BJSM Physio Podcasts

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 practical tips on the use and safety of non-steroidal anti-inflammatory drugs (NSAIDs). Please feel free to contact us at thesportsmedcast@gmail.com, and follow us on twitter twitter.com/sportsmedcast.

See also:

Read the article that Scott and Cole discuss - bjsm.bmj.com/content/47/17/1127

Use of NSAIDs in triathletes: prevalence, level of awareness and reasons for use: bjsm.bmj.com/content/45/2/85.full

E-letter: Prophylactic use of NSAIDs in endurance runners: http://blogs.bmj.com/bjsm/2009/10/07/e-letter-prophylactic-use-of-nsaids-in-endurance-runners/

“Mythbuster” on NSAIDs in sports medicine, challenging nutrition dogma, and evidence-based practice: https://soundcloud.com/bmjpodcasts/mythbuster-on-nsaids-in-sports

Republished research: Non-steroidal anti-inflammatory drugs (NSAIDs): http://bjsm.bmj.com/content/early/2013/09/06/bmj.f3195.full

Do non-steroidal anti-inflammatory drugs adversely affect stress fracture healing? A short review: http://bjsm.bmj.com/content/39/2/65.full?sid=8f2906bc-ea42-48fc-a5c1-8a5132504322

Sports Medcast Ep 4 - Practical tips on NSAIDs

In this podcast Glen Hagemann, a sports physician from Durban, South Africa, shares with you his two-year experience and lessons learned as President of the South African Sports Medicine Association (SASMA).

One of the highlights of his presidency was the 15th Biennial SASMA congress held recently at the Wild Coast Sun, and for those of you who are interested in viewing the presentations, please click on
https://www.dropbox.com/l/HcISe1tlrMdfzl8PioTiGb/invite to download these.

Keynote speakers such as Bob Sallis, Ann Cools, Peter Brukner, Babette Pluim and Michael Turner were integral to the success of the event.

During this congress, The Sharks won South Africa's premier rugby
competition, the Currie Cup, which immensely pleased Glen, as he oversees the medical care of the Sharks professional and Academy players at the Life Healthcare Sharks Medical Centre.

Glen is an Executive Committee member of SASMA and Exercise is Medicine (South Africa) and discusses the specific challenges facing this movement in South Africa, and the role of SASMA in helping to overcome these obstacles.

For more information on SASMA and Exercise is Medicine (South Africa) please see www.sasma.org.za.

Finally, he explains why social media are a "must" for all health
professionals in sports and exercise medicine.

See also:

Why some Africans stand out in a crowd: BokSmart for injury prevention and other SASMA-related jewels: http://bjsm.bmj.com/content/46/8/543.full

SASMA: happy to be ‘hip’, wary of being too ‘hip happy’: http://bjsm.bmj.com/content/48/14/1071.full

How BJSM embraces the power of social media to disseminate research: http://bjsm.bmj.com/content/48/8/680.full

SASMA Wins (3rd year in a row) – Best BJSM Cover: http://blogs.bmj.com/bjsm/2014/03/31/sasma-wins-3rd-year-in-a-row-best-bjsm-cover/

Glen Hagemann on his term as President of the South African Sports Medicine Association

If you have wondered about the connection between pain and pathology in tendons, this podcast is for you. 

In this new forum, a BJSM reader takes the hard questions to the experts, Chris Littlewood, who has expertise as a clinician and researcher in the rotator cuff, asks questions of Craig Purdam, who needs little introduction to you, and Ebonie Rio, who has expertise as a clinician in tendons and as a researcher in tendon pain. 

Listen to the answers on the complex nature of tendons and the relationship between pain and pathology, and let us know via bjsm@bmjgroup.com if you have a pressing desire to ask an expert yourself about a clinical issue in a podcast. We are always open to suggestions. 

See also:

Greater glycosaminoglycan content in human patellar tendon biopsies is associated with more pain and a lower VISA score: http://bjsm.bmj.com/content/48/6/469.full

Prospective study of change in patellar tendon abnormality on imaging and pain over a volleyball season: http://bjsm.bmj.com/content/40/3/272.full

Tendinopathy – rehab progression – part 1: http://blogs.bmj.com/bjsm/2013/07/23/tendinopathy-rehab-progression-part-1/

Achilles Tendinopathy: is foot strike important?: http://blogs.bmj.com/bjsm/2014/01/22/achilles-tendinopathy-is-foot-strike-important/

Australian football players’ Achilles tendons respond to game loads within 2 days: an ultrasound tissue characterisation (UTC) study: http://bjsm.bmj.com/content/early/2014/06/26/bjsports-2013-092713.full

Chris Littlewood - Tendons: Where does pain fit in the continuum model?

