BJSM Podcast

In this week’s BJSM podcast, BJSM deputy editor Dr Jane Thornton (T: @JaneSThornton) joins Daniel Friedman (T: @ddfriedman) to discuss physical activity counselling. Dr Jane Thornton MD PhD is a sports medicine physician and researcher currently based in London, Canada, and is an international advocate for physical activity. She has a wealth of international experience in the field of preventative medicine, with a particular passion for promoting physical activity as both prevention and treatment of chronic disease. Alongside a super impressive medical career, Dr Thornton is also a World Champion and former Olympic rower for Canada. In Part 1 of this 2-part podcast, Dr Thornton discusses: · Why physical activity is the single best thing we can do for our health · The evidence for physical activity prescription in primary care · The shared decision making of how to prescribe physical activity to patients · How to talk about physical activity intensity with patients Mentioned in this podcast: 23 and a half hours YouTube video: https://www.youtube.com/watch?v=aUaInS6HIGo Make Your Day Harder http://www.makeyourdayharder.com/ PA Prescription Position Statement https://bjsm.bmj.com/content/50/18/1109 Naci et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. BJSM 2019. https://bjsm.bmj.com/content/53/14/859

On this week’s BJSM podcast, Dr Celeste Geertsema joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the imbalance between men’s and women’s football medicine research and what needs to be done to move towards equality. Dr Geertsema is is a Sports Medicine Physician at Aspetar with her main interests being in football, skiing, snowboarding and athletes traveling. She has extensive experience working alongside FIFA in various World Cups. She was the first ever female Team Physician at the FIFA world Cup (in South Africa 2010) and also worked as FIFA Medical Officer at the Women’s Football World Cup and U17 Women’s World Cup, as well as Medical Officer at the Winter Olympic Games and Commonwealth Games. https://www.aspetar.com/person-profile.aspx?id=12〈=en In this 20-minute conversation, Dr Geertsema discusses: • Her current role at the Women’s FIFA World Cup in France • The medical requirements of men vs women at the World Cup • Why men and women footballers should be studied separately • The gaps in women’s football medicine research • What the SEM community can do to help out *Disclaimer: This is a personal interview for BJSM. Dr Geertsema is not speaking on the behalf of FIFA.* Pele in a skirt: https://www.cbc.ca/sports/2.720/marta-pele-in-skirts-1.731293 Germany Women’s FIFA World Cup Ad: https://www.youtube.com/watch?v=layoVXL5mnw

It has been another big year for tennis, and for British Tennis in particular with further successes in the Fed Cup and a number of exciting juniors making an impact on the world stage. In the run up to Wimbledon, we thought we’d catch up with some of the practitioners tasked with not only caring for these athletes, but responsible for the medical provision at some of the biggest sporting events in the international calendar. In this podcast we hear from Dr Jo Larkin and Dr Wing Chu. Jo is a Sport & Exercise Medicine consultant and Lead Doctor for British Tennis, with Wing an SEM registrar and qualified GP who works with Jo at the Lawn Tennis Association. In this podcast, you can hear about everything from the challenges of working in tennis, to some of the often under-appreciated public health benefits linked to the sport.  Patients needing advice & input across multiple continents at the same time  Policy-making as well as ‘pitch-side’ care  Population health – what role does tennis have? Do you know someone who could benefit from a healthier heart, reduced stress and a leaner body? Or, does this sound like a personal target for you? We would implore the #SEM community to share the podcast, infographics, papers and animations widely in order to try and spread the knowledge not only of #TennisMedicine, but tennis AS medicine https://www.youtube.com/watch?v=X4UHmZ6PL30 Seminal Papers Health Benefits of tennis infographics: https://bjsm.bmj.com/content/52/3/201 Health Benefits of tennis paper: https://bjsm.bmj.com/content/41/11/760 Associations of specific types of sports and exercise with all-cause and cardiovascular- disease mortality https://bjsm.bmj.com/content/51/10/812.long Leisure-Time Physical Activity & Life-Expectancy https://www.mayoclinicproceedings.org/article/S0025-6196(18)30538-X/fulltext

What is like working at one of the biggest clubs in the world? How do you manage the intense workload of the English premier league? What happens when players retire? In this hard hitting BJSM podcast, we are joined by Dr Andy Massey, physiotherapist and doctor who currently works as head of medical services at Liverpool FC. Topics discussed include: ●Managing the load of the premier league footballer ●Looking at the whole squad; substitutes and non-playing members ●The £177 million conundrum; the cost of injured players to the league ●Managing a rectus femoris injury; how to approach it? ●1%ers- what is their place in football? ●Transitioning into retirement- do we do enough? ●Top tips for early career professionals wanting to work in football Links to some of the papers mentioned: Bye Bye MRI? https://bit.ly/2KfChKQ POLICE principle for treating injuries : https://bit.ly/2EHcS9C

Have we been thinking about Osgood Schlatter Disease (OSD) all wrong? To answer this question, Dr. Erin Macri interviewed Prof. Jens Lykkegaard Oleson and Dr. Sinead Holden from Aalborg University on a recent visit to Denmark. Prof. Olesen is a rheumatologist and sports medicine physician, currently located at the Center for Almen Medicine at Aalborg University. His research focuses on tendon and fascia tissue adaption to loading, and the use of ultrasound examination in tendon and fascia pathology. Dr. Holden is a Senior Researcher at the Center for General Practice in Aalborg, where she is co-founder and research co-ordinator for the OptiYouth Research Group focused on ‘optimising physical health in youth’. Her research aims to increase understanding of musculoskeletal injuries and pain in youth, to identify those at increased risk for developing chronic MSK problems. In this episode, we delve into some recent evidence suggesting the OSD may not be the self-limiting condition we have typically believed it to be. In fact, OSD may be more akin to a tendonopathy in its presentation, which lends itself to exploring some novel treatment approaches that may change OSD management in clinical practice. Related Articles and Links OSD table: http://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2019/06/OSD-table.pdf Cairns G, Owen T, Kluzek S, Thurley N, Holden S, Rathleff MS, Dean BJ. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med. 2018 Aug 13;4(1):e000383. doi: 10.1136/bmjsem-2018-000383 https://bmjopensem.bmj.com/content/4/1/e000383 Holden S, Winiarski L, Krommes K, Thorborg K, Olesen JL, Hölmich P & Rathleff MS. Prognosis of Osgood-Schlatter - poorer than anticipated? A prospective cohort study with 24-month follow-up. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Vad, CG; Rathleff, MS; Jensen, HP; Holden S. Osgood Schlatter is associated with significant impairments in knee function and quality of life 4 years after diagnosis: a retrospective study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Lyng K, Rathleff MS, Dean B, Kluzek S, Holden S. Current Management Strategies in Osgood Schlatter: A quantitative study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Kaya DO, Toprak U, Baltaci G, et al. Long-term functional and sonographic outcomes in Osgood-Schlatter disease. Knee Surg Sports Traumatol Arthrosc 2013;21(5):1131-9. Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop 1990;10(1):65-8.

On this week’s BJSM podcast, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) EIC elect Dr Clare Ardern PhD (T: @clare_ardern) joins BJSM EIC Prof Karim Khan to answer the difficult questions about return to play. Dr Clare Ardern is a physiotherapist and clinical researcher who completed her award-winning PhD on return to play in 2013. Since then, Clare has worked as a clinical researcher at the Aspetar Orthopaedic & Sports Medicine Hospital (Qatar) and Linköping University (Sweden). Clare led the 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. She has a particular interest in the psychological aspect of returning to play and how the return to play transition can be improved with specific clinical interventions and superior clinical decision making. We here at BJSM would like to thank Clare for her tireless work as BJSM Deputy Editor and wish her all the best for her upcoming role as EIC at JOSPT! In this 30-minute conversation, Clare discusses: · Tips for clinicians when approaching RTP with athletes · The psychological aspects of RTP and the importance of shared decision making · Athletes’ biggest fears when RTP · Non-operative management of ACL injuries · Paediatric ACL injuries On Oct 4-5, Clare will be speaking at the The IFSPT Third World Congress of Sports Physical Therapy in Vancouver, Canada. She will be presenting alongside a world-class line up of local and international experts exploring the theme “High performance to clinical practice”. https://www.sportphysio.ca/calendar-of-upcoming-events/spc2019/ Mentioned in this episode: Ardern CL, Ekås G, Grindem H, et al. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018;doi:10.1136/bjsports-2018-099060 (article co-published by Knee Surgery Sports Traumatology Arthroscopy, Journal of ISAKOS and Orthopaedic Journal of Sports Medicine). https://bjsm.bmj.com/content/52/7/422 Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med 2016;50:853-864. https://bjsm.bmj.com/content/50/14/853 Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med 2014;48:1543-1552. Grindem H, Snyder-Mackler L, Moksnes H, et al Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study British Journal of Sports Medicine 2016;50:804-808. https://bjsm.bmj.com/content/50/13/804 Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine. 2010 Jul 22;363(4):331-42. Headspace App: https://www.headspace.com/headspace-meditation-app

