JOSPT Insights

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review. In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy. ------------------------------ RESOURCES Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/ Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/ Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/ Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/ Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Sports Corner is back for 2024! Today, we revisit ice hockey, and focus on acute injuries—preventing and managing them. Dr Joe Robinson is the head physical therapist for the National Hockey League’s Boston Bruins. He skates into Sports Corner to explain the physical demands of hockey, the typical acute injuries he sees and how to prevent them, and runs through how the medical team responds during emergency scenarios.

Does the thought of managing elbow pain leave you reaching for your orthopaedics textbook? Maybe you've got lateral elbow tendinopathy sorted, but how confident do you feel about managing elbow fractures and dislocations? Today, Val Jones, Clinical Lead Physiotherapist at the Sheffield Shoulder and Elbow Unit at the Sheffield Teaching Hospital Foundation Trust, shares practical advice to help you feel confident about managing elbow pain. ------------------------------ RESOURCES CT versus MRI for assessing osteochonritis dissecans of the capitellum: https://pubmed.ncbi.nlm.nih.gov/36342019/ Shoulder arm return to sport test battery: https://pubmed.ncbi.nlm.nih.gov/31203142/ Lateral elbow pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2022.0302 2022 Bern shoulder consensus: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952 JOSPT Insights episode 136 (lateral elbow pain with Drs Lucado and Day): https://podcasts.apple.com/us/podcast/ep-136-lateral-elbow-pain-2022-clinical-practice-guideline/id1522929437?i=1000617533681 JOSPT Insights episode 103 (baseball pitching biomechanics with Wake Forest Pitching Lab): https://podcasts.apple.com/us/podcast/ep-103-baseball-pitching-biomechanics-with-the-wake/id1522929437?i=1000581372250

Did you know that calf injuries are one of the most common soft tissue injuries in team sports? How comfortable do you feel assessing and managing calf pain, especially designing and progressing a program to help someone get back to their sport? Today, Dr Seth O'Neill from the University of Leicester, joins us to blend the latest science in calf injury with high-level clinical reasoning. You'll get something out of today's chat whether you're beginning in your clinical career or whether you're looking for suggestions for advanced clinical practice.

Two (gentle) giants of physiotherapy/physical therapy research and practice join JOSPT Insights today. Associate Professor Peter Kent and Professor Peter O'Sullivan (Curtin University, Perth, Australia) share, on behalf of the whole trial team, the results of their RESTORE trial. Does cognitive functional therapy herald a revolution in how clinicians can support people to live well with back pain? Let's find out. ------------------------------ RESOURCES For the published trial: https://pubmed.ncbi.nlm.nih.gov/37146623/ Find out lots more about the RESTORE trial, including how patients and clinicians feel about cognitive functional therapy: https://www.restorebackpain.com/

Someone walks into your clinic with a sore shoulder. Are you dealing with a stiff shoulder? A rotator cuff problem? The acromioclavicular joint? Or something else entirely? Today, Dr Angela Cadogan (PT, PhD) - Specialist Physiotherapist and clinical consultant - is helping you hone your clinical reasoning in differential diagnosis of subacromial pain. Dr Cadogan shares her practical approach to diagnosing subacromial pain in a way that you can take straight to the clinic tomorrow.

Welcome to part 2 of our masterclass with Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia) on understanding, talking about and shifting the narratives we all carry about musculoskeletal pain. We are exploring the explicit and implicit messages that you communicate with your words and actions when you work with patients. Drs Bunzli and Caneiro share tips on communicating, and on developing your own practice as a musculoskeletal rehabilitation clinician. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

We're wrapping up the 2023 JOSPT Insights year with a 2-part chat with physiotherapists, researchers and educators, Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia). In part 1, we discuss the way that patients understand pain. Dr Bunzli kicks off by summarising the best research evidence, and Dr Caneiro shares some compelling clinical examples to explain how to apply the research to deliver quality musculoskeletal rehabilitation practice. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

