BJSM Podcast

Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Here’s a link to his personal website: http://www.hiparthroscopyclinic.co.uk/ He was the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302. He has published a major paper in the field of hip pain in one of the top sports medicine journals – The Lancet. Published @TheLancet on June 2nd. http://ow.ly/4LhQ30kvJ1u BJSM fortunate to have chatted with @DamianGriffin courtesy of @footballmed. Podcast about it with the BJSM community in two weeks - 15th June (all 2018). Previous podcast with Damian Griffin: About the FAI syndrome: http://ow.ly/oo7530kvJB5. Two years ago. Griffin DR, Dickenson EJ, O'Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med2016;50:1169-1176. http://bjsm.bmj.com/content/50/19/1169 You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on [email protected]

Dr Marcos Agostinho (@MarcMedMD) asks Professor Peter Krustrup (http://ow.ly/9slg30koLv1) about the history of football fitness. What is it? Does it involve games/competition? Who are the main beneficiaries? And what of ‘walking football’ – what does that entail? This short podcast is a celebration of the health benefits of football and it provides powerful practical examples of what can be done. Kudos! The 2nd International Football and Medicine Conference will be held in Odense, Denmark, on 25-26th January 2019. Here is a 2018 systematic review: Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis. http://ow.ly/oGBs30koLzT

Have you ever felt frustrated that research doesn’t get into the public domain? It’s stuck in journals, on shelves. But Lorimer is tackling that head on with community based engagement in his characteristic quirky way. Listen to the story of the ‘Pain Revolution’ – a movement that engages local communities by having trained pain educators share contemporary pain science in accessible ways. Ignore the massive bike ride that Lorimer and friends undertake to spread the message and raise the funds (for now!). Listen to the story that underpins ‘Tame the Beast’ and watch it. Share it widely. Part 2 next week! 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 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

How do we assess running biomechanics? Does it translate to practice? BJSM editor Tej Pandya chats with Chris Bramah (@chrisbramah), England Athletics physiotherapist and biomechanist based at the Manchester Institute of Health and Performance. Chris is completing a PhD dissertation on the links between running gaits and running injuries. They discuss: - Biomechanics of elite running athletes - Applying biomechanics to produce clinically relevant outcomes - A case of ITB syndrome in runners: What’s the role of biomechanical assessment? - Advances biomechanics technology - How the clinician can use biomechanics to assess athletes Links to some of the papers mentioned in the podcast: - How to estimate centre of mass in running? https://bit.ly/2k4KbbV - Movement of the spine and pelvis during running. https://bit.ly/2La501S

A great conversation between the fascinating Dr Alex Hutchinson and sports physiotherapist Chris Napier. Alex Hutchinson will be known to many because of his sports writing for Runners World (in the past) and Outside Magazine (now). He spent 9 years asking the question that is the title of this podcast – you get the answers in 20 minutes! In addition to the discussion of limits of performance, they share practical tips on how to improve your own running times! Here’s a link to Alex’s website https://alexhutchinson.net/about.htm and his twitter handle is @SweatScience. Here’s the link to Alex’s book ‘Endure’: http://ow.ly/oqlF30jWuiw The insightful interviewer is also a runner - the Vancouver sports physiotherapist and near PhD graduate – Chris Napier @RunnerPhysio. Chris heads the Scientific Committee for the World Congress in Sports Physiotherapy (2019). That conference, which builds on previous World Congresses in Bern and Belfast will be held in Vancouver, Canada, October 4-5, 2019. http://ow.ly/Y1Qj30jWutO. The World Congress is being hosted by Sports Physio Canada @SportPhysio_ON.

Dr. Cheri Blauwet is a leading and inspiring voice in sport and exercise medicine (SEM). She is a former Paralympic athlete in the sport of wheelchair racing, competing for the United States Team in three Paralypmic Games (Sydney '00, Athens '04, Beijing '08) and bringing home a total of seven Paralympic medals. She is also a two-time winner of the Boston Marathon. After an elite sporting career, she turned her attentions to medicine. Dr. Blauwet completed her residency training in Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital/Harvard Medical School and followed this by a Sports Medicine Fellowship at the Rehabilitation Institute of Chicago. A successful and influential career in SEM has so far culminated in Cheri acting as the Chairperson of the International Paralympic Committee’s Medical Commission. She also serves on the Board of Directors for the United States Anti-Doping Agency (USADA), promoting clean competition in sports. BJSM’s Liam West talks to Dr. Blauwet to highlight top learning points from her journey into SEM and the must know topics in disability sport. You can hear Cheri talk further on this topic at the Canadian Academy of SEM 2018 conference in New Halifax in June - https://bit.ly/2rif5S0 Similar Podcasts; Cerebral Palsy Soccer - https://soundcloud.com/bmjpodcasts/cerebral-palsy-football-1?in=bmjpodcasts/sets/bjsm-1 Further Reading; Webborn N, et al. Heads up on concussion in para sport. Br J Sports Med 2017 doi:10.1136/bjsports-2016-097236 Derman W, et al. Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-097962 Mountjoy M, et al. The IOC Consensus Statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med 2016 doi:10.1136/bjsports-2016-096121 Derman W, et al. High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days. Br J Sports Med 2017 doi:10.1136/bjsports-2017-098039 Blauwet CA, et al. Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline A Prospective Cohort Study at the London 2012 Paralympic Games. Am J Sports Med 2016;44:6 Blauwet CA, et al. Low Energy Availability, Menstrual Dysfunction, and Low Bone Mineral Density in Individuals with a Disability: Implications for the Para Athlete Population. Sports Med 2017;47(9):1697-1708

Thanks to Christina Le for providing the first ‘patient voices’ podcast for BJSM. Christina is speaking as a 31-year old patient who is dealing with a common scenario – non-contact ACL rupture while playing soccer. You can follow her patient journey and obtain advice from a top sports physio at @YEGphysio. Christina chatted with BJSM editor-in-chief Karim Khan. Christina addresses these common questions: How did the injury occur? Did you feel any pain later? How did you decide whether to opt for surgery or no surgery? What lifestyle changes are you prepared to make after this injury? With whom did you discuss further options? How do you know when to return to sport? Links: Return to play: 2016 Consensus statement link - http://bjsm.bmj.com/content/50/14/853 Dr Stepanie Filbay on return to sport factors post ACL reconstruction. https://www.ncbi.nlm.nih.gov/pubmed/27167588 Patient voices: Thanks to Osman Ahmed and Tracy Blake for launching the BJSM series. Read the blog here. http://ow.ly/1s4H30jHO1U.

Managing stress fractures in any athlete can be difficult. Liam West discussed the topic with international expert Dr. Kathryn Ackerman, to find out clinical management gems. Dr. Ackerman has specialist training in Internal Medicine, Sports Medicine and Endocrinology, Diabetes & Metabolism. This training has cumulated in positions as Medical Director of the Female Athlete Program at Boston Children's Hospital, Associate Director of the Sports Endocrine Research Lab at Massachusetts General Hospital, and Assistant Professor of Medicine at Harvard Medical School. She has focused research efforts on hormonal treatments to improve bone density and fracture healing, as well as various imaging modalities for assessing bone quality. Related Articles Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. bjsm.bmj.com/content/49/6/370.long IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491 Associated Podcasts Management of difficult stress fractures in sport - http://bit.ly/2EVorIM Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04 Podcast Quotes “There is a transient osteopenia during adolescenece that predisposes them to stress fractures” “Amenorrhic athletes have wider but weaker bones”

