles associated with this episode:

Maxwell S, Sterling M. An investigation of the use of a numeric pain rating scale with ice application to the neck to determine cold hyperalgesia. Manual therapy. 2013 Apr 1;18(2):172-4.

Machado GC, Maher CG, Ferreira PH, Day RO, Pinheiro MB, Ferreira ML. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Annals of the rheumatic diseases. 2017 Jul 1;76(7):1269-78.

Zhu S, Zhu J, Zhen G, Hu Y, An S, Li Y, Zheng Q, Chen Z, Yang Y, Wan M, Skolasky RL. Subchondral bone osteoclasts induce sensory innervation and osteoarthritis pain. The Journal of clinical investigation. 2019 Mar 1;129(3):1076-93.

 

2020-09-17
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105. Scapular dyskinesis - Does it really matter? with Jo Gibson

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:

Abnormal scapular kinematics cause pain We can predict patients that are going to get shoulder pain Upper traps should be retrained to decrease their activation Scapular-based interventions are superior to rotator cuff based treatment 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? Links associated with this episode: 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 Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter Articles associated with this episode: CLICK HERE to download the articles associated with this podcast Andersson SH, Bahr R, Clarsen B, Myklebust G. Risk factors for overuse shoulder injuries in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed. British journal of sports medicine. 2018 Sep 1;52(18):1191-8. Asker M, Brooke HL, Waldén M, Tranaeus U, Johansson F, Skillgate E, Holm LW. Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis. British journal of sports medicine. 2018 Oct 1;52(20):1312-9. Christiansen DH, Møller AD, Vestergaard JM, Mose S, Maribo T. The scapular dyskinesis test: Reliability, agreement, and predictive value in patients with subacromial impingement syndrome. Journal of Hand Therapy. 2017 Apr 1;30(2):208-13.
2020-06-29
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104. Peripheral nerve sensitisation & neural tissue pain disorders with Dr Toby Hall

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.

Links associated with this episode: 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 Sherlock Holmes & the Sign of the Four Hypotheses case study with Nick Kendrick Comprehensive, practical training to improve your skills, clinical reasoning, treatment results & confidence with a free trial Clinical Edge membership Dr Toby Hall on Twitter Manual Concepts Dr Annina Schmid Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Join live Q&A podcasts on Facebook Infographics by Clinical Edge
2020-06-18
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103. An unusual cause of shoulder pain with Jo Gibson

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.

Links associated with this episode: 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 Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast

Clarke CJ, Torrance E, McIntosh J, Funk L. Neuralgic amyotrophy is not the most common neurologic disorder of the shoulder: a 78-month prospective study of 60 neurologic shoulder patients in a specialist shoulder clinic. Journal of shoulder and elbow surgery. 2016 Dec 1;25(12):1997-2004.

Cup EH, Ijspeert J, Janssen RJ, Bussemaker-Beumer C, Jacobs J, Pieterse AJ, van der Linde H, van Alfen N. Residual complaints after neuralgic amyotrophy. Archives of physical medicine and rehabilitation. 2013 Jan 1;94(1):67-73.

DO MAGDALIA PB. Neuralgic Amyotrophy. Challenging Neuropathic Pain Syndromes: Evaluation and Evidence-Based Treatment. 2017 Nov 12:197.

Feinberg JH, Nguyen ET, Boachie?Adjei K, Gribbin C, Lee SK, Daluiski A, Wolfe SW. The electrodiagnostic natural history of parsonage?turner syndrome. Muscle & nerve. 2017 Oct;56(4):737-43.

Lustenhouwer R, Cameron IG, van Alfen N, Oorsprong TD, Toni I, van Engelen BG, Groothuis JT, Helmich RC. Altered sensorimotor representations after recovery from peripheral nerve damage in neuralgic amyotrophy. Cortex. 2020 Feb 28.

Seror P. Neuralgic amyotrophy. An update. Joint Bone Spine. 2017 Mar 1;84(2):153-8.