In part 2 of this series, we continue chatting about designing and implementing a rehabilitation program after cervical discectomy with Drs Justin Lantz, Jessica Evaristo and Joseph Derian. Today we work through phases 3 and 4 in the rehabilitation program: re-modeling and maturation occurring around 12-weeks after surgery. We cover nerve glides and how to dose them, the goals and areas of focus for manual therapy and therapeutic exercise, incorporating proprioception training, and important clinical milestones to consider along the way. The patient’s goal was to return to manual labor, and we talk about how healing timelines impact on clinical decisions in the later stages of rehabilitation. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608 Catch part 1 here: https://podcasts.apple.com/us/podcast/ep-158-planning-a-rehabilitation-program-after/id1522929437?i=1000637409917 or https://open.spotify.com/episode/0Ci1ya1CHXB8FgYYBO4Q3q?si=94b548f8e3bd4b4e

Join a group of experienced orthopaedic clinicians as they review the background of anterior cervical discectomy and fusion surgery in a 2-part podcast series. In part 1, we cover who does well with surgery, the indications and surgical procedure, plus a deep dive into evidence-based pre- and post-operative rehabilitation. There's not much hard research evidence to guide your decisions on how to structure and deliver, so tune into hear how expert clinicians approach things. You'll learn about the phases of rehabilitation (we tackle the first two in today's episode), what’s normal, what’s not, strategies for collaborating with surgeons, and suggested interventions. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608

Dr Jeremy Graber joins us to help answer the question: how often should patients with total knee arthroplasty come to rehabilitation? To answer this and more, we dive into the 2023 JOSPT article, “Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study.” ------------------------------ RESOURCES Dr Graber and his colleagues led a expert consensus process to establish recommendations for how often and for how long you might consider scheduing rehabilitation visits. The group also discussed discharge planning, how to implement telerehabilitation, and monitoring the patient's progress to guide clinical decisions Check out the JOSPT article: https://www.jospt.org/doi/10.2519/jospt.2023.11840 For more on predicting outcomes after total knee replacement: https://www.medrxiv.org/content/10.1101/2023.10.23.23297404v1 (preprint)

What you can do to help prevent neck pain? What are the best exercise approaches? PhD candidate, Florian Teichert, and Professor Daniel Belavy, from The University of Applied Sciences in Bochum, Germany, discuss which exercises and why they might work. We use their recent systematic review published in JOSPT as a launching point for the discussion. ------------------------------ RESOURCES To read the full systematic review: https://www.jospt.org/doi/10.2519/jospt.2023.12063 Blog and infographic: https://www.jospt.org/do/10.2519/jospt.blog.20231011/full/

How do you help someone manage cancer-related fatigue or get back to exercise after their treatment? Is it safe for someone with bone metastases to exercise? PhD candidate and recent Master of Physical Therapy graduate, Kendra Zadravec, and Professor Kristin Campbell (Department of Physical Therapy at the University of British Columbia, Canada) share their research and clinical expertise in developing physiotherapy interventions for people with cancer to help answers to these questions and more. ------------------------------ RESOURCES Canadian Physiotherapy Association Oncology Division: https://www.oncologycpa.ca/ American PT Association Oncology: https://oncologypt.org/ Australian Physiotherapy Association - Cancer, Palliative Care and Lymphodema: https://australian.physio/membership/national-groups/cancer-palliative-care-and-lymphoedema Macmillan UK: https://www.macmillan.org.uk/healthcare-professionals ACSM guidelines for exercise and cancer: https://www.acsm.org/news-detail/2019/10/16/expert-panel-cancer-treatment-plans-should-include-tailored-exercise-prescriptions One stop shop for cancer and exercise information: www.cancerexercise.ca (direct link to resources for health care providers: https://cancerexercise.med.ubc.ca/resources-hcp/ Recommendations for exercise with bone metastases (open access): https://pubmed.ncbi.nlm.nih.gov/34990293/ Systematic review on exercise for people with bone metastases: https://pubmed.ncbi.nlm.nih.gov/34358650/ Physical activity recommendations for cancer survivors living with bony metastases: https://pubmed.ncbi.nlm.nih.gov/33604871/