Machine learning. One of the buzz expressions currently being bandied around healthcare. But how can it be applied in sports medicine? In this BJSM podcast, we discuss it with two scientists currently applying machine learning to their practice, Chris Kelly and Dr Tommy Wood from nourishbalancethrive, a US-based performance optimization company. We discuss the applications of machine learning and its potential implications for healthcare. Topics include: - How to go about creating a machine learning model - What have they managed to predict so far - Limitations of using machine learning - Where do they see this technology moving forward to the future? - How can clinicians in sports use machine learning in practice? - How can anyone learn about machine learning? Link to nourishbalancethrive: https://bit.ly/2q3Yyk4 Link to an easy way to getting into coding: https://bit.ly/2EjQM9Y

We all know that exercise is medicine’s polypill. On this podcast, Dr. Blaise Williams discusses how to help older patient’s get active again. BJSM’s Liam West provides the questions that see Dr. Williams cover how the aged runner differs both in biomechanics and physiology, how this effects the forces through various areas of their bodies and finally the top clinical pearls you can use in your office today to help these older patients get moving again. If you haven’t listened to the first BJSM podcast with Blaise on his readiness to run scale, make sure you check that out too! Dr. Williams is an Associate Professor in the Department of Physical Therapy and the Director of the Virginia Commonwealth University (VCU) RUN LAB. Blaise teaches students at VCU within the orthopaedic and sports curriculum. Alongside this, he continues to treat athletes of all levels at the VCU Sports Medicine Clinic. Related Reading Paquette MR, DeVita P, Williams DSB 3rd. Biomechanical Implications of Training Volume and Intensity in Aging Runners. Med Sci Sports Exerc. 2017. Epub ahead of print. Powell DW, Williams DS. Changes in Vertical and Joint Stiffness in Runners with Advancing Age. J Strength Cond Res. 2017. Epub ahead of print. Devita P, Fellin RE, Seay JF, Ip E, Stavro N, Messier SP. The Relationships between Age and Running Biomechanics. Med Sci Sports Exerc. 2016. 48:98-106. Bus SA. Ground reaction forces and kinematics in distance running in older-aged men. Med Sci Sports Exerc. 2003, 35:1167-75. Similar Podcasts ▪From the AMSSM: Drilling down into running injuries – what they don’t teach in medical school http://bit.ly/2EvQbCP ▪From the AMSSM: 3 sports medicine legends on running injuries, illness and footwear http://bit.ly/2mfG7pM ▪Gait retraining to reduce leg pain with Dr Andy Franklyn-Miller http://bit.ly/1iTsOWb ▪Keeping runners running: the secrets of running assessment - advice and exercise progressions http://bit.ly/2EuGrIH Quotes “These changes occur as early as in our 40s, and in females even earlier” “Our physiology changes way before we see changes in our biomechanics”

Retired professional footballers are at a significantly increased risk of several health problems including osteoarthritis, mental health conditions, and difficulties pertaining to suboptimal lifestyle choices. During this podcast, Sean Carmody talks to Dr Vincent Gouttebarge, a retired professional footballer and current Chief Medical Officer of FIFPro (World Players’ Union), about what can be done to reduce the risk of health issues for footballers in retirement. Dr Gouttebarge has led several initiatives to improve outcomes for footballers in retirement, including a pilot ‘exit health examination’ study in collaboration with the Dutch Football Association and Dutch Players’ Union. Related Articles: Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in the general population: a cross-sectional study - http://bjsm.bmj.com/content/early/2017/10/25/bjsports-2017-097503 Perceptions of retired professional soccer players about the provision of support services before and after retirement - http://bjsm.bmj.com/content/bjsports/36/1/33 Prevalence and determinants of symptoms related to mental disorders in retired male professional footballers - https://www.ncbi.nlm.nih.gov/pubmed/27285354 Lower extremity osteoarthritis is associated with lower health-related quality of life among retired professional footballers - https://www.tandfonline.com/doi/abs/10.1080/00913847.2018.1451718

“There is no real optimal exercise program. There’s no such thing it doesn’t really exist.” LIVE from Copenhagen at the 14th Scandinavian Congress of Medicine & Science in Sports, Dr. Karen Litzy, PT, DPT, with the Healthy, Wealthy and Smart Podcast, interviews Dr. Peter Malliaras about exercise principles for patellar and Achilles tendinopathy. Peter Malliaras is an Associate Professor at Monash University in the Department of Physiotherapy. His research focus is musculoskeletal disorders, sports medicine and tendinopathy. In 2006 he completed his PhD in tendinopathy identifying novel risk factors, and since has undertaken post-doctoral research in the UK and Australia. Peter maintains a strong clinical focus, specializing in difficult tendinopathy cases and delivering clinical postgraduate education for clinicians in Australia and internationally. In this podcast, Peter discusses different loading programs, pain responses and the value of imaging for patellar and Achilles tendinopathy. Resources Peter Malliaras Twitter - http://bit.ly/2ESwPch Scandinavian Congress of Medicine & Science in Sports - http://bit.ly/2nHdZ0h Peter Malliaras Research Gate Profile - http://bit.ly/2G3K61c Tendinopathy Rehabilitation - http://bit.ly/2C94T0H Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness - http://bit.ly/2Bn2d34 Monash University Peter Malliaras Profile - http://bit.ly/2Ey1sGg

Professor Lars Engebretsen, MD, PhD, Head of Medicine & Science at the IOC’s Scientific and Medical Department discusses the massive problem that is ACL injuries in children under 12 years of age. Kids’ ACL ruptures are becoming more prevalent, the condition seems to affect boys and girls equally, and the management is controversial. There is universal agreement that preserving the meniscus (which can include meniscal suture) is critical. See the full consensus statement here - http://bit.ly/2FwQMF6 Links: Link to the FREE 2018 consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. http://bjsm.bmj.com/content/early/2018/03/07/bjsports-2018-099060 Editorial by Professor Nick Mohtadi, Dr Clare Ardern and Professor Lars Engebetsen on the need to preserve the meniscus. http://bjsm.bmj.com/content/early/2018/03/09/bjsports-2018-099169 Podcast: Lars Engebretsen on adult knee injuries (2016 podcast, 10K listens) https://soundcloud.com/bmjpodcasts/professor-lars-engebretsen-on-management-of-young-adult-and-older-patients-with-knee-injuries Podcast: Dr Ben Clarsen on elite athlete screening and monitoring https://soundcloud.com/bmjpodcasts/nipping-injuries-in-the-bud-practical-tips-for-injuryillness-care-in-elite-athletes Website: IOC Sports Physiotherapy Diploma – What is it? http://www.sportsoracle.com/Sports+Physical+Therapies/Home/

Dr. Tasha Stanton’s background in physiotherapy and pain science means her research is very clinically relevant. BJSM’s Liam West discusses with Dr. Stanton the pain experienced by patients with osteoarthritis, how fear and emotions can alter this pain and where the future of osteoarthritis pain management might lie. Related Articles: Evidence of central sensitisation, impaired pain inhibition, enhanced pain facilitation in OA: Edwards et al. BMC Musculoskeletal Disorders 2016; 17:284 Perception of harm influences pain: Wiech et al J Neurosci 2010; 30:16324-31 What people with OA think about exercise/harm: Holden MA, et al. Role of exercise for knee pain: what do older adults in the community think? Arthritis Care Res. 2012;64:1554-64. Somers et al. J Pain Symptom Manage. 2009;37:863-72. Pouli N, et al. The experience of living with knee OA. Disabil Rehabil. 2014;36:600-7 Modulation of pain by vision: Longo et al. J Neurosci 2009; 29: 12125-30; Longo et al. J Neurosci 2012; 32: 2601-7 Alterations in body perception in people with OA: Nishigami et al. PLoS ONE 2017; 12:e0179225 Gilpin et al. Rheumatology 2015; 54:678-82 Body illusions in people with pain: Bosch et al. PAIN 2016; 157:519-29. Altering sounds alters feelings of back stiffness: Stanton et al. Scientific reports 2017; 7: 9861. Associated Podcasts: Prof Hunter on OA and exercise - http://bit.ly/2DQAd9z OA in the spotlight - http://bit.ly/1Frwnxt Prof Moseley on the brain and mind in chronic pain - http://bit.ly/1u33pPY Pain coach and first patient contact for pain management - http://bit.ly/2DHCaGa Am I safe to move? Prof Moseley on understanding pain and focusing on the patient - http://bit.ly/2nmCAqu Podcast Quotes: “Give your patient the locus of control” “Knowledge helps you frame what is happening in your world” “People with osteoarthritis often hold beliefs that movement is harmful”

