Podcasts about j orthop sports phys ther

"Dear Newly Graduated Physical Therapist": A Direct Message Containing Advice We Wish We Had Received Powell JK, Cook C, Lewis J, et al. J Orthop Sports Phys Ther. 2024;54(10):621-624. doi:10.2519/jospt.2024.12676 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik/Jason/Chris's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

In this episode of The Shoulder Physio Podcast, I am interviewed by my wife, Tara, about my recently completed PhD. For the past 7 years of my life I have been engaged in a research based PhD investigating the causal mechanisms underpinning the effectiveness of exercise therapy for rotator cuff related shoulder pain. This research program has produced 6 published pieces of research that is contained with the thesis. In this episode I briefly discuss the premise of the thesis, its main findings, and recommendations for future research. I also gives some tips and tricks and to prospective PhD or current PhD students which may help their journey. Don't miss this episode with myself, Dr Jared Powell, and my wife, the amazing Tara Powell. Buckle up! Key Papers: Powell JK, Lewis JS. Rotator Cuff-Related Shoulder Pain: Is It Time to Reframe the Advice, "You Need to Strengthen Your Shoulder"? J Orthop Sports Phys Ther. 2021 Apr;51(4):156-158. doi: 10.2519/jospt.2021.10199. PMID: 33789431. Powell JK, Schram B, Lewis J, Hing W. "You have (rotator cuff related) shoulder pain, and to treat it, I recommend exercise." A scoping review of the possible mechanisms underpinning exercise therapy. Musculoskelet Sci Pract. 2022 Dec;62:102646. doi: 10.1016/j.msksp.2022.102646. Epub 2022 Aug 8. PMID: 35964499. Powell JK, Schram B, Lewis J, Hing W. Physiotherapists nearly always prescribe exercise for rotator cuff-related shoulder pain; but why? A cross-sectional international survey of physiotherapists. Musculoskeletal Care. 2023 Mar;21(1):253-263. doi: 10.1002/msc.1699. Epub 2022 Sep 11. PMID: 36089802. Powell JK, Costa N, Schram B, Hing W, Lewis J. "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain. Phys Ther. 2023 Dec 6;103(12):pzad088. doi: 10.1093/ptj/pzad088. PMID: 37440455; PMCID: PMC10733131. Powell JK, Lewis J, Schram B, Hing W. Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice. Musculoskeletal Care. 2024 Jun;22(2):e1879. doi: 10.1002/msc.1879. PMID: 38563603. READ THE WHOLE THESIS! Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

Can Baseline MRI Findings Identify Who Responds Better to Early Surgery Versus Exercise and Education in Young Patients With Meniscal Tears? A Subgroup Analysis From the DREAM Trial Clausen S, Boesen M, Thorlund JB, et al. J Orthop Sports Phys Ther. Published online January 30, 2025:1-23. doi:10.2519/jospt.2025.12994 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik/Jason/Chris's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

The Fragility Index of Risk Factors for Hamstring Injuries Anthis M, Gourd S, Kim B, et al. J Orthop Sports Phys Ther. 2024;54(10):672-678. doi:10.2519/jospt.2024.12300 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik/Jason/Chris's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

I denne episoden diskuterer vi det provokative spørsmålet “er trening egentlig riktig behandling for skulderplager?” Vi belyser hvordan en nylig publisert kronikk gikk viralt i sosiale medier, hvordan slike kronikker gir oss en selvtillitsboost og hvordan det er lett å bli revet med av lettbente og provokative artikler. Vi tar en fot i bakken og stiller oss selv noen ubehagelige spørsmål: Er egentlig trening så effektivt som vi skal ha det til? Fungerer det egentlig å løfte vekter for å bli bedre i en smertefull skulder? Finnes det virkelig en “optimal dose” når det kommer til trening for skuldersmerter? Finnes det andre tiltak som er like gode som trening? Skifter egentlig Jørgen underbukser sjeldnere enn Stian publiserer en ny bok? Er Stian nødt til å skrive autograf hver gang han går på klatresenteret nå? REFERANSER: Kjerpeset Ø. Den neglisjerte vidundermedisinen. Tidsskrift for den Norske Legeforening. 2024;144(9).Powell JK, et al. "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain. Phys Ther. 2023;103(12).Powell JK, et al. Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice. Musculoskeletal Care. 2024;22(2):e1879.Powell JK, Lewis JS. Rotator Cuff-Related Shoulder Pain: Is It Time to Reframe the Advice, "You Need to Strengthen Your Shoulder"? J Orthop Sports Phys Ther. 2021;51(4):156-8.Powell JK, et al. "You have (rotator cuff related) shoulder pain, and to treat it, I recommend exercise." A scoping review of the possible mechanisms underpinning exercise therapy. Musculoskelet Sci Pract. 2022;62:102646.PATREON: Fra 2024 spør vi lytterne våre om å bidra til podcasten ved å bli patreons. For prisen av en Oslokaffe i måneden gir du oss muligheten til å fortsette podcasten, samtidig som du skaffer deg selv VIP-billetter til VONDT fellesskapet. Her får du blant annet tilgang på lukket diskusjonsforum, referanselister fra episodene, mulighet til å stille gjestene spørsmål og rabatter på kurs&fagdager. Les mer og bli en patreon i dag på: patreon.com/vondt MUSIKK: Joseph McDade - Mirrors

Dans cet épisode Anthony Halimi amène Marco à dévoiler les éléments de représentation qui sous-tendent le modèle qu'il s'est forgé au cours de sa pratique. Les deux intervenants tentant ensuite d'en faire une analyse critique en déconstruisant les a priori sur lesquels ce modèle se base. Ils abordent également les questions d'allostasie et charge allostatique. Références Musique Epic Rock, Alex Grohl, Envato Elements. Discours De Lionel Jospin A L'Issue du Premier Tour 21 Avril 2002 De L'Election Présidentielle Discours de Charles de Gaulle à Alger le 4 juin 1958 Artus, M., Windt, D. van der, Jordan, K. & Hay, E. (2010) Low back pain symptoms show a similar pattern of improvement following a wide range of primary care treatments: a systematic review of randomized clinical trials. Artus M, van der Windt D, Jordan KP, Croft PR. The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies. BMC Musculoskelet Disord. 2014 Mar 7;15:68 Tagliaferri SD, Mitchell UH, Saueressig T, Owen PJ, Miller CT, Belavy DL. Classification Approaches for Treating Low Back Pain Have Small Effects That Are Not Clinically Meaningful: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022 Feb;52(2):67-84.

In this episode of The Shoulder Physio podcast, I am joined by Kim Bennell, a professor and research physiotherapist from the University of Melbourne. Kim has been involved in designing and implementing dozens of clinical trials over her many years of research and is a true giant of the physiotherapy profession. In this episode we discuss something novel. We venture into the world of physiotherapists providing dietary advice for people with knee osteoarthritis, which might be controversial. Kim has just published a landmark clinical trial on this very topic. We also delve into exercise for knee and hip osteoarthritis and whether there is an ideal dose or adherence level that leads to superior clinical outcomes. This is based on a recent review and there is some surprising results. Don't miss this enlightening episode with professor Kim Bennell. Key Papers: 1. Allison K et al. Alternative models to support weight loss in chronic musculoskeletal conditions: effectiveness of a physiotherapist-delivered intensive diet programme for knee osteoarthritis, the POWER randomised controlled trial. Br J Sports Med. 2024 May 2;58(10):538-547. doi: 10.1136/bjsports-2023-107793. PMID: 38637135.2. 2. Lawford BJ et al. How Does Exercise, With and Without Diet, Improve Pain and Function in Knee Osteoarthritis? A Secondary Analysis of a Randomized Controlled Trial Exploring Potential Mediators of Effects. Arthritis Care Res (Hoboken). 2023 Nov;75(11):2316-2327. doi: 10.1002/acr.25140. Epub 2023 Jun 15. PMID: 37128836; PMCID: PMC10952828. 3. Marriott KA et al. Are the Effects of Resistance Exercise on Pain and Function in Knee and Hip Osteoarthritis Dependent on Exercise Volume, Duration, and Adherence? A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken). 2024 Jun;76(6):821-830. doi: 10.1002/acr.25313. Epub 2024 Apr 15. PMID: 38317328. 4. Bailey DL, Holden MA, Foster NE, et al. Defining adherence to therapeutic exercise for musculoskeletal pain: a systematic review. British Journal of Sports Medicine 2020;54:326-331. 5. Nicolson PJA, Hinman RS, Wrigley TV, Stratford PW, Bennell KL. Self-reported Home Exercise Adherence: A Validity and Reliability Study Using Concealed Accelerometers. J Orthop Sports Phys Ther. 2018 Dec;48(12):943-950. doi: 10.2519/jospt.2018.8275. Epub 2018 Jul 27. PMID: 30053792. The Shoulder Physio Online Course is on sale for a limited time! Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Kim on Twitter: @kimbennell The Centre for Health, Exercise and Sports Medicine (CHESM): @CHESM_unimelb See our Disclaimer here: The Shoulder Physio - Disclaimer

I denne episoden snakker vi med Arnlaug Wangensteen om hamstringskader. Vi diskuterer de ulike skadetypene og skademekanismene, kliniske og billeddiagnostiske undersøkelser, konservativ vs operativ tilnærming og selvfølgelig rehabilitering og retur til idrett. Arnlaug er utdannet fysioterapeut fra Høgskolen i Oslo (2007) og tok mastergrad i idrettsfysioterapi ved Norges idrettshøgskole 2009-11. Hun forsvarte sitt doktorgradsprosjekt med tittelen «Diagnosis and prognosis after acute hamstring injuries in male athletes» i 2018. Prosjektet ble utført i samarbeid mellom Aspetar Orthopaedic and Sports Medicine Hospital i Doha (hvor hun var ansatt som Post Graduate Researcher i perioden 2013-2016) og Senter for idrettsskadeforskning på Nih. Hun jobber nå som klinisk fysioterapeut på NIMI (Volvat) og har en liten forskerstilling på Senter for idrettsskadeforskning som koordinator i korsbåndsprosjektet «Tryggere retur til idrett». PATREON: Fra 2024 spør vi lytterne våre om å bidra til podcasten ved å bli patreons. For prisen av en Oslokaffe i måneden gir du oss muligheten til å fortsette podcasten, samtidig som du skaffer deg selv VIP-billetter til VONDT fellesskapet. Her får du blant annet tilgang på lukket diskusjonsforum, referanselister fra episodene, mulighet til å stille gjestene spørsmål og rabatter på kurs&fagdager. Les mer og bli en patreon i dag på: patreon.com/vondt LITTERATUR (NB! Kun et lite utvalg. Patreons får tilgang på full litteraturliste) Skademekanisme: Kerin F.  Its not all about sprinting: mechanisms of acute hamstring strain injuries in professional male rugby union-a systematic visual video analysis. Br J Sports Med. 2022Klinisk undersøkelse: Whiteley R. Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries and their association with running speed and rehabilitation progression. Br J Sports Med 2018MR klassifikasjoner: Kerin F. Are all hamstring injuries equal? A retrospective analysis of time to return to full training following BAMIC type ‘c' and T-junction injuries in professional men's rugby union. Scand J Med Sci Sports. 2024Rehabilitering av akutt hamstringskade: Ishøi L. Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport – grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)Br J Sports Med 2020Proksimal totalruptur: van der Made AD. Potential hamstring injury blind spot: we need to raise awareness of proximal hamstring tendon avulsion injuries. Br J Sports Med 2019Proximal hamstrings tendinopatiGoom T. Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. J Orthop Sports Phys Ther 2016 MUSIKK: Joseph McDade - Mirrors

In this episode of The Shoulder Physio podcast, I am joined by Amy McDevitt, an associate professor and clinician at the University of Colorado. Amy shared her perspective on manual therapy and the importance of unraveling the mechanisms behind this treatment approach.We discussed the evolving causal explanations of manual therapy, moving beyond antiquated notions towards a more contemporary and scientifically based explanation for how it many help people in pain.We delved into the complexities of how manual therapy works, from historical biomechanical viewpoints to more contemporary neurophysiological aspects. Amy highlighted the importance of considering contextual factors and therapeutic alliance, which may play a more significant role in patient outcomes than previously believed. Don't miss this enlightening episode that sheds light on the intricacies of manual therapy and the quest for a deeper understanding of how interventions work to benefit patients. Key Papers: 1. McDevitt AW, O'Halloran B, Cook CE. Cracking the code: unveiling the specific and shared mechanisms behind musculoskeletal interventions. Arch Physiother. 2023 Jul 6;13(1):14. doi: 10.1186/s40945-023-00168-3. PMID: 37415258; PMCID: PMC10327381. 2. Bialosky JE, Beneciuk JM, Bishop MD, Coronado RA, Penza CW, Simon CB, George SZ. Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther. 2018 Jan;48(1):8-18. doi: 10.2519/jospt.2018.7476. Epub 2017 Oct 15. PMID: 29034802. 3. Silvernail JL, Deyle GD, Jensen GM, Chaconas E, Cleland J, Cook C, Courtney CA, Fritz J, Mintken P, Lonnemann ME. Orthopaedic Manual Physical Therapy: A Modern Definition and Description. Phys Ther. 2024 Mar 8:pzae036. doi: 10.1093/ptj/pzae036. Epub ahead of print. PMID: 38457654. 4. Powell JK, Lewis JS. Rotator Cuff-Related Shoulder Pain: Is It Time to Reframe the Advice, "You Need to Strengthen Your Shoulder"? J Orthop Sports Phys Ther. 2021 Apr;51(4):156-158. doi: 10.2519/jospt.2021.10199. PMID: 33789431. The Shoulder Physio Online Course Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Amy on Twitter: @awmcdevittDPT See our Disclaimer here: The Shoulder Physio - Disclaimer

Which portion of physiotherapy treatments' effect is attributable to contextual effects in people with musculoskeletal pain?: A meta-analysis of randomised placebo-controlled trials. Ezzatvar Y, Dueñas L, Balasch-Bernat M, et al. J Orthop Sports Phys Ther. Online Ahead of Print. doi:10.2519/jospt.2024.12126 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

Patello-femoral pain is a common, and at times, debilitating condition of the knee that can impact people across the lifespan. Professor Bill Vicenzino is a world leading expert on this topic and to that end I've enticed him onto the show to give us the ins and outs of this tricky condition. This is truly a must listen episode with a real pioneer of physiotherapy about a very common and important musculoskeletal condition. Key Papers: 1. Rathleff MS, Holden S, Krommes K, Winiarski L, Hölmich P, Salim TJ, Thorborg K. The 45-second anterior knee pain provocation test: A quick test of knee pain and sporting function in 10-14-year-old adolescents with patellofemoral pain. Phys Ther Sport. 2022 Jan;53:28-33. doi: 10.1016/j.ptsp.2021.11.002. Epub 2021 Nov 4. PMID: 34775189. 2. Powers CM, Witvrouw E, Davis IS, Crossley KM. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. Br J Sports Med. 2017 Dec;51(24):1713-1723. doi: 10.1136/bjsports-2017-098717. Epub 2017 Nov 6. PMID: 29109118. 3. Powers CM, Ho KY, Chen YJ, Souza RB, Farrokhi S. Patellofemoral joint stress during weight-bearing and non-weight-bearing quadriceps exercises. J Orthop Sports Phys Ther. 2014 May;44(5):320-7. doi: 10.2519/jospt.2014.4936. Epub 2014 Mar 27. PMID: 24673446. 4. Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM, McConnell J, Vicenzino B, Bazett-Jones DM, Esculier JF, Morrissey D, Callaghan MJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016 Jul;50(14):839-43. doi: 10.1136/bjsports-2016-096384. Epub 2016 Jun 24. PMID: 27343241; PMCID: PMC4975817. 5. Nimon G, Murray D, Sandow M, Goodfellow J. Natural history of anterior knee pain: a 14- to 20-year follow-up of nonoperative management. J Pediatr Orthop. 1998 Jan-Feb;18(1):118-22. PMID: 9449112. 6. Dye SF. The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clin Orthop Relat Res. 2005 Jul;(436):100-10. doi: 10.1097/01.blo.0000172303.74414.7d. PMID: 15995427. 7. Holden S, Matthews M, Rathleff MS, Kasza J; Fohx Group; Vicenzino B. How Do Hip Exercises Improve Pain in Individuals With Patellofemoral Pain? Secondary Mediation Analysis of Strength and Psychological Factors as Mechanisms. J Orthop Sports Phys Ther. 2021 Dec;51(12):602-610. doi: 10.2519/jospt.2021.10674. PMID: 34847699. 8. Robertson CJ, Hurley M, Jones F. People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskelet Sci Pract. 2017 Apr;28:59-64. doi: 10.1016/j.msksp.2017.01.012. Epub 2017 Feb 2. PMID: 28171780. The Shoulder Physio Online Course Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Bill on Twitter: @Bill_Vicenzino See our Disclaimer here: The Shoulder Physio - Disclaimer

There is a Lack of Clinical Homogeneity in Lower-Limb Tendinopathy Trials: A Scoping Review Lyng KD, Sørensen LB, Platzer OJ, et al. J Orthop Sports Phys Ther. 2024;54(1):1-10. doi:10.2519/jospt.2023.11722 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

Beware of the 'moving target' - uninvolved limb strength increases to exceed pre-operative values during rehabilitation after ACL reconstruction in male professional and recreational athletes. Barbosa O, Kotsifaki R, Whiteley R, et al. J Orthop Sports Phys Ther. Published Ahead of Print. doi:10.2519/jospt.2023.11961 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

We're back for 2024! On today's episode, Ben and Tom discuss Bankart lesions and repairs. Research mentioned in today's podcast: Defroda, S., Mehta, N., and Owens, B. Physical Therapy Protocols for Arthroscopic Bankart Repair. Sports Health. 2018 Jan 3, 10(3): 250–258doi: 10.1177/1941738117750553 Gaunt, B., Shaffer, M., Sauers, E., Michener, L., Mccluskey, G., Thigpen, C. The American Society of Shoulder and Elbow Therapists' Consensus Rehabilitation Guideline for Arthroscopic Anterior Capsulolabral Repair of the Shoulder. Journal of Orthopaedic & Sports Physical Therapy. 2010;40(3):155-168. doi:10.2519/jospt.2010.3186 Ialenti MN, Mulvihill JD, Feinstein M, Zhang AL, Feeley BT. 2017. Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017 Sep 14;5(9):2325967117726055. doi: 10.1177/2325967117726055. PMID: 28944249; PMCID: PMC5602217. Kasik CS, Rosen MR, Saper MG, Zondervan RL. High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: a systematic review. J ISAKOS. 2019 Jan;4(1):33-40. doi: 10.1136/jisakos-2018-000224. Epub 2018 Nov 10. PMID: 31044093; PMCID: PMC6487304. Provencher MT, Sanchez G, Bernhardson AS, Peebles LA, Haber DB, Murphy CP, Sanchez A. The Instability Severity Index Score Revisited: Evaluation of 217 Consecutive Cases of Recurrent Anterior Shoulder Instability. Orthop J Sports Med. 2019 Jul 29;7(7 suppl5):2325967119S00269. doi: 10.1177/2325967119S00269. PMCID: PMC6668005. Saper MG, Milchteim C, Zondervan RL, Andrews JR, Ostrander RV. Outcomes After Arthroscopic Bankart Repair in Adolescent Athletes Participating in Collision and Contact Sports. Orthopaedic Journal of Sports Medicine. 2017;5(3). doi:10.1177/2325967117697950 Schwank A, Blazey P, Asker M, Møller M, Hägglund M, Gard S, Skazalski C, Haugsbø Andersson S, Horsley I, Whiteley R, Cools AM, Bizzini M, Ardern CL. 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation, and Return to Sport for Athletes at All Participation Levels. J Orthop Sports Phys Ther. 2022 Jan;52(1):11-28. doi: 10.2519/jospt.2022.10952. PMID: 34972489. Swindell HW, McCormick KL, Tedesco LJ, Herndon CL, Ahmad CS, Levine WN, Popkin CA. Shoulder instability, performance, and return to play in National Hockey League players. JSES Int. 2020 Sep 22;4(4):786-791. doi: 10.1016/j.jseint.2020.08.008. PMID: 33345216; PMCID: PMC7738589. Wilk KE, Bagwell MS, Davies GJ, Arrigo CA. RETURN TO SPORT PARTICIPATION CRITERIA FOLLOWING SHOULDER INJURY: A CLINICAL COMMENTARY. Int J Sports Phys Ther. 2020 Aug;15(4):624-642. PMID: 33354395; PMCID: PMC7735686. White, Alex E. BA; Patel, Nirav K. MD, FRCS; Hadley, Christopher J. BS; Dodson, Christopher C. MD. An Algorithmic Approach to the Management of Shoulder Instability. JAAOS: Global Research and Reviews 3(12):p e19.00168, December 2019. | DOI: 10.5435/JAAOSGlobal-D-19-00168 Ben Ashworth's website: https://athleticshoulder.com Mike Reinold's podcast: https://podcasts.apple.com/us/podcast/the-sports-physical-therapy-podcast/id1618458855