Does the thought of managing elbow pain leave you reaching for your orthopaedics textbook? Maybe you've got lateral elbow tendinopathy sorted, but how confident do you feel about managing elbow fractures and dislocations? Today, Val Jones, Clinical Lead Physiotherapist at the Sheffield Shoulder and Elbow Unit at the Sheffield Teaching Hospital Foundation Trust, shares practical advice to help you feel confident about managing elbow pain. For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427. ------------------------------ RESOURCES CT versus MRI for assessing osteochonritis dissecans of the capitellum: https://pubmed.ncbi.nlm.nih.gov/36342019/ Shoulder arm return to sport test battery: https://pubmed.ncbi.nlm.nih.gov/31203142/ Lateral elbow pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2022.0302 2022 Bern shoulder consensus: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952 JOSPT Insights episode 136 (lateral elbow pain with Drs Lucado and Day): https://podcasts.apple.com/us/podcast/ep-136-lateral-elbow-pain-2022-clinical-practice-guideline/id1522929437?i=1000617533681 JOSPT Insights episode 103 (baseball pitching biomechanics with Wake Forest Pitching Lab): https://podcasts.apple.com/us/podcast/ep-103-baseball-pitching-biomechanics-with-the-wake/id1522929437?i=1000581372250

Dr Casey Humbyrd—orthopaedic surgeon and Chief of foot & ankle orthopedics at the University of Pennsylvania—shares her expertise and insights on treating ankle sprains that are not responding to non-surgical treatment. Dr Humbyrd reviews ankle anatomy and her rationale for recommending surgery, how she performs a Broström repair, and explains how she works in close partnership with physical therapists and patients to achieve quality rehabilitation and return to sport outcomes. For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Do you work with young people with ACL injury? Well, you're in the right place! Today, Drs Chris Kuenze and Adam Weaver walk through the story behind creating a comprehensive normative dataset for knee function and strength outcomes. You'll learn how the project got started, and how you can use the information to help make even more informed clinical decisions. ------------------------------ RESOURCES Find the paper "Age-, Sex-, and Graft-specific Reference Values From 783 Adolescent Patients At 5-7 months After ACL Reconstruction: IKDC, PEDI-IKDC, KOOS, ACL-RSI, Single-leg Hop, and Thigh Strength" on the JOSPT website: https://www.jospt.org/doi/abs/10.2519/jospt.2023.11389 To access the normative database: https://dataverse.lib.virginia.edu/dataset.xhtml?persistentId=doi:10.18130/V3/JNPHUB For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

A surfer walks into your clinic with neck pain…What do you do next? And why? Dr Lynn McKinnis expertly walks through when and how to apply the Canadian C-Spine Rule when a patient presents with neck pain, types of vertebral artery injuries, and tips for diagnosing and treating acute neck trauma. ------------------------------ RESOURCES Learn more about the specific case here: https://www.jospt.org/doi/full/10.2519/jospt.2016.0416 Canadian C-Spine Rule: https://med-fom-clone-pt.sites.olt.ubc.ca/files/2014/01/C-spine-Rule-FAQs.pdf NEXUS Criteria for detecting clinically-important cervical spine injury following blunt trauma: https://www.nejm.org/doi/full/10.1056/NEJM200007133430203 For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Does the thought of dermatomes and myotomes, nerve trunks and nerve roots fill you with confidence or fill you with fear? Physiotherapist and neuroscientist, Dr Annina Schmid (Nuffield Department of Clinical Neurosciences, Oxford University), shares a checklist of what you need to know, and what you need to do, to nail your neurological assessment next time you're in the clinic. ------------------------------ RESOURCES Does your neurological examination for suspected peripheral neuropathies measure up? Do a check-up here: https://doi.org/10.2519/jospt.2022.11281 Why you cannot trust the dermatomes: https://www.youtube.com/watch?v=BZYtAR4zUpg&t=283s More from Dr Schmid's Neuromusculoskeletal Health and Science Laboratory: https://www.ndcn.ox.ac.uk/research/neuromusculoskeletal-health-and-science-lab For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Tendinopathy is a common and often challenging musculoskeletal condition. A cornerstone of diagnosing and managing tendinopathy is assessing the problem well. In today's episode, Dr Myles Murphy (Edith Cowan University, Australia) shares a new patient-reported outcome measure for evaluating Achilles tendinopathy-related disability, the TENDINS-A (TENDINopathy Severity Assessment-Achilles). ------------------------------ RESOURCES The TENDINopathy Severity Assessment-Achilles (TENDINS-A) patient-reported outcome measure: https://www.jospt.org/doi/10.2519/jospt.2023.11964 ICON 2019 International Scientific Tendinopathy Symposium consensus statement: https://pubmed.ncbi.nlm.nih.gov/31685525/ JOSPT Insights episode 79: Treating tricky tendons, with Dr Ebonie Rio: https://podcasts.apple.com/au/podcast/ep-79-treating-tricky-tendons-with-dr-ebonie-rio/id1522929437?i=1000558586146 or https://open.spotify.com/episode/6d8WMYDQI8s0X9Iu1G68aK Systematic review of Achilles tendinopathy outcome measures: https://pubmed.ncbi.nlm.nih.gov/34797533/ For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Foot and ankle surgeon, Dr Casey Humbyrd, returns to JOSPT Insights to share the surgeon’s perspective on Achilles tendon repair. What does she consider when helping patients to make a decision about surgery or no surgery? How does she perform the surgical repair, and why is she so fastidious with post-op restrictions? Dr Humbyrd is a champion for physical therapy, and underscores wound care, person-centred care, and why tension can help the Achilles! ------------------------------ RESOURCES For more about the American Orthopaedic Foot & Ankle Society: https://www.aofas.org/ More resources to share with patients: https://www.footcaremd.org/ For more on the AASPT x JOSPT Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Assessing how people move and helping them to reach their goals for moving is your bread and butter as a clinician. Today we're learning from 2 leaders in sports biomechanics: Drs Elanna Arhos and Stephanie Di Stasi from the Ohio State University. We discuss how to make sense of a biomechanics research article, how to translate what you read to clinical practice, and the minimum biomechanics set-up for your clinic. ------------------------------ RESOURCES For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.

