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Return to Play – BJSM Virtual Conference

15 Jul, 16 | by BJSM

A monthly round-up of podcasts and articles

By Zach Spargo (@ZachSpargo) & Steffan Griffin (@lifestylemedic)

Can’t keep up with what the latest research on return-to-play is saying? Need direction on where to find all the up-to-date literature and podcasts? This is your place! We’ve put together the greatest and latest RTP work from BJSM into this Virtual Conference to create ease of access – you can read or listen to all material via clicking the links or downloading the BJSM app.

So if you’re on your summer holidays at the moment (or wishing you were!) then get stuck into all your RTP goodness here!

  1. 2016 Consensus statement on Return to Sport

http://bjsm.bmj.com/co

First up – This is the big one. Brand new consensus statement on return to play or ‘return to sport’ (RTS) as is used in the paper. It contains discussion on the definition of RTS and proposes a framework that incorporates the StARRT 3 step model (http://bjsm.bmj.com) and the Biopsychosocial model with appropriate load management. Great stride forward for return to play!

RTP infographic

  1. Criteria based return to play. Psychological readiness. How? Whose call? With Clare Ardern

https://soundcloud.com/bmj

This podcast is a close sibling of the consensus statement above! Clare Ardern explains and answers questions in regard to how fear and anxiety can affect return to play and how we as clinicians can become desensitised to the psychological stresses on an athlete post injury. There is a specific ACL example used to illustrate how we can examine a player’s psychological readiness.

  1. To risk, or not to risk: the return to play dilemma, with Roald Bahr

https://soundcloud.com/bmjpodcasts/

Where is the traditional RTP model letting athletes down? How can we be more holistic in our approach? Prof Roald Bahr explains by focusing on physical deficits and the danger of not customising your rehab to individual sport/position requirements. Finally the discussion dives into why sport and health are sometimes opposing entities. Not to be missed!

  1. “I can’t return to play” – When fear of re-injury dominates after ACL reconstruction, with Adam Gledhill

https://soundcloud.com/bmjpodcasts/

Now let’s get sport specific. Adam Gledhill brings his knowledge of sport psychology (particularly among top female football players) to the forefront in discussing the ACL injury example of ‘Joanna’. We hear about specific tools that address psychological readiness and their application and success in real life! Best results achieved with combined reading of this paper bjsm.bmj.com/content.

  1. MRI findings and return to play in football: Hamstring injuries

http://bjsm.bmj.com

Big paper here. Prospective analysis of 255 hamstring injuries within elite football was completed by Jan Ekstrand et al. (2016). Some interesting findings! Combine with this podcast if possible! https://soundcloud.com/bmjpodcasts

  1. ACL injuries in men’s professional football: a 15 year prospective study

http://bjsm.bmj.com/

Another ACL source here. This time it’s the work of Markus Walden et al. 2016 with their paper on return to play rates after ACL injury. This is currently a very popular paper and shows the startling finding that only 65% of players still play top level football 3 years post rupture. Vital information here.

  1. The brain and mind in chronic pain, with Lorimer Moseley

https://soundcloud.com/

And finally we’ll tie up all the above with some pain science from the master – Lorimer Moseley. It’s a BJSM classic. As discussed in all of the RTP work in this virtual conference, one cannot underestimate the factor of psychological readiness. You’ll hear how Lorimer proposes clinicians working in sport can use pain science to further inform their athletes.

So that’s it. Another virtual conference with all the ingredients to make a RTP soufflé. As always, let us know your thoughts via our various social media channels – Twitter (@BJSM_BMJ), Facebook (BJSM) and Google + (https://plus.google.com/u/0/com). We value and appreciate Feedback!

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Zachary Spargo (@ZachSpargo) MSc Physiotherapist working within NHS Betsi Cadwaladr, BSc (Hons) Sport and Exercise Science. BJSM Editorial Team and ACPSEM member.

