Podcasts about sports physical therapy

Thanks for listening to The SHIFT Show! Check out SHIFT's most popular courses here!https://courses.shiftmovementscience.com/Rehabbing elbow injuries in young gymnasts requires a specific approach, especially when dealing with osteochondritis dissecans (OCD) lesions and other complex conditions that lack standardized return-to-sport protocols.• Elbow OCD occurs when repetitive compression creates a "pothole" in the cartilage of the capitellum• OATS procedure uses a bone plug from the knee to replace damaged elbow cartilage• Young patients who are casted post-surgery develop significant stiffness issues• Creative approaches like using heat while allowing distractions help children tolerate stretching• Weight-bearing should typically be delayed until 12 weeks post-surgery, unlike knee/ankle protocols• Strength training with BFR can help maintain muscle mass during non-weight-bearing phases• Handstand progressions should begin with sideways walking against a wall to control loading• Return-to-sport protocols should follow 2-week phases with progressive increases in repetitions and surface hardness• Hand position during skills affects injury risk—neutral or slightly turned in positions distribute forces better• Strength testing should assess shoulder, elbow, and grip symmetry before return to full gymnasticsWe're finalizing a comprehensive paper for the Journal of Sports Physical Therapy that will provide detailed rehab protocols from day one post-surgery through six months of recovery, creating a resource for clinicians who don't regularly work with gymnasts.We appreciate you listening! To learn more about SHIFT, head here - https://shiftmovementscience.com/To learn about SHIFT's courses, check our website here - https://courses.shiftmovementscience.com/Also, please consider rating, reviewing, and sharing the podcast with your friends! Thanks :)Thanks for listening to The SHIFT Show! Check out SHIFT's most popular courses here! https://courses.shiftmovementscience.com/Want to join our online educational community of over 1000 gymnastics professionals and get 40+ hours of gymnastics lectures? Join The Hero Lab below!https://shiftmovementscience.com/theherolab/ Check out all our past podcast episodes here!https://shiftmovementscience.com/podcast/

In this episode, we cover the science behind fatigue and readiness.  Try Hybrid Athlete Training (Code: RUNPR2025): https://marketplace.trainheroic.com/workout-plan/team/the-movement-system-hybrid-athlete-team?attrib=538955-pod Program Design 101: https://www.themovementsystem.com/programdesigncourse  

In this episode, we dive into the treatment and rehabilitation of patellar tendinopathy, specifically patellar tendinosis. This condition is notoriously difficult to treat, often requiring six months to a year for full recovery, but with the right approach, athletes and active individuals can return to full function.Using a structured, stage-based progression, we discuss how to:Implement isometric exercises to manage pain and begin strengtheningProgress to isotonic loading to rebuild muscle strengthIntroduce energy storage and plyometric training to restore full functionPrevent recurrence by optimizing load management and recovery strategiesThis episode is based on the research by van Ark et al. (2018):"Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations" in JOSPT (Journal of Orthopaedic & Sports Physical Therapy).Support the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. Join the email list HERE On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend Medbridge because it's genuinely valuable.) Optimize Your Patient Care with Tindeq Looking for a reliable dynamometer to enhance your clinical measurements? Tindeq ...

Scott Greenberg is a sports medicine physio with 25 years of experience working with University of Florida Gator athletes, professional athletes, and Olympians. He is the current Manager of Operations for UF Health's Department of Rehabilitation, the director of their sports and orthopedic physical therapy residency programs, and the Membership Chair of the American Academy of Sports Physical Therapy. Scott also co-founded the Gait Geeks, whose mission is to empower healthcare professionals and enthusiasts with specialized knowledge in walking and running gait analysis, and the fabrication and implementation of foot orthoses.-------The Gait GeeksScott's XScott's Instagram------Noah's InstagramFor questions and business inquiries: noahmandelphysio@gmail.com

In this episode of the Braun Performance & Rehab Podcast, Dan is joined by Regan Dewhirst to discuss a variety of considerations for working with the ski athlete, including biomechanics, return to snow progressions, and more! Regan Dewhirst is a Physical Therapist and Board Certified Orthopedic Clinical Specialist, currently serving as the lead PT for Olympic Gold Medalist Mikaela Shiffrin. Regan attended the University of Vermont, where she earned a Bachelor's degree in Exercise and Movement Science in 2013, followed by a Doctorate of Physical Therapy in 2015. During her time at UVM, she was a 4-year member of the NCAA Division I Women's Soccer Team. Regan started her professional career in an outpatient sports clinic, where she completed a post-doctoral Orthopedic Residency through Arcadia University. Most recently she coached at Tom Brady's Performance and Recovery Center (TB12). Regan's key areas of interest include athletic spine management, recovery science, and return to snow programming. She is passionate about continued learning, teaching, and she is committed to building a team environment that allows all members to excel at the highest levels. When not traveling, Regan enjoys running, mountain biking, CrossFit, and spending time on the water. Regan is entering her 5th season with Team Shiffrin.For more on Team Shiffrin, be sure to follow @mikaelashiffrin on all platforms, and check out her "moving right along" YouTube series! *SEASON 6 of the Braun Performance & Rehab Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit -BE SURE to use coupon code BraunPR25% to save 25% on your Isophit order! **Season 6 of the Braun Performance & Rehab Podcast is also brought to you by Oro Muscles. For more on Oro, please check out www.oromuscles.com Episode Affiliates: Kinetic Arm: Use code " BraunPR " at checkout! MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to by clicking here: https://linktr.ee/braun_pr Liked this episode? Leave a 5-star review on your favorite podcast platform

In this episode, Noah spoke with Jason Tuori. Jason is a sports PT out of Rochester, New York and is the Vice Chair of the Running Special Interest Group of the American Academy of Sports Physical Therapy. He is also the host of the popular podcast, PT Inquest. Jason has a special interest in running performance and running related injuries, the latter of which is discussed in great detail in this episode. Enjoy!-------Become a better physiotherapist with Physio Network's Masterclass video courses. Use this link and enter the code "Noah10" for an exclusive 10% off on Masterclass:Masterclass Video Courses - Physio Network (physio-network.com)------Jason's InstagramJason's XJason's Course------Noah's InstagramFor questions and business inquiries: noahmandelphysio@gmail.com

Dr. Rosy Boa dives into the science behind pole dancing, discussing the physical adaptations required for the sport. She clarifies the specific strength requirements for pole dancers, emphasizing the importance of specialized training over general fitness. Through examining recent studies, she highlights how pole dancing improves core, upper body strength, and grip strength, while identifying the need for anti-rotational strength, unilateral strength, and proper shoulder flexion. The podcast also offers insights into the unique physical and psychological benefits that come with pole dancing experience. Learn more and take class with Rosy online at https://www.slinkthroughstrength.com/ Chapters: 00:00 Introduction and Clarification 00:21 Common Misconceptions About Pole Dancing 00:41 Specific Physical Adaptations in Pole Dancers 02:33 Research on Pole Dancing Strength 03:39 Methods of Measuring Pole Strength 05:26 Studies on Pole Dance Training Effects 10:14 Psychological and Physiological Outcomes 12:58 Recommended Strength Training for Pole Dancers 18:36 Conclusion and Final Thoughts Citations Hawley, J. A. (2002). Adaptations of skeletal muscle to prolonged, intense endurance training. Clinical and experimental pharmacology and physiology, 29(3), 218-222. Gustavo F. Pedrosa, Fernando V. Lima, Brad J. Schoenfeld, Lucas T. Lacerda, Marina G. Simões, Mariano R. Pereira, Rodrigo C.R. Diniz & Mauro H. Chagas. (2022) Partial range of motion training elicits favorable improvements in muscular adaptations when carried out at long muscle lengths. European Journal of Sport Science 22:8, pages 1250-1260. Ignatoglou, D., Paliouras, A., Paraskevopoulos, E., Strimpakos, N., Bilika, P., Papandreou, M., & Kapreli, E. (2024). Pole Dancing-Specific Muscle Strength: Development and Reliability of a Novel Assessment Protocol. Methods and Protocols, 7(3), 44. Nawrocka, A., Pawelak, Z., & Mynarski, A. (2024). Longitudinal Effects of Pole Dance Training on Body Composition and Muscular Strength in Women. Greenspan, S. J., & Stuckey, M. I. (2024). Preparation For Flight: The Physical Profile of Pre-Professional and Professional Circus Artists in the United States. International Journal of Sports Physical Therapy, 19(5), 591.  Dias, A. R. L., De Melo, B. L., Dos Santos, A. A., Silva, J. M. A., Leite, G., Bocalini, D. S., ... & Serra, A. J. (2022). Women pole dance athletes present morphofunctional left ventricular adaptations and greater physical fitness. Science & Sports, 37(7), 595-602. Nicholas, J., Dimmock, J. A., Alderson, J. A., Donnelly, C. J., Jackson, B., Dimmock, J. A., ... & Donnelly, C. J. (2024). Exploring the psychological and physiological outcomes of recreational pole dancing: a feasibility study. Circus: Arts, Life, and Sciences, 2(2).

The complex world of clinical practice in musculoskeletal rehabilitation brings many challenges. Some you might feel prepared for, while others...not so much. Musculoskeletal physiotherapist and shoulder specialist, Jared Powell, is here to reassure us that no-one expects you to have all the answers, encourage us all to think carefully and critically when evaluating information, and to embrace a work-related niche that resonates with your passions and strengths. Jared shares ideas on how to succeed as a compassionate and effective musculoskeletal rehabilitation specialist. ------------------------------ RESOURCES "Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

Today brings a refresher on best practice in managing non-traumatic shoulder pain. Professor Karen McCreesh (University of Limerick) guides the listener to the best available clinical practice guidelines and runs the ruler over different approaches to exercise therapy. ------------------------------ RESOURCES Diagnosing, managing and supporting return to work for people with rotator cuff disorders (practice guideline): https://www.jospt.org/doi/10.2519/jospt.2022.11306 Efficacy of exercise therapy - systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12453 GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34382931/ JOSPT Insights episode 173 (shared decision making): https://podcasts.apple.com/ca/podcast/ep-173-shared-decision-making-what-it-is-and-what-it/id1522929437?i=1000651049481 or https://open.spotify.com/episode/6CCh5FRTGAsz54bdpWbYGB?si=c40b2c227eb94a12 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

In Folge #80 des PhysioBib Podcasts, in dieser Folge hatten wir Prof. Dr. Daniel Belavy zu Gast. Daniel ist Professor an der Hochschule für Gesundheit in Bochum und kommt ursprünglich aus Australien, wo er unter anderem Professor an der Deakin University in Melbourne war. Daniel war vor zwei Jahren in Folge 35 unseres Podcast schon mal zu Gast, seitdem hat sich bei ihm und auch bei uns einiges getan und wir haben die Gelegenheit genutzt aktuelle Entwicklungen an seiner Hochschule zu besprechen und über ein Thema zu sprechen, dass wir schon länger mal abdecken wollten und zwar das Publizieren von wissenschaftlichen Arbeiten und Abschlussarbeiten. Daniel ist Associate Editor bei zwei wichtigen Physiotherapie Journalen nämlich dem Journal of Orthopaedic & Sports Physical Therapy und BMJ Open Sports & Exercise Medicine, und hat uns in dieser Folge Einblicke gegeben wie ein Publikationsprozess einer wissenschaftlichen Arbeit abläuft, worauf man beim Schreiben von Publikationen achten sollte und wir haben ein wenig darüber gesprochen wie wichtig Publikationen für die Entwicklung der Deutschen Physiotherapie sind. Viel Spaß bei der Folge! Mehr zu unserem Gast: https://tinyurl.com/3n97s747 DOSage of Exercise for chronic low back pain disorders (DOSE): https://doi.org/10.1136/bmjsem-2024-002108 Redaktion: Nils Reiter & Noak Liem Produktion: Loïc Luttmann __________________________________________________________________________________________

Today's episode takes the spirit of our popular SPORTS CORNER series, and flips it to learning about playing a leading role in the world of sports medicine and rehabilitation. Dr Ciara Burgi has worked across collegiate, professional men's, and professional women's sport, and has a ton of wisdom to share. From building rapport with athletes and patients, to valuing your work in the present without looking too far ahead to what might (or might not) come next, and doing what you can with the resources at your disposal, are among the topics Dr Burgi covers. ------------------------------ RESOURCES The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the extended early-bird price and the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

Qual è il ruolo nascosto dei glutei nel nostro benessere fisico? Analizziamo l'importanza dei glutei nella postura e nella prevenzione degli infortuni, offrendo esercizi mirati e consigli pratici per mantenerli in salute. Unisciti a noi per migliorare la tua consapevolezza e cura del corpo. Segui Postura Da Paura su Instagram e Facebook per trovare altri consigli e informazioni per vivere una vita più equilibrata e serena. Per noi il movimento è una medicina naturale, visita il sito www.posturadapaura.com per trovare il programma di allenamento più adatto alle tue esigenze. Come promesso ecco le fonti citate durante la puntata: Barker, P. J., Hapuarachchi, K. S., Ross, J. A., Sambaiew, E., Ranger, T. A., & Briggs, C. A. (2014). Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint. Clinical Anatomy, 27(2), 234–240. https://doi.org/10.1002/ca.22233 Boren, K., Conrey, C., le Coguic, J., Paprocki, L., Voight, M., & Robinson, T. K. (2011). ELECTROMYOGRAPHIC ANALYSIS OF GLUTEUS MEDIUS AND GLUTEUS MAXIMUS DURING REHABILITATION EXERCISES. In The International Journal of Sports Physical Therapy | (Vol. 6, Issue 3). Cooper, N. A., Scavo, K. M., Strickland, K. J., Tipayamongkol, N., Nicholson, J. D., Bewyer, D. C., & Sluka, K. A. (2016). Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal, 25(4), 1258–1265. https://doi.org/10.1007/s00586-015-4027-6 Jeong, U.-C., Sim, J., Kim, C.-Y., hwang-Bo, gaK, & nam, C. (n.d.). The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. Kendall, K. D., Schmidt, C., & Ferber, R. (2010). The Relationship Between Hip-Abductor Strength and the Magnitude of Pelvic Drop in Patients With Low Back Pain. In Journal of Sport Rehabilitation (Vol. 19). Mendieta, C. G., & Sood, A. (2018). Classification System for Gluteal Evaluation: Revisited. In Clinics in Plastic Surgery (Vol. 45, Issue 2, pp. 159–177). W.B. Saunders. https://doi.org/10.1016/j.cps.2017.12.013 Neumann, D. A. (2010). Kinesiology of the Hip: A Focus on Muscular Actions. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 82–94. https://doi.org/10.2519/jospt.2010.3025