Luke Keaney's career at the top level of Gaelic football was cut short at the age of 24 by hip pain and injury. After 5 hip surgeries and countless hours of hard work in the gym and rehabilitation room, Luke has switched his focus from Gaelic football to rowing, and has his eye on the Paris Olympics. While Luke's career in sport has continued in a different guise, he feels that things might have been different had the clinicians and practitioners he interacted with as a young athlete taken the time to listen and communicate better. Luke's messages about communicating are relevant whether you work with athletes or non-athletes, at professional or recreational levels, and with youth or adults - there's something for all musculoskeletal rehabilitation clinicians. ------------------------------ RESOURCES For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427. If you purchase your ticket before the end of August, you can take advantage of a $50 discount. Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir You can register to access full recordings of the Young Athlete's Hip Symposium, and the Oxford-Aspetar-La Trobe Young Athlete's Hip Webinar Series (11 webinars): https://www.ndorms.ox.ac.uk/events/Oxford-Hip-2022 The next Young Athlete's Hip Symposium is on 25-27 September, 2024 at Worcester College, Oxford University.

Have you ever found yourself feeling uncertain or confused when choosing a patient-reported outcome measure (PROM)? Today we're talking about the hallmarks of a PROM for people with patellofemoral pain. Physical therapist, educator and researcher, Professor Lisa Hoglund, fills in the gaps to help us find the promise in PROMs. ------------------------- RESOURCES Construct validity, reliability, responsiveness and interpretability of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2023.11730 Content validity and feasibility of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.11317 Find out more about the KOOS (including the Excel scoring sheet): http://www.koos.nu/index.html ------------------------- The American Academy of Sports Physical Therapy and JOSPT are joining forces to bring you the Virtual Sports PT Conference on Friday the 3rd and Saturday the 4th of November, 2023. Visit the link below to see the full conference programme and to secure your ticket. If you purchase your ticket before the end of August, you can take advantage of a $50 discount. https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427

Maybe you think of health literacy as the building blocks of knowing how to access the healthcare system, and knowing what to do when you have a cold? Today, Dr Rachel Harris is guiding us as we consider our collective health literacy of the particular health, wellbeing and performance needs of female athletes. Dr Harris represented Australia at the Olympics as a swimming athlete, and was the Chief Medical Officer for the Australian Paralympic team in Tokyo 2021. She leads the Australian Institute of Sport's female athlete performance and health, menstrual cycle and hormonal contraception project. ------------------------- RESOURCES For trustworthy education resources to share with athletes, coaches, parents and others who support female athletes, check out: https://www.ais.gov.au/fphi/education