Can Clinicians Trust Objective Measures of Hip Muscle Strength From Portable Dynamometers? A Systematic Review With Meta-analysis and Evidence Gap Map of 107 Studies of Reliability and Criterion Validity Using the COSMIN Methodology Waiteman MC, Garcia MC, Briani RV, et al. J Orthop Sports Phys Ther. 2023;53(11):655-672. doi:10.2519/jospt.2023.12045 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

On this episode we were joined by special guest physical therapist/athletic trainer Sam Oft. Relationships between common preseason screening measures and dance-related injuries in preprofessional ballet dancers. Critchley ML, Bonfield S, Ferber R, et al. J Orthop Sports Phys Ther. 2023;53(11):703-711. doi:10.2519/jospt.2023.11835 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Physio Network - https://physio.network/pt-research-reviews Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Sam Roux - Spanish Jungle

Drawing a "Perfect Circle": How Clinicians Can Become Better Communicators. Peterson S, Miciak M, Kleiner M, et al. J Orthop Sports Phys Ther. 2023;53(10):579-584. doi:10.2519/jospt.2023.11917 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Physio Network - https://physio.network/pt-research-reviews Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Sam Roux - Spanish Jungle

Adding brief pain science or ergonomics messages to guideline advice did not increase feelings of reassurance in people with acute low back pain: a randomised experiment. Ferreira GE, Zadro JR, Traeger AC, et al. J Orthop Sports Phys Ther. Published Ahead of Print. doi:10.2519/jospt.2023.12090 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Physio Network–https://www.physio-network.com/ Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by: Kevin MacLeod – incompetech.com: Mining by Moonlight Sam Roux: Spanish Jungle

On this episode we were joined by special guest researcher Dr. Justin Losciale from the University of British Columbia. Description, Prediction, and Causation in Sport and Exercise Medicine Research: Resolving the Confusion to Improve Research Quality and Patient Outcomes. Losciale JM, Bullock GS, Collins GS, et al. J Orthop Sports Phys Ther. 2023;0(7):1-7. doi:10.2519/jospt.2023.11773 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

這次跟大家討論如何在評估過程中運用CFT 以及如何在治療中融入CFT 希望對大家有幫助囉 歡迎到Facebook, Instagram追蹤或來信來訊跟我們提出疑問～ Email: 2propt@gmail.com Timecode: 00:30 閒聊美國的夏令營，跳脫舒適圈 09:40 複習CFT三個重點 12:12 CFT評估流程：是否有紅旗=》是否為慢行？=〉是否為持續性疼痛？=》是否對疼痛、動作有恐懼？=〉判斷疼痛機制（mechanical, nonmechanical, or mix) 18:30 CFT評估流程：判斷可調控的心理因子：認知、情緒 21:30 CFT 評估流程：判斷可調控的行為因子：動作行為、社交行為、生活型態 25:40 CFT處理流程：疼痛教育 30:17 CFT處理流程：可控範圍下動作行為暴露 37:46 CFT處理流程：生活型態改變 42:36 本篇病人處理流程實例 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial [published correction appears in Lancet. 2023 Jun 17;401(10393):2040]. Lancet. 2023;401(10391):1866-1877. Caneiro JP, Smith A, Rabey M, Moseley GL, O'Sullivan P. Process of Change in Pain-Related Fear: Clinical Insights From a Single Case Report of Persistent Back Pain Managed With Cognitive Functional Therapy. J Orthop Sports Phys Ther. 2017;47(9):637-651.

這次跟大家討論接受及承諾療法ACT和CFT的差異 以及如何幫助病人找到目標 希望大家對CFT有更深一層的了解 Timecode: 00:30 閒聊美國信用卡優惠 11:30 接受與承諾療法ACT與認知功能療法CFT的不同之處 15:34 ACT的六重點：present movement, value, committed action, self as context, cognitive defusion, acceptance 16:00 如何幫助病人找出有意義的治療目標 25:30 不要把注意力放在「疼痛」上 28:55 CFT的評估治療有別於其他心理治療不同之處：問診的重點、衛教解釋疼痛、控制下暴露、生活型態改變 35:30 CFT治療重點複習 36:30 CFT 使用前的注意事項 37:40 認知、情緒相關介入的使用時機，痛三個月就算慢性疼痛嗎？大腦到底發生什麼事？ 歡迎到Facebook, Instagram追蹤或來信來訊跟我們提出疑問～ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial [published correction appears in Lancet. 2023 Jun 17;401(10393):2040]. Lancet. 2023;401(10391):1866-1877. Caneiro JP, Smith A, Rabey M, Moseley GL, O'Sullivan P. Process of Change in Pain-Related Fear: Clinical Insights From a Single Case Report of Persistent Back Pain Managed With Cognitive Functional Therapy. J Orthop Sports Phys Ther. 2017;47(9):637-651.

這次主題很長所以分為兩集 先跟大家討論為什麼認知功能療法對物理治療師很重要 以及認知功能療法的基本原則 下集會有更多細節盡請期待囉！ Timecode: 00:30 台大操作治療學課程相關澄清：基礎物理治療學、實證操作治療學 12:40 本篇CFT case study 簡介 17:30 為什麼spinal pain 容易發展成慢性疼痛 20:15 疼痛是多面向的概念：認知、情緒、行為改變…等，運動為什麼沒辦法完全解決疼痛 25:00 物理治療師也可以學得起來認知、行為介入的技巧嗎？ 27:40 CFT與其他常見的心理治療方式的相同之處（認知行為療法, CBT；接受與承諾療法, ACT…等） 29:00 共同原則(1)以病人為中心的問診(patient-center interview) 31:30 多專業介入處理慢性疼痛與物理治療師使用CFT的差別 35:30 疼痛強度很高無法被控制的處理方法 38:30 與病人一起達成共識，一起決定要怎麼治療 41:20 病人的認知、想法、信念如何被改變？蘇格拉底式對話(Socratic conversation) 46:25 漸進式暴露、生活型態改變 歡迎到Facebook, Instagram追蹤或來信來訊跟我們提出疑問～ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial [published correction appears in Lancet. 2023 Jun 17;401(10393):2040]. Lancet. 2023;401(10391):1866-1877. Caneiro JP, Smith A, Rabey M, Moseley GL, O'Sullivan P. Process of Change in Pain-Related Fear: Clinical Insights From a Single Case Report of Persistent Back Pain Managed With Cognitive Functional Therapy. J Orthop Sports Phys Ther. 2017;47(9):637-651.

這次跟大家分享2021年更新的下背痛臨床指引 接下來的集數會進入到討論慢性疼痛的系列 請大家盡請期待囉！ Timecode: 00:30 QA: 場邊物理治療與隨隊物理治療差別？ 06:16 QA: 場邊或隨隊物理治療機會哪裡找？推薦「台灣運動物理治療學會」 16:00 下背痛CPG更新概要，2012年版的CPG還是很重要！ 19:45 運動對於下背痛的療效證據更新 28:15 徒手治療對於下背痛的療效證據更新。徒手治療被妖魔化？ 32:30 下背痛的分類系統：Treatment-based, McKenzie system, Movement system impairment, Cognitive functional therapy 36:00 各種儀器治療討論：拉腰、超音波、體外震波 44:30 衛教對於下背痛的療效證據更新 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60.

On this week's episode of the Ready to Run Podcast, we have the pleasure of meeting with Lindsey Plass to discuss femoroacetabular impingement (otherwise known as FAI) and hip labrum tears in runners. Lindsey is a Chicago-based physical therapist, performance coach, author, and international speaker. Lindsey is a former college soccer player turned 10-time marathoner and triathlete. She completed an orthopedic physical therapy residency and manual therapy fellowship making her a board certified Orthopedic Clinical Specialist and Fellow of the American Academy of Orthopedic Manual therapists.  It was her own lived experience, nearly 10 years ago, with hip pain related to FAI and a labral tear that sparked her interest in helping others with hip issues getting back to doing the things they love.  She is a clinician and coach and owner of Plass Physical Therapy and Performance. She is currently faculty in the University of Chicago Medicine Orthopedic Physical Therapy Residency and University of Chicago Manual Physical Therapy Fellowship. In 2021, Lindsey was invited to be a part of the international Young Athlete's Hip Research Collaboration led by Dr. Henrik (Paul) Dijkstra who is the Director of Medical Education at Aspetar. Lindsey was also invited as an expert clinician panel member of the 2022 Oxford University Young Adult Hip Consensus meeting, where she represented physical therapists internationally.  We are excited to share her wealth of knowledge and expertise in how to recognize and manage these injuries with the best current evidence. Let's get ready to run with Lindsey Plass! Show notes: 5:10- What is FAI and its associated pathologies? 7:50- Prevalence of FAI  9:15- When does cam/pincer morphology develop? 12:15- Signs and symptoms of FAI/hip labrum tear 19:15- Key components of the physical exam and diagnostic work-up 28:45- Interpretation of MRI findings 33:00- Common functional impairments in patients with symptomatic FAI 39:10- Understanding non-surgical and surgical treatment options and managing expectations  44:10- Effect of athlete level of sport and decision-making process for surgical and non-surgical treatment of FAI References: Freke MD, Kemp J, Svege I, Risberg MA, Sem-ciw A, Crossley KM. Physical impairments in symptomatic femoroacetabular impingement: a systematic review of the evidence. Br J Sports Med. 2016;50:1180. Kemp JL, Coburn SL, Jones DM, Crossley KM. The Physiotherapy for Femoroacetabular Impingement Rehabilitation STudy (physioFIRST): A Pilot Randomized Controlled Trial. J Orthop Sports Phys Ther. 2018 Apr;48(4):307-315. Mansell NS, Rhon DI, Meyer J, Slevin JM, Marchant BG. Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med. 2018 May;46(6):1306-1314. Thorborg K, Reiman MP, Weir A, Kemp JL, Serner A, Mosler AB, HÖlmich P. Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management. J Orthop Sports Phys Ther. 2018 Apr;48(4):239-249.  Social media links: Website: https://plassptperformance.com/ Instagram: @plassptperformance

References:Buckthorpe M, Gimpel M, Wright S, et alHamstring muscle injuries in elite football: translating research into practiceBritish Journal of Sports Medicine 2018;52:628-629 Duhig S, Shield AJ, Opar D, Gabbett TJ, Ferguson C, Williams M. Effect of high-speed running on hamstring strain injury risk. Br J Sports Med. 2016;50(24):1536-1540 Ekstrand J, Waldén M, Hägglund M. Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. Br J Sports Med. 2016;50(12):731-737 Gronwald T, Klein C, Hoenig T, et al. Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases. Br J Sports Med. 2022;56(3):165-171. Hickey JT, Timmins RG, Maniar N, et al. Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. J Orthop Sports Phys Ther. 2020;50(2):91-103. Pizzari, T., Green, B., van Dyk, N. (2020). Extrinsic and Intrinsic Risk Factors Associated with Hamstring Injury. In: Thorborg, K., Opar, D., Shield, A. (eds) Prevention and Rehabilitation of Hamstring Injuries. Springer, Cham Pollock N, James SL, Lee JC, Chakraverty R. British athletics muscle injury classification: a new grading system. Br J Sports Med. 2014;48(18):1347- 1351 Timmins, R. G., Bourne, M. N., Shield, A. J., Williams, M. D., Lorenzen, C., & Opar, D. A. (2016). Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. British journal of sports medicine, 50(24), 1524-1535

In the latest episode of The Flip N' Shift Podcast, my guest is Dr. Tawny Kross. Dr. Tawny Kross, Pain Specialist of Kross Centered Care. Dr. Kross is a Doctor of Physical Therapy and a Pain Specialist. She has nearly a decade of experience at a Veteran's hospital in North Carolina working with patients that have some of the most complex chronic pain cases. Dr. Kross  believes passionately in our brain and body's innate ability to heal. She is SO excited to be able to share her knowledge with you now as a Pain and Wellness Coach.  Website:  https://www.drtawnykross.com Facebook: https://www.facebook.com/tawny.kross Instagram:  https://www.instagram.com/dr.tawny.kross Link Tree:  https://journals.lww.com/pain/Abstract/2022/02000 https://uspainfoundation.org/news/the-financial-and-emotional-cost-of-chronic-pain https://pubmed.ncbi.nlm.nih.gov/16896359 https://www.nytimes.com/2017/06/23/science/john-sarno-dead-healing-back-pain-doctor.html   Article and Publication Cite Sourcing: eyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344(5):363-370. doi:10.1056/NEJM200102013440508; Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society [published correction appears in Ann Intern Med. 2008 Feb 5;148(3):247-8]. Ann Intern Med. 2007;147(7):478-491. doi:10.7326/0003-4819-147-7-200710020-00006; Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013;38(22):1939-1946. doi:10.1097/BRS.0b013e3182a42eb6 Koes BW, Van Tulder MW. Clinical Review, Diagnosis and treatment of low back pain.  Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018;48(7):519-522. doi:10.2519/jospt.2018.0610 Major NM, Helms CA. MR imaging of the knee: findings in asymptomatic collegiate basketball players. AJR Am J Roentgenol. 2002;179(3):641-644. doi:10.2214/ajr.179.3.1790641   Please subscribe to the Flip N' Shift Podcast Channels. Connect with us through The Flip N Shift website.   The Flip N Shift Self Healing Podcast is Now Available on ALL Podcast Platforms.   All audio formatted episodes will have corresponding visual/kinesthetic aides, tools and techniques available for download in our website.  (click on the link below)   https://www.flipnshift.com   The Instatie link will connect you to all of our social media platforms and podcast platforms.   https://www.instatie.com/FlipnShift-Podcast    

In this episode, I am joined by Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD, to discuss diagnosing and rehabilitating gluteal tendinopathy.   Show notes:  00:01:06 Painful gluteal tendons. 00:06:11 Recognize gluteal tendinopathy. 00:15:50 Load gluteal tendons actively. 00:21:03 Education and exercise first. 00:28:43 Reduce provocative positions. 00:34:44 Improve patient-specific function. 00:35:07 Listen and tailor the program. 00:45:17 Insurance limits treatment options. 00:50:01 Invest in continuing education.   More About Alison: Dr. Grimaldi is an Australian Sports Physiotherapist and the practice principal of PhysioTec Physiotherapy in Brisbane, Australia, with over 30 years of clinical experience and a special interest in the management of hip, groin and pelvic pain. She has a Bachelor of Physiotherapy, Masters of Sports Physiotherapy and a PhD through the University of Queensland, Australia. Alison was a key investigator on the multicentre LEAP randomized clinical trial comparing the effects of treatment for gluteal tendinopathy. She has had involvement in research for over 20 years and continues her research interests as an Adjunct Senior Research Fellow at the University of Queensland, and in collaborative international research. She has contributed to three leading clinical texts, conducted over 100 clinical workshops worldwide and presented over 50 keynotes, invited or podium conference presentations. Alison also runs a Hip Academy with online learning and live mentoring at www.dralisongrimaldi.com.    Resources from this Episode:   15% discount on Hip Academy joining fee for Healthy, Wealthy & Smart podcast listeners : Use coupon code: HWS2023 Website Alison's Twitter Alison's Instagram Alison's Facebook Alison's LinkedIn Dr Alison Grimaldi's Hip Academy May 13-14 New York Hip Workshop Registrations   Key Papers: Wilson R, Abbott JH, Mellor R, Grimaldi A, Bennell K, Vicenzino B. Education plus exercise for persistent gluteal tendinopathy improves quality of life and is cost-effective compared with corticosteroid injection and wait and see: economic evaluation of a randomised trial. J Physiother. 2023 Jan;69(1):35-41. doi: 10.1016/j.jphys.2022.11.007. Epub 2022 Dec 14. PMID: 36526564. Link: https://www.sciencedirect.com/science/article/pii/S183695532200114X?   Mellor R, Kasza J, Grimaldi A, Hodges P, Bennell K, Vicenzino B. Mediators and Moderators of Education Plus Exercise on Perceived Improvement in Individuals With Gluteal Tendinopathy: An Exploratory Analysis of a 3-Arm Randomized Trial. J Orthop Sports Phys Ther. 2022 Dec;52(12):826-836. doi: 10.2519/jospt.2022.11261. Epub 2022 Oct 28. PMID: 36306175. Link: https://www.jospt.org/doi/10.2519/jospt.2022.11261?   Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, Wajswelner H, Vicenzino B. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018 May 2;361:k1662. doi: 10.1136/bmj.k1662. PMID: 29720374; PMCID: PMC5930290. Link: https://www.bmj.com/content/361/bmj.k1662.long   Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio    

Exercise Descriptors That Determine Muscle Strength Gains Are Missing From Reported Anterior Cruciate Ligament Reconstruction Rehabilitation Programs: A Scoping Review of 117 Exercises in 41 Studies Vlok A, van Dyk N, Coetzee D, et al. J Orthop Sports Phys Ther. 2022;52(2):100-112. doi:10.2519/jospt.2022.10651 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Nathan Carlson is a physical therapist, coach, and business owner based out of Kansas City. He specializes in the management of bone stress injuries, managing the high school and collegiate runner, and implementing resistance training with endurance athletes. Nathan teaches nationally and internationally on these topics. Nathan has two digital resources - A Guidebook to Running After a Stress Fracture and A Guidebook to Navigating High School Running. In this episode, we focus on how to approach bone stress injuries once we have established our diagnosis. We open our discussion with the physiology of bone healing and what the current research says about how long it actually takes for a bone to heal and how that may differ based on the location of the injury. We also discuss the factors that influence treatment, how to test when an athlete is ready to return to running, and how to progress training load for a successful recovery. Bone stress injuries are one of the most complex and frustrating injuries for runners. After our discussion with Nathan, we hope that you will have a better understanding of the training, nutrition, and metabolic factors that need to be considered with diagnosing and treating these injuries. What we talked about: 3:05- The physiology of bone healing and the expectations to set for patients 17:40- Modalities for recovery 22:20- Focus for the return to run program 31:00- Being flexible with the protocol Show notes: Nathan's website Nathan on Instagram References: Gehman S, Ackerman KE, Caksa S, Rudolph SE, Hughes JM, Garrahan M, Tenforde AS, Bouxsein ML, Popp KL. Restrictive Eating and Prior Low-Energy Fractures Are Associated With History of Multiple Bone Stress Injuries. Int J Sport Nutr Exerc Metab. 2022 May 6;32(5):325-333. Popp KL, Ackerman KE, Rudolph SE, Johannesdottir F, Hughes JM, Tenforde AS, Bredella MA, Xu C, Unnikrishnan G, Reifman J, Bouxsein ML. Changes in Volumetric Bone Mineral Density Over 12 Months After a Tibial Bone Stress Injury Diagnosis: Implications for Return to Sports and Military Duty. Am J Sports Med. 2021 Jan;49(1):226-235. Rudolph SE, Caksa S, Gehman S, Garrahan M, Hughes JM, Tenforde AS, Ackerman KE, Bouxsein ML, Popp KL. Physical Activity, Menstrual History, and Bone Microarchitecture in Female Athletes with Multiple Bone Stress Injuries. Med Sci Sports Exerc. 2021 Oct 1;53(10):2182-2189. Warden SJ, Davis IS, Fredericson M. Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014 Oct;44(10):749-65. Warden SJ, Edwards WB, Willy RW. Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning. J Orthop Sports Phys Ther. 2021 Jul;51(7):322-330.

