reflecting the poor quality of studies in this domain

ironically most of the purported quackery is emerging from the movement space

sounds like adam needs some shoulder injuries to personally navigate

except that the 'tissue' is epiphenomenal to movement patterns

This week the panel are joined by Michael Brady, the national advisor for LGBT Health to discuss why your patient’s queerness might matter to you, and how to practice inclusively, as well as an interview with Lisa Power MBE,  a British sexual health and LGBT rights campaigner. Have a listen to hear Michael Brady answering your questions, agony aunt style!

Inclusive Practice

The mental health of athletes has been in the spotlight throughout this summer, as high-profile athletes such as Naomi Osaka and Simone Biles have spoken out about the importance of prioritizing their physical, and especially their mental, well-being.

In this episode, host Dr. Giselle Aerni, MD is joined by AMSSM Past Presidents Dr. Cindy Chang, MD and Dr. Margot Putukian, MD to discuss the AMSSM Position Statement on Mental Health Issues and Psychological Factors in Athletes, which Dr. Aerni also co-authored.

In this 33-minute conversation, they address the following topics:
The importance of a position statement on the mental health of athletes and the novel aspects addressed in the document
The team-based approach to mental health care and why it’s a crucial component for the well-being of athletes
How the acceptance of mental health issues has evolved in recent years and the impact social media has on those perceptions
The impact of the COVID-19 pandemic on athletes’ mental health and how it reinforces the need for conversations about this vital issue

Resources:
Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement (https://bjsm.bmj.com/content/54/4/216.full)
Madam Athlete Podcast (https://madamathlete.com/)

The Importance of Mental Health in Athletes with Two AMSSM Past Presidents EP #483

Professor Lorimer Moseley holds the Inaugural Chair in Physiotherapy at the University of South Australia as well as being a Professor of Neurosciences. He completed his PhD in 2002 and has both learned and shared wisdom at the Universities of Queensland, Sydney and Oxford before settling in Adelaide. He leads the Body in Mind Research Group and coauthored the best-selling ‘Explain Pain’.

In this podcast he answers questions from Ebonie Rio, Department of Physiotherapy, Monash University, covering the important difference between pain and nociception, and sharing thoughts on how pain science can help clinicians working in sports medicine. 

You’ll hear him share the best, and worst, ways to explain pain to patients. He predicts how low back pain management will look in 100 years’ time. As always with Lorimer Moseley. expect thoughtful reflections shared with big dob of humour and humility. 

See also:

TEDx talk ‘Why things hurt’: http://www.youtube.com/watch?v=gwd-wLdIHjs

Acupuncture applied as a sensory discrimination training tool decreases movement-related pain in patients with chronic low back pain more than acupuncture alone: a randomised cross-over experiment http://goo.gl/zaNX8s

Are children who play a sport or a musical instrument better at motor imagery than children who do not? http://goo.gl/Xv9Qum

Exercise is medicine, for the body and the brain: http://bjsm.bmj.com/content/48/12/943.full

Chronic traumatic encephalopathy in sport: a systematic review: http://bjsm.bmj.com/content/48/2/84.full

Professor Lorimer Moseley on the brain and mind in chronic pain

Professor Michael Kjaer is Professor in Sports Medicine at the Institute of Sports Medicine and Centre for Healthy Ageing in Copenhagen, Denmark. He has published articles in the areas of Sports Medicine and muscle and tendon adaptation at the structural and mechanical levels as well as at the cellular and molecular level. Michael is interested in mechanisms of adaptations to muscle and tendon following exercise, disuse, disease and ageing. 

In this podcast on tendon and tendon pathology he gives a synthesis of seven models of tendinopathy, explains the difference between mid-tendon and insertional tendinopathy, presents his views on the healing capacity of tendons, talks about the (absence of a) link between tendinopathy and tendon rupture, and discusses the various interventions that are used in an attempt to promote tendon healing, including eccentric and concentric exercises. 

Links to articles: 
Heinemeier KM, Schjerling P, Heinemeier J, Magnusson SP, and Kjaer M. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C. FASEB Journal 2013;27:2074–9. http://goo.gl/MRmulq

Kjaer M. Role of extracellular matrix in adaptation of tendon and skeletal muscle to machanical loading. Physiol Rev 2004;84:649-8. http://goo.gl/tEiirg

Magnusson SP, Langberg H, Kjaer M. The pathogenesis of tendinopathy: balancing the response to loading. Nat Rev Rheumatol 2010;6:262-8. http://goo.gl/s1dpDc

Michael Kjaer on the pathogenesis of tendinopathy and tendon healing

This is a podcast by Dr Robert-Jan de Vos, sports physician in the Erasmus Medical Centre in the Netherlands, with Guustaaf Reurink, who is a registrar in Sports medicine in the Netherlands and is currently finishing his thesis on diagnosis and treatment of acute hamstring injuries. Recently, he published a paper in the New England Journal of Medicine about the role of Platelet-rich Plasma (PRP) treatment for acute hamstring injuries (http://www.nejm.org/doi/full/10.1056/NEJMc1402340). 

We start with discussing this interesting study, which did not show a benefit of PRP injections in acute hamstring injuries. Dr Reurink expresses the methods and results of this study and possible explanations for these findings are debated.

Dr Reurink also performed a number of studies on the value of clinical tests and Magnetic Resonance Imaging (MRI) in acute hamstring injuries. Previously, he already showed that most MRIs are still abnormal when the athlete already returned to gameplay (http://bjsm.bmj.com/content/early/2013/11/19/bjsports-2013-092450.abstract?eaf). 

We close by discussing the role of MRI and standardised clinical tests as a predictor of time to return to play and re-injury.

Diagnosing and treating acute hamstring injuries

Physical rehab (physiotherapy), behavioural rehab and combinations of these have been mainstays of back pain treatment.  Dr Kieran O’Sullivan shares his expertise on what to do and what not to do – lessons from 15 years of providing specialised clinical care and engaging in top level research. 

Specifically, what is the role of patient advice, targeted exercises, and novel therapies including injections? 

You can link to Dr O’Sullivan’s home page at the University of Limerick here: http://www.ul.ie/clinicaltherapies/node/443

Interested in back pain? Related resources: 

Editorial: Common misconceptions about back pain in sport: Tiger Woods’ case brings five fundamental questions into sharp focus
http://bjsm.bmj.com/content/early/2015/02/08/bjsports-2014-094542.extract

Podcast:  Professor Peter O’Sullivan on Tiger Woods’ back and ‘core strength’
https://soundcloud.com/bmjpodcasts/professor-peter-osullivan-peteosullivanpt-on-tiger-woods-back-and-core-strength?in=bmjpodcasts/sets/bjsm-1

Effective treatments for back pain: Kieran O'Sullivan’s practical tips within a guiding framework

Most clinicians who manage patients with tendinopathy will have encountered the situation where the clinical picture and imaging findings do not match up. 

Sean Docking, researcher at La Trobe University’s Sports and Exercise Medicine Research Centre in Melbourne, has been using Ultrasound Tissue Characterisation (UTC) to visualise changes associated with tendinopathy in 3D detail.  In this podcast he talks to Liam West about how UTC may help us explain this discrepancy between current imaging and clinical pictures in tendinopathy. He also gives the listener an insight into the clinical relevance of UTC and the lessons that have been learnt from his research within the field.

Timeline
0.45 – Current imaging modalities used in tendinopathy
3.45 – Disconnect between imaging findings and clinical picture
4.45 – Place imaging in clinical context
6.00 – Deep dive on UTC
7.55 – Tendon response to pathology
10.45 – Treat the donut, not the hole 

Further Reading
	Using UTC to measure game load on tendons in AFL - http://bit.ly/29rSr3k 
	Pathological tendons have good amounts of normal structure - 
	http://bit.ly/29iCfiG 
	Revisiting the continuum model of tendon pathology - http://bit.ly/29rSDPK 

Further Related Podcasts
	Jill Cook revisits Tendon Pathology - http://bit.ly/1UR3tvL 
	Michael Kjaer on the pathogenesis of tendinopathy and tendon healing - http://bit.ly/29pOZol 


Treat the donut, not the hole: What UTC imaging teaches us about tendon pathology. Dr Sean Docking

How does a leading shoulder physiotherapist approach patients in the clinic? What are 3 fundamental principles that guide every consultation? Hear from extended scope practitioner Adam Meakins on how his approach to the patient with shoulder pain has changed over the past years.

Learn how you can provide exercises for your patient without needing sophisticated video equipment or cameras. Listen to tips on how to tell if the patient is fearful, perhaps at greater risk for a central contribution to pain.

Timeline 
0:40 - Adam makes the case for 3 principles that guide every consultation 
2:30 - Encouraging movement – both for health and to exercise injured parts (e.g. the shoulder) 
4:00 - The need for patient education and advice. And how to do it.  
8:35 - How much pain is OK?  
10:30 - Treating the patient as an individual – the whole patient 
12:40 - Is there a central component of pain?  
13:19 - Which exercises to choose

Shoulder focus with leading sports physiotherapist Adam Meakins. Practical clinical pearls

In this episode of the Heart podcast, Digital Media Editor Dr. James Rudd is joined by a vascular biology legend, Professor Peter Libby from Harvard University and Chief of Cardiovascular Medicine at Brigham and Women's Hospital in Boston. They discuss how the inflammation hypothesis of atherosclerosis has been proven by the CANTOS trial and what the future might hold. We trust you'll enjoy the police sirens in the middle of the interview and hope you enjoy the discussion.

Link for CANTOS study - http://www.nejm.org/doi/full/10.1056/NEJMoa1707914

Inflammation and heart disease - what's next?

In this episode of the Heart podcast, Digital Media Editor DrJames Rudd is joined by Dr Cara Hendry from Manchester and Dr Iain Simpson from Southampton. They are passionate about reducing barriers that exist in cardiology and other medical specialities. They discuss what the issues are and what is being done to help in the UK and beyond. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Women in cardiology - breaking down the barriers

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Professor Charalambos Antoniades from Oxford, UK. They discuss his novel method of measuring coronary plaque inflammation using CT imaging, and how this method might be important for predicting heart attacks.
If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2017-312324

Perivascular adipose tissue and coronary atherosclerosis

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Charlotte Warren-Gash from the London School of Hygiene and Tropical Medicine. They discuss the links between respiratory infections and subsequent heart attacks and strokes.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://www.lshtm.ac.uk/newsevents/news/2018/respiratory-infections-could-increase-risk-heart-attack-and-stroke

Respiratory infections and subsequent heart attacks and strokes

In this episode of the Heart podcast, Digital Media Editor Dr James Rudd, is joined by Professor Bernard Prendergast from St Thomas' Hospital, London. They discuss his recent publication in Heart concerning the ability of the stethoscope to detect important valve disease in asymptomatic primary care patients. They also cover POCUS, the feasibility of screening elderly patients for valve disease and whether Bernard still uses a stethoscope in real life.

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: 
Primary paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2018-313082
Editorial: https://heart.bmj.com/content/early/2018/05/24/heartjnl-2018-313474
The Oxvalve study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216199/

Do we still need stethoscopes?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Eric Topol, founder and director of the Scripps Research Translational Institute. They discuss the impact that AI will have in medicine and how this will affect us all.

Relevant links related to this podcast:
About Dr Topol - https://drerictopol.com/about/
Nature Medicine AI review - https://www.nature.com/articles/s41591-018-0300-7
Twitter - https://twitter.com/EricTopol?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
Book - https://drerictopol.com/book/deep-medicine/
NHS Topol review - https://www.hee.nhs.uk/our-work/topol-review

Deep Medicine with Eric Topol, author of the Topol NHS review

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Thomas Butler from the University of Chester. They discuss his Review paper in Heart entitled "Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR)".

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: https://heart.bmj.com/content/106/10/724

Diet after a heart attack - what should we tell patients?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by lipid expert Dr Susan Connolly from Enniskillen, Northern Ireland. They discuss primary and secondary prevention, risk scores, imaging and two new drugs with the potential to improve lipid management significantly over the next 5 years.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Shoulder focus with leading sports physiotherapist Adam Meakins. Practical clinical pearls

BMJ talk medicine

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