Dr Lionel Chia joins Chelsea and Dan to bring his 2022 article in JOSPT, Beginning With The End In Mind: Implementing Backward Design To Improve Sports Injury Rehabilitation Practices, to life. Lionel outlines 4 categories to consider when planning return to sport and performance: (1) deconstructing goals, (2) determining key performance indicators, (3) assessing the challenge point, and (4) using the control-chaos continuum to guide interventions. We work through examples of why and where to use the concept of backward design during rehabilitation. ------------------------- RESOURCES Find Lionel's paper here: https://www.jospt.org/doi/10.2519/jospt.2022.11440 More on designing effect exercise progressions during rehabilitation (Blanchard & Glasgow): https://pubmed.ncbi.nlm.nih.gov/28756390/ More on motor learning and the challenge point—where effective practice occurs: https://pubmed.ncbi.nlm.nih.gov/15130871/ The control-chaos continuum and progressing rehabilitation (Taberner and colleagues): https://pubmed.ncbi.nlm.nih.gov/30737202/

As a JOSPT Insights listener, you already know programs like the FIFA 11+, the PEP program and the GetSet app for reducing injury rates in team sports like soccer (football) and handball. When you're working with athletes, coaches and parents, how easy is it to get them set up with a warm-up program that athletes can follow and stick to a few times a week? Today's chat might just give you a tool to make life easier for you and the athletes, coaches and parents you work with. Drs Hayley Root and Jeff Driban are here to tell us all about the new Remain in the Game toolkit. ------------------------- RESOURCES Get access to the Remain in the Game toolkit: https://oaaction.unc.edu/remain-in-the-game-a-joint-effort/ Learn more about all the work of the Osteoarthritis Action Alliance: https://oaaction.unc.edu/standup2oa/

The YAHiR (Young Athletes' Hip Research) Collaborative takes over the JOSPT Insights podcast today with a deep dive into best practice for imaging the painful hip. What is the best approach to imaging for young people with hip pain? When do you reach for radiographs? What are the pros and cons of MRI for hip pain? And how do you interpret and act on the information you gather from the scan? Never fear, Dr Vasco Mascarenhas—radiologist and Assistant Professor at Católica Medical School, Portugal—is here to explain all you need to know to confidently use imaging for hip pain in clinical practice. ------------------------------ RESOURCES More on the methods of imaging for hip preservation: https://pubmed.ncbi.nlm.nih.gov/31163499/ Overview of the state of play for imaging in suspected femoroacetabular impingement syndrome: https://pubmed.ncbi.nlm.nih.gov/32845416/

In part 2 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield and Dr Laura Cutler, with Dr Jake Bleacher continue discussing how they used graded motor imagery to help a patient with low back pain. Treatment sessions 3 and 4 include breakthroughs, progressions, graded movement exposure, and mindfulness training. We discuss who finds pain neuroscience most helpful, and Dr Chris Hughes explains why this case was a perfect match for JOSPT Cases. ------------------------------ RESOURCES Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875 Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/ Find the Why I Hurt Flashcards and heaps of helpful information about pain neuroscience education here: https://whyyouhurt.com/WYH-why.html Find out more about Headspace, and download the app for free: https://www.headspace.com/ Find "Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation" here: https://www.jospt.org/doi/10.2519/jospt.2018.0610 The NOI Group's website has plenty of courses and resources for clinicians on managing pain: https://www.noigroup.com/ Don't forget, JOSPT has a terrific series called Pain Science in Practice, which is all about helping you understand and link basic pain science to the clinic and quality musculoskeletal rehabilitation care. Find part 1 in the series (6 editorials, and more on the way!) here: https://www.jospt.org/doi/10.2519/jospt.2022.10995

In part 1 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield, Dr Laura Cutler, and Dr Jake Bleacher review their approach to supporting a patient with chronic low back pain. First, they review the history, clinical assessment, and the interventions performed over the first 2 treatment sessions. Next, the clinical team reviews how they decided when to leave the biomechanical world and when to focus on graded motor imagery and laterality training. Dr Chris Hughes, Editor-in-Chief for JOSPT Cases, introduces the journal. He explains why case reports are important in musculoskeletal health and rehabilitation. ------------------------------ RESOURCES Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875 Dr Lorimer Moseley on the role of the brain in chronic pain (snake story): https://www.youtube.com/watch?v=bj9CUGzw6fs&t=26s Dr Peter O’Sullivan and “Jack” sharing how Jack regained his life: https://www.youtube.com/watch?v=j4gmtpdwmrs&t=214s Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/

