BJSM Podcast

“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/

In 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 1 of this 2-part podcast, Dr Thornton discusses: · Why physical activity is the single best thing we can do for our health · The evidence for physical activity prescription in primary care · The shared decision making of how to prescribe physical activity to patients · How to talk about physical activity intensity with patients Mentioned in this podcast: 23 and a half hours YouTube video: https://www.youtube.com/watch?v=aUaInS6HIGo Make Your Day Harder http://www.makeyourdayharder.com/ PA Prescription Position Statement https://bjsm.bmj.com/content/50/18/1109 Naci et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. BJSM 2019. https://bjsm.bmj.com/content/53/14/859

On this week’s BJSM podcast, Dr Celeste Geertsema joins BJSM’s Daniel Friedman (T: @ddfriedman) to discuss the imbalance between men’s and women’s football medicine research and what needs to be done to move towards equality. Dr Geertsema is is a Sports Medicine Physician at Aspetar with her main interests being in football, skiing, snowboarding and athletes traveling. She has extensive experience working alongside FIFA in various World Cups. She was the first ever female Team Physician at the FIFA world Cup (in South Africa 2010) and also worked as FIFA Medical Officer at the Women’s Football World Cup and U17 Women’s World Cup, as well as Medical Officer at the Winter Olympic Games and Commonwealth Games. https://www.aspetar.com/person-profile.aspx?id=12〈=en In this 20-minute conversation, Dr Geertsema discusses: • Her current role at the Women’s FIFA World Cup in France • The medical requirements of men vs women at the World Cup • Why men and women footballers should be studied separately • The gaps in women’s football medicine research • What the SEM community can do to help out *Disclaimer: This is a personal interview for BJSM. Dr Geertsema is not speaking on the behalf of FIFA.* Pele in a skirt: https://www.cbc.ca/sports/2.720/marta-pele-in-skirts-1.731293 Germany Women’s FIFA World Cup Ad: https://www.youtube.com/watch?v=layoVXL5mnw

It has been another big year for tennis, and for British Tennis in particular with further successes in the Fed Cup and a number of exciting juniors making an impact on the world stage. In the run up to Wimbledon, we thought we’d catch up with some of the practitioners tasked with not only caring for these athletes, but responsible for the medical provision at some of the biggest sporting events in the international calendar. In this podcast we hear from Dr Jo Larkin and Dr Wing Chu. Jo is a Sport & Exercise Medicine consultant and Lead Doctor for British Tennis, with Wing an SEM registrar and qualified GP who works with Jo at the Lawn Tennis Association. In this podcast, you can hear about everything from the challenges of working in tennis, to some of the often under-appreciated public health benefits linked to the sport.  Patients needing advice & input across multiple continents at the same time  Policy-making as well as ‘pitch-side’ care  Population health – what role does tennis have? Do you know someone who could benefit from a healthier heart, reduced stress and a leaner body? Or, does this sound like a personal target for you? We would implore the #SEM community to share the podcast, infographics, papers and animations widely in order to try and spread the knowledge not only of #TennisMedicine, but tennis AS medicine https://www.youtube.com/watch?v=X4UHmZ6PL30 Seminal Papers Health Benefits of tennis infographics: https://bjsm.bmj.com/content/52/3/201 Health Benefits of tennis paper: https://bjsm.bmj.com/content/41/11/760 Associations of specific types of sports and exercise with all-cause and cardiovascular- disease mortality https://bjsm.bmj.com/content/51/10/812.long Leisure-Time Physical Activity & Life-Expectancy https://www.mayoclinicproceedings.org/article/S0025-6196(18)30538-X/fulltext

What is like working at one of the biggest clubs in the world? How do you manage the intense workload of the English premier league? What happens when players retire? In this hard hitting BJSM podcast, we are joined by Dr Andy Massey, physiotherapist and doctor who currently works as head of medical services at Liverpool FC. Topics discussed include: ●Managing the load of the premier league footballer ●Looking at the whole squad; substitutes and non-playing members ●The £177 million conundrum; the cost of injured players to the league ●Managing a rectus femoris injury; how to approach it? ●1%ers- what is their place in football? ●Transitioning into retirement- do we do enough? ●Top tips for early career professionals wanting to work in football Links to some of the papers mentioned: Bye Bye MRI? https://bit.ly/2KfChKQ POLICE principle for treating injuries : https://bit.ly/2EHcS9C

