BJSM Podcast

Dr Juan Manual Alonso is a spanish sports physician and PhD with vast experience in track and field - six Summer Olympic Games just to start! He is the head of the IAAF (Athletics) where he had a global responsibility for antidoping (since 2003) and for guiding athlete care for all 200 countries in the Athletics Federation. He has recently begun working at Aspetar-Qatar Orthopaedic and Sports Medicine Hospital. Jurdan Mendiguchia is a spanish physiotherapist with vast experience at home and in Italian football. He has published and lectured widely on rehabilitation with a focus on hamstring injuries. His 2012 BJSM editorial “Hamstring strain injuries: Are we heading in the right direction?” has had over 5,000 downloads http://tiny.cc/rgmrww. In this podcast he and Dr Alonso introduce the listeners to a multifactorial approach to managing hamstring strain. Spanish speakers can listen to both Juan Manuel and Jurdan discussing sports medicine issues in detail in spanish here http://bit.ly/18FP3be.

El Dr Juan Manuel Alonso es un médico del deporte español con dilatada experiencia en el atletismo (¡ha estado presente en 6 juegos olímpicos!). Es el presidente de la Comisión Médica y Anti-dopaje de la IAAF donde se ocupa de la lucha antidopaje y del cuidado general de los atletas de los 200 países que integran la Federación Internacional de Atletismo. Recientemente se ha incorporado a trabajar en Catar en el Hospital Aspetar de Medicina del Deporte y Cirugía Ortopédica. Jurdan Mendiguchia es un fisioterapeuta español con amplia experiencia en el tratamiento de deportistas de élite y en especial de jugadores de fútbol profesional. Trabaja también como asesor en el área de prevención y manejo de casos clínicos difíciles de clubes de fútbol de España, Europa y Sudamérica. Ha publicado ampliamente y dado conferencias alrededor del mundo sobre su visión de la rehabilitación y prevención con especial interés en las lesiones de isquiotibiales. Su editorial en BJSM “Hamstring strain injuries: Are we heading in the right direction?” ha sido descargado más de 5000 veces. http://tiny.cc/rgmrww. En este podcast, Mendiguchia y el Dr Alonso presentan a los oyentes un enfoque multifactorial dirigido al manejo clínico de las lesiones de isquiotibiales.

Professor Jiri Dvorak discusses the major public health initiative ‘Football for Health’ which has already been adopted in 19 countries. He also introduces that 11 steps to prevent cardiac death and revisits progess on the 11+, a warmup program that reduces lower limb injuries in football. Professor Dvorak is the Chief Medical Officer for FIFA and Chairman F-MARC.

Professor David Bishop, from the Institute of Sport, Exercise, and Active Living (SEAL) at the University of Victoria in Melbourne, Australia, discusses the evidence base for altitude training to improve performance. The innovation is the role in team sports like football codes. He discusses with Karim Khan the differences between low oxygen and low barometric pressure, ways of replicating environmental effects without having to travel. Can this help your team? A top podcast for strength and conditioning coaches (S&C) and clinicians contributing to the strategy for team performance.

Terrified of Twitter? Afraid of apps? Evert Verhagen, sports scientist and academic from de Vue University Medical Centre, Amsterdam, guides us through everything sports clinicians need to know about social media and apps, and how they can aid clinical practice and health promotion. As well as being able to have references and guidance on your phone or tablet, these can help you stay bang up up to date in your field, and keep an eye on your athletes’ wellbeing. See also: Evert’s blog: Social media 101 http://bit.ly/VjNnye

Paul McCrory, neurologist and sports physician at the University of Melbourne, talks us through what to do if you think you’ve had a concussion, when you can go back to sport, and what the complications of concussion are.

If you’re worried that your child has had concussion, this podcast is for you. Paul McCrory, neurologist and sports physician at the University of Melbourne, discusses the Concussion Recognition Tool, the guide that you can use if you suspect a diagnosis of concussion. What should you do? Dr McCrory also talks us through the symptoms of concussion, and how to know when a child has recovered. You can access the Concussion Recognition Tool here http://bit.ly/11TiFxW. And the SCAT recognition tool here http://bit.ly/100CzEc

Paul McCrory, neurologist and sports medic at the University of Melbourne, gives us the new, take home messages from the latest concussion consensus statement. For a guide to all the content in the latest injury prevention and health protection issue of BJSM, where the consensus is published, listen to Dr McCrory’s earlier podcast http://bit.ly/12XvGb5. All the content from the issue can be found here http://bjsm.bmj.com/content/47/5.toc.