Isometric Training Deep Dive! Shoutout to Alex Naterra for a lot of the info provided here: https://www.sportsmith.co/courses/isometric-strength-training-online-course/ Amazon Crane Scale: https://www.amazon.com/shop/themovementsystem/list/79J7X77UCVJ5?ref_=aip_sf_list_spv_ofs_mixed_d  

In this episode of the Brawn Body Health and Fitness Podcast, Dan is joined by Dr. Justin Tallard to discuss exercise programming considerations for Overhead Athletes. Dr. Justin Tallard is the MiLB Rehab Coordinator for the Philadelphia Phillies. Justin completed his Sports Physical Therapy residency at Houston Methodist where he worked with Rice University Athletics, the Houston Astros, and the Houston Dyanamo and Dash. He is Board Certified as a Sports Clinical Specialist (SCS), and a Certified Strength and Conditioning Specialist (CSCS). Justin graduated with his Doctorate in Physical Therapy from the University of Texas at El Paso in 2017, and his Bachelors degree in Sport Science and Spanish from Loras College in 2014. For more on Justin, you can find him on LinkedIn *SEASON 5 of the Brawn Body Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit - BE SURE to use coupon code brawnbody10 at checkout to save 10% on your Isophit order! Episode Sponsors: MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! PurMotion: "brawn" = 10% off!! GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Training Mask: "BRAWN" = 20% off at checkout https://www.trainingmask.com?sca_ref=2486863.iestbx9x1n Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform! --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

Dive into the world of elite sports physical therapy with hosts Chris Gorres and Craig Hoffman in the latest episode of the "Train With The Best Podcast." Joining them is Zack Tabrani, a distinguished physical therapist who serves as the personal therapist to a Major League Baseball player. In this insightful discussion, Zack shares his unique experiences and sheds light on the intricacies of his work outside traditional clinical settings.

In this episode of the Healthy, Wealthy, and Smart podcast, host Dr. Karen Litzy discusses the state of physical therapy with guest Dr. Airelle Giordano, Director of Clinical Services and Residency Training at the University of Delaware. Dr. Giordano, a candidate for president-elect of the American Academy of Sports Physical Therapy, shares her journey from being a former athlete to becoming a physical therapist with a passion for teaching and mentoring. Tune in to learn more about the importance of participating in professional elections and shaping the future of physical therapy.   Show notes:  [00:02:43] Diverse Practice in Sports Therapy. [00:07:22] The future of physical therapy. [00:11:53] Knowledge translation in physical therapy. [00:16:30] Knowledge translation in research. [00:18:56] Knowledge translation for clinicians. [00:24:25] Knowledge translation is important. [00:31:41] Communication challenges in organizations. [00:34:28] Collaboration among different academies. [00:39:07] Advice for 20-year-old self.   More About Dr. Arielle Giordano: Airelle Giordano is the Director of Clinical Services and Residency Training at the University of Delaware PT Clinic. She is Board Certified as a Sports and Orthopedic Clinical Specialist and an Associate Professor in the Doctor of Physical Therapy Program. She is the current Education Committee Chair for the American Academy of Sports Physical Therapy (AASPT) and is a co-chair for the ESKKA-AOSSM-AASPT consensus initiative on meniscus rehabilitation.  Her current clinical focus is on complicated knee injuries and gait, post-concussion rehabilitation, and is a current co-author on the multi-Academy Clinical Practice Guideline on Concussion Rehabilitation. She also focuses on mentoring the next generation of sports and orthopedic specialists.   Resources from this Episode: University of Delaware PT Clinic Airelle's Instagram Airelle's X (Twitter)   Jane Sponsorship Information: Book a one-on-one demo here Mention the code LITZY1MO for a free month     Follow Dr. Karen Litzy on Social Media: Karen's Twitter Karen's Instagram Karen's LinkedIn   Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio

On this episode, we are joined by Ann Lucado, a physical therapist and Certified HandTherapist who led a team of clinicians to develop the clinical practice guideline, “LateralElbow Pain and Muscle Function Impairments.” Ann shares with us what a clinicalpractice guideline is and how they are developed, as well as the results of this guidelineand how therapists treating patients with lateral elbow pain can best utilize theevidence.Guest bio:Ann Lucado, PT, PhD, CHTAnn Lucado is a physical therapist and Certified Hand Therapist who has specialized inupper extremity and orthopedic rehabilitation for the past 30 years. She is an activemember of the APTA's Academy of Orthopedic Physical therapy and is currently servingas the Chair of the Research Committee and Coordinator of Clinical Practice GuidelineDevelopment for the Academy of Hand and Upper Extremity Physical Therapy. Shereceived her Master of Science in Community Health Education and Physical Therapyand received her PhD in research methodology and design in Physical Therapy. Dr.Lucado is currently an Associate Professor in the Doctor of Physical Therapy Programat Mercer University located in Atlanta, Georgia. She has conducted numerousinstructional seminars and is the author of several research articles related to elbowtendinopathies. She headed the Guideline Development group for the recentlypublished Clinical Practice Guideline related to Lateral Elbow Pain and Muscle FunctionImpairments in the Journal of Orthopedic and Sports Physical Therapy.https://www.linkedin.com/in/ann-lucado-6a656520/https://instagram.com/annlucado?igshid=NzZlODBkYWE4Ng%3D%3D&utm_sour

About the Episode:Ever wondered what it's like to be a PT in the NFL? Today we've got the playbook as we talk to Jess Galey, a recent graduate of UPMC NFL Sports PT Residency who worked with the Pittsburgh Steelers. Jess breaks down her day-to-day responsibilities, the pros and cons of working with professional athletes, and the importance of sports residencies for advanced training.What You'll Learn:The roles of a Sports PT in a pro football training roomHow PTs collaborate with athletic trainers and other healthcare providersThe value of advanced training through sports residenciesTips for those considering a career in sports physical therapyGuest:Jess Galey, Board Certified Sports PT, Adjunct Assistant Professor, Sports Residency Mentor

In this episode of the Brawn Body Health and Fitness Podcast, Dan is joined by Eric D'Agati, Dr. Nathan Denning, & Dr. Justin Tallard to discuss baseball and a variety of S&C and PT considerations, including return to sport, load management, concerning trends amongst youth sports, and more. Eric D'Agati has spent the past 20 years in the fitness industry as a coach, trainer and instructor, pioneering his unique approach to client assessment, performance enhancement and injury prevention. His company, ONE Human Performance, provides fitness, training and wellness services in New Jersey and operated as multidisciplinary facility for 12 years before Eric moved on to focus solely on his coaching and consulting services. Eric has an incredible resume with numerous certifications and valuable mentoring experiences - he's learned from the likes of Gray Cook and Charles Poliquin and has over 8 certifications in addition to an exercise physiology degree. He teaches for the Functional Movement Systems (FMS) course series and is on the advisory board for On Base University baseball screenings. For more on Eric, you can find him on Instagram @ericdagati Dr. Nathan Denning is a physical therapist and owner of Integrated Performance. He has had years of experience working with high level and professional athletes during his time spent with EXOS as well as the Minnesota Twins. He specializes in Return to Sport, Movement Optimization, and injury Risk Reduction. For more on Nathan and Integrated Performance, be sure to check out @integrated.performance on Instagram, @Nate_Denning on Twitter, and Integrated Performance on Facebook Dr. Justin Tallard is the MiLB Rehab Coordinator for the Philadelphia Phillies. Justin completed his Sports Physical Therapy residency at Houston Methodist where he worked with Rice University Athletics, the Houston Astros, and the Houston Dyanamo and Dash. He is Board Certified as a Sports Clinical Specialist (SCS), and a Certified Strength and Conditioning Specialist (CSCS). Justin graduated with his Doctorate in Physical Therapy from the University of Texas at El Paso in 2017, and his Bachelors degree in Sport Science and Spanish from Loras College in 2014. For more on Justin, you can find him on LinkedIn or reach out to him at justinctallard@gmail.com To keep up to date with everything Dan is doing on the podcast, be sure to subscribe and follow @brawnbody on social media! Episode Sponsors: MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! PurMotion: "brawn" = 10% off!! TRX: trxtraining.com coupon code "TRX20BRAWN" = 20% off GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Training Mask: "BRAWN" = 20% off at checkout https://www.trainingmask.com?sca_ref=2486863.iestbx9x1n Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

Well Kyle got his knickers in a bunch over an article's title so we decided to talk about it for an hour or so. Within, Johnny, Ben, Zac, and Kyle talk about how they go about screening BFR papers to decide if they deserve a closer read. The paper that got this conversation going: * Grossl, F. S., Da-Sila-Grigoletto, M. E., Ferretti, F., Copatti, S. L., Corralo, V. da S., & De-Sá, C. A. (2023). The use of a single resistance exercise with or without blood flow restriction in the treatment of pain in knee osteoarthritis: a randomized clinical trial. BrJP, ahead. https://doi.org/10.5935/2595-0118.20230023-en The first BFR paper…20 years ago…calling for individualization of pressure: * Fahs, C. A., Loenneke, J. P., & Rossow, L. M. (2012). Methodological considerations for blood flow restricted resistance exercise. Journal of. https://www.jstage.jst.go.jp/article/trainology/1/1/1_14/_article/-char/ja/ Reference for weekly volume: * Schoenfeld, B. J., Ogborn, D., & Krieger, J. W. (2017). Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis. Journal of Sports Sciences, 35(11), 1073–1082. References for Research Procedures: * Büttner F, Toomey E, McClean S, et al Are questionable research practices facilitating new discoveries in sport and exercise medicine? The proportion of supported hypotheses is implausibly high British Journal of Sports Medicine 2020;54:1365-1371. * McCambridge, A. B., Nasser, A. M., Mehta, P., Stubbs, P. W., & Verhagen, A. P. (2021). The Journal of Orthopaedic and Sports Physical Therapy, 51(10), 503–509. * TIDieR: Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., Altman, D. G., Barbour, V., Macdonald, H., Johnston, M., Lamb, S. E., Dixon-Woods, M., McCulloch, P., Wyatt, J. C., Chan, A.-W., & Michie, S. (2014). Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ , 348, g1687. * CERT: Slade, S. C., Dionne, C. E., Underwood, M., & Buchbinder, R. (2016). Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. British Journal of Sports Medicine, 50(23), 1428–1437.

Have you ever found yourself feeling uncertain or confused when choosing a patient-reported outcome measure (PROM)? Today we're talking about the hallmarks of a PROM for people with patellofemoral pain. Physical therapist, educator and researcher, Professor Lisa Hoglund, fills in the gaps to help us find the promise in PROMs. ------------------------- RESOURCES Construct validity, reliability, responsiveness and interpretability of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2023.11730 Content validity and feasibility of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.11317 Find out more about the KOOS (including the Excel scoring sheet): http://www.koos.nu/index.html ------------------------- The American Academy of Sports Physical Therapy and JOSPT are joining forces to bring you the Virtual Sports PT Conference on Friday the 3rd and Saturday the 4th of November, 2023. Visit the link below to see the full conference programme and to secure your ticket. If you purchase your ticket before the end of August, you can take advantage of a $50 discount. https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427

In this episode of the Brawn Body Health and Fitness Podcast - Dan is joined by Dr. Derrick Nillissen, PT, DPT, CSCS, SCS, to discuss his experiences as a Physical Therapist in both the WNBA and the NBA. Derrick Nillissen is a Physical Therapist for the Phoenix Suns.  Previously, Nillissen worked with the Phoenix Mercury as Physical Therapist and Head Strength and Conditioning Coach and served as a Physical Therapist with the Suns during Mercury off-seasons.  Nillissen is residency trained, Board Certified as a Sports Clinical Specialist (SCS), and a Certified Strength and Conditioning Specialist (CSCS).  Nillissen played college basketball at Iowa Wesleyan and completed his DPT degree at Carroll University. A native of Wittenberg, Wisconsin, Nillissen resides in Phoenix with his wife and son. For more on Derrick, you can find him on Instagram @dnillissen  Episode Sponsors: AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! PurMotion: "brawn" = 10% off!! TRX: trxtraining.com coupon code "TRX20BRAWN" = 20% off GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Training Mask: "BRAWN" = 20% off at checkout https://www.trainingmask.com?sca_ref=2486863.iestbx9x1n Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform! --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

With this episode, you'll learn all about gait mechanics and how to choose appropraite corrective exercises to address gait deficits. You'll also learn about the biomechanics of the hip, knee, and ankle. Learn more from Connor: Join his newsletter: https://www.conorharris.com/newsletter Biomechanics Course: https://www.conorharris.com/offline-biomechanics-program

In this episode of the Brawn Body Health and Fitness Podcast - Dan is joined by Keelan Enseki to discuss Physical Therapy Considerations for the Hip Joint, including examination, return to sport, & more! Keelan attended the University of Pittsburgh completing a Master of Physical Therapy and a Master of Science Degree in Health and Rehabilitation Science. He completed the Sports Physical Therapy Residency Program through the University of Pittsburgh and Centers for Rehab Services/University of Pittsburgh Center for Sports Medicine. Keelan is also a certified athletic trainer (ATC), certified orthopaedic (OCS) & sports (SCS) physical therapy specialist. He is currently serving as the Director of Clinical Practice Innovation, Administrative Director of Physical Therapy Residency Programs, and Orthopaedic Physical Therapy Residency Program Director at the Centers for Rehab Services/UPMC Center for Sports Medicine Clinic as well as an adjunct professor for the University of Pittsburgh Departments of Physical Therapy and Sports Medicine & Nutrition. Keelan's time is divided time between clinical practice, residency administration, project consultation, & professional development responsibilities. His areas of clinical interest include determinants of outcomes and treatment options available for active individuals with pathological conditions of the hip joint. He regularly presents nationally & internationally on these topics. Keelan has been an author including peer-reviewed articles for the Journal of Orthopaedic and Sports Physical Therapy, Clinics in Sports Medicine, Archives of Orthopedic Trauma Surgery, Current Reviews in Musculoskeletal Medicine, Operative Techniques in Orthopaedics, The Physician and Sportsmedicine, Journal of Bodywork and Movement, and Sports Health. He has served as a content reviewer for the American Journal of Sports Medicine, the Journal of Orthopaedic and Sports Physical Therapy, Journal of Sport Rehabilitation, Journal of Athletic Training, Journal of Manipulative and Physiological Therapeutics, Journal of Hip Preservation, PM&R and Physical Therapy in Sport, Journal of Sports Rehabilitation, Sports Health, guest editor for Topics in Geriatric Rehabilitation, and is an associate editor for the International Journal of Sports Physical Therapy. Additionally, he has co-authored book chapters & continuing education manuscripts covering the topics of rehabilitation of hip and knee injuries. Keelan is a member of the APTA Academy of Orthopaedic Physical Therapy, & serves as chairperson & a head author for the ICF-linked clinical practice guidelines of the hip, & director of the annual academy meeting (AOM). He also is currently serving as the chair of the Hip Special Interest Group for the American Academy of Sports Physical Therapy. He serves on the Physiotherapy Committee for the International Society for Hip Arthroscopy (ISHA). For more on Keelan, you can find him at https://www.researchgate.net/profile/Keelan-Enseki Episode Sponsors: AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! PurMotion: "brawn" = 10% off!! TRX: trxtraining.com coupon code "TRX20BRAWN" = 20% off GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Training Mask: "BRAWN" = 20% off at checkout https://www.trainingmask.com?sca_ref=2486863.iestbx9x1n Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform! --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

The Journal of Orthopedic and Sports Physical Therapy, or JOSPT, is one of the most well-read and prestigious journals in our field. Clare Ardern, Editor-in-Chief of the journal, has done an amazing job.In this episode, she's going to share some exciting new things that JOSPT has been working on that I know you're going to love. Plus, we're going to take a peek behind the scenes of the editorial process of JOSPT, talk about her role as editor-in-chief, and she's even going to share some valuable advice for prospective authors on how to write the best manuscripts to increase your chances of publication.Full show notes: https://mikereinold.com/behind-the-scenes-of-jospt-with-clare-ardern----------Want to learn a complete system to help people restore, optimize, and enhance their performance?Enrollment in my Champion Performance Specialist program is opening soon. We only open the doors to new cohorts twice per year. Click here to learn how to join the pre-sale VIP list to save $300 and enroll a week early to secure your spot. Click Here to View My Online Courses Want to learn more from me? I have a variety of online courses on my website!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show_____Want to learn more? Check out my blog, podcasts, and online courses Follow me: Instagram | Twitter | Facebook | Youtube

Hip dysplasia is a commonly missed cause of hip and groin pain, catching, clicking, locking or popping, resulting from lack of coverage of the femoral head by the acetabulum. How can you identify hip dysplasia in your hip or groin pain patients, and avoid misdiagnosing it as iliopsoas or adductor related groin pain? What signs and symptoms will your patients reveal in their subjective history that'll help you identify this condition? Find out the key signs and symptoms of hip dysplasia in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the article associated with this podcast Jacobsen JS, Søballe K, Thorborg K, Bolvig L, Storgaard Jakobsen S, Hölmich P, Mechlenburg I. Patient-reported outcome and muscle–tendon pain after periacetabular osteotomy are related: 1-year follow-up in 82 patients with hip dysplasia. Acta orthopaedica. 2019 Jan 2;90(1):40-5. Nunley RM, Prather H, Hunt D, Schoenecker PL, Clohisy JC. Clinical presentation of symptomatic acetabular dysplasia in skeletally mature patients. JBJS. 2011 May 4;93(Supplement_2):17-21. O'Brien MJ, Jacobsen JS, Semciw AI, Mechlenburg I, Tønning LU, Stewart CJ, Heerey J, Kemp JL. Physical impairments in Adults with Developmental Dysplasia of the Hip (DDH) undergoing Periacetabular osteotomy (PAO): A Systematic Review and Meta-Analysis. International Journal of Sports Physical Therapy. 2022 Oct 1;17(6):988-1001. Reiman MP, Décary S, Mathew B, Reiman CK. Accuracy of clinical and imaging tests for the diagnosis of hip dysplasia and instability: a systematic review. journal of orthopaedic & sports physical therapy. 2019 Feb;49(2):87-97.   Chapters: 03:43 - Who develops hip dysplasia? 06:35 - Objective tests 09:11 - Hip dysplasia vs gluteal tendinopathy 10:45 - Hip dysplasia vs femoral neck stress structure  14:13 - Key takeaways  

Blood Flow Restriction Training (BFR) is becoming such a common way to improve strength in the rehab and sports performance world, but is also often used incorrectly.  If you're a runner coming back from injury or attempting to gain strength while decreasing fatigue, this podcast episode is for you! In this episode, physical therapist, Dr. Scott Greenberg discusses…What is Blood Flow Restriction Training?Why Should Runners Care About Blood Flow Restriction Training / What Are the Benefits of Blood Flow Restriction Training?What Type of Runner Can Benefit From Blood Flow Restriction Training?What Are The Parameters When Using Blood Flow Restriction Training?Blood Flow Restriction Training As We AgeScott holds a Doctor of Physical Therapy from Slippery Rock University, a Master of Business Administration from American Military University, and a Bachelor of Science in Exercise and Sports Science from the University of Florida. He has worked with the University of Florida Gators, professional athletes, and Olympians for over 20 years. He specializes in running medicine, injury prevention, rehabilitation, sports testing, and sports performance. He is a skilled leader and communicator with extensive business and management expertise. Scott is the Manager of Operations for the Department of Rehabilitation at UF Health and the Director of their sports and orthopedic physical therapy residency programs. On the national and state levels, he is a sought-after, dynamic educator. Scott is a NSCA Certified Strength and Conditioning Specialist and a Specialist in Endurance Running through USTFCCCA. He is also the Membership Chair of the American Academy of Sports Physical Therapy and was previously the Chair of their Running Special Interest Group. Scott enjoys sharing his knowledge through his teachings in continuing education courses on topics such as running medicine, strength and conditioning, and blood flow restriction.Connect with Dr. Scott Email:  greeniedpt@gmail.comScott's Website https://runsaferunfast.comInstagram:@scottgreenberg.dptConnect with Dr. KatInstagram-  @Runwithkat_dptTik-tok- @Runwithkat_dptFacebook Group- RunwithKat ShowWebsite- RunwithKat.netTo Inquire About Physical Therapy with Dr. KatInstagram- @BlueIronPhysioWebsite- BlueIronPhysio.comListen and Subscribe Apple PodcastSpotifyGoogle PlayIHeartRadioAmazon Music 

In this episode, we dive deep into the world of sports physical therapy with Dr. Zach Baker, PT, DPT,SCS. Board-Certified in Sports Physical Therapy and Sports Residency Director for Rehab 2 Perform. With his extensive experience and commitment to excellence, Dr. Baker provides valuable insights into effective PT practices and strategies for overcoming common challenges. We kick off our discussion by introducing Dr. Baker and learning about his role at Rehab 2 Perform, where he oversees the Frederick and Mt. Airy clinics. As an expert in his field, Dr. Baker shares details about the upcoming Blueprints course on May 6-7 ⁠https://r2p-academy.mykajabi.com/blueprints-HIDEF, an educational opportunity designed for physical therapists looking to enhance their skills and knowledge. Dr. Baker then delves into the topic of programming in physical therapy, sharing his perspective on periodization and how Rehab 2 Perform stands out among other clinics in this regard. We also explore the keys to successful ACL rehab and discuss the critical elements often missing from the majority of cases. Weighing in on the debate between residency and structured mentorship, Dr. Baker emphasizes the importance of mentorship for new grads, particularly those with less than three years of experience.He also shares his thoughts on the PT profession as a whole, addressing common criticisms and misconceptions. Finally, we touch on the vital issue of burnout in the PT profession. Dr. Baker offers recommendations for preventing burnout and maintaining passion for one's work. Don't miss this enlightening conversation with one of the top experts in sports physical therapy! Check out Dr. Zack Baker and Rehab 2 Perform Below. https://rehab2perform.com/zach-baker/

Building Spaceflight: NASA Human Performance Optimization with Maj Danielle Anderson & Christi Keeler, MS, ATCIt's the second week of our Spaceflight mini-series and we're thrilled to bring you an awesome and informative conversation with Maj Danielle Anderson and Christi Keeler, MS, ATC!Maj Anderson is making history being the first active-duty service member to be assigned to NASA. Maj Anderson and her teammate Christi are part of the integrative dream team at NASA Johnson Space Center working daily in astronaut human performance care. We pick their brains about both their roles in the Spaceflight HPO program and break down what exactly it is they do day to day. And spoiler, it's even cooler than you think! In this episode we get into some basics about spaceflight standards, the innovation that comes with being part of the human performance team for astronauts and how rewarding the job truly is. But we don't stop there, we cover an eclectic variety of burning questions:What length of time is required to be considered long duration Spaceflight?How do you rehab someone in space?What type of rehab equipment is available in space?What are the go-to exercises that astronauts have to do daily to maintain health?Mobility.... in space? Why or why not? Come wrap up our mini-series with us and get all the questions you've had since being a little kid about space answered! We can't wait to have them back in the future!Talk to ya later!Guest Bios: Major Danielle Anderson  is a Physical Therapist currently assigned to Johnson Space Center, National Aeronautics and Space Administration as the Musculoskeletal Medicine and Rehabilitation Lead. She delivers a spectrum of neuromusculoskeletal care preparing and supporting both U.S and International Astronauts for long duration space flight aboard the International Space Station (ISS). Additionally, she provides consultation and management recommendations to Crew and Deputy Crew Flight Surgeons working neuromusculoskeletal conditions on board the ISS. She serves as the Air Force's liaison to the Military Musculoskeletal residency, a tri-service one-year Physical Therapy residency, where she oversees admittance, regional instruction, and successful program completion of Air Force, Army and Navy Physical Therapists. Major Anderson received her Doctor of Physical Therapy from Regis University and direct Air Force commission in 2012. During her first assignment to Travis Air Force Base, she deployed to Kabul, Afghanistan in support of Operation Enduring Freedom. She provided musculoskeletal care for Joint Special Operations Task Force Afghanistan and NATO partners, earning her the United States Air Force Biomedical Service Corps and Military Health Systems Junior Clinician of the Year. In addition, she served as the sole physical therapist while deployed with Navy Special Warfare Unit Three in Bahrain, supporting the training and assistance to the special operations forces of the Nations of the Gulf Cooperation Council. She has instructed numerous Air Force Physical Therapy courses and currently serves as an Assistant Professor to the Doctor of Physical Therapy Program at Army-Baylor University, Joint Based San Antonio (JBSA), Tx. Lastly, she is published in Military Medicine and the Journal of Orthopedic and Sports Physical Therapy and has presented in over ten National Physical Therapy conferences. Prior to her current position, Major Anderson was the Orthopedic and Rehabilitation Flight Commander at 59th Surgical Operations Squadron, JBSA-Lackland, Tx., where she led 72 members among six elements across two sites, providing 77k specialty visits and ove If you like what you hear, leave us a 5- star rating and subscribe! Find us on IG and LinkedIn @ Not Your Typical Doctors or reach out to us anytime through: notyourtypicaldoctors@gmail.com

Chris and Sam sat down with Clare Ardern to discuss all things return to sport. Clare is the Editor-in-Chief of JOSPT, the Journal of Orthopedic and Sports Physical Therapy, Physiotherapist, and researcher currently based out of Vancouver, British Columbia. We focus the conversation around the paper titled, “2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern” in which Clare was the lead author. We discuss: The spectrum of return to participation all the way up to return to performance, defining success across multiple stakeholders, shared decision making, the StaRRT Framework, assessing readiness, ACL specific RTS considerations and timelines, and future priorities and directions. Primary Paper Discussed:  2016 Consensus statement on return to sport  An additional read that Clare recommends:  2022 Bern Consensus Statement on Shoulder Injury Prevention  More About Clare and JOSPT:  Clare's Twitter JOSPT Twitter JOSPT Insights Podcast JOSPT.org JOSPT Instagram --- More about us:  YouTube: https://www.youtube.com/e3rehab  Website: https://e3rehab.com/  Instagram: https://www.instagram.com/e3rehab/ Twitter: https://twitter.com/E3Rehab --- Sponsors: Minimalist Footwear: https://www.vivobarefoot.com/ (Discount code: E3Rehab15 for 15% off) VALD: www.vald.com --- @dr.samspinelli @dr.surdykapt @tony.comella @chrishughen --- This episode was produced by Matt Hunter.  

The American Physical Therapy Association's Academy of Sports Physical Therapy is now in its 50th year. Today, Academy President, Dr Mike Reinold, is celebrating not only the achievements of the past 50 years, but looking forward to the future. Mike has assumed the role of Sports Academy President at an exciting time of innovation in learning, professional development, and mentorship. Today we discuss how the Sports Academy is nurturing the physical therapy profession and its future leaders. ------------------------------ RESOURCES Academy of Sports Physical Therapy: https://sportspt.org/ Sports Academy Learning Centre: https://learn.sportspt.org/

In today’s episode I share some pearls of wisdom I gleaned from the recent American Physical Therapy Association Combined Sections Meeting. As a member of the American Academy of Orthopedic Physical Therapy, and the American Academy of Sports Physical Therapy, I enjoyed reviewing new, cutting-edge literature and learning from innovators and thought leaders in the profession. I provide some simple…

Chris and Sam sat down with Chris Juneau to discuss a variety of topics including: his time spent at The Ohio State University and University of Louisville, his experience in New Zealand for his masters, his transition into working the military / special forces population, military medicine, assessments in the military, recommendations for other rehab providers working in the military setting, and much more! Chris Juneau is a Sports Residency and Performance Trained Doctor of Physical Therapy with a Specialization in Athletic Performance, a Masters of Philosophy in Biomechanics (specifically rate of force development), and a Certification in Strength & Conditioning. Chris is currently working with the US Army Special Operations Command at Fort Bragg in North Carolina. He currently also serves in leadership with the American Academy of Sports Physical Therapy and also in various mentorship and educational roles. More about Chris:  Chris' Website Chris' Twitter PT Inquest Podcast --- More about us:  YouTube: https://www.youtube.com/e3rehab  Website: https://e3rehab.com/  Instagram: https://www.instagram.com/e3rehab/ Twitter: https://twitter.com/E3Rehab --- Minimalist Footwear: https://www.vivobarefoot.com/ (Discount code: E3Rehab15 for 15% off) --- @dr.samspinelli @dr.surdykapt @tony.comella @chrishughen --- This episode was produced by Matt Hunter.

Lewis Lupowitz is a Certified-Sport Physical Therapist specializing in treating conditions of the shoulder, elbow and knee. He assists with care among local high schools, multiple collegiate programs and the New York Riptides. He has published and reviewed research for the International Journal of Sports Physical Therapy and has presented his evaluation methods and techniques at national conferences. Episode TakeawaysWhat is sports physical therapy?Integrating vibration and percussion therapy into your rehab and sports performance treatmentAvailable mentor and fellowships in sportsHow to work in a multidisciplinary team Three QuestionsCurrent Research? The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles' Range of Motion and PerformanceWhat is something the audience should take a look at if they want to take a deeper dive into some of the things we talked about today? Hyperrice or Pubmed articles Why should people care about this episode/topic? It's understanding why to use percussive massage Parting Shot“When it comes to modalites, you need to try it yourself and you need to believe what your patients tell you.” - Lewis Lupowitz Connect with Lewis!TwitterInstagram Do you want to be part of PT Pintcast Book Club? Join the PT Pintcast Happy Hour Facebook Group for more information.PT Pintcast is brewed by:Practice Freedom UFor PT Owners who want to Treat Less, Earn More, and create the business you've always dreamed of. Take the Practice Quiz now to see where you stack up. Visit practicefreedomu.com.CBDRX4U.comYOUR CBD Store - get the ABC's of CBD at CBDRX4u.comJackson TherapyProviding awesome adventures in patient care for physical therapists who care about where they're going! Look no further than JacksonTherapy.comMW TherapyAn EMR is to a Physical Therapist as a Hammer is to a Carpenter. You deserve to LOVE USING IT!It's time for something better. It's time for something customizable. That's where MWTherapy comes in, take a demo of their amazing EMR now at MWTherapy.com where switching your EMR is easy!Brooks Rehabilitation Institute of Higher Learning The Brooks Institute of Higher Learning is a world class organization on the cutting edge of evidence-informed practice and professional development for rehabilitation professionals. Learn more at BrooksIHL.org. FIRST ROUND Owens Recovery ScienceYour single course for clinicians who want certification in Personalized Blood Flow Restriction Rehabilitation Training and the equipment YOU Need to apply it properly In your clinical practice. Find out where you can get certified NEXT at www.owensrecoveryscience.com. PARTING SHOTThe Academy of Orthopaedic Physical TherapyThe leaders in orthopedic PT are the academy OF orthopedic PT, orthoPT.org now with Current concepts of Orthopedic PT 5th edition.

On today's episode, I'm talking to physical therapist Dr. Margaret Pittman about building the next generation. Margaret is a physical therapist at Momentous Sports Medicine and an adjunct assistant professor of physical therapy at George Washington University. She's doing a lot to make sure that the next generation of physical therapists are exposed to the field and see themselves represented within it. She's a board member of Minority Women in Sports Medicine started by former guest, Andrea Durham, as well as an Executive Board Member of the USC Biokinesiology and Physical Therapy Black Alumni Association. Additionally, she's currently back in school herself, working towards her MBA at GW, making sure she has the tools she needs to see her visions through.We talk about:The challenges of negotiating early on in your career.How goals become reality when you share them with others who can help advocate for you.Why it's okay to pivot and just because it's not now doesn't mean never.If you'd like a little help with your next negotiation, grab my free to guide to negotiation specifically written for women working in male-dominated fields like sports medicine and athletics!You can find the show notes and more resources at https://madamathlete.comKeep an eye out for new content or let us know what you'd like to see next by following us on social:Instagram: @theMadamAthleteFacebook: @MadamAthleteTwitter: @MadamAthlete

In episode 36 of the Deskbound Therapy Podcast, I chat with Dr. Aaron Horschig (@draaronhorschig). He is a Sports/Orthopedic Physical Therapist, author, and speaker. He is also the founder of Squat University, a strength & conditioning specialist, an Olympic weightlifter, and a coach. We talk about the importance of mobility and how it can make a massive difference in your workout routine and your life. He also shares his daily routine with us to give us an idea of incorporating movement into your day-to-day activities. After graduating with his bachelor's in exercise science from Truman State University in 2009, Dr. Aaron Horschig received a doctorate in physical therapy from the University of Missouri in 2012. Dr. Aaron now works at Boost Physical Therapy & Sport Performance in Kansas City, Missouri. Dr. Aaron published his first book, “The Squat Bible,” in the spring of 2017 and published it in numerous professional journals. His most recent appearance in the International Journal of Sports Physical Therapy presented a new way to periodize a weight-training program with the back squat after ACL reconstruction. Dr. Aaron's background includes being involved in Olympic weightlifting as an athlete and coach for over the past decade. His goal is to provide the highest quality rehabilitation to athletes who have sustained an injury and help our sports medicine society become proactive in approaching the athlete – both from a rehabilitation and training perspective. Learn more about Squat University: Squat University Web: https://squatuniversity.com/ Squat University FB: http://facebook.com/SquatUniversity Squat University IG: https://www.instagram.com/Squat_University Squat University YT: https://www.youtube.com/@SquatUniversity Personal IG: https://www.instagram.com/draaronhorschig/ Check out his podcast: https://squatuniversity.com/podcast/ Get a copy of his book: Rebuilding Milo - https://squatuniversity.com/featured-links/rebuilding-milo/ Show notes: [0:00] Intro [0:49] Dr. Aaron's journey to creating Squat University [2:51] The inspiration behind Squat University [6:58] The importance of mobility and the benefits of doing squats [12:42] "If you don't use it, you lose it" [16:30] How the footwear makes an impact on your body and mobility [23:38] Squat = moving better [28:25] Understanding load, and spinal flexion and extension [33:08] Why Dr. Aaron isn't a fan of Jefferson Curl [38:29] Technique is KEY [40:18] The Movement first approach [45:03] On bandaid joint mobilization [51:55] Backache due to prolonged sitting [55:03] Dr. Aaron's daily routine [1:1:23] The warm-up is part of your workout [1:02:8] Why being a strength conditioning professional alongside being a physical therapy works great [1:07:56] The future of Squat University [1:10:31] Biggest takeaway [1:11:26] Outro For online coaching inquiries and questions about my online programs connect with me below. Free Beginner Desk Stretch Routine: https://bit.ly/FreeDeskStretchRoutine IG: https://www.instagram.com/DeskboundTherapy Coaching Application: https://deskboundtherapy.typeform.com/to/KSexJVbO --- Support this podcast: https://anchor.fm/deskboundtherapy/support

On today's episode, I'm talking to Associate Professor of Physical Therapy Dr. Stephanie Di Stasi about choosing to focus on work you love and where it feels like you can have the most impact.Dr. Di Stasi is an Associate Professor in the Division of Physical Therapy at The Ohio State University and a Research Scientist at the Sports Medicine Research Institute at The Ohio State University Wexner Medical Center. As an athlete with an interest in the biomechanics of the human body, Steph initially started out on a clinical PT pathway before talking with a mentor and deciding to go back to school for her PhD. During her time as a PhD student, she fell in love with teaching and research and combined them into her current academic career.We talk about:Choosing to focus on work you love and where it feels like you can have the most impact rather than trying to do it all.The importance of mentorship, peer relationships, and being thoughtful with giving and receiving feedback.Getting rid of the mom guilt by sharing your excitement about work with your kids.You can find the show notes and more resources at https://madamathlete.comKeep an eye out for new content or let us know what you'd like to see next by following us on social:Instagram: @theMadamAthleteFacebook: @MadamAthleteTwitter: @MadamAthlete

Learn more about our Sponsor Impact Fitness Coach Academy: https://www.impactcoachacademy.com/ref-matt-casturos Thanks Marcin for coming on the podcast! https://www.instagram.com/marcin.dpt/ Studying for the CSCS Exam? Check out The Movement System CSCS Study Resources: https://www.themovementsystem.com/strength-and-conditioning-study-course-sales-page

In this episode, Physiotherapy Lecturer and Tendinopathy Researcher, Seth O'Neill, talks about tendinopathy. Today, Seth talks about his interest in tendinopathy, and his presentation at the Fourth World Congress of Sports Physical Therapy. What is the warmup response? Hear about Seth's diagnosis framework, the appropriate use of imaging, rehabilitation, and get his advice to his younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast. Key Takeaways “You're going to have some discomfort with these exercises and that's okay.” “Get your diagnosis right in the first place.” “Say yes to things when you can. Push yourself and you'll get there.” More about Seth O'Neill Seth is a Physiotherapy Lecturer at the University of Leicester whilst also maintaining clinical work. He has a PhD on tendinopathy, within this Seth has identified prevalence rates of tendinopathy in UK runners and developed a greater understanding of risk factors surrounding Achilles tendinopathy. His later work has completed a more in-depth analysis of how tendinopathy affects the Plantarflexors. This has focussed on how the strength and endurance is affected and which of the Plantarflexors is most involved. This work has highlighted the involvement of the Soleus muscle in human Achilles tendinopathy. This has led to the further work related to Calf injuries in sports. Whilst Seth's focus is on the Lower limb he maintains a strong interest in all MSK conditions. Seth feels passionately about supporting Physiotherapists to undertake further research either as standalone projects or MRes's or PhD's. Seth is currently examining tendon structure and changes that occur during health and disease along with Biopsychosocial interventions for tendinopathy and LBP and developing an international database of calf injuries. Suggested Keywords Healthy, Wealthy, Smart, Tendinopathy, Physiotherapy, IFSPT, Injuries, Recovery, Rehabilitation, Diagnosis, Exercises, Resources IFSPT Fourth World Congress of Sports Physical Therapy To learn more, follow Seth at: ResearchGate: Seth O'Neill Twitter: @seth0neill Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts: https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify: https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927 Read the Full Transcript Here: 00:02 Hey, Seth, welcome to the podcast. I'm so happy to have you on. 00:06 Thanks very much for having me, Karen. It's great to be here. 00:08 Excellent. And today we're going to be talking about tendinopathy, maybe specifically Achilles tendinopathy. But before we get into that, I just want to let the listeners know that you're one of the amazing speakers at the fourth World Congress of sports, physical therapy taking place in Denmark at the end of this month, August 26, and 27th. And you will be talking about tendinopathy. So before we move on, I would love to know why. Why tendinopathy? How did that become sort of your specialty, your interest? 00:46 Yeah, tricky to sometimes answer these type of questions, really. But I've had tendon problems myself. So being active and sporty, I developed an Achilles problem, number of years back when I was a relatively junior physio, and we didn't really understand how we were trying to manage these things. And that took a long time to settle down. So that really sparked it off. And then not long after I developed poutine. And problem as well, my Achilles from wearing sorts of constricted footwear. So wearing wetsuits, boots, for a day, with doing wakeboarding and stuff. So developed the interest because I had the problem myself, which is probably the answer for most people, I think, with how we ended up specializing in one thing and went on to look at Achilles problems and differentiating these out as part of a master's dissertation project that did, and then still had some clinical questions I wanted to answer to help me understand how to manage people better. So I did my PhD in it as well. So yeah, it's one of those sort of sorry, stories of a while me. 01:50 And before this sort of deep dive into the literature, and a master's in a PhD, and maybe even during that journey, are there any cases that you worked on that you were like, Man, I would do it so differently now? Because I'm sure I mean, I know I have that every physio listening to this can probably relate to this. But where have you learned from your mistakes in relation? We'll say, we'll stick to Achilles tendinopathy. Right. So in relation to Achilles, tendinopathy, so that the listeners out there can be like, Oh, I think I just did that. And maybe I'm gonna change my mind. Yeah, 02:28 yeah, we're at a good number of these things, including not too distant past as well. I think like everyone, we're always learning. And we've all just got to admit to mistakes and where we can benefit and do better. So I think my early ones, particularly were around differential diagnosis, getting or missing things that were going on as well. So remember, one relatively young lad with an Achilles problem, sent him off doing Alfredsson Essentrics, this was probably 2001, something like that, came back loads loads worse and had this funny swelling around the back of his money, hola. And I was like, never seen this, this is rare, and didn't know what was going on at all. So sent them off for an MRI scan via our consultant at the time and came back with an accessory soleus, which is where part of the muscle is low lying and actually sort of fills where cake is fat pad is back in money can cause pain and be symptomatic. And the old school approach is to just go in and cut it out. So the surgeon is booked out and ordered and dusted. But I totally missed it. The first time I saw him, I don't know whether the swelling was there at that point, or whether I triggered him off or made him worse with the sort of rehab. So possibly, but also then I've had a couple of people during Alfredsson regimes that have actually ended up with ruptured or partial ruptures, partial tears, as a consequence, and then yeah, you end up sort of feeling terribly bad that what you were doing to try and help someone's actually caused a significant worsening of their function and symptoms, and they even had a patient with this happened last year, who will go and try and write up as a case study because it's really interesting management program afterwards with scans and stuff, but ultimately, they have big problems. 04:15 Yeah, it does. It happens to us all. And how do you from that? You can, you know, we can edit this out if you don't want to answer this. But how do you deal with that from sort of the mental standpoint of oh, shoot, like how do you mentally deal with that? Because I think that when that happens, it can you start to question why am I doing this? Am I the right person for this job? It can lead to burnout, that stress. So how do you manage that from a mental health standpoint, when things like this happen? 04:53 I think the thing is often as a junior therapist, you beat yourself up more because you sort of think I should have known I should sort of understand that, I think as you get more experienced than me, I'm 22 years 23 years qualified. Now you have lots of experiences like this and have to pick yourself up from them. And you just start to accept that that is like that's normal, whatever area of work you specialize in, or work in, whether it's physio, or even being an accountant or something, mishaps in things that you can learn from learning experiences happen all the time. And it's really just then taking what you can from it and developing and getting better. And when you have a bit of a boo boo happen like this, we tend to remember it and you never then miss it in the future. I mean, a couple of examples that I had in the past would be like federal stress fractures wasn't even on my diagnostic radar back when I was a junior therapist. You don't get taught at university and stuff, and then you sort of you miss one. And it's like, right, never missed one again. Now, it's always high up on your index of suspicion. So it's really just not trying to beat yourself up, realize it's a learning experience and identify what you can do. Going forward with it. Part of your CPD of your reflective practice that we're all encouraged to do and often do do but not formally. So yeah. 06:14 Yeah, great advice. Okay, now, let's get into the meat of the podcast here. So what we'll talk about is kind of you mentioned it differential diagnosis. So we'll talk a little bit about that, and then go into some possible treatments and, and outcomes and things like that. So let's say someone comes to you, with posterior ankle heel pain, they haven't been to their GP or to the orthopedic yet, because that happens a lot. Here in the US, I'm sure it happens a lot with you in the UK, as well. So I will hand the mic over to you. And you can maybe walk us through your differential diagnosis framework, what are you looking for when someone comes in with that? 07:03 So the first thing, I think is, as everyone already knows, is not to take whatever the previous diagnostic decision was, if they have seen someone as well, I make sure you do your own workup, because let's face it, we all make mistakes as well. So I'd always look at them with fresh eyes and not go with the the original diagnosis and make my own mind that the three big things that mimic Achilles tendinopathy really then are related to posterior ankle impingement. So in order to try going on, whether it's a bony impingement or not, and they're the ones actually see quite commonly that have been mismanaged that add a cricketer, recently, his professional cricketer, who had been sent from their medical team in one of the counties in the UK, or England, I should say, and unfortunately, that miss that he had a posterior impingement, not an Achilles problem and been trying to manage them and manage him using some invasive procedures, and actually scan and everything else when I scanned in, but absolutely pristine and fine. And that's the one thing I do come across time and time again, it's just people miss the impingement side of it, and normally, the x, so aggravating factors and easing factors that the patient will report to you if you listen carefully, and inquire, will be very, very different. It'll be a totally different set of positions, not about tendon load, it'll be their ankle position. And being in that plantar flexed position that's relatively simple and straightforward. But again, it just, it commonly crops up other common or relatively frequent presentations, then we'll be around several nerve. So one of the branches of your sciatic nerve runs on the lateral aspect of your Achilles, we just want to simply look at something like a straight leg raise with a neural bias for the inverter area. So you do inversion with dorsiflexion. And if movements like that provoked the pain, that's not normal for a tendon, it would normally only hurt when you put larger loads through it. And energy storage demands not simple structures, except in very highly irritable cases. But you can only determine that clinically. So they're the two big things that the third group then is other localized tendinopathies. So to be honest, posterior, or per Nei, which I think you guys call something different in the States. What are the perineal inverters of the foot? We always have problems when we teach anatomy with our students, if they use an American app, it gives it a different name. I forgot this. But anyway, so yeah, so just looking at the differential between those other tendons. So patients may refer and sort of suggest its posterior heel, but actually it's in front of the Achilles. So it's normally relatively localized pain and there's lots of debates on social media about what happens when you get diffuse pain in that area. diffuse pain is really quite rare in this area, and I do see a lot I still work clinically as well as work in that university from a research perspective and I do a lot of consultant work in sports. and wider as well. And we just don't see widespread pain in this region particularly. And the evidence really suggests that tendon off the Achilles particularly will be localized pain. It doesn't sort of spread out. But there will always be some exceptions, I'm sure. 10:15 And it sounds like from what you're saying one of the other really important things is that subjective interview. Yeah, right. So what questions are you honing in on? What are you What do you really want to know? 10:29 So I'm actually take a leaf out of Peter O'Sullivan's approach for back pain and look at the patient's story. How do they describe this originally starting? What's gone on with it from then? And what are their thought processes around that. So we really look at the whole patient, not just that the mechanical bio sorts of components here, but then our teas into the aggravating and easing factors. So where the pain is what makes it worse, what makes it better how long it takes to come on, often expecting a latent response. So the pain is not necessarily happening during this activity, it will be a latent flare up later. Although you'll sometimes get a warm up response during the activity as well. So we're looking for these hallmarks. And what we should pick up in the subjective is progressive tendons stress. So the example would be walking for the Achilles versus running versus hopping or jumping or London being progressive load, the higher you go up that ladder, the more it will flare them up or make them sore. And then what we're trying to do is look at the sin factor, then if you guys use that, as well, so severity, irritability, and the nature, but the irritability is key, the more irritable these are the lower level, we're going to start your rehab. And a lot of this subjective really helps guide our initial intervention program. But of course, on top of all this, we've got to consider the patient and the complexities that we get from our psychosocial component. And we've just had a sort of paper out with Neil Miller, and the group from Glasgow on biopsychosocial approach to tendinopathy. This the icon statement from the international group, that Karen Silverado that you mentioned earlier, and that's really looking at the psychological factors and social factors that are relevant for tendinopathy. Because like any musculoskeletal condition, the person's important, it's not just the the localized tissue that we sometimes can get overly focused on. 12:25 Absolutely, I'm preaching to the choir there. Now you had mentioned something in that, just now the warm up response. So can you explain what that is for the listeners in case they're not quite familiar with that? 12:38 Yeah. So this will be the person that will go for a walk or a run, or whatever their activity tennis, squash, whatever it happens to be, and they'll find it sore initially, and then it will get better, it feels better during the activity. And we tend to see this happens when they've sat for any length of time, if they're an inactive person, they'll get the same response then so the first five minutes of getting up having sat for an hour or two will feel sore, and then it gets better. And this is particularly common in the morning, where patients get up. And they say I was sore for 10 minutes until I've walked downstairs, made myself a coffee or had a shower. And then I feel better ready for the day. And that's typically what we see. So this sorts of pain that is focused around starting an activity when you've been inactive for a period. So that's 13:27 excellent. Thank you so much. So going back to our fictional patients here, they come in, they've got sort of posterior ankle pain, you've ruled out posterior ankle impingement, sural, nerve, local tendinopathies. And now you're really thinking well, given their subjective exam, given the little bit of objective exam that I've done, I think that we're dealing with an Achilles tendinopathy. Right, so you've kind of made that diagnosis. Now, what happens? 14:03 So once we've determined that we think it's an Achilles problem, we just want to make sure that's the case. And the best, most accurate, sensitive clinical test at this moment, whilst it gets a bad press is actually the site of pain. So asking the patient's point to it, or you look at then gripping it and looking at how Patri pain, they should put them to touch that tendon. If it doesn't, then we perhaps not dealing with an Achilles problems that would set up some alarm bells. The next thing then is to work out what sort of tendinopathy they have. And within that, what I mean is there's this sub entities, so there's different groups that will cause Achilles pain. So you could have a parent teen and disorder, like I mentioned, with myself earlier, which is essentially inflammation of the sheath around the tendon a bit like you get with the equivalence, Tina synovitis in the wrist or thumb is that same process, and that probably needs to be managed very differently because that's about friction of the sheath against the tendon. And so we've managed differently, we'd also then consider insertional, tendinopathy versus midportion, the risk factors, and some of the subtle management may differ. And as part of that, often we'll talk about trying to reduce compression of the tendon, which is what happens when you're in a dorsiflex position where the tendon will swash against the superior aspects of the calcaneus. That is had probably inappropriate interpretation from lots of clinicians, where they've heard about it and then say, we should avoid dorsiflexion. And patients then get told to avoid it. But that is forever. And of course, dorsiflexion is normal. So we've got to make sure we have encourages it. But in a highly irritable case behind center factor, we'd avoid that in the initial phases, or reduce it. So might use a heel wedge, so midportion and insertion burn, then with the mid portion, we're trying to look at whether it's really related to the Para tienen there's a potential of a partial tear. Or you can get these other disorders, which we have academic disagreements about, called splits, where actually, if the fibers run sort of longitudinally, you can get a pull in a part of the fibers. And they're called longitudinal splits, or occasionally get a flat tear where the back of the tendon or deep section and tendon pulls off. 16:18 Clinically, for me, they are much harder to manage. And they're the ones that I have, certainly in the last 510 years, made much worse, both symptomatically, functionally and also structurally. And they're the ones I think we need to be cautious about how we look at differentiating those out clinically is on subjective, again of how did it start? Was this a onset that you develop during a sporting activity or a activity a functional activity, like crossing the road and stepping up a curb? Or going down stairs or making a bed or something? Or did it involve whatever else or did it just come on gradually, you were sore the next day, after you did a long walk or a long run, that's more akin to normal typical tendinopathy being a generalized process of degeneration with some inflammatory elements that we sort of know and love as tendinopathy. But these sub entities seem to be very different, I think for management, the problem with all the research, nobody splits them out. So all the research doesn't differentiate out these sub entities, they stick them all together. And part of this is why I think a lot of regimes have washed out, they they look like people get a generally good response, some get worse, some don't respond. But generally about 70% of people get better. I personally think if we can look at these different entities, we will probably improve our rehabilitation. And Karen silver novels work I've forgotten now is going to go ahead and first author a bit. So I apologize. Currently the senior author, they've looked at actually identifying clinical groups, so psychological. So the profile group, a structural group, and more of a biomechanical sort of weakness group. And that's, I think, got some legs to go forward with how we might look at our patients in the clinic. And remember, if there's one more group, there is one more sort of sub entity which is plant Taris, induced tendinopathy. So typical presentation will be middle section pain, a little bit higher than typical midportion. And they may find that actually been in plantar flexed or dorsiflex positions when contracting the muscle, and therefore loading the tendon actually hurts. And that's because the RENNtech muskies work that he's done has shown that you get some compression of the plantaris tendon against the Achilles tendon, it seems to then set up a tendinopathy based on compression. So we can identify that clinically with palpating, the medial side. But ultimately imaging is probably then the better way to identify it. But it doesn't mean they need surgery, either. That's the other important message for you to take away from it, they've always had that plantaris. It's always been there for that person's life, they've developed the symptoms for whatever the reason, and they will probably respond to normal management, but maybe with some modification to load in in dorsi, flex or plantar flex positions. So we work in the middle a bit more initially until we're starting to settle and improve. Certainly in my clinical work, they will settle just as well as any other area does. But of course, with a lot of the research people are seeing tertiary sort of work failed, we have failed rehab with multiple people. And then of course, they're more likely to go on to surgery. So we've always got to interpret the literature a little bit with caution based on the populations that the research groups or whoever is writing the paper actually see and deal with clinically. 19:45 Yeah, that was a great overview. Thank you so much. Now that you mentioned imaging, so can you explain how you explain to the patient Do you need imaging? Do you not need imaging? When it comes back? Let's say an MRI comes back. And they're all out of sorts, because Oh, the doctor said, I have damage to my tendon, how am I going to fix this? Right? So how do you deal with that? Because if that is what happens, and then people say, well, when we're done, should I get another MRI? So that I can see the tendons back to normal? So how do you respond to that? 20:29 So that last one I'll deal with first, that is that actually, you're probably going to see some residual changes in the tendon that will take a long time to settle down. And this may be akin to scarring. So when you put your hand you end up with the scar afterwards. And that actually, what we're seeing on the imagery at a later date may be similar to that scoring process. And also reminding them that attendance is very slow to remodel and recover. So really, we're talking about imaging a year plus, if we want to look at it. And it doesn't matter what the tendon looks like, it matters, whether their symptoms and their function and good early on, I would have a different conversation in an elite sporting population, though, where actually, we know that attending that has structural changes is seven times more likely to develop symptoms the next season. And actually, I would probably then want to be changing the tendons structure. But again, that will be a discussion I have with the medical team, perhaps not the athletes so much, because we don't want to, we have to be very careful about the psychological impact of our words with our patients. And this is why imaging has had bad press over a number of years. Because it's often given to patients and they get told, Well, you've got tendinopathy, you've got big tearing there, there's loads of fluid and inflammation and the patient's like, well, I need to then rest until it settles, I need to sort of get this better, and how the hell is it loading exercise is going to help me get better when that's actually what's triggered it. So they're the clinical challenges that we have to explain in terms of the first phase, when we do the imaging, I simply try and D threaten them with it. So say, Look, this is typical of what we'd observe for somebody with tendinopathy. So that is tendon pain that you've presented with. This is not out of the ordinary, this isn't something that's particularly severe, assuming that that's the case based on the imaging. And I've also with MRI identify that it's actually a poor technique to look at collagen. So all we're going to see is high signal, really, it's very, very hard, you need to be have an excellent scan and an excellent radiology radiologist to really examine collagen fibers with it. So it will tell us how big the tendon is. And it will tell us how much fluid there is in there. But we know that that doesn't have a strong relationship with pain. And this is again, part of the reason why we wouldn't want to do it down the line say much. Having said that, again, Karen southern handles group, it's got some lovely papers that have come out that showing structural change does occur with functional resolution and improvement in symptoms. So we've got 42 different research groups in the world at the minute the Australians have often said we shouldn't be looking at imaging, whereas actually Karen's group and I think where we're taking it in the UK is that we should it has a use. But we've got to be very careful with that interpretation. And we certainly see changes in tendon structure as we have patients, we don't need to see it in order to get resolution. But that's because structure doesn't correspond to what's likely to be the key chemical factors in the tendon that are actually what's triggering pain. And we know there's lots of different chemicals involved in tendinopathy. So it's sort of trying to tie it all together. My reason for imaging, I use imaging in practice most of the time is to help we lay patients fears because often they're concerned about the risk of rupture. And this has come out in Shama core lifts qualitative work on Achilles patients. So by imaging, I can actually say, Look, your tendon has plenty of healthy tissue here. This, as best we can say, at this moment in time, is a very low risk for rupture is no higher than a normal person, because there's the same amount of tissue as a normal person would have. 24:06 Where we then have to be careful is where we find that's not the case. And we've just been doing a big longitudinal study in premiership rugby in the UK. Looking at this to see about how that changes. And Matt, who's doing a PhD with me, is going to be analyzing and looking at that data. So Matt Lee is head of medicine at Northampton saints. So Matt's got a big bit of work to determine whether really it ties in and whether we can predict who gets more symptoms, how that ties and, and they don't leave those, but we need to test that and so we're going into it to see probably, but yeah, good use, I think for imaging but not longitudinally imaging for most of your patient group. And it's not necessary and most of you patients you've got coming through your front door for a normal practice. But where there was a sudden onset of pain during activity, and they don't respond Do a six week sort of period of intervention or 12 week period, that's when I would want to image to see what I'm dealing with. Or where there's overt metabolic changes in the person. So adiposity, so high lipid levels, high adipose levels, so the waist circumference, and diabetes, then we want to just make sure they've not got some underlying problems, like, sort of gout that's going on or pseudo arthritic complaints. So yeah, that's where we're going, we might just step up a little bit and maybe consider blood tests as well. 25:33 Great, thank you. Now, let's move on to some treatment options. Right? So we've we've done the differential diagnosis, maybe we got imaging, maybe we didn't, we've, we've ruled everything out, we're pretty confident we've got an Achilles tendinopathy, I will leave it up to you, if you want to say well split it from like, you know, lower to sort of an upper you can, I'll let, I'll leave that in your hands, and how the rehab may be different. 26:05 There's no magic. So that's the first thing. There's no exercise, it's better than the other. It's about understanding the basic principles of rehabilitation here. And this is really what we do, I think, for all of our patients we ever see during a normal clinical role is going well, what do they want to do? Where are they now? How do we bridge that gap? And that's essentially what you're trying to do with your patient is, what's their functional ability at this moment in time? What do they want to do going forwards and coming up with a strategy to try and progress through that? Making sure that that allows for appropriate timescales. So tissue recovery, after exercise, if we're trying to adapt muscles, and muscle strength, which is often one of our big aims, we need to allow appropriate timescales. So 12 weeks plus, rather than expecting rapid changes quickly. So what that looks like in practice is going well, initially, we're going to start off with some form of loading for the Achilles tendon. Now, I would use a very, very isolated exercise, because you can compensate by offloading us in other muscles if we do more complex tests often. So an isolated simple exercise will be a heel race, you can't cheat, you can't use your quads and glutes to compensate, you have to use your calf and it puts stress through your tendon. And there's a nice work with Steph Leser, there's just to out on a systematic review, we're just sort of tweeting about earlier today on tendon material properties and how loading modifies the tendon, and part of what we want to do is improve the stiffness of the tendon, because with the Achilles tendinopathy, it will be less stiff. And that's generally pretty accepted. So we want to make it stiffer. And loading does that the loading needs to be progressive in nature. So we use the symptoms to determine that current simple novel, initially pioneered the pain monitoring model. So looking at how sources during the activity and afterwards, getting an appropriate level of discomfort that the patient can tolerate, doesn't impact their function and making it harder. So something like bilateral heel raises if somebody's really Niggli and saw progressed to a unilateral heel raise, that's about four times body weight through the Achilles tendon. For a bilateral erase, again, depending on the modeling method that's used Josh Baxter in the state system, some nice work on this in his lab, and he's got a lovely paper with Karen as well showing exercises that increase tendons stress. And that's a really good paper for your listeners to have a little read off to look at how to progress or to give ideas of exercises and how they would progress through that. Running, for example, be about five to six times body weight for the Achilles per step. So what we're trying to do is go well walk ins for running six, how do we cross that boundary and use other exercises, or just add external load on to heel race, which is probably easiest way. And that then allows very isolated, monitored exercises. At the same time, I would always use walking or running the same period of time, we wouldn't withdraw them unless we're very, very slow and very struggling. So we'd always use that. And in most patients, if we're not talking athletic, we don't need to use plyometric training jumping up in and stuff we can use walking and running, if necessary to do that. But the more elite athletes, I would always be looking at plyometrics. So hopping jump in London, whatever it happens to be accelerations decelerations off tangent runs, they all increase the stress through different fascicles of the tendon. And that's I guess one of the aspects we can consider that's not been researched yet, and it's where we're going with our work is how we might bend the knee or straighten the knee or rotate the foot to isolate the stress through different sections of the Achilles that correspond to where on imaging we see the degradation. So if we ever want to remodel the tendon, we also need to Reese stress To the tendon at an appropriate threshold, that needs to be 85 to 90 or more percent of your maximum voluntary contraction. And let's face it, we have never done that because most rehab doesn't quantify strength. So I'd always measure spend 30 on a lot of you guys, I think in the states have access to isokinetic devices within your clinics or in local clinics, or other force measurement devices. And I, Scott Morrison's, got quite a lot of sort of workout suggesting how you might be able to do this with a handheld dynamometer, then there's methods we can do with that, or even a set of bathroom scales, to actually utilize a measure strength to give a patient a marker. So our normal data in rugby and football on large cohorts is twice body weight is normal. And we've got similar in endurance runners, our patients are typically one and a half times the weight. But that means doing a heel raise with just their bodyweight will not strengthen them significantly. And that's where we lack we have been our rehab has to be a lot heavier than we've often done in the past. So yeah, so in a nutshell, bilateral raises unilateral progressing through I don't use isometrics early as a method for pain relief, because the evidence substantiates it's not actually that good for pain relief, unless patients find it when the fork which case use it, the heel raises. good warm up response anyway. 31:24 Perfect. Yeah. And in the states do a lot of places have isokinetic testing? I don't know. Sorry. I don't I don't know about that. Even here in New York, I don't think you know, outside of like the larger systems. I don't know that a lot of individual physical therapy offices have that i i do have a handheld dynamometer. And I'm lucky enough to be friends with Scott Morrison. So he was able to kind of take me through and and how to use it. And but it's sometimes this setups can be a little complicated, especially if you don't have an office, if you go to people's homes, how do you stabilize one end and use the other end, and I've come up with some interesting options? Yeah, it's work. I use a seatbelts, I have chains, I have like this, the green, you know, the green stretch strap. Yeah, that with all that I started using that, because it doesn't give, you know, it's pretty, it's pretty good. So kind of it kind of along the line of a seatbelt, you know. So I started using that instead of using even some chain link, I found it to be a little bit easier, a little more gentle for people on their phones, 32:49 strap ratchet strap that you might use on a roof bar. So roof rack, you might actually use that strap and those type of straps can be very good, especially if the wider if the narrower than it hurts the person's knee when you strap it on top. But ultimately, I like it because we can showcase that they need to do strength work because they are weak, more data to give them when you haven't got that opportunity, it's really just sort of giving them this sort of step sort of wise approach to go while you're here need to be there, we need to progress through this and you then just target an exercise that is tolerable, but is sort of getting a little bit of reaction afterwards for a short period. So I've said bilaterally raises unilateral, unilateral with weight, or progressive forwards. And if you're a physio or PT that likes lots of different exercises, give them a dozen, that's fine. But if you're like me, I'm very simple, I just give them one or two things to do really well to do very regularly. And what we avoid in that way is they don't do the things that feel comfortable and easy, because that's what patients generally do. And they're avoid the ones that hurt them because they think it's making them worse. But if we educate them that this is critical, we've got to poke it a little bit to stimulate the cells and improve muscle strength to help the muscle shock absorber for the tendon, which is our current understanding of what we're trying to do with rehab. Then we've got to actually sort of work very well in a bit of discomfort. 34:21 And you beat me to the punch that was going to be my next question is how do you talk to the patient about like, this is not going to be pain free, necessarily, you know, you're gonna have some discomfort. So you kind of beat me to the punch on that. But I think it's important that patients know that you're gonna have some discomfort with these exercises and that's okay. Because a lot of people have been told, I certainly I see it, I'm sure you see it their whole life if it hurts, don't do it. 34:47 Yeah. says and what you've got to explain to them and I often use examples of relatives that you might have had that have had a hip or knee replacement done in the hospital and how afterwards they have to bend it have to walk And actually, yes, it hurts when he gets better or if you've broken your arm and you're in a plaster how gently stretching out when you come out of plaster help to get better. And that's then normally enough to help people go. Yeah, I understand that I can see how that would help and I also then often just explain that as you do this and you get the symptoms afterwards that's the cells in the tendon excreting some chemicals that whilst it makes it a bit sore, they also actually be modelled the tissue. And what we're trying to do is wait the cells up to repair the tissue, wait, repair the tendon, but also improve your muscle as well at the same time. And we've got to stimulate it. It's no different from delayed onset muscle soreness if you go to the gym so that's the other one that are commonly used as the example then we'll turn them penis Dom's is this chap called William Gibson in Australia has done a whole PhD on delayed onset soreness, because it's tendons that you've looked at and connective tissue, not muscle fibers sarcomere itself. And his work I think is really pivotable pivotal with our understanding of it. So yeah, flip it around as Dom's most patients have had Dom's at some point in their life. Yeah. 36:11 Oh, that's great. Yeah, I love that. Well, I have to say, I'm gonna have to re listen to this a couple of times, even though I'm here, I feel like I'm missing things. Like you're speaking I'm like, wait, what? Wait, did I miss this? And we have to listen to this over and over again, because everything is so good. And I think thank you for making it so applicable to the practicing therapist. Because I think that there are nothing against researchers. But there are a lot of practicing therapists out there probably more so than researchers who depend on you guys to be able to to some disseminate this information in a way that is practical and makes sense. So thank you for that. Now, as we start to wrap things up, what do you want the audience to take away from our conversation today? What are some key points, 36:56 I guess the most important parts of monitoring and treating people with tendinopathy is just get your diagnosis right in the first place. Differential diagnosis gets a lot of bad press at the moment, I think on social media, and it's been wanting to sort of dumb down and go with just we've got posterior heel pain, but how I treat an impingement versus tendinopathy will be very, very different, you need to differentiate. And then you need to look at isolated tendon and muscle exercises that is progressive in nature. And I think the key message to physical therapists and physios is that we need to load a lot heavier than often we've done in the past. And by getting normative values for certain sports like we're doing at the moment will help guide what we should be targeting. And they have performance relevance as well when you're dealing with athletes. But for a normal patient, this is a difference between crossing the road quickly in front of the car that's coming in, versus actually ended up with the car getting a bit too close to you. 37:55 Got it? Yeah. And and I love that load heavier and looking at the normative values, because like you said, if running is five to six times body weight, and you're working with someone doing a single leg heel raise, just with their own body weight, that's just not going to be enough. Yeah, right, we've got to we've got to push them a little bit more to load a little heavier. So thank you for that. Now, Seth, where can people find you if they have questions they want to ask you or they, you know, they want to find your research, where can they contact you. 38:27 I'm not a huge one for pushing the sort of research out other than via Twitter. So I have a Twitter handle that we sort of use regularly. And we'll put papers on there and things. But I don't have technically got a website that's on my Twitter profile, but I don't update it. So I'm terribly slack and too busy to bother updating it and need to sort it out. But hopefully this next year, I have a bit more time. So Twitter's The best one is just Sefo Neil, but yo is zero, because there's already another stuff anyone in the world someone and then my other handle is Achilles tendons on there. And just so you all know, it wasn't ego thing. We set it as Achilles tendons, because we went on Twitter originally to recruit patients for our research because some cancer specialist at the University had suggested it was a really good way is terrible, because you need loads of followers to be able to recruit patients and actually get your message out there. It was great for networking. And that's I think the big thing with it. So I network predominantly and occasionally advertise research projects that we're doing now. I've got enough followers to actually get some patients through the door that way. But yeah, not ego because it just so we're clear, 39:33 of course, and we'll have links to those Twitter accounts in the show notes at podcast at healthy, wealthy smart.com. And like I said at the top of the our conversation, you are speaking a few times at the fourth World Congress is Sports Physical Therapy in Denmark at the end of this month, August 26 to 27th. So do you want to give a little sneak peek about what you're going to be talking about? At And what are you excited about for the conference? 40:03 So, myself and Karen Silva novel are going to be running a joint session for the British Journal Sports Med breakout on treating people with tendinopathy. So we're gonna do two sort of sessions of that. So replicate it. So hopefully, if you're interested in coming in, you can come in and send that and hopefully, it'll be nice and interactive, and flesh out some of the aspects we've discussed now, Karen, and then I'm chairing the session, which will be the session that I'm most looking forward to with Karen's there, who else have we got, I gotta get it right now. Michael Caja, and also Ben, Steph, Dakin, as well. So really looking forward to that. We're really nice to hear these guys talk because they are literally at the top of that sort of pinnacle of researchers and clinicians really worldwide. And then Denmark's nice. I mean, every conference, all I've ever managed to see is a little bit of Copenhagen. Because it's been sports Congress. And I normally dash in and bash out at conferences. So it's a little bit the same this time around. But I'm actually looking forward to seeing a bit of seen a bit of Nyborg. And also put two hours in the middle of the day for activity. And they've suggested paddleboarding. And whilst I dislocated my shoulder a week ago, or two weeks ago, it's my second time and I'm actually I was paddleboarding at the end of the week. So I'm hoping that there'll be a bit better by then and actually get out and have a decent paddle board and some exercise rather than just sat at the conference. So that's one of the things I'm looking forward to, and of course, enjoying a small beer with yourself. 41:40 That's yeah, it's a small beer. I look forward to it. And I'm looking forward to going in the summer, because I've only been to Copenhagen in February, and it is cold, and snowy and rainy, and all that stuff. So I'm looking forward to going in the summer. And just looking forward to seeing a lot of people that I haven't seen in a while. So that'll be really fun. And now last question, it's a one I asked everyone knowing where you are now in your life and in your career, what advice would you give to your younger self? 42:13 Oh, gosh. Yeah, it's a really hard question. For me. I always fancied doing research, but I was always put off because there was no ability to do it when I first qualified to do a PhD in the UK was rare in physio, and you might have been able to get a stipend which is 15,000, a year, UK, which actually quite peaker often they further physios as well. Whereas now I'd actually say if that opportunity comes up, even if it's a bit of paper, I take it if you can, because it does open a lot of doors as you progress forwards. And I would unlike other people, sometimes I'd actually say yes to everything. Generally speaking, when it comes to work, not anything else in life, to look at options that we can just opens doors, you get so many things that you don't realize where it will lead and you agree to do something and actually, certainly in these uncertain other things that are fantastic and change your career. So say yes to things when you can push yourself. And yeah, you'll get that. So read the next Roscoe put that. 43:21 Perfect. Thank you so much. This was a great interview you gave us so much to think about as myself as a practicing clinician. So this was great. Thank you so much. 43:31 Pleasure, absolute pleasure. And thank you very much for having me, Karen. Yeah. And 43:35 everyone. Thanks so much for tuning in. Have a great, great couple of days, stay healthy, wealthy and smart. And also if you hope to see you in Denmark, so there's still time we've still got a couple of weeks before the end of August. So if you haven't already, sign up because it's going to be great. So thanks, Seth, and thanks everyone for listening and stay healthy, wealthy and smart.

Many physical therapists want to work in sports and fill their schedule with athletes.But realistically, most outpatient orthopedic clinics don't treat just athletes, even if the word "sports" is in their name!Here's how to find a clinic that is more involved with sports physical therapy, and what to do to see more athletes in a typical outpatient setting.To see full show notes and more, head to: https://mikereinold.com/finding-a-true-sports-physical-therapy-clinicClick Here to View My Online Courses Want to learn more from me? I have a variety of online courses on my website!Support the show

In this episode, Principal Research Fellow at Latrobe Sport and Exercise Medicine Research Centre, Dr Joanne Kemp PhD, talks about hip pain treatment and research. Today, Joanne talks about the common causes of hip pain, the difference between men's and women's hip pain, and the outcomes for patients that “wait and see”. How can PTs design and conduct evidence-based treatment programs? Hear about treating overachievers, referring out and using other treatments, and the upcoming Fourth WCSPT, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways “It's important that patients understand that exercise is good for them and is not going to cause damage.” “With any strengthening program, you only need to do it 2 or 3 times a week to be effective.” “It's probably going to take 3 months for our rehabilitation programs to reach their full effect.” “If you don't get it right the first time, and if it takes you a little while to find your space, that's actually okay, because it's about the long journey, and you'll get there eventually.” “Don't stress about failure. It's about what you learn from that failure and how you adapt and change what you do.”   More about Joanne Kemp Associate Professor, Dr Joanne Kemp, is a Principal Research Fellow at Latrobe Sport and Exercise Medicine Research Centre and is a titled APA Sports Physiotherapist of 25+ years' experience. Joanne has presented extensively on the management of hip pain and hip pathology in Australia and internationally. Her research is focused on hip pain including early onset hip OA in younger adults, and its impact on activity, function, and quality of life. She is also focussed on the long-term consequence of sports injury on joint health. She has a particular focus on surgical and non-surgical interventions that can slow the progression and reduce the symptoms associated with hip pain, pathology, and hip OA. Joanne maintains clinical practice in Victoria.   Suggested Keywords Healthy, Wealthy, Smart, Pain, Hip Pain, Pain Management, Injuries, Research, Osteoarthritis, Exercise, Physiotherapy, WCSPT, To learn more, follow Joanne at: Email:              j.kemp@latrobe.edu.au Website:          https://semrc.blogs.latrobe.edu.au/ Twitter:            @joannelkemp ResearchGate   4th World Congress of Sports Physical Therapy.   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript Here:  00:02 Hey, Joe, welcome to the podcast. I'm so happy to have you on. I've been wanting to have you on this podcast for such a long time. So thank you so much.   00:10 Thanks, Karen. It's great to be here, finally.   00:13 And of course, today we're going to be talking about hip pain, hip pathology, that is your zone of genius. So let's just dive right in. So let's talk about some common causes of hip pain in adults. And does this differ between women and men?   00:36 Yeah, look, it's a great question. And I think probably, we, I think we're starting to change our perspective on that difference between men and women and the causes of hip pain. I think that previously, we've sort of been very aware of the burden of hip pain in men and particularly young male athletes that there's been, you know, a growing body of research that's looked at at the prevalence and burden and causes of hip pain in young men. And probably that's led to a misconception that it affects men more than women. But it's only really that the research has been done in men, less and less so in women, like we see across, you know, the whole medical space. So if we think about the common causes of hip pain across the lifespan, when we're looking in sort of the adolescent and young adult population, you know, typical causes can be things like hip dysplasia, and that's actually is more common in women or young girls and women than boys and men so probably affects three times as many girls and women as it does men. And I think the prevalent when we're you know, the prevalence is perhaps higher than we previously thought. So, some studies are suggesting that up to 20% of adults have some form of hip dysplasia are shallow, hip socket shallow, so turbulent, and, and that that does lead to an increased risk of developing hip osteoarthritis in later life in later life. And even as young adults, sometimes we see patients with hip dysplasia, presenting with arthritis who need to go to hip replacement at a really young age in their 20s and 30s. So, hip dysplasia is a really common one. Another one that we've heard a lot about in the last 10 years is femoral acetabular, impingement syndrome, or FAI syndrome. So that's traditionally thought to be where there's impingement between the ball and the socket, either due to extra bone on the ballpark of the hip, which is can morphology or deep or retroverted socket, which has pencil morphology. And that's probably where a lot of the studies have been done, particularly in that young male adult adult population. But what we're now seeing when we look at the big cohorts, particularly of patients that end up presenting to hip arthroscopy is that it's about 5050. It's about 50% men and 50% women. So that burden is pretty equal across men and women. And that's another thing that does lead to an increased risk of hip osteoarthritis in later life. But the risk is not quite as high in FAI syndrome as it is in hip dysplasia. And it certainly is, it tends to be a slower burn. So these patients present for their hip replacements probably in their 50s and 60s, whereas hip dysplasia, we're seeing these patients in their 20s and 30s, with hip osteoarthritis. So that's probably the second most, the you know, the second cause in that younger age group. Then as we move into older adults, so sort of, you know, people 35 Plus sort of middle aged and older adults, that's where we really see hip osteoarthritis presenting itself, and it can be due to dysplasia or FAI syndrome. But it can also just sort of be that idiopathic arthritis that might be due to occupation, lots of different things. And again, that's reasonably equal men and women, but we do see women probably having a little bit more arthritis than men and more women going to hip replacement than men. And the outcomes for hip replacement are not as good in women as they are in men. So that burden is still probably skewed towards being higher in women than men. And then the other cause of hip pain that we see particularly in the middle age and older women is other gluteal pathologies or lateral hip pain, sometimes called you know, TRAQ, enteric, besides gluteal, tendinopathy, gluteal tendinitis, it has lots of different names. But that's a burden that definitely disproportionately affects women, over men. And particularly, once women get into that perimenopause, or menopause or post menopausal age group, there seems to be a relationship with with with hormones and with estrogen levels and the likelihood of gluteal tendinopathy becoming symptomatic as women sort of transition through that change. And so that's another really common cause. And we're now starting to be aware that often these women will present with combined hip osteoarthritis and gluteal tendinopathy. And that's where it can get really, really, really tricky as well. So yeah, look, it does. There's different, you know, different things that you see across the lifespan, but the burden is definitely I think, disproportionately higher in women than in men in a number of those conditions.   04:58 Yes, and I am firmly In the last group that you mentioned, I am just getting over, if you will, getting over gluteal tendinopathy, where I have to tell you it that is some serious pain. And, you know, when you're a physical therapist and you have people coming in, and they're explaining their pain to you, and you try and sympathize or empathize now I'm like, it is painful. Like I couldn't walk, I couldn't stand for more than like, four minutes. Yeah,   05:29 at least I've had the same thing. And, and I've been lucky that mine, I was sort of able to get on to it, knowing what it was and what to do fairly quickly. But it's very, and I think this is the thing with hip pain until you've had hip pain, whether it's glute tendinopathy, or intra articular, hip pain, it's really disabling. And it really affects everything you do in life, you can't sit without hurting, you can't walk without it hurting, you can't stand without it hurting, you can't lie on your side, without it hurting, you're getting in and out of the car, getting dressed, you know, trying to put your shoes on, it just affects every aspect of your life. And you know, and the pain can be quite intense and severe. So it does. You know, for people who are affected by hip pain, the burden is huge. And we see it reflected in the studies as well, where if you look at outcome scores for quality of life, young people with things like displays your FAI syndrome, their quality of life scores are as bad as people who have hip arthritis who are waiting for hip replacement. So it does, it's very, when you've got it, it's very, very impactful. And I think people until you've experienced it, perhaps people underestimate how bad it can be.   06:33 Yeah, and it can be really, like you said, it's very, very disabling. And it also can can make you very nervous. So you know, when these patients come in to see you. So as the physio, when these patients come in to see you, it really behooves you to sit and listen and really get that whole story so that you can make that differential diagnosis as best you can, if you don't have the diagnostic test to back it up, which often happens. Yeah, absolutely.   07:01 And I think that's the thing when the patient's present to you, and they're complaining of pain in that hip area, you can't just go to one test or one scan and say, Oh, it's definitely these, it's actually there's lots of pieces of the puzzle puzzle that you've got to put together, it can be really complex, and you absolutely have to listen to the patient. And I think fear, like you just said, is a huge thing. And we've seen this in our some of our qualitative work that's currently under review, but others as well that these patients are terrified to move, or to do exercise because they think it's going to hurt more. And they're really scared that it's going to cause more damage. And, and the irony is that exercise is the thing that we know is like is going to make them better. And once they get moving, they do feel better, but they're so scared to move because they're scared, they're gonna break something or make it worse or end up needing a hip replacement that they they don't they don't move. And it fear is a huge problem, you know, with these people.   07:53 Yeah, I mean, even myself as a physio I knew I needed to exercise, I sort of outsource my physio exercises to a friend of mine, Ellie summers, who's on the, on the west coast here in the United States, and she sent me exercises and even doing them, like it's not super comfortable. But within a month, I felt so much better. And now, you know, I'm back to running on the treadmill and doing all the things. But oftentimes, these patients and I may be wrong, but they're not sort of picking up on this within the first month of pain, you know, they might say, Oh, um, it'll go away. Let me give it another couple of weeks and have a couple of weeks. Whereas I was like, Okay, this is really painful. I'm getting to a doctor asap and starting these exercises ASAP. So what have you seen, even through the literature about when patients start to seek out care for this? And how can that affect their outcomes?   08:52 I think it's one of the things with hip pain that patients often will just leave it and they'll wait and see. And so we do know that in the younger age group, like if you think about FAI syndrome, for example, people will often not present for two or three years, they will pull up with the pain because it kind of comes and goes so they'll have a flare up, they'll be bad for a few weeks, it'll go away for a few weeks and have another flare up. And so because it's coming and going, they, I guess remain optimistic. It's human nature to be optimistic that it's going to get better by itself. And so it can often be a couple of years. We see this in the literature, you know, two or three years, but I see that in my clinical practice. And I'm sure you do, too, Karen, that patients, they'll come to you and they'll say, oh look, I've had this for two or three years, I was waiting for it to go away and now it's you know, suddenly getting worse and that's when they seek out care. And I think too, you know if we think coming back to what we were talking about with women is that these problems affect women who are really busy so they are often have busy careers. They're looking after families often, they they might be studying as well. They're juggling lots of things. So for them to try and fit in the medical care or, you know, physio care or whatever they need. It's really hard for them to find to make the time to do that. And I think that that's probably why they potentially delay seeking, seeking treatment as well.   10:12 Yeah, so many factors go into it. But bottom line is it hurts. Now, how let's talk about the physio side of things. So how can PTS design and conduct an evidence based treatment program? For, we'll say, for adults with hip pain? Yep.   10:31 So I think we probably the first thing is to set really good expectations for the patient. So often patients will come potentially looking for the quick fix. And so I think it's important that right up front, we say to our patients, that it does take a while for things to work, you should be starting to improve over that time, but they need to be committed to an exercise program that we know needs to be now at least three months long. So I think both the therapist and the patient need to be prepared for that longer term commitment as well. So I think that's the first thing is setting expectations, right. And then around those expectations, it's also really important that patients understand that exercise is good for them and is not going to cause damage. So you're really trying to get the confident to be able to exercise part of that is an understanding that it will like you just said like when you did your exercises, it's not super comfortable. But that's okay, they need to they don't want to be in a lot of pain, but they will probably have some pain and that that's actually okay and normal to have that. And it doesn't mean that they're causing more damage. That's just a normal part of the body adapting to the exercise process. Sometimes I find with patients to you in order to convince them of that, because sometimes they're a bit skeptical, they don't quite believe you that they give you know, they will do exercises for a week, just look, just have a week off the exercise and see what happens to your pain. And what they find is pain is no better when they're not exercising. But sometimes it's worse, it's usually worse or the same. And so then they're like, Oh yeah, now I understand the exercises and actually making my pain any worse. And so sometimes you might need to do that to get them to buy in. So I think getting them to buy into the timeframe the commitment that they're going to need to do and the fact that they will have a bit of pain, that's probably the biggest thing, then once you've done that, then you can start to develop your exercise program and the foundations of our exercise program. I like to think of it as being sort of two pronged. So the first one is the local exercise that we're doing for the hip joints. So that's where we do a lot of our strengthening exercises. So strengthening up the muscles around the hip. So the hip abductors, and the adductors flexes in the extensors. But then also really focusing on the core and the trunk is important because that controls the acetabulum, which controls the socket. So putting that in and then you know functional exercises as well. So teaching them how to do things like squats and lunges and going up and down stair. So our local rehab exercises should have primarily a strength focus, they might also need to have a range of motion focus as well. But we need to be careful with ranges of motion because sometimes those ranges of motion might be provocative for patients. So going into a lot of rotation or a lot of flexion could provoke pain. So strength is probably our big biggest focus. But then the second prong of our rehab program should be around general fitness in general activity. So you know, we know that the physical activity guidelines say that everybody should be doing 150 minutes of moderate activity a week or 75 minutes of vigorous activity, then that's just to be a healthy person, regardless of whether you've got a sore hip or not. So I think trying to get them to do general fitness, cardio, whatever you want to call it alongside their hip specific rehab is, is the thing that you need to do. And then what I try and do is I try and make that hip specific rehab, sort of normalize it as fitness training, rather than rehab. Because people get, they're going to be like, don't want to do rehab, everyone gets bored of rehab, you know, at home with your little bands. So trying to get them to do things like you know, incorporated as part of their twice a week strength training, where they go to the gym, for example, is really important. And with any strengthening program, you only need to do it two or three times a week to be effective. So people don't have to do it every day. So I think that's important too to for them to know, they'll get they'll have days off where they don't have to do it. But to find two or three days a week where they can commit to this the strengthening component of the program, the cardio fitness component of their program can fit in around their schedule. And something that I really like to do with patients is to sit down and actually look at their weekly schedule and help them schedule it into their diary. So don't just say to them, you go do this, you know, five times a week, you actually have to fight help them find those chunks of time where they can do it and they can find 30 minutes in their day to be able to commit to that exercise program.   14:50 Yeah, I really love that you said to emphasize that the strength thing has to be done two to three times a week, because oftentimes Well, I mean, I'm in New York City where you have a lot of is like very driven, sort of type A folks. And they think if you're not doing it every day, then it's not working. Yeah, you know, so to be able to reframe that for them and say, Hey, listen two to three times a week is what our goal is, and be very forceful on almost holding them back. Do you have any tips on how to hold people back? For those folks? Who are the overachievers?   15:26 It's hard. Yeah, it's really tricky, isn't it? I think sometimes I think people have to learn for themselves. So you kind of have to let them find out the hard way, maybe, and be prepared with some painkillers to settle things down. But ideally, you don't want to do that, if you can help it, I think, I find that presenting the evidence can be really, really helpful. So you know, talking about the strengthening guidelines that that show that two to three times a week is where you're going to get the maximum effect of strength. And if you do more than that, it's not going to really add to that you'll have already sort of hit that ceiling, and potentially give them something different to do on those other days, if you don't want them doing strength training two to three times a week. If there's someone who wants to do something every day, helping them find other things on those other days, so perhaps, you know, mixing it up with some cycling, walking or jogging, if they are able to do that some swimming, you know, sometimes, you know, it might be appropriate or safe for these patients, if they enjoy things like yoga or pilates, they can do that if it if it doesn't hurt in addition to their other things. So I think those type A personalities, you might need to fill the space on those other days. Give me something else to do.   16:33 Yeah, I think that's great advice. And now, sometimes, as physiotherapist we have to refer out. So when is it appropriate to refer out or to use other treatments such as surgery? How do we navigate that as a physio?   16:50 It's tricky. And I think the most important thing is that that has to be a shared decision that we make with our patients. And at the end of the day, they will have their beliefs and their priorities that will probably take them in certain directions. Having that three month rule is a good rule, I think that we know it's probably going to take three months for our rehabilitation programs to reach their full effect. But but it doesn't mean to say you keep doing things for three months, if you're not getting any improvement, we really want to see them starting to head in the right direction, probably within around about four weeks. Within, you know, two or three treatments, you should be starting to see some change even though we know it's gonna take longer than that to get the full effect. I think that if you're not seeing change within that first month or so, you have to start asking yourself questions about well, why why why aren't I getting changed? Do I need to look at this and red flags here? Do I need to potentially refer the patient to their GP? For some imaging, we know that, you know, people have a history of cancer, that breast cancer and the gynecological cancers and prostate cancer really caught the hip joint is a really common point from you know, where the cancer metastasizes. So, I think bearing in mind our red flags, you know, women with guide other gynecologic non cancer, but other gynecological issues, you often get pain in that same area. So, being open minded about some of the non musculoskeletal causes of pain and being prepared to refer on if someone's not improving in that time is important. Imaging, you know, we don't want to jump to imaging straightaway, it's not always necessary, but it is sometimes it is necessary. And I think don't be frightened to refer for imaging. If someone's not improving. The one thing that I and it's different in every country and our health systems are all different. But here in Australia as physios, we can refer for imaging, but I if I'm if I'm suspicious that there's a red flag, that's a medical thing that's outside my scope of practice, I will refer them to the GP for the GP to refer for imaging. And the reason for that is I if you refer for imaging, you need to be able and confident to tell the patient the results of their imaging and interpret them and then refer them on for appropriate care now, for those medical things. I think as physios that's way outside our scope of practice and we shouldn't be you know, if the scan comes back with cancer, like we can't that's way outside our scope and we shouldn't be having to to explain those results to patients, I think only refer for imaging yourself with your confidence of what you'll be able to interpret those findings. So don't be afraid to refer to the doctor. Some patients often need pain relief as well or anti inflammatory. So that's, you know, if you're not getting improvements in that four weeks, you may need to refer them to the doctor to get pain relief or anti inflammatory medication. Things like injectables again, we don't want to inject give people lots of injections but we know that the hip joint is often sign up at green flame. So you know a judiciously used cortisone injection can be helpful in in some cases. So I think it's been not afraid to refer on you know, when you just turn the video off, when you need when you need to, to, you know to those other things and then surgery is probably your last resort, but There are a small number of people who will potentially need surgery as well. So, but you wouldn't actually be looking at surgery until you really finish this full three months of rehab.   20:09 Yeah, that all makes perfect sense. And now as we kind of start to wrap things up, where there, is there anything that you know, we didn't cover, that you would really like the listeners to know, or to take away, whether that's from the literature or from your experience when it comes to hips?   20:31 Yeah, I think, look, I think we've covered most things. But I think what it is, is just being really confident to prescribe a good quality exercise program. And if you don't feel like you have the knowledge or skills to do that, don't be scared to either refer to a colleague who who might have more knowledge or skills, or to, you know, to look up the evidence with, you know, that the evidence is has really grown in the last couple of years. And we published a consensus paper in V jsme, 2020. That was a consensus paper on what physio treatment for hip pain in young and middle aged adults would be. So that's a really good resource, it's got some some good examples in that paper of the types of exercise that you should be doing. And then my colleague from the US might Raman also lead a consensus paper in that same series on the diagnosis and classification of hip pain. So that's another really good resource that you can go to that will help you clarify the different diagnosis in the hip and what what what sort of things you can do to confirm your clinical suspicion and your diagnosis.   21:34 Perfect. And now, you will also be speaking at the fourth World Congress of sports, physical therapy in Denmark, which is August 26th, to the 27th, you're doing to sort of 15 minute 15 minute talks repeated twice. So one talk repeated twice. On the second day of the conference, can you let the listeners know a little bit more about that. And if you have any sneak peak that you want to share?   22:04 Yeah, so I'm going to be doing that talk in combination with a with a great colleague of mine, a Danish colleague, Julie Jacobson. And so we're going to be talking about hip pain in women specifically. So looking at the common causes of hip pain in women and as as physios, or physical therapists, what we should be doing to manage to manage that, because it's a congress of sports, physio, or sports, physical therapy. It'll be slanted probably towards the younger, more athletic population. But I think there'll be some really great takeaways for anyone treating women in particular with hip pain. So we're going to be really, I think, trying to focus on what it is about women with hip pain that's unique and different to men, and really helping the therapist develop a rehab program that really targets the things that are important for women. So the impairments that women have the physical impairments, but also really targeting some of those, you know, we've got to think about the biopsychosocial model. So some of the psychological challenges that people with hip pain have that we've sort of touched on in terms of being fearful to move, but then the social challenges too, because we know that we do live in a gendered environment. And it's no different for women with hip pain, where they might face additional barriers to, you know, in this the way society is constructed to be able to access the best care. So it's also helping helping the clinician really become an help patients navigate some of those challenges as well.   23:27 I look forward to it. It sounds great. Now are what is there anything that you're looking forward to at the conference in Denmark? Have you looked through the program? Are there talks that you're looking forward to?   23:40 I look, there's there's going to be so many great talks there. Like it's such a I can't believe how many how much they've packed into two days, like for two day program, I'm actually really excited. by so many of the different tools, I think the thing I'm most excited about is after two years, it'll be nearly three years by then that we've actually been able to see each other face to face, just to have the opportunity to catch up face to face with so many great colleagues that I've worked with before, but also meet new colleagues as well, and have the chance to travel to beautiful Denmark. You know, I haven't been to the conference venue, but it looks amazing being on the coast. In summer, it's going to be beautiful. I know the conference Organizing Committee has got a great social program as well organized and the Danish conference dinners are always a highlight, I think of any program. So I'm really excited about that as well. Yeah, I just I just can't wait.   24:31 Yeah, it's it. You have the same answer that so far everyone has said as they just can't wait to be in person and to network and to hang out with people and to meet new people. So you're right along with everyone else that I think a lot of the other speakers that are going to the conference, and now where can people find you if they have questions, they want to see more of your research, where can they go?   24:55 So, um, so I'm on Twitter, so my Twitter account is at Joanne L. him. So L is my middle initial. And you're welcome to send me a message via Twitter. But you can also contact me via email. So my email address is the letter j.camp@latrobe.edu.au. And then our sports medicine allotropes sports and exercise Medicine Research Center has a has a webpage and a blog page where a lot of our research is highlighted there as well. So if you just Google up Latrobe, Sport and Exercise Medicine Research Center, that's the first thing that will pop up as well. And we have a lot of, you know, a lot of really good information. We've got a really our Research Center has a really strong knowledge translation arm and so a lot of my colleagues, which credit to all my colleagues who work in this space, have developed a lot of really great resources to infographics, videos of exercises, lots and lots of different things that can be found on our on our research, our centers, webpage and blog page as well. So lots of good resources there.   25:57 Excellent. And we'll have links to all of that in the show notes for this episode at podcast at healthy, wealthy smart.com. So one click will take you to all of the resources that that Joe just mentioned. And last question that I ask everyone is knowing where you are now in your life and in your career? What advice would you give to your younger self? So maybe straight out of physio I pick pick a year, any year you'd like?   26:22 It's great question. And it's funny because I was actually talking to my son's girlfriend the other night, who's at university, and she's finding it stressful and hard. And I actually shared with her something that I'm not afraid to share that I actually nearly failed my first year of university, because I was too busy enjoying the social aspect of uni life. And I think what I would say to my young, and that stressed me out and really upset me at the time. And I think what I would say to my younger self is if you don't get it right the first time. And if it takes you a little while to find your space, that that's actually okay, because it's about the long journey, and you'll get there eventually. And so if you hit hurdles and bumps and you don't, you're not always successful every time, it actually doesn't matter. Because as long as you keep on trying, you'll you'll get there in the end. So don't don't stress about failure. It's about what you learn from that failure and how you adapt and change what you do.   27:12 What excellent advice. Thank you so much. And thank you for coming on to the podcast. This was great. And I think the audience now has a better idea of what to do with their patients when they have hip pain. And if they don't, they can head over to Latrobe, they can go over to the website and get a lot of great resources from from you all and also look up a lot of your research. And if we can also put your Research Gate. Yeah, we can put that up in the show notes as well if that's okay, so that way people can kind of get a one stop shop on all of your research because it's extensive. So we'll have that up there as well. Thanks, Karen. Thank you so much. And everyone. Thanks so much for tuning in listening and we hope to see you in August in Denmark at the fourth World Congress Sports Physical Therapy again, that's August 26 and 27th. If you haven't registered, I highly suggest you get on it and hopefully we'll be able to see you in Denmark. So I look forward to seeing you then. And everyone have a great couple of days and stay healthy, wealthy and smart.