Injury Prevention Virtual Conference: Summary of papers and podcasts that address key issues and debates

2 Mar, 16 | by BJSM

A monthly round-up of podcasts and articles

By Zach Spargo (@ZachSpargo) & Steffan Griffin (@lifestylemedic)

Welcome back to another BJSM Virtual Conference. This month’s edition hones in on the holy grail of SEM – injury prevention. As usual, our aim is to provide you with the most recent and very best of BJSM content all in one easy to access location. There has been some huge papers/podcasts in this area recently so here, we’ll help you find what matters.

The training-injury prevention paradox

virtual podcast injury prevention

PODCAST: Heavy Training vs injury risk – Tim Gabbett http://bit.ly/1WR1acD

We start with a brilliant podcast with load management expert Tim Gabbett. Tim talks about how physiotherapists and S&C coaches can work together to create a more resilient athlete. A main focus of Tim’s is regarding the relationship between quantity of load and injury risk. He proposes that load needs to be increased slowly so that the ratio between acute load (last week of training) and chronic load (last 4-6 weeks of training) remains similar.

PAPERS: Has the athlete trained enough to return to play? http://bit.ly/1WR0Me8

Train smarter and harder http://bit.ly/1WR0DHM

Following on from above, these two papers need no introduction. Two game changers here from Tim Gabbett and Peter Blanch. They will change how you manage a player’s load!

Sport Specific

PODCAST: Keeping runners running http://bit.ly/1P4OC18

Wondering what a running assessment might consist of? Need ideas for how you might prevent running injuries? Andy Cornelius a previous sport rehabilitator and head running coach at Premiership Football clubs, gives offers suggestions in this area, and identifies what makes a great runner like Mo Farah.

PODCAST: Preventing catastrophic injury at the rugby world cup http://bit.ly/1oOWeum

Now we head to the world of rugby – with Dr James Brown and Dr Sharief Hendricks from the University of Cape Town. We hear of recent advances in rugby such as doctors being given real time video access to assess potential injuries. This podcast also illustrates how players should be exposed to tackling without pads in training in order to reduce injuries related to contact in matches.

Muscle Injuries

PAPER: Hamstrings – Prevention better than a cure? http://bit.ly/1oOUy3W

Peter Brukner gives his expert analysis of all things new in hamstring literature. In short the paper highlights a hamstring lengthening exercise programme with definite inclusion of Nordics!

Hamstring injury prevention – a 10-minute update http://bit.ly/1oOTZXV

This podcast addresses questions related to (i) the inclusion of lengthening exercises, trunk stabilisation, Nordic curls or PRP injections, and (ii) a comprehensive, evidence-based update on hamstring injury prevention.

So there you have it! We hope you find these resources valuable. It’s a massive topic and of course prevention has many associated factors such as sleep quality and previous injury. These resources will hopefully be a great starting point! We really love to hear your thoughts/questions at BJSM and you can do this on Google+ SEM community, Facebook and Twitter. We are always open to suggestions. See you next time!

Zachary Spargo MSc Physiotherapy student at York St John University, BSc (Hons) Sport and Exercise Science (@ZachSpargo). BJSM team member, Yorkshire and Humber CSP Communications Lead. ACPSEM student member.

Muscle Injury Virtual Conference: Summary of papers and podcasts that address key issues and debates

5 Feb, 16 | by BJSM

A monthly round-up of podcasts and articles

By Steffan Griffin (@lifestylemedic) &

Dr Markus Laupheimer (@swisssportscare)

Welcome to the first virtual conference of 2016, where we focus on an important yet polarising topic for all SEM practitioners– muscle injuries. There is a lot of discussion as to the best muscle injury classification to guide diagnosis and treatment. Below is a collection of BJSM papers and podcasts so you can decide which one you think is most useful!


muscle injuryAn Overview of muscle injury classification systems
http://bit.ly/23BCPwH

This paper provides a great overview and a good insight into the development of muscle injury classification systems. It also provides a framework from which to understand the historical progression of the classification and grading of muscle injuries and delve into the strengths and weaknesses of various systems.

Munich Consensus Statement

Inconsistent terminology among SEM practitioners led to the formulation of the Munich muscle injuries consensus statement, where some of the biggest names in sports medicine gathered to define and establish practical and systematic terms. In addition, a new comprehensive classification system was developed, which differentiates between four types… but you’ll have to read/listen to find out more!

PODCAST: The Munich muscle classification – Using it for more accurate diagnosis and treatment http://bit.ly/23BCrhT

Dr Peter Ueblacker is an internationally renowned orthopaedic surgeon and sports medicine doctor who had a long and very successful career with Bayern Munich from 2009 – 2015. He gives us an overview of the development of the Munich classification and how it is used in practice, with a particular focus on the spine.

PODCAST: Managing muscle injuries – Does the Munich Consensus Statement help? http://bit.ly/1Vz0qZ9

Grading of muscle injuries should have a big influence on time to return to sport but it’s not so easy! Babette Pluim asks Prof Gino Kerkhoffs how the Munich Consensus Statement of terminology and classification of muscle injuries in sport was developed. And what are the practical implications for clinicians?

PAPER: Terminology and classification of muscle injuries in sport – The Munich consensus statement http://bit.ly/23BDKxl #OpenAccess

Not convinced it works in practice? Ekstrand, Askling and others applied the classification to thigh muscle injuries in elite football and documented the results… http://bit.ly/23BDZbC

British Athletics Muscle Injury Classification

The British Athletics model, constructed by Noel Pollock and others, argue that commonly used muscle injury grading systems lack diagnostic accuracy and provide limited prognostic information to the clinician. Whilst there is recent evidence regarding the prognostic features of muscle injuries, this evidence has not often been incorporated into the grading proposals. The British Athletics Muscle Injury Classification proposes a new system, based on the available evidence, which they hope will provide a sound diagnostic base for therapeutic decision-making and prognostication.

PODCAST: Managing muscle injuries better – tips from Dr Noel Pollock http://bit.ly/23BCyd9

Dr Noel Pollock explains to Dr Markus Laupheimer how and why the Classification developed, as well as why the (older) Munich classification was not ideal. Listen for tips on how this classification adds something special and is of practical value for treating your athletes with muscle injuries.

PAPER: British athletics muscle injury classification: a new grading system http://bit.ly/1Vz0Y13

Again, the authors also put the system to the test in hamstring injuries, and found that time to return to full training is delayed and recurrence rate is higher in intratendinous (‘c’) acute hamstring injury – one of the grades that form the British Athletics classification system http://bit.ly/1Vz1ood

We hope you have found these articles and podcasts useful. If you have any thoughts on the issue, why not let us know on twitter (@BJSM_BMJ) or on Google+, we may even be able to set-up a forum with some of the experts.

A Festive Virtual Conference – Nutrition

22 Dec, 15 | by BJSM

A monthly round-up of podcasts and articles 

By Steffan Griffin (@lifestylemedic)

seasons-eatings-baconIn the final virtual conference of 2015, the topic is one that is probably most relevant at this time of year – nutrition! Whilst no one should feel guilty about using the time to rest and relax with friends and family, the majority of the population will at some stage want to shed some of the Christmas pounds, and may ask you for advice…

To make it easier for you, we thought we’d collect the most popular nutritional podcasts & papers on the BJSM site – we hope you find them useful (if not interestingly controversial!). Don’t forget to check out our last virtual conference on running, which may come in handy when advising people with well-meaning new-year resolutions!

High-fat for health http://bit.ly/1PcNdDe

A great chat between two legends – Tim Noakes and Peter Brukner. Noakes talks about his views on carbohydrates, and how his experience of a very low carb diet has changed the way he views the decades old advice of low-fat intake – particularly when it comes to treatment of patients with type-2 diabetes and cardiovascular disease. They discuss this diet in the specific setting of sport – long distance and football codes #LCHF

You can’t outrun a bad diet http://bit.ly/1bW7Cxi

This is not only one of the BJSM’s most popular podcasts (and editorial), it made headlines around the world and started an international conversation on whether the science supports the notion of energy balance. Karim Khan puts Aseem Malhotra under the spotlight here, and it makes for fantastic listening! You can also listen to Aseem talk on the role of diet in cardiovascular disease, in yet another hard-hitting podcast http://bit.ly/1JwVX2U