The latest injury prevention and health protection issue of BJSM focuses on concussion, and in this podcast Paul McCrory, neurologist and sports physician at the University of Melbourne, gives us an overview of what’s included, so you can target the content which you find most helpful. Dr McCrory takes us through the consensus statement on concussion in sport published in the issue, as well as the 12 review papers which inform it. All the content from the issue can be found here bjsm.bmj.com/content/47/5.toc.

As we hit marathon season, Peter Brukner, BJSM senior associate editor, discusses the controversy around hydration for athletes with Tim Noakes, professor of exercise and sports science at the University of Cape Town and author of ‘Waterlogged: The Serious Problem of Overhydration in Endurance Sports’. Professor Noakes explains who is at risk of hyponatremia, and how to spot and treat the condition. He lays out the advice sports physicians should be giving athletes. He also describes how commercial messages led to athletes thinking they need to drink more than they should. See also: Waterlogged: The Serious Problem of Overhydration in Endurance Sports http://bit.ly/12avAeV Case proven: exercise associated hyponatraemia is due to overdrinking. So why did it take 20 years before the original evidence was accepted? http://bit.ly/17UF9SM The truth about sports drinks http://bit.ly/NB379z

To provide additional insights to the April Injury Prevention Health Promotion (IPHP) issue of BJSM [http://bit.ly/YKvsQ5], Professor Meeuwisse takes you behind the scenes. What are the new elements for concussion management, why do some parents insist on unsafe practices for their children, how can you make sure you are up to date in your clinical practice? Professor Meeuwisse is from the University of Calgary and leader of the Brain Injury Initiative of the Hotchikiss Brain Institute. As well as being co-chair of the 4th International Consensus Conference on Concussion in Sport, he is co-chair of the University of Calgary Sport Injury Prevention Research Centre. Enjoy and send any questions you have to us via email ([email protected]) or via Twitter (@BJSM_BMJ).

With Professor Roald Bahr, chairman of the Scientific Committee and member of the IOC Medical Commission. Are you planning your conference contribution or attendance for 2014? Those who attended the first 3 World Conferences on Injury & Illness Prevention in Sport are keen to make Monaco a destination in April 10-12, 2014. In this podcast, Professor Roald highlights the unique contribution of these triennial meetings, and reminds you of upcoming opportunities to contribute by proposing a workshop or submitting an abstract.

Lateral epicondylalgia, often referred to by patients as tennis elbow, has a range of treatment options available to the clinician. A group at the University of Queensland, Australia, headed by Bill Vicenzino have been investigating short and long term outcomes of different treatment modalities. Last month, they published an RCT in JAMA examining the effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia. Professor Jill Cook asks the hard question - is it time to drop corticosteroid injection from the treatment options for tennis elbow?

Malcolm Collins is professor of human biology at the University of Cape Town and a chief specialist scientist at the South African Medical Research Council. He is one of the leading researchers at the Exercise Science and Sports Medicine Research Unit, which is located at the Sports Science Institute of South Africa, a multidisciplinary institution committed to promoting sporting excellence and the health of Africans. This podcast complements BJSM’s recent chat with Professor Tim Caulfield [http://bit.ly/10xfp8w], but focuses more on sports injuries and talent identification in sport. Professor Collins, who discovered the first gene variants associated with chronic tendinopathies, explains the implications for clinical care and screening. He also has discovered some genetic variant relationships with ACL injuries and we discuss what that means for players, parents and coaches. We discuss the topic of ‘What makes champions’, a highly downloaded paper from BJSM’s 2012 archive. Finally, we return to the big question in the field - should you send your DNA to a lab to discover either (i) what sports you may excel in, or (ii) whether you are at risk for, or protected against, certain injuries? Prof Collins is not afraid to give clear suggestions and comments so enjoy this podcast with a preeminent sports genetics authority.

In questo podcast Cristiano Eirale, specialista dello sport in Aspetar, Qatar Orthopedic and Sport Medicine Center e medico della Nazionale del Qatar, intervista Stefano Della Villa, Presidente dell’Isokinetic Medical Group, su passato, presente e futuro della medicina dello sport in Italia.