Have we been thinking about Osgood Schlatter Disease (OSD) all wrong? To answer this question, Dr. Erin Macri interviewed Prof. Jens Lykkegaard Oleson and Dr. Sinead Holden from Aalborg University on a recent visit to Denmark. Prof. Olesen is a rheumatologist and sports medicine physician, currently located at the Center for Almen Medicine at Aalborg University. His research focuses on tendon and fascia tissue adaption to loading, and the use of ultrasound examination in tendon and fascia pathology. Dr. Holden is a Senior Researcher at the Center for General Practice in Aalborg, where she is co-founder and research co-ordinator for the OptiYouth Research Group focused on ‘optimising physical health in youth’. Her research aims to increase understanding of musculoskeletal injuries and pain in youth, to identify those at increased risk for developing chronic MSK problems. In this episode, we delve into some recent evidence suggesting the OSD may not be the self-limiting condition we have typically believed it to be. In fact, OSD may be more akin to a tendonopathy in its presentation, which lends itself to exploring some novel treatment approaches that may change OSD management in clinical practice. Related Articles and Links OSD table: http://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2019/06/OSD-table.pdf Cairns G, Owen T, Kluzek S, Thurley N, Holden S, Rathleff MS, Dean BJ. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med. 2018 Aug 13;4(1):e000383. doi: 10.1136/bmjsem-2018-000383 https://bmjopensem.bmj.com/content/4/1/e000383 Holden S, Winiarski L, Krommes K, Thorborg K, Olesen JL, Hölmich P & Rathleff MS. Prognosis of Osgood-Schlatter - poorer than anticipated? A prospective cohort study with 24-month follow-up. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Vad, CG; Rathleff, MS; Jensen, HP; Holden S. Osgood Schlatter is associated with significant impairments in knee function and quality of life 4 years after diagnosis: a retrospective study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Lyng K, Rathleff MS, Dean B, Kluzek S, Holden S. Current Management Strategies in Osgood Schlatter: A quantitative study. Presented at the Scandinavian Sports Medicine Conference 2019, Copenhagen, Denmark. Kaya DO, Toprak U, Baltaci G, et al. Long-term functional and sonographic outcomes in Osgood-Schlatter disease. Knee Surg Sports Traumatol Arthrosc 2013;21(5):1131-9. Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop 1990;10(1):65-8.

On this week’s BJSM podcast, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) EIC elect Dr Clare Ardern PhD (T: @clare_ardern) joins BJSM EIC Prof Karim Khan to answer the difficult questions about return to play. Dr Clare Ardern is a physiotherapist and clinical researcher who completed her award-winning PhD on return to play in 2013. Since then, Clare has worked as a clinical researcher at the Aspetar Orthopaedic & Sports Medicine Hospital (Qatar) and Linköping University (Sweden). Clare led the 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. She has a particular interest in the psychological aspect of returning to play and how the return to play transition can be improved with specific clinical interventions and superior clinical decision making. We here at BJSM would like to thank Clare for her tireless work as BJSM Deputy Editor and wish her all the best for her upcoming role as EIC at JOSPT! In this 30-minute conversation, Clare discusses: · Tips for clinicians when approaching RTP with athletes · The psychological aspects of RTP and the importance of shared decision making · Athletes’ biggest fears when RTP · Non-operative management of ACL injuries · Paediatric ACL injuries On Oct 4-5, Clare will be speaking at the The IFSPT Third World Congress of Sports Physical Therapy in Vancouver, Canada. She will be presenting alongside a world-class line up of local and international experts exploring the theme “High performance to clinical practice”. https://www.sportphysio.ca/calendar-of-upcoming-events/spc2019/ Mentioned in this episode: Ardern CL, Ekås G, Grindem H, et al. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018;doi:10.1136/bjsports-2018-099060 (article co-published by Knee Surgery Sports Traumatology Arthroscopy, Journal of ISAKOS and Orthopaedic Journal of Sports Medicine). https://bjsm.bmj.com/content/52/7/422 Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med 2016;50:853-864. https://bjsm.bmj.com/content/50/14/853 Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med 2014;48:1543-1552. Grindem H, Snyder-Mackler L, Moksnes H, et al Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study British Journal of Sports Medicine 2016;50:804-808. https://bjsm.bmj.com/content/50/13/804 Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine. 2010 Jul 22;363(4):331-42. Headspace App: https://www.headspace.com/headspace-meditation-app

What are the most effective strategies for preventing sport-related concussions in youth? What role do clinicians have in this arena? Dr. Erin Macri took advantage of Prof. Emery’s recent visit to the Netherlands to get caught up on the latest evidence in concussion prevention. Prof. Emery is a physiotherapist and epidemiologist. She currently holds an appointment in the Faculty of Kinesiology at the University of Calgary, with joint appointments in Pediatrics and Community Health Sciences, Cumming School of Medicine, and is Chair of the Sport Injury Prevention Research Centre at the University of Calgary. Her research focuses on injury prevention in youth sport and recreation, concussion, and pediatric rehabilitation. In this episode, Prof. Emery discusses over a decade of work aimed at preventing sport-related concussion in ice hockey in Canada. Related Articles and Links Emery CA, Black AM. Are rule changes the low-hanging fruit for concussion prevention in youth sport? JAMA pediatrics 2019. E-pub ahead of print doi:10.1001/jamapediatrics.2018.5498 Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med 2017;51(12):978-84 Kolstad A, Nadeau L, Eliason P, Palacios-Derflingher L, Goulet C, Emery CA. The Effect Of Body Checking Policy Change On Offensive Game Skill Performance In 13–14 Year Old Ice Hockey Players. Br J Sports Med 2017;51(4):345-45 McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun 1;51(11):838-47. Concussion: prevention, detection and management (online course): https://www.ucalgary.ca/knes/online-concussion-course Concussion Awareness Training Tool: https://cattonline.com/ Canadian Concussion Guidelines and other resources, Parachute Canada: http://www.parachutecanada.org/injury-topics/item/concussion