The science behind low carb diets for athletes: A rational approach http://bit.ly/1PcNTZj

Is a high-carb diet a requirement for optimal endurance performance? What if that failed to take into account the physiological changes that occur with adaptation to low carbohydrate diets? Stephen Phinney delves into 30 years of research around low-carb ketogenic diets, covering potential benefits in sporting contexts, common criticisms, and future research in the field

The impact of diet on obesity and type 2 diabetes mellitus http://bit.ly/1H3EwtH

We know the guidelines and what the science shows, but does it work in practice? Jason Fung explains the evidence behind the impact of diet on obesity and Type 2 Diabetes Mellitus (T2DM). We also hear how the calories in/calories out model that has previously been described is incorrect, and how T2DM should not be considered a chronic progressive diseases, due to its preventability and reversibility. A thought-provoking concept!

Fit vs Fat….http://bit.ly/1BbJYUA

For an overview of where diet fits into the overall notion of ‘health’, we spoke to Steven Blair, whose research was instrumental in helping physical inactivity gain recognition as a global public health issue. He discusses the wealth of evidence he’s built up on the benefits of exercise, why physical inactivity is a bigger problem than obesity, and how much and of what we should all be doing. A must-listen!

——

So there we go! We hope you find these resources, which feature some of the most prominent names in the field extremely useful. Please do let the BJSM know your thoughts/questions on twitter, Facebook and in the Google+ SEM community, we are always open to suggestions for new topics! That just leaves us to wish you a lovely festive period and best wishes for 2016, see you in the New Year!

Running Virtual Conference: all the hot topics and resource links in one blog!

7 Nov, 15 | by BJSM

A monthly round-up of podcasts and articles 

By Steffan Griffin (@lifestylemedic)

LONDON, UNITED KINGDOM - APRIL 26:  A runner dressed in a naked suit in the mass start during the Virgin Money London Marathon on April 26, 2015 in London, England. (Photo by Stephen Pond/Getty Images)

LONDON, UNITED KINGDOM – APRIL 26: A runner dressed in a naked suit in the mass start during the Virgin Money London Marathon on April 26, 2015 in London, England. (Photo by Stephen Pond/Getty Images)

In the penultimate virtual conference of 2015, the topic is one that becomes increasingly relevant at the turn of the year, likely featuring on a lot of people’s New Year’s resolutions – running. In the same format as its predecessors on the hamstring, shoulder, and tendons (among others) – here’s a list of BJSM resources so you’re clued up to treat any runners that come limping your way!

Running Injuries – an overview http://bit.ly/1P4Of6J

Don’t know where to start? This may be the best place, an overview of running injuries with Andy Franklyn-Miller, with secrets from 15 years of experience in treating runners and running injuries.

Running shoes and running injuries: mythbusting and a proposal for two new paradigms http://bit.ly/1KQZeJt 

A recent and hugely popular paper – mainly concerning whether or not running shoes (or sport shoes in general) influence the frequency of running injuries at all. Contains two new paradigms which are likely to stick around for the considerable future. A must read!

Biomechanical overload and lower limb injuries http://bit.ly/1KQZzeU

Sticking with one of the BJSM’s most popular podcast guests (Andy Franklyn-Miller), this podcast delves into the issue of chronic exertional compartment syndrome and the potential role of running re-education in managing the pathology. The podcast also touches on the historically hot topic of barefoot running.

Barefoot running: an evaluation of current hypothesis, future research and clinical applications http://bit.ly/1KQZLuN

The podcast leads nicely on to this fantastic review by the great team in Cape Town, looking into the factors driving the prescription of barefoot running, whilst also examining which of these factors may have merit, what the collected evidence suggests about the suitability of barefoot running for its purported uses and describe the necessary future research to confirm or refute the barefoot running hypotheses.

Keeping runners running – the secrets of running assessment and advice http://bit.ly/1P4OC18

Following on from Andy Franklyn-Miller’s podcast, this discussion with Andy Cornelius asks if we can assess running patients and guide them to improve their technique. Might gait education prove more effective than medication to treat symptoms?

Overuse injuries – what to consider http://bit.ly/1P4OG0S

Moving on slightly to an issue that most serious runners have to deal with at some stage – burnout. Although not quite specific to running, there are still some good nuggets to take home from this.

Patellofemoral pain – a masterclass http://bit.ly/1P4OHln

Likewise, not strictly unique to running is the issue of patellofemoral pain – but this chat with the world-renowned Kay Crossley is 100% worth a listen on the way to work – covering the best PFP treatments and evidence for them as well as new insights into knee pain after ACL reconstruction.

The foot core system: a new paradigm for understanding intrinsic foot muscle function http://bmj.co/1K3vbUB

The final resource on the list is another game-changing paper proposing a new paradigm, shifting the goalposts in regard to how we regard the intrinsic muscles of the foot. The authors draw the parallels between the small muscles of the trunk region that make up the lumbopelvic core and the intrinsic foot muscles, introducing the concept of the ‘foot core’, before then integrating the concept of the foot core into the assessment and treatment of the foot.

And that’s it! Hope you enjoyed trawling through the resources from some hugely influential names – please do let the BJSM know your thoughts/questions on twitter, Facebook and the Google+ SEM community, we are always open to suggestions for improvement!

BJSM Virtual Conference – RED-S, FAT and ACL (Enough abbreviations?)

5 Oct, 15 | by BJSM

A monthly round-up of podcasts and articles 

By Steffan Griffin (@lifestylemedic)

Not only does the start of this month bring some fantastic sporting events but also another of our Virtual Conferences. This one is inspired by this fantastic recent podcast with Pippa Bennett, who addresses Relative Energy Deficiency in Sport (RED-S) and anterior cruciate ligament (ACL) injuries– both of which are the focus of this virtual conference.

woma runningRED-S/Female Athlete Triad

If you learn best through listening then your first stop has to be this podcast with Margot Mountjoy, who clarifies the IOC’s consensus statement on this condition, explaining why it is needed, what the controversies are and what clinicians can do in the clinic (amongst other things)  ow.ly/RMYRq

If you are more of a visual learner, then make the most of the IOC consensus statement mentioned in the podcast – full of fantastic graphics and key-points ow.ly/RN0II. Likewise – if you can see yourself using this in practice (although interesting even if not!), here is the link to the RED-S Clinical Assessment Tool (CAT) – also mentioned and explained clearly in the aforementioned podcast ow.ly/RN171

Some of you may be wondering where the historical ‘Female Athlete Triad’ has disappeared to, and in that case you might be pleased/confused/surprised to know that it is still an academic entity. A paper that makes for good reading is one by the #FAT camp (Female Athlete Triad to avoid controversy), which refutes the IOC consensus statement on RED-S http://bit.ly/1jIbnuz

For completion – if you want a good read that provides some deeper insight, then here is the #FAT consensus statement, one of our most popular papers of recent years ow.ly/RN0Ae

ACL Injuries

Moving onto ACLs and a recent paper that has been a huge hit in the football medicine world – using video analysis to determine which on-field football scenarios precede ACL rupture.  You can listen to Markus Walden ow.ly/RMYw5 or again view the recent paper http://ow.ly/QUezQ

Keeping with ACLs – here’s a classic podcast concerning the management and prevention of ACL injuries with Grethe Myklebust – one of the pioneers to investigate the role of exercise for ACL prevention – providing a one-stop shop for all things ACL ow.ly/RMZcX

Any injury prevention programme that can reduce the risk of ACL injury is a golden-ticket to both practitioners and athletes alike. Following the famous Norwegian ACL prevention paper in 2003 – the authors revisit ACL injury incidence in female handball 10 years after the Norwegian ACL prevention study – and demonstrate important clinical as well as research tips to consider for any sports-medicine practitioners ow.ly/RN1jj.