In this episode we discuss the Patellofemoral Pain Clinical Practice Guidelines. Topics Include: Differential Diagnosis Objective Exam Techniques Functional Tests and Measures Classification Systems Treatment References: 1. Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302 Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover! More About Us: Website: https://athletesfirstperformance.weebly.com/ Instagram: https://www.instagram.com/athletes_first_physio/ Run Time: 58:36 Released on October 9, 2022

The effectiveness of gait retraining on running kinematics, kinetics, performance, pain, and injury in distance runners: a systematic review with meta-analysis Doyle E, Doyle TLA, Bonacci J, et al. J Orthop Sports Phys Ther. 2022;52(4):192-A5. doi:10.2519/jospt.2022.10585 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Dr. Joshua Heerey chats on this podcast to BJSM's Dr. Liam West about hip joint imaging. Josh gives us a sneak peek into the findings from the “Femoroacetabular impingement & hip OsteoathRitis Cohort (FORCe) study & how they may help clinicians manage their patients with hip and groin pain. The podcast is heavily based around clinical scenarios that are commonly faced in the clinic or sports team settings. Dr Heerey is a physiotherapist and Hip Osteoarthritis Research and Development Lead at La Trobe University's Sport and Exercise Medicine Research Centre in Melbourne, Australia. Dr Heerey obtained his PhD in 2021, with his research programme focusing on understanding the relationship between hip joint imaging findings and pain, and risk factors for development of early hip osteoarthritis in football players. He has published numerous articles examining the diagnosis and treatment of intra-articular hip conditions and is a current member of the International Hip-Related Pain Research Network and Young Athlete's Hip Research Collaboration, which are multi-disciplinary international research teams created to improve the care of people living with hip and groin conditions. Dr Heerey works clinically at Lifecare Prahran Sports Medicine Clinic. He has a particular interest in the management of longstanding hip and groin conditions Relevant links: - Heerey et al. What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. Br J Sports Med. 2018;52(9):581-93. http://dx.doi.org/10.1136/bjsports-2017-098264 - Heerey et al. What is the prevalence of hip intra-articular pathologies and osteoarthritis in active athletes with hip and groin pain compared with those without? A systematic review and meta-analysis. Sports Med. 2019;49:951-972. https://doi.org/10.1007/s40279-019-01092-y - Heerey et al. Prevalence of early hip OA features in high- impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study. Osteoarthritis Cartilage. 2021; 29(3): 323-334. https://doi.org/10.1016/j.joca.2020.12.013 - Heerey et al. The size and prevalence of bony hip morphology do not differ between football players with and without hip and/or groin pain: Findings from the FORCe cohort. J Orthop Sports Phys Ther. 2021; 51(3): 115-125. https://www.jospt.org/doi/10.2519/jospt.2021.9622 - Heerey et al. Cam morphology is associated with MRI-defined cartilage defects and labral tears: a case–control study of 237 young adult football players with and without hip and groin pain. BMJ Open Sport & Exercise Medicine 2021;7:e001199. http://dx.doi.org/10.1136/bmjsem-2021-001199

Welcome to the Down Week segment of the Ready to Run Podcast! These episodes will be shorter than our standard interviews with guests and will be packed with clinical information on some of the most common and challenging cases we see as clinicians. We will be providing listeners a lens into how we use the most current evidence based medicine to help athletes navigate injury in our practice. There will be some parts of the conversation that get more technical but we will try to break it down so that you can take home some practical tips whether you are a clinician working with runners or an athlete wanting to know what options are available and what questions to ask.  We hope that these episodes will serve as a resource of information to help you get ready to run! What we talked about: 3:35- Initial assessment and exam 7:40- When is imaging helpful? Advantages and limitations of different imaging modalities? What are we looking for? How do we interpret abnormal findings? 17:25- Considerations for the differential diagnosis - including ischiofemoral impingement, nerve entrapment, lumbar radiculopathy, intra-articular hip pathology 21:10- Tips for reducing sitting pain 24:45- Setting expectations for return to running 28:35- Hamstring rehabilitation - when and how to progress 34:35- Determining readiness to return to running - including graded exposure to speed work, uphill training, and long runs 37:00- Pain-threshold monitoring and assessing load tolerance 42:50- Treatment options for recalcitrant tendinopathy References Goom TS, Malliaras P, Reiman MP, Purdam CR. Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. J Orthop Sports Phys Ther. 2016 Jun;46(6):483-93. Sherry MA, Johnston TS, Heiderscheit BC. Rehabilitation of acute hamstring strain injuries. Clin Sports Med. 2015 Apr;34(2):263-84. Davenport KL, Campos JS, Nguyen J, Saboeiro G, Adler RS, Moley PJ. Ultrasound-Guided Intratendinous Injections With Platelet-Rich Plasma or Autologous Whole Blood for Treatment of Proximal Hamstring Tendinopathy: A Double-Blind Randomized Controlled Trial. J Ultrasound Med. 2015 Aug;34(8):1455-63. Rosales J, García N, Rafols C, Pérez M, Verdugo MA. Perisciatic Ultrasound-Guided Infiltration for Treatment of Deep Gluteal Syndrome: Description of Technique and Preliminary Results. J Ultrasound Med. 2015 Nov;34(11):2093-7. Lempainen L, Johansson K, Banke IJ, et al. Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments Tendons J. 2015;5(1):23-28. Published 2015 Mar 27. Connect with the Ready to Run Podcast: Ready to Run Podcast on Instagram Ready to Run Website Follow SandyBoy Productions: Sandyboy Productions on Twitter Sandyboy Productions on Instagram SandyBoy Productions Shows: Why is Everyone Yelling? I'll Have Another Podcast The Illuminate Podcast The Herban Farmacy Podcast

People with knee osteoarthritis attending physical therapy have broad education needs, and prioritize information about surgery and exercise: A concept mapping study. Goff AJ, Donaldson A, De Oliveira Silva D, et al. J Orthop Sports Phys Ther. Published Ahead of Print. doi:10.2519/jospt.2022.11089 Physical therapists prioritize providing education about exercise therapy and to dispel misconceptions about radiology for people with knee osteoarthritis. A concept mapping study. Goff AJ, Donaldson A, De Oliveira Silva D, et al. J Orthop Sports Phys Ther. Published Ahead of Print. doi:10.2519/jospt.2022.11090 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

On this episode, Erik and Jason talk about testing using isokinetic dynamometers and force plates ahead of Erik and Laura Opstedal's course, "Practical Force Testing for the Rehab Professional: Force Plates & Isokinetic Machines" Diagnostic Accuracy of Handheld Dynamometry and 1-Repetition-Maximum Tests for Identifying Meaningful Quadriceps Strength Asymmetries. Sinacore JA, Evans AM, Lynch BN, et al. J Orthop Sports Phys Ther. 2017;47(2):97-107. doi:10.2519/jospt.2017.6651 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Adding Physical Activity Coaching and an Activity Monitor Was No More Effective Than Adding an Attention Control Intervention to Group Exercise for Patients With Chronic Nonspecific Low Back Pain (PAyBACK Trial): A Randomized Trial. Oliveira CB, Christofaro DGD, Maher CG, et al. J Orthop Sports Phys Ther. 2022;52(5):287-299. doi:10.2519/jospt.2022.10874 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Screening for Yellow Flags in Orthopaedic Physical Therapy: A Clinical Framework. Stearns ZR, Carvalho ML, Beneciuk JM, et al. J Orthop Sports Phys Ther. 2021;51(9):459-469. doi:10.2519/jospt.2021.10570 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

En el episodio de hoy, vamos a hablar de la cadera post-ictus, un tema que, como dice el título, es una encrucijada, ya que es un lugar donde se cruzan varios caminos, varias explicaciones sobre el movimiento de los pacientes neurológicos. El episodio parte de un introducción, un breve recordatorio anatómico de la cadera, una justificación de por qué hacer episodios como este y después iremos recorriendo algunos estudios que he leído y sintetizado que tienen relación con el fenotipo de la cadera post-ictus. Compensaciones, fatiga, biomecánica...al servicio de la neurociencia. Referencias del episodio: (1) Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010 Feb;40(2):82-94. doi: 10.2519/jospt.2010.3025. PMID: 20118525 (https://pubmed.ncbi.nlm.nih.gov/20118525/). (2) Hyngstrom AS, Onushko T, Heitz RP, Rutkowski A, Hunter SK, Schmit BD. Stroke-related changes in neuromuscular fatigue of the hip flexors and functional implications. Am J Phys Med Rehabil. 2012 Jan;91(1):33-42. doi: 10.1097/PHM.0b013e31823caac0. PMID: 22157434; PMCID: PMC3940208 (https://pubmed.ncbi.nlm.nih.gov/22157434/). (3) Rybar MM, Walker ER, Kuhnen HR, Ouellette DR, Berrios R, Hunter SK, Hyngstrom AS. The stroke-related effects of hip flexion fatigue on over ground walking. Gait Posture. 2014 Apr;39(4):1103-8. doi: 10.1016/j.gaitpost.2014.01.012. Epub 2014 Jan 31. PMID: 24602975; PMCID: PMC4007512 (https://pubmed.ncbi.nlm.nih.gov/24602975/). (4) Lewek MD, Schmit BD, Hornby TG, Dhaher YY. Hip joint position modulates volitional knee extensor muscle activity after stroke. Muscle Nerve. 2006 Dec;34(6):767-74. doi: 10.1002/mus.20663. PMID: 16967491 (https://pubmed.ncbi.nlm.nih.gov/16967491/). (5) Cruz TH, Dhaher YY. Evidence of abnormal lower-limb torque coupling after stroke: an isometric study. Stroke. 2008 Jan;39(1):139-47. doi: 10.1161/STROKEAHA.107.492413. Epub 2007 Dec 6. PMID: 18063824; PMCID: PMC3641752 (https://pubmed.ncbi.nlm.nih.gov/18063824/). (6) Finley JM, Perreault EJ, Dhaher YY. Stretch reflex coupling between the hip and knee: implications for impaired gait following stroke. Exp Brain Res. 2008 Jul;188(4):529-40. doi: 10.1007/s00221-008-1383-z. Epub 2008 Apr 30. PMID: 18446331; PMCID: PMC2881696 (https://pubmed.ncbi.nlm.nih.gov/18446331/). (7) Sulzer JS, Gordon KE, Dhaher YY, Peshkin MA, Patton JL. Preswing knee flexion assistance is coupled with hip abduction in people with stiff-knee gait after stroke. Stroke. 2010 Aug;41(8):1709-14. doi: 10.1161/STROKEAHA.110.586917. Epub 2010 Jun 24. PMID: 20576947; PMCID: PMC3306800 (https://pubmed.ncbi.nlm.nih.gov/20576947/). (8) Matsuda et al. 2016. Analysis of strategies used by hemiplegic stroke patients to achieve toe clearance (https://www.jstage.jst.go.jp/article/jjcrs/7/0/7_111/_article). (9) Awad LN, Bae J, Kudzia P, Long A, Hendron K, Holt KG, OʼDonnell K, Ellis TD, Walsh CJ. Reducing Circumduction and Hip Hiking During Hemiparetic Walking Through Targeted Assistance of the Paretic Limb Using a Soft Robotic Exosuit. Am J Phys Med Rehabil. 2017 Oct;96(10 Suppl 1):S157-S164. doi: 10.1097/PHM.0000000000000800. PMID: 28777105; PMCID: PMC7479995 (https://pubmed.ncbi.nlm.nih.gov/28777105/). (10) Akbas T, Prajapati S, Ziemnicki D, Tamma P, Gross S, Sulzer J. Hip circumduction is not a compensation for reduced knee flexion angle during gait. J Biomech. 2019 Apr 18;87:150-156. doi: 10.1016/j.jbiomech.2019.02.026. Epub 2019 Mar 8. PMID: 30876735 (https://pubmed.ncbi.nlm.nih.gov/30876735/).

Classification Approaches for Treating Low Back Pain Have Small Effects That Are Not Clinically Meaningful: A Systematic Review With Meta-analysis. Tagliaferri SD, Mitchell UH, Saueressig T, et al. J Orthop Sports Phys Ther. 2022;52(2):67–84. Epub 15 Nov 2021. doi:10.2519/jospt.2022.10761 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight  

全新系列啟動（雖然半年前就錄好了） 這系列我們將透過JOSPT的Evidence in Practice系列文章 加上Dr. Frank的獨到見解來幫助大家連結學術與臨床 這集我們會告訴大家difference、change、和p value解讀上常見的謬誤 喜歡的話記得留言告訴我們，並按讚、分享、訂閱我們的podcast喔！ 下週過年期間休更一週，預祝大家新年快樂！ Timecode: 00:27 想做這個系列的原因是Frank的執著 08:56 原來被2PRO PT訪問是讓你成為教授的跳板？ 12:58 第一篇：如何解讀outcome? Difference和change的差別是？ 16:01 Frank佩服這系列作者戳破你被學術文章誘導的套路，以及更深入的對difference和change的解讀 24:06 第二篇：統計上的差異p value與臨床的應用 28:08 作者建議臨床治療師應該看什麼樣的數據呢？MIC, MCID是你的好幫手 31:53 Frank的補充時間（內含很多的統計概念，重要！） 39:36 Roger的貼心小統整 40:20 樣本數越多就越容易顯著？真假?! 42:15 Frank補充大家常常對p value的誤解 44:43 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Kamper SJ. Interpreting Outcomes 1—Change and Difference: Linking Evidence to Practice. J Orthop Sports Phys Ther 2019;49(5):357–358 Kamper SJ. Interpreting Outcomes 2—Statistical Significance and Clinical Meaningfulness: Linking Evidence to Practice. J Orthop Sports Phys Ther 2019;49(7):559–560.

What is the most efficient way to treat a hamstring strain? What criteria can we use to feel sure our patients are ready to return to sport?For reference:Erickson LN, Sherry MA. Rehabilitation and return to sport after hamstring strain injury. J Sport Health Sci. 2017 Sep;6(3):262-270. doi: 10.1016/j.jshs.2017.04.001. Epub 2017 Apr 10. PMID: 30356646; PMCID: PMC6189266.Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010;40(2):67-81. doi:10.2519/jospt.2010.3047The purpose of this podcast is to provide useful, condensed information for exhausted, time-crunched Physical Therapists and Student Physical Therapists who looking to build confidence in their foundational knowledge base and still have time to focus on other important aspects of life. Hit follow to make sure you never miss an episode. Have questions? Want to connect? Contact me at ptsnackspodcast@gmail.com or check out more at ptsnackspodcast.com. On Instagram? Check out the unique content on @ptsnackspodcast!Need CEUs but low on time and resources? Go to https://www.medbridgeeducation.com/pt-snacks-podcast for $175 off a year subscription. Use the promo code PTSNACKSPODCAST. This is an affiliate link, but I wouldn't recommend MedBridge if I didn't think they offered value.Willing to support monetarily? Follow the link below to help me continue to create free content. You can also support the show by sharing the word about this show with someone you think would benefit from it.Support the show (https://buymeacoffee.com/Ptsnackspodcast)

In this episode, we discuss bone stress injuries in running athletes and military population. Topics Include What is a bone stress injury (BSI) Basic pathophysiology of BSI and healing, Epidemiology and risk factors Clinical dx and low vs high risk BSI, Overarching treatment plan mobility, strength, and plyometrics for bone loading, When can athletes return to run and how to progress running program References 1. Warden SJ, Davis IS, Fredericson M. Management and Prevention of Bone Stress Injuries in Long-Distance Runners. J Orthop Sports Phys Ther. 2014;44(10):749-765. doi:10.2519/jospt.2014.5334 2. Warden SJ, Edwards WB, Willy RW. Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning. J Orthop Sports Phys Ther. 2021;51(7):322-330. doi:10.2519/jospt.2021.9982 3. Warden SJ, Edwards WB, Willy RW. Preventing Bone Stress Injuries in Runners with Optimal Workload. Curr Osteoporos Rep. 2021;19(3):298-307. doi:10.1007/s11914-021-00666-y Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover! More About Us: Website: https://athletesfirstperformance.weebly.com/ Instagram: https://www.instagram.com/athletes_first_physio/ Run Time: 55:04 Released on November 4th, 2021

REFERÊNCIAS1.Zappia M, Reginelli A, Russo A, D'Agosto GF, Di Pietto F, Genovese EA, et al. Long head of the biceps tendon and rotator interval. Musculoskelet Surg. 2013;97 Suppl 2:S99-108.2.Khazzam M, George MS, Churchill RS, Kuhn JE. Disorders of the long head of biceps tendon. J Shoulder Elbow Surg. 2012;21(1):136-45.3.Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med. 2000;28(1):28-31.4.Nakata W, Katou S, Fujita A, Nakata M, Lefor AT, Sugimoto H. Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics. 2011;31(3):791-810.5.Elser F, Braun S, Dewing CB, Giphart JE, Millett PJ. Anatomy, function, injuries, and treatment of the long head of the biceps brachii tendon. Arthroscopy. 2011;27(4):581-92.6.Krupp RJ, Kevern MA, Gaines MD, Kotara S, Singleton SB. Long head of the biceps tendon pain: differential diagnosis and treatment. J Orthop Sports Phys Ther. 2009;39(2):55-70.7.Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007;89(8):1001-9.8.Ejnisman B, Monteiro GC, Andreoli CV, de Castro Pochini A. Disorder of the long head of the biceps tendon. Br J Sports Med. 2010;44(5):347-54.9.Mazzocca AD, McCarthy MB, Ledgard FA, Chowaniec DM, McKinnon WJ, Jr., Delaronde S, et al. Histomorphologic changes of the long head of the biceps tendon in common shoulder pathologies. Arthroscopy. 2013;29(6):972-81.10.Boileau P, Ahrens PM, Hatzidakis AM. Entrapment of the long head of the biceps tendon: the hourglass biceps--a cause of pain and locking of the shoulder. J Shoulder Elbow Surg. 2004;13(3):249-57.11.Zappia M, Chianca V, Di Pietto F, Reginelli A, Natella R, Maggialetti N, et al. Imaging of long head biceps tendon. A multimodality pictorial essay. Acta Biomed. 2019;90(5-S):84-94.12.Castagna A, Mouhsine E, Conti M, Vinci E, Borroni M, Giardella A, et al. Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):645-8.13.Skendzel JG, Jacobson JA, Carpenter JE, Miller BS. Long head of biceps brachii tendon evaluation: accuracy of preoperative ultrasound. AJR Am J Roentgenol. 2011;197(4):942-8.14.Carvalho CD, Cohen C, Belangero PS, Pochini AC, Andreoli CV, Ejnisman B. Supraspinatus Muscle Tendon Lesion and Its Relationship with Long Head of the Biceps Lesion. Rev Bras Ortop (Sao Paulo). 2020;55(3):329-38.15.Gaskin CM, Anderson MW, Choudhri A, Diduch DR. Focal partial tears of the long head of the biceps brachii tendon at the entrance to the bicipital groove: MR imaging findings, surgical correlation, and clinical significance. Skeletal Radiol. 2009;38(10):959-65.

REFERÊNCIAS1.Zappia M, Reginelli A, Russo A, D'Agosto GF, Di Pietto F, Genovese EA, et al. Long head of the biceps tendon and rotator interval. Musculoskelet Surg. 2013;97 Suppl 2:S99-108.2.Khazzam M, George MS, Churchill RS, Kuhn JE. Disorders of the long head of biceps tendon. J Shoulder Elbow Surg. 2012;21(1):136-45.3.Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med. 2000;28(1):28-31.4.Nakata W, Katou S, Fujita A, Nakata M, Lefor AT, Sugimoto H. Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics. 2011;31(3):791-810.5.Elser F, Braun S, Dewing CB, Giphart JE, Millett PJ. Anatomy, function, injuries, and treatment of the long head of the biceps brachii tendon. Arthroscopy. 2011;27(4):581-92.6.Krupp RJ, Kevern MA, Gaines MD, Kotara S, Singleton SB. Long head of the biceps tendon pain: differential diagnosis and treatment. J Orthop Sports Phys Ther. 2009;39(2):55-70.7.Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007;89(8):1001-9.8.Ejnisman B, Monteiro GC, Andreoli CV, de Castro Pochini A. Disorder of the long head of the biceps tendon. Br J Sports Med. 2010;44(5):347-54.9.Mazzocca AD, McCarthy MB, Ledgard FA, Chowaniec DM, McKinnon WJ, Jr., Delaronde S, et al. Histomorphologic changes of the long head of the biceps tendon in common shoulder pathologies. Arthroscopy. 2013;29(6):972-81.10.Boileau P, Ahrens PM, Hatzidakis AM. Entrapment of the long head of the biceps tendon: the hourglass biceps--a cause of pain and locking of the shoulder. J Shoulder Elbow Surg. 2004;13(3):249-57.11.Zappia M, Chianca V, Di Pietto F, Reginelli A, Natella R, Maggialetti N, et al. Imaging of long head biceps tendon. A multimodality pictorial essay. Acta Biomed. 2019;90(5-S):84-94.12.Castagna A, Mouhsine E, Conti M, Vinci E, Borroni M, Giardella A, et al. Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):645-8.13.Skendzel JG, Jacobson JA, Carpenter JE, Miller BS. Long head of biceps brachii tendon evaluation: accuracy of preoperative ultrasound. AJR Am J Roentgenol. 2011;197(4):942-8.14.Carvalho CD, Cohen C, Belangero PS, Pochini AC, Andreoli CV, Ejnisman B. Supraspinatus Muscle Tendon Lesion and Its Relationship with Long Head of the Biceps Lesion. Rev Bras Ortop (Sao Paulo). 2020;55(3):329-38.15.Gaskin CM, Anderson MW, Choudhri A, Diduch DR. Focal partial tears of the long head of the biceps brachii tendon at the entrance to the bicipital groove: MR imaging findings, surgical correlation, and clinical significance. Skeletal Radiol. 2009;38(10):959-65.