Understanding and managing your patient’s pain can be extremely difficult. Liam West spoke to Dr. Tasha Stanton to tap into her vast expertise in the area of pain science. Dr. Stanton is a Senior Research Fellow for the “Body in Mind” group in Australia and has a background in physiotherapy, spinal biomechanics and pain neuroscience. Her work to date has led to several prestigious pain science awards. In this podcast she explains the disconnect between tissue damage and the pain experience, why people experience different levels of pain to the same stimulus and shares how to explain pain to a patient within a clinic setting. Related Articles Discordance between findings on scans (i.e., tissue damage) and pain Hannan MT, Felson DT, and Pincus T. 2000. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatology 27:1513-1517. Brinjikji et al American Journal of Neuroradiology 2015;36:811-16 Central sensitisation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/ http://www.noigroup.com/en/Product/EPBII Things that fire together, wire together: http://www.noigroup.com/en/Product/EPSB Explaining the neurobiology of pain: Moseley GL, Butler DS. Fifteen years of Explaining Pain. J Pain. 2015;16:807-13 Our sensations (including pain) are based on the believable, credible evidence that is available to us: Expectations of pain can be important: Bingle et al. Sci Transl Med 2011;3:70ra14 Other sensory input can change pain – the stinky smell study: Bartolo et al PAIN 2013 Our sensations are influence by the meaning that we attach to information: Moseley, Arntz. PAIN 2007;133:64-71 People with chronic pain are not good at learning safety (extinguishing fear to what was painful movement): https://www.ncbi.nlm.nih.gov/pubmed/27776989 A feeling of control and pain: http://psycnet.apa.org/doiLanding?doi=10.1037%2F0033-2909.90.1.89 Associated Podcasts Prof Moseley on the brain and mind in chronic pain - http://bit.ly/1u33pPY Pain coach and first patient contact for pain management - http://bit.ly/2DHCaGa Am I safe to move? Prof Moseley on understanding pain and focusing on the patient - http://bit.ly/2nmCAqu Podcast Quotes “Things that fire together, wire together” “Things that change the ‘need to protect’ your body changes pain”

Research so often includes ‘education’ in the comparison arm of clinical trials as though it is a universal, standardized, or perhaps even inert component of intervention. But what if education IS a key ingredient in managing patellofemoral pain? Erin Macri met up with Dr. Michael Rathleff after hearing some impressive presentations from him and his team members at the 5th International Patellofemoral Pain Research Retreat in Gold Coast, Australia. Dr. Rathleff works at the Research Unit for General Practice in Aalborg. He is an associate professor and head of the OptiYouth research group that works towards improving musculoskeletal health in adolescents. In this podcast, Dr. Rathleff shares some innovative and evidence-based approaches to optimizing outcomes for patellofemoral pain using strategic, targeted education. Related Articles Rathleff MS, Roos E, Olesen J, Rasmussen S. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial. Br J Sports Med 2015;49(6):406-12 Associated Materials for upload Educational slides for use with patients (attached)

Listen to leading physiotherapists continue their conversation on common ground when treating patients with disabling pain. (Link to Part 1 here http://ow.ly/mi3c30iqGSI) In this episode the focus is treatment - what can you do to provide an all-around programme that respects the biopsychosocial model. · How to assess the patient given the history you have obtained · Common ground they have discovered in treating backs and knees – there are many shared experiences and lessons from them · Exercise is the most powerful treatment – which ones, when, how to promote adherence with a programme. Links to papers: 1. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. bjsm.bmj.com/content/50/14/839 2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) bjsm.bmj.com/content/50/14/844 3. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. bjsm.bmj.com/content/51/24/1713.long The link to Part 1 of the conversation: http://ow.ly/mi3c30iqGSI The link to previous podcasts by these experts: Prof Kay Crossley’s previous BJSM podcast on treatment of patellofemoral pain (2015) http://ow.ly/PnHl30iqNlJ (10,000 listens) Prof Peter O’Sullivan on treatment of back pain (2014) http://ow.ly/Ws2Y30iqNyD

Join BJSM editor in chief Karim Khan eavesdropping on Professors Kay Crossley (La Trobe University, Melbourne) and Peter O’Sullivan (Curtin University, Perth) as they discuss the assessment and management of typical patients who present with long-standing knee pain and/or back pain. In podcast 1 (episode 320), they discuss: · The context from which to begin the consultation. What is the physio’s goal when taking the history? · What to ask about · How to frame the assessment when discussing the patient’s fears · What NOT to do or say! Links to papers: 1. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. bjsm.bmj.com/content/50/14/839 2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) bjsm.bmj.com/content/50/14/844 3. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. bjsm.bmj.com/content/51/24/1713.long Links to podcasts: Prof Kay Crossley’s previous BJSM podcast on treatment of patellofemoral pain (2015) https://soundcloud.com/bmjpodcasts/assoc-prof-kay-crossley-on-procedures-for-patellofemoral-pain Prof Peter O’Sullivan on treatment of back pain (2014) https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-curtin-walks-you-through-two-cases-of-low-back-pain

Dr. Blaise Williams has a passion for helping people to get active and especially to get running. He is an Associate Professor in the Department of Physical Therapy and the Director of the Virginia Commonwealth University (VCU) RUN LAB. Blaise teaches students at VCU within the orthopaedic and sports curriculum. Alongside this, he continues to treat athletes of all levels at the VCU Sports Medicine Clinic. His research interests are in the areas of biomechanics and pathomechanics of running injuries, dynamic balance after injury and limb coordination during functional tasks. On this podcast he discusses his readiness to run scale with BJSM’s Liam West. Related Reading Roelofs EJ, Smith-Ryan AE, Melvin MN, Wingfield HL, Trexler ET, Walker N. Muscle size, quality, and body composition: characteristics of division I cross-country runners. J Strength Cond Res. 2015, 29:290-6. Paquette MR, Peel SA, Schilling BK, Melcher DA, Bloomer RJ. Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise. Eur J Sport Sci. 2017, 17:546-554. Kuhman D, Melcher D, Paquette MR. Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners. Eur J Sport Sci. 2016;16:433-40. Raabe ME, Chaudhari AMW. Biomechanical consequences of running with deep core muscle weakness. J Biomech. 2018;67:98-105. Luedke LE, Heiderscheit BC, Williams DS, Rauh MJ. Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Med Sci Sports Exerc. 2016;48:1244-50. Similar Podcasts ▪From the AMSSM: Drilling down into running injuries – what they don’t teach in medical school http://bit.ly/2EvQbCP ▪From the AMSSM: 3 sports medicine legends on running injuries, illness and footwear http://bit.ly/2mfG7pM ▪Gait retraining to reduce leg pain with Dr Andy Franklyn-Miller http://bit.ly/1iTsOWb ▪Keeping runners running: the secrets of running assessment - advice and exercise progressions http://bit.ly/2EuGrIH Quotes “I always try to get them to work on distance slowly, before they work on speed or intensity” “Injured athletes need to be able to land before they are able to go back running”

