BJSM Podcast

Dr Martin Raftery and Dr Ross Tucker join the BJSM to discuss World Rugby’s injury prevention journey, and most recent player welfare initiatives. We also hear from World Rugby chairman Sir Bill Beaumont on how rugby has evolved in this regard. All links can be found in the e-Edition.

In this podcast, we are joined by Dr Stephen West to discuss all things load. Stephen recently completed his PhD at the University of Bath, looking into the Epidemiology of injury and associated risk factors in Professional Rugby Union. Topics covered include: - Athlete monitoring - The way we capture data - Practical tips for those working in sport - Where are the next big gains likely to be found? Resources: https://www.semanticscholar.org/paper/Athlete-Monitoring-in-Rugby-Union%3A-Is-Heterogeneity-West-Williams/b8e39759a7f83fb57c9c571d1212db8ea16bf406 https://researchportal.bath.ac.uk/en/publications/patterns-of-training-volume-and-injury-risk-in-elite-rugby-union- https://researchportal.bath.ac.uk/en/publications/better-way-to-determine-the-acute-chronic-workload-ratio

Should we still be using ice and cryotherapy? Do we need to foam roll before or after working out? Are we wasting our money on compression gear? On this week’s BJSM podcast, award-winning science writer and best-selling author Christie Aschwanden (T: @cragcrest) joins BJSM’s Daniel Friedman (T: @ddfriedman) to cut through all the hype and explain what works and what doesn’t when it comes to recovery. Christie Aschwanden is the author of New York Times bestseller GOOD TO GO: What the Athlete in All of Us Can Learn From the Strange Science of Recovery and co-host of EMERGING FORM, a podcast about the creative process. She’s the former lead science writer at FiveThirtyEight and was previously a health columnist for The Washington Post. Christie is a frequent contributor to The New York Times. She’s also been a contributing editor for Runner’s World. https://christieaschwanden.com/ In this podcast, Christie dissects the evidence for common recovery methods and discusses: - The changing definition of recovery and how we measure it - Ice and cryotherapy - Massage and foam rolling - Which recovery methods actually work and how to optimise them - The best indicators of recovery - How to improve the quality of recovery research Mentioned in this podcast: Good to Go - https://www.goodtogobook.com/ Methodology problems in sport science - https://fivethirtyeight.com/features/sports-science-is-finally-talking-about-its-methodology-problems/

Predicting and preventing injuries is seen as the ‘holy grail’ of sports medicine. The literature is brimming with efforts to understand injury prevention, and popular buzzwords such as ‘artificial intelligence’ has seen the emergence of questionable methods to predict sports injuries. In this podcast, Dr Nicol van Dyk speaks to Dr Sean Carmody about current concepts in injury prevention and the validity of the evidence underpinning them. Nicol draws on the experience of his PhD investigating risk factors for hamstring injuries in professional football to forecast the future for preventive efforts in elite sport. Key resources discussed in the podcast have been included below, and if you want to hear more on the topic, Nicol will be presenting at the South African Sports Medicine Association Conference in October 2019. Key Resources: Why screening tests to predict injury do not work—and probably never will…: a critical review Do not throw the baby out with the bathwater; screening can identify meaningful risk factors for sports injuries Risk factors for hamstring in football - thinking fast and slow by Nicol van Dyk Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study The quadrant of doom and hamstring injuries: sexy but too easy? The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players The acute-chronic workload ratio: a critical appraisal Aspetar – Hamstring Issue The training—injury prevention paradox: should athletes be training smarter and harder?

