Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review.

In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy.

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RESOURCES

Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/

Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/

Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf

More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/

Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/

Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Achilles Pain, Stiffness, and Muscle Power Deficits - updated clinical practice guideline from AOPT: https://www.jospt.org/doi/10.2519/jospt.2024.0302

When patients improve following treatment, how much can be attributed to the intervention delivered, and how much is due to contextual factors and nonspecific effects that lie outside of the clinician's control?

Dr. Giacomo Rossettini joins the podcast again as a co-author of a paper (link below) that answers that very question.

Dr. Rossettini and his research colleagues tried to quantify the effect of contextual factors with a meta-analysis. They found non-specific effects play a big role in patients' outcomes. Today's discussion covers what these contextual factors are, how the researchers quantified them, and how musculoskeletal rehabilitation clinicians can harness non-specific effects to boost patients' outcomes.

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RESOURCES

Non-specific effects in musculoskeletal pain treatment outcomes (meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2024.12126

Musicians and athletes might sometimes appear to exist in very different cultures. And yet, the single-minded focus, thousands of hours of practice, and high training loads on their musculoskeletal systems mean that musicians and athletes probably have more in common than they have differences. At least from a musculoskeletal rehabilitation perspective.

Today's guest is Marianne Roos - a former clarinetist and forever musician-at-heart, who now practices as a physiotherapist and conducts her PhD research from Laval University, Canada. Marianne explains the physical and psychological demands of orchestra performance on the musician's body, and shares the results of her PhD research in developing programmes to reduce musculoskeletal injuries among orchestra musicians.

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RESOURCES

Barriers and facilitators to implementing rehabilitation and wellness programs for orchestral musicians: https://pubmed.ncbi.nlm.nih.gov/33853373/

Workplace injury prevention and wellness program for orchestra musicians: https://www.jospt.org/doi/10.2519/jospt.2024.12277

When it comes to serious injury, like an ACL tear, in college sport, how many young athletes return to their previous level of performance?

Today's guest led a team that has done the hard yards of synthesising all the available data to find an answer.

Dr Cortez Brown is a junior orthopaedic surgery resident at the University of Pittsburgh Medical Centre.

In today's episode, Dr Brown shares the results of his systematic review, and guides listeners through the complex factors that affect return to play outcomes for college athletes.

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RESOURCES

Return to college sport after ACL reconstruction systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12483

Systematic review of return to competitive sport (all levels) after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/

Ballooning wait times, overworked and burnt out staff. No doubt you're only too familiar with the signs of a health system that's under serious strain. And not just since the Covid-19 pandemic.

Simon Lafrance, physiotherapist and researcher from the University of Montreal, explains musculoskeletal care models that flip the traditional medical model of the doctor as the first contact point a patient has with the health system, to a musculoskeletal specialist, like a physical therapist, leading instead.

Simon's clinical work and research work merge as he works to develop and evaluate advance practice physiotherapy models.

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RESOURCES

Trial of single vs. multiple sessions of advanced practice physiotherapy: https://www.jospt.org/doi/10.2519/jospt.2024.12618

Musculoskeletal rehabilitation clinicians are well versed in the physical and mental benefits of regular physical activity. Unfortunately there is limited evidence to guide clinicians on how to best support return to sport and physical activity after childbirth. That's where today's guest comes in.

Dr Jenna Schulz (physiotherapist and postdoctoral researcher from Western University, Canada) specializes in pelvic health and sport, women’s health, and improving longevity in sport for females across the lifespan. Today, Jenna shares how she approaches supporting physical and mental readiness for sport postpartum, and when to refer to your colleagues in the multidisciplinary health care team.

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RESOURCES

Systematic review of exercise interventions for physical activity and cardiorespiratory fitness: https://www.jospt.org/doi/10.2519/jospt.2024.12666

Scoping review of guidelines for returning to physical activity and sport postpartum: https://pubmed.ncbi.nlm.nih.gov/37898507/

Relative Energy Deficiency in Sport (REDs) and the lactating athlete: https://pubmed.ncbi.nlm.nih.gov/37752008/

Most people who pursue a career in health care do so because they want to help people. Depending on where you work, patients might find it easier or harder to access high-value musculoskeletal care, and you might run into barriers to providing the care you would like to provide.

Dr Roy Film is a physical therapist, educator and current President of APTA Maryland. In today's episode, Roy explains his work trying to make it easier for people to choose high-value musculoskeletal rehabilitation.

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RESOURCES

Racial disparities in outpatient PT use: https://www.jospt.org/doi/10.2519/jospt.2024.12641

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.

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RESOURCES

"Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676

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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.

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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

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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

If you consult a clinical practice guideline for any musculoskeletal condition, you'll probably see advice and education included as part of the recommendations for helping someone manage their musculoskeletal pain.

How well do the recommendations in clinical practice guidelines about what topics advice and education should cover align with the main concerns of people with back pain?

Dr Giovanni Ferreira (University of Sydney) joins JOSPT Insights to explain.

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RESOURCES

Concerns of people with acute back pain: https://www.jospt.org/doi/10.2519/jospt.2024.12571

AI chatbots answering questions about low back pain: https://pubmed.ncbi.nlm.nih.gov/39299722/

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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'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.

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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