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

2020-06-11
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102. Stretching for shoulder pain - Is it time to put sleeper stretches to bed? with Jo Gibson

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: 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 Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast

Hall K, Borstad JD. Posterior Shoulder Tightness: To Treat or Not to Treat?. journal of orthopaedic & sports physical therapy. 2018 Mar;48(3):133-6.

Keller RA, De Giacomo AF, Neumann JA, Limpisvasti O, Tibone JE. Glenohumeral internal rotation deficit and risk of upper extremity injury in overhead athletes: a meta-analysis and systematic review. Sports health. 2018 Mar;10(2):125-32.

Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of stretching on posterior shoulder tightness and glenohumeral internal-rotation deficit: a systematic review of randomized controlled trials. Journal of sport rehabilitation. 2017 Jul 1;26(4):294-305.

2020-05-18
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101. Return to play testing after shoulder surgery with Jo Gibson

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? Links associated with this episode:

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
Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Jo Gibson on Twitter

Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast

2020-05-05
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100. 5 practical strategies to improve your clinical reasoning & treatment results with David Toomey, Jordan Craig & Simon Olivotto

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.

Links associated with this episode:

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
Improve your clinical reasoning, assessment and treatment effectiveness, efficiency and results with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Clinical Edge Education & presentation team
Simon Olivotto on Twitter
Jordan Craig
David Toomey on Twitter

Articles associated with this episode:

CLICK HERE to download your podcast handout

2020-04-03
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099. Upper traps - are they really a bad guy with Jo Gibson

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.

Links associated with this episode:

Download and subscribe to the podcast on iTunes
Listen to the podcast on Spotify
Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Jo Gibson on Twitter

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.

2020-03-13
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098. How to use strength training in your treatment with David Joyce

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

 

 

CLICK HERE to download your podcast handout Links associated with this episode:

Download and subscribe to the podcast on iTunes
Listen to the podcast on Spotify
S&C online courses with Dr Claire Minshull - available with a free trial
S&C for youths and adolescents online course with Dr Jon Oliver
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
David Joyce on Twitter
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Join live Q&A podcasts on Facebook
Infographics by Clinical Edge

2020-02-14
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097. Anterior shoulder pain, long head of biceps and SLAP tears with Jo Gibson

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? Links associated with this episode:

Download and subscribe to the podcast on iTunes
Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Jo Gibson on Twitter

2020-01-29
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096. Thoracic outlet syndrome with Jo Gibson

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? Links associated with this episode:

Download and subscribe to the podcast on iTunes
Listen to the podcast on Spotify
Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Jo Gibson on Twitter

Articles associated with this episode:

CLICK HERE to download the articles associated with this podcast

2019-12-16
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095. Sternoclavicular joint pain diagnosis, imaging & red flags with Jo Gibson

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 Links associated with this episode:

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
Improve your diagnosis of acute shoulder pain with 3 free videos with Jo Gibson
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Jo Gibson on Twitter

2019-12-05
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094. Strength training treating knee osteoarthritis with Dr Claire Minshull

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?

 

CLICK HERE to download your podcast handout

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 Links associated with this episode:

Download and subscribe to the podcast on iTunes
Listen to the podcast on Spotify
Improve your confidence and clinical reasoning with a free trial Clinical Edge membership, and get access to the online courses on S&C with Dr Claire Minshull
Let David know what you liked about this podcast on Twitter
Review the podcast on iTunes
Like the podcast on Facebook
Infographics by Clinical Edge
Dr Claire Minshull on Twitter
Website - Get Back to Sport
Instagram - Get Back to Sport
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.

2019-10-11
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093. Manual therapy - evidence effects and expectations with Prof Chad Cook

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 Links associated with this episode:

Download and subscribe to the podcast on iTunes

Listen to the podcast on Spotify

Improve your confidence and plantar fasciopathy results with a free trial Clinical Edge membership, and get access to the 3 part webinar series on PHP with Henrik Riel

Let David know what you liked about this podcast on Twitter

Review the podcast on iTunes

Like the podcast on Facebook

Infographics by Clinical Edge

Dr Chad Cook at Duke University

Twitter - @ChadCookPT

Book - Orthopaedic Manual Therapy

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.