As part of the series of podcasts highlighting the best of sports medicine the world over, Dr Stefano Della Villa shares a very successful model of sports medicine clinical care in Italy; Cristiano Eirale comments on his experiences in Italy and for the last 6 years in Qatar. Both sports physicians have tremendous football experience but a focus of the podcast is delivery of clinical care - the patient journey in setting a multidisciplinary clinical setting. Dr Della Villa highlights the ‘case manager’ role of the sports physician and this model has been critical in the Isokinetic clinics in Italy. The Isokinetic Medical Group, established in 1987, is a FIFA Medical Centre of Excellence. The headquarters and the very substantial Education and Research Department, directed by Professor Giulio Sergio Roi, are located in Bologna, with other outpatient clinics located in Rome, Milan, Turin, Verona and Rimini. The group has now expanded to Harley Street in London. Dr Eirale was the first sports physician recruited to Aspetar - Qatar Orthopaedic and Sports Medicine Hospital and he has witnessed not just the building of a massive state-of-the art hospital but the emergence of a new focus of sports medicine excellence in the Gulf Region. Those of you who appreciate the Italian language will enjoy Dr Della Villa being interviewed by Dr Eirale about other topics in the first Italian language podcast in the BMJ Grouphttp://bit.ly/15T7NCK.

This short podcast is directed to patients - specifically active sportspeople who have recently rupture an anterior cruciate ligament (ACL). Associate Professor Richard Frobell is the lead of the team that has addressed a key question with the most rigorous research study to date. Is there any benefit to immediate knee reconstruction? Will waiting for a knee reconstruction lead to more injury or arthritis? See also: Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial bit.ly/Yqr25b A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears bit.ly/cgTUfO Renström PA. Eight clinical conundrums relating to anterior cruciate ligament (ACL) injury in sport: recent evidence and a personal reflection. Br J Sports Med. 2012 Aug 31 1.usa.gov/14M4mzO G Myklebust, R Bahr, Return to play guidelines after anterior cruciate ligament surgery bit.ly/ZK5pZk

In this second of two podcasts for clinicians, associate professor Richard Frobell discusses how his 2010 RCT was received by some members of the clinical community and how he addressed those concerns. His new paper sheds further light on the issues that generated debate. See also: Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial bit.ly/Yqr25b A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears bit.ly/cgTUfO Renström PA. Eight clinical conundrums relating to anterior cruciate ligament (ACL) injury in sport: recent evidence and a personal reflection. Br J Sports Med. 2012 Aug 31 1.usa.gov/14M4mzO G Myklebust, R Bahr, Return to play guidelines after anterior cruciate ligament surgery bit.ly/ZK5pZk

Dr Richard Frobell is an associate professor in the Department of Orthopaedics at Lund University in Southern Sweden. His background is in physiotherapy but he’s worked as a specialist in clinical diagnosis for over a decade in a dedicated knee service program. In this podcast he discusses his recent BMJ paper, which is a follow up to the NEJM on ACL injury treatment. See also: Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial bit.ly/Yqr25b A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears bit.ly/cgTUfO Renström PA. Eight clinical conundrums relating to anterior cruciate ligament (ACL) injury in sport: recent evidence and a personal reflection. Br J Sports Med. 2012 Aug 31 1.usa.gov/14M4mzO G Myklebust, R Bahr, Return to play guidelines after anterior cruciate ligament surgery bit.ly/ZK5pZk

Harm Kuipers, emeritus professor of the University of Maastricht, talks to Babette Pluim, BJSM deputy editor, about the meaning of sport, the challenges of being an editor, and his most exciting scientific research projects. These are overtraining, delayed onset muscle soreness and glycogen restoration during exercise. Harm recently wrote his autobiography “Starting on two left skates”. He is a former elite athlete and became world all-round speed skating champion in 1975. See also: Pre-exercise ingestion of carbohydrate and transient hypoglycemia during exercise bit.ly/ZK4Te3 Structural muscle damage and muscle strength after incremental number of isometric and forced lengthening contractions bit.ly/17UCjx6 Adaptation and overtraining in horses subjected to increasing training loads bit.ly/11AxqnY Carbohydrate feeding and glycogen synthesis during exercise in man bit.ly/13seQzR

‘Personalized medicine’ has been touted as a major health opportunity. How likely is the promise to be realised? Tim Caulfield hit the global headlines in February 2011 when he was one of the first to argue that human genome had not delivered in the way that some had claimed it would. His Science paper echoed around in the world and was picked up by major news sources like the NY Times, Al Jazeera and the BJSM Blog http://bit.ly/11Ax6pn. Professor Caulfield is a terrific health communicator - a champion of ‘knowledge translation’ aka ‘knowledge exchange’ among other things. The concept of turning research into action. In this podcast he gives BJSM listeners insights into how genomic discoveries may or may not influence personal and public health. He even underwent personal genomic screening in the interests of science! This podcast is relevant to one of BJSM’s most popular papers - ‘What makes champions’ by geneticist Professor Malcolm Collins and physiologist Dr Ross Tucker http://bit.ly/10bIshB. In upcoming weeks we’ll drill deeper into injury risk and genetic predisposition with Professor Malcolm Collins. You can keep an eye on new BJSM podcast releases on our home page (www.bsjm.bmj.com) and via Twitter (@BJSM_BMJ)