From the University of Queensland, Australia, physiotherapist and PhD candidate Liam McLachlan and Professor of Sports Physiotherapy Bill Vicenzino share clinical pearls relating to the patient with patellofemoral pain. Dr Erin Macri, physiotherapist and BJSM editorial board member doing her postdoctoral studies at the University of Delaware leads the conversation. •Why is it important to consider psychological factors in patellofemoral pain? •Which instruments should I use in the clinic (clue, google “Startback tool”) •Which comes first, the psychological distress or the pain? •Can explanation and reassurance contribute to reducing pain and improving function? •Bottom line – time to rethink from the narrow mechanical (only) perspective. Here are some key links: *Systematic review: The psychological features of patellofemoral pain: a systematic review. First author: Liam Maclachlan. http://bjsm.bmj.com/content/51/9/732 FREE *Be sure to check the 3 BJSM Patellofemoral consensus statements (all free): 1.2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. http://bjsm.bmj.com/content/50/14/839 2. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) http://bjsm.bmj.com/content/50/14/844 3. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. http://bjsm.bmj.com/content/51/24/1713.long *The STarT Back Screening Tool (SBST): Home page. https://www.keele.ac.uk/sbst/startbacktool/ Twitter: @Bill_Vicenzino: https://twitter.com/Bill_Vicenzino @PaulWHodges: https://twitter.com/PaulWHodges (coauthor)

In this Podcast, Heart Digital Media Editor Dr. James Rudd is joined by Dr. Aseem Malhotra from Lister Hospital, Stevenage, UK. They discuss what we should tell our patients about diet and exercise - high fat, low fat or something else? Link to published paper: bjsm.bmj.com/content/51/15/1111 Further Listening Management of mature athletes with cardiovascular conditions - https://soundcloud.com/bmjpodcasts/management-of-mature-athletes-with-cardiovascular-conditions?in=bmjpodcasts/sets/heart-podcast Physical activity for the prevention of heart disease - https://soundcloud.com/bmjpodcasts/physical-activity-in-the-prevention-of-coronary-heart-disease-implications-for-the-clinician?in=bmjpodcasts/sets/heart-podcast Aseem Malhotra on the impact of diet on heart disease https://soundcloud.com/bmjpodcasts/aseem-malhotra-dont-fear-the-fat Fearless cardiologist author, Dr Aseem Malhotra, busts myths and shares Pioppi health secrets https://soundcloud.com/bmjpodcasts/fearless-cardiologist-author-dr-aseem-malhotra-busts-myths-and-shares-pioppi-health-secrets

Dr. Kathryn Ackerman talks in this podcast to Dr. Liam West about the hot topic of energy availability in sport giving us clinical tips to manage athletes we suspect might be at risk of the consequences of low energy availability. Dr. Ackerman has undertaken board certification in Internal Medicine, Sports Medicine and Endocrinology, Diabetes & Metabolism. This training has cumulated in positions as Medical Director of the Female Athlete Program at Boston Children's Hospital, Associate Director of the Sports Endocrine Research Lab at Massachusetts General Hospital, and Assistant Professor of Medicine at Harvard Medical School. Kathryn’s research focuses on the Female Athlete Triad and the various aspects of Relative Energy in Deficiency in Sport. Related Articles IOC Concensus Statement: RED-S - http://bjsm.bmj.com/content/48/7/491 Misunderstanding the FAT - http://bjsm.bmj.com/content/48/20/1461 IOC RED-S Clinical Assessment Tool - http://bjsm.bmj.com/content/49/21/1354 Associated Podcasts AMSSM Sports Medcast- Female Athlete triad - http://bit.ly/2lBP7WJ Thoughts from the England Football CMO - http://bit.ly/2CpV6Zp Margo Mountjoy on the REDS debate - http://bit.ly/1KzYT04 Podcast Quote Low energy availability happens to others, it can happen to men, it can happen to disabled athletes.

For the 2nd time on the BJSM podcast, Sean Carmody is joined by David Dunne to discuss practical considerations for the travelling athlete. During his time with Orreco, David has worked closely with athletes from professional golf and the NBA, most of whom face gruelling travel demands during competition. David and Sean delve into the strategies the practitioner can employ to help reduce the risk of illness, minimise the effects of jet lag, improve sleep and optimise performance. These strategies are complimented by lessons David has learnt during his PhD in Behaviour Change at Liverpool John Moores University. Key research linked below: Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2–3-fold increased risk of illness: http://bjsm.bmj.com/content/46/11/816.

In this podcast, Dr Sean Carmody speaks to Dr Nick van der Horst, who has recently published a paper on decision-making and medical criteria for return to play following hamstring strain injuries. Nick, who is First team physiotherapist at the Go Ahead Eagles in the Dutch Eerst Divisie and holds a PhD in football medicine, provides his thoughts on the controversies around the role of MRI and eccentric strength in determining return to play, and also shares his beliefs about why hamstring strain injuries continue to rise. Finally, Nick closes the podcast with his key tips for clinicians managing hamstring strain injuries. There is lots of research referred to during the podcast, and these are linked below: Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making: http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-097206 Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study: http://bjsm.bmj.com/content/early/2016/01/08/bjsports-2015-095359 Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey: http://bjsm.bmj.com/content/early/2015/05/20/bjsports-2015-094826 Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making: http://bjsm.bmj.com/content/early/2015/06/02/bjsports-2014-094569.short?rss=1 Hamstring injuries and predicting return to play: ‘bye-bye MRI?’ http://bjsm.bmj.com/content/49/18/1162 MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes: http://bjsm.bmj.com/content/early/2015/08/24/bjsports-2015-094892

Over the last few years, rugby medicine has been somewhat mired with controversy. From ‘Bloodgate’, to concussion, there have been many back-page features in the press, often calling for quite sensationalist measures. Against this backdrop, and away from the gaze of the press, World Rugby have been busy synthesising an evidence base, and adapting the game to try and maximise player welfare. Such efforts have often flown under the radar, and today on the podcast we hear from its Chief Medical Officer & Senior Scientific Advisor, who address a variety of topics including: -The process behind the recent law changes -Trying to optimise the prevention and management of concussion -Injury prevention -Trying to build an evidence-informed player welfare initiative Some resources that you may find useful, and are mentioned in the podcast include: -World Rugby Medical website http://playerwelfare.worldrugby.org/ -The evidence underpinning the tackle laws -Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies http://bjsm.bmj.com/content/51/15/1152 -Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review http://bjsm.bmj.com/content/50/15/921 -Tackle technique and body position of the tackler and ball carrier significantly influences head injury risk in rugby union http://bjsm.bmj.com/content/51/11/A70.2 -Berlin Concussion Consensus http://bjsm.bmj.com/content/51/11/838 Let us know your thoughts on what is discussed via the normal social media channels – we look forward to hearing from you!

Embedding physical activity in the undergraduate healthcare curriculum is an important step to building capacity in the future workforce to promote physical activity, every contact. This podcast features two UK medical schools and schools of health describing their approaches to upskilling tomorrow’s healthcare professionals, in physical activity, for tomorrow’s patients using the #MovementForMovement educational resources and a community of practice approach. More about Ann Gates here: http://www.exercise-works.org/. And here is the BJSM 2015 podcast with Ann Gates and Ian Ritchie on this topic - https://soundcloud.com/bmjpodcasts/training-tomorrows- doctors-in- exercise-medicine-for-tomorrows- patients. 6,000 listens already.