Melissa Haberfield, very patiently, takes Chelsea and Dan through all things Australian Rules Football. From the field, scoring, and rules, to the punching, kicking, and tackling required to play—it’s a crash course in the game of footy. Melissa breaks down the demands of the sport, the common injuries, and key things for clinicians to keep in mind when working with Australian football athletes. ------------------------------ RESOURCES More on the Prep2Play injury prevention program, including player, coach and clinician resources: https://www.play.afl/coach/resources/prep-to-play/ Intro to footy video: https://www.youtube.com/watch?v=u_SqfNNfhmM&authuser=0 Tayla Harris and the landmark AFLW photo: https://www.abc.net.au/news/2019-03-21/tayla-harris-aflw-photo-could-be-landmark-moment-in-australia/10921892

Kids are resilient, but that doesn't mean they don't struggle with pain. Sometimes it can feel daunting to know how best to support a child in pain, and their family, as everyone navigates school, sport and other environments. Physiotherapist, researcher and educator at University of Technology Sydney, Dr Joshua Pate, is on a mission to help kids and clinicians work better together when it comes to understanding and managing musculoskeletal pain. Today he shares the latest on pain neuroscience, and tips for honing your listening and communicating skills. ------------------------------ RESOURCES More on assessing children's understanding of pain: https://pubmed.ncbi.nlm.nih.gov/32960825/ (Concept of Pain Inventory) and what paediatric pain experts think https://pubmed.ncbi.nlm.nih.gov/29342976/ More on the pGALS (paediatric Gait Arms Legs and Spine) quick musculoskeletal assessment tool: https://pubmed.ncbi.nlm.nih.gov/24219838/ https://www.zoeandzakspainhacks.com is the free online portal for kids, clinicians, parents and teachers. You'll find the books at: https://www.noigroup.com/product/zoe-and-zaks-pain-hacks/ More from Josh on his website: https://joshuawpate.com/

Look no further for the latest information on assessing, diagnosing, treating and making a prognosis about, lateral elbow pain! CPG authors Dr Ann Lucado and Dr Joseph “Matt” Day review the key take-aways from the CPG. They share the important differential diagnoses to consider, the outcome measures to use, and impairment measures to track. Clinicians will love the clever approach to classifying the irritability stage of elbow pain, to guide both treatment and prognosis and liberate you to decide what's best for tailoring your recommendations throughout rehabilitation. ------------------------------ RESOURCES Read the full CPG for free: https://www.jospt.org/doi/10.2519/jospt.2022.0302 One-page summary of the key points for clinicians (including decision tree): https://www.jospt.org/doi/10.2519/jospt.2023.0501 One-page summary of the key CPG points for patients: https://www.jospt.org/doi/10.2519/jospt.2023.0504

Dr Mitchell Selhorst continues his chat about spondylosis/spondylolysis/spondylolisthesis in adolescent athletes. After reviewing the who, why, and what in part 1, today’s episode is full of clinical pearls about rehabilitation and return to sport. Dr Selhorst presents a 3-stage approach to rehabilitation, and shares how he thinks differently when planning rehabilitation for an acute vs. a chronic injury. Another big take-home message: how important it is to consider the psychological aspect of these injuries for youth athletes. ------------------------------ RESOURCES More on rehabilitation for spondylolysis in youth athletes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134351/ Micheli Functional Scale: https://pubmed.ncbi.nm.nih.gov/22382433/

Today, Dr Mitchell Selhorst dives in the world of pediatric spondylosis/spondylolysis/spondylolisthesis injuries with Chelsea and Dan. And it’s not all about female gymnasts! You can expect about 3 in every 10 adolescents with low back pain to have a spondy. So, knowing the population, risk factors, and key things to look for on examination are incredibly important. Dr Selhorst reviews the epidemiology, shares the current evidence on the effects of bracing and surgery, and explains how imaging findings can influence rehabilitation decisions. ------------------------------ RESOURCES More on rehabilitation for spondylolysis in youth athletes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134351/

Two gentle giants of physiotherapy/physical therapy research and practice join JOSPT Insights today. Associate Professor Peter Kent and Professor Peter O'Sullivan (Curtin University, Perth, Australia) share, on behalf of the whole trial team, the results of their RESTORE trial. Does cognitive functional therapy herald a revolution in how clinicians can support people to live well with back pain? Let's find out... ------------------------------ RESOURCES Toll-free link to access the published trial until June: https://www.sciencedirect.com/science/article/abs/pii/S0140673623004415?dgcid=coauthor. After June, you'll find it here: https://pubmed.ncbi.nlm.nih.gov/37146623/ Find out lots more about the RESTORE trial, including how patients and clinicians feel about cognitive functional therapy: https://www.restorebackpain.com/

Someone walks into your clinic with a sore shoulder. Are you dealing with a stiff shoulder? A rotator cuff problem? The acromioclavicular joint? Or something else entirely? Today, Dr Angela Cadogan (PT, PhD) - Specialist Physiotherapist and clinical consultant - is helping you hone your clinical reasoning in differential diagnosis of subacromial pain. Dr Cadogan shares her practical approach to diagnosing subacromial pain in a way that you can take straight to the clinic tomorrow.

Dr Rick Joreitz (University of Pittsburgh) joins Chelsea and Dan to chat all things ice hockey. From the unique demands on the hip in all planes of motion—c’mon, we couldn’t do a podcast about ice hockey without talking hips!—to the acute and chronic injuries, helpful manual therapy tips, and ways to progress a return to the ice. Dr Joreitz has got your key questions covered. Who would have thought the boards of the rink were such an important part of rehabilitation?

The YAHiR (Young Athletes Hip Research) Collaborative take over the JOSPT Insights podcast today with the second part of our explainer on hip dysplasia. Drs Inger Mechlenburg and Julie Jacobsen cover the key elements of an effective treatment program, when hip preserving surgery is an option, and how to balance loading, exercise and information to help people with hip dysplasia to stay active and healthy throughout life. ------------------------------ RESOURCES Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir You can register to access full recordings of the Young Athlete's Hip Symposium, and the Oxford-Aspetar-La Trobe Young Athlete's Hip Webinar Series (11 webinars): https://www.ndorms.ox.ac.uk/events/Oxford-Hip-2022 The next Young Athlete's Hip Symposium is on 25-27 September, 2024 at Worcester College, Oxford University

The YAHiR (Young Athletes' Hip Research) Collaborative takes over the JOSPT Insights podcast today with Part 1 of a 2-part explainer on hip dysplasia. Tune in to learn about what causes hip dysplasia and how common the problem is, plus how to put the clinical history, pain and imaging puzzle together to diagnose and identify the major impairments that come along with hip dysplasia. ------------------------------ RESOURCES Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir You can register to access full recordings of the Young Athlete's Hip Symposium, and the Oxford-Aspetar-La Trobe Young Athlete's Hip Webinar Series (11 webinars): https://www.ndorms.ox.ac.uk/events/Oxford-Hip-2022 The next Young Athlete's Hip Symposium is on 25-27 September, 2024 at Worcester College, Oxford University

Today’s sports corner is all about managing high-level basketball athletes. Dr Maggie Bryant, Director of Rehabilitation for the LA Clippers, explains the physical demands of basketball, common injuries, and important things to consider when planning rehabilitation with basketball athletes. From the acceleration and deceleration demands, physical playing space restrictions, challenging anthropometrics of these athletes, and the variation in position demands—your rehabilitation plans for basketball athletes will require careful thought. Maggie’s hot tip: don’t forget about the foot and ankle!

Dr Chris Napier is a physiotherapist, Assistant Professor and Director of the Run Lab at Simon Fraser University in Vancouver, Canada, and 2:33-marathoner. Who better to share tips for ramping up running training? Today we discuss strategies for performing well and staying injury free while running, how to choose a new running shoe, and Chris shares his approach to designing an effective all-round running training program. ------------------------------ RESOURCES Chris' book 'Science of Running: Analyze your Technique, Prevent Injury, Revolutionize your Training' is available wherever you purchase books (https://www.penguinrandomhouse.ca/books/612657/science-of-running-by-chris-napier/9780744022087)

The American Physical Therapy Association's Academy of Sports Physical Therapy is now in its 50th year. Today, Academy President, Dr Mike Reinold, is celebrating not only the achievements of the past 50 years, but looking forward to the future. Mike has assumed the role of Sports Academy President at an exciting time of innovation in learning, professional development, and mentorship. Today we discuss how the Sports Academy is nurturing the physical therapy profession and its future leaders. ------------------------------ RESOURCES Academy of Sports Physical Therapy: https://sportspt.org/ Sports Academy Learning Centre: https://learn.sportspt.org/

Dr Seth O'Neill (University of Leicester) is back sharing his tips on diagnosing the source of calf pain in active people. What are the common diagnoses? The things you should not miss? The concerning diagnosis masquerading as calf pain? And much more.