腦震盪的介入竟然是騎腳踏車！ 腦震盪後，心跳血壓忽高忽低，原來自主神經也受傷了。 腦震盪的評估與介入，完美地結合了神經、骨科與心肺物理治療。 聽完本CPG最後一集，跟2PROPT一起成為腦震盪大師吧 Timecode: 00:27 閒聊時間 05:55 針對腦震盪後心肺耐力不好的病人執行漸進式有氧訓練 07:39 針對腦震盪後的動作功能損傷的介入重點 08:52 治療師應該定期追蹤腦震盪病患的症狀變化、定期施測outcome measure 17:14 腦震盪CPG總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

你絕對可以比起昨日的自己更強大！ 腦震盪的介入看似包山包海，重點還是在切確的評估之後，做出對應的治療 病人有脖子痛要記得參考之前的頸痛CPG 病人有前庭問題，在治療病人前要記得複習dix-hallpike maneuver喔！ Timecode: 00:27 閒聊時間 05:49 病人衛教和reassurance很重要喔！相對適當的休息、儘早介入和逐漸回到生活/場上會比較好喔！ 13:29 根據檢查結果來設計個人化治療計畫 17:13 Stanley補充：對於腦震盪的病人早期介入是有益無害的 18:43 適時轉介給其他專業的重要性，CPG告訴你什麼樣的病人你該轉出去 19:43 針對腦震盪後的頸椎、胸椎肌肉骨骼系統介入重點 21:49 針對腦震盪後的前庭-視動系統的介入重點 23:17 Roger方享介入前庭障礙的病人的經驗 27:20 針對腦震盪後有前庭-視動障礙的病人應該要客製化介入計畫 29:17 要是病人同時脖子痛又有前庭問體，要怎麼處理？ 30:33 要是治療師沒有治療前庭障礙病人的經驗的話，請轉介給其他有經驗的治療師 32:37 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

In this episode we introduce the new clinical practice guidelines for managing lateral ankle sprains. We break down the CPG and discuss how we will be using the evidence to help improve our treatment for athletes/patients following a lateral ankle sprain. The flow of the podcast starts with defining a lateral ankle sprain and then identifying risk factors for primary and secondary injury. We then dive into our assessment of specific impairments for acute sprains then analyze a new framework for return to sport criteria. There is also discussion on prophylactic ankle bracing vs taping, stable and unstable surface balance training, and updated views on ankle special testing. Thanks for listening and as always, please let us know if you have any questions, recommendations, or topics you would like us to cover! Articles Caffrey E, Docherty CL, Schrader J, Klossnner J. The Ability of 4 Single-Limb Hopping Tests to Detect Functional Performance Deficits in Individuals With Functional Ankle Instability. J Orthop Sports Phys Ther. 2009;39(11):799-806. doi:10.2519/jospt.2009.3042 Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302 Smith MD, Vicenzino B, Bahr R, et al. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework—an international multidisciplinary consensus. Br J Sports Med. Published online June 22, 2021:bjsports-2021-104087. doi:10.1136/bjsports-2021-104087 Run Time: 1:08:12 Released on July 13th, 2021

腦震盪之後，病人變得容易喘了!? (該不會是COVID??) 病人說他運動的時候會天旋地轉該怎麼辦？ 身為治療師的你要如何評估呢？快來聽這集的內容吧！ Timecode: 00:26 IG問答的聽眾提問回答：電影震盪效應對我們的啟發。轉型影評podcast囉！ 10:58 Elaine小老師幫大家複習證據等級分類 11:13 腦震盪病人的自主神經系統和運動耐力檢查 14:17 Stanley和Frank補充Buffalo concussion treadmill/bike test 19:28 閒聊為什麼大家都要買穿戴式裝置，廠商Garmin, Asus, 捷安特這邊就交給你們了！ 23:48 腦震盪病人的運動功能損傷的測試 26:37 補充”A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation” CPG的內容 30:19 IG問答的聽眾提問回答：腦震盪後顱內壓介入的安全範圍 35:26 到底要不要分類腦震盪的病人呢？目前沒有實證的分類方式喔 39:07 腦震盪病人的社會心理因子影響評估 41:35 成效評估工具(outcome measure)的選擇，一定要選一個做紀錄並持續使用喔！ 43:41 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

好的檢查，從排順序開始 要依據症狀容易加劇的程度排序，把最容易加劇症狀的檢查放在最後，才不會把病人嚇跑 如果病人有兩個主訴，可以把選擇權丟回去給病人，請他選一個最想先治療的問題/部位 Timecode: 00:26 Elaine消失兩週回來啦！ 03:15 Elaine實習完之後有沒有什麼心得？疫情下的實習要怎麼進行？ 14:04 針對腦震盪的病人/選手，該檢查哪些系統呢？ 15:37 現在針對腦震盪的檢查有沒有protocol? 有，但還未被廣泛接受或驗證 17:47 這麼多系統要測，要怎樣安排測試的順序比較好？CPG建議用irritability的程度來排序 19:57 Elaine好奇如果病人同時有頸椎和暈眩的問題該如何安排檢查順序？ 22:52 要如何判斷症狀的irritability呢？ 24:26 肌肉骨骼系統檢查：該檢查什麼呢？ 25:51 什麼情況要測前庭-視動系統？該做哪些測試？ 29:28 IG上問答的聽眾提問回答：腦震盪和眩暈之間的關係 30:22 Roger補充頭暈(lightheadedness)和眩暈(vertigo)的鑑別診斷 32:28 前庭-視動系統評估的好工具：Vertigo Oculomotor Motor Screening (VOMS) 39:04 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

鑑別診斷的精髓在於第一次看到病人時就知道病人需不需要送急診， 這時12對腦神經測試就很重要！60%不記得的聽眾們趕快去複習吧～ 做完評估之後，要仔細打病歷，這樣才會知道病人哪裡進/退步了！ Timecode: 00:27 還在端午節快樂？ 00:57 Roger道歉啟事：他的個人言論不代表本台立場XD 05:40 聽眾問題分享時間：使用下背痛量表的使用時機和是否需要協助病人填表 15:32 腦震盪的診斷實證：要詳細記錄病人有和沒有的症狀喔！ 19:34 看到什麼神經學或肌肉骨骼症狀是要把病人送急診的呢？ 21:45 病人的症狀惡化了，有可能是有腦震盪的情況喔！ 23:45 突然想閒聊？中風快篩F.A.S.T.居然跟看到帥哥美女的表現一樣?! 25:30 如何篩檢病人是不是有腦震盪？ 28:39 病人除了頭部傷害，也有來自頸椎的問題喔！ 29:40 12對腦神經的測試會了沒？還沒的話趕快學起來就是比較厲害的物理治療師了！ 32:17 腦震盪的鑑別診斷：實證告訴你問診很重要！推薦等級A!!! 33:10 目前不建議單純使用影像學診斷腦震盪喔！臨床上有其他判斷的資源協助診斷腦震盪的工具 37:32 CPG說：除了問診問仔細，病歷也要寫仔細喔！ 39:08 Frank補充Computerized neurocognitive assessment的相關實證 42:02 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

美國高中生畢業前每4個就有一個有腦震盪 為什麼年輕女性、注意力不足過動症、有偏頭痛病史是腦震盪的危險因子呢？ 這又跟前陣子台灣發生跆拳道的事件有什麼樣的關連 就讓我們說給你聽！ Timecode: 00:28 Elaine人呢？ 02:05 感謝物理治療界前輩們分享我們的podcast 03:58 本集節目由中國醫藥大學物理治療學系贊助播出 08:46 正片開始：為什麼要介紹腦震盪(concussion)的CPG呢？腦震盪發生率其實很高！ 13:17 腦震盪的病程大致上是很短暫的，但也有可能有長期持續對生活有影響 15:42 腦震盪發生率其實是被低估的！被低估的原因是什麼？ 17:10 2PRO們討論危險因子有過動(ADHD)的可能原因是什麼？ 18:50 大家猜猜在美國高中畢業前每幾人就有一個人有經歷過腦震盪？ 20:22 2PRO們討論腦震盪的高風險運動類型 21:09 由社會事件討論應該提高關注腦震盪的發生、症狀判斷、及早期物理治療介入的重要性 26:10 今日總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1-CPG73. doi:10.2519/jospt.2020.0301

病人主訴除了脖子痛，還有失憶、對光敏感、甚至還有創傷症候群的症狀等， 讓你覺得好像不只是鞭甩症候群的症狀。 讓2PRO 告訴你如何鑑別診斷和介入，並轉介合適的專科醫師。 Timecode: 00:00 Frank登山居然撞到頭?! 04:23 鞭傷跟腦震盪傻傻分不清楚，很多症狀都重複，要怎麼鑑別診斷？ 09:34 個案一介紹：這位45歲的女性，車禍後除了頸痛以外，到底有沒有腦震盪呢？ 16:06 2PRO的各位對於個案一的想法和鑑別診斷的看法 18:47 關於視動功能評估，眼球震顫(nystagmus)和跳視(saccade)是不一樣的喔！但是有垂直震顫和跳視的話，都有可能是中樞神經的問題要轉介出去喔！ 21:05 個案二介紹：這位24歲女性，車禍被追撞以後，到底有沒有腦震盪呢？ 27:00 Roger解釋雷諾氏症(Raynaud's disease)和偏頭痛(migraine)之間的關係 28:16 Frank對temporal summation的理解與討論 30:14 Stanley解釋pin prick測試的測法 31:50 個案三介紹：這位44歲男性，發生時速100公里的車禍後，到底有沒有腦震盪呢？ 37:40 Elaine疑惑單純鞭傷的病人就不會有中樞神經系統的問題嗎？ 40:20 總結三個個案和文獻discussIon部分的重點整理 43:47 下個系列預告：腦震盪(Concussion)臨床指引 CPG 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Rebbeck T, Evans K, Elliott JM. Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management. J Orthop Sports Phys Ther. 2019;49(11):819-828. doi:10.2519/jospt.2019.8946

台灣疫情最近很嚴重，還爆出人與人的連結。但鞭傷病人的健康還是要照顧啊 尤其是那些超過35歲的人，大家要好好關心他，早日助他脫離苦海。也可以讓他填填量表，就知道是不是命中註定。再好一點，用clinical prediction rule 幫他預言一下一年之後是不是還和鞭傷有連結 Timecode: 00:00 Frank喜歡上登山了，還分享了一個食指斷掉卻繼續突破極限的攀岩高手! (喜歡的人可以去看看 The Dawn Wall這部紀錄片喔!) 07:10 行為療法: 鞭傷症候群的病人可能伴有創傷症候群，會建議使用行為療法。 10:00 要如何決定哪些鞭傷病人需要較多的治療和資源呢? 看看Clinical Prediction Rule怎麼說 14:14 鞭傷病人決策樹:低風險的病人vs. 高風險的病人 21:00 轉介是為了讓病人得到更好的照護，一直想著把病人留在身邊，可能是在傷害病人。 23:20 面對鞭傷病人應該用甚麼樣的態度和思路呢? 28:14 "本質-壓力模型"(Diathesis-Stress Model)可以讓我們更了解為甚麼每個鞭傷病人在面對疼痛的反應都不一樣喔 32:20 避免鞭傷病人出現慢性疼痛的第一步，就是要衛教他們對疼痛與鞭傷症候群有正確地認識與認知。另外，也可以協助病人取得能夠幫助到他們資源，減少額外的壓力來源。 35:40 鞭傷病人是不是情緒比較平穩，預後就會比較好嗎? 40:43 為什麼睡眠品質很重要? 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Walton DM, Elliott JM. An Integrated Model of Chronic Whiplash-Associated Disorder. J Orthop Sports Phys Ther. 2017;47(7):462-471. doi:10.2519/jospt.2017.7455

我就喜歡病人挑三揀四 只有病人說比較好的時候，才是真的好 徒手一時爽，卻是慢性毒藥 忽略了病人的感受，是分手擂台的前奏 Timecode: 00:00 閒聊時間:美國實習時如何跟臨床老師(Clinical Instructor, CI)相處呢? 如何與臨床老師討論問題才專業? 13:00 Whiplash鞭傷病人運動介入的各國CPG統整。判斷病人是High Risk vs. Low Risk，將有助於安排運動計畫喔! 17:12 原來鞭傷病人運動的喜好可能比強迫他們只做脖子的運動來的重要 20:48 其實治療師的工作就是要陪病人一起找出能夠緩解症狀的運動。目前的研究表示:沒有特定運動優於其他運動喔。 22:45 "Active ROM"非常適合急性期或有活動度受限的病人，建議讓病人在pain-free range裡面活動 24:49 病人急性期的時候，盡量陪病人找到可以減緩疼痛的運動，讓病人心裡可以將運動與止痛效果做連結，達到疼痛控制的效果喔! 28:10 McKenzie Method目前實證等級不高，只要病人疼痛沒有加劇，還是可以試試。 29:09 如果評估當天沒有辦法幫病人找到可以舒緩疼痛的運動怎麼辦？2PRO PT建議治療師不要盲目地給病人運動，只要單純地給予衛教反而是最合適的。 31:02 頸椎本體感覺的運動，是使用Cranio-Cervical Flexion Test的檢測儀器來做訓練，可以幫助鞭傷病人的肌肉型態回到創傷前的狀態。近期研究，建議也要練Cervical extensors喔! 37:52 被動療法(Passive Therapy)，例如徒手、針灸、肌內效等，雖然有研究表示可以舒緩疼痛，但是並不建議做為第一線的治療內容，也不建議單純只使用用被動療法來治療病人。 39:49 治療師應該衛教病人"盡可能地保持適度的活動" (Stay Active)，不要讓被動療法成為讓病人上癮的毒藥。被動療法甚至可能讓病人短痛變長痛喔! 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Rebbeck T. The Role of Exercise and Patient Education in the Noninvasive Management of Whiplash. J Orthop Sports Phys Ther. 2017;47(7):481-491. doi:10.2519/jospt.2017.7138

不要再跟病人說你馬上就會好了! 實證建議：要對病人說實話，不能讓病人有不切實際地期待 即便鞭傷症候群恢復需要較長的時間（可能長達一年），也要實話告訴病人，才是真正幫助他們脫離苦海的開始喔 Timecode: 00:28 近況閒聊：Elaine 要去實習了!實習心態的調整與準備（也適用在台灣的實習喔！） 13:00 運動和衛教是目前針對Whiplash Associated Disorder (WAD)的最高證據等級的介入方式 16:15 針對WAD的衛教重點ㄧ：鼓勵病人維持正常生活，但沒有完全反對戴頸圈！ 20:20 針對WAD的衛教重點二：衛教WAD的本質；Quebec Task Force (QTF) 分級要怎麼用來衛教病人 25:00 針對WAD的衛教重點三：給予病人合理的病人期待與預後好壞 31:33 針對WAD的衛教重點四：衛教病人如何自我處理疼痛，可分為物理性策略（擺位，姿勢調整）及心理層面策略（認知行為療法等） 35:17 針對WAD的衛教重點五：疼痛科學 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Rebbeck T. The Role of Exercise and Patient Education in the Noninvasive Management of Whiplash. J Orthop Sports Phys Ther. 2017;47(7):481-491. doi:10.2519/jospt.2017.7138

病人有頸因性暈眩是會前後晃，那左右晃的怎麼辦?那就有可能是前庭系統造成的平衡問題 針對頭暈的病人，目前研究也建議要針對眼球設計運動喔 Timecode: 00:00 各國語言大亂鬥 09:08 正題開始：如何測試因頸椎問題造成的平衡和視動問題 09:41 頸因性和前庭系統的靜態平衡問題臨床表現差異 13:16 頸因性和前庭系統的動態平衡問題臨床表現差異 18:19 頸因性和前庭系統的視動功能問題的鑑別診斷方法 24:08 其他可以協助鑑別診斷頸因性或前庭問題的測試 28:55 頸因性暈眩的鑑別診斷 30:00 暈眩有可能是很少見的椎動脈剝離(vertebral artery dissection)造成的 32:40 當病人有受傷時有axial rotation的話可能有耳石滑落的問題 33:16 當你怎麼治療都無解的時候，病人可能是有前庭引起的偏頭痛 36:22 判斷是否為頸因性頭暈時，要先確認病人是不是都只有在脖子在特定角度才有症狀 36:55 判斷是不是中樞系統引起的頭暈有個好幫手：HiNT cluster screening (head impulse, nystagmus and skew) 41:04 這篇臨床評論推薦的鑑別診斷測試cluster: smooth pursuit, balance, joint position sense in torsion 44:04 頸因性頭暈的介入方法，詳細內容請鎖定這系列之後的集數 44:38 針灸居然能改善頭暈，太神啦 48:07 Roger的介入小遊戲分享給大家 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Treleaven J. Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain. J Orthop Sports Phys Ther. 2017;47(7):492-502. doi:10.2519/jospt.2017.7052

The Muscle & The Brain werden dieses Mal sehr intim. The ReWork Crew berichtet über die Feiertage und The ReCoach Gräf lässt endlich die Hose fallen und spricht über seinen "herausragenden" Bizeps, ähm nein, natürlich seinen ReTest. Sie ReAnalysieren die nackte Wahrheit ihrer Leistungsüberprüfungen und veröffentlichen erstmalig ihre Daten rund um die berüchtigte VO2max, ANS, FATmax und vieles mehr... Ihr wollt noch genauer ins Detail gehen? Hier sind Studien dazu: The Carbohydrates & Performance: Viribay A, Arribalzaga S, Mielgo-Ayuso J, Castañeda-Babarro A, Seco-Calvo J, Urdampilleta A. Effects of 120 g/h of Carbohydrates Intake during a Mountain Marathon on Exercise-Induced Muscle Damage in Elite Runners. Nutrients. 2020; 12(5):1367. Whitfield J, Burke LM, McKay AKA, et al. Acute Ketogenic Diet and Ketone Ester Supplementation Impairs Race Walk Performance. Medicine and Science in Sports and Exercise. 2020 Oct. Burke, L.M., Whitfield, J., Heikura, I.A., Ross, M.L.R., Tee, N., Forbes, S.F., Hall, R., McKay, A.K.A., Wallett, A.M. and Sharma, A.P. (2021), Adaptation to a low carbohydrate high fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability. J Physiol. The Pain: Louw A, Sluka KA, Nijs J, Courtney CA, Zimney K. Revisiting the Provision of Pain Neuroscience Education: An Adjunct Intervention for Patients, but a Primary Focus for Clinician Education. J Orthop Sports Phys Ther. 2020 Oct 19:1-12. Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020 Jan;54(2):72-73. Bei Fragen oder Anregungen meldet euch einfach via: Instagram: instagram.com/re_work.at Facebook: facebook.com/rework.at E-mail: office@re-work.at Homepage: www.re-work.at