What are the most effective strategies for preventing sport-related concussions in youth? What role do clinicians have in this arena? Dr. Erin Macri took advantage of Prof. Emery’s recent visit to the Netherlands to get caught up on the latest evidence in concussion prevention. Prof. Emery is a physiotherapist and epidemiologist. She currently holds an appointment in the Faculty of Kinesiology at the University of Calgary, with joint appointments in Pediatrics and Community Health Sciences, Cumming School of Medicine, and is Chair of the Sport Injury Prevention Research Centre at the University of Calgary. Her research focuses on injury prevention in youth sport and recreation, concussion, and pediatric rehabilitation. In this episode, Prof. Emery discusses over a decade of work aimed at preventing sport-related concussion in ice hockey in Canada. Related Articles and Links Emery CA, Black AM. Are rule changes the low-hanging fruit for concussion prevention in youth sport? JAMA pediatrics 2019. E-pub ahead of print doi:10.1001/jamapediatrics.2018.5498 Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med 2017;51(12):978-84 Kolstad A, Nadeau L, Eliason P, Palacios-Derflingher L, Goulet C, Emery CA. The Effect Of Body Checking Policy Change On Offensive Game Skill Performance In 13–14 Year Old Ice Hockey Players. Br J Sports Med 2017;51(4):345-45 McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun 1;51(11):838-47. Concussion: prevention, detection and management (online course): https://www.ucalgary.ca/knes/online-concussion-course Concussion Awareness Training Tool: https://cattonline.com/ Canadian Concussion Guidelines and other resources, Parachute Canada: http://www.parachutecanada.org/injury-topics/item/concussion

On this week’s BJSM podcast, Kathrine Switzer (T: @KVSwitzer) joins BJSM’s Daniel Friedman (T: @ddfriedman) to chat about empowering female athletes and the changing face of women’s sport in 2019. In 1967, 20-year-old Kathrine Switzer became the first woman to complete the all-male Boston Marathon as an official entrant. She managed to fight off a race official who tried to force her from the course after only several kilometres, and made history as she crossed the finish line four hours later. Empowered by her experience, Kathrine became determined to create change for all women and has dedicated her career to advancing women’s sport, health and equality. https://kathrineswitzer.com/ In this 25-minute conversation, Kathrine discusses: · The story of her historic 1967 Boston Marathon · Her activism in advancing women’s running · 261 Fearless – a global supportive social running network http://www.261fearless.org/ · The biggest barriers to female participation in sport today · What SEM clinicians can do to help out On June 6-8, Kathrine will be speaking at the 4th biennial Female Athlete Conference in Boston. She will be presenting alongside a world-class line up of local and international experts on women’s sport and exercise medicine, coaching, leadership and culture. https://bostonchildrens.cloud-cme.com/default.aspx?P=1&EID=910 Learn more about NZ’s Green Rx: https://www.health.govt.nz/our-work/preventative-health-wellness/physical-activity/green-prescriptions

What venue are we at today? Which half is it now? Who scored last in this match? The Maddocks questions are a key part of immediate or on-field assessment of concussion. But do you have an easy way of remembering what else needs to be done? On this week’s episode, Dr Jim Bovard joins BJSM’s Daniel Friedman (T: @ddfriedman) to share his ABC concussion tool for rapid on-field assessment. Dr Bovard is the team physician for the Vancouver Canucks and Vancouver Whitecaps. He currently consults for Canada Snowboard and Tennis Canada. In this 20 minute conversation, Dr. Bovard discusses: · Clinical reasoning for approaching the collapsed athlete · His own ABC concussion tool for on field assessment · Tips for coaches and parents for managing concussion · The difference between caring for elite athletes vs general population Further reading: Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenbogen RG, Echemendia RJ, Makdissi M, Sills A, Iverson GL. The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). Br J Sports Med. 2017 Apr 26:bjsports-2017. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

What are your favourite sports medicine research articles from 2018? This week, we are excited to share an AMSSM Sport Medcast hosted by Drs Scott Young and Dr. Meghan Raleigh In this abbreviated episode, learn about the latest research regarding: · Treatment of Achilles tendinopathy · Effect of NSAIDs on bone healing rates · Management of lateral hip pain · Exercise as medicine for concussion · Physiotherapy vs surgery for meniscal tears To listen to the full episode and learn about all ten studies, please visit the AMSSM’s website: https://www.amssm.org/E-Learning.php Further reading: Johannsen F, Jensen S, Wetke E. 10-year follow-up after standardised treatment for Achilles tendinopathy. BMJ open sport & exercise medicine. 2018 Oct 1;4(1):e000415. Wheatley BM, Nappo KE, Christensen DL, Holman AM, Brooks DI, Potter BK. Effect of NSAIDs on Bone Healing Rates: A Meta-analysis. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2019 Apr 1;27(7):e330-6. Nissen MJ, Brulhart L, Faundez A, Finckh A, Courvoisier DS, Genevay S. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clinical rheumatology. 2019 Mar 14;38(3):647-55. Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is medicine for concussion. Current sports medicine reports. 2018 Aug 1;17(8):262-70. van de Graaf VA, Noorduyn JC, Willigenburg NW, Butter IK, de Gast A, Mol BW, Saris DB, Twisk JW, Poolman RW. Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the ESCAPE randomized clinical trial. Jama. 2018 Oct 2;320(13):1328-37.

Farooq Mohammed was a football fan who discovered that he has heart disease. In this BJSM podcast, we focus on the patient voice and hear from Farooq who shares his own lived experience with the disease and, importantly, how football became part of his rehabilitation. Farooq shows that by empowering patients to take control of their own health, rehabilitation can become a fun activity, not a boring ‘must do’ where the individual is counting down the minutes until it’s over. If you want to learn more about the “friendly group of ‘Heart Patients’ from #EastLondon” who make up Two Touch Athletic Football Club, connect with them on Twitter (@TwoTouchAFC) or Linked In (TwoTouchAthleticAFC). The conference that Farooq refers to was the 2019 Football is Medicine conference, University of Southern Denmark, Odense. It was led by Professor Peter Krustrup: http://ow.ly/7Xxn30oxFFR You can find another BJSM patient podcast here: http://ow.ly/rXis30oxFMJ Christina Le shares her lived experience of suffering an ACL injury in 2017.

In this podcast Dr Katie Marino interviews Dr Rebecca Robinson about physical activity & cancer. Dr Robinson is a Sport and Exercise Medicine Consultant in Sheffield who has clinics at Weston Park Hospital in Sheffield working directly with cancer patients. During the podcast she gives a great insight into our current understanding of the use of physical activity in cancer patients. As Macmillan quote that by 2020 almost half the population will develop some form of cancer in their lifetime, it is important that we increase our understanding of how physical activity can be used to improve quality of life in this patient group. As mentioned in the podcast, please visit the following link for more information: https://movingmedicine.ac.uk/disease/cancer/#start

Drop and give us 20. On this week’s BJSM podcast, Dr Alex Hutchinson PhD (T:@sweatscience) joins BJSM’s Daniel Friedman (T: @ddfriedman) to make sense of all of the click-bait headlines and explore whether push-up prowess is the secret to long life. Alex writes Outside’s Sweat Science column, about the science of endurance and adventure. He started out as a Cambridge-trained physicist and long-distance runner on the Canadian national team. As a journalist, he earned a National Magazine Award for his energy reporting with Popular Mechanics, covered adventure travel for The New York Times, and wrote a training column for Runner’s World. His latest book, out in February 2018, is ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance. He lives in Toronto, where he runs fast, climbs poorly, and gets outside as much as possible with his wife and daughters. In this 17-minute conversation, Alex discusses: · If push-ups can predict your likelihood of future cardiovascular events · What we can learn from functional tests that aim to assess different health outcomes · New data on the cardio vs weights debate Further reading: Yang J, Christophi CA, Farioli A, Baur DM, Moffatt S, Zollinger TW, Kales SN. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA network open. 2019 Feb 1;2(2):e188341-. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778 Stamatakis E, Williamson C, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH. Infographic. Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts. Br J Sports Med. 2019 Mar 1:bjsports-2018. https://bjsm.bmj.com/content/early/2019/03/01/bjsports-2018-100468.abstract Harb SC, Cremer PC, Wu Y, Xu B, Cho L, Menon V, Jaber WA. Estimated age based on exercise stress testing performance outperforms chronological age in predicting mortality. European journal of preventive cardiology. 2019 Feb 13:2047487319826400. https://journals.sagepub.com/doi/10.1177/2047487319826400

Seth is a physiotherapy lecturer at the University of Leicester with a special interest in calf & Achilles injuries, having completed his PhD on Achilles Tendinopathy. He joins us to answer some of these questions · What are the biggest risk factors for Achilles tendinopathy (AT)? · What would be your biggest bang-for-buck treatments for AT? · What would you say were the most useful markers for progression? · Where do you think people are going wrong in the treatment of AT in general – what are the most common misconceptions/mistakes? · How important is the role of the soleus in ankle/calf function, and sporting performance in general? · In terms of managing soleus injuries, what tips would you have for clinicians out there?