Did you know that calf injuries are one of the most common soft tissue injuries in team sports? How comfortable do you feel assessing and managing calf pain, especially designing and progressing a program to help someone get back to their sport? Today, Dr Seth O'Neill from the University of Leicester, joins us to blend the latest science in calf injury with high-level clinical reasoning. You'll get something out of today's chat whether you're beginning in your clinical career or whether you're looking for suggestions for advanced clinical practice.

Dr Dustin Jones, from StrongerLife, talks about the important impact that preventing falls can have on an older adult's wellbeing. He explains how to assess falls risk and physical performance, and recommends his top measures and resources. Dr Jones addresses why it’s important to focus, not only on preventing falls, but on helping older people prepare for falls too, and reviews some drills he uses with his clients. ------------------------------ RESOURCES STEADI: https://www.cdc.gov/steadi/index.html Ability Lab: https://www.sralab.org/additional-resources Stronger Life: https://www.strongerlifehq.com/

A surfer walks into your clinic with neck pain…What do you do next? And why? Dr. Lynn McKinnis expertly walks through when and how to apply the Canadian C-Spine Rule when a patient presents with neck pain, types of vertebral artery injuries, and tips for diagnosing and treating acute neck trauma. ------------------------------ RESOURCES Learn more about the specific case here: https://www.jospt.org/doi/full/10.2519/jospt.2016.0416 Canadian C-Spine Rule: https://med-fom-clone-pt.sites.olt.ubc.ca/files/2014/01/C-spine-Rule-FAQs.pdf NEXUS Criteria for detecting clinically-important cervical spine injury following blunt trauma: https://www.nejm.org/doi/full/10.1056/NEJM200007133430203

Do you work with young people with ACL injury? Well, you're in the right place! Today, Drs Chris Kuenze and Adam Weaver walk through the story behind creating a brilliant, new normative dataset for function and strength outcomes. You'll learn how the project got started, and how you can use the information to help make even more informed clinical decisions. ------------------------------ RESOURCES Find the paper "Age-, Sex-, and Graft-specific Reference Values From 783 Adolescent Patients At 5-7 months After ACL Reconstruction: IKDC, PEDI-IKDC, KOOS, ACL-RSI, Single-leg Hop, and Thigh Strength" on the JOSPT website: https://www.jospt.org/doi/abs/10.2519/jospt.2023.11389 To access the normative database: https://dataverse.lib.virginia.edu/dataset.xhtml?persistentId=doi:10.18130/V3/JNPHUB

Dr Casey Humbyrd—orthopaedic surgeon and Chief of foot & ankle orthopedics at the University of Pennsylvania—shares her expertise and insights on treating ankle sprains that are not responding to non-surgical treatment. Dr Humbyrd reviews ankle anatomy and her rationale for recommending surgery, how she performs a Broström repair, and explains how she works in close partnership with physical therapists and patients to achieve quality rehabilitation and return to sport outcomes.

How do you approach managing low back pain with children and adolescents? Do you have a different approach than when working with adults? Diving into the 2022 JOSPT clinical commentary, “What Works When Treating Children and Adolescents with Low Back Pain?”, Dan and Chelsea chat with author Dr Tiê Yamato. They review the physical, psychological, pharmacological, interdisciplinary and family-centered, and communication interventions that are most effective for treating and managing low back pain in this important population. Read Dr Yamato's article here: https://www.jospt.org/doi/10.2519/jospt.2022.10768

Dr Cara Baxter takes Dan and Chelsea through the keys to designing top-quality rehabilitation programs for ski and snow athletes. Dr Baxter describes the wide variety of competitive events, the demands they place on the athlete, plus the common acute and chronic injuries that plague particular snow sport disciplines. We discuss the travel and schedule demands of the sport, the cognitive demands, the harsh and changing environment, and how you and the athlete can make an informed decision about when is the right time to return to snow.