Listen as chiropractor and founder of the Cox Technic, Dr. James Cox explains what Cox Technic is and why it is so effective for treating back pain. James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H) Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world. Resources: About Dr. Cox curriculum vitae  More about Cox Technic Find a Back Doctor The Cox 8 Table by Haven Medical References: Chesterton P, Evans W, Wright M, Lolli L, Richardson M, Atkinson G. Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30201-3. doi: 10.1016/j.jmpt.2020.09.005. Epub ahead of print. PMID: 33248746. INFLUENCE OF LUMBAR MOBILIZATIONS DURING THE NORDIC HAMSTRING EXERCISE ON HAMSTRING MEASURES OF KNEE FLEXOR STRENGTH, FAILURE POINT, AND MUSCLE ACTIVITY: A RANDOMIZED CROSSOVER TRIAL. AFTER SPINAL MOBILIZATION, IMMEDIATE CHANGES IN BILATERAL HAMSTRING FORCE PRODUCTION AND PEAK TORQUE OCCURRED DURING THE NHE. THE EFFECT ON THE NHE FAILURE POINT WAS UNCLEAR. ELECTROMYOGRAPHIC ACTIVITY INCREASED ON THE IPSILATERAL SIDE. Meet the Nordic hamstring exercise, also known as the Nordic hamstring curl—your potential new favorite go-to that can help keep you healthy while boosting your performance.  me 19 Lead researcher Nicol van Dyk, Ph.D., of Aspetar Orthopaedic and Sports Medicine Hospital in Qatar, told Runner's World the move is simple: Begin in a kneeling position with both ankles secured—tucking your feet under a bar, for example, or having a running buddy hold them down—and then progressively lean forward as slowly as possible while keeping your back straight. When you can't resist anymore, just fall forward, catching yourself with your hands against the floor. Check out the video below for how to do it properly.   Ekşi MŞ, Özcan-Ekşi EE, Özmen BB, Turgut VU, Huet SE, Dinç T, Kara M, Özgen S, Özek MM, Pamir MN. Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain. J Pediatr Orthop B. 2020 Nov 27. doi: 10.1097/BPB.0000000000000833. Epub ahead of print. PMID: 33252539. FATTY INFILTRATION IN THE PARASPINAL MUSCLES AND IVDD WERE CLOSELY ASSOCIATED WITH MODIC CHANGES IN CHILDREN AND ADOLESCENTS WITH LBP. LUMBAR IVDD IN CHILDREN AND ADOLESCENTS COULD BE THE RESULT OF A MECHANICAL PATHOLOGY   Karartı C, Özüdoğru A, Basat HÇ, Özsoy İ, Özsoy G, Kodak Mİ, Sezgin H, Uçar İ. Determination of Biodex Balance System Cutoff Scores in Older People With Nonspecific Back Pain: A Cross-sectional Study. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30153-6. doi: 10.1016/j.jmpt.2020.07.006. Epub ahead of print. PMID: 33248744. DETERMINATION OF BIODEX BALANCE SYSTEM CUTOFF SCORES IN OLDER PEOPLE WITH NONSPECIFIC BACK PAIN: A CROSS-SECTIONAL STUDY BBS CUTOFF SCORES ARE SENSITIVE AND SPECIFIC IN DISTINGUISHING BETWEEN POOR AND GOOD POSTURAL PERFORMANCE IN OLDER PEOPLE WITH NSLBP.   TRACTION EFFECTS: TRACTION AND DISTRACTION STUDIES ON WHICH OUR WORK IS BASED. Luigi Albano, DC introduced the first paper on which I built the remaining studies. This gives us foundational understanding as to the benefits of placing a spine into distraction prior to producing ranges of motion – IT FIRST REDUCES STENOTIC EFFECTS THAT COULD CAUSE GREATER NERVE AND DRG COMPRESSION AND CHEMICAL INFLAMMATORY IRRITATION. - JMC   Gaowgzeh RAM, Chevidikunnan MF, BinMulayh EA, Khan F. Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial. J Back Musculoskelet Rehabil. 2020;33(2):225-231. doi: 10.3233/BMR-171099. PMID: 31282394. A COMBINATION OF SPINAL DECOMPRESSION THERAPY WITH CORE STABILIZATION EXERCISE HAS PROVEN TO BE MORE SIGNIFICANT WHEN COMPARED WITH CSE ALONE TO REDUCE PAIN AND DISABILITY IN SUBJECTS WITH CHRONIC LDP.   Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1015-1022. doi: 10.3233/BMR-169581. PMID: 28505956. THIS STUDY SHOWED THAT PATIENTS WITH LHNP RECEIVED PHYSIOTHERAPY HAD IMPROVEMENT BASED ON CLINICAL AND RADIOLOGIC EVIDENCE. NON-INVASIVE SPINAL DECOMPRESSION THERAPY (NSDT) CAN BE USED AS ASSISTIVE AGENT FOR OTHER PHYSIOTHERAPY METHODS IN TREATMENT OF LUMBAR DISC HERNIATION.   Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):247-253. doi: 10.3233/BMR-160741. PMID: 27636836. SEGMENTAL TRACTION THERAPY MIGHT PLAY AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LBP STIMULATED BY LDH.   Kamanli A1, Karaca-Acet G, Kaya A, Koc M, Yildirim H Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 247-253, 2017 CONVENTIONAL PHYSICAL THERAPIES WITH LUMBAR TRACTION WERE EFFECTIVE IN THE TREATMENT OF PATIENT WITH SUBACUTE LDH. THESE RESULTS SUGGEST THAT CLINICAL IMPROVEMENT IS NOT CORRELATED WITH THE FINDING OF MRI. PATIENTS WITH LDH SHOULD BE MONITORED CLINICALLY   Choi J, Lee S, Hwangbo G. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci. 2015 Feb;27(2):481-3. doi: 10.1589/jpts.27.481. Epub 2015 Feb 17. PMID: 25729196; PMCID: PMC4339166. SPINAL DECOMPRESSION THERAPY AND GENERAL TRACTION THERAPY ARE EFFECTIVE AT IMPROVING THE PAIN, DISABILITY, AND SLR OF PATIENTS WITH INTERVERTEBRAL DISC HERNIATION. THUS, SELECTIVE TREATMENT MAY BE REQUIRED   JUDOVICH BD. Herniated cervical disc; a new form of traction therapy. Am J Surg. 1952 Dec;84(6):646-56. doi: 10.1016/0002-9610(52)90127-x. PMID: 12986095. CLINICAL STUDIES INDICATE THAT IN THE AVERAGE INTRACTABLE CASE THE CERVICAL SPINE SHOULD BE STRETCHED BY FORCE RANGING FROM 25 TO 45 POUNDS. ALMOST HALF THE PATIENTS IN A SERIES OF SIXTY CASES EXPERIENCED PARTIAL OR COMPLETE MOMENTARY RELIEF WHEN THIS FORCE WAS APPLIED. ROENTGEN STUDIES REVEAL THAT IN THE AVERAGE PATIENT THE INTERVERTEBRAL SPACES OF THE CERVICAL SPINE BEGIN TO SHOW MEASURABLE WIDENING WITH TRACTION FORCE RANGING FROM 25 TO 50 POUNDS. THE NECESSARY FORCE TO RELIEVE PAIN CANNOT BE TOLERATED BY THE AVERAGE PATIENT WHEN IT IS ADMINISTERED AS A CONSTANT PULL. IF ADMINISTERED INTERMITTENTLY, ADEQUATE AND MUCH GREATER TRACTION LOAD CAN BE TOLERATED WITHOUT THE DISCOMFORT WHICH WOULD NORMALLY ACCOMPANY SUCH FORCE. A NEW METHOD OF MOTORIZED INTERMITTENT TRACTION IS PRESENTED. THE CLINICAL RESULTS OF INTERMITTENT TRACTION, BECAUSE OF ADEQUATE FORCE, HAVE BEEN EXCELLENT AS COMPARED TO CONVENTIONAL TRACTION METHODS.   Burton AK, Tillotson KM, Cleary J. Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation. Eur Spine J. 2000 Jun;9(3):202-7. doi: 10.1007/s005869900113. PMID: 10905437; PMCID: PMC3611397. BECAUSE OSTEOPATHIC MANIPULATION PRODUCED A 12-MONTH OUTCOME THAT WAS EQUIVALENT TO CHEMONUCLEOLYSIS, IT CAN BE CONSIDERED AS AN OPTION FOR THE TREATMENT OF SYMPTOMATIC LUMBAR DISC HERNIATION, AT LEAST IN THE ABSENCE OF CLEAR INDICATIONS FOR SURGERY. Further study into the value of manipulation at a more acute stage is warranted.   Kirkaldy-Willis WH, Cassidy JD. Spinal manipulation in the treatment of low-back pain. Can Fam Physician. 1985 Mar;31:535-40. PMID: 21274223; PMCID: PMC2327983. RESULTS OF SPINAL MANIPULATION IN 283 PATIENTS WITH LOW BACK PAIN ARE PRESENTED. THE PHYSICIAN WHO MAKES USE OF THIS RESOURCE WILL PROVIDE RELIEF FOR MANY PATIENTS.   Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004 Mar-Apr;27(3):197-210. doi: 10.1016/j.jmpt.2003.12.023. PMID: 15129202. THE APPARENT SAFETY OF SPINAL MANIPULATION, ESPECIALLY WHEN COMPARED WITH OTHER “MEDICALLY ACCEPTED” TREATMENTS FOR LDH, SHOULD STIMULATE ITS USE IN THE CONSERVATIVE TREATMENT PLAN OF LDH.   Kane MD, Karl RD, Swain JH. Effects of Gravity-Facilitated Traction on lntervertebral Dimensions of the Lumbar Spine*. J Orthop Sports Phys Ther. 1985;6(5):281-8. doi: 10.2519/jospt.1985.6.5.281. PMID: 18802302. MEAN POSTERIOR SEPARATION WAS SIGNIFICANT AT ALL LEVELS EXCEPT L1-L2 AND L5-S1. MEAN INTERVERTEBRAL FORAMINAL SEPARATION WAS SIGNIFICANT AT ALL LEVELS BUT L5-S1. IF INCREASES IN INTERVERTEBRAL DIMENSIONS PLAY A ROLE IN THE RELIEF OF LOW BACK SYNDROME, THEN GRAVITY-FACILITATED TRACTION MAY BE AN EFFECTIVE MODALITY IN THE TREATMENT OF THIS CONDITION.   Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008 Mar;31(3):191-8. doi: 10.1016/j.jmpt.2008.02.001. PMID: 18394495. TRACTION, ULTRASOUND, AND LOW POWER LASER THERAPIES WERE ALL EFFECTIVE IN THE TREATMENT OF THIS GROUP OF PATIENTS WITH ACUTE LDH. THESE RESULTS SUGGEST THAT CONSERVATIVE MEASURES SUCH AS TRACTION, LASER, AND ULTRASOUND TREATMENTS MIGHT HAVE AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LDH   Chung TS, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology. 2015 Jun;275(3):755-62. doi: 10.1148/radiol.14141400. Epub 2015 Jan 22. Erratum in: Radiology. 2015 Jun;275(3):934-5. PMID: 25611735. HERNIATED LUMBAR DISKS: REAL-TIME MR IMAGING EVALUATION DURING CONTINUOUS TRACTION CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.   Isner-Horobeti ME, Dufour SP, Schaeffer M, Sauleau E, Vautravers P, Lecocq J, Dupeyron A. High-Force Versus Low-Force Lumbar Traction in Acute Lumbar Sciatica Due to Disc Herniation: A Preliminary Randomized Trial. J Manipulative Physiol Ther. 2016 Nov-Dec;39(9):645-654. doi: 10.1016/j.jmpt.2016.09.006. Epub 2016 Nov 9. PMID: 27838140. HIGH-FORCE VERSUS LOW-FORCE LUMBAR TRACTION IN ACUTE LUMBAR SCIATICA DUE TO DISC HERNIATION: A PRELIMINARY RANDOMIZED TRIAL PATIENTS WITH ACUTE LUMBAR SCIATICA SECONDARY TO DISC HERNIATION WHO RECEIVED 2 WEEKS OF LUMBAR TRACTION REPORTED REDUCED RADICULAR PAIN AND FUNCTIONAL IMPAIRMENT AND IMPROVED WELL-BEING REGARDLESS OF THE TRACTION FORCE GROUP TO WHICH THEY WERE ASSIGNED. THE EFFECTS OF THE TRACTION TREATMENT WERE INDEPENDENT OF THE INITIAL LEVEL OF MEDICATION AND APPEARED TO BE MAINTAINED AT THE 2-WEEK FOLLOW-UP. DURING THE 2-WEEK FOLLOW-UP AT DAY 28, ONLY THE LT10 GROUP IMPROVED (P < .05) IN VAS (–52%) AND EIFEL SCORES (–46%).   Onel D, Tuzlaci M, Sari H, Demir K. Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine (Phila Pa 1976). 1989 Jan;14(1):82-90. doi: 10.1097/00007632-198901000-00017. PMID: 2913674. COMPUTED TOMOGRAPHIC INVESTIGATION OF THE EFFECT OF TRACTION ON LUMBAR DISC HERNIATIONS. CHANGES OCCURRING UNDER THE EFFECT OF A TRACTION LOAD OF 45 KG HAVE BEEN EVALUATED IN 30 PATIENTS WITH LUMBAR DISC HERNIATION WITH CT INVESTIGATION. THE HERNIATED NUCLEAR MATERIAL (HNM) HAS RETRACTED IN 11 (78.5%) OF MEDIAN, SIX (66.6%) OF POSTEROLATERAL, AND FOUR (57.1%) OF LATERAL HERNIATIONS.   Clarke J, van Tulder M, Blomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1591-9. doi: 10.1097/01.brs.0000222043.09835.72. PMID: 16778694. INTERMITTENT OR CONTINUOUS TRACTION AS A SINGLE TREATMENT FOR LBP CANNOT BE RECOMMENDED FOR MIXED GROUPS OF PATIENTS WITH LBP WITH AND WITHOUT SCIATICA. NEITHER CAN TRACTION BE RECOMMENDED FOR PATIENTS WITH SCIATICA BECAUSE OF INCONSISTENT RESULTS AND METHODOLOGICAL PROBLEMS IN MOST OF THE STUDIES INVOLVED. HOWEVER, BECAUSE HIGH-QUALITY STUDIES WITHIN THE FIELD ARE SCARCE, BECAUSE MANY ARE UNDERPOWERED, AND BECAUSE TRACTION OFTEN IS SUPPLIED IN COMBINATION WITH OTHER TREATMENT MODALITIES, THE LITERATURE ALLOWS NO FIRM NEGATIVE CONCLUSION THAT TRACTION, IN A GENERALIZED SENSE, IS NOT AN EFFECTIVE TREATMENT FOR PATIENTS WITH LBP   Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study. Arch Phys Med Rehabil. 2008 Feb;89(2):269-74. doi: 10.1016/j.apmr.2007.06.778. PMID: 18226650. TRACTION APPLIED IN THE PRONE POSITION USING THE VAX-D FOR 8 WEEKS WAS ASSOCIATED WITH IMPROVEMENTS IN PAIN INTENSITY AND RMDQ SCORES AT DISCHARGE, AND AT 30 AND 180 DAYS AFTER DISCHARGE IN A SAMPLE OF PATIENTS WITH ACTIVITY-LIMITING LBP. CAUSAL RELATIONSHIPS BETWEEN THESE OUTCOMES AND THE INTERVENTION SHOULD NOT BE MADE UNTIL FURTHER STUDY IS PERFORMED USING RANDOMIZED COMPARISON GROUPS.   REAL-TIME MR IMAGING WHILE PERFORMING TRACTION IS POSSIBLE. Mitchell UH, Beattie PF, Bowden J, Larson R, Wang H. Age-related differences in the response of the L5-S1 intervertebral disc to spinal traction. Musculoskelet Sci Pract. 2017 Oct;31:1-8. doi: 10.1016/j.msksp.2017.06.004. Epub 2017 Jun 9. PMID: 28624722. TO DETERMINE DIFFERENCES IN THE APPARENT DIFFUSION COEFFICIENT (ADC) OBTAINED WITH LUMBAR DIFFUSION-WEIGHTED IMAGING (DWI) OF THE L5-S1 IVD BEFORE, AND DURING, THE APPLICATION OF LUMBAR TRACTION STATIC TRACTION WAS ASSOCIATED WITH AN INCREASE IN DIFFUSION OF WATER WITHIN THE L5-S1 IVDS OF MIDDLE-AGE INDIVIDUALS, BUT NOT IN YOUNG ADULTS, SUGGESTING AGE-RELATED DIFFERENCES IN THE DIFFUSION RESPONSE. FURTHER STUDY IS NEEDED TO ASSESS THE RELATIONSHIP BETWEEN THESE FINDINGS AND THE SYMPTOMS OF BACK PAIN. HIGHLIGHTS: STATIC TRACTION IS ASSOCIATED WITH AN INCREASE IN ADC IN OLDER DISCS, NOT YOUNGER. INVERSE RELATIONSHIP BETWEEN BASELINE ADC AND PERCENT INCREASE WITH TRACTION. FINDINGS SUGGEST PRESENCE OF AGE-RELATED CHANGES IN THE RATE OF DIFFUSION RESPONSE.   SAAL, JEFFREY A., MD; SAAL, JOEL S., MD Nonoperative Treatment of Herniated Lumbar Intervertebral Disc with Radiculopathy: An Outcome Study, Spine: April 1989 - Volume 14 - Issue 4 - p 431-437 64 PATIENTS WITH LUMBAR HERNIATED NUCLEUS PULPOSUS WITHOUT SIGNIFICANT STENOSIS WERE TREATED NON SURGICALLY. 90% GOOD OR EXCELLENT OUTCOME WITH A 92% RETURN TO WORK RATE. FOR THE SUBGROUPS WITH EXTRUDED DISCS AND SECOND OPINIONS, 87% AND 83% HAD GOOD OR EXCELLENT OUTCOMES, RESPECTIVELY, ALL (100%) OF WHOM RETURNED TO WORK. SICK LEAVE TIME FOR THESE SUBGROUPS WAS 2.9 MONTHS (+/- 1.4 MONTHS) AND 3.4 MONTHS (+/- 1.7 MONTHS), RESPECTIVELY. THESE RESULTS COMPARED FAVORABLY WITH PREVIOUSLY PUBLISHED SURGICAL STUDIES. FOUR OF SIX PATIENTS WHO REQUIRED SURGERY WERE FOUND TO HAVE STENOSIS AT OPERATION.   Sari H, Akarirmak U, Karacan I, Akman H. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-Mar;21(1):3-11. PMID: 16385939. DURING TRACTION OF INDIVIDUALS WITH ACUTE LDH THERE WAS A REDUCTION OF THE SIZE OF THE HERNIATION, INCREASED SPACE WITHIN THE SPINAL CANAL, WIDENING OF THE NEURAL FORAMINA, AND DECREASED THICKNESS OF THE PSOAS MUSCLE.   Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther. 2014 Dec;19(6):527-33. doi: 10.1016/j.math.2014.05.004. Epub 2014 May 22. PMID: 24913413. A COMBINATION OF GLOBAL AXIAL TRACTION AND LOCAL DECOMPRESSION WOULD BE HELPFUL FOR REDUCING TENSILE STRESS ON THE FIBERS OF THE ANNULUS FIBROSUS AND LIGAMENTS, AND INTRADISCAL PRESSURE IN TRACTION THERAPY. THIS STUDY COULD BE USED TO DEVELOP A SAFER AND MORE EFFECTIVE TYPE OF TRACTION THERAPY   Chow DHK, Yuen EMK, Xiao L, Leung MCP. Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study. Musculoskelet Sci Pract. 2017 Jun;29:78-83. doi: 10.1016/j.msksp.2017.03.007. Epub 2017 Mar 20. PMID: 28347933. HORIZONTAL TRACTION WAS EVIDENTLY EFFECTIVE IN INCREASING THE DISC HEIGHT OF LOWER LUMBAR LEVELS, PARTICULARLY IN THE POSTERIOR REGIONS OF THE DISCS. FURTHER EVIDENCE OF THE EFFECTS OF TRACTION OF DIFFERENT MODES, MAGNITUDES, AND DURATIONS ON THE CHANGE IN DISC HEIGHT IS REQUIRED FOR PROPER CONTROL OF TRACTION APPLIED TO SPECIFIC DISC LEVELS. HIGHLIGHTS: MECHANICAL EFFECTS OF TRACTION ON LUMBAR DISCS WAS EVALUATED USING MRI. HORIZONTAL TRACTION USING 42% OF BODY WEIGHT WAS ASSOCIATED WITH AN INCREASED DISC HEIGHT OF LOWER LUMBAR DISCS. HORIZONTAL TRACTION ALSO RESULTED IN REDUCED LORDOSIS AND CHANGE IN TILT ANGLE. THE EFFECTS WERE MORE PROMINENT AT THE POSTERIOR DISCAL REGIONS.   Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14. PMID: 28192789. a  systematic  review  of  randomized, controlled  trials  and  systematic  reviews  published  through  April 2015  on  noninvasive  pharmacologic  and  nonpharmacologic treatments  for  low  back  pain.  Updated  searches  were  performed through  November  2016. Recommendation  1: Given  that  most  patients  with  acute  or subacute  low  back  pain  improve  over  time  regardless  of  treat-ment,  clinicians  and  patients  should  select  nonpharmacologic treatment  with  superficial  heat  (moderate-quality  evidence),  massage,  acupuncture,  or  spinal  manipulation  (low-quality  evidence). If  pharmacologic  treatment  is  desired,  clinicians  and  patients should  select  nonsteroidal  anti-inflammatory  drugs  or  skeletal muscle  relaxants  (moderate-quality  evidence).  (Grade:  strong recommendation) Recommendation  2: For  patients  with  chronic  low  back  pain, clinicians  and  patients  should  initially  select  nonpharmacologic treatment  with  exercise,  multidisciplinary  rehabilitation,  acupuncture,  mindfulness-based  stress  reduction  (moderate-quality  evidence),  tai  chi,  yoga,  motor  control  exercise,  progressive relaxation,  electromyography  biofeedback,  low-level  laser therapy,  operant  therapy,  cognitive  behavioral  therapy,  or  spinal manipulation  (low-quality  evidence).  (Grade:  strong recommendation) Recommendation  3: In  patients  with  chronic  low  back  pain  who have  had  an  inadequate  response  to  nonpharmacologic  therapy, clinicians  and  patients  should  consider  pharmacologic  treatment with  nonsteroidal  anti-inflammatory  drugs  as  first-line  therapy,  or tramadol  or  duloxetine  as  second-line  therapy.  Clinicians  should only  consider  opioids  as  an  option  in  patients  who  have  failed  the aforementioned  treatments  and  only  if  the  potential  benefits  out-weigh  the  risks  for  individual  patients  and  after  a  discussion  of known  risks  and  realistic  benefits  with  patients.  (Grade:  weak  recommendation,  moderate-quality  evidence) Low  back  pain  is  one  of  the  most  common  reasons for  physician  visits  in  the  United  States.  Most  Americans  have  experienced  low  back  pain,  and  approximately  one  quarter  of  U.S.  adults  reported  having  low back  pain  lasting  at  least  1  day  in  the  past  3  months  (1).Low  back  pain  is  associated  with  high  costs,  including those  related  to  health  care  and  indirect  costs  from missed  work  or  reduced  productivity  (2).  The  total  costs attributable  to  low  back  pain  in  the  United  States  were estimated  at  $100  billion  in  2006,  two  thirds  of  which were  indirect  costs  of  lost  wages  and  productivity  (3).Low  back  pain  is  frequently  classified  and  treated on  the  basis  of  symptom  duration,  potential  cause, presence  or  absence  of  radicular  symptoms,  and  corresponding  anatomical  or  radiographic  abnormalities. Acute  back  pain  is  defined  as  lasting  less  than  4  week   Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):493-505. doi: 10.7326/M16-2459. Epub 2017 Feb 14. PMID: 28192793. Background: A  2007  American  College  of  Physicians  guideline addressed  nonpharmacologic  treatment  options  for  low  back pain. The  current  evidence  on  non-pharmacologic  therapies  for  acute  or  chronic  nonradicular  or  ra-dicular  low  back  pain from  MEDLINE  (January  2008  through  February 2016),  Cochrane  Central  Register  of  Controlled  Trials,  CochraneDatabase  of  Systematic  Reviews,  and  reference  lists. Evidence  continues  to  support  the  effectiveness  of  exercise,  psychological  therapies,  multidisciplinary  rehabilitation,  spinal  manipulation,  massage,  and  acupuncture  for  chronic  low  back  pain. Funding  Source:Agency  for  Healthcare  Research  and Quality.  (PROSPERO:  CRD42014014735)Ann  Intern  Med.2017;166:xxx-xxx.  doi:10.7326/M16-2459Annals.org the  American  College  of  Physicians  (ACP)and  American  Pain  Society  (APS)  recommended  spinal manipulation  as  a  treatment  option  for  acute  low  back pain  and  several  nonpharmacologic  therapies  for  sub-acute  or  chronic  low  back  pain.    Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20. PMID: 28429142. Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset ( If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.   Krekoukias G1, Gelalis ID1,2, Xenakis T1, Gioftsos G3, Dimitriadis Z4, Sakellari V3. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23. MANUAL THERAPY SPINAL MOBILIZATION IS PREFERABLE TO CONVENTIONAL PHYSIOTHERAPY IN ORDER TO REDUCE THE PAIN INTENSITY AND DISABILITY IN SUBJECTS WITH CHRONIC LBP AND ASSOCIATED DISK DEGENERATION. THE FINDINGS OF THIS STUDY MAY LEAD TO THE ESTABLISHMENT OF SPINAL MOBILIZATION AS ONE OF THE MOST PREFERABLE APPROACHES FOR THE MANAGEMENT OF LBP DUE TO DISK DEGENERATION.   REFERENCES FOR 25% RELIEF PAPER BY WIRTH ET AL Wirth B1, Riner F1, Peterson C1, Humphreys BK1, Farshad M2, Becker S3, Schweinhardt P1. An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment. Chiropr Man Therap. 2019 Feb 5;27:6. doi: 10.1186/s12998-018-0225-8. eCollection 2019. Refs on minimal clinical improvement determination: Farrar JT, Young JP, Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158. doi: 10.1016/S0304-3959(01)00349-9. [PubMed] [CrossRef] Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Cano A, et al. Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain. Spine (Phila Pa 1976) 2007;32:2915–2920. doi: 10.1097/BRS.0b013e31815b75ae. [PubMed] [CrossRef] Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8:283–291. doi: 10.1016/j.ejpain.2003.09.004. [PubMed] [CrossRef] Robinson-Papp J, George MC, Dorfman D, Simpson DM. Barriers to chronic pain measurement: a qualitative study of patient perspectives.Pain Med. 2015;16:1256–1264. doi: 10.1111/pme.12717. [PMC free article] [PubMed] [CrossRef] Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 2008;33:90–94. doi: 10.1097/BRS.0b013e31815e3a10. [PubMed] [CrossRef]   Chung TS1, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology 2015 Jan 22:141400. CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.    Wong A, Parent E, Dhillon S, Prasad N, Kawchuk G: Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls? Spine: 01 September 2015 - Volume 40 - Issue 17 - p 1329–1337  doi: 10.1097/BRS.0000000000000981 PARTICIPANTS WITH LBP AND ASYMPTOMATIC CONTROLS ATTENDED 3 SESSIONS FOR 7 DAYS. ON SESSIONS 1 AND 2, PARTICIPANTS WITH LBP RECEIVED SMT (+LBP/+SMT, N = 32) WHEREAS ASYMPTOMATIC CONTROLS DID NOT (−LBP/−SMT, N = 57). IN THESE SESSIONS, SPINAL STIFFNESS AND MULTIFIDUS THICKNESS RATIOS WERE OBTAINED BEFORE AND AFTER SMT AND ON DAY 7. RESULTS. AFTER THE FIRST SMT, SMT RESPONDERS DISPLAYED STATISTICALLY SIGNIFICANT DECREASES IN SPINAL STIFFNESS AND INCREASES IN MULTIFIDUS THICKNESS RATIO SUSTAINED FOR MORE THAN 7 DAYS; THESE FINDINGS WERE NOT OBSERVED IN OTHER GROUPS. SIMILARLY, ONLY SMT RESPONDERS DISPLAYED SIGNIFICANT POST-SMT IMPROVEMENT IN APPARENT DIFFUSION COEFFICIENTS.     Wong AYL1,2, Parent EC3, Dhillon SS4, Prasad N5, Samartzis D6, Kawchuk GN3. Differential patient responses to spinal manipulative therapy and their relation to spinal degeneration and post-treatment changes in disc diffusion. Eur  Spine J. 2019 Jan 2. doi: 10.1007/s00586-018-5851-2. NON-SPECIFIC LOW BACK PAIN PATIENTS WHO RESPOND WITH >30% RELIEF SHOW HIGHER APPARENT DIFFUSION COEFFICIENT DISC DIFFUSION OF WATER THAN NON POSITIVE RESPONDERS. MRI WAS PERFORMED BEFORE AND AFTER SMT ON DAY 1 OF CARE. OSWESTRY DISABILITY TEST WAS ALSO USED.     Beattie PF, Butts R, Donley JW, Liuzzo DM. The Within-Session Change in Low Back Pain Intensity Following Spinal Manipulative Therapy is Related to Differences in Diffusion of Water in the Intervertebral Discs of the Upper Lumbar Spine and L5-S1. Orthop Sports Phys Ther. 2013 Nov 21. Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC. STUDY TO DETERMINE DIFFERENCES IN THE CHANGES IN DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS BETWEEN THOSE SUBJECTS WITH LOW BACK PAIN (LBP) WHO DID, AND DID NOT, REPORT A WITHIN-SESSION REDUCTION IN PAIN INTENSITY FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY (SMT) WAS DONE. CHANGES IN THE DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS AT THE L1-2, L2-3, AND L5-1 LEVELS APPEAR TO BE RELATED TO DIFFERENCES IN WITHIN-SESSION PAIN REPORTS FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY. PARTICIPANTS UNDERWENT T2- AND DIFFUSION-WEIGHTED LUMBAR MAGNETIC RESONANCE IMAGING SCANS IMMEDIATELY BEFORE, AND AFTER, RECEIVING A SINGLE TREATMENT OF SMTJ     Kuo, Ya-Wen PhD; Hsu, Yu-Chun MS; Chuang, I-Ting MS; Chao, Pen-Hsiu Grace PhD; Wang, Jaw-Lin PhD Spinal Traction Promotes Molecular Transportation in a Simulated Degenerative Intervertebral Disc Model. Spine: April 20th, 2014 - Volume 39 - Issue 9 - p E550 Traction biomechanics studied in the porcine model biomechanical benefits include disc height recovery, foramen enlargement, and intradiscal pressure reduction. 48 thoracic discs were dissected from 8 porcine spines and then divided into 3 groups: intact, degraded without traction, and degraded with traction. From Day 4 to Day 6, half of the degraded discs received a 30 min traction treatment per day (traction force: 20 kg, loading: unloading = 30 sec: 10 sec). Traction treatment is effective in enhancing nutrition supply and promoting disc cell proliferation of the degraded discs.  