Dr Rogerio Teixeira da Silva, from the Sao Luiz Hospital in Sao Paulo, Brazil, former President of the Brazilian Orthopaedic Sports Medicine Society, has a great interest in sports medicine, specifically upper extremity injuries in tennis players. He talks about his experiences with Gustavo Kuerten and what the athlete has meant for tennis in Brazil, the medical care of junior tennis players, hip range of motion, scapular dyskinesia and humeral stress reactions. He also previews the 13th STMS World Congress on Tennis Medicine and Science - Buenos Aires, 21-23 February 2013. See also: Stress reaction of the humerus in tennis players bit.ly/13UYSCh Clinical and ultrasonographic correlation between scapular dyskinesia and subacromial space measurement among junior elite tennis players bit.ly/11h9SUK Sacral stress fracture: an unusual cause of low back pain in an amateur tennis player bit.ly/ZlB2wQ Shoulder strength profile in elite junior tennis players: horizontal adduction and abduction isokinetic evaluation bit.ly/10widsD

In this podcast we look at what sports and exercise medicine around the world can learn from Australia, just one of the countries where the area is thriving. Scott Gardner is an Australian sports scientist currently working in the UK, recently with British Cycling, and he describes what’s going on at the Australian Institute of Sport, and why he thinks they’re so good at training clinicians (0.45). Sports medicine in football is where John Orchard, associate professor at the University of Sydney and sports physician for Australian cricket and the Sydney Roosters, thinks the country is getting it right. He argues that politics in the English Premier League can prevent clinicians from doing their job properly, whereas those working in Australia face a much more open culture (5.24). And Peter Brukner, previously head of Sports Medicine & Sports Science at Liverpool FC and media commentator, talks about how the media and public down under are very interested in, and hence knowledgeable about, sports injuries, and how this has a positive impact for clinicians. He also gives us a round up of what other countries are doing particularly well in sports and exercise medicine (13.11). Future BJSM podcasts will put other nations under the spotlight; Phil Glasgow will share Team GB’s Olympic success story in the next installment in this series. Drs Gardner, Orchard and Brukner spoke about sports and exercise medicine in Australia at a meeting organised by the Sporting Health Group, where Harriet Vickers (BMJ’s assistant multimedia editor) recorded this podcast. See also: Who is to blame for all the football inuries? http://bit.ly/NOJQF5 On the value of team medical staff: can the “Moneyball” approach be applied to injuries in professional football? http://bit.ly/10aYJSY

Professor Kim Harmon from the University of Washington, former President of AMSSM, has a strong clinical record in managing concussion on sideline in football. She led the AMSSM’s consensus document on concussion and here she guides you as to how to interpret current concussion ‘guidelines’ into best practice for your players on game day. She also previews AMSSM’s Annual Meeting - San Diego, April 2012.

Jill Cook is BJSM’s deputy editor with particular emphasis on physiotherapy. She is a professor at Monash University, Frankston, Australia, and a renowned international tendon authority. In this podcast she answers questions she is commonly asked about the ‘continuum model’ of tendinopathy that she and Craig Purdam (Australian Institute of Sport) proposed. See also: Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy bit.ly/YKmKkM Is compressive load a factor in the development of tendinopathy? bit.ly/XTvZlk Jeremy Lewis’s podcast on rotator cuff tendinopathies bit.ly/Nhll0U Jill’s previous podcast on managing tendinopathies bit.ly/15DM8Qp

GlobalPANet is the world’s first dedicated global physical activity communication network. GlobalPANet rapidly communicates the latest research around the globe via its unique e-News and website. GlobalPANet informs about recent physical activity developments, careers and events, as well as being linked to a global network of those with professional and personal interests in physical activity. It is brought to you by the International Society of Physical Activity and Health (ISPAH). Listen to Trevor explain this benefit or see the website. Feel free to submit content for the GlobalPANet site to Trevor via [email protected].