2019-08-30
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092. Plantar heel pain - The latest research how to apply it with Henrik Riel

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? Links associated with this episode:

Download and subscribe to the podcast on iTunes

Download the podcast now using my favourite podcast app - Overcast

Improve your confidence and plantar fasciopathy results with a free trial Clinical Edge membership, and get access to the 3 part webinar series on PHP with Henrik Riel

Let David know what you liked about this podcast on Twitter

Review the podcast on iTunes

Like the podcast on Facebook

Infographics by Clinical Edge

Twitter - @Henrik_Riel

Research Gate - Henrik Riel

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

2019-08-06
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091. Return to running - a guide for therapists with Tom Goom

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

 

Links associated with this episode: Free lateral hip pain video series with Tom Goom Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 084 Running injury treatment - tendinopathy, MTSS, total hip replacement & high BMI patients. Q&A with Tom Goom Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
2019-06-14
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090. Combating hand wrist injuries part 3 - Treatment with Ian Gatt

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.

Links associated with this episode:

Download and subscribe to the podcast on iTunes

Listen to the podcast on Spotify

Improve your confidence and patient results with a free trial Clinical Edge membership

Let David know what you liked about this podcast on Twitter

Review the podcast on iTunes

Like the podcast on Facebook

Infographics by Clinical Edge

LinkedIn - Ian Gatt

Twitter - @IanGattPhysio

Instagram - @IanGattman

Sheffield Hallam University - Ian Gatt

Courses - HE Seminars

 

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:

PE089 - Combating hand & wrist injuries part 2 - Objective assessment with Ian Gatt

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

2019-05-16
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089. Combating hand wrist injuries part 2 - Objective assessment with Ian Gatt

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Download the podcast now using my favourite podcast app - Overcast Listen to the podcast on Spotify Improve your confidence and patient results with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Linked In - Ian GattTwitter - @IanGattPhysio Instagram - @IanGattman Sheffield Hallam University - Ian Gatt Courses - HE Seminars

 

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

2019-04-12
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088. Combating hand wrist injuries part 1 with Ian Gatt

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Listen to the podcast on Spotify Improve your confidence and patient results with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Linked In - Ian Gatt Twitter - @IanGattPhysio Instagram - @IanGattman Sheffield Hallam University - Ian Gatt Courses - HE Seminars 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

 

2019-03-29
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087. AC Joint injuries with Dr Ian Horsley

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

Links associated with this episode:

Download and subscribe to the podcast on iTunes

Listen to the podcast on Spotify

Improve your confidence and patient results with a free trial Clinical Edge membership

Online course - Shoulder rehabilitation for contact sports and the rugby shoulder with Dr Ian Horsley

Let David know what you liked about this podcast on Twitter

Review the podcast on iTunes

Like the podcast on Facebook

Infographics by Clinical Edge

Dr Ian Horsley on Twitter - @Back_in_action

Back in Action Physiotherapy

You Tube - Back in Action

Facebook - Back in Action

Research Gate - Dr Ian Horsley

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

2019-01-11
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086. "Sore but not stuffed" - understanding and explaining your patients pain with Dr Tim Mitchell and Dr Darren Beales

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Increase your confidence and results with patients with a free trial Clinical Edge membership Discover a quick simple shoulder assessment in three free videos with Jo Gibson Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Musculoskeletal Clinical Translation Framework Dr Tim Mitchell Dr Darren Beales Twitter: @PeteOSullivanPT TWITTER: @hels_slater Curtin University - Master of Clinical Physiotherapy Resources associated with this episode: BJSM Podcast - Lorimer Moseley Pain Options - Pain Resources Pain Health - Pain Self-checks Örebro Musculoskeletal Pain Questionnaire Örebro Musculoskeletal Pain Questionnaire Short Form Agency for Clinical Innovation - Best practice care for people with acute low back pain Pain-Ed Other Episodes of Interest: PE 035 - Know pain with Mike Stewart Part 1 PE 036 - Know pain with Mike Stewart Part 2
2018-12-14
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085. How to rehab groin and lower abdominal pain in runners gym junkies with Andrew Wallis

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!

