JOSPT Insights

Does the thought of managing elbow pain leave you reaching for your orthopaedics textbook? Maybe you've got lateral elbow tendinopathy sorted, but how confident do you feel about managing elbow fractures and dislocations? Today, Val Jones, Clinical Lead Physiotherapist at the Sheffield Shoulder and Elbow Unit at the Sheffield Teaching Hospital Foundation Trust, shares practical advice to help you feel confident about managing elbow pain. ------------------------------ RESOURCES CT versus MRI for assessing osteochonritis dissecans of the capitellum: https://pubmed.ncbi.nlm.nih.gov/36342019/ Shoulder arm return to sport test battery: https://pubmed.ncbi.nlm.nih.gov/31203142/ Lateral elbow pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2022.0302 2022 Bern shoulder consensus: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952 JOSPT Insights episode 136 (lateral elbow pain with Drs Lucado and Day): https://podcasts.apple.com/us/podcast/ep-136-lateral-elbow-pain-2022-clinical-practice-guideline/id1522929437?i=1000617533681 JOSPT Insights episode 103 (baseball pitching biomechanics with Wake Forest Pitching Lab): https://podcasts.apple.com/us/podcast/ep-103-baseball-pitching-biomechanics-with-the-wake/id1522929437?i=1000581372250

Did you know that calf injuries are one of the most common soft tissue injuries in team sports? How comfortable do you feel assessing and managing calf pain, especially designing and progressing a program to help someone get back to their sport? Today, Dr Seth O'Neill from the University of Leicester, joins us to blend the latest science in calf injury with high-level clinical reasoning. You'll get something out of today's chat whether you're beginning in your clinical career or whether you're looking for suggestions for advanced clinical practice.

Two (gentle) giants of physiotherapy/physical therapy research and practice join JOSPT Insights today. Associate Professor Peter Kent and Professor Peter O'Sullivan (Curtin University, Perth, Australia) share, on behalf of the whole trial team, the results of their RESTORE trial. Does cognitive functional therapy herald a revolution in how clinicians can support people to live well with back pain? Let's find out. ------------------------------ RESOURCES For the published trial: https://pubmed.ncbi.nlm.nih.gov/37146623/ Find out lots more about the RESTORE trial, including how patients and clinicians feel about cognitive functional therapy: https://www.restorebackpain.com/

Dr Angela Cadogan, specialist physiotherapist and clinical consultant, shares her approach to diagnosing subacromial pain. She discusses the challenges in diagnosing shoulder pain, the use of imaging, and the value of clinical tests. The decision-making process for surgery vs. rehabilitation for traumatic tears is also explored.

Welcome to part 2 of our masterclass with Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia) on understanding, talking about and shifting the narratives we all carry about musculoskeletal pain. We are exploring the explicit and implicit messages that you communicate with your words and actions when you work with patients. Drs Bunzli and Caneiro share tips on communicating, and on developing your own practice as a musculoskeletal rehabilitation clinician. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

We're wrapping up the 2023 JOSPT Insights year with a 2-part chat with physiotherapists, researchers and educators, Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia). In part 1, we discuss the way that patients understand pain. Dr Bunzli kicks off by summarising the best research evidence, and Dr Caneiro shares some compelling clinical examples to explain how to apply the research to deliver quality musculoskeletal rehabilitation practice. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

In part 2 of this series, we continue chatting about designing and implementing a rehabilitation program after cervical discectomy with Drs Justin Lantz, Jessica Evaristo and Joseph Derian. Today we work through phases 3 and 4 in the rehabilitation program: re-modeling and maturation occurring around 12-weeks after surgery. We cover nerve glides and how to dose them, the goals and areas of focus for manual therapy and therapeutic exercise, incorporating proprioception training, and important clinical milestones to consider along the way. The patient’s goal was to return to manual labor, and we talk about how healing timelines impact on clinical decisions in the later stages of rehabilitation. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608 Catch part 1 here: https://podcasts.apple.com/us/podcast/ep-158-planning-a-rehabilitation-program-after/id1522929437?i=1000637409917 or https://open.spotify.com/episode/0Ci1ya1CHXB8FgYYBO4Q3q?si=94b548f8e3bd4b4e

Join a group of experienced orthopaedic clinicians as they review the background of anterior cervical discectomy and fusion surgery in a 2-part podcast series. In part 1, we cover who does well with surgery, the indications and surgical procedure, plus a deep dive into evidence-based pre- and post-operative rehabilitation. There's not much hard research evidence to guide your decisions on how to structure and deliver, so tune into hear how expert clinicians approach things. You'll learn about the phases of rehabilitation (we tackle the first two in today's episode), what’s normal, what’s not, strategies for collaborating with surgeons, and suggested interventions. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608

Dr Jeremy Graber joins us to help answer the question: how often should patients with total knee arthroplasty come to rehabilitation? To answer this and more, we dive into the 2023 JOSPT article, “Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study.” ------------------------------ RESOURCES Dr Graber and his colleagues led a expert consensus process to establish recommendations for how often and for how long you might consider scheduing rehabilitation visits. The group also discussed discharge planning, how to implement telerehabilitation, and monitoring the patient's progress to guide clinical decisions Check out the JOSPT article: https://www.jospt.org/doi/10.2519/jospt.2023.11840 For more on predicting outcomes after total knee replacement: https://www.medrxiv.org/content/10.1101/2023.10.23.23297404v1 (preprint)

Florian Teichert and Dr Daniel Belavy discuss exercise interventions for preventing neck pain, emphasizing the importance of individual engagement and tailoring programs to individual preferences. They also explore the relationship between exercise dose and its impact on pain and disability. The podcast highlights the effectiveness of different exercises in preventing and managing chronic back and neck pain, emphasizing individualized routines and compassionate care. Additionally, the importance of healthcare professionals understanding diagnosis development and effective communication with patients is discussed.