February's JNNP is a neuropsychiatry special issue, with papers on a broad range of disorders which lie between neurology and psychiatry. Associate editor Alan Carson discusses the contents, and the thinking behind the edition.

To accompany the issue, JNNP and the Association of British Neurologists convened a roundtable of experts to discuss, and advise on, diagnosing and treating functional symptoms. Dr Carson takes part in this, along with:

Kailash Bhatia, professor of neurology, Institute of Neurology

Mark Edwards, neurologist at the National Hospital for Neurology and Neurosurgery

Jon Stone, neurologist, University of Edinburgh, Western General Hospital

This podcast is one of a series produced in collaboration with the Association of British Neurologists. You can find all the podcasts in the series here: soundcloud.com/tags/abn%202013

Diagnosing and treating functional symptoms

Mark Huizinga, a Dutch judoka, is 5 time European and Olympic Champion. Mark won the gold medal in the men’s under 90 kg class at the 2000 Summer Olympics and took bronze at both the 1996 and 2004 Summer Olympics. He retired after the 2008 Olympic Games and is currently national coach of the juniors in the Netherlands.

In this podcast he talks to BJSM deputy editor Babette Pluim about the most memorable moment during his distinguished judo career, about the traditions in judo, dealing with injuries, weight classes and weighing in and injury prevention in judo. He ends with an important lesson for sports physicians, which you will hear when you listen to this podcast!

See also:

Injuries in judo: a systematic literature review including suggestions for prevention: http://bjsm.bmj.com/content/47/18/1139.full

Energy demands during a judo match and recovery: http://bjsm.bmj.com/content/37/3/245.full

The common mechanisms of anterior cruciate ligament injuries in judo: a retrospective analysis: http://bjsm.bmj.com/content/44/12/856.full

Mark Huizinga, Olympic Judo champion, on his career

Julien Périard is a Canadian research scientist. After racing on the International Triathlon Union Circuit, he completed a PhD at the University of Sydney, investigating the mechanisms that limit prolonged exercise in the heat. He continues to be intrigued by the mechanisms that mediate performance and fatigue in adverse conditions and is now based in Qatar, an ideal place conduct heat studies in athletes. 

In this podcast he talks about a study he led with tennis players competing in both hot (37ºC) and cool (22ºC) conditions. He discusses the thermal, physiological and perceptual strain associated with match-play tennis in these conditions, as well as fatigue from a physical and neuromuscular performance perspective. He further discusses the impact of playing in the heat on oxidative stress, and the role of an individualized hydration regimen on performance under heat stress. 

He gives several important take home messages for coaches and players who plan to compete in the heat.

See also:

Heat stress does not exacerbate tennis-induced alterations in physical performance: http://bjsm.bmj.com/content/48/Suppl_1/i39.full

Coping with heat stress during match-play tennis: Does an individualised hydration regimen enhance performance and recovery?: http://bjsm.bmj.com/content/48/Suppl_1/i64.full

Increase in tennis injuries at the Australian Open – media hype or evidence based: http://blogs.bmj.com/bjsm/2014/01/28/increase-in-tennis-injuries-at-the-australian-open-media-hype-or-evidence-based/

Australian Open – Hot Tennis. To play or not to play? That is the question: http://blogs.bmj.com/bjsm/2014/01/18/australian-open-hot-tennis-to-play-or-not-to-play-that-is-the-question/

Thermal, physiological and perceptual strain mediate alterations in match-play tennis under heat stress: http://bjsm.bmj.com/content/48/Suppl_1/i32.full

Hydration and thermal strain during tennis in the heat: http://bjsm.bmj.com/content/48/Suppl_1/i12.full

Core body temperature during competition in the heat: national boys’ 14s junior tennis championships: http://bjsm.bmj.com/content/41/11/779.full

An integrated physiological and performance profile of professional tennis: http://bjsm.bmj.com/content/41/8/531.full

The impact of match-play tennis in a hot environment on indirect markers of oxidative stress and antioxidant status: http://bjsm.bmj.com/content/48/Suppl_1/i59.full

Neuromuscular adjustments of the knee extensors and plantar flexors following match-play tennis in the heat: http://bjsm.bmj.com/content/48/Suppl_1/i45.full


Julien Périard Tennis in the heat

After a patient has undergone ACL surgery, rehabilitation is bread and butter in many physiotherapy/sports medicine clinics. Many BJSM podcast listeners will be expert in this role. If you are less expert and wondering if there is an ‘optimum’ way to guide the patient back to sport, Dr Andy Franklyn-Miller provides some food for thought. 

He discusses some novel ways of assessing a patient’s progress after ACL reconstruction, advocates for the use of video in the clinic, and shares the dynamic tests he uses before allowing a player to return to sport. He shares exercises that both test, and help rehabilitate athletes in this setting.
 
Dr Franklyn-Miller is a sports physician at the Sports Surgery Clinic in Dublin, Ireland. He has published widely in sports medicine and his book, Clinical Sports Anatomy (2011), co-authored with Eanna Falvey and Peter Brukner, is an international best-seller. You can follow him on Twitter @AFranklynMiller and his blog provides great resources (www.drAndyFranklyMiller.com) including a further series of podcasts.
 
See also:
His previous podcasts on BJSM relating to running injuries (http://bit.ly/1bqMh8C) and groin pain (http://bit.ly/1fo2TAW).

Consensus criteria for defining ‘successful outcome’ after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation: http://bjsm.bmj.com/content/early/2013/07/23/bjsports-2013-092299.full

Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years: http://bjsm.bmj.com/content/47/15/980.full
 

Andy Franklyn-Miller - Tuning up rehabilitation after ACL reconstruction

Dr Jonathan Drezner, BJSM Senior Associate Editor (Sports Cardiology) is the team physician for Seattle Seahawks in the National Football League. 

Speaking in the week after his team’s first Super Bowl appearance, he shares thoughts with Karim Khan about a typical week at the Seahawks, the season’s climax in New Jersey, and what budding sports medicine clinicians might do if aspiring to work in the top levels of professional sport. 

Off the playing field, Professor Drezner served as President of AMSSM in 2012, contributes to the Primary Care Sports Medicine Fellowship at the University of Washington, Seattle and heads the Sports Cardiology Centre. 

To find more related to sports cardiology (not the subject of this podcast), please go to this BMJ Learning site – over 10,000 educational modules have been completed. http://tinyurl.com/o5jcc5v
 
See also:

Peter Brukner on – Lessons from 30 years as a team physician http://bjsm.bmj.com/articleusage?rid=47/10/610


The use of local anaesthetic injections in professional football: http://bjsm.bmj.com/content/35/4/212.full

Super Bowl: Two ACL tears and the landmark paper still under review: http://blogs.bmj.com/bjsm/2012/02/13/super-bowl-two-acl-tears-and-the-landmark-paper-still-under-review/

The Super Bowl Professor! A special day in the life of Dr Jonathan Drezner and the Seattle Seahawks

Dr Bert Mandelbaum is the team doctor for Team USA (soccer), the LA Galaxy, and Director of Research for Major League Baseball. He shares his optimism about the role of PRP in various injuries, while cautioning that stem cells, despite their promise, may still be like a ‘Ferrari without a steering wheel’. 

He was a pioneer in ACL prevention research and believes that programs successful in women may well translate across to men in sport such as NFL football. 

He takes 2 questions from @BJSM_BMJ Twitter followers. You can catch him next at the 23rd Isokinetic Football Medicine Conference in Milan, March 22-23, 2014 www.footballmedicinestrategies.com/en/
 
Read two of Dr Mandelbaum's prominent papers:

A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players bit.ly/1fWWCfu

Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes bit.ly/1lwfzt8

See also:

Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial bit.ly/1iXJRmS

Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial bit.ly/LSeWgb

Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial bit.ly/1fWWjRF

Growth factor delivery methods in the management of sports injuries: the state of play: http://bjsm.bmj.com/content/42/5/314.full

The PRP debate: http://blogs.bmj.com/bjsm/2010/11/15/the-prp-debate/

IOC consensus paper on the use of platelet-rich plasma in sports medicine: http://bjsm.bmj.com/content/44/15/1072.full

What constitutes the safe use of PRP in sports injuries? Continuing the PRP debate: http://blogs.bmj.com/bjsm/2010/11/25/what-constitutes-the-safe-use-of-prp-in-sports-injuries-continuing-the-prp-debate/

No magical therapeutic benefit of PRP in Achilles tendinopathy — JAMA paper follow-up and BJSM podcast: http://blogs.bmj.com/bjsm/2011/10/18/no-magical-therapeutic-benefit-of-prp-in-achilles-tendinopathy-jama-paper-follow-up-and-bjsm-podcast/

Platelet-rich plasma: a ‘feeling' and ‘hope' ailing athletes: http://bjsm.bmj.com/content/44/Suppl_1/i1.2.abstract

Airway injury during high-level exercise: http://bjsm.bmj.com/content/46/6/385.full

PRP within the wider context of regenerative medicine: http://blogs.bmj.com/bjsm/2010/12/07/prp-within-the-wider-context-of-regenerative-medicine/

Dr Bert Mandelbaum on PRP and stem cells for treatment / exercises for injury prevention

Dr Alex Kountouris tries to stay out of the limelight despite his position as physiotherapist to the Australian Men’s cricket team. Despite his attempts, he finds himself in the media talking  about players’ injuries and the reasons behind their inclusion or exclusion from the team. 

Listen to him discuss injury prevention and treatment in cricket, and for the first time hear the questions posed by our twitter followers.  

See also:

Batting head injury in professional cricket: a systematic video analysis of helmet safety characteristics: http://bjsm.bmj.com/content/47/10/644.full

International cricket injury surveillance: a report of five teams competing in the ICC Cricket World Cup 2011: http://bjsm.bmj.com/content/47/10/637.full

Injuries in West Indies cricket 2003–2004: http://bjsm.bmj.com/content/40/2/119.full

Methods for injury surveillance in international cricket: http://bjsm.bmj.com/content/39/4/e22.full

Cricket injuries, with Alex Kountouris

Dr Alex Kountouris is the physiotherapist or the Australian men’s cricket team, a position he has held for 8 years. He has just completed his PhD on the relationship between quadratus lumborum and lumbar stress fractures. 

In this podcast he discusses strategies for the prevention and treatment of lumbar spine injuries in cricket. The interesting questions posed to him come from our twitter followers, so hear his responses to your questions!

See also:

Biomechanics of lumbar spine injury in young Australian fast bowlers: http://bjsm.bmj.com/content/44/Suppl_1/i4.3.abstract

MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players: http://bjsm.bmj.com/content/41/11/836.full

A stress fracture of the lumbar spine in a professional rugby player: http://bjsm.bmj.com/content/41/5/337.full

Injuries in West Indies cricket 2003–2004: http://bjsm.bmj.com/content/40/2/119.full

@PeterBrukner discusses today’s major headline: Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/

Book Review: Clinical anatomy of the lumbar spine and sacrum: http://blogs.bmj.com/bjsm/2008/10/16/book-review-clinical-anatomy-of-the-lumbar-spine-and-sacrum/



Lower back injuries in cricket players, with Alex Kountouris

This month, an unusual variant of Guillain Barre syndrome - the pharyngeal cervical brachial variant. Benjamin Wakeley, a consultant neurologist at the Gloucester Hospitals NHS Foundation trust talks through what clinicians need to know.

Also, a look at an uncommon but difficult to resolve complication of Parkinson’s disease therapy - that of dopamine dysregulation syndrome. Robert Cilia, from the Parkinson Institute in Milan, discusses his paper examining the characterisation, management and long-term outcome.

If you found that useful you may want to listen to our accompanying podcast on impulse control disorder in Parkinson’s disease, produced with the British Neuropsychiatry association. David Okai, a consultant in psychological medicine in Oxford discusses assessing and managing the disorder. Listen here: goo.gl/gEsUUA

Read the articles:

Dopamine dysregulation syndrome in Parkinson's disease: from clinical and neuropsychological characterisation to management and long-term outcome goo.gl/AEH3vr

Pharyngeal-cervical-brachial variant of Guillain–Barré syndrome goo.gl/HFIqla


An unusual variant of Guillain–Barré syndrome, and dopamine dysregulation syndrome

Professor Philippe Neyret from Lyon, France, is a renowned sports orthopaedic surgeon. Following from his talk at the Isokinetic Football Medicine Conference in Milan, BJSM editor Karim Khan reached him via mobile phone. 

Prof Neyret discusses patellar dislocation in the setting of football and explains that certain anatomic variations (including trochlea dysplasia) make the condition more likely to occur. For players who have suffered patellar dislocation, next steps are not straightforward. Professor Neyret explains which players he would recommend have surgery.  

See also:

Injuries of the sporting knee: http://bjsm.bmj.com/content/34/6/467.1.full

Patient Information Sheet: Patellar Instabilities (dislocation or subluxation of the kneecap): http://blogs.bmj.com/bjsm/2008/10/16/patient-information-sheet-patellar-instability-dislocation-or-subluxation-of-the-kneecap/

Patellar dislocation in football, with Professor Philippe Neyret, France

Are you an exercise advocate? Dr Mike Loosemore, leader of the ‘Exercise is Medicine’ task force in the UK shares recent advances in this field. He spearheaded a most successful conference in that topic in 2013 and shares highlights with BJSM Editor Karim Khan.

He previews the 2014 Exercise Medicine conference which you can catch at the Royal Society of Medicine in London on Friday June 20 and Saturday June 21. Keynote speakers include Professors Steven Blair and Greg Whyte. Here is the link for the meeting; themes include the role of technology, digital health and influencing behaviour change. http://www.rsm.ac.uk/academ/spe02.php 

BJSM’s special 2014 issue on Exercise is Medicine, edited by Professors Steven Blair and Stewart Trost can be found here: http://bjsm.bmj.com/content/48/3.toc

See also:

Developing a strategic research framework for Sport and Exercise Medicine: http://bjsm.bmj.com/content/48/14/1120.full

Developing learning outcomes for an ideal MSc course in sports and exercise medicine: http://bjsm.bmj.com/content/39/1/20.full

Leisure-time aerobic physical activity, muscle-strengthening activity and mortality risks among US adults: the NHANES linked mortality study: http://bjsm.bmj.com/content/48/3/244.full

Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects: http://bjsm.bmj.com/content/42/8/636.full

Intensity of leisure-time physical activity and cancer mortality in men: http://bjsm.bmj.com/content/45/2/125.full

CT scans and X-rays increase risk of cancer – changing the goal posts in sports medicine: http://blogs.bmj.com/bjsm/2012/09/19/ct-scans-and-x-rays-increase-risk-of-cancer-changing-the-goal-posts-in-sports-medicine/

Physical activity more likely to prevent breast cancer in certain groups: http://blogs.bmj.com/bjsm/2008/05/18/physical-activity-more-likely-to-prevent-breast-cancer-in-certain-groups/

Dr Mike Loosemore on ‘Exercise is Medicine’ – technology & behaviour change

Rob Swire has had 22 years of experience at Manchester United. BJSM asked him ‘How do you screen a professional football team pre-season?’

He shares how it’s done, as well as the challenges of being a team clinician and struggling to keep up with continuing education. In the most recent season, Manchester United have moved to include a software package to simplify their screening data entry, risk calculation and the offer of advice as to what might be appropriate exercises in specific settings.  

‘I’m a pragmatic (physio) surfing on a wave of science’ was how Steyn Van der Bruggen described his role. Previously at West Ham and more recently at Moscow Dynamo, he shares his approach on how to evaluate players’ functional capacity and then address limitations with targeted exercise.  

See also:

Impact energy attenuation performance of football headgear: http://bjsm.bmj.com/content/34/5/337.full

Dehydration of football referees during a match: http://bjsm.bmj.com/content/37/6/502.full

Reductions in pre-season training loads reduce training injury rates in rugby league players: http://bjsm.bmj.com/content/38/6/743.full

The effect of pre-season dance training on physical indices and back pain in elite cross-country skiers: a prospective controlled intervention study: http://bjsm.bmj.com/content/38/2/148.full

Community football players’ attitudes towards protective equipment—a pre-season measure: http://bjsm.bmj.com/content/38/4/426.full

Concussion, risk assessment, and practical steps to reform: Learning from the Hugo Lloris example: http://blogs.bmj.com/bjsm/2013/11/21/concussion-risk-assessment-and-steps-to-reform-learning-from-the-lloris-example/

Are you responsible for pre-season screening and injury prevention in a football setting?

With Rob Swire (Manchester United) and Stijn Vandenbroucke (Moscow Dynamo).

‘You always start off the season with a masterplan of what you are wanting to do but we’ve never had a master plan that works or goes anywhere near where it is supposed to, but you just try your best’. Given this validation of what you are doing, listen and see how you CAN make prevent injuries and improve team performance by working as a team with your other health professional as well as strength and conditioning colleagues.  

It’s all about load monitoring and here you can hear from two very experienced physios in the field. What role GPS? What role other software? This is a scenario where ‘e-Health’ or ‘M-health’ meets performance. 

Our guests speak about how to customise training and monitor players’ adaptation – What are the things to watch out for? When can a player return to training after an injury spell? Is the coach the greatest risk factor – and can the GPS help communicate load messages to the coach? 

See also:

General practitioners’ perceptions and practices of physical activity counselling: changes over the past 10 years: http://bjsm.bmj.com/content/43/14/1149.full

Technology in Paralympic sport: performance enhancement or essential for performance?: http://bjsm.bmj.com/content/44/3/215.full

Planning and implementing a nationwide football-based health-education programme: http://bjsm.bmj.com/content/46/1/6.full

Monitoring stress and recovery: new insights for the prevention of injuries and illnesses in elite youth soccer players: http://bjsm.bmj.com/content/44/11/809.full

Reproducibility of computer based neuropsychological testing among Norwegian elite football players: http://bjsm.bmj.com/content/39/suppl_1/i64.full

Practical tips for in-season injury prevention and monitoring professional football players

Isabel van Obergen and Hannes Cleppe discuss their prevention platform for sports: a software program (SpartaNova) that is in the ‘e-Health’ category for physiotherapy and sports medicine. 

We begin with an obvious competing interest disclaimer. BJSM has no financial interest or association with SpartaNova. Because clinicians use specific products, such as ‘Theraband’ ® for example, BJSM will report on the utility of such products while being open about any competing interests. Have you considered using software in your practice? Feel free to suggest what we should assess. We love to share ‘success stories’ – and if a commercial product adds value for you we’d report that information.

Our guests in this podcast are the CEO of SpartaNova, (IvO) who was attending London’s ‘Leaders in Performance’ conference in 2013, and Hannes Cleppe, who trained as a physiotherapist in Belgium and the US before focusing on developing the injury prevention module for this product. The team includes active clinical advisors as well as experts in computer sciences and maths and closely co-operates with science partners from its founding universities and a broader network of researchers. 

See also:

Developing an injury tracking software system specific for volleyball: a case example: http://bjsm.bmj.com/content/45/6/545.3.abstract

Visual or computer-based measurements: important for interpretation of athletes’ ECG: http://bjsm.bmj.com/content/48/9/761.full

Helping clinicians to turn evidence into practice – software for injury prevention and rehab

Integrating athlete care – ‘one stop shop’ to optimize athlete care - sports medicine with a focus on PERFORMANCE.

Dr Paul Dijkstra has vast experience in elite track and field athlete care. He shares his experience from UK Athletics – the team won 4 gold medals at the London Olympic Games. What’s new in this approach? This model of athlete care emphasises the partnership among not only the health professionals, but also with the strength and conditioning team and the coach(es). Also emphasised is performance – too often clinicians tend to focus exclusively on health whereas the athlete’s focus is performance.

Dr Dijkstra provides case scenarios -- how the management model works in real life. He shares the public domain case of UK heptathlete Jessica Ennis who forewent the Beijing Olympic Games (2008) because of a navicular stress fracture, but chose full healing and a longer future over ‘patch up’ to get to the 2008 Olympic Games. 

The paper outlining this approach was featured in the April issue of BJSM supported by the IOC (Injury Prevention, Health Protection). You can read the Open Access paper here: http://bjsm.bmj.com/content/48/7/523.full

See also:

Seeing you through London 2012: eye care at the Olympics: http://bjsm.bmj.com/content/47/7/463.full

The role of sports physiotherapy at the London 2012 Olympic Games: http://bjsm.bmj.com/content/48/1/63.full

The London 2012 Summer Olympic Games: an analysis of usage of the Olympic Village ‘Polyclinic’ by competing athletes: http://bjsm.bmj.com/content/47/7/415.full

Fit and healthy Paralympians—medical care guidelines for disabled athletes: a study of the injuries and illnesses incurred by the Polish Paralympic team in Beijing 2008 and London 2012: http://bjsm.bmj.com/content/47/13/844.full

Massage provision by physiotherapists at major athletics events between 1987 and 1998: http://bjsm.bmj.com/content/38/2/235.full

Care of the multisport athlete: lessons from Goldilocks: http://bjsm.bmj.com/content/45/14/1086.full

Public health implications of establishing a national programme to screen young athletes in the UK: http://bjsm.bmj.com/content/45/7/576.full

Suicide, sport and medicine: more education and awareness needed for athletes’ mental health: http://blogs.bmj.com/bjsm/2012/12/10/suicide-sport-and-medicine-more-education-and-awareness-needed-for-athletes-mental-health/

“How does a clinician know what’s in the athlete’s best interest?” An Olympic experience: http://blogs.bmj.com/bjsm/2012/08/24/what-defines-an-athletes-best-interest-an-olympic-experience/

Paul Dijkstra - Time for a different way to deliver care to high level athletes

Here’s the podcast that over 12,000 listeners have been demanding – physiotherapist Adam Meakins (@TheSportsPhysio)on a number of controversial topics, including:
Is diagnostic palpation accurate?
Can the sacroiliac joint really be ‘unstable’?
How does ‘touch’ in physiotherapy have its therapeutic effect? 

Adam provides great value on Twitter and on his blog – here you can listen to him in your favourite podcast setting. 

Adam shares his way of explaining neural pain to patients and that alone is worth the price. 

He also discusses his popular blogs on ‘5 Least Favourite Shoulder Rehab Exercises’ as well as ‘Top 5 Shoulder Rehab Exercises’. 

He argues that the key to managing some knee conditions is to manage load and he refers to Scott Dye’s classic ‘envelope of function’ concept. 

And we close by discussing a couple of  figures that have gained great traction in the Twittersphere. You might find them useful in your clinical practice. But it’s a risk on radio – I get that! Enjoy and comment via @BJSM_BMJ or on Facebook.

See also:

Why does my shoulder hurt? A review of the neuroanatomical and biochemical basis of shoulder pain: http://bjsm.bmj.com/content/47/17/1095.full

Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis: http://bjsm.bmj.com/content/48/16/1216.full

Rehabilitation for shoulder instability: http://bjsm.bmj.com/content/44/5/333.full

Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury: http://bjsm.bmj.com/content/45/4/245.full

Adam Meakins' practical physio tips – explaining neural pain, shoulder rehab and managing knee load

Over-diagnosis, over-treatment and industry influence. Surely not in sports medicine?

Ray Moynihan is an internationally renowned contributor in the battle to limit any inappropriate influence of pharmaceutical, diagnostic, and technology companies on good clinical practice. 

He shares his concerns about the role of drug/implant companies but also argues that clinicians may well be contributing to suboptimal care – almost subconsciously. This is relevant for conditions such as femoroacetabular impingement (FAI). The issue of ‘preventive’ surgery to prevent future arthritis in currently pain-free hips is a massive issue in sports medicine of course. How do we know which patients need this treatment? 

Enjoy this podcast from a voice outside BJSM’s traditional network of physiotherapists, physicians, massage therapists, clinicians working with active people. 

When we planned the podcast, Ray Moynihan said he didn’t know about sport but I think you’ll agree that what he offers is hugely relevant to sport and exercise medicine. Thanks Ray! 

And the 2nd ‘Preventing Overdiagosis’ conference is at Oxford from September 15-17 – just google ‘overdiagnosis conference’. Share your thoughts to @BJSM_BMJ - is this a problem in sports medicine? 

See also:

Online First editorial about FAI: http://goo.gl/ziOLNz

In the June issue of BJSM we carry a review of PRP suggesting it isn’t helpful: http://goo.gl/xARb44

The authors of one of the key papers respond here: 
http://goo.gl/B1hxqc

You can read several of Ray Moynihan’s papers in the BMJ including this one that summarises his thoughts on overdiagnosis: 
http://goo.gl/8uxcGS

Repudiation of the ‘magic bullet’ approach to health improvement: a call to empower people to get moving and take charge: http://bjsm.bmj.com/content/46/5/303.full

‘Overdiagnosis’ / ‘overtreating’– relevant in sportsphysio/medicine? Professor Peter O’Sullivan: https://soundcloud.com/bmjpodcasts/overdiagnosis-overtreating-relevant-in-sportsphysiomedicine-peter-osullivan

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