Links associated with this episode: Download and subscribe to the podcast on iTunes Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Andrew Wallis on Twitter @Andrewwallis15 Facebook - The Hip and Groin Clinic The Hip and Groin Clinic website Resources associated with this episode: Cook and Purdam. 2009. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy King et al. 2018. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes Other Episodes of Interest: Physio Edge 070 How to treat adductor related groin pain and complex cases with Dr Adam Weir Physio Edge 069 Adductor related groin pain, stress fractures and nerve entrapment assessment and diagnosis with Dr Adam Weir Physio Edge 054 Hip and groin part 2: Assessment and treatment with Benoy Mathew Physio Edge 053 Hip and groin part 1: Diagnosis, pathology and red flags with Benoy Mathew Physio Edge 028 Groin Injury Screening and Rehabilitation With Dr Kristian Thorborg Physio Edge 025 Groin Assessment With Dr Kristian Thorborg
2018-10-18
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084. Running injury treatment - tendinopathy, MTSS, total hip replacement & high BMI patients. Q&A with Tom Goom

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"

Links associated with this episode: Submit questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
2018-09-13
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083. Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom

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"

Links associated with this episode: Submit your running-injury related questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
2018-09-06
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082. Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @Seth0Neill Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode:

Beyer R, Kongsgaard M, Hougs Kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. The American journal of sports medicine. 2015 Jul;43(7):1704-11.

O?Neill S, Radia J, Bird K, Rathleff MS, Bandholm T, Jorgensen M, Thorborg K. Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy. 2018:1-9.

Rio E, Kidgell D, Purdam C, Gaida J, Moseley GL, Pearce AJ, Cook J. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015 May 15:bjsports-2014.

Other episodes of interest: Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
2018-08-03
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081. How to treat ankle syndesmosis injuries with Chris Morgan

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @ChrisMorgan10 Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode:

Calder et al. 2016. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports

Latham et al. 2017. Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report

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 051 - Lateral knee and LCL injuries with Matt Konopinski PE 052 - Conservative or surgical management of ACL injuries with Enda King
2018-07-19
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080. How to assess ankle syndesmosis injuries with Chris Morgan

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

Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @ChrisMorgan10 Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge 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

2018-07-05
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079. How to rehabilitate ACL injuries with Dr Lee Herrington

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:

Physio Edge 052 Conservative or surgical management for ACL injuries with Enda King Physio Edge 051 Lateral knee and LCL injuries with Matt Konopinski Physio Edge 034 - Advanced ACL rehab with Enda King

 

Click here to download the podcast handout

Links associated with this episode: Download and subscribe to the podcast on iTunes Twitter - @LeeHphysio MSc Sports injury rehabilitation - University of Salford

Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership

Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino

Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Articles associated with this episode: Bollen et al. 1996. Rupture of the anterior cruciate ligament - a quiet epidemic? Comfort et al. 2011. Kinetic comparisons during variations of the power clean Frobell et al. 2010. A randomised trial of treatment for acute anterior cruciate ligament tears Gabbett. 2016. The training - injury prevention paradox: should athletes be training smarter and harder? Harris et al. 2017. Tibiofemoral osteoarthritis after surgical or nonsurgical treatment of anterior cruciate ligament rupture: a systematic review Herrington et al. 2013. Task based rehabilitation protocol for elite athletes following Anterior Cruciate ligament reconstruction: a clinical commentary Hewett et at. 2010. Understanding and Preventing ACL injuries: current biomechanical and epidemiological considerations Mikkelsen et al. 2000. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study Weiler et al. 2015. Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football plater with return to play in less that 8 weeks: applying common sense in the absence of evidence
2018-06-08
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078. High performance athlete management with David Joyce