Every physical activity advocate dreams that physical activity will one day have the same ‘brand equity’ as popular products like Apple. Many folks know of successful media campaigns for physical activity promotion in various countries. There is a science behind this, and getting it right can save hundreds of thousands of dollars in failed campaigns. Dr Trevor Shilton, National Heart Foundation, Perth, Australia, is an international expert on promoting physical activity using various forms of media. He shares these secrets with BJSM editor Karim Khan. Think of it as Mad Men (marketing) meets Dragon’s Den (persuasion - selling a product!). See also: Fiona Bull’s podcast on the 7 investments http://bit.ly/R0asX0 Related paper on 7 investments http://bit.ly/OY9t7o Social marketing: why injury prevention needs to adopt this behaviour change approach http://bit.ly/ZK3m7G

Fiona Bull, professor at the School of Population Health, University of Western Australia, talks Karim Khan through the investments the Global Advocacy for Physical Activity has identified as key for getting more people active. These include public awareness, urban planning, sports programmes, and promoting activity in primary care and schools. See also: NON COMMUNICABLE DISEASE PREVENTION: Investments that Work for Physical Activity http://bit.ly/hcWRMN

Matthew Wilson, who runs the Sports Cardiology Research Programme at Aspetar Sports Medicine Centre, Qatar, talks Karim Khan through key issues, and the latest research, in sports cardiology. 0.46 Five clinical questions in pre participation screening 3.44 Should ECGs be mandatory? 4.56 Who should be screened? 6.34 Risk stratification for cardiac arrest 8.52 The common electrical and ion channel issues 12.37 Key papers See also: BJSM supplement:Advances in Sports Cardiology bit.ly/RLIBWq

The focus of this podcast is health promotion and behaviour change. Joining Karim Khan, BJSM editor, and Domhnall McAuley, BMJ primary care editor, is Mike Evans, associate professor of family medicine at the University of Toronto and founder of the Health Design Lab. Dan Heath, senior fellow at Duke University’s Center for the Advancement of Social Entrepreneurship, and co-author of a book “Switch – how to change things when change is hard” also joins the panel. The Health Design Lab’s viral video 23 and 1/2 hours: What is the single best thing we can do for our health? has been watched over 2.5m times, and is freely available on youtube http://bit.ly/sHJgx6 See also: www.heathbrothers.com www.myfavouritemedicine.com This podcast is a BMJ production, previously published here http://bit.ly/InCkgD

Karim Khan, BJSM editor, crosses the table to be quizzed on the evidence behind exercise. He briefly reviews Steven Blair’s findings about exercise and mortality, and answers the ubiquitious question “how much should I actually be doing?” He also highlights a new report on next steps - how we can move from ‘exercise is medicine’ to actually implementing physical activity across community sectors. 0.26 - Summary of the evidence for exercise and health 4.00 - Dose 10.26 - Public health uptake of exercise

Liam West, a medical student at University Hospital of Wales in Cardiff and passionate student of sport & exercise medicine, talks to Karim Khan about the barriers to developing a career path in sports and exercise medicine. He shares a successful approach to carving out a path while also coping with the rigid obligations of medical school. Liam also coordinates a blog series for the BJSM on the undergrad’s perspective, and has helped set up a national network for undergraduate students who will be the future doctors in SEM called USEMS (Undergraduate Sports & Exercise Medicine Society). 0.49 - Getting into SEM 3.10 - Barriers to starting your career 6.00 - Overcoming the obstacles 8.15 - Undergrad SEM societies 10.41 - Take home messages See also Original article Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow’s doctors equipped to follow clinical guidelines? http://bit.ly/PARRhn Review: Investments that work for physical activity. http://bit.ly/OY9t7o This is the WHO blueprint for physical activity promotion across sectors. Undergraduate students should be aware of it and please look for ways to incorporate it into your student society information pages and the medical curriculum! Liam’s BJSM blogs http://bit.ly/XTu9B1

Phillip Newman (assistant professor of physiotherapy, University of Canberra) gives his advice on shin pain, and explains how two simple tests can predict those at higher risk of developing Medial Tibial Stress Syndrome. BJSM editor Karim Kham asks the questions. 0.33 Studying shin pain in the military population 1.51 The shin palpation test and the shin oedema test and how they’re useful 5.45 Are these tests useful in the broader population? 6.22 A quick summary of the findings 7.40 Treatment of shin pain 9.29 The use of orthotics 10.21 Professor Newman’s views on barefoot running See also: Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test http://bit.ly/17NbVCo Managing leg pain - focus on chronic exertional compartment syndrome http://bit.ly/ZMnOnr