Joining Dr Steffan Griffin in the studio this week are Drs Martin Raftery and Ross Tucker, Chief Medical Officer and one of the lead Research Scientists at World Rugby respectively. Following on from their debut podcast two years ago, we dive into rugby’s complex relationship with concussion, and the journey that World Rugby have been on over the last few years to tackle the issue. Much of the resources discussed will be in the special #RugbyMedicine e-Edition, that will be launched in time for #RWC2019. In this podcast we cover: - The concussion journey rugby has been through, and the interventions that have been trialled/implemented - The high tackles sanction framework - Recent law trials - Advice to other governing bodies looking to prioritise player welfare

Is iliotibial band pain a friction problem? Or a load problem? On this week’s BJSM podcast, Dr Rich Willy (T: @rwilly2003) and BJSM’s Daniel Friedman (T: @ddfriedman) discuss the clinical management of iliotibial band pain. Dr. Richard Willy PT, PhD, is an Assistant Professor in the School of Physical Therapy, University of Montana (Missoula, MT, USA). He received his PhD in Biomechanics and Movement Science from the University of Delaware and his master of physical therapy from Ohio University. In addition to his research, Dr. Willy has been a clinician for 18 years specialising in the treatment of the injured runner. His research aims to develop clinically effective treatments for patellofemoral pain syndrome, Achilles tendon injuries and tibial stress fractures. In this podcast, Dr Willy discusses: · How to assess the injured runner with ITB pain · Misconceptions about ITB pain – it’s not a friction problem and you need some tightness! · How to progress the rehabilitation in managing ITB pain · Is there a role for stretching and foam rolling? The case study used in this podcast was originally from Pegrum James, Self Alex, Hall Nick. Iliotibial band syndrome BMJ 2019; 364 :l980 https://www.bmj.com/content/364/bmj.l980

CrossFit: dangerous fad or fitness panacea? The AMSSM talks safety with Drs Sean Rockett and Robert Oh. Few topics in sports draw such universally strong opinions from medical providers as that of CrossFit. Most seem to love or hate it, but are their strong opinions justified? Does current data back-up the concerns many of us have regarding the safety of this sport? What are the common injury patterns that are found? Host Dr. Devin McFadden, MD is joined by Dr. Sean Rockett, MD and Dr. Robert Oh, MD to explore these topics and more on the AMSSM Sports Medcast. Dr. Sean Rockett is an Associate Professor of Orthopedic Surgery at Tufts University School of Medicine, president of Orthopedics New England and author of 321GoMD.com an injury prevention website for CrossFitters. He is head of the Orthopedic division for the Medical team for The CrossFit Games. Dr. Robert Oh, Sports Medicine physician and CrossFitter for 12 years. He’s the Chief of the Family Medicine Dept at Madigan Army Medical Center and Fellowship director for the Leader and Faculty Development at Madigan. References: 1. Sport Med - open. 2018;4(1):11. doi:10.1186/s40798-018-0124-5. 2. J Sports Med Phys Fitness. 2017;57(9):1147-1153. doi:10.23736/S0022-4707.16.06827-4 3. Orthop J Sport Med. 2018;6(10):2325967118803100. doi:10.1177/2325967118803100 4. J Sport Rehabil. 2018;27(3):295-299. doi:10.1123/jsr.2016-0040. 5. Sport Med. 2017;47(3):479-501. doi:10.1007/s40279-016-0575-0 6. Annals of epidemiology 2006; 16(9):712-719.) 7. Work Heal Saf. 2017. doi:10.1177/2165079916685568. 8. Mil Med. 2016;181(7):627-637. doi:10.7205/MILMED-D-15-00273 9. US Army Med Dep J.:36-47. http://www.ncbi.nlm.nih.gov/pubmed/24146241. Accessed August 5, 2018.