Professor Stanley Herring is a clinical professor at the University of Washington (UW) in the Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine, and Neurological Surgery. He is director of the UW Medicine Sports Health & Safety Institute, medical director of Sports, Spine and Orthopedic Health for UW Medicine, and co-medical director of the Sports Concussion Program, a partnership between UW Medicine and Seattle Children's. Dr. Herring's clinical interests include non-operative musculoskeletal and sports medicine with a particular interest in disorders of the spine and sports concussion. He is a team physician for the Seattle Mariners and a consultant to the UW Sports Medicine Program. In this podcast he talks to BJSM’s Liam West about an important cause of low back pain in our adolescent sporting population – spondylolysis. They discuss common presentations, examination techniques, imaging protocols and clinical pearls for treatment. References Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis - http://bjsm.bmj.com/content/40/11/940.info Nonoperative treatment of active spondylolysis in elite athletes with normal X-ray findings: literature review and results of conservative treatment - https://www.ncbi.nlm.nih.gov/pubmed/11806390 Union of defects in the pars interarticularis of the lumbar spine in children and adolescents - http://bjj.boneandjoint.org.uk/content/86-B/2/225 Nonoperative treatment in lumbar spondylolysis and spondylolisthesis: a systematic review - https://www.ncbi.nlm.nih.gov/m/pubmed/24427393/

Die Evidenz basierte Medizin ist ein Grundpfeiler medizinischen Handelns und ist im täglichen Leben des Arztes und Physiotherapeuten nicht mehr wegzudenken. Dr Andreas Waltering (IQWIQ) gibt uns eine Einführung in die Evidenz basierte Medizin (EBM). Anfangen mit der Entstehungsgeschichte der EBM. Die EBM wurde im Gegensatz zu Deutschland von der Ärzteschafft selber gefordert. Im deutschsprachigen Raum wurde die EBM primär eingeführt um der Fehlversorgung entgegen zu wirken. Dr Markus Laupheimer (@swisssportscare) stellt die Fragen. Wieso ist EBM wichtig? Sollen wir den Vorlieben der Chef oder Oberärzte folgen? Oder sollen wir Patientenbezogen die EBM einsetzten? EBZ ist für ein Gesundheitssystem wichtig um Therapien die nachweislich was Bewirken zu fördern und zu bezahlen. Im Gegensatz dazu sollten Therapien die Nachweislich keinen Nutzen haben nicht von der Solidargemeinschaft bezahlt werden. Systematische Übersichtsarbeiten helfen Verzerrungen von einzelnen Studien zu vermeiden um den größten Aussagewert zu erhalten. Hierarchie der Evidenz: http://canberra.libguides.com/c.php?g=599346&p=4149721 Praktisches Beispiel in der Sportmedizin gibt es viele, jedoch eines der meisten untersuchten Therapien ist die Arthroskopie bei Gonarthrose, welche keinen Vorteil zu Placebo zeigt. #Bewegungsmedizin #Evidenzbasiert Dabei sollten wir nicht vergessen “Bewegung bringt Heilung” (https://soundcloud.com/bmjpodcasts/einfuhrung-in-die-bewegungsmedizin-bewegung-bringt-heilung-mit-dr-boris-gojanovic?in=bmjpodcasts/sets/bjsm-1) Weitere links zur Evidenzbasierten Medizin: Deutsches Netzwerk Evidenzbasierten Medizin e.V. http://www.ebm-netzwerk.de/ Center of evidence-based medicine University of Oxford IQWIQ : Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen https://www.iqwig.de/ Euch einen aktiven und bewegungsreichen Tag! Nun viel Spaß mit diesem Podcast des BJSM. Und vergesst nicht uns auf Twitter @BJSM_BMJ, Facebook oder google+ zu folgen. Da gibt es regelmäßig neue updates. Für feedback oder Anregungen für neue Podcasts schreibt mir einfach eine mail [email protected]

Dr. Michael Makdissi is a Sports & Exercise Medicine (SEM) Physician based in Melbourne. He has pursued a career that blends both clinical and research roles. His research is mainly based around concussion and it is this area where he has become a globally respected voice. Liam West poses the questions in this podcast that sees Dr. Makdissi discuss the new Sports Concussion Assessment Tool (SCAT) 5, common mistakes made when managing athletes with concussion, updates within the SCAT5 and tips on how to use it. To read the full paper related to the new SCAT5 please follow the link, The Consensus Statement - http://bjsm.bmj.com/content/51/11/838. Or head to the BJSM website to find further related papers: The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale - http://bjsm.bmj.com/content/51/11/848; Sport concussion assessment tool - 5th edition - http://bjsm.bmj.com/content/51/11/851.

Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. http://people.unisa.edu.au/lorimer.moseley He combines Oxford rigour with a laconic and very popular Australian style of communication. In this podcast he addresses the questions: What’s new in our understanding of the spinal cord? What should we be telling patients? Is the ‘hands on, hands off’ debate a useful one? How do you feel the profession is performing right now? On the subject of what should we be telling patients, he argues we should train them to ask clinicians 3 questions. 1.How do I know my pain system is over-protective? 2.What can I do to retrain my system to be less protective? 3.Am I safe to move? You can find his patient website ‘Tame the Beast’ here: https://www.tamethebeast.org/#home And is previous BJSM podcast was on tendons. It has had >17K listens: http://ow.ly/5OGN30gkaD7. And here is a link to the Pain Revolution website: https://www.painrevolution.org/

Allyson M Pollock is professor of public health and Director of Institute of Health and Society in the Medical Faculty of Newcastle University. She is a public health doctor and has been researching injuries and rugby injuries for more than ten years. She takes what she describes as the ‘child’s perspective’ and asks – Do children know the risks of playing school rugby? Do all schools have appropriate risk mitigation? She reminds us that the health benefits of physical activity are well proven – but if one critically reviews the literature those benefits have not been proven for school rugby. This is a controversial position that is strongly countered by others. BJSM doesn’t have a position in this debate – our job is to highlight that there is a respectful debate and to encourage scrutiny of the existing evidence. We encourage researchers to add new data to this question and similar ones in sport. Links: University of Newcastle Press Release: Prof Pollock’s letter to all 4 Chief Medical officers of the UK: http://www.ncl.ac.uk/press/news/2017/09/banrugbytackleforkids/ World Rugby’s reply to above call. From The Guardian. https://www.theguardian.com/sport/2017/sep/26/ban-harmful-contact-from-school-rugby-games-to-reduce-injury-risk-say-experts Professor Pollock’s call to ban tackling in rugby in the BMJ: http://blogs.bmj.com/bmj/2017/09/25/allyson-pollock-and-graham-kirkwood-tackle-and-scrum-should-be-banned-in-school-rugby/ A reply to Prof Pollock by Dr Ross Tucker and colleagues: http://bjsm.bmj.com/content/50/15/921 Prof Pollock’s reply to World Rugby: http://bjsm.bmj.com/content/51/15/1113 The BMJ profile of Prof Pollock – “BMJ Confidential” (must have BMJ subscription): http://www.bmj.com/content/359/bmj.j4625 Prof Pollock’s Wikipedia page: https://en.wikipedia.org/wiki/Allyson_Pollock

Why are groin injuries so difficult to manage? How has rehabilitation advanced over the years? In this BJSM podcast, we interview Professor Michael Callaghan, Professor of Physiotherapy at Manchester Metropolitan University and Head of Physical Therapies at MUFC. We discuss the pressures of dealing with groin injuries in a team environment, the use of 1%ers, and surgical options for dealing with the groin. Michael is involved with the organisation of the inaugural MUFC Conference starring experts in the field such as Damian Griffin, details of which can be found here: www.manutd.com/medicalconference Another key BJSM podcast focusing on the biomechanics of groin injury can be here: https://goo.gl/GWeQ62 Adam Weir, vastly experienced physiotherapists, also shares his pearls on groin treatment here: https://tinyurl.com/y88zplkb