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the three million times viewed BJSM physical examination videos [http://bit.ly/17UzOuu], gives Karim Khan an update on examination and management of leg pain. He explains why he doesn’t use the term ’shin splints’. In this podcast Dr Hutchinson covers: (i) clinical work-up of persistent leg pain (ii) investigating compartment pressure (iii) two or four compartments? (iv) tips for surgeons treating compartment syndrome (v) fasciotomy or fasciectomy? Three extremely relevant papers in BJSM include: Chronic exertional compartment syndrome testing: a minimalist approach http://bit.ly/10aWJu3 Chronic exertional compartment syndrome http://bit.ly/ZMnzIW Intracompartmental pressure testing: results of an international survey of current clinical practice, highlighting the need for standardised protocolshttp://bit.ly/17Nbvfd

Dr Robert Sallis (Exercise Is Medicine Advisory Board chairman) offers advice on how to get patients and colleagues engaged with exercise as medicine. Karim Khan (BJSM editor) asks him about his experience promoting this at Kaiser Permanente, and resources and schemes available. As Dr Sallis is a former president of the American College of Sports Medicine, they also discuss what’s coming up for the organisation. An update on Exercise Is Medicine 0.51 How to get started with Exercise Is Medicine 2.00 The Everybody Walks scheme 3.00 Getting exercise as a vital sign into consultations 4.11 Referral resources 6.23 How encorporating exercise into healthcare has worked for Kaiser Permanente 11.06 The upcoming triathlon conference in Kona 13.30 ACSM in 2013 15.57 The National Activity Plan in the US 18.49 See also: Podcast: Exercise on prescription, Mai-Lis Hellénius and Carl Johan Sundberg http://bit.ly/13USrPH Podcast: Mike Loosemore - how to prescribe exercise http://bit.ly/naC5QV

Darren Burgess, head of fitness and conditioning at Liverpool FC and former strength and conditioning coach of the Socceroos, talks to Karim Khan about his role and how he deals with the unique challenges of the premier league. They discuss the interface between the conditioning team the coach and the manager and how technology has changed the way in which players fitness needs are understood. One specific topic of interest to many will be how GPS can help guide training volumes. 1.25 - Assessing a player for fitness to play 5.26 - Words of advice for emerging sports scientists 7.21 - Resolving tensions between strength and conditioning and medical teams 11.30 - Player tracking systems 19.25 - Top 3 recovery tips

Hans Tol (BJSM senior associate editor) talks to Gino Kerkhoffs (Orthopaedic Surgery, Academic Medical Centre, Amsterdam, Netherlands) about diagnosing and treating acute ankle injuries, as his group has just published clinical guidelines on this in BJSM. 0.37 Who the guidlines are aimed at 2.11 Risk factors for ankle injuries 5.09 Is there still a place for MRI in diagnosing acute ankle injuries? 11.50 Functional treatment - tape or brace? 15.03 Should injuries where the syndesmotic ligament is involved be treated the same as lateral injuries? 16.50 Surgery 21.45 Prevention after surgical repair 24.16 The future of diagnosis and treatment 26.24 What’s the evidence for platelet rich plasma treatment? See also: Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline http://bit.ly/Qn0UTG

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the three million times viewed BJSM physical examination videos [http://bit.ly/17UykR2], gives Karim Khan an update on examination and management of shoulder injuries. In this podcast Dr Hutchinson covers (i) Common pitfalls and what to do instead (ii) How to diagnose overuse in the throwing shoulder (iii) ‘Labral tears’ vs ‘SLAP’ tears nomenclature (iv) Shoulder dislocation – when is surgery appropriate? and (v) Scaphoid fracture - has screw fixation become first line treatment? If you missed Dr Hutchinson’s knee podcast listen here http://bit.ly/O2rRe2. Another popular shoulder podcast is by Professor Jeremy Lewis on rotator cuff tendinopathy http://bit.ly/11yxbel.

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the 3 million times viewed BJSM physical examination videos [http://bit.ly/17UykR2] gives Karim Khan an update on examination and management of acute knee injuries. He shares his experience in interpreting physical signs, imaging indications, and the advantages of early sideline diagnosis. He also answers 4 key questions: (i) knee haemarthrosis - to drain or not to drain?, (ii) mensical tear - arthroscopy or wait?, (iii) is surgery always indicated after ACL tear, and (iv) first time patellar dislocation - conservative or surgical management? Please note that Professor Hutchinson’s shoulder podcast will be released next week! What this space, BJSM’s Facebook page, or our Twitter feed for updates!

