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Neurological symptoms occur in approximately 20% of patients with Sjögren's syndrome, and may be the presenting manifestations of the disease. 

In this podcast, PN co-editor Phil Smith asks Aaron Berkowitz, Department of Neurology, Brigham and Women's Hospital, Boston, about several neurological conditions that can occur in Sjögren's syndrome: sensory ganglionopathy, painful small fibre neuropathy, and transverse myelitis (independently or as part of neuromyelitis optica).

Dr Berkowitz describes the symptoms, signs, differential diagnoses, recommended diagnostic evaluation, and treatment of each of these, highlighting the features that should alert neurologists to consider Sjögren's syndrome.

Read the full review here: bit.ly/1fF2lev

The neurology of Sjögren's syndrome and the rheumatology of peripheral neuropathy and myelitis

With over twenty years' experience, accreditation in Sports Physiotherapy, and a recent PhD in the topic of lateral hip pain, Alison Grimaldi (@AlisonGrimaldi) was invited to this podcast by BJSM’s Twitter community. 

She is a popular conference speaker internationally. Here she walks you through each step of the assessment and treatment of an older patient with right hip pain. She then shares how to assess and treat a younger sportsperson. 

In both cases, Dr Grimaldi emphasizes that compression is bad for tendons that run over bony prominences (trochanter in this case) and indicates how this can be addressed. 

Enjoy one of our most practical podcasts. Recorded at the Physiotherapy New Zealand Conference, Auckland (September 2014) with thanks to the NZ Sports Physiotherapy Interest Group (@SportsPhysioNZ).

Links: 
1) JL Cook, C Purdam Is compressive load a factor in the development of tendinopathy? Br J Sports Med 46(3):163-8. 2012 http://bjsm.bmj.com/content/46/3/163.abstract

2) Fearon A, Stephens S, Cook J, et al. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study. Br J Sports Med. 2012 http://bjsm.bmj.com/content/46/12/888.long

Dr Alison Grimaldi with practical physiotherapy tips on treating lateral hip pain

Shoulder pain patients often have poor scapula control. Is their shoulder pain caused by poor scapula control, or is their scapula dysfunction caused by shoulder pain? When your patients present with shoulder pain, should your focus be on scapula control, glenohumeral control, or treatment of the neck and thorax?

In this podcast, David Pope talks to Ann Cools, a Physiotherapist and Head of Education for Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium, and is also the founding member and president (2010–2012) of EUSSER - European Society of Shoulder and Elbow Rehabilitation. We discuss in detail assessment of the scapula, the role of the scapula in shoulder pain and how to retrain unruly scapulae.

Other topics covered in this podcast include:

Research by Ann Cools
What we currently know from the research about the role, movement and control of
the scapula
Scapula dyskinesis - what is it
Static vs dynamic assessment of the scapula
Altering muscle balance and timing with specific exercises
How altering scapula mechanics effects muscle balance around the shoulder
Important parts of the subjective history
Scapula vs glenohumeral joint
How subjective will guide your objective assessment and treatment
Red flags around the shoulder, nerve pathology and frozen shoulder
Frozen shoulder imaging
Nerve injuries - symptoms, objective examination and treatment
Assessment of the scapula, Type 1 scapula dyskinesis
Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula)
Testing GHJ IR
Clinical Edge and online education on the shoulder
Stretching and shoulder joint mobilisation
Palpation, stretching and manual therapy for pec minor
Type 2 scapula dysfunction
Handheld dynamometry - serratus
Handheld dynamometry - middle and lower traps
Pain when strength testing
Type 3 scapula dysfunction
Dynamic assessment of the scapula
To retract and depress the scapula or not?
Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis
Special tests around the shoulder
Laxity tests for the GH joint
Posterior GHJ laxity
Anterior GHJ laxity
Explanations of scapula dysfunction to your patients
Information on Ann Cools
EUSSER

PE #031 Unruly Scapula Assessment and Retraining With Ann Cools

Acetabular Labral tears in the hip are becoming more commonly diagnosed and operated on. In this episode, I chat to Nichole Hamilton, a Physio with a lot of experience treating hips, designing post-op arthroscopic hip protocols and lecturing about the hip. Some nice insights into hip injuries and diagnosing and treating labral tears.

This week we talk about all sorts of issues around the hip, including:

Diagnosing labral tears
Labral tear symptoms
What causes a labral tear?
Activities that contribute to labral tears
When is surgery required for labral tears
When is conservative treatment a good option
Kicking sports – what muscle control is required
What is the role of psoas
Dancers – what activities and positions load the labrum
How can maximum hip range of movement be attained safely
Posterior pelvic tilt or tuck – how does this relate to the hip
Progressing exercises to incorporate functional positions
I hope you enjoy this episode, please post our questions below, on www.physioedge.com.au and we would love you to give us a review on iTunes

PE #004  Hip Injuries And Labral Tears. An Interview With Nichole Hamilton

When should Transversus (TA) be included in your patient rehab? When is TA retraining a waste of time? Are your patients running like a block of wood with legs? Is planking good for anything other than entertaining your mates? How can we go beyond just treating the pain experience to connect with your patient and improve their performance.

In Episode 6 of the Physio Edge podcast, I chat with LJ Lee for the second time, this time covering TA, “Core Stability”, and more including:

Retraining TA in your treatment
Planks
McGill’s Big 3 exercises
Body “flow” and agility Vs stiffness and rigidity
Specificity of exercise
How can the Cervical Spine affect knee pain in a squat?
The Discover Physio Series
“Salsa in your ribcage” and breathing
The impact of intra-thoracic pressure on the pelvic floor

PE #006  TA,  Core Stability , Drivers And Going Beyond The Pain Experience With LJ Lee

Dry Needling has become incredibly popular in Physiotherapy recently. Is dry needling really the way forward for Physios?

In this podcast I chat with Andrew Hutton of Dry Needling Plus, presenter of the Dry Needling Plus courses for Clinical Edge, and we discuss dry needling and whether it complements regular Physio treatment. Some of the topics we cover include

What are the different styles of dry needling?
How can dry needling be used in sporting populations?
How to know immediately if your needling has been effective
What is the evidence for dry needling
Studies show decreased ROM with needling, is it possible to improve ROM with dry needling
How does changing ROM actually relate to a patient’s pain?
Some clinical scenarios where dry needling could be incorporated

PE #007  Dry Needling With Andrew Hutton

All golfers want to hit as far as Tiger Woods, but without the injuries. How can you treat the injuries in your golfing patients, prevent further injury and improve their “coachability” and performance?

Golfers regularly need Physio treatment for injuries like tendinopathy around the elbow, low back and neck pain, and plenty of other injuries. In episode 8 of the Physio Edge podcast, I chat with Matt Green of High Performance Golf about

Common golf injuries
How to assess and treat golfers
Technique errors that contribute to injury
Tendinopathy around the elbow
Assessing the golf swing
Strengthening and motor control
Advice to give your golfers and
plenty more.
If you treat golfers, or would like to treat more golfers, get stuck into this episode free on iTunes, and brought to you by the podcast sponsor Clinical Edge.

PE #008 Golf Injuries And Performance Improvement. An Interview With Matt Green

Patients regularly present for Physiotherapy with lateral hip pain. This is often aggravated by walking or standing, sidesleeping, performing hip stretches, and sitting, amongst other activities, and lateral hip pain can often mimic lumbar spine pathology. In this podcast, Alison and I discuss symptoms, assessment and treatment of an extremely common cause of lateral hip pain – Glute Med Tendinopathy (GMT), a condition which is often misdiagnosed as Trochanteric Bursitis.

Some of the aspects we explore in this podcast are:

Subjective clues that someone may have a Glute Med Tendinopathy
“Trochanteric Bursitis”
Differentiating Glute Med Tendinopathy from pain of Lumbar origin
Assessment of the hip
Tests to confirm or rule out a Glute Med Tendinopathy
Causes of a Glute Med Tendinopathy
Advice for patients
Treatment of Glute Med Tendinopathy
Deep hip muscle activation
Essential elements for an effective treatment program
much more
I also want to take this moment to wish you and your family a very Happy New Year.

PE #009 Lateral Hip Pain With Dr Alison Grimaldi

Shoulder pain – what are the causes, and how can you treat it? Are your special tests around the shoulder really isolating and identifying pathology? How can the rotator cuff still function with small and large tears?

In Episode 21 of the Physio Edge podcast, Jeremy Lewis and David Pope discuss these questions and more including:

What is the value of special tests around the shoulder?
What diagnosis can you provide your patients for their shoulder pain
How can you identify if you need to focus your treatment on the scapula, glenohumeral joint, cervical spine or thorax?
How can you identify a rotator cuff tendinopathy?
What is the Rotator Cable, and how is it important in rotator cuff tears?
Is the acromion really the cause of “impingement” or subacromial pain?
If a patient has a biceps tendinopathy and a rotator cuff tendinopathy, which should be treated first?
What contributes to biceps tendinopathy?
Theraband – valuable?
When imaging of the shoulder is valuable, and when it is a waste of time
Frozen shoulder – what treatments work well
And much more.

PE #021 Shoulder Pain With Dr Jeremy Lewis

Dr Kieran O’Sullivan is back on the Physio Edge podcast after talking previously about hamstring injuries, this time discussing his other big area of interest and expertise – chronic low back pain (CLBP). In this episode, Kieran and David Pope discuss

Recent research on chronic low back pain
Central vs peripheral contributions to CLBP
Sitting postures and behaviours, and the relationship of this to pain
Is there an ideal sitting posture, and does changing sitting behaviour change CLBP?
Manual therapy in CLBP
Lumbar kyhposis/lordosis
Physical and psychological interventions for CLBP
The effect of exercise on CLBP
Movement patterns and retraining in chronic pain states
The challenges of talking to patients about chronic pain states
Enjoy this episode, brought to you by the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

PE #022 Chronic Low Back Pain With Dr Kieran O'Sullivan

Lower limb tendinopathies with Dr Peter Malliaras

Tendinopathies are a hot topic, and there are lots of new developments in research and treatment. Dr Peter Malliaras, a Physiotherapist with a PhD studying tendinopathy, has a special interest in the treatment of tendinopathy, and treats elite basketball and volleyball, EPL football, rugby, and cricket players, the Royal Ballet and track and field athletes. Peter has also published numerous studies on tendinopathy.

In this episode of the Physio Edge podcast, Peter and David Pope discuss

The latest research on tendinopathy
Different types of loading programs for tendinopathy
Outcomes for various types of loading
Tendinopathy on Doppler Ultrasound or other imaging, and what changes with a loading program
The tendon pathology continuum by Dr Jill Cook and Craig Purdham
Mid portion Achilles tendinopathy
Insertional Achilles treatment
Patellar tendinopathy treatment, and a loading program for this that may challenge your preconceptions!
Tenosynovitis
Biomechanics contributing to tendinopathy
Return to sport following tendinopathy
Injury reduction/prevention
Injections
Peter shared so much great info on tendinopathy, check it out now on episode 23 of the Physio Edge podcast

Show your love for the podcast sponsor, Clinical Edge, and their fantastic face to face and online education. Get 20% off your first months Clinical Edge membership with the code “PHYSIOEDGE”.

PE #023 Lower Limb Tendinopathies With Dr Peter Malliaras

The thorax is often considered stiff and stable by Physiotherapists and manual therapists, and precious little of our undergrad or postgrad training incorporates motor control of this area. Is it really important?

In episode 24 of the Physio Edge podcast, LJ Lee and David Pope explore the function of the thorax, the impact the thorax can have, not only on thoracic pain, but also on other parts of the body. We discuss the Thoracic Ring Approach (TRA) created by LJ, which incorporates manual techniques to assess and treat the thoracic rings, and integrates motor control training for this area. In this podcast you will learn:

What bones and joints make up a “Thoracic ring”
What is the Thoracic Ring Approach?
Is the thorax inherently stiff?
What is ideal motor control of the thorax?
How can listeners identify non-optimal control of the thorax in their patients
How can motor control of the thorax be trained?
Identifying articular/joint restriction vs neuromuscular factors interfering with normal thorax movement
How can the thorax impact on other areas of the body eg the hip
When is manipulation of the thorax ideal?
What are some guidelines for manipulation of the thorax?

PE #024 Thoracic Ring Approach With Dr Linda - Joy (LJ) Lee.mp3

Barefoot running has been sweeping the globe in the last few years, and as a Physio, which of your patients are best suited to this type of running technique. How does running technique relate to a runner’s pain and dysfunction, and really, what is the ideal running technique?

In this podcast with Blaise Dubois – a Physiotherapist with a clinic, website and courses devoted to helping runners and Physiotherapists that treat runners, we chat about these topics, as well as:

Running assessment
Biomechanics of running
Improving running technique and performance
Which patients should change their running technique
Barefoot running
Heelstrike and landing
Current evidence on running technique
Injury prevention in runners
Downhill running technique
Footwear for running
Improving running in patients with pathology eg Achilles Tendinopathy
Blaise has also been kind enough to provide a PDF handout to go along with this podcast, which is available for free download –

PE #010 Biomechanics Of Running With Blaise Dubois

Hamstrings are one of the more frequently injured muscles in sportspeople, and in this episode, Alison and I discuss hamstring tendinopathy, symptoms, assessment and treatment of this common condition.

Some of the aspects we explore in this podcast are:

Subjective clues that someone may have a Hamstring Tendinopathy
Differentiating Hamstring Tendinopathy from pain of Lumbar origin
Assessment of the hamstring
Tests to confirm or rule out a Hamstring Tendinopathy
Causes
Advice for patients
Rehabilitation
Deep hip muscle activation
Keys to a successful treatment program
a whole lot more
There is currently limited research around the area of hamstring tendinopathy, and Alison’s tips and insights are based on this evidence base as well as her clinical experience.

I hope you enjoy it!

PE #011 Hamstring Tendinopathy With Dr Alison Grimaldi

David Pope and Russell Wright talk about everything to do with feet and ankles. Plantar Fascia and Achilles Tendinopathy are conditions that need good differential diagnosis and specific tailored treatment programs, especially in runners, and in this episode we chat about how you can get the best results with these patients. We cover:

causes of plantar fasciosis
strengthening of the plantar fascia
what exercises work with plantar fasciosis, and which ones are a waste of time
nerve entrapments that can be involved in plantar fasciosis, and how to identify these
the role of taping and orthotics
achilles tendinopathy
eccentric programs and progressions
keys to successful Achilles rehab
ankle sprain rehab – keeping it functional
Listen to it now, and subscribe to the podcast in iTunes

(Warning: this podcast has occasional explicit language)

New!  Free Online Education featuring Russell Wright on Plantar Fasciosis, and Acetabular Labral Tears with Nichole Hamilton at www.clinicaledge.com.au 

PE #012 Plantar Fascia, Achilles Tendinopathy And Nerve Entrapments With Russell Wright

What is contributing to your patients low back pain? How do you know when manual therapy, education, exercise, motor control programs, CBT or any other approach for chronic LBP will be helpful? In episode 14 of the Physio Edge podcast, Peter O’Sullivan and David Pope discuss chronic low back pain, Peter’s research into this area, and the approach of Peter and his team to getting over chronic low back pain. Some of the topics we dug into include:

Causes, classification and treatment of chronic low back pain (CLBP)
Common treatment errors
Identifying mechanical contributors
When manual therapy is helpful
Myths around “core stability” for CLBP
What is the current evidence base for CLBP classification and treatment
Tips for treatment of CLBP
A lot of other great treatment advice for CLBP….
What are your thoughts? Let us know below – I will be reading out the best comments on the next podcast..
Listen to it now, and subscribe free to the podcast in iTunes

PE #014 Chronic Low Back Pain With Peter O Sullivan 1

How to treat anterior knee pain with Kurt Lisle

Anterior knee pain can occur in your elite sports patients right through to office workers and weekend warriors. In this podcast with Kurt Lisle, we discuss anterior knee pain, the causes, how to diagnose the source of the pain, and the best ways to treat and rehabilitate these patients.

Kurt Lisle is the Australian Socceroos Physio and co-owner of The Knee Joint Physio in Queensland. Kurt and I discussed acute knee injuries on the Physio Edge podcast in episode 29, and I really wanted to get Kurt back on the podcast to discuss the anterior knee.

In this fantastic, detailed episode of the Physio Edge podcast, Kurt and I explore:

Subjective clues that give you ideas about differential diagnosis
Fat pad - location of pain, activities that irritate
Patellofemoral joint - aggravating activities and DDx
Patellar tendon - subjective clues, location of pain
Objective examination of the anterior knee
Tests for PFJ
Functional tests first or examination on the treatment table?
Palpation of the anterior knee
Fat pad palpation and tests
Is the fat pad tender medial and laterally, or can it be tender only on one aspect
Neuromuscular patterning
Squat and one leg squat examination
What causes “catching” pain on movement
Chondral defects - identifying
Is there value in the grind test
When to refer for MRI and other imaging
Important factors that may contribute to AKP
Gait contributors to AKP
Treatment of PFJ pain
Modifying PFJ aggravating activities
Using EMG
Quadricep rehabilitation and strengthening
When to incorporate squats into your rehabilitation program
The role of taping for PFJ or fat pad irritation
Red flags causing knee pain
You can download this episode from iTunes or Soundcloud.

If you enjoy the Physio Edge podcast, we would love you to take a couple of minutes write us a review on iTunes. Please take a screenshot of your review before posting it, and email it to info@physioedge.com.au so I can give you a shoutout in the next podcast

Links of Interest

Kurt Lisle

The Knee Joint Physiotherapy, Bokarina, QLD

Socceroos

Review the Physio Edge podcast in iTunes

Download the Physio Edge podcast from iTunes

Clinical Edge

20% off your first month’s membership to Clinical Edge with the code PHYSIOEDGE

Review the Physio Edge podcast in iTunes

Download the Physio Edge podcast from iTunes

Clinical Edge

20% off your first month’s membership to Clinical Edge with the code PHYSIOEDGE

Tags: anterior knee, pain, knee, knee injuries, socceroos, patellofemoral joint, fat pad, impingement, patellar tendon, knee joint, imaging, strengthening, examination, rehabilitation, return to play, graft, tendon, conservative, football, soccer, physio edge, physiotherapist, physio, edge, clinical edge, podcast, online education, kurt lisle, socceroos, the knee joint


PE #033 How to treat anterior knee pain with Kurt Lisle

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

Historian and professor Crystal Feimster joins host Nicholas Forster to describe her journey to graduate school and the critical mentoring required of professors and academics. From her original interest in going to law school to her first book Southern Horrors, Feimster explains the complicated path to professorship, a path never isolated from the world outside of the academy. Along the way Feimster describes her first research interests and the crucial roles certain advisors played.

African American Studies Website: afamstudies.yale.edu

Crystal's website: http://afamstudies.yale.edu/people/crystal-feimster

The Lower Frequencies Podcast Website: thelowerfrequenciespodcast.com

Episode 4: Professor Crystal Feimster

PE035 - Know Pain with Mike Stewart Part 1
Persistent pain can be a challenge, but also enjoyable to treat. In this episode of the Physio Edge podcast, Mike Stewart and I focus on specific examples and case studies of patients with complex or persistent pain, how you may approach persistent pain patients, explain their pain, use metaphors and explanations so they understand it, and help guide them through the recovery process. 
Mike and I get into the details on:
	•	Why Physios need a deep understanding of pain science
	•	How does the “bio” part come into bio-pscyho-social
	•	How can we identify if the patient needs pain education, further investigations, a biological approach eg specific exercise
	•	How can you incorporate pain science into the treatment of patients with acute pain
	•	Mike’s top tips when working with persistent pain
	•	Specific case studies of patients with persistent and complex back pain, and how Mike has worked with these patients, including their presentation, beliefs, Mike’s language used in their session, activity modification and results achieved with these patients
	•	How to develop our teaching skills to achieve the best results with our patients
Links of Interest
Mike Stewart
Know Pain
Courses with Mike Stewart
Mike Stewart on Twitter
Virtual conferences with Physio Edge and Clinical Edge
Clinical Edge discounts for Undergraduate Physio students available by emailing verification of your student status to info at clinicaledge.com.au
Clinical Edge online education
Free video on Metatarsal head padding with Nick Torrance
Free video on soft metatarsal domes for acute metatarsalgia
Free video on firmer metatarsal domes for metatarsalgia
Facebook
David on Twitter
Tags: Pain, persistent pain, chronic pain, complex pain, know pain, mike stewart, physiotherapy, physio, podcast, physio edge, clinical edge, courses, virtual conference, conference, understanding, biopsychosocial, communication