Referências1.Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999;27(6):393-408.2.Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015;33(6):780-4.3.Ryan M, Bisset L, Newsham-West R. Should We Care About Tendon Structure? The Disconnect Between Structure and Symptoms in Tendinopathy. J Orthop Sports Phys Ther. 2015;45(11):823-5.4.Scott A, Backman LJ, Speed C. Tendinopathy: Update on Pathophysiology. J Orthop Sports Phys Ther. 2015;45(11):833-41.5.Abate M, Silbernagel KG, Siljeholm C, Di Iorio A, De Amicis D, Salini V, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235.6.Tran PHT, Malmgaard-Clausen NM, Puggaard RS, Svensson RB, Nybing JD, Hansen P, et al. Early development of tendinopathy in humans: Sequence of pathological changes in structure and tissue turnover signaling. FASEB J. 2020;34(1):776-88.7.Millar NL, Murrell GA, McInnes IB. Inflammatory mechanisms in tendinopathy - towards translation. Nat Rev Rheumatol. 2017;13(2):110-22.8.Speed C. Inflammation in Tendon Disorders. Adv Exp Med Biol. 2016;920:209-20.9.Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, et al. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach. J Exp Orthop. 2017;4(1):18.10.Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409-16.11.D'Addona A, Maffulli N, Formisano S, Rosa D. Inflammation in tendinopathy. Surgeon. 2017;15(5):297-302.12.Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med. 2016;50(19):1187-91.13.Rabello LM, van den Akker-Scheek I, Kuipers IF, Diercks RL, Brink MS, Zwerver J. Bilateral changes in tendon structure of patients diagnosed with unilateral insertional or midportion achilles tendinopathy or patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2020;28(5):1631-8.14.Docking SI, Ooi CC, Connell D. Tendinopathy: Is Imaging Telling Us the Entire Story? J Orthop Sports Phys Ther. 2015;45(11):842-52.15.Matthews W, Ellis R, Furness JW, Rathbone E, Hing W. Staging achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology. BMJ Open Sport Exerc Med. 2020;6(1):e000699.16.Splittgerber LE, Ihm JM. Significance of Asymptomatic Tendon Pathology in Athletes. Curr Sports Med Rep. 2019;18(6):192-200.17.Comin J, Cook JL, Malliaras P, McCormack M, Calleja M, Clarke A, et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med. 2013;47(2):89-92.

Referências1.Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999;27(6):393-408.2.Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015;33(6):780-4.3.Ryan M, Bisset L, Newsham-West R. Should We Care About Tendon Structure? The Disconnect Between Structure and Symptoms in Tendinopathy. J Orthop Sports Phys Ther. 2015;45(11):823-5.4.Scott A, Backman LJ, Speed C. Tendinopathy: Update on Pathophysiology. J Orthop Sports Phys Ther. 2015;45(11):833-41.5.Abate M, Silbernagel KG, Siljeholm C, Di Iorio A, De Amicis D, Salini V, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235.6.Tran PHT, Malmgaard-Clausen NM, Puggaard RS, Svensson RB, Nybing JD, Hansen P, et al. Early development of tendinopathy in humans: Sequence of pathological changes in structure and tissue turnover signaling. FASEB J. 2020;34(1):776-88.7.Millar NL, Murrell GA, McInnes IB. Inflammatory mechanisms in tendinopathy - towards translation. Nat Rev Rheumatol. 2017;13(2):110-22.8.Speed C. Inflammation in Tendon Disorders. Adv Exp Med Biol. 2016;920:209-20.9.Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, et al. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach. J Exp Orthop. 2017;4(1):18.10.Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409-16.11.D'Addona A, Maffulli N, Formisano S, Rosa D. Inflammation in tendinopathy. Surgeon. 2017;15(5):297-302.12.Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med. 2016;50(19):1187-91.13.Rabello LM, van den Akker-Scheek I, Kuipers IF, Diercks RL, Brink MS, Zwerver J. Bilateral changes in tendon structure of patients diagnosed with unilateral insertional or midportion achilles tendinopathy or patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2020;28(5):1631-8.14.Docking SI, Ooi CC, Connell D. Tendinopathy: Is Imaging Telling Us the Entire Story? J Orthop Sports Phys Ther. 2015;45(11):842-52.15.Matthews W, Ellis R, Furness JW, Rathbone E, Hing W. Staging achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology. BMJ Open Sport Exerc Med. 2020;6(1):e000699.16.Splittgerber LE, Ihm JM. Significance of Asymptomatic Tendon Pathology in Athletes. Curr Sports Med Rep. 2019;18(6):192-200.17.Comin J, Cook JL, Malliaras P, McCormack M, Calleja M, Clarke A, et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med. 2013;47(2):89-92.

Referências1.Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999;27(6):393-408.2.Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015;33(6):780-4.3.Ryan M, Bisset L, Newsham-West R. Should We Care About Tendon Structure? The Disconnect Between Structure and Symptoms in Tendinopathy. J Orthop Sports Phys Ther. 2015;45(11):823-5.4.Scott A, Backman LJ, Speed C. Tendinopathy: Update on Pathophysiology. J Orthop Sports Phys Ther. 2015;45(11):833-41.5.Abate M, Silbernagel KG, Siljeholm C, Di Iorio A, De Amicis D, Salini V, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235.6.Tran PHT, Malmgaard-Clausen NM, Puggaard RS, Svensson RB, Nybing JD, Hansen P, et al. Early development of tendinopathy in humans: Sequence of pathological changes in structure and tissue turnover signaling. FASEB J. 2020;34(1):776-88.7.Millar NL, Murrell GA, McInnes IB. Inflammatory mechanisms in tendinopathy - towards translation. Nat Rev Rheumatol. 2017;13(2):110-22.8.Speed C. Inflammation in Tendon Disorders. Adv Exp Med Biol. 2016;920:209-20.9.Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, et al. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach. J Exp Orthop. 2017;4(1):18.10.Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409-16.11.D'Addona A, Maffulli N, Formisano S, Rosa D. Inflammation in tendinopathy. Surgeon. 2017;15(5):297-302.12.Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med. 2016;50(19):1187-91.13.Rabello LM, van den Akker-Scheek I, Kuipers IF, Diercks RL, Brink MS, Zwerver J. Bilateral changes in tendon structure of patients diagnosed with unilateral insertional or midportion achilles tendinopathy or patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2020;28(5):1631-8.14.Docking SI, Ooi CC, Connell D. Tendinopathy: Is Imaging Telling Us the Entire Story? J Orthop Sports Phys Ther. 2015;45(11):842-52.15.Matthews W, Ellis R, Furness JW, Rathbone E, Hing W. Staging achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology. BMJ Open Sport Exerc Med. 2020;6(1):e000699.16.Splittgerber LE, Ihm JM. Significance of Asymptomatic Tendon Pathology in Athletes. Curr Sports Med Rep. 2019;18(6):192-200.17.Comin J, Cook JL, Malliaras P, McCormack M, Calleja M, Clarke A, et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med. 2013;47(2):89-92.

Pain flare-ups are one of the most frustrating things for patients and clinicians alike. Are they normal? Who gets them? Why is it important to know their prevalence? What are Sandy and Cory's thoughts on dealing with them?  All this and more in episode 50! Prevalence, Severity, and Correlates of Pain Flares in Response to a Repeated Sit-to-Stand Activity: A Cross-sectional Study of 14 902 Patients With Knee and Hip Osteoarthritis in Primary Care. Søren T Skou, Dorte T Grønne, Ewa M Roos. J Orthop Sports Phys Ther. 2020 Jun;50(6):309-318. doi: 10.2519/jospt.2019.9125. Epub 2019 Sep 6. Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

這次要跟大家介紹膝關節韌帶損傷的介入臨床建議 到底ACL術後要早點動？還是晚點動？ ACL術後建議的介入竟然有冰敷又有電療！？太扯了吧 讓CPG來告訴你該如何選擇適當的運動和適合的儀器 讓他們相輔相成！ 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b 在這裡追蹤我們得到更多資訊喔 Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Reference: Logerstedt DS, Scalzitti D, Risberg MA, et al. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Revision 2017. J Orthop Sports Phys Ther 2017;47(11);A1-A47. Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s

這次要跟大家介紹膝關節韌帶損傷的臨床進程和檢查項目 到底ACL傷後要不要要手術？要馬上去還是晚點去？ 不同的韌帶移植對outcome有什麼差異？ 是什麼讓選手回不到球場，他們到底在怕什麼？ 我們要怎麼正確的選擇量表(outcome measure)去了解我們的病人? 讓CPG來告訴你該怎麼辦吧！ 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b 在這裡追蹤我們得到更多資訊喔 Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Reference: Logerstedt DS, Scalzitti D, Risberg MA, et al. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Revision 2017. J Orthop Sports Phys Ther 2017;47(11);A1-A47. Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s

這次要跟大家介紹膝關節韌帶損傷的評估與鑑別診斷 什麼病人是可以看的，什麼病人是要轉介給醫師的 有什麼條件是要請病人去照Xray? 原來專業的訓練讓你的評估跟MRI一樣準，有如行走的MRI? special tests學了一堆，是不是每個都要測？ 讓Level 1的實證來告訴你吧！ Timecode: 0:00 聽眾問題Q&A: 評估的脈絡該從哪下手? 0:15 膝韌帶損傷發生率 16:20 常見ACL受傷族群、ACL再受傷的機率 20:31 女性return to sport vs. not return to sport再受傷的機率 22:16 non-contact ACL injury在比賽場上的受傷機率比平時練習高 23:18 女性、男性選手分別在哪個年齡層最容易ACL受傷 23:43 討論ACL重建手術的數量逐年上升的可能原因 28:03 發生率總結 28:50 膝韌帶損傷危險因子 31:00 Female Athlete Triad (女性運動員三聯症) 35:06 Risk factors: knee position 35:23 危險因子2017年版更新 37:00 Risk factors總結 37:30 膝關節韌帶常見受傷機制 41:40 Knee unhappy triad 43:12 Diagnosis and Classification的四大重點 47:05 CPG建議special tests跟key signs/symptoms: ACL 49:34 CPG建議special tests跟key signs/symptoms: PCL 50:55 小補充: Sensitivity & Specificity ("Snout" and "Spin") 53:07 CPG建議special tests跟key signs/symptoms: MCL 55:34 鑑別診斷:骨折或脫臼後對神經肌肉控制的影響、術後併發症 56:56 鑑別診斷:Patella Fracture 57:56 鑑別診斷:Psychosocial factors 58:13 臨床經驗分享: psychosocial factors、術後fibrosis 1:06:28 Fear of movement、kinesiophobia、Self-efficacy，以及PT該如何介入 1:08:52 什麼時候需要讓病人照X光: Ottawa Knee Rules 1:14:46 受過訓練的臨床人員其實不輸MRI?! 1:17:36 臨床決策樹狀圖 1:19:17 是Irritability還是Yellow Flag 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b 在這裡追蹤我們得到更多資訊喔 Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Reference: Logerstedt DS, Scalzitti D, Risberg MA, et al. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Revision 2017. J Orthop Sports Phys Ther 2017;47(11);A1-A47. Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s

Support us on Patreon! The literature around dry needling has some...issues...to say the least. But is it just dry needling? Or is this common around other PT interventions? How should we investigate some of these ideas? Should some of them be investigated at all? Join us along with study author Giovanni Ferreira to find out more! Dry Needling Combined With Guideline-Based Physical Therapy Provides No Added Benefit in the Management of Chronic Neck Pain: A Randomized Controlled Trial. Fábio Franciscatto Stieven, Giovanni Esteves Ferreira, Matheus Wiebusch, Francisco Xavier de Araújo, Luis Henrique Telles da Rosa, Marcelo Faria Silva. J Orthop Sports Phys Ther. 2020 Aug;50(8):447-454. doi: 10.2519/jospt.2020.9389. Epub 2020 Apr 9. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission Other Music by Kevin MacLeod - incompetech.com: MidRoll Promo - Mining by Moonlight

In this episode we discuss Dr. Boyd's favorite condition aka CuBOYD Syndrome! A condition commonly misdiagnosed for lateral ankle sprains and overall misunderstood in today's rehab. We discuss how we detect whether the cuboid is involved and how we treat it. Check the video for the research articles, the manual therapy techniques especially the CuBOYD whip (and Dr. Boyd's first social media manual therapy technique #classic