So there we are for another month! If you have any suggestions or would like to see another topic featured then please don’t hesitate to contact us on social media – be it twitter, facebook or Google+.

BJSM Virtual Conference – Tendons

20 Jun, 15 | by BJSM

A monthly round-up of podcasts and articles 

By Steffan Griffin (@lifestylemedic)

If you were hoping for further additions to the cluster series (previously on hamstring and shoulder injuries), fear not, here it is. We have simply changed the (now-monthly) series’ name from “cluster” to “virtual conference” to better reflect its provision of sleek and sexy resources.

Whether you fancy becoming a 24-hour expert or need to stay awake on your commute to & from work, enjoy these great contributors to BJSM podcasts and publications.

Tennis Player Preparing to Serve --- Image by © Royalty-Free/Corbis

Tennis Player preparing to serve

This month’s focus is on the key academic and clinical entity of tendons, featuring some of the world’s most respected authorities on the matter.

1. “Mechanotherapy” and why it’s important for clinicians, with Karim Khan http://bit.ly/1AkWmFB

A podcast centred on the “the most important fundamental concept that underpins rehabilitation exercises” – containing nuggets of information including why ‘rest doesn’t work’ and the evidence-base underpinning the theory. For best results, combine listening to reading the paper http://bmj.co/1Ejpiw4.

2. The continuum model of tendinopathy, with Jill Cook http://bit.ly/1GeLavw

Is tendon pathology a continuum? Prof Jill Cook explains and answers questions relating to this famous pathology model to explain the clinical presentation of load-induced tendinopathy (Accompanying paper can be found at http://bit.ly/1GeLwlL).

3.Tendons: Where does pain fit in the continuum model? with Chris Littlewood http://bit.ly/1bcAa5H

So now you’re familiar/brushed up on the tendinopathy continuum, do you have any questions about the connection between pain and pathology in tendons? Chris Littlewood, who has expertise as a clinician and researcher in the rotator cuff, asks questions of Craig Purdam and Ebonie Rio in this fantastic podcast.

4. Time to revisit inflammation in tendons, with Jon Rees http://bit.ly/1QyDhm9

So inflammation is completely out of the window, right? Although widely accepted that chronic tendinopathy is caused by a degenerative process devoid of inflammation, the evidence for non-inflammatory degenerative processes alone as the cause of tendinopathy is surprisingly weak. In this podcast, Jon Rees tells Jill Cook why the role of inflammation offers potential opportunities in treating chronic tendinopathies and should be explored further.

5. Managing tendinopathies, with Jill Cook http://bit.ly/1QyDB4p and Hakan Alfredson http://bit.ly/1orG1JL

Cook and Alfredson focus on the management aspect of tendinopathy, with practical pointers and a tip to consider the time-course of tendon injury when making treatment decisions. It fits nicely with Hakan Alfredson’s ‘treating tendinopathy’ podcast; here they discuss the clinical challenge of whether to opt for exercise treatment, new ‘biological therapies’ like platelet-rich plasma (PRP), or surgery.

 6. The pathogenesis of tendinopathy and tendon healing, with Michael Kjaer http://bit.ly/1GeO57r

This great podcast discusses seven models of tendinopathy, and the important difference between mid-tendon and insertional tendinopathy. We also hear about the healing capacity of tendons, the (absence of a) link between tendinopathy and tendon rupture, and various interventions that are used in an attempt to promote tendon healing – a real one-stop shop for those short on time!

7. The brain and mind in chronic pain, with Lorimer Moseley http://bit.ly/1GeOQ0c

A man needing no introduction, this podcast discusses the important difference between pain and nociception, with thoughts on how pain science can help clinicians working in sports medicine. You’ll hear him share the best, and worst, ways to explain pain to patients, with thoughtful reflections along with a big dob of humour and humility.

So there we go, the first official virtual conference, all for free! As always, let us know your thoughts via our various social media channels – Twitter (@BJSM_BMJ), Facebook and Google+. Feedback is appreciated and valued!

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