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

Links associated with this episode: David Joyce at Greater Western Sydney Giants David Joyce on Twitter - @DavidGJoyce Twitter - Giants Athletic Performance Unit @Giants_APU Book - Sports injury prevention and rehabilitation Book - High performance training for sports Online course - Acute low back pain treatment with David Pope - available with a free trial Clinical Edge membership Download and subscribe to the podcast on iTunes Free sports injuries videos with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: PE 003 - Rugby, rehab and return to sport with the Australian Wallabies Physio PE 027 - Sports injury management with Dr Nathan Gibbs PE 034 - Advanced ACL rehab with Enda King
2018-05-15
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077. Anterior shoulder pain, long head of biceps tendon pathology and SLAP tears with Jo Gibson

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 Links of Interest Free Shoulder assessment videos with Jo Gibson - a series of three evidence-based videos to get you great results with shoulder pain

Free sports injuries videos including the AC joint with Jo Gibson

Download and subscribe to the podcast on iTunes

Jo Gibson on Twitter - @ShoulderGeek1

Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Courses - Steps to Success Articles associated with this episode: Hendy et al. 2012. Cross education and immobilisation: mechanisms and implications for injury rehabilitation Kibler et al. 2009. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder McCreesh et al. 2017. Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy Parle et al. 2017. Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect? Saithna et al. 2016. Shoulder Arthroscopy Does Not Adequately Visualize Pathology of the Long Head of Biceps Tendon Schroder et al. 2017. Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial Taylor et al. 2017. The "3-Pack" Examination Is Critical for Comprehensive Evaluation of the Biceps-Labrum Complex and the Bicipital Tunnel: A Prospective Study Exercise videos Thoracic rotation exercise Dynamic rotation exercise Other episodes of interest: PE 043 - Sporting Shoulder with Jo Gibson PE 031 - Unruly scapular assessment and retraining with Ann Cools
2018-02-09
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076. Footwear advice for running injuries with Tom Goom

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

Links of Interest

Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

Download and subscribe to the podcast on iTunes

Download your free podcast handout on treatment of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live

Related posts

Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom

Research associated with this episode

Esculier et al. 2015. A consensus definition and rating scale for minimalist shoes. Fuller et al. 2017. Six week transition to minimalist shoes improves running economy and time-trial performance. Kong et al. 2009. Running in new and worn shoes: a comparison of three types of cushioning footwear. Mallisoux et al. 2015. Influence of heel to toe drop of standard cushioned running shoes on injury risk in leisure time runners: a randomised controlled trial with 6 month follow up. Nigg et al. 2015. Running shoe and running injuries: myth busting and a proposal for two new paradigms: ?preferred movement path? and ?comfort filter?. Salzier et al. 2016. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.
2018-01-25
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075. Tendinopathy, imaging and diagnosis with Dr Sean Docking

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

 

Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Twitter - @SIDocking Sean Docking - La Trobe University website Sean Docking - Research gate David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership 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

2017-12-11
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074. Hip pain and femoroacetabular impingement FAI with Dr Joanne Kemp

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

Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Twitter - @JoannaLKemp Joanna Kemp - Research gate David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership LaTrobe Sports and Exercise Medicine Research Blog Twitter - @LaTrobeSEM GLA:D Australia Lake Health Group 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: Physio Edge 054 - Hip and groin pain part 2 with Benoy Matthew Physio Edge 053 - Hip and groin pain part 1 with Benoy Matthew Physio Edge 009 - Lateral hip pain with Dr Alison Grimaldi Physio Edge 004 - Hip injuries and labral tears with Nicole Hamilton
2017-11-24
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073. Neck pain rehabilitation and strengthening with Kay Robinson

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

 

Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Enrol on the 2017 Sports Injuries virtual conference Kay Robinson on Twitter - @kaylourob Kay Robinson at Total Physiotherapy David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership Book - Sports Injury Prevention and Rehabilitation: Integrating Medicine and Science for Performance Solutions High-Performance Training for Sports 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.

2017-11-10
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072. Accelerated hamstring injury rehabilitation exercise selection and progressions with Jack Hickey

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

 

Links associated with this episode: Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino Jack Hickey David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership ACU open access hamstring journal repository Dr David Opar on Twitter Dr Anthony Shield Dr Morgan Williams Dr Matthew Bourne Nicol van Dyk Rod Whiteley Nirav Maniar Ryan Timmins

Dr Steve Duhig

Sliding discs to use in hamstring slider exercises in your clinic - available in Australia. Use the code "clinicaledge" to get 20% off your order (at the above link, not applicable on Amazon)

Amazon (outside Australia)- Sliding discs to use in hamstring slider exercises

 

Other episodes of interest: PE 071 - Hamstring strengthening, lengthening and injury prevention with Dr David Opar PE 019 - Hamstring strength, flexibility and injury reduction with Dr Kieran O?Sullivan PE016 - Preventing hamstring injuries with Dr Kristian Thorborg Articles associated with this episode: Askling et al. 2013. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols Aspetar Hamstring Protocol Hickey et al. 2016. Criteria for Progressing Rehabilitation and Determining Return-to-Play Clearance Following Hamstring Strain Injury: A Systematic Review Jacobsen et al. 2016. A combination of initial and follow-up physiotherapist examination predicts physician-determined time to return to play after hamstring injury, with no added value of MRI. Järvinen et al. 2007. Muscle injuries: optimising recovery. Mendiguchia et al. 2017. Hamstring rehab for football players. Silder et al. 2013. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial
2017-11-03
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071. Hamstring strengthening, lengthening and injury prevention with Dr David Opar

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 Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino David Pope on Twitter Clinical Edge on Facebook Have a free trial Clinical Edge membership ACU open access hamstring journal repository Dr David Opar on Twitter Dr Anthony Shield Dr Morgan Williams Dr Matthew Bourne Nicol van Dyk Rod Whiteley Nirav Maniar Jack Hickey Ryan Timmins Dr Steve Duhig Articles associated with this episode: Bourne et al. 2017. Impact of exercise selection on hamstring muscle activation. Opar et al. 2015. Eccentric hamstring strength and hamstring injury risk in Australian footballers. Petersen et al. 2011. Preventive Effect of Eccentric Training on Acute Hamstring Injuries in Men?s Soccer. Timmins et al. 2015. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Timmins et al. 2016. Architectural Changes of the Biceps Femoris Long Head after Concentric or Eccentric Training. van Dyk et al. 2016. Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries: A 4-Year Cohort Study.
2017-10-27
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070. How to treat adductor related groin pain and complex cases with Dr Adam Weir

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: Get your access to free Sports Injuries presentations Download your free podcast handout Dr Adam Weir on Twitter - @adamweirsports Aspetar ? Sports groin pain centre Get your free trial Clinical Edge membership David Pope on Twitter Clinical Edge on Facebook Adductor protocol on Mobile devices Adductor protocol videos on Youtube Articles associated with this episode:

Branci et al. 2014. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls.

Drew et al. 2017. Experimental pain in the groin may refer into the lower abdomen: implications to clinical assessment.

Drew. 2017. PhD Thesis - Beyond the pathoanatomical explanation of long-standing groin pain in athletes

Mosler et al. 2015. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis.

Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes.

Whittaker et al. 2015. Risk factors for groin injury in sport: an updated systematic review.

2017-10-19
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069. Adductor related groin pain stress fractures and nerve entrapment assessment diagnosis with Dr Adam Weir

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: Get your access to free Sports Injuries presentations Download your free podcast handout Dr Adam Weir on Twitter - @adamweirsports Aspetar ? Sports groin pain centre Erasmus University Hospital Academic Centre for Groin Injuries Get your free trial Clinical Edge membership David Pope on Twitter Clinical Edge on Facebook Articles associated with this episode:

Branci et al. 2014. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls.

Drew et al. 2017. Experimental pain in the groin may refer into the lower abdomen: implications to clinical assessment.

Drew. 2017. PhD Thesis - Beyond the pathoanatomical explanation of long-standing groin pain in athletes

Mosler et al. 2015. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis.

Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes.

Whittaker et al. 2015. Risk factors for groin injury in sport: an updated systematic review.