DRA, the separation of the abdominal muscles most often associated in women with pregnancy, is very close to my heart and I am so excited to bring you this AMAZING conversation on the research on #exercise for #diastasisrecti with David Larson @dmlarson31 dmlarson@asu.edu   Aside from discussing what research we do have , the drawbacks of this limited data, and the physiology behind the effects of adequate load on connective tissue, he talks about his research into patient satisfaction with exercise programs. Just because as professionals we think someone is better, doesn't mean they feel that way.    Bio from Arizona State University website: (see below for reference list) David is a Lecturer and Coordinator for CHS100/300 in the College of Health Solutions at Arizona State University.  David earned a Doctoral degree in Health Science from A. T. Still University, Masters degree in Kinesiology from A. T. Still University, and a Bachelors degree Kinesiology from Arizona State University.  His research is primarily focused on conservative treatment modalities such as abdominal strength training for the postpartum condition diastasis recti.  David is a Certified Strength and Conditioning Specialist (CSCS), a Certified Pre- and Postnatal Coach (CPPC), and Certified Level 2 Nutrition Coach through Precision Nutrition (PN2).  He specializes in pre- and post-natal training, youth athletic performance, and strength and conditioning and has over 10 years of experience in the fitness and sport performance industry.    Reference list: Acharry, N., & Kutty, R. K. (2015). Abdominal exercise with bracing, a therapeutic efficacy in reducing diastasis-recti among postpartal females. International Journal of Physiotherapy and Research, 3(2), 999-1005. doi:10.16965/ijpr.2015.122 Awad, M. A., Mahmoud, A. M., El-Ghazaly, H. M., & Tawfeek, R. M. (2017). Effect of Kinesio Taping on Diastasis Recti. Med. J. Cairo Univ., 85(6), 2289-2296. Benjamin, D., Van de Water, A., & Peiris, C. (2014). Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy, 100(1), 1-8. doi:https://doi.org/10.1016/j.physio.2013.08.005 Bo, K., Hilde, G., Tennfjord, M. K., Sperstad, J. B., & Engh, M. E. (2017). Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn, 36(3), 716-721. doi:10.1002/nau.23005 Boissonnault, J. S., & Blaschak, M. J. (1988). Incidence of diastasis recti abdominis during the childbearing year. Phys Ther, 68(7), 1082-1086. Chiarello, C. M., McAuley, J. A., & Hartigan, E. H. (2016). Immediate Effect of Active Abdominal Contraction on Inter-recti Distance. J Orthop Sports Phys Ther, 46(3), 177-183. doi:10.2519/jospt.2016.6102 da Mota, P. G. F., Pascoal, A. G. B. A., Carita, A. I. A. D., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual therapy, 20(1), 200-205. El-Kosery, S. M., El-Aziz, A. A., & Farouk, A. (2007). Abdominal muscles exercise program and/or electrical stimulation in postnatal diastasis recti. Bull. Fac. Ph. Th. Cairo Univ, 12(2). El-Mekawy, H. S., Eldeeb, A. M., El-Lythy, M. A., & El-Begawy, A. F. (2013). Effect of Abdominal Exercises versus Abdominal Supporting Belt on Post-Partum Abdominal Efficiency and Rectus Separation. International Journal of Medical and Health Sciences, 7(1), 75-79. Gallus, K. M., Golberg, K. F., & Field, R. (2016). Functional Improvement Following Diastasis Rectus Abdominus Repair in an Active Duty Navy Female. Military Medicine, 181(8), e952-e954. doi:10.7205/MILMED-D-15-00387 Gluppe, S. L., Hilde, G., Tennfjord, M. K., Engh, M. E., & Bo, K. (2018). Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial. Phys Ther, 98(4), 260-268. doi:10.1093/ptj/pzy008 Gluppe, S. L., Hilde, G., Tennfjord, M. K., Engh, M. E., & Bø, K. (2018). Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial [Article]. Physical Therapy, 98(4), 260-268. doi:10.1093/ptj/pzy008. (Accession No. 128847946) Grgic, J., Schoenfeld, B. J., & Latella, C. (2019). Resistance training frequency and skeletal muscle hypertrophy: A review of available evidence. Journal of Science and Medicine in Sport, 22(3), 361-370. doi:https://doi.org/10.1016/j.jsams.2018.09.223 Gunnarsson, U., Stark, B., Dahlstrand, U., & Strigård, K. (2015). Correlation between Abdominal Rectus Diastasis Width and Abdominal Muscle Strength. Digestive Surgery, 32(2), 112-116. doi:10.1159/000371859 Gürşen, C., İnanoğlu, D., Kaya, S., Akbayrak, T., & Baltacı, G. (2016). Effects of exercise and Kinesio taping on abdominal recovery in women with cesarean section: A pilot randomized controlled trial. Archives of gynecology and obstetrics, 293(3), 557-565. doi:10.1007/s00404-015-3862-3 Hills, N. F., Graham, R. B., & McLean, L. (2018). Comparison of Trunk Muscle Function Between Women With and Without Diastasis Recti Abdominis at 1 Year Postpartum. Phys Ther, 98(10), 891-901. doi:10.1093/ptj/pzy083 Kamel, D. M., & Yousif, A. M. (2017). Neuromuscular Electrical Stimulation and Strength Recovery of Postnatal Diastasis Recti Abdominis Muscles [Article]. Annals of Rehabilitation Medicine, 41(3), 465-474. doi:10.5535/arm.2017.41.3.465. (Accession No. 124103784) Keeler, J., Albrecht, M., Eberhardt, L., Horn, L., Donnelly, C., & Lowe, D. (2012). Diastasis recti abdominis: a survey of women's health specialists for current physical therapy clinical practice for postpartum women. Journal of women’s health physical therapy, 36(3), 131-142. Keshwani, N., Mathur, S., & McLean, L. (2018). Relationship Between Interrectus Distance and Symptom Severity in Women With Diastasis Recti Abdominis in the Early Postpartum Period. Physical Therapy, 98(3), 182-190. doi:10.1093/ptj/pzx117 Khandale, S. R., & Hande, D. (2016). Effects of abdominal exercises on reduction of diastasis recti in postnatal women. IJHSR, 6(6), 182-191. Lee, D., & Hodges, P. W. (2016). Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: an observational study. journal of orthopaedic & sports physical therapy, 46(7), 580-589. Lee, H., Kim, I.-G., Sung, C., & Kim, J.-S. (2017). The Effect of 12-Week Resistance Training on Muscular Strength and Body Composition in Untrained Young Women: Implications of Exercise Frequency. Journal of Exercise Physiology Online, 20, 88+. Liaw, L. J., Hsu, M. J., Liao, C. F., Liu, M. F., & Hsu, A. T. (2011). The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. J Orthop Sports Phys Ther, 41(6), 435-443. doi:10.2519/jospt.2011.3507 Litos, K. (2014). Progressive therapeutic exercise program for successful treatment of a postpartum woman with a severe diastasis recti abdominis. Journal of Women’s Health Physical Therapy, 38(2), 58-73. doi:10.1097/JWH.0000000000000013 Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., & Kaczmarczyk, K. (2018). Diastasis recti abdominis - a review of treatment methods. Ginekol Pol, 89(2), 97-101. doi:10.5603/GP.a2018.0016 Mota, P., Pascoal, A., Carita, A., & Bø, K. (2015). Inter-recti distance at rest, during abdominal crunch and drawing in exercises during pregnancy and postpartum. Physiotherapy, 101, e1050-e1051. Newman-Beinart, N. A., Norton, S., Dowling, D., Gavriloff, D., Vari, C., Weinman, J. A., & Godfrey, E. L. (2017). The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS). Physiotherapy, 103(2), 180-185. doi:10.1016/j.physio.2016.11.001 Parker, M. A., Millar, L. A., & Dugan, S. A. (2009). Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction-are they related? Journal of Women’s Health Physical Therapy, 33(2), 15-22. Thabet, A., & Alshehri, M. A. (2019). Efficacy of Deep Core Stability Exercise Program in Postpartum Women with Diastasis Recti Abdominis: A Randomised Controlled Trial (Vol. 19). Tuttle, L. J., Fasching, J., Keller, A., Patel, M., Saville, C., Schlaff, R., . . . Gombatto, S. P. (2018). Noninvasive Treatment of Postpartum Diastasis Recti Abdominis: A Pilot Study. Journal of Women’s Health Physical Therapy, 42(2), 65-75. doi:10.1097/JWH.0000000000000101 Walton, L. M., Costa, A., LaVanture, D., McIlrath, S., & Stebbins, B. (2016). The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, Oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). Physical Therapy and Rehabilitation, 3(1), 3. doi:http://dx.doi.org/10.7243/2055-2386-3-3 Youssef, A. M., Sabbour, A. A., & Kamel, R. M. (2003). Muscle Activity in Upper and Lower Portions of Rectus Abdominis During Abdominal Exercises in Postnatal Women Having Diastasis Recti. Bull. Fac. Ph. Th. Cairo Univ, 8(1).   Listen and enjoy and a big thanks to Always Discreet for sponsoring this episode of The Pelvic Health Podcast. Head to Always Discreet to learn more about bladder leak tips, management and incredible bladder leakage protection!

CPG S1E2: 下背痛臨床指引特輯(2)- 好的分類讓你上天堂，不好的評估讓你住套房 醫療用診斷著重在受傷的組織，對於治療師而言卻如雞肋！ 同樣是Spondylosis（關節退化），為什麼有些人需要做核心訓練，有些人卻只需要做徒手？ 今天我們將介紹下背痛物理治療功能性分類系統，不讓你再被常用的醫療診斷混淆套牢，突破一定要找出受傷組織的思考限制，藉由有效的分類系統搭配出病人需要且適合的治療！ 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b 在這裡追蹤我們得到更多資訊喔 Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Delitto A, George SZ, Van Dillen L, et al. Low back pain. J Orthop Sports Phys Ther. 2012;42(4):A1-A57. https://www.jospt.org/doi/full/10.2519/jospt.2012.42.4.A1

I denne episoden snakker vi med manuellterapeut og idrettsfysioterapeut Lars Haugvad om styrketrening. Paradoksalt er hans hobby og idrettsprestasjoner primært innen snowboard og jøgling, samt innen utholdenhetssegmentet med 2.47på maraton og 2.plass i Ironman. Allikevel slenger han oppdatert litteratur på bordet når vi diskuterer hvordan og hvorfor vi tester styrke og hvilken verdi ulik styrketrening har som tiltak i håndteringen av muskel- og skjelettplager. Vi går løs på noen myter både om styrketrening og coretrening, noe vi også skal høre mer om i fremtidige episoder. Lars er spesialist i idrettsfysioterapi og jobber på Olympiatoppen primært med landslagene i snowboard, beachvolley og seiling og har tidligere jobbet som medisinsk koordinator hopplandslaget. Han er også screeningansvarlig for de norske olympiske utøverne. Lars vil gjerne takke kolleger ved NIMI og Olympiatoppen for faglig utvikling, samt forskningsmiljøene ved Norges Idrettshøgskole, og rette ekstra takk til Gøran Paulsen som lar han surre rundt i fagmiljøet kraft/styrke.Referanser:Beyer, R. et al. Am J Sports Med, 2015.Bjornsen, T. et al. Med Sci Sports Exerc, 2019.Bjornsen, T. et al. J Appl Physiol (1985), 2019.Clausen, M.B. et al. PeerJ, 2018.Cook, J.L. et al. Br J Sports Med, 2009.Docking, S.I. et al. J Musculoskelet Neuronal Interact, 2019.Douglas, J. et al. Sports Med, 2017.Gravare Silbernagel, K. et al. Br J Sports Med, 2019.Halperin, I. et al. Int J Sports Physiol Perform, 2018.Helms, E.R. et al. Strength Cond J, 2016.Ioannidis, J.P. Milbank Q, 2016.Loenneke, J.P. et al. Sports Med, 2019.Low, M. J Orthop Sports Phys Ther, 2018.Malliaras, P. et al. J Orthop Sports Phys Ther, 2015.Moholdt, T. et al. Br J Sports Med, 2014.Rhodes, R.E. et al. Br J Sports Med, 2017.Rio, E. et al. Br J Sports Med, 2015.Roig, M. et al. Br J Sports Med, 2009.Silfies, S.P. et al. Braz J Phys Ther, 2015.Smith, B.E. et al. BMC Musculoskelet Disord, 2014.Smith, B.E. et al. Br J Sports Med, 2019.Steele, J. et al. BMC Public Health, 2017.Wirth, K. et al. Sports Med, 2017. Andre referanser:  2020 Eitzen I, Hollekim-Strand SM, Markussen, H: Idrettsfysioterapeuten. Breddeidrett – toppidrett – aktivitetsmedisin. Se kap 26: Testing og screening av utøvere (Lars Haugvad),Podcast: The InForm Fitness Podcast2015 Gardeton achilles clinical treatment guidelines2019 Hargrove Playing with movement; How to explore the many dimensions of physical health and performance MUSIKK: Joseph McDade-Mirrors   

These questions arise very frequently in rehabilitation. Should it hurt? Is it OK if it hurts? Will I set myself back if it hurts? Will I get better if it doesn't hurt? In this episode we examine a pair of articles that examine these questions. One article is an RCT that covers pain free vs. painful exercise in an acutely injured population, while the other is a systematic review and meta analysis of the approach in chronic pain populations. Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. J Orthop Sports Phys Ther. 2020 Feb;50(2):91-103. doi: 10.2519/jospt.2020.8895. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. Smith BE, Hendrick P, Smith TO, Bateman M, Moffatt F, Rathleff MS, Selfe J, Logan P. Br J Sports Med. 2017 Dec;51(23):1679-1687. doi: 10.1136/bjsports-2016-097383. Epub 2017 Jun 8. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

Dr. Merv Travers is a Senior Research Scholar working in the area of low back pain, tendon pain and exercise rehabilitation at the School of Physiotherapy, The University of Notre Dame Australia. In today's episode, Merv discusses what exactly strength training is, why it’s important for all of our bodies and how physiotherapists can get their patients started and progressing. And of course my son, Rylan, had to compete with his sister in podcast recording (and special blooper takes at the end). Check out the reference list below Merv kindly put together for us! More about Merv...he completed his PhD at Curtin University where he also maintains an Adjunct Research Fellow role. His teaching areas include anatomy and exercise rehabilitation. He has a Masters of Manipulative Therapy and is a qualified strength & conditioning coach (Australian Strength and Conditioning Association – Level 2). Merv’s clinical background includes working in professional rugby union and he provides clinical consultation for complex musculoskeletal conditions at Star Physio, WA. Merv guest lectures nationally and internationally on the topics of strength and conditioning for physiotherapists and tendinopathy rehabilitation, as well as runs an international strength conditioning course for physiotherapists. Optimise Rehab - courses for Strength and Conditioning courses for physios Some key references pertaining to some of this things we spoke about: Public Health and strength training: Steele, J., Fisher, J., Skivington, M., Dunn, C., Arnold, J., Tew, G., . . . Winett, R. (2017). A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health, 17(1), 300. Dankel, S. J., Loenneke, J. P., & Loprinzi, P. D. (2016). Determining the Importance of Meeting Muscle-Strengthening Activity Guidelines: Is the Behavior or the Outcome of the Behavior (Strength) a More Important Determinant of All-Cause Mortality? Mayo Clin Proc, 91(2), 166-174. Strain, T., Fitzsimons, C., Kelly, P., & Mutrie, N. (2016). The forgotten guidelines: cross-sectional analysis of participation in muscle strengthening and balance & co-ordination activities by adults and older adults in Scotland. BMC Public Health, 16(1), 1108. Physio knowledge of guidelines: Lowe, A., Littlewood, C., McLean, S., & Kilner, K. (2017). Physiotherapy and physical activity: a cross-sectional survey exploring physical activity promotion, knowledge of physical activity guidelines and the physical activity habits of UK physiotherapists. BMJ Open Sport & Exercise Medicine, 3(1) Lifting with a neutral spine: Saraceni, N., Kent, P., Ng, L., Campbell, A., Straker, L., & O'Sullivan, P. (2019). To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-Analysis. J Orthop Sports Phys Ther, 1-50 Achilles tendon pain and loading: Murphy, M., Travers, M., Gibson, W., Chivers, P., Debenham, J., Docking, S., & Rio, E. (2018). Rate of Improvement of Pain and Function in Mid-Portion Achilles Tendinopathy with Loading Protocols: A Systematic Review and Longitudinal Meta-Analysis. Sports Medicine. Placebo and Exercise: Crum, A. J., & Langer, E. J. (2007). Mind-set matters: exercise and the placebo effect. Psychol Sci, 18(2), 165-171. Minimum strength dosage: Androulakis-Korakakis, P., Fisher, J. P., & Steele, J. (2019). The Minimum Effective Training Dose Required to Increase 1RM Strength in Resistance-Trained Men: A Systematic Review and Meta-Analysis. Sports Medicine.  

Brought to you by CSMi What does it mean to have self-efficacy? How does that differ from one's perceived locus of control? Are they situation dependent? Can we changed them or just measure them? How does this affect our patients. The Self-Efficacy for Home Exercise Programs Scale: Development and Psychometric Properties. Picha KJ, Lester M, Heebner NR, Abt JP, Usher EL, Capilouto G, Uhl TL. J Orthop Sports Phys Ther. 2019 Sep;49(9):647-655. doi: 10.2519/jospt.2019.8779. Epub 2019 Jul 10. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi After acute hamstrings injury is it ok to push into pain during rehab? Would you actually get better results? If you didn't, why not? If you did, what would that mean? Join us as we look at loading up injured hamstrings with special guest Jack Hickey! Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. J Orthop Sports Phys Ther. 2019 Jun 28:1-35. doi: 10.2519/jospt.2019.8895. [Epub ahead of print] Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi Doing a manipulation on the thoracic spine may help people with cervical radiculopathy but there are a lot of questions to answer here. This paper has an odd presentation of the data and generates concerns when looking at the pretrial registration (https://clinicaltrials.gov/ct2/show/NCT01495728?term=NCT01495728&rank=1). Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. Young IA, Pozzi F, Dunning J, Linkonis R, Michener LA. J Orthop Sports Phys Ther. 2019 May;49(5):299-309. doi: 10.2519/jospt.2019.8150. Epub 2019 Apr 25. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Em sua segunda participação no podcast, Bruno Uemura fala sobre a importância de se preparar bem antes de pleitear corridas de distâncias maiores, como por exemplo as maratonas. Siga-nos no instagram @podcastcorredoresfundao Curta a página do Facebook: @corredoresfundao Apadrinhe o projeto Padrim: padrim.com.br/podcastcorredoresdofundao Artigos citados no episódio Dorn TW, Schache AG, Pandy MG. Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. J Exp Biol 2012; 215(Pt 11):1944-56. Francis P, Whatman C, Sheerin K, Hume P, Johnson MI.The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review. J Sports Sci Med 2019; 18(1):21-31 Fredericson M, Misra AK. Epidemiology and aetiology of marathon running injuries. Sports Med. 2007; 37(4-5):437-9. Kulmala JP1, Avela J, Pasanen K, Parkkari J. Forefoot Strikers Exhibit Lower Running-Induced Knee Loading than Rearfoot Strikers Med Sci Sports Exerc 2013; 45(12):2306-13 Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D'Andrea S, Davis IS, Mang'eni RO, Pitsiladis Y. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 2010; 463(7280):531-5. Nielsen RO, Buist I, Sørensen H, Lind M, Rasmussen S.Training errors and running related injuries: a systematic review. Int J Sports Phys Ther 2012; 7(1):58-75. Petersen J, Sørensen H, Nielsen RØ. Cumulative loads increase at the knee joint with slow-speed running compared to faster running: a biomechanical study. J Orthop Sports Phys Ther 2015; 45(4):316-22. Rasmussen CH, Nielsen RO, Juul MS, Rasmussen S. Weekly running volume and risk of running-related injuries among marathon runners. Int J Sports Phys Ther 2013; 8(2):111-20. Sinclair J Effects of barefoot and barefoot inspired footwear on knee and ankle loading during running. Clin Biomech (Bristol, Avon). 2014 Apr;29(4):395-9. Videbæk S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of Running-Related Injuries Per 1000 h of running in Different Types of Runners: A Systematic Review and Meta-Analysis. Sport Med 2015; 45(7):1017-26.

Brought to you by CSMi Returning to sport after ACL reconstruction is kind of a complex mess. Strength issues, coordination, soreness, not to mention the psychological factors. How do these things interact? What matters? What should we measure and how? Join us with special guest Ryan Zarzycki from Arcadia University! Psychological Readiness to Return to Sport Is Associated With Knee Kinematic Asymmetry During Gait Following Anterior Cruciate Ligament Reconstruction. Zarzycki R, Failla M, Capin JJ, Snyder-Mackler L. J Orthop Sports Phys Ther. 2018 Dec;48(12):968-973. doi: 10.2519/jospt.2018.8084. Epub 2018 Jul 27. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