What comes first—the robust athlete or the high training load? What is the role of moderating factors in training load? And is the ‘10% rule’ a myth? On this episode, Dr. Tim Gabbett PhD x2 (T: @TimGabbett) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss all things training load and debunk some common misconceptions. Tim has over 20 years of experience working as an applied sport scientist with elite athletes, coaches, and high performance teams from around the world. He holds a PhD in Human Physiology (2000) and has completed a second PhD in the Applied Science of Professional Football (2011), with special reference to physical demands, injury prevention, and skill acquisition. www.gabbettperformance.com In this 20 minute conversation, Tim discusses: · The definition of training load and its different components · The Acute:Chronic Workload Ratio (ACWR) and its limitations · What separates robust from fragile athletes · The 10% rule ‘myth’ · How to design a rehabilitation training program for an injured athlete Further reading: Gabbett TJ, Nielsen RO, Bertelsen ML, Bittencourt NF, Fonseca ST, Malone S, Møller M, Oetter E, Verhagen E, Windt J. In pursuit of the ‘Unbreakable’Athlete: what is the role of moderating factors and circular causation? https://bjsm.bmj.com/content/early/2018/11/13/bjsports-2018-099995 Gabbett TJ. Debunking the myths about training load, injury and performance: empirical evidence, hot topics and recommendations for practitioners. Br J Sports Med. 2018 Oct 26:bjsports-2018. https://bjsm.bmj.com/content/early/2018/10/26/bjsports-2018-099784 Gabbett TJ. The training—injury prevention paradox: should athletes be training smarter and harder?. Br J Sports Med. 2016 Mar 1;50(5):273-80. https://bjsm.bmj.com/content/50/5/273 Hulin BT, Gabbett TJ, Lawson DW, Caputi P, Sampson JA. The acute: chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med. 2016 Feb 1;50(4):231-6. https://bjsm.bmj.com/content/50/4/231 Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett T, Gleeson M, Hägglund M, Hutchinson MR, Van Rensburg CJ. How much is too much?(Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016 Sep 1;50(17):1030-41. https://bjsm.bmj.com/content/50/17/1030

What common injury patterns do adolescent overhead throwing athletes face? What are the current pitch count recommendations and evidence for their use? How can we best monitor and encourage compliance with these recommendations? Host Dr. Devin McFadden, MD is joined by Dr. Jason Zaremski to explore these topics and more on the AMSSM Sports Medcast. Dr. Zaremski is an assistant professor from the Division of Physical Medicine and Research, Department of Orthopaedics and Rehabilitation and Co-Medical Director of the Adolescent and High School Outreach Program at the University of Florida College of Medicine in Gainesville, Florida. He is also a past participant in the AMSSM International Travelling Fellowship program, having recently travelled to Scandinavia where he shared insights on the above topics and learned how the Scandinavians deal with similar injuries. In this 30 minute conversation Dr. Zaremski addressed the following topics: What are common injury patterns in adolescent overhead throwing athletes? What injury prevention strategies have been enacted and what is the evidence for their use? When to consider operative rather than conservative treatments. Mechanisms and Treatment of Throwing Injuries- https://journals.lww.com/acsm-csmr/fulltext/2017/05000/Mechanisms_and_Treatments_for_Shoulder_Injuries_in.17.aspx Zaremski ZL, Wasser JG, Vincent HK. Mechanisms and Treatments for Shoulder Injury in Overhead Throwing Athletes. Current Sports Medicine Reports. 2017;16(3):179-188 Unaccounted Workload in Pitch Counts- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894908/ Zaremski JL, Zeppieri G, Jones DL, et al. Unaccounted workload factor: game-day pitch counts in high school baseball pitchers- an observational study. Orthop J Sports Med. 2018;6(4):1-7 The Thrower’s Ten Exercises- https://insights.ovid.com/pubmed?pmid=28498227 Wilke KE, Yenchak AJ, Arrigo CA, et al. The advanced throwers ten exercise program: a new exercise series for enhanced dynamic shoulder control in the overhead throwing athlete. Phys Sportsmed. 2011;39(4):90-97.

Breakneck speeds. Scorching heat. Extreme g-forces. Motor racing is one of the most challenging of all sports - not only for drivers themselves, but also for the teams that play an integral role in the performance of the driver and car. As the 2019 Formula One World Championship Season launches into action this weekend in Melbourne, F1 physiotherapist Kim Keedle takes a pit stop with BJSM’s Daniel Friedman (T: @ddfriedman) to share insights into the physically and mentally demanding world of motor racing. Kim graduated from Melbourne University in 2012 with a Bachelors of Physiotherapy, and completed a Masters in Strength & Conditioning at Edith Cowan University in 2016. He is currently working full time as a physiotherapist and high performance coach for the Haas F1 Team, based in Geneva. In this 17 minute conversation, Kim explains: · His pathway into F1 · The role of the physiotherapist within the broader F1 medical team · The physical and mental demands of F1 racing · The importance of neck and trunk strength for drivers · Cervical loading programs and conditioning during the off season Further reading: https://blogs.bmj.com/bjsm/2013/03/26/the-fast-and-the-furiousand-physiotherapy-training-for-extreme-g-force-loads-on-the-neck/ Contact Kim: [email protected]

Following their recent editorial (https://bjsm.bmj.com/content/early/2018/11/09/bjsports-2018-099457) in the BJSM, and the publication of the reliability paper in the #BMJOpenSEM https://t.co/lCFcZNi5Tu - we managed to get this international team of collaborators around the table at BMA House, to discuss the applicability of the ASH test in guiding the return to play process following shoulder injuries. Steffan Griffin had the pleasure of hosting Ben Ashworth, Laura Tulloch, Nav Singh & Daniel Cohen, who take us through the journey behind the test, and how it can be used within the clinical setting. Some great examples & case-studies for anyone who sees upper limb injuries in sport! If you’re interested in the paper & the group’s work, you can follow them here: https://twitter.com/AthleteShoulder https://twitter.com/benashworth https://twitter.com/lt_physio https://twitter.com/paddhog https://twitter.com/danielcohen1971 https://twitter.com/i/status/1021381112378155009

Since 1996, the Football Association has mandated that every young professional footballer in England undergoes cardiac screening. In this podcast, Dr Aneil Malhotra, lead author on the recent NEJM paper which reported the outcomes of the FA’s screening programme, discusses the implications of the research and what it means for screening in the future. In this conversation with Dr Sean Carmody, he also discusses other measures support staff can take to minimise the risk of sudden cardiac deaths in athletes. Related Articles: Outcomes of Cardiac Screening in Adolescent Soccer Players Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England

NCAA athletes face the realization of career ending injuries, whether they are acute/catastrophic or cumulative. As team physicians and athletic trainers it is imperative that we have our athletes' long- term health as a priority in their care. Presenters of this podcast are Pierre Rouzier, MD, head team physician of the University of Massachusetts, Jennifer Brodeur, ATC, director of Sports Medicine and Jeff Smith, ATC, senior associate Athletic Director for Internal Operations at UMass. This presentation will discuss various medical categories considered career ending and disqualifying; some of these are clear-cut, some may be more nebulous. Athletes facing 'retirement due to injury' are known to have significant psycho-social issues in their transition; we will discuss important institutional resources to help our athletes. We will present cases and outcomes from data collected at the University of Massachusetts. At the conclusion of the podcast, listeners will have learned various NCAA definitions, such as 'medical disqualification', 'medical hardship', 'medical red-shirt' and changes new to 2018. Program participants will know the consequences and implications of being 'medically disqualified' from an NCAA sport, and the impact on the athletes' financial assistance and what this means to their team's scholarship numbers. Listeners will be able to learn the process of medically disqualifying an athlete and how to provide the support and care they need to transition out of their sport. Hayley Marks, Daniel R. Czech, Brandonn S. Harris, Trey Burdette, David D. Biber, An Examination of Coping with Career Ending Injuries: An NCAA Division I and NCAA Division III Comparison, International Journal of Sports Science, Vol. 5 No. 2, 2015, pp. 87-92. https://doi.org/10.5923/j.sports.20150502.07 Leena Ristolainen, Jyrki A. Kettunen, Urho M. Kujala & Ari Heinonen (2011): Sport injuries as the main cause of sport career termination among Finnish top-level athletes, European Journal of Sport Science, https://doi.org/10.1080/17461391.2011.566365 2017-18 NCAA Division 1 Manual https://www.ncaapublications.com/p-4511-2017-2018-ncaa-division-i-manual-august-version- available-august-2017.aspx 2014-15 NCAA Sports Medicine Handbook https://www.ncaapublications.com/p-4374-2014-15-ncaa-sports-medicine-handbook.aspx