2017-10-13
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068. Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras

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

Download your podcast handout Dr Peter Malliaras on Twitter Tendinopathy rehab blog with Dr Peter Malliaras Get your free trial Clinical Edge membership David Pope on Twitter Clinical Edge on Facebook

Other episodes of interest:

PE 046 - Proximal hamstring tendinopathy with Tom Goom PE 042 ? Treatment of plantaris and Achilles tendinopaty with Seth O?Neil PE 023 ? Lower limb tendinopathies with Dr Pete Malliaras

Articles associated with this episode:

Coombes et at. 2016. Isometric exercise above but not below an individuals pain threshold influences pain perception in people with lateral epicondylalgia

Rio et al. 2015. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy

Silbernagel et al. 2007a. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled trial.

Silbernagel et al. 2007. Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy.

2017-10-06
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067. Shoulder special tests and the rotator cuff with Dr Chris Littlewood

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 .

Links of interest

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

2017-08-18
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066. How to treat calf pain in runners with Tom Goom

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

Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

Download and subscribe to the podcast on iTunes

Download your free podcast handout on treatment of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live

 

Related posts

Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom

Research associated with this episode

Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis
2017-06-23
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065. Differential diagnosis of calf pain in runners with Tom Goom

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

Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy

Download and subscribe to the podcast on iTunes

Download your free podcast handout on differential diagnosis of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live

 

 

Related posts

Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom

 

Research associated with this episode

Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis
2017-06-15
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064. What is causing calf pain in runners and how can you assess it with Tom Goom

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 Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live

Related posts

Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom

Research associated with this episode

Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series
2017-06-09
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063. How to assess and treat posterior hip and gluteal pain with Benoy Mathew

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

Download and subscribe to the podcast on iTunes Download your free podcast handout on how to assess and treat posterior hip pain Physio Edge podcast 053 Hip and groin pain part 1 - diagnosis, pathology and red flags with Benoy Mathew Physio Edge 054 Hip and groin part 2 - assessment and treatment with Benoy Mathew Download the free podcast handout for Physio Edge 054 Hip & Groin pain Part 2 Webinar on groin pain rehabilitation with Benoy Benoy Mathew on Twitter Benoy Mathew's website and courses 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:

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 Grimaldi & Fearon (2015)- Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Management, JOSPT. Open Access Link Hernando et al (2016)- Evaluation and management of ischio-femoral impingement: a pathophysiologc, radiolgic and therapeutic approach to a complex diagnosis, Skeletal Radiol Martin et al (2016)- Deep Gluteal Syndrome, JHPS, Open Access Link 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 Michel et al (2013)- Piriformis muscle syndrome: Diagnostic criteria and treatment of a mono centricseries of 250 patients, Annals of Physical and Rehabilitation Medicine The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist Physical Examination of the Hip by Dr. Hal D. Martin
2017-05-31
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062. How to treat plantar fasciopathy in runners with Tom Goom

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 Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live

 

Related posts

Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom

 

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.

2017-05-25
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061. How to assess & diagnose plantar fasciopathy in runners with Tom Goom

Assessment and diagnosis is vital in planning your plantar fasciopathy treatment program, and successfully returning your patients to activity and running. Structures in the vicinity of the plantar fascia insertion may contribute to plantar heel pain, but require a very different treatment approach. How can you identify other structures that are involved? What questions do you need to ask in the history? How can you perform an examination, and what tests should you perform on patients with plantar fasciopathy?

In episode 61 of the Physio Edge podcast, Tom Goom and David Pope help you discover exactly how you can assess and differentially diagnose plantar fasciopathy.

You will discover:

Plantar fasciopathy clinical presentation How to identify fat pad irritation Patterns of calcaneal and navicular bony stress injuries How you can identify nerve entrapment and radiculopathy Red flags such as spondyloarthropathy Questions to ask in your subjective that will guide your diagnosis and treatment How to perform an objective assessment Tests you need to perform Identifying impairments to address during rehabilitation When you should perform a running assessment

Download Physio Edge podcast episode 61 now to find out all of this and more

This podcast follows on from Physio Edge 060 Plantar fasciopathy in runners with Tom Goom

Links of Interest

Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar "How to treat persistent pain, and use the latest pain education strategies in your treatment" with Mike Stewart Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy

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. Riel H, et al Is ?plantar heel pain? a more appropriate term than ?plantar fasciitis?? Time to move on
2017-05-17
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060. Plantar fasciopathy in runners with Tom Goom

Plantar fasciopathy is one of the most common causes of foot pain in runners and non-athletes alike. Our understanding of plantar fasciopathy (PF) pathology and treatment has progressed significantly over recent years. In episode 60 of the Physio Edge podcast, Tom Goom and David Pope explore PF, what we know about it, and how you can explain the condition, treatment and recovery process to your patients.

You will discover:

What we know about plantar fasciopathy What pathology is present What information imaging provides Which forms of imaging are the most useful What are the risk factors for developing PF Which aspects of running may be related or contribute to developing PF? How can you explain PF the condition, treatment and recovery process to your patients

Download this podcast now to find out all of this and more

Links of Interest

Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy

 

Enrol on the free webinar ?How to perform a running assessment? with Dr Rich Willy

 

Research associated with this episode

Sullivan et al. 2015. Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain Nielsen et al. 2013. Predictors of Running-Related Injuries Among 930 Novice Runners van Leeuwen, et al. 2015. Higher body mass index is associated with plantar fasciopathy/?plantar fasciitis?: systematic review and meta-analysis of various clinical and imaging risk factors Riel H, et al Is ?plantar heel pain? a more appropriate term than ?plantar fasciitis?? Time to move on
2017-05-09
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059. Running Injuries - What are the most important factors? A group discussion with Tom Goom, Greg Lehman & Dr Christian Barton

How can you identify the most important factors involved in your patients running injuries? During your rehabilitation of runners, which is most important to address - load, gait pattern, strength, foot strike, pelvic position, footwear, range of movement or other factors?

I wanted to discuss and debate these issues with a number of Physiotherapists that treat and research running injuries, so I have a very different format for you on this episode of the Physio Edge podcast - a group podcast.

On this podcast, we have Tom Goom, Greg Lehman and Dr Christian Barton all in one virtual room discussing and debating the merits of the various approaches to running injuries.

In this episode of the Physio Edge podcast David Pope and the group discuss:

When is it ok for your runners to continue running, and when do they need to stop Common myths around running retraining When is it important to change your patients foot strike? Which patient presentations and pathologies will be assisted with running retraining? How can you identify a suitable running load during rehab How can you incorporate running retraining into your rehab Which areas are important to running assessment How can you manage training load strength and conditioning When are plyometrics appropriate during rehabilitation Other factors that impact injury prognosis and duration What advice can you give new runners Which footwear should runners wear?

Download this podcast now to find out all of this and more

Links of Interest

Download and subscribe to the podcast on iTunes Download your free podcast handout on running injuries Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership

 

Tom Goom - Running Physio website - Tom on Twitter - Tom Goom's website & courses - Tom on Facebook Live

Greg Lehman - Greg Lehman's website - Twitter - Facebook

Dr Christian Barton - Twitter - LaTrobe Sport and Exercise Medicine Research Blog

 

Enrol on the free webinar ?How to perform a running assessment? with Dr Rich Willy

 

Papers mentioned in this episode

Is there an economical running technique? A review of modifiable biomechanical factors affecting running economy

Influence of step length and landing pattern on patellofemoral joint kinetics during running

The training-injury prevention paradox: should athletes be training smarter and harder?

Optimizing strength training for running and cycling endurance performance: A review

A negative life event impairs psychosocial stress, recovery and running economy of runner

Running shoes and running injuries: mythbusting and a proposal for two new paradigms: preferred movement path and comfort filter

The effectiveness of exercise interventions to prevent sports injuries: a syatematic review and meta-analysis of randomized controlled trials

Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period

Frontal plane kinematics of the hip during running: Are they related to hip anatomy and strength?

High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self structured running program: a 1 year observational study

2017-05-06
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