This episode takes place from Surrey Sports Park, the training base of Harlequins Rugby Union. During the podcast, performance nutritionist David Dunne delves into the following topics with Dr Sean Carmody: -Managing weight loss safely in weight dependent sports (eg boxing, MMA) -Developing muscle mass appropriately in rugby union players -Nutritional considerations in the professional golfer In addition to his work with Harlequins, David has worked in several sports including Queens Park Rangers FC (football), Team Wiggins (cycling), GB Canoeing and professional boxing. David also holds a position with data analytics and sport science company, Orreco. Links to the research discussed during the podcast are listed below: https://www.researchgate.net/publication/304529333_Acute_Weight_Loss_Strategies_for_Combat_Sports_and_Applications_to_Olympic_Success https://www.researchgate.net/project/Waterloading-in-combat-sport-athletes-as-means-to-manipulate-body-mass http://www.tandfonline.com/doi/abs/10.1080/17461391.2017.1297489?scroll=top&needAccess=true&journalCode=tejs20 The Liverpool John Moores University observational MMA case study discussed is still currently in press. To keep up to date on this research follow the below profiles on researchgate: https://www.researchgate.net/profile/Carl_Langan-Evans https://www.researchgate.net/profile/Ben_Crighton

Michele Verroken is the founding director of Sporting Integrity, a consultancy which advises governing bodies about identifying, adopting and managing best practice procedures relating to risk, ethical and integrity standards and issues in sport. Formerly Director of Ethics and Anti-Doping at UK Sport, Michele has worked in elite sport for over thirty years. She currently works as an Anti-Doping advisor to the PGA European Tour and is Secretary of the Commonwealth Games Federation Medical Commission. Here, in conversation with Sean Carmody, Michele outlines her anti-doping efforts in golf, the problems with the TUE system, and the three key things that any clinician working in golf must consider in order to prevent doping.

Respiratory conditions are often neglected in the world of sports medicine, so we’ve got two world leaders on a podcast, recorded at the famous Centre for Health & Human Performance in London, to enlighten us on respiratory conditions in sport. Our guests Dr James Hull is Consultant Respiratory Physician with a specialist expertise in assessing athletes with unexplained breathlessness. He is an invited member of the American Thoracic Society expert committee for Exercise Induced Bronchoconstriction and is widely published in this field. Dr. John Dickinson is an Exercise Respiratory Physiologist with a specialist in assessing exercise respiratory symptoms in athletes. He has tested over 1,000 elite athletes from a range of sports including all Olympic and many professional sports, such as rugby and Premier League football. In this podcast we discuss: What are the common respiratory conditions that every sport & exercise medicine clinician should be comfortable with? What work-up do these athletes need? What is the gold-standard management of exercise-induced bronchoconstriction in athletes? What is EILO – and why is it important we know about it? Check out the BJSM social media channels for further resources!

Professor Jon Drezner is a family medicine physician from Seattle, USA with expertise in sports medicine and sports cardiology. He shares the new international criteria for electrocardiogram (ECG) interpretation in athletes - these lead to a lower false positive rate while maintaining sensitivity. He clearly defines the key changes and what to look out for on an ECG. You can access the International ECG Criteria paper below and also check out the conference Prof. Drezner is organising in Seattle 2-3 November 2017. International ECG Interpretation Criteria - http://bjsm.bmj.com/content/early/2017/03/03/bjsports-2016-097331. Conference: “Prevention of Sudden Cardiac Death in Athletes: Sports Cardiology for the Team Physician and Cardiology Consultant” - https://uw.cloud-cme.com/Ap2.aspx?EID=4649&P=5.

Angela Smith is an attending orthopaedist at Nemours/Alfred I duPont Hospital for children, and Clinical Professor of Orthopaedics and Paediatrics at Sidney Kimmel Medical College of Thomas Jefferson University. She is the past president of the American College of Sports Medicine, and acts as a member of the Executive Committee of FIMS. She draws upon her extensive clinical experience of working with youth athletes to discuss with BJSM’s Liam West the hotly debated topic of early sports specialisation. Is this needed in order for athletes to be success? Or are we causing a higher injury risk in these kids? All this and more inside the podcast… Further Reading: Caring for the young athlete: past, present and future - http://bjsm.bmj.com/content/51/3/141 Debunking early single sport specialisation and reshaping the youth sport experience: an NBA perspective - http://bjsm.bmj.com/content/51/3/142 Early sport specialisation, does it lead to long-term problems? - http://bjsm.bmj.com/content/47/17/1060 Youth sports injury prevention: keep calm and play on - http://bjsm.bmj.com/content/51/3/145 Sports specialised risks for re-injury in young athletes: A 2+ year clinical prospective evaluation - http://bjsm.bmj.com/content/51/4/334.2 Promoting the athlete in every child: physical activity assessment and promotion in healthcare - http://bjsm.bmj.com/content/51/3/143 Similar Podcasts: Injuries in kids: Why do they occur? Is specialisation a problem? Sam Blanchard - http://bit.ly/1HqnXsf

AMSSM Podcast host Dr. Krystian Bigosinski is joined by Dr. Alessio Fasano, the W. Allan Walker Chair in Pediatric Gastroenterology and Nutrition and Director of the Center for Celiac Research and Treatment at Massachusetts General Hospital, as well as Dana Lis, RD, PhD, owner of Summit Sports Nutrition in Vancouver, British Columbia. Topics of conversation include the definition of gluten and FODMAPs and their potential role in leading to both gastrointestinal and constitutional symptoms in athletes, a practical diagnostic approach to evaluate an athlete manifesting GI symptoms, recognition of the spectrum of disease from gluten sensitivity to true celiac disease, when to consider initiating a restrictive diet and subsequently how to reintroduce foods, and the potential risks of athletes restricting their diets without a formal pathological diagnosis. Links: Noakes T, Volek JS, Phinney SD. Low-carbohydrate diets for athletes: what evidence?. Br J Sports Med 2014;48:1077-1078. http://bjsm.bmj.com/content/48/14/1077 Collins J, McCall A, Bilsborough J, et al. Football nutrition: time for a new consensus?. Br J Sports Med Published Online First: 02 March 2017. doi: 10.1136/bjsports-2016-097260 http://bjsm.bmj.com/content/early/2017/03/02/bjsports-2016-097260 Lis DM, Fell JW, Ahuja KDK, Kitic CM, Stellingwerff T. Commercial Hype Versus Reality: Our Current Scientific Understanding of Gluten and Athletic Performance. Current sports medicine reports. 2016;15(4):262-268. doi:10.1249/JSR.0000000000000282. http://journals.lww.com/acsm-csmr/fulltext/2016/07000/Commercial_Hype_Versus_Reality___Our_Current.11.aspx

A respected global voice within Sports Physiotherapy, Phil Glasgow returns to the BJSM podcast to share his thoughts and expertise on loading for injury prevention and treatment. Phil has worked at numerous major international sporting events and was the Chief Physiotherapy Officer for Team GB at the Rio 2016 Olympics. As Former Head of Sports Medicine at Sports Institute, Northern Ireland, he has amassed extensive experience in high performance sport working with elite athletes from a wide range of sports learning their best loading patterns amongst the way. BJSM’s Liam West poses the questions that see Phil take you through the fundamental principles of loading, when to start loading after injury, different loading patterns based on tissue type and loading pattern variations during rehabilitation. Want to hear more on loading? Check out these two conferences below that Phil and other great speakers will be discussing loading patterns more in depth; -Second World Congress of Sports Physical Therapy in Belfast, Northern Ireland on 6th-7th October 2017 (http://www.opload2017.com) -New Zealand Sports Physiotherapy Conference in Auckland, 14th-15th October 2017 (http://bit.ly/2vudQmN). Some further reading: PRICE needs updating, should we call the POLICE? - http://bjsm.bmj.com/content/46/4/220 Optimal loading: key variables and mechanisms - http://bjsm.bmj.com/content/49/5/278 Optimising load to optimise outcomes - http://bjsm.bmj.com/content/51/13/985 A view from New Zealand and an invitation to Sports Physiotherapy New Zealand’s Symposium (14–15 October 2017) - http://bjsm.bmj.com/content/51/5/413 Training – injury prevention paradox. Should athletes be training smarter AND harder bjsm.bmj.com/content/early/2016…sports-2015-095788 Related Podcasts: Dream Team of training load management: How training influences injury and performance - http://bit.ly/29gPxxg Putting load management evidence into practice: Sometimes you can’t! Dr Darren Burgess - http://bit.ly/2el00rR