Did you know that worldwide, more than one in four adults (28% or 1.4 billion) are physically inactive? In some countries, it’s as high as one in three! How many more times do we need to be reminded that physical inactivity is one of the leading risk factors for global mortality before we finally decide to get off the couch? On this week’s episode, Prof Fiona Bull MBE (T: @fiona_bull) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the latest physical activity trend data and explain how clinicians can play their part to increase levels of physical activity for a more active world. Prof Bull is the Programme Manager in the Department of Prevention of Noncommunicable Diseases (NCD) at the World Health Organization based in Geneva, Switzerland. She leads the WHO’s global work on physical inactivity, healthy eating and the prevention of obesity, and provides leadership for global monitoring and surveillance of NCDs and their risk factors. Bull joined WHO in 2017 after 25 years in applied research in Australia, the UK and the USA. Her recent positions include Professor of Public Health and Director of the Centre for Built Environment and Health at the University of Western Australia and Professor of Sports Science and Director of National Centre of Physical Activity at Loughborough University in the UK. Bull has co-authored over 180 scientific publications and reports. Her interest is in bridging the knowledge-policy-practice gap, and she has been actively involved in civil society. She is immediate past President of the International Society of Physical Activity. In 2014, Bull was awarded a Member of the British Empire (MBE) for her services to public health. In this 15 minute conversation, Prof Bull addresses: · Physical inactivity trends over the past 16 years · The causes of physical inactivity · What the WHO is doing to support countries increase physical activity · What clinicians can do to play their part Further reading: Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. The Lancet Global Health. 2018 Oct 1;6(10):e1077-86. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30357-7/fulltext World Health Organization. (‎2018)‎. ACTIVE: a technical package for increasing physical activity. World Health Organization. http://www.who.int/iris/handle/10665/275415 Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018. http://apps.who.int/iris/bitstream/handle/10665/272722/9789241514187-eng.pdf Global action plan on physical activity 2018-2030: At a glance http://apps.who.int/iris/bitstream/handle/10665/272721/WHO-NMH-PND-18.5-eng.pdf

Our guest for this podcast is Professor Greg Whyte, one of the world’s most respected and renowned Sport & Exercise Scientists. Greg combines his academic position at Liverpool John Moores University with both public & private work around the UK, and is a hugely respected scientist and voice, with expertise in a wide range of domains. Not content with overseeing breathtaking Sport Relief challenges and helping to raise >£30m for charity, he has recently published a book titled ‘Bump It Up’, focused on advice for pregnant women. In this podcast, Greg covers: - The current consensus - Common misconceptions - Common barriers and how to overcome them - Safety & contraindications - The importance of physical activity at every life-stage Further resources: Greg’s Book: https://www.penguin.co.uk/books/111/1111959/bump-it-up/9780593077481.html BJSM Special Edition on Pregnancy: https://bjsm.bmj.com/content/52/21 2019 Canadian guideline for physical activity throughout pregnancy https://bjsm.bmj.com/content/52/21/1339

Did you know that up to 3.8 million sports-related concussions occur in the USA annually? As the largest membership organisation representing sports medicine physicians in North America, the AMSSM is perfectly placed to provide advice and guidance to clinicians who are expected to manage every stage of the concussion spectrum. On this week’s episode, Prof Kimberly Harmon (T: @DrKimHarmon) returns for another podcast and joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the upcoming updated 2019 AMSSM position statement on managing concussion in sport. Prof Harmon is a Professor in the Department of Family Practice and Departments of Family Medicine and Orthopaedics and Sports Medicine at the University of Washington, as well as a past president of the AMSSM. She has over 20 years of experience as a team physician for the University of Washington, and is currently the head physician for the university’s American football team. In this 20 minute conversation, Prof Harmon discusses: · Our current understanding of concussion · The 2019 updated AMSSM Concussion in Sport position statement vs the 2013 statement · Managing concussed athletes and return to play at the collegiate level · Efforts to prevent concussion and reduce its severity in college football Prof Harmon will be speaking at the upcoming 2019 ACSEP conference (https://bit.ly/2HkQsi5) in Queenstown, NZ, and at the 2019 AMSSM Annual Meeting (https://bit.ly/2U573rD) in Houston, USA. Don't miss out! Further reading: Harmon KG, Drezner JA, Gammons M Endorsed by the National Trainers’ Athletic Association and the American College of Sports Medicine, et al. American Medical Society for Sports Medicine position statement: concussion in sport Br J Sports Med 2013;47:15-26. https://bjsm.bmj.com/content/47/1/15.short Turner M Happy Birthday Concussion! Br J Sports Med Published Online First: 01 December 2018. doi: 10.1136/bjsports-2018-100316 McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017;51:838-847

Traditionally, sports medicine may have focussed on joints and tendons and muscles, but, as with medicine more widely, nutrition is now being properly recognised as an essential aspect of health. Food is a very strong lever to improve human health and environmental sustainability on earth. However, food is currently threatening both people and planet. The food we eat, the ways we produce it, and the amounts wasted or lost affect us all – athletes, patients and clinicians. On this BJSM podcast Prof Jess Fanzo (T: @jessfanzo) from Johns Hopkins (full bio below) joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the recently published report Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems that is making headlines around the world. The report is also creating much controversy. Not everyone will agree with the commission, just as not everyone agrees with all nutrition advice. At BJSM, our job is to share major views from the scientific world with our community and here you can listen to a major player in this report. In this 15-minute conversation, Prof Fanzo shares the report’s key takeaways (!) and how sport and exercise medicine clinicians can contribute to “the great food transformation". Prof Jess Fanzo PhD is the Bloomberg Distinguished Associate Professor of Ethics and Global Food & Agriculture at the Johns Hopkins Berman Institute of Bioethics, the School of Advanced International Studies, and the Bloomberg School of Public Health, Department of International Health. She also serves as the Director of the Global Food Ethics and Policy Program. Prof Fanzo received her PhD in Nutrition at the University of Arizona, and was the Stephen I. Morse Postdoctoral Fellow in Immunology in the Department of Molecular Medicine at Columbia University. https://eatforum.org/contributor/dr-jessica-fanzo/ Have something to say about the commission or the podcast? Let us know your thoughts by leaving us a comment via social media or wherever you get your podcasts! Further reading: https://eatforum.org/eat-lancet-commission/ https://eatforum.org/lancet-commission/healthcare-professionals/ Full report: Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems https://hubs.ly/H0gcll-0

Is it possible to support small, individual clinicians with an interest for research, while also encouraging collaborative research from major medical centers and teaching hospitals? These topics and others are explored on this episode of the AMSSM Sports Medcast. Host Dr. Devin McFadden, MD is joined by a panel which includes Dr. Anthony Beutler, MD, Dr. Andrew Peterson, MD, and Dr. Stephanie Kliethermes, PhD who help form a portion of the AMSSM’s Collaborative Research Network leadership. They cover the history of this organization from inception to present day, and discuss the challenges and strategic issues which the organization has faced in its brief existence to date. Collaborative Research Network website: https://www.amssm.org/CRN.php Editorial on the CRN- https://bjsm.bmj.com/content/early/2018/11/26/bjsports-2018-100330 Kliethermes SA, Beutler AI. Clinical research and the AMSSM collaborative research network. Br J Sports Med. Published Online First: 27 November 2018. doi: 10.1136/bjsports-2018-100330

We have known for a long time that exercise is effective in lowering blood pressure. But how does it stack up against antihypertensive medication? On this episode, Dr. John Ioannidis joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss his recently published BJSM meta-analysis that made headlines around the world https://bit.ly/2EYW66J Dr Ioannidis is recognised as one the most influential scientists alive today. A Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine and a Professor of Statistics at Stanford University School of Humanities and Sciences, Dr Ioannidis has authored close to 1,000 academic papers and served on the editorial boards of 30 of the world's top journals. He is best known for his legendary 2005 PLOS medicine paper “Why Most Published Research Findings Are False”, which has been viewed over 2.5 million times. https://profiles.stanford.edu/john-ioannidis In this 15 minute conversation, Dr Ioannidis discusses: · The findings of his latest BJSM meta-analysis · How trials that examine exercise’s effects on blood pressure can be made more useful · How exercise can become part of routine hypertension management · What needs fixing in the world of evidence-based medicine Further reading: Naci H, Salcher-Konrad M, Dias S, et al How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure Br J Sports Med Published Online First: 18 December 2018. doi: 10.1136/bjsports-2018-099921 Naci H, Ioannidis JP. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. Bmj. 2013 Oct 1;347:f5577. Ioannidis JP. Why most clinical research is not useful. PLoS medicine. 2016 Jun 21;13(6):e1002049. Ioannidis JP. Why most published research findings are false. PLoS medicine. 2005 Aug 30;2(8):e124.