Professor Lars Nordsletten, from the Olso Sports Trauma Research Centre, talks to Karim Khan, BJSM editor, questioning the role of NSAIDs and COX-2 inhibitors in sport. He discusses how mediation of inflammatory response may not be in an athlete’s best interest. He shares data on NSAIDs delaying fracture healing, and discusses which drugs are most appropriate at various points during recovery. See also: Professor Nordsletten’s biography page http://bit.ly/10aK8XL Abuse of medication during international football competition in 2010 – lesson not learned. Philippe Tscholl and colleagues. http://bit.ly/Y1smw1 Nonsteriodal anti-inflammatory drug use in sports medicine: Guidelines for practical but sensible use. Jason Paoloni and colleagues. http://bit.ly/10aV6MY

Jeremy Lewis, consultant physiotherapist and visiting professor of Physiotherapy at Chelsea and Westminister NHS Foundation Trust, talks to Prof Jill Cook about management of rotator cuff tendinopathy. They cover the role of the subacromial bursa in the condition, new treatment paradigms, hopes for future developments. Bursa: 3.40 Changing treatment paradigms: 6.00 Future developments: 13.30

In the second part of this two-part podcast, Ross Tucker, one of the authors on The Science of Sport (http://www.sportsscientists.com/) explains how a understanding what limits performance can help an athlete achieve their best. He covers the use of GPS data and other measures of training volume, the difficulty that massive volumes of data creates, and how teams can use advanced sport science programs to gain a competitive advantage. He illuminates recent discoveries that ‘central’ processes - ‘the central governor’ - regulate performance; this contrasts with older views that suggested anaerobiosis (lack of oxygen) in skeletal muscle limited performance. Ross Tucker’s paper on pacing/limits of performance tiny.cc/ybc3hw The January 2013 issue of BJSM focused on pacing and the Central Governor bjsm.bmj.com/content/46/1.toc Part 1 of the podcast: ‘What makes an Olympic champion?’ http://bit.ly/MQNiyf

In the first part of this two-part podcast, Dr Ross Tucker, one of the authors of the hugely popular blog - The Science of Sport (http://www.sportsscientists.com/) - talks about what makes an Olympic champion. Dr Tucker assesses the role of genetics, training and the validity of the ‘10,000 hour’ concept. He rationally, and with evidence, discusses the eligibility of Oscar Pistorius and Caster Semenya in the Olympics. Dr Tucker is an exercise physiologist, conditioning coach, and team coach. He is based at the University of Cape Town in the Exercise Science and Sports Medicine Department and the Sports Science Institute of South Africa. Related links: Ross Tucker’s Blog: http://www.sportsscientists.com/ Ross Tucker’s Twitter account: @ScienceofSport Ross Tucker and Malcolm Collins: BJSM paper ‘What makes champion?’ http://bit.ly/11ygMXx Part 2 of this podcast:Understanding performance http://bit.ly/17fzGVe

Sudden cardiac death in footballers has been headline news, so how should those involved in the sport be looking out for players? FIFA’s chief medical officer Jiri Dvorak explains what the organisation is doing, and Bolton Wanderers’ club doctor Jonathan Tobin gives us a pitch-side view. BJSM editor Karim Khan asks the questions. 0.45 FIFA’s pre-competition medical assessment 3.53 Organisation pitch-side 5.32 Researching the aetiology of sudden cardiac death – FIFA’s Medical and Research Centre 6.40 Putting plans in place 10.09 Getting the message and resources out worldwide 12.16 What to do if you want your club to be more prepared for cardiac events 15.27 Checklists for all involved 17.18 Automatic external defibrillators See also: FIFA’s Medical and Research Centre http://bit.ly/PDKLt5 Jon Drezner and the 2012 sudden cardiac death update: two new key messages http://bit.ly/M5Tjan

Per Holmich, head of the Arthroscopic Centre at Amager University Hospital, has been working for many years on overuse problems especially hamstring, groin and hip problems focusing on exercise treatment and hip arthroscopy. In this podcast he talks to Karim Khan about groin injuries, what to watch out for in diagnosis, and how to treat.