“Only by speaking out can we create lasting change” On this week’s BJSM podcast, Prof Margo Mountjoy (T:@margomountjoy) joins BJSM’s Daniel Friedman (T:@ddfriedman) to discuss harassment and abuse in sport. Prof Mountjoy is an Associate Clinical Professor in the Department of Family Medicine at McMaster University Medical School and Regional Assistant Dean of the Michael G. DeGroote School of Medicine, McMaster University. She is also a clinician scientist – sports medicine physician practicing at the Health + Performance Centre at the University of Guelph, as the Clinical + Academic Director. Prof Mountjoy works for several International Sports organizations in the field of sports medicine including the International Olympic Committee (Games Group), the International Federation for aquatics (FINA), the Association of Summer Olympic International Federations and for the World Anti-Doping Agency. In this episode, Prof Mountjoy discusses: · The Larry Nassar case · Sexual abuse in sport · MeToo movement’s impact on sport · Types of abuse and harassment and the impact on the athlete vs organisation · The Olympic Athlete Welfare Programme · Tips for clinicians to help prevent abuse and harassment in sport Mentioned in this podcast: Mountjoy M ‘Only by speaking out can we create lasting change’: what can we learn from the Dr Larry Nassar tragedy? British Journal of Sports Medicine 2019;53:57-60. https://bjsm.bmj.com/content/53/1/57 The Larry Nasser Tragey – BMJ https://blogs.bmj.com/bmj/2018/03/29/margo-mountjoy-on-the-larry-nassar-tragedy-never-again/ Reardon CL, Hainline B, Aron CM, et al Mental health in elite athletes: International Olympic Committee consensus statement (2019) British Journal of Sports Medicine 2019;53:667-699. https://bjsm.bmj.com/content/53/11/667 Safeguarding athletes from harassment and abuse in sport IOC toolkit https://www.iwf.net/wp-content/uploads/downloads/2018/10/IOC_Safeguarding_Toolkit_ENG.pdf You can find two of Professor Mountjoy’s previous podcasts here: Relative energy deficiency syndrome (RED-S): http://ow.ly/VCZK50v2A7f Psychological abuse in sport (2017) http://ow.ly/ljJt50v2Amt (Harrassment, abuse, bullying)

Jonathan Hanson is a Sports Medicine consultant with a background in emergency medicine. He works as team doctor for the Glasgow Warriors rugby union team, has worked as an Emergency care advisor to the FA and worked on Head injury systems and immediate care with the Senior men at the 2018 FIFA World Cup. Given his background, he has a particular interest in the human factors associated with working in SEM, especially in a pitch-side/pre-hospital setting. In this podcast, we discuss:  What is meant by the term ‘human factors’?  How do we develop these? Can they be developed at an individual level, or do they need to be embraced more broadly by a team/department as a whole?  Examples of how human factors have affected practice  Getting people to ‘buy-in’ to the importance of human factors? For listeners, you can follow Jonathan @SportsDocSkye – and the links to the resources we mentioned can be found below: BJSM Three-Part Blog Series: https://blogs.bmj.com/bjsm/2019/04/30/human-factors-in-sports-medicine-part-1/ https://blogs.bmj.com/bjsm/2019/05/17/human-factors-in-sports-medicine-part-2/ https://blogs.bmj.com/bjsm/2019/05/25/human-factors-part-3/ Just a routine operation: https://www.youtube.com/watch?v=JzlvgtPIof4 13 minutes to the moon: https://www.bbc.co.uk/programmes/w27vq4km

On this week’s BJSM podcast, BJSM deputy editor Dr Jane Thornton (T: @JaneSThornton) joins Daniel Friedman (T: @ddfriedman) to discuss physical activity counselling. Dr Jane Thornton MD PhD is a sports medicine physician and researcher currently based in London, Canada, and is an international advocate for physical activity. She has a wealth of international experience in the field of preventative medicine, with a particular passion for promoting physical activity as both prevention and treatment of chronic disease. Alongside a super impressive medical career, Dr Thornton is also a World Champion and former Olympic rower for Canada. In Part 2 of this 2-part podcast, Dr Thornton discusses: · Her efforts leading the Canadian Medical Education Strategy · Physical activity resources for clinicians and patients · Examples for successful physical activity counselling initiatives around the world · What SEM clinicians can start doing today to help their patients become more physically active Mentioned in this podcast: Make Your Day Harder http://www.makeyourdayharder.com/ PAPRICA (Switzerland) https://www.paprica.ch/ WHO Global Action Plan on Physical Activity https://www.who.int/ncds/prevention/physical-activity/gappa In-bed cycling for patients https://www.cbc.ca/news/canada/hamilton/biking-in-bed-is-good-for-icu-patients-says-new-mcmaster-study-1.3915472 Park Run https://www.parkrun.com/ PA prescription in Luxembourg http://www.sport-sante.lu/