F. Scott Feil chats with Mike Connors, Mark Milligan, & Dana Tew regarding the upcoming opportunity for the state of Texas to have Direct Access passed along with how PTs in Texas can get involved and contribute to making this a reality. Texas Physical Therapy Association Website: https://www.tpta.org/  TPTA Capital Area District Facebook Page: https://www.facebook.com/CapitalAreaDistrictTPTA/  APTA Direct Access Page on Website: http://www.apta.org/StateIssues/DirectAccess/  APTA Action App on APTA Website: http://www.apta.org/ActionApp/   Texas House Bill 29: https://legiscan.com/TX/bill/HB29/2019  Evidence: 1. Texas Department of State Health Services. (2018) Texas Projections of Supply and Demand for Primary Care Physicians and Psychiatrists, 2017 – 2030. Austin, TX: Texas Health and Human Services https://dshs.texas.gov/chs/hprc/default.shtm  2. Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort ME Horn, JM Fritz BMC health services research 18 (1), 887 https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-018-3699-0    3. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Frogner et al Health Serv. Res. 2018  https://www.researchgate.net/publication/325319327_Physical_Therapy_as_the_First_Point_of_Care_to_Treat_Low_Back_Pain_An_Instrumental_Variables_Approach_to_Estimate_Impact_on_Opioid_Prescription_Health_Care_Utilization_and_Costs    4. Denninger TR, et al. The influence of patient choice of first provider on costs and outcomes: analysis from a physical therapy patient registry. J Orthop Sports Phys Ther. 2018;48(2):63–71. http://pt-cpr.com/images/jospt.2018.7423.pdf    5. Rhon, D. I., Snodgrass, S. J., Cleland, J. A., Sissel, C. D., & Cook, C. E. (2018). Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule. Perioperative medicine (London, England), 7, 25. doi:10.1186/s13741-018-0105-8   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249901/        Biographies:    Michael Connors, PT, DPT, OCS, PhD received his Master of Physical Therapy degree from University of Medicine and Dentistry of NJ-Rutgers University in May 2003 with honors.  Dr. Connors obtained his post professional Doctor of Physical Therapy degree from Temple University in December 2008.  He became a board certified specialist in Orthopaedic Physical Therapy by the American Board of Physical Therapy Specialties in June 2011. He completed a PhD degree in Physical Therapy from Texas Woman's University in August 2017. Dr Connors is the current President of the Texas Physical Therapy Association. He also is an assistant professor within the UNT Health Science DPT Program.   Email: mjconnorspt@gmail.com     Mark Milligan PT, DPT, Cert TPS, OCS, FAAOMPT Mark Milligan is an orthopedic manual therapist that specializes in the evaluation and treatment of musculoskeletal and spinal conditions, both acute and chronic. He is Certified in Therapeutic Pain Science, Applied Prevention and Health Promotion and dry needling, Board Certified in Orthopedics and a Fellow of the American Academy of Orthopedic Manual Therapy.  He earned his Doctorate of Physical Therapy at the University of the Colorado School of Medicine in Denver, Colorado.  He went on to complete an Orthopedic Physical Therapy Residency and Orthopedic Manual Physical Therapy Fellowship with Evidence in Motion (EIM). He is a full-time clinician and Founder of Revolution Human Health, a non-profit physical therapy network and he also founded a continuing education company specializing in micro-education. He is currently a physical therapist with Encompass Home Health in Austin, Texas. Dr. Milligan serves as adjunct faculty for the Doctor of Physical Therapy Programs at South College and The University of St. Augustine.  Dr. Milligan is also primary faculty for Musculoskeletal Courses for EIM. Mark has presented and spoken at numerous state and national conferences and has been published in peer reviewed journals. He is an active member of the TPTA, APTA, and AAOMPT and is current the Capital Area District Chair for the Texas Physical Therapy Association and has great interest in public health and governmental affairs.   Revolution Human Health is a non-profit physical therapy network in Austin, TX that transforms the healing experience by offering access to treatment, education, and movement based therapy for all.  Continuing education division specializes in customized, micro-education for physical therapists across the country. Customizable options of courses include manual therapy, spinal and extremity manipulation, dry needling, clinical reasoning, and preventative care and population health. Please contact us about customizing a course for you and your team! Email: markmilligandpt@gmail.com     Dana Tew PT, DPT, OCS, FAAOMPT CEO/ Program Director of OPTIM Physical Therapy and OPTIM Fellowship Program. Dana specializes in orthopaedic physical therapy. His experience includes clinical management of patients with both acute and chronic orthopedic injuries in the outpatient environment. His practice is focused on integration of manual therapy and exercise into a holistic, evidence-based and biopsychosocial approach to physical therapy treatment. He is the residency manager of Harris Health System’s Orthopedic Physical Therapy Residency Program. He was honored by the Texas Physical Therapy Association Southeastern District, as clinical instructor of the year in 2013. He is also a guest lecturer at Texas Woman’s University and has presented at multiple conferences. Dana earned his APTA Board Certification in Orthopedic Physical Therapy and is also a Fellow, in the American Academy of Orthopedic and Manual Physical Therapists. He has served locally for the Southeastern District, as a delegate for the TPTA, and nationally on the American Board of Physical Therapy Residency and Fellowship Education credentialing council for the APTA.   Email: danatew@gmail.com  

A home exercise program is not very effective if the patient isn't actually, you know, doing the exercises. Is self-report accurate? What about a home program diary? Does it matter? Does this have any impact on our interpretations of previous literature? Self-Reported Home Exercise Adherence: A Validity and Reliability Study Using Concealed Accelerometers. Nicolson PJA, Hinman RS, Wrigley TV, Stratford PW, Bennell KL. J Orthop Sports Phys Ther. 2018 Jul 27:1-38. doi: 10.2519/jospt.2018.8275. [Epub ahead of print] Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

F. Scott Feil chats with Mike Connors, Mark Milligan, & Dana Tew regarding the upcoming opportunity for the state of Texas to have Direct Access passed along with how PTs in Texas can get involved and contribute to making this a reality. Texas Physical Therapy Association Website: https://www.tpta.org/  TPTA Capital Area District Facebook Page: https://www.facebook.com/CapitalAreaDistrictTPTA/  APTA Direct Access Page on Website: http://www.apta.org/StateIssues/DirectAccess/  APTA Action App on APTA Website: http://www.apta.org/ActionApp/   Texas House Bill 29: https://legiscan.com/TX/bill/HB29/2019    Evidence: 1. Texas Department of State Health Services. (2018) Texas Projections of Supply and Demand for Primary Care Physicians and Psychiatrists, 2017 – 2030. Austin, TX: Texas Health and Human Services https://dshs.texas.gov/chs/hprc/default.shtm  2. Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort ME Horn, JM Fritz BMC health services research 18 (1), 887 https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-018-3699-0    3. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Frogner et al Health Serv. Res. 2018  https://www.researchgate.net/publication/325319327_Physical_Therapy_as_the_First_Point_of_Care_to_Treat_Low_Back_Pain_An_Instrumental_Variables_Approach_to_Estimate_Impact_on_Opioid_Prescription_Health_Care_Utilization_and_Costs    4. Denninger TR, et al. The influence of patient choice of first provider on costs and outcomes: analysis from a physical therapy patient registry. J Orthop Sports Phys Ther. 2018;48(2):63–71. http://pt-cpr.com/images/jospt.2018.7423.pdf    5. Rhon, D. I., Snodgrass, S. J., Cleland, J. A., Sissel, C. D., & Cook, C. E. (2018). Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule. Perioperative medicine (London, England), 7, 25. doi:10.1186/s13741-018-0105-8   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249901/    The PT Hustle Website: https://www.thepthustle.com/  Schedule an Appointment with Kyle Rice: www.passtheptboards.com    HET LITE Tool: www.pteducator.com/het    Anywhere Healthcare: https://anywhere.healthcare/ (code: HET)         Biographies:    Michael Connors, PT, DPT, OCS, PhD received his Master of Physical Therapy degree from University of Medicine and Dentistry of NJ-Rutgers University in May 2003 with honors.  Dr. Connors obtained his post professional Doctor of Physical Therapy degree from Temple University in December 2008.  He became a board certified specialist in Orthopaedic Physical Therapy by the American Board of Physical Therapy Specialties in June 2011. He completed a PhD degree in Physical Therapy from Texas Woman's University in August 2017. Dr Connors is the current President of the Texas Physical Therapy Association. He also is an assistant professor within the UNT Health Science DPT Program.   Email: mjconnorspt@gmail.com     Mark Milligan PT, DPT, Cert TPS, OCS, FAAOMPT Mark Milligan is an orthopedic manual therapist that specializes in the evaluation and treatment of musculoskeletal and spinal conditions, both acute and chronic. He is Certified in Therapeutic Pain Science, Applied Prevention and Health Promotion and dry needling, Board Certified in Orthopedics and a Fellow of the American Academy of Orthopedic Manual Therapy.  He earned his Doctorate of Physical Therapy at the University of the Colorado School of Medicine in Denver, Colorado.  He went on to complete an Orthopedic Physical Therapy Residency and Orthopedic Manual Physical Therapy Fellowship with Evidence in Motion (EIM). He is a full-time clinician and Founder of Revolution Human Health, a non-profit physical therapy network and he also founded a continuing education company specializing in micro-education. He is currently a physical therapist with Encompass Home Health in Austin, Texas. Dr. Milligan serves as adjunct faculty for the Doctor of Physical Therapy Programs at South College and The University of St. Augustine.  Dr. Milligan is also primary faculty for Musculoskeletal Courses for EIM. Mark has presented and spoken at numerous state and national conferences and has been published in peer reviewed journals. He is an active member of the TPTA, APTA, and AAOMPT and is current the Capital Area District Chair for the Texas Physical Therapy Association and has great interest in public health and governmental affairs.   Revolution Human Health is a non-profit physical therapy network in Austin, TX that transforms the healing experience by offering access to treatment, education, and movement based therapy for all.  Continuing education division specializes in customized, micro-education for physical therapists across the country. Customizable options of courses include manual therapy, spinal and extremity manipulation, dry needling, clinical reasoning, and preventative care and population health. Please contact us about customizing a course for you and your team!   Email: markmilligandpt@gmail.com     Dana Tew PT, DPT, OCS, FAAOMPT CEO/ Program Director of OPTIM Physical Therapy and OPTIM Fellowship Program. Dana specializes in orthopaedic physical therapy. His experience includes clinical management of patients with both acute and chronic orthopedic injuries in the outpatient environment. His practice is focused on integration of manual therapy and exercise into a holistic, evidence-based and biopsychosocial approach to physical therapy treatment. He is the residency manager of Harris Health System's Orthopedic Physical Therapy Residency Program. He was honored by the Texas Physical Therapy Association Southeastern District, as clinical instructor of the year in 2013. He is also a guest lecturer at Texas Woman's University and has presented at multiple conferences. Dana earned his APTA Board Certification in Orthopedic Physical Therapy and is also a Fellow, in the American Academy of Orthopedic and Manual Physical Therapists. He has served locally for the Southeastern District, as a delegate for the TPTA, and nationally on the American Board of Physical Therapy Residency and Fellowship Education credentialing council for the APTA.   Email: danatew@gmail.com  

It's time for another season finale and we conclude with a discussion of one of the worst things in modern science, the predatory journal. These are journals that make money by publishing literally ANYTHING as long as you pay your fee. The authors of this editorial did just that, publishing a paper where they claimed that manual therapy was applied to a subject who had been dead for 5 years - and he was revived! We explore the history of demonstrations of how bad articles get into publication. Happy Holidays to everyone and we'll see you in March! Manual Therapy Cures Death: I Think I Read That Somewhere. Cook CE, Cleland JA, Mintken PE. J Orthop Sports Phys Ther. 2018 Nov;48(11):830-832. doi: 10.2519/jospt.2018.0107. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Thinking your ACLR patients are using compensatory strategies when they are squatting? Simple! Just watch them do a squat and you'll see it with your own eyes...OR WILL YOU?! This week our super-special guest is study lead-author Susan Sigward, Associate Professor of Clinical Physical Therapy at the University of Southern California. Compensatory Strategies That Reduce Knee Extensor Demand During a Bilateral Squat Change From 3 to 5 Months Following Anterior Cruciate Ligament Reconstruction. Sigward SM, Chan MM, Lin PE, Almansouri SY, Pratt KA. J Orthop Sports Phys Ther. 2018 Sep;48(9):713-718. doi: 10.2519/jospt.2018.7977. Epub 2018 Jun 12. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Anterior Cruciate Ligament Reconstruction (ACLR) is a procedure that has a lot published on it yet there are still second injury rates as high as 40% in some populations. There seems to be some consensus in the literature as to how these patients should be managed, but do physical therapists actually manage them this way? Embarrassingly the answer is no. Rehabilitation Practice Patterns Following Anterior Cruciate Ligament Reconstruction: A Survey of Physical Therapists. Greenberg EM, Greenberg ET, Albaugh J, Storey E, Ganley TJ. J Orthop Sports Phys Ther. 2018 Oct;48(10):801-811. doi: 10.2519/jospt.2018.8264. Epub 2018 May 22. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

A lot of people out there, including medical providers, believe that our understanding of chronic traumatic encephalopathy (CTE) or even concussions is complete and conclusive. As with many things, our understanding is very much just emerging. Everything from management to definitions of terms are constantly changing. Is the horse still chasing the cart here? In this episode we take a little tour of what we know and don't know with special guest Jason Hugentobler, the director of the sports physical therapy residency program at Cincinnati Children's Hospital. Chronic Traumatic Encephalopathy: The Horse Is Still Chasing the Cart. Asken BM, Bauer RM. J Orthop Sports Phys Ther. 2018 Sep;48(9):672-675. doi: 10.2519/jospt.2018.0612. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Many clinicians wonder is tests such as the quad index are good enough for returning an athlete to sport after ACLR. Turns out, clinicians aren't even doing that! In the episode we have special guests Allison Toole and Matt Ithurburn discussing their recent paper that looked at how athletes tested after they had already been cleared to return to play after ACLR. Spoiler - they didn't look very good. Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs? Toole AR, Ithurburn MP, Rauh MJ, Hewett TE, Paterno MV, Schmitt LC. J Orthop Sports Phys Ther. 2017 Nov;47(11):825-833. doi: 10.2519/jospt.2017.7227. Epub 2017 Oct 7. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Key tag words: foot types, rearfoot, forefoot, pronation, supination, shoe fit, forefoot varus, forefoot supinatus, rearfoot inversion, ankle rocker, injuries, rehab, corrective exercises Rearfoot varus and Rearfoot valgus. Knowing the anatomy of your rear foot and its anatomic and functional posturing can lead to many problems in anyone. If you do not know the rearfoot type and posturing, you will not understand the rest of the foot mechanics. Without this knowledge, you will not know the reason for midfoot or forefoot problems, not understand what shoe you are in, or even why the shoe, footbed, orthotic you have chosen is either not fixing your problems, or causing them.  Join us on a journey down the rearfoot rabbit hole over the next hour.  Plus a few funny stories to lighten the biomechanics-heavy dialogue. Show links: Show sponsors: www.newbalancechicago.com www.thegaitguys.com That is our website, and it is all you need to remember. Everything you want, need and wish for is right there on the site. Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).   Our podcast is on iTunes, Soundcloud, and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.   Show Notes: https://www.ncbi.nlm.nih.gov/pubmed/27134364 https://www.ncbi.nlm.nih.gov/pubmed/25364132 RearFoot positions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3588658/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990938/ Powers CM, Maffucci R, Hampton S. Rearfoot posture in subjects with patellofemoral pain. J Orthop Sports Phys Ther. 1995 Oct;22(4):155-60. Power V, Clifford AM. The Effects of Rearfoot Position on Lower Limb Kinematics during Bilateral Squatting in Asymptomatic Individuals with a Pronated Foot Type. J Hum Kinet. 2012 Mar;31:5-15. doi: 10.2478/v10078-012-0001-0. Epub 2012 Apr 3. Shultz SP, Song J, Kraszewski AP, Hafer JF, Rao S, Backus , Mootanah R, Hillstrom HJ. An Investigation of Structure, Flexibility and Function Variables that Discriminate Asymptomatic Foot Types. J Appl Biomech. 2016 Dec 19:1-25. [Epub ahead of print]  

The quad index (side to side strength comparison of the quadriceps) is one of the best known correlations to knee function, but can you test it accurately in the clinic? Do you need an expensive electromechanical dynamometer or can you get by with simpler tools? Also, are you going to CSM? Diagnostic Accuracy of Handheld Dynamometry and 1-Repetition-Maximum Tests for Identifying Meaningful Quadriceps Strength Asymmetries. Sinacore JA, Evans AM, Lynch BN, Joreitz RE, Irrgang JJ, Lynch AD. J Orthop Sports Phys Ther. 2017 Feb;47(2):97-107. doi: 10.2519/jospt.2017.6651. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Training and activity is your no1 option when recovering from low back pain.  This episode introduces two of the most important exercises for building up strength within your lower back and practice movement control.   Strength Training for People with Low Back Pain  Always check with your medical professional if it is save for you to exercise! This exercises are not a substitute for individual medical treatment but aim to complement and support your recovery process. Find all videos for this episode on: http://mybackrecovery.com/resources.page video episode 07   The exercises we are going to explore on this episode build up on your basic movement control skills and are both: challenging your movement control skills helping you building up strength and strength endurance within your back muscles  If you have listened to episode 06 you already have come to learn that clinical guidelines recomend therapeutic exercise and activity with strong supporting evidence for the management of chronic low back pain. A recent review concluded that: "The hypothesis of specific lumbar extensor deconditioning as being a causal factor in LBP is presently well supported." meaning: weak back muscles could cause LBP.1 It further says: "It is by no means the only causative factor and further research should more rigorously test this hypothesis (...) however specific exercise may be a worthwhile preventative and rehabilitative approach."   In this episode i will share some of my most favorite exercises for building up strength within your back extensor muscles and practice movement control. These classis exercises will give you more options with your training, and will take your training to the next level.   Training introduced on 'my Back recovery' so far: Episode 03: Easy and back specific circle training with save loading profiles in terms of exercising. A first step in starting to work on strength and strength endurance as well as stability. Also a great way of improving blood flow in your muscles. video   Episode 05: Movement control exercises - basic skills for exercising - moving your pelvis/hip influences the posture of your lower back - being able of keeping a neutral position during certain exercises. video   As you learned the basics for movement control (ep 5) and started to get familiar with a back specific circle training (ep 3) it´s time for you to take the next step!   'Good Morning' & Squat Video The good morning and the squat are static exercises for your back. This means no movement in the back while you are doing the exercises. They are more difficult to perform than the exercise-set from episode 03.  It really pays of focusing on doing the good morning and the squat with correct posture! Once you got this you can do most of other exercises in a correct way and will have more options to adjust exercises to your own needs. Remember to always adjust your exercises to your individual situation so that you are able to perform pain free and without aggravation of your symptoms. Good Morning The 'good morning' is great for building strength2 and movement control. Actually the 'good morning' is also used as a part of a validated test series used to detect impaired movement control within people with LBP.3 It works the gluteus, hamstrings and lower back.   Basically the 'good morning' is about bending forward with a straight (neutral) back. Remember the last movement control exercise from episode 05: sitting and rocking forward and backward while keeping a moderate arch of your lower back with no movement in the back. The good morning exercise is the same in a standing position.   Stay upright, bend your knees slightly. This will help you doing the movement from your hips (because your hamstrings are not that much stretched when you are bending your knees). Bend forward while you are keeping a straight back (remember straight means slightly curved, we wanna see a moderate arch (like a weightlifter) at the lower back, if your back seems to be flat, it is already flexed, we want to trigger those back extensor muscles and keep a neutral position thats why we need that arch!  This exercise should be pain free! So if you are doing it correctly and start to experience pain while leaning forward, remember the golden training principles. Adjust the exercise. Don´t go so far. Maybe you can do it leaning fwd 45 degrees out from the vertical position and will feel fine, and pain starts only if you go further. So respect your pain and adjust the exercise. Most people who hadn´t done this kind of exercise will find it difficult to perform in the beginning. Here is how i teach the 'good morning' to my clients:   First i start with all the exercises from episode 05. If you havent mastered these go back and work on them until you feel comfortable with them. video - basic movement control skills episode 05 Most of the time the problem is that people don´t know how to keep good posture in their lower back. The movement you need to do is 'push your bum out while leaning forward'. This will result in hip flexion and back extension and result in a moderate arch in your lower back. Again some people could experience discomfort when arching to much. So experiment and find a position that is comfortable and pain free. The basic movement control skills from episode 05 will help you with that!   Than i let my clients sit on a high chair or at the edge of a table with their feet standing on the ground. Now it´s like a mix of the rocking forward and backward exercise we did at the end of episode 05, and the good morning. It´s a bit easier than in the standing position. If you feel fine proceed to the standing position.   It´s natural that when leaning forward to much, you will loose the arch in your lower back. So just go as far as it is pain free and you can keep correct posture. Even when you are doing only a small movement like 10-20 degrees forward bending you still train your muscles and start to practice movement control.   One thing i experience quite often when people are doing the good morning is that they are squatting simultaneously. Although there is nothing harmful with this i suggest making two exercises out of it and not mixing the good morning and the squat. With this strategy you will gain better movement control and have more variability in you training options. So keep your knees slightly bent but try not to squat while leaning forward, and check this in a mirror from your side! You have to actively work for not bending your knees while leaning forward.   Squats Absolut classics! Squats also work your back extensor muscles. Squatting is a typical everyday activity. Besides working all major muscle groups in your body and helping you stay fit, good form/posture with squatting will help you becoming more aware of your posture in everyday activities. The squat is almost the same as the good morning but with knee-movement and less dynamic leaning forward and backward.  Starting position: Standing upright, having your weight evenly distributed to both of your feet, leaning a bit forward and squatting down. Again keep that lower back arched when leaning forward. If you can control your back already let´s check your knees. When squatting down look to your knees and feet: have your toes pointing straight forward and try to keep your medial border of your kneecap outside of your big toe. This will result in proper hip knee ankle alignment and less stress and strain on your knee. 4, 5 You can do the squat in a narrow stance or a wide stance. But keep your feet pointing forward and mind your knee position!     find more information at www.mybackrecovery.com   Literatur:  Steele J, Bruce-Low S, Smith D. A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning. Curr Med Res Opin. 2014;30(January):1-47. doi:10.1185/03007995.2013.875465. Steele J, Bruce-Low S, Smith D. A Review of the Clinical Value of Isolated Lumbar Extension Resistance Training for Chronic Low Back Pain. PM R. 2014;(OCTOBER 2014):1-18. doi:10.1016/j.pmrj.2014.10.009. Luomajoki H, Kool J, de Bruin ED, Airaksinen O. Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord. 2008;9(Mc):170. doi:10.1186/1471-2474-9-170. Lee TQ, Morris G, Csintalan RP. The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther. 2003;33(11):686-693. doi:10.2519/jospt.2003.33.11.686. Koga H, Nakamae A, Shima Y, et al. Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med. 2010;38(11):2218-2225. doi:10.1177/0363546510373570.      

Running on a treadmill is not the same as running over ground!!! Or is it? It appears that in most respects it's a wash. But what about regarding loads to the patellofemoral joint and the Achilles tendon? Find out as Rich Willy (the author of the paper) joins Erik and JW to discuss this and more! Hip Patellofemoral Joint and Achilles Tendon Loads During Overground and Treadmill Running. Willy RW, Halsey L, Hayek A, Johnson H, Willson JD. J Orthop Sports Phys Ther. 2016 Aug;46(8):664-72. doi: 10.2519/jospt.2016.6494. Epub 2016 May 12. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission