Bjsm Podcasts

Adam Weir talks to Ben Kibler from the Shoulder Center of Kentucky about the 2013 consensus statement on scapular dyskinesis in shoulder injury.

Read the editor's choice article for free online: http://bjsm.bmj.com/content/47/14/877.full

The second international consensus conference on the scapula was held in Lexington Kentucky. The purpose of the conference was to update, present and discuss the accumulated knowledge regarding scapular involvement in various shoulder injuries and highlight the clinical implications for the evaluation and treatment of shoulder injuries. 

Scapular summit 2013 with Ben Kibler

It is currently widely accepted among clinicians that chronic tendinopathy is caused by a degenerative process devoid of inflammation. The evidence for non-inflammatory degenerative processes alone as the cause of tendinopathy is surprisingly weak. 

In this podcast, Jon Rees a rheumatologist at Cambridge University Hospitals NHS Foundation Trust tells Jill Cook why the role of inflammation offers potential opportunities in treating chronic tendinopathies and should be explored further.

Read the article online: http://bjsm.bmj.com/content/early/2013/03/08/bjsports-2012-091957.full

Time to revisit inflammation in tendons, with Jon Rees

Welcome to the Sports Medcast, brought to you in association with the American Medical Society for Sports Medicine.

In this episode, hosts Dr Scott Young and Dr Cole Taylor discuss the practical considerations of concussion evaluation and management with Dr Jeffrey Kutcher, a neurologist at the University of Michigan, and the Director of Michigan NeuroSport. 

Please feel free to contact us at thesportsmedcast@gmail.com regarding this or any other Sports Medcast

Further reading:
Zurich consensus statement on concussion http://bjsm.bmj.com/content/47/5/250.full

Sport medcast in association with the AMSSM: Concussion

Treating tendinopathies remains a challenge, despite many advances in the past decade. Listen to practical tips and a tip to consider the time course of tendon injury when making treatment decisions.

More information can be found in Professor Cook’s paper Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy http://bit.ly/R0PDbT

See also:
Jeremy Lewis on shoulder tendinopathy http://bit.ly/mm3C1f
Tendon-focussed issue, BJSM #5, April 2011http://bit.ly/11A4rRb

Professor Jill Cook on managing tendinopathies in 2011

In this BJSM podcast, Karim Khan talks to Anthony Beutler (Injury Prevention Research Lab, Uniformed Services University, Bethesda, Maryland) about the JUMP-ACL study http://www.iprc.unc.edu/jumpacl/. It is a large prospective cohort study which investigates risk factors for ACL injury - results will be published soon.

They discuss the mechanism of ACL injury in different athletes, the risk of recurrence, and plans to turn the results into practical steps to prevent this injury.

Related articles in BJSM include:
the IOC current concepts statement on ACL injuries http://bit.ly/ZkTHJ4
Roald Bahr’s editorial - ACL injuries - problem solved? http://bit.ly/13TDrBm
as well as previous podcasts if you missed them - Tim Hewett and Lars Engebretsen/Liza Arendt.

Topic timecodes
Main findings - 02.35
Frequency of occurrence - 07.45
Prevention - 11.30
Link with BMI - 18.00

The JUMP-ACL study with Anthony Beutler

Whether to opt for exercise treatment, new ‘biological therapies’ like platelet-rich plasma (PRP), or surgery is a clinical challenge. Sweden’s Professor Håkan Alfredson has unique experience in considering these options for patients with Achilles pain. He has 15 years experience as an international leader in sports and exercise medicine.

In this podcast, he tells BJSM’s editor Karim Khan how to manage both straightforward (0.37) and complicated (7.34) Achilles tendinopathy. He shares novel insights into the contribution of the aberrant plantaris tendon to chronic medial leg pain (12.40).

Prof Alfredson also provides a memorable clinical story to underscore the effectiveness of heavy loading eccentric training in one particularly stubborn patient (3.49). He argues against the use of PRP (17.37) and considers cortisone to be a short-term fix but long-term liability (15.24). The podcast concludes with discussion of both jumper’s knee (19.35) and lateral elbow tendinopathy (24.44).

Related paper:
Midportion Achilles tendinosis and the plantaris tendon http://bit.ly/11y79bc

Related podcasts:
Robert Jan de Vos and Adam Weir on platelet rich plasma injections http://bit.ly/JdmFkJ
Professor Jill Cook on managing tendinopathies in 2011 http://bit.ly/15DM8Qp

Treating tendinopathy with Professor Håkan Alfredson

Coming together at the UKSEM conference in London, Professor Lars Engebretsen (Oslo Sports Trauma Research Center and IOC medical commission) talks to Dr Richard Frobell (Lund University, Malmo, Sweden) about his work on return to exercise after ACL (anterior cruciate ligament) injury.

Dr Frobell describes the evidence already on this issue, and his recently published randomized trial on whether surgery or rehabilitation improves pain, symptoms, function in sports and recreation, and knee-related quality of life post-injury

See also:
A randomized trial of treatment for acute anterior cruciate ligament tears http://bit.ly/rrS51Y
The BJSM Warm up about this injury http://bit.ly/tBNdiu
Our 2010 interview with Richard Frobell and coauthors of the NEJM paper above http://bit.ly/99leZd

Return to exercise after ACL (anterior cruciate ligament) injury, with Dr Richard Frobell

Hamstring injuries are the most prevalent muscle injuries in sport. Symptoms can be particularly prolonged, healing response poor, and the risk of re-injury high.

Carl Askling (Karolinska Institute, Stockholm) has been trialling a new way of categorising these injuries, thinking about them as high-speed running or stretching types. He explains to Karim Khan how these types can be diagnosed and the different treatment and monitoring they require. He also describes how to assess athletes post hamstring injury for return to sport.

See also:
High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis http://bit.ly/15Dzv8a
Hamstring strain injuries: are we heading in the right direction? http://bit.ly/LfwK2I
Hamstring issues in sports: still a major clinical and research challenge http://bit.ly/JTzgb7

February’s BJSM has a special focus on hamstring injuries, so there’s even more related content in the issue and on the website.

Hamstring injuries with Carl Askling

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

Groin injuries, with Professor Per Holmich

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

Professor Mark Hutchinson’s pearls on knee examination: Do the simple things extraordinarily well

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

Acute ankle injuries, with Professor Gino Kerkhoffs

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

Managing leg pain - focus on chronic exertional compartment syndrome

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

Professor Phillip Newman on dealing with shin pain

Jill Cook is BJSM’s deputy editor with particular emphasis on physiotherapy. She is a professor at Monash University, Frankston, Australia, and a renowned international tendon authority. In this podcast she answers questions she is commonly asked about the ‘continuum model’ of tendinopathy that she and Craig Purdam (Australian Institute of Sport) proposed.

See also:
Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy bit.ly/YKmKkM
Is compressive load a factor in the development of tendinopathy? bit.ly/XTvZlk
Jeremy Lewis’s podcast on rotator cuff tendinopathies bit.ly/Nhll0U
Jill’s previous podcast on managing tendinopathies bit.ly/15DM8Qp

Jill Cook on the continuum model of tendinopathy

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

Professor Roald Bahr - IOC World Conference on Prevention of Injury & Illness in sport 2014

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

Professor Winne Meeuwisse on concussion in sport

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

Dr Paul McCrory’s overview of the Zurich Concussion Consensus Statement (BJSM April 2013)

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

Dr Paul McCrory’s 3-minute snapshot of what’s new in managing concussion

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

Dr Paul McCrory explains what parents need to know about concussion

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

Bjsm Podcasts

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