BJSM Podcast

Karim Khan, BJSM editor, crosses the table to be quizzed on the evidence behind exercise. He briefly reviews Steven Blair’s findings about exercise and mortality, and answers the ubiquitious question “how much should I actually be doing?” He also highlights a new report on next steps - how we can move from ‘exercise is medicine’ to actually implementing physical activity across community sectors. 0.26 - Summary of the evidence for exercise and health 4.00 - Dose 10.26 - Public health uptake of exercise

Liam West, a medical student at University Hospital of Wales in Cardiff and passionate student of sport & exercise medicine, talks to Karim Khan about the barriers to developing a career path in sports and exercise medicine. He shares a successful approach to carving out a path while also coping with the rigid obligations of medical school. Liam also coordinates a blog series for the BJSM on the undergrad’s perspective, and has helped set up a national network for undergraduate students who will be the future doctors in SEM called USEMS (Undergraduate Sports & Exercise Medicine Society). 0.49 - Getting into SEM 3.10 - Barriers to starting your career 6.00 - Overcoming the obstacles 8.15 - Undergrad SEM societies 10.41 - Take home messages See also Original article Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow’s doctors equipped to follow clinical guidelines? http://bit.ly/PARRhn Review: Investments that work for physical activity. http://bit.ly/OY9t7o This is the WHO blueprint for physical activity promotion across sectors. Undergraduate students should be aware of it and please look for ways to incorporate it into your student society information pages and the medical curriculum! Liam’s BJSM blogs http://bit.ly/XTu9B1

Phillip Newman (assistant professor of physiotherapy, University of Canberra) gives his advice on shin pain, and explains how two simple tests can predict those at higher risk of developing Medial Tibial Stress Syndrome. BJSM editor Karim Kham asks the questions. 0.33 Studying shin pain in the military population 1.51 The shin palpation test and the shin oedema test and how they’re useful 5.45 Are these tests useful in the broader population? 6.22 A quick summary of the findings 7.40 Treatment of shin pain 9.29 The use of orthotics 10.21 Professor Newman’s views on barefoot running See also: Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test http://bit.ly/17NbVCo Managing leg pain - focus on chronic exertional compartment syndrome http://bit.ly/ZMnOnr

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the three million times viewed BJSM physical examination videos [http://bit.ly/17UzOuu], gives Karim Khan an update on examination and management of leg pain. He explains why he doesn’t use the term ’shin splints’. In this podcast Dr Hutchinson covers: (i) clinical work-up of persistent leg pain (ii) investigating compartment pressure (iii) two or four compartments? (iv) tips for surgeons treating compartment syndrome (v) fasciotomy or fasciectomy? Three extremely relevant papers in BJSM include: Chronic exertional compartment syndrome testing: a minimalist approach http://bit.ly/10aWJu3 Chronic exertional compartment syndrome http://bit.ly/ZMnzIW Intracompartmental pressure testing: results of an international survey of current clinical practice, highlighting the need for standardised protocolshttp://bit.ly/17Nbvfd

Dr Robert Sallis (Exercise Is Medicine Advisory Board chairman) offers advice on how to get patients and colleagues engaged with exercise as medicine. Karim Khan (BJSM editor) asks him about his experience promoting this at Kaiser Permanente, and resources and schemes available. As Dr Sallis is a former president of the American College of Sports Medicine, they also discuss what’s coming up for the organisation. An update on Exercise Is Medicine 0.51 How to get started with Exercise Is Medicine 2.00 The Everybody Walks scheme 3.00 Getting exercise as a vital sign into consultations 4.11 Referral resources 6.23 How encorporating exercise into healthcare has worked for Kaiser Permanente 11.06 The upcoming triathlon conference in Kona 13.30 ACSM in 2013 15.57 The National Activity Plan in the US 18.49 See also: Podcast: Exercise on prescription, Mai-Lis Hellénius and Carl Johan Sundberg http://bit.ly/13USrPH Podcast: Mike Loosemore - how to prescribe exercise http://bit.ly/naC5QV

Darren Burgess, head of fitness and conditioning at Liverpool FC and former strength and conditioning coach of the Socceroos, talks to Karim Khan about his role and how he deals with the unique challenges of the premier league. They discuss the interface between the conditioning team the coach and the manager and how technology has changed the way in which players fitness needs are understood. One specific topic of interest to many will be how GPS can help guide training volumes. 1.25 - Assessing a player for fitness to play 5.26 - Words of advice for emerging sports scientists 7.21 - Resolving tensions between strength and conditioning and medical teams 11.30 - Player tracking systems 19.25 - Top 3 recovery tips

Hans Tol (BJSM senior associate editor) talks to Gino Kerkhoffs (Orthopaedic Surgery, Academic Medical Centre, Amsterdam, Netherlands) about diagnosing and treating acute ankle injuries, as his group has just published clinical guidelines on this in BJSM. 0.37 Who the guidlines are aimed at 2.11 Risk factors for ankle injuries 5.09 Is there still a place for MRI in diagnosing acute ankle injuries? 11.50 Functional treatment - tape or brace? 15.03 Should injuries where the syndesmotic ligament is involved be treated the same as lateral injuries? 16.50 Surgery 21.45 Prevention after surgical repair 24.16 The future of diagnosis and treatment 26.24 What’s the evidence for platelet rich plasma treatment? See also: Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline http://bit.ly/Qn0UTG

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the three million times viewed BJSM physical examination videos [http://bit.ly/17UykR2], gives Karim Khan an update on examination and management of shoulder injuries. In this podcast Dr Hutchinson covers (i) Common pitfalls and what to do instead (ii) How to diagnose overuse in the throwing shoulder (iii) ‘Labral tears’ vs ‘SLAP’ tears nomenclature (iv) Shoulder dislocation – when is surgery appropriate? and (v) Scaphoid fracture - has screw fixation become first line treatment? If you missed Dr Hutchinson’s knee podcast listen here http://bit.ly/O2rRe2. Another popular shoulder podcast is by Professor Jeremy Lewis on rotator cuff tendinopathy http://bit.ly/11yxbel.

Dr Mark Hutchinson, professor of Orthopaedics and Sports Medicine at the University of Illinois Medical Centre, and star of the 3 million times viewed BJSM physical examination videos [http://bit.ly/17UykR2] gives Karim Khan an update on examination and management of acute knee injuries. He shares his experience in interpreting physical signs, imaging indications, and the advantages