Karim Khan talks to Andy Murray, Scotland’s official Physical Activity Champion. After completing a gruelling 2659 mile run from John O’Grotes in Scotland to the Sahara Desert, Andy is now working to promote physical activity in the rest of the population. He talks about the programmes that the Scottish government is putting in place to improve the health of the nation through exercise. See also: Scotland2Sahara http://www.scotland2sahara.com/ Global Advocacy for Physical Activity http://www.globalpa.org.uk/ 23.5 hours video http://bit.ly/sHJgx6 Andy’s twitter feed https://twitter.com/docandrewmurray Healthier Scotland www.takelifeon.co.uk Active Scotland http://www.activescotland.org.uk/

Professor Jon Drezner emphasises the need for careful planning and practice of emergency protocols in the sports medicine setting. He also shares the new criteria for ECG screening - these lead to a much lower false positive rate than was previously reported. He makes a compelling case to include a resting 12-lead ECG in the periodic health examination of athletes. In this podcast he previews the international collaboration to improve the criteria for interpreting ECGs in athletes. These ‘Seattle criteria’ will be shared for free world-wide via BMJ Learning though sponsorship by numerous stakeholders including FIFA, AMSSM, PACES and ESC. 0.47 Has there been an increase in the rate of sudden cardiac death in sportspeople aged over 35 years? 1.42 What can clinicians do to minimize the risk of sudden cardiac death? 5.14 Screening and periodic health examination 8.56 Efforts to increase the accuracy of ECG interpretation - the Seattle meeting 21.04 AMSSM - a great member society for primary care physicians 23.33 Summary See also: BJSM blog: ECG Summit in Seattle: Successes and Next Steps http://bit.ly/wCELeS You can read how a two page tool with criteria for assisting interpreting ECGs in athletes led to improved accuracy in ECG reading by sports medicine attendings, primary care attending and primary care residents http://bit.ly/12EJwz4 Jon’s previous BJSM podcast: Preventing sudden cardiac death with Jon Drezner http://bit.ly/occXQj The two page tool http://bit.ly/14LIF2Y Recommendations for interpretation of 12-lead electrocardiogram in the athlete http://bit.ly/Y1iUbO Detailed criteria for the interpretation of the electrocardiogram in young athletes http://bit.ly/ZJOMgi

Babette Pluim (BJSM deputy editor) talks to Ann Cools (professor in the Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Belgium) about her varied research into shoulder injuries. 0.21 Scapular involvement in shoulder pain in overhead athletes 1.32 Treatment strategy of internal impingement in the overhead athlete 3.11 The Scapular Summit 2012 4.49 Eccentric training for shoulder injuries 6.27 Scapula Dyskinesis 8.56 Age related change in the shoulder in tennis players 11.15 Adaptations in scapular movement, subacromial space, and range of movement and strength in elite handball players 15.47 The European Society for Shoulder and Elbow Rehabilitation (EUSSER) See also: Descriptive profile of scapulothoracic position, strength and flexibility variables in adolescent elite tennis players http://bit.ly/ZJOhTI Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review http://bit.ly/ZJOkyC Screening the athlete’s shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology http://bit.ly/15DCSMn Internal impingement in the tennis player: rehabilitation guidelines http://bit.ly/Y1iEtt Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms http://bit.ly/129KBxq EUSSER www.eusser.org

Babette Pluim (BJSM’s deputy editor) talks to Alan Vernec of the World Anti-Doping Agency (WADA). They discuss the work of the organisation and the new posibilities blood passports are offering doping detection. See also: Leading Sports Ethics expert Mike McNamee’s 2011 comments on doping and sport http://bit.ly/11IsZGk A discussion of the challenges of doping test (for B-2 agonists) in asthma http://bit.ly/ZFW6g8

Karim Khan talks to Steven Blair, professor at the Arnold School of Public Health, South Carolina. Professor Blair 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. 0.51 Why physical inactivity is a greater health problem than obesity 3.20 Why physical inactivity is an important factor in causing the obesity epidemic 6.18 How the World Health Organisation is waking up to the fact physical inactivity is a major health problem 8.47 The impact of genetic makeup on the benefits gained from physical activity 10.44 The benefits of physical activity in those over 60 11.52 How much and of what sort of exercise should we be doing to get the benefits? See also: Physical inactivity: the biggest public health problem of the 21st century http://bit.ly/11yeqrJ Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men http://bit.ly/10vSKQ4 Changes in Physical Fitness and All-Cause Mortality http://bit.ly/XT6yQS Physical Fitness and All-Cause Mortality http://bit.ly/Zl6gEo WHO Global status report on noncommunicable diseases 2010 http://bit.ly/i5ZiVf Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues http://bit.ly/XT6HDM Is physical activity or physical fitness more important in defining health benefits? http://bit.ly/17UmOFe How Much Physical Activity is Good for Health? http://bit.ly/10vT29B