Did you know that fewer than 15% of women will actually achieve the minimum recommendation of 150 min per week of moderate-intensity physical activity throughout their pregnancy? Meeting the recommendation can reduce the risk of pregnancy-related illness such as depression by at least 25%, and the risk of developing gestational diabetes, hypertension and preeclampsia by 40%! So why are some clinicians still scared to prescribe physical activity to soon-to-be-mums? On this week’s episode, Dr. Margie Davenport PhD joins BJSM’s Daniel Friedman (T: @ddfriedman) to address common misconceptions regarding physical activity during pregnancy and explain the new 2019 Canadian guideline for physical activity throughout pregnancy (https://bjsm.bmj.com/content/52/21/1339) that was recently published in the BJSM. Dr. Davenport is an Assistant Professor in the Faculty of Kinesiology, Sport, and Recreation at the University of Alberta. She received her PhD in Integrative Exercise Physiology from the University of Western Ontario and conducted a two year Postdoctoral Fellowship at the University of Calgary. She is an emerging expert in metabolic and cardiovascular adaptations associated with normal and complicated pregnancies. Her primary interest is in the benefits of exercise prior to, during and following pregnancy for both mother and child. In this 20 minute conversation, Dr. Davenport discusses: · Who should be physically active throughout pregnancy + contraindications · How much physical activity is recommended throughout pregnancy · Examples of physical activity · Common misconceptions and safety precautions Resources: www.exerciseandpregnancy.ca Program for Pregnancy and Postpartum Health videos: https://www.youtube.com/channel/UCtvzYizIALcs5-RzfHrf5UA 2019 Canadian Guideline: http://csepguidelines.ca/wp-content/uploads/2018/10/4208_CSEP_Pregnancy_Guidelines_En_P2A.pdf. https://bjsm.bmj.com/content/52/21/1339

Did you know that one in four people have hypertension? And with recent changes to diagnostic criteria in major clinical practice guidelines, the prevalence is only going to increase. With concerns about the cost, effectiveness, and potential for side effects of antihypertensive drugs, isn’t it time we looked beyond the pharmacy shelves to lower blood pressure? On this episode, Dr. Huseyin Naci PhD (T: @huseyinnaci2) joins BJSM’s Daniel Friedman (T:@ddfriedman) to discuss his recently published BJSM meta-analysis that compares the effectiveness of exercise and antihypertensive medications on lowering blood pressure. Dr Naci is an Assistant Professor of Health Policy at the London School of Economics and Political Science. During the 2018-2019 academic year, he is a UK Harkness Fellow in Health Care Policy and Practice at the Harvard Kennedy School of Government and Harvard Medical School. His research to date has evaluated the quality and quantity of the evidence base underpinning the approval, adoption, and reimbursement of new pharmaceutical and health technologies in Europe and the US. He has a PhD in Health Policy from the Department of Social Policy at the LSE and an MHS in International Health from the Johns Hopkins Bloomberg School of Public Health. In this 20 minute conversation, Dr Naci discusses: · The history of antihypertensive medications · Exercise’s effects on blood pressure · The findings of his latest meta-analysis · His 2013 study that compared the effectiveness of pharmacological and non-pharmacological interventions on mortality · The clinical practice and guideline implications of the meta-analysis Further reading: Naci H, Ioannidis JP. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. Bmj. 2013 Oct 1;347:f5577. https://bjsm.bmj.com/content/early/2018/12/05/bjsports-2018-099921.citation-tools Naci H, Ioannidis JP. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. Bmj. 2013 Oct 1;347:f5577. https://www.bmj.com/content/347/bmj.f5577

Host Dr. Devin McFadden, MD is joined by Dr. Lisa Fortier, DVM, PhD on the AMSSM Sports Medcast to discuss regenerative medicine technologies and the current evidence for their use. Dr. Fortier is a Professor of Surgery at Cornell University, College of Veterinary Medicine in Ithaca, New York, with a particular interest in translational research including the prevention of post- traumatic osteoarthritis. In addition, her internationally renowned research investigates the clinical application of stem cells and biologics such as platelet-rich plasma and bone marrow concentrate for cartilage repair and tendinosis. In this 15 minute conversation Dr. Fortier addresses the following topics: What are orthobiologics and regenerative medicine? What is the evidence behind their use? What current research is being conducted in this field? Where she see the field in 5-10 years. IOC Consensus on Use of PRP in Sports Medicine- https://bjsm.bmj.com/content/44/15/1072 Engebretsen L, Steffen K, Alsousou J, et al. IOC consensus paper on the use of platelet-rich plasma in sports medicine. Br J Sports Med. 2010;44:1072-1081. Systematic Review of Stem Cell Use in Tendon Injuries- https://bjsm.bmj.com/content/51/13/996 Pas HIMFL, Moen MH, Haisma HJ, et al. No evidence for the use of stem cell therapy for tendon disorders: a systematic review. Br J Sports Med. 2017;51:996-1002. Role of platelet-rich plasma in articular cartilage injury and disease- https://www.thieme-connect.com/DOI/DOI?10.1055/s-0034-1384672 Mascarenhas R, Saltzman BM, Fortier LA, et al. Role of platelet rich plasma in articular cartilage injury and disease. J Knee Surg. 2015 Feb;28(1):3-10

What should we eat in order to stay healthy and avoid disease? Nutrition is one of the biggest drivers of chronic disease, including obesity and diabetes, yet the answer to this seemingly simple question remains a subject of heated debate. On this week’s episode, Dr. Zoë Harcombe (@zoeharcombe) joins BJSM’s Daniel Friedman (@ddfriedman) to address some common nutrition myths. Zoë has a PhD in public health nutrition. The full title of her thesis is: “An examination of the randomised controlled trial and epidemiological evidence for the introduction of dietary fat recommendations in 1977 and 1983: A Systematic Review and Meta-analysis“. She researches in the fields of nutrition, diet, dietary advice, diet-related health and obesity and writes and talks about these topics daily - http://www.zoeharcombe.com/ In this 30 minute conversation, Zoë reviews the evidence supporting commonly held nutrition beliefs and discusses: · Does red and process meat cause cancer? · Should everyone follow a Mediterranean diet? · Are wholegrains healthy? · How many fruit + veg should we be eating daily? · What makes up a nutritious diet? Further reading: Harcombe, Zoe. "Designed by the food industry for wealth, not health: the ‘Eatwell Guide’." (2017): 1730-1731.https://bjsm.bmj.com/content/early/2016/05/25/bjsports-2016-096297 Harcombe, Zoe. World Health Organisation, meat & cancer http://www.zoeharcombe.com/2015/10/world-health-organisation-meat-cancer/ Estruch, Ramón, et al. "Primary prevention of cardiovascular disease with a Mediterranean diet." New England Journal of Medicine 368.14 (2013): 1279-1290.

Professor Jon Drezner, a world authority on Sports Cardiology and vastly experienced Sport & Exercise Medicine physician, kindly gives us his time on this BJSM podcast to fill us in on updates in the Sports Cardiology world. Covering everything from high-risk groups, to the subsequent management of ‘positive’ screening results, this podcast will ensure that the listener is very much up-to-date with the latest research & developments in Sports Cardiology. For more information & a deeper-dive into the publications mentioned: Sports cardiology: preventing sudden cardiac death https://bjsm.bmj.com/content/48/15/1133 BMJ Learning ECG Interpretation Course: https://learning.bmj.com/learning/course-intro/.html?courseId=10042239 International criteria for electrocardiographic interpretation in athletes: Consensus statement https://bjsm.bmj.com/content/51/9/704 Outcomes of Cardiac Screening in Adolescent Soccer Players (NEJM) https://www.nejm.org/doi/full/10.1056/NEJMoa1714719 Cardiac arrest survival greatly increases when bystanders use an automated external defibrillator - Circulation Journal Report https://newsroom.heart.org/news/cardiac-arrest-survival-greatly-increases-when-bystanders-use-an-automated-external-defibrillator