One of the most influential cardiologists in Britain and a world leading expert in the prevention, diagnosis and treatment of heart disease, Dr Aseem Malhotra is a brave advocate for public health initiatives. An award-winning NHS cardiologist, Dr Malhotra has successfully motivated leading academics, the media and politicians to make sugar reduction a health priority in the UK. His academic publications can be found in the BMJ and BJSM (see links below) and he is prominent in mainstream media. He recently published what is already a best-seller, “the Pioppi Diet: A 21 day lifestyle plan”. https://www.penguin.co.uk/books/305991/the-pioppi-diet/ Links: Dr Malhotra explains that if folks want to lose weight they need address eating habits and food choices: http://bjsm.bmj.com/content/49/15/967 “You can’t outrun a bad diet” Dr Malhotra on saturated fat - it does not clog the arteries. Coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced by healthy lifestyle interventions: http://bjsm.bmj.com/content/51/15/1111. Interesting in low-carb eating and the rationale for real food? Here is obesity warrior, Dr Sarah Hallberg on TEDx. She explains how to reverse Type 2 diabetes (‘sugar diabetes’). >2million views! https://www.youtube.com/watch?v=da1vvigy5tQ Previous related podcasts: Dr Aseem Malhotra: You cannot outrun a bad diet. https://soundcloud.com/bmjpodcasts/you-cant-outrun-a-bad-diet-draseemmalhotra-on-weight-loss-strategies Professor Tim Noakes: Time to revisit real food choices. https://soundcloud.com/bmjpodcasts/prof-tim-noakes-time-to-revisit-food-choices-the-real-meal-revolution-lchf-summit-for-health Dr Sarah Hallberg: Why we get fat. https://soundcloud.com/bmjpodcasts/why-we-get-fat-insulin-is-a-fat-storing-hormone-dr-sarah-hallberg-renowned-obesity-doctor

Ian Needleman is a Professor of Restorative Dentistry at the Centre of Oral Health and Performance, University College London (UCL) Eastman Dental Institute. Prof Needleman is on a mission to combat poor oral health in athletes. Alongside his research team, he has proven oral healthcare at the elite level to be poor, that this leads to a decrease in performance and has suggested that oral health screening should be routine for athletes (link to these papers below). You can also check out, download and use an infographic on oral healthcare published in the BJSM (link below). BJSM's Medical Editor Dr. Liam West caught up with Prof. Needleman at the 2017 IOC Injury and Illness Prevention Conference (Monaco) to discuss why athletes should care about their oral healthcare. You can find out more from Ian and his team on their website - www.ucl.ac.uk/cohp - Extra Links Poor Oral Health in Professional Football Study - http://bjsm.bmj.com/content/50/1/41 Oral health screening should be routine in professional football: a call to action for SEM clinicians - http://bjsm.bmj.com/content/50/21/1295 Oral Healthcare Infographic - http://bjsm.bmj.com/content/51/9/757 London 2012 paper: http://bjsm.bmj.com/content/47/16/1054 Systematic review: http://bjsm.bmj.com/content/48/7/561.3

The American Medical Society for Sports Medicine (AMSSM) podcast is hosted by Dr Devin McFadden (Sports Medicine Fellow, Washington D.C) is your host. He chats with Dr Bert Fields (Sports Medicine Physician, Greensborough, North Carolina), Dr Robert Oh (Sports M edicine, Fort Benning, Georgia) and Dr Chad Asplund (Athletic Sports Medicine, Georgia Southern University). In this podcast (part 2 of 2), the experts on running injuries discuss: •What is the role of motion control shoes? •What factors unrelated to footwear do you look for in an injured runner? •What’s the role of the core? •Can nutrition contribute to obesity, metabolic syndrome even in distance runners? •What are the greatest risks to failing to meet your running goals? Link to Laurent Malisoux’s RCT on injury risk in motion control shoes vs standard shoes: http://bjsm.bmj.com/content/50/8/481 (Free) Link to part 1 of this podcast: https://soundcloud.com/bmjpodcasts/from-the-amssm-3-sportsmedicine-legends-on-running-injuries-illness-and-footwear The next AMSSM Annual meeting will be in Orlando, Florida, April 24-29, 2018.

Dr Boris Gojanovic (@DrSportSante) is a specialist sports medicine physician and a board member of the Swiss Sports Medicine Society. In addition to his Sports Medicine training, he is certified in Internal Medicine (General Medicine). In this chat about paediatric sports development, training and injuries he shares tips on interdisciplinary management of concussion, knee injuries. He tackles hip pain including that related to femoroacetabular impingement. He reveals his lessons from working as the lead doctor for national teams in the sports of gymnastics and youth triathlon. The Young Athletes Forum conference is in Montreux, September 21, 22, 2017. http://yaf2017.org/, Twitter @YAFfoundation Links to related podcasts: Lars Engebretsen on whether or not to reconstruct the ACL in children: http://ow.ly/1Hzr30e9Fu6 Ben Clarsen on monitoring workload in team settings: http://ow.ly/q6iL30e9FDw

Andy Nicholettos @sportinjuryandy is co-founder and head of sports medicine at Prevail Golf Performance, a specialist academy that blends golf coaching, sports medicine and strength and conditioning practice. Andy is also the author of “a movement in golf performance”. Aside from golf, Andy is the clinical lead at the Pain Clinic Oxford. He has lectured nationally and internationally on the application of pain science to sports performance, and has contributed to literature spanning exercise physiology, and orthopedics The discussion includes: •The Tiger Woods effect •What is golf fitness? •Marrying research and clinical practice. •Back pain in the golfer •How to get patients off the treatment merry-go-round •Myths in golf practice

New York physiotherapist Dr Karen Litzy @KarenLitzyNYC, host of physio podcast 'Healthy Wealth and Smart' poses the practical questions to Dublin’s Dr Marie-Elaine Grant. Dr Grant has been Ireland’s Olympic Team Chief Physiotherapist since 1992 and Chief Physiotherapist with the IOC Medical Commission for the London 2012 Games. The discussion includes: •Whether to tape or brace or not •For how long should an athlete use tape or brace? •If the athlete is superstitious? Is it OK to keep taping for luck •The K-tape question •Tape falling off – re-tape or not? •Any adverse events? Contraindications •How long do the properties of the tape last? •Bracing vs. neuromuscular training Download the ‘BJSM’ mobile app to your phone, tablet or desktop computer if you want to benefit from over 200 experts sharing their tips.