Minimalist? Maximalist? Zero drop? Is there really one running shoe paradigm to rule them all? On this week’s episode, Dr. Chris Napier PhD (T: @runnerphysio) and Paul Blazey (T: @Blazey85) joins BJSM’s Daniel Friedman (T:@ddfriedman) to debate running shoe prescription. Chris is a Clinical Assistant Professor in the Department of Physical Therapy at the University of British Columbia, where he recently obtained his his PhD (“Running biomechanics and injury prevention”) in 2018. Since becoming a physio, Chris has specialised his training with postgraduate studies in manual therapy and sport physiotherapy. He is currently a physiotherapist of Athletics Canada. Chris competed at the national level as a successful middle-distance runner and today is an avid skier, kayaker, and marathoner. A self-proclaimed encyclopaedia of running shoes, Paul is a physio who has spent time working with Crystal Palace and Arsenal FC, with a keen interest in managing running and triathlon injuries. He left his physiotherapy clinic in England behind in 2017 to take up research at the University of British Columbia and currently works as a senior associate editor for BJSM. Like Chris, Paul is an accomplished runner with envious marathon times. In this 20 minute conversation, Chris and Paul discuss: Eliud Kipchoge’s recent marathon world record Different running shoes’ effects on running economy Running shoe prescription and tips for choosing shoes in-store Gait retraining The future of running shoes Further reading: Brick NE, McElhinney MJ, Metcalfe RS. The effects of facial expression and relaxation cues on movement economy, physiological, and perceptual responses during running. Psychology of Sport and Exercise. 2018 Jan 1;34:20-8. https://www.sciencedirect.com/science/article/pii/S1469029217303461 Napier C, Willy RW. Logical fallacies in the running shoe debate: let the evidence guide prescription. https://bjsm.bmj.com/content/early/2018/10/22/bjsports-2018-100117 Hoogkamer W, Kram R, Arellano CJ. How biomechanical improvements in running economy could break the 2-hour marathon barrier. Sports Medicine. 2017 Sep 1;47(9):1739-50.https://link.springer.com/article/10.1007/s40279-017-0708-0 Barnes KR, Kilding AE. A Randomized Crossover Study Investigating the Running Economy of Highly-Trained Male and Female Distance Runners in Marathon Racing Shoes versus Track Spikes. Sports Medicine. 2018:1-2. https://link.springer.com/article/10.1007/s40279-018-1012-3 Nigg BM, Baltich J, Hoerzer S, Enders H. Running shoes and running injuries: mythbusting and a proposal for two new paradigms:‘preferred movement path’and ‘comfort filter’. Br J Sports Med. 2015 Jul 28:bjsports-2015. https://bjsm.bmj.com/content/49/20/1290.short

Is this a dysplasia problem? Or is this an impingement problem? Did you know that a young adult with a non-arthritic hip problem sees an average of 4.2 health care providers before a diagnosis of impingement is made?! On this week’s podcast, Dr J.W. Thomas Byrd MD (T:@nashvillehipmds) joins AMSSM’s Sports Medcast (T: @TheAMSSM) to discuss femoroacetabular impingement and hip dysplasia. Dr. Byrd founded the Nashville Hip Institute to help treat patients with complex hip disorders using advanced surgical techniques. A recent Past President of both the International Society for Hip Arthroscopy (ISHA) and the Arthroscopy Association of North America (AANA), Dr Byrd has pioneered many of the surgical techniques for hip arthroscopy commonly employed throughout the orthopaedic world and invented numerous instruments that have revolutionised aspects of orthopaedic surgery. He has been one of the leaders for defining and developing the role of less invasive arthroscopic techniques in and around the hip. Dr. Byrd is currently the team physician for the Tennessee Titans and consults for many professional sports teams. https://nashvillehip.org/jw- thomas-byrd-md-orthopedic-hip-specialist-nashville-tn/ In this 20 minute conversation, Dr. Byrd addresses the following topics: What is FAI? The work-up of FAI – examination and imaging Management of FAI - when to intervene Hip dysplasia in athletes Common errors in managing hip pathology

Knowledge translation with Dr Sandro Demaio. Episode #354 There are over 1.5 million papers published each year…but as many as 50% of them are never read by anyone other than their authors, referees and journal editors. How can we move research from the laboratory, the academic journal, and the medical conference into the hands of people and organisations who can put it to practical use? On this week’s podcast, Dr Sandro Demaio (@SandroDemaio) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss how we can bridge the gap between evidence and practice in the real world. After leaving his role as the WHO’s medical officer for NCDs and Nutrition, Sandro was appointed the CEO of EAT (https://eatforum.org/contributor/dr-alessandro-demaio), a non-profit startup focused on food and sustainability. Formerly an Assistant Professor and Course Director at the University of Copenhagen’s School of Global Health, and a postdoctoral fellow at Harvard, Sandro regularly shares his knowledge and ideas at international conferences, universities and public events. He founded the PLOS Global Health Blog, NCDFREE (https://ncdfree.org) and festival21 (https://www.festival21.com.au), and is currently a bestselling author and TV host. http://sandrodemaio.com/about In this 20 minute conversation, Sandro addresses the following topics: The importance of knowledge translation Ways in which knowledge translation can be achieved Overcoming the “leaky research pipeline” Social media tips for clinicians

Management of shoulder pain has been estimated to account for 4.5 million visits to the doctor and $3bn (£2.3bn; €2.6bn) each year in the US alone. 44-70% of patients with shoulder pain are diagnosed with shoulder impingement syndrome. Although various non-operative treatment modalities are recommended as initial treatment for patients with shoulder impingement, subacromial decompression has become one of the most frequently performed orthopaedic procedures in the world...BUT DOES IT ACTUALLY HELP? On this week’s episode, Prof. Teppo Järvinen (@shamteppo) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the results from his latest clinical trial – the FIMPACT trial - that was recently published in the BMJ. Teppo is a Professor of Orthopaedics and Traumatology at the University of Helsinki and Helsinki University Hospital, and is head of the Finnish Centre for Evidence-Based Orthopaedics. He recently organised the 2018 Too Much Medicine symposium that took place in Helsinki, Finland. http://too-much-medicine.com/ In this 15 minute conversation, Prof. Järvinen addresses: ∙ shoulder impingement and subacromial decompression ∙ a brief overview of the FIMPACT trial ∙ the results of the trial and how to integrate the findings into clinical practice ∙ what does too much medicine mean for orthopaedic surgery ∙ the future of sham surgery Further reading: Paavola Mika, Malmivaara Antti, Taimela Simo, Kanto Kari, Inkinen Jari, Kalske Juha et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial BMJ 2018; 362 :k2860 https://www.bmj.com/content/362/bmj.k2860 FIDELITY infographic: https://www.bmj.com/content/bmj/362/bmj.k2860/F1.large.jpg Beard, David J., et al. "Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial." The Lancet 391.10118 (2018): 329-338. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32457-1/fulltext Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 2013;369:2515–24. https://www.nejm.org/doi/10.1056/NEJMoa1305189?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov FIDELITY study video: https://www.youtube.com/watch?v=RaDWkJHmEB0 Savulescu, Julian, Karolina Wartolowska, and Andy Carr. "Randomised placebo-controlled trials of surgery: ethical analysis and guidelines." Journal of medical ethics (2016): medethics-2015.https://jme.bmj.com/content/42/12/776

We catch up with BJSM Deputy Editor, Physiotherapist and hugely influential researcher Mario Bizzini. We discuss everything from the evidence behind injury prevention programmes, maximising their implementation, and the upcoming #SportSuisse2018 Links below: JOSPT Clinical Guideline https://www.jospt.org/doi/10.2519/jospt.2018.0303 Knakentroll (Swedish Group) - https://blogs.bmj.com/bjsm/2016/11/02/football-injuries-prevention-swedish-football-injury-warriors-martin-markus/ FIFA11+ https://bjsm.bmj.com/content/49/9/577 The Santa Monic Sports Medicine Research Foundation – The PEP Program: Prevent injury and Enhance Performance http://www.aclstudygroup.com/pdf/pep-program.pdf Implementing Injury Prevention – Aspetar Journal - http://www.aspetar.com/journal/viewarticle.aspx?id=406#.W6TYAf4zbEY Reference to Implementation Studies by Dr Alex Donaldson & colleagues in AFL https://www.ncbi.nlm.nih.gov/pubmed/30217833 #Sportsuisse2018 https://sportsuisse2018.ch/

Type 2 diabetes is a complex systems disease, caused by interactions between lifestyle and genes. It is an illusion to believe that it can be cured by medication. Lifestyle change should always be at the heart of treatment. Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care. Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology. In our 20 min conversation we discuss Dietary advice for people with type 2 diabetes The importance of other lifestyle measures Effects of lifestyle intervention in clinical practice Patient preferences

Do I really need this test, treatment or procedure? What are the downsides? What happens if I do nothing? And are there simpler, safer alternatives? Dr. Ray Moynihan (@raymoynihan) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the growing problem of overdiagnosis and overtreatment, and what is being done to wind back the harms of too much medicine. Ray is an Australian academic, author and award-winning health journalist who completed his PhD on overdiagnosis in 2015 at the Centre for Research in Evidence-Based Practice at Bond University in Australia, where he is also a senior research fellow. Having reported across print, radio, television and social media, Dr Moynihan has worked at the ABC TV’s investigative program, Four Corners and the 7:30 Report, and The Australian Financial Review. He has also developed an impressive body of academic work published in the Lancet, the New England Journal of Medicine, PLOS ONE and the BMJ. Dr. Moynihan has won several awards for his investigative journalism, and his book ‘Selling Sickness’ (2005) was described in the New York Times as a “compelling case” and has been translated into a dozen languages. His fourth book, ‘Sex, Lies & Pharmaceuticals’ was released globally in 2010 and generated widespread interest internationally. Dr Moynihan hosts the very popular podcast, ‘The Recommended Dose’, that is produced by Cochrane Australia and co-published by the BMJ. https://soundcloud.com/therecodo In this 25 minute conversation, Dr Moynihan explains the drivers of too much medicine and addresses: embracing healthy scepticism in healthcare the threat of too much medicine to our health the problem with diagnostic labels his ground-breaking discovery of a dangerous new disease what clinicians should do to practice ‘just the right amount’ of medicine (Goldilocks Principle)

We were thrilled to catch up again with Dr Andrew Murray, the recently appointed Chief Medical Officer to the PGA European Tour, European Tour Performance Institute, and Ryder Cup Europe. He is universally known for his work promoting physical activity for health, his ultra-endurance challenges, and for leading the ‘Golf and Health project’. In this podcast he covers everything from the health benefits of golf, how to produce a consensus statement, the WHO’s GAPPA, to how to overcome various factors affecting knowledge translation #Gold Various papers/resources are referred to throughout the podcast, links to which can be found below: http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099509 http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099771 The relationships between golf and health: a scoping review https://bjsm.bmj.com/content/51/1/12 Previous BJSM podcast on Golf & Health: https://soundcloud.com/bmjpodcasts/andrew-murray-1 The World Health Organization’s Global Action Plan for Physical Activity: Prof Fiona Bull https://soundcloud.com/bmjpodcasts/the-world-health-organizations-global- action-plan-for-physical-activity-prof-fiona-bull?in=bmjpodcasts/sets/bjsm-1 It is time to replace publish or perish with get visible or vanish: opportunities where digital and social media can reshape knowledge translation https://bjsm.bmj.com/content/early/2017/11/17/bjsports-2017-098367 We hope you enjoyed the podcast – get in touch with us via social media if you have any questions for @docandrewmurray

Contrary to the long held contention that low fat diets are best for people with type 2 diabetes (DM2), the totality of current evidence suggests that low carb diets are at least as effective in ameliorating metabolic health in DM2. In fact, low carb seems to be somewhat better, particularly in the short to medium term, although the evidence is of moderate certainty. On this week’s episode Prof Hanno Pijl (@HannoPijl) and dr Esther van Zuuren (@Ezzoef) join Dr Aseem Malhotra (@DrAseemMalhotra) to discuss the most appropriate diet for people with DM2 Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care. Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology In our 20 min conversation we discuss Efficacy of low fat versus low carb diets in the treatment of type 2 diabetes The method of weighing the certainty of evidence we used in our systematic review of the literature Dietary recommendations for people with type 2 diabetes https://academic.oup.com/ajcn/article-abstract/108/2/300/5051863

Did you know that the worldwide prevalence of obesity nearly tripled between 1975 and 2016? In 2016, more than 1.9 billion adults and more than 340 million children were classified as overweight or obese. At the individual level and in our modern, obesogenic world, weight gain has become the norm—the biological and social path of least resistance. On this week’s podcast, Dr Sandro Demaio (@SandroDemaio) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss childhood obesity and public health nutrition policy. After recently leaving his role as the WHO’s medical officer for NCDs and Nutrition, Sandro was appointed the CEO of EAT , a non-profit startup focused on food and sustainability. Formerly an Assistant Professor and Course Director at the University of Copenhagen’s School of Global Health, and a postdoctoral fellow at Harvard, Sandro regularly shares his knowledge and ideas at international conferences, universities and public events. He founded the PLOS Global Health Blog, NCDFREE and festival21, and is currently a bestselling author and TV host. http://sandrodemaio.com/about In this conversation, Sandro addresses the following topics:  Our current state of obesity  Policies needed to address childhood obesity  Sugar-sweetened disease and the sugar tax  Role of the clinician in addressing the obesity pandemic Further reading: Renzella, Jessica A., and Alessandro R. Demaio. "It’s time we paved a healthier path of least resistance." (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/03/07/bjsports-2017-098805 Murphy, Lisa, and Alessandro R. Demaio. "Understanding and removing barriers to physical activity: one key in addressing child obesity." (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/01/18/bjsports-2017-098546 Demaio, Alessandro. "A lifeSPANS approach: Addressing child obesity in Australia." Health Promotion Journal of Australia (2018). https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.44 Demaio, Alessandro, and Alexandra Jones. "The true price of sugar-sweetened disease: political inertia requires renewed, strategic action." The Medical Journal of Australia 209.2 (2018): 1. https://www.mja.com.au/journal/2018/209/2/true-price-sugar-sweetened-disease-political-inertia-requires-renewed-strategic Beale, Anna L., and Alessandro R. Demaio. "Non-communicable disease risk factors: a call for primary care clinicians to act and to refer. Brief intervention, not silent abdication." (2017): bjsports-2017. https://bjsm.bmj.com/content/early/2017/10/05/bjsports-2017-098475

Is saturated fat good or bad? But doesn’t it cause cardiovascular disease? And what about the guidelines? On this week’s episode, Dr. Zoë Harcombe (@zoeharcombe) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the takeaways from The BMJ’s Food For Thought conference 2018 (https://www.bmj.com/food-for-thought) and the demonisation of dietary fats. Zoë has a PhD in public health nutrition. The full title of her thesis is: “An examination of the randomised controlled trial and epidemiological evidence for the introduction of dietary fat recommendations in 1977 and 1983: A Systematic Review and Meta-analysis“. She researches in the fields of nutrition, diet, dietary advice, diet-related health and obesity and writes and talks about these topics daily - http://www.zoeharcombe.com/ In this 30 minute conversation, Zoë discusses: The strength of evidence in nutrition research Facts about dietary fats Our current understanding of saturated fat Does saturated fat cause cardiovascular disease? Are universal dietary guidelines feasible? Further reading: Forouhi, Nita G., et al. "Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance." BMJ361 (2018): k2139. https://www.bmj.com/content/361/bmj.k2139 Harcombe, Zoë. "Dietary fat guidelines have no evidence base: where next for public health nutritional advice?." Br J Sports Med 51.10 (2017): 769-774. https://bjsm.bmj.com/content/51/10/769 Harcombe, Zoë, Julien S. Baker, and Bruce Davies. "Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis." Br J Sports Med 51.24 (2017): 1743-1749. https://bjsm.bmj.com/content/51/24/1743.info Harcombe, Zoë, et al. "Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis." Open Heart 3.2 (2016): e000409. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985840/ Harcombe Z US dietary guidelines: is saturated fat a nutrient of concern? Br J Sports Med Published Online First: 14 August 2018. doi: 10.1136/bjsports-2018-099420 https://bjsm.bmj.com/content/early/2018/08/14/bjsports-2018-099420 Malhotra, Aseem, Rita F. Redberg, and Pascal Meier. "Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions." (2017): bjsports-2016. https://bjsm.bmj.com/content/51/15/1111

Did you know that a regular bottle of Gatorade contains 34g of sugar? That’s over 8 teaspoons of sugar! The WHO recommends that https://www.ncbi.nlm.nih.gov/pubmed/29735573

This heavyweight podcast is sure to be a knockout! On this week’s episode, sports medicine physician Dr. John Neidecker (@DrJohnNeidecker) joins BJSM’s Daniel Friedman (@ddfriedman) in the ring to discuss the hot topics in combat sports today. Dr. Neidecker is a physician for USA Boxing and USA Taekwondo, and is the vice president for the Association of Ringside Physicians (ARP) (http://www.ringsidearp.org/), an international non-profit organisation dedicated to the health and protection of boxers and mixed martial artists. He serves as the ARP certification committee chair, enabling physicians to become certified in ringside medicine, and currently practices at Orthopedic Specialists of North Carolina. Dr. Neidecker is also the lead author of the ARPs Consensus Statement on concussion in combat sports that was recently published in the BJSM. In this 20 minute conversation, Dr. Neidecker explains the current medical practices and controversies in combat sports, and addresses the following topics:  concussion management in combats sports  return to fighting protocol  common injuries in combats sports  weight cutting  ethics of combats sports Further reading: Neidecker, John, et al. "Concussion management in combat sports: consensus statement from the Association of Ringside Physicians." Br J Sports Med (2018): bjsports-2017. https://bjsm.bmj.com/content/early/2018/07/26/bjsports-2017-098799 McCrory, Paul, et al. "Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016." Br J Sports Med (2017): bjsports-2017. https://bjsm.bmj.com/content/51/11/838 Crighton, Ben, Graeme L. Close, and James P. Morton. "Alarming weight cutting behaviours in mixed martial arts: a cause for concern and a call for action." (2015): bjsports-2015. https://bjsm.bmj.com/content/50/8/446 Association of Ringside Physicians Releases Consensus Statement On Weight Management in Professional Combat Sports (2014) http://www.ringsidearp.org/resources/Documents/Position%20Statements/Weight%20Management% 20in%20Professional%20Combat%20Sports.pdf

Fresh off ‘BJSM Podcast World Cup’ victory, superstar physiotherapist Dr. Alison Grimaldi returns for what is sure to be another chart-topping podcast. On this week’s episode, Dr. Alison Grimaldi (@alisongrimaldi) joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the results from her latest clinical trial – the LEAP trial - that was recently published in the BMJ. https://www.bmj.com/content/361/bmj.k1662 With 25 years of clinical experience and particular expertise in the management of hip, groin and lumbo-pelvic pain and dysfunction, Alison is Principal Physiotherapist at Physiotec in Brisbane, Australia, and an Adjunct Research Fellow at the University of Queensland. Alison also has a special interest in the assessment and optimisation of lumbo-pelvic and lower limb biomechanics for running, change of direction and all weight bearing sports. She is currently involved with research studies through the University of Queensland and University of Melbourne. https://dralisongrimaldi.com/ Alison explains the clinical significance of the findings from the LEAP trial and shares some practical physiotherapy tips for clinicians helping patients manage gluteal tendinopathy pain. She discusses: Treatment options for managing gluteal tendinopathy pain Load management for gluteal tendinopathy Specific exercises for gluteal tendinopathy Alison continues to publish, present and provide practical workshops for other health professionals, and will be coming to Vancouver in September 2018 for her hip and groin pain masterclass! https://www.eply.com/DrGrimaldi-2018 You can listen to Dr. Grimaldi’s previous BJSM podcast on treating lateral hip pain here: https://soundcloud.com/bmjpodcasts/dr-alison-grimaldi-with-practical-physiotherapy-tips-on-treating-lateralhippain?in=bmjpodcasts/sets/bjsm-1

After listening to this one, you may want to think twice before reaching for that next bottle of kombucha! On this week’s podcast, microbiome expert Dr Patrick Hanaway joins BJSM’s Daniel Friedman (@ddfriedman) to discuss the implications of the gut microbiome for athlete health and performance. Dr Hanaway is a family physician who has served as the Director of Medical Education for the Institute for Functional Medicine, as well as the Medical Director at the Cleveland Clinic Center for Functional Medicine. He is also a past president of The American Board of Integrative Holistic Medicine. He is currently the Director of Research at the Cleveland Clinic Center for Functional Medicine (https://my.clevelandclinic.org/departments/functional-medicine), and practices at his clinic (http://www.familytofamily.org) in Asheville, North Carolina. In this 20 minute conversation, Dr Hanaway shares how clinicians can apply our current understanding of the gut microbiome in their clinical practice, and addresses the following topics: · What is the gut microbiome? · Microbial diversity throughout the life cycle and its relationship with different disease states · The relationship between different diets/foods/macronutrients and the gut microbiome · The effects of different types of physical activity on the gut microbiome · The role of probiotics in sport

In this podcast Katie Marino speaks to Jack Forsyth. Jacky Forsyth (@JackyForsyth) is a senior lecturer at Staffordshire University. She is a lead organiser of the Women in Sport and Exercise Conference. In this podcast Katie Marino (@krmarino1) speaks to Jacky about the difference in the amount of research done on exercise in women compared to exercise in men, and why we need to correct this imbalance. The research community needs to strengthen and promote research on women in sport and exercise, with the goal of optimising women’s athletic success and increase their participation rates. The Women in Sport and Exercise Academic Network (WISEAN) is mentioned in the podcast. It is a research-orientated interdisciplinary group that focuses on: Generating high quality, impactful research into women in sport and exercise (WISE); Collaborating and sharing resources; Increasing the visibility of WISE issues and Research mentoring. If you would like to join this network, please email [email protected] or [email protected] To keep up to date on WISEAN and the Women in Sport and Exercise Conference follow WISEAN on Twitter (@WISE_AN)

Thanks to BJSM editorial board member Daniel Friedman (@DDFriedman), who has also served as in intern at the World Health Organization, for hosting this podcast. The BJSM’s guest is Professor Fiona Bull, MBE – Program Manager of WHO Prevention of Noncommunicable Diseases Management Team, Geneva, Switzerland. @fiona_bull The conversation gives the listener a 20-minute gem that covers the following points What is the global action plan? How was it developed? Why was this needed? How does it differ from the 7 investments? What is the overall goal? (15% reduction in physical inactivity by 2030) What can the BJSM community and how can we follow progress? The answer to the last question is via the WHO ‘Let’s be active’ page: http://www.who.int/ncds/prevention/physical-activity/gappa Here is the link for the ‘’7 investments” document: https://bjsm.bmj.com/content/46/10/709 Here is the link for the Bangkok Declaration on Physical Activity: https://bjsm.bmj.com/content/bjsports/51/19/1389.full.pdf If you are interested in physical activity, see the 2018 BJSM special issue on walking here: https://bjsm.bmj.com/content/52/12

Thanks to Professor Lorimer Moseley for his 4th BJSM podcast over the last 4 years. Here he chats with final year medical student Daniel Friedman who is at the coalface (@DDFriedman). How are the terms pain, nociception and central sensitisation used? Are they taught accurately or poorly? All of us can learn from Lorimer as he clarifies these concepts. Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. people.unisa.edu.au/lorimer.moseley He combines Oxford rigour with a laconic and very popular Australian style of communication. You can find his patient-focused website ‘Tame the Beast’ here: www.tamethebeast.org/#home You can find his academic/health professional website ‘Body in Mind’ here: www.bodyinmind.org/ Lorimer’s 2014 BJSM podcast was on tendons. Still worth listening to. It has had 20K listens: ow.ly/5OGN30gkaD7. The 2017 podcast on pain was on pain (some overlap): http://ow.ly/XgNi30kaQax His 2018 update, focusing particularly on knowledge translation – helping the community become aware of, and benefit from contemporary pain science, is here: http://ow.ly/q3b230kIf4R

BJSM is one of very few channels that comments on food but doesn’t receive any funds from any food-related stakeholder. The BMJ doesn’t receive funds from food companies (as far as I know) and the new BMJ Open journal on nutrition doesn’t either. What about the ‘British Nutrition Foundation’ – sounds pretty helpful right? Well, it may be, but if you know where to click 5 times you can find that about 1/3 of its funding from corporate sponsors. The Academy of Nutrition and Dietetics has food sponsors too. That’s perfectly legal. What about Government Food Guidelines – surely they are based on health evidence? Well, they may be, but governments run the food guidelines past their Departments of Agriculture before finalizing them. And that is OK too – I can understand why that would happen – of course that Department has to have input. Government requires balancing competing interests. I don’t recommend people following national food guidelines (personal opinion – k2). I wouldn’t follow most nations’ food guidelines if I were given the food for free and paid $100 per day. Not for $500 per day – sorry. I’m fortunate as I’m on stable financial footing (touch wood). And what I eat may be ‘wrong’. This podcast is shared with the BJSM community in a spirit of humility and to provide data for folks to make up their own minds. Nina Teicholz is a journalist (let’s get than in early to save the critics from bringing it up – pre-empting the ad hominem attack) and she has a fascinating book that argues fats have been unfairly demonized. Since that book was published the news that Harvard scientists were paid for a report suggesting that fats, not sugar, caused obesity. http://ow.ly/j1Bc30kCvqx. Nina Teicholz tweets from @bigfatsurprise. Thanks to Dr Mark Hyman (@MarkHymanMD) for allowing us to edit his conversation with Nina Teicholz. Link to a recent Nina Teicholz comment in The BMJ: https://www.bmj.com/content/360/bmj.k822/rr-13 Here’s a link to the book that documents the case for healthy fats: https://thebigfatsurprise.com/ The original (full version) of Dr Mark Hyman’s podcast with Nina Teicholz on YouTube https://youtu.be/Zc_e5ME_5Cg Thanks again to Dr Mark Hyman and Nina Teicholz.