Prof. Roald Bahr is the Head of the Aspetar Sports Injury & Illness Prevention Programme, Chair of the Oslo Sports Trauma Research Center and a member of the IOC medical committee. Prof. Bahr’s main research area is the prevention of injury and illness in athletes, and has published more than 200 papers and book chapters. In this podcast he talks to BJSM's Dr. Liam West about his views on musculoskeletal screening - why it doesn't work and probably never will. You can access his review paper on this topic using the link below: Bahr - Why screening tests to predict do not work - http://bjsm.bmj.com/content/50/13/776 Clarsen - Screening is dead. Long live screening! - http://bit.ly/2tPJ5Hu If you want to catch Prof. Bahr and other keynote speakers get along to the Dutch annual sports medicine scientific conference in Holland on the 23rd and 24th November 2017. http://www.sportmedischwetenschappelijkjaarcongres.nl/pg-31582-7-113164/pagina/home.html

Jo Gibson is a Clinical Physiotherapy Specialist at the Liverpool Upper Limb Unit based at the Royal Liverpool Hospital, UK. She lectures both nationally and internationally about rehabilitation of the shoulder. Her research interests are shoulder instability and motor learning. Jo is currently Squad Physiotherapist for the Great Britain Endurance riding Team.

Dr. Jeremy Lewis is a Consultant Physiotherapist and Professor of Musculoskeletal Research (University of Limerick, Ireland). Originally born in New Zealand, he trained in Australia before moving to England where he now works in both the Public (NHS) and Private sectors. Dr. Lewis has distinguished himself and become a globally respected voice in the area complex shoulder issues in both clinical and research capacities. This podcast has been adapted from one originally published by our friends Kinetic Labs (https://kineticlabs.ca/ - where you can find the full version). Dr. Lewis shares his thoughts with the listeners on; •Shoulder Impingement •Rotator Cuff tears •Shoulder special tests and why they aren't that special •Shoulder Surgery •Shoulder Symptom Modification Procedures and how they help treat patients •What mistakes we commonly make when treating shoulder pain For extra podcast resources on shoulder issues in SEM, check out; •Practical Clinical Shoulder Pearls with Adam Meakins - https://soundcloud.com/bmjpodcasts/shoulder-focus-with-leading-sports-physiotherapist-adam-meakins-practical-clinical-pearls?in=bmjpodcasts/sets/bjsm-1 •Prof McCormack on whether to operate on Shoulder Dislocations - https://soundcloud.com/bmjpodcasts/shoulder-dislocation-to-operate-or-rehabilitate-prof-bob-mccormack-olympic-physician?in=bmjpodcasts/sets/bjsm-1 •Scapular Summit with Ben Kibler - https://soundcloud.com/bmjpodcasts/scapular-summit-2013?in=bmjpodcasts/sets/bjsm-1 •5 Clinical shoulder tips with Dr. Mark Hutchinson - https://soundcloud.com/bmjpodcasts/five-clinical-tips-for?in=bmjpodcasts/sets/bjsm-1 •Prof Jeremy Lewis on Rotator Cuff Tendinopathy - https://soundcloud.com/bmjpodcasts/prof-jeremy-lewis-rotator-cuff?in=bmjpodcasts/sets/bjsm-1 •Shoulder Injuries with Ann Cools - https://soundcloud.com/bmjpodcasts/shoulder-injuries-with-ann?in=bmjpodcasts/sets/bjsm-1 •The Shoulder in Sport with Ben Kibler - https://soundcloud.com/bmjpodcasts/the-shoulder-in-sport-with-ben?in=bmjpodcasts/sets/bjsm-1 •Clinical assessment of the Tennis Shoulder with Ben Kibler - https://soundcloud.com/bmjpodcasts/dr-ben-kibler-examination-and-diagnosis-of-the-tennis-player-part-one?in=bmjpodcasts/sets/bjsm-1

Assistant Professor Dr Fiona Wilson is a Chartered Physiotherapist in the discipline of Physiotherapy, Trinity College, Ireland. She has over 25 years of clinical experience in the UK, South Africa and Ireland. She has worked with elite and international athletes throughout her career and was Lead Physiotherapist for Rowing Ireland for 10 years. Her research has focused on sport and exercise medicine with a special focus on rowing and back pain and recently in rugby and concussion. She is editorial board member for BJSM and was awarded the prestigious Cochrane Fellowship in 2012. In this podcast Dr Wilson shares wisdom on topics such as: •Managing back pain in the mature rower •3 common pitfalls / stroke issues to assess •How to assess the rowing athlete •How rowers monitor load / or not •How you can use technology and apps to monitor rowers •How to apply lessons from rowing to managing back pain in all sports and among the general public •Debate on stability and mobility – are planks associated with increased incidence of back pain? 3 previous BJSM podcasts on back pain in sport include the very popular: •Tiger Woods – soon after his 2014 spinal surgery, @PeteOSullivanPT (Prof Peter O’Sullivan) feared for the worst. Was surgery a good idea? Remember this conversation predated Tiger Woods’ plunging down the world ranking. https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-peteosullivanpt-on-tiger-woods-back-and-core-strength •Tiger Woods – 2015 update. With @PeteOSullivanPT after a 2nd operation a year later. How helpful is the postoperative MRI scan? https://soundcloud.com/bmjpodcasts/test •Dr Kieran O’Sullivan (no relation to Peter above) shares 7 habits of highly effective clinicians who manage back pain. It’s had 23K listens! https://soundcloud.com/bmjpodcasts/dr-kieran-osullivan-on-managing-back-pain-7-habits-of-highly-effective-clinicians-part-2-2016

Struggling with swimmers and their shoulders? It’s something we clinicians struggle with, and have been for a long time. Today we’re gonna take this head on, how we can move the model from external impingement to anterior superior internal impingement (ASII). We are joined on this BJSM podcast with Andrew Delbridge and Craig Boetcher from Australia. Craig completed his PhD through Sydney University examining shoulder EMG back in 2010. He’s been the physiotherapist for the Australian swim team for the last 8 years, and offers a unique perspective to this issue, having been an elite swimmer himself. Craig is currently supervising Kylie Holt who is completing her PhD on Shoulder pain and pathology in elite swimmers. Kylie is a senior sport physio at the Australian institute of sport, and has been looking after the swimming programme since 2009. Our second guest is Andrew Delbridge, who has been working with Craig at Regent St Physiotherapy for the last 17 years. Andrew has been working in elite sport with throwing athletes, and has found a fresh way of looking at the swimmer’s shoulder. 1:25 What is swimmer’s shoulder? External impingement model from the 70s outdated 2:00 Difference between primary and secondary impingement 3:40 We’ve got swimmer’s shoulder wrong. Andrew explains some of the reasons. 5:10 Spoiler alert - you guessed it, its internal impingement. ASII- Anterior superior internal impingement 6:00 Clinical background that initially drove the reason for the new ASII approach 8:20 What can baseball teach us about swimming? The loads don’t make sense! Buhrkart influenced throwing shoulder which led to applying that in swimmers 9:25 3 questions to understand the swimmer’s shoulder: 1) What is the unique position for swimmers in their stroke, 2) what is the anatomical relations in that position, 3) can we reconcile pathology we see? 10:00 Unique position for the demands of swimming - elevation and internal rotation while in large amount of elevation 10:30 Literature also looks at this position (classic Hawkins & Kennedy) investigating the anatomy in this position. 11:30 Position vs load - which causes the pain? It’s mix of tensile and compressive load 12:00 ASSI explained Swimmers are super overhead workers 13:15 The data are building, but it’s still early. 60 swimmers included in large MRI study 15:00 Does this only apply to elite swimmers? No. 16:25 Key differences in ASII model: Internal not external, tendinopathy (anterior or posterior). Mix loading (compressive load in ASII) which might apply to the whole cuff, Broad term of swimmer’s shoulder to vague, sub-classification needed to differentiate treatment 18:15 3 practical tips for the clinician: 1) Shift in thinking, apply your tendinopathy theory 2) Use dynamometry to assess cuff health 3) Monitor training load. Full text now available here: https://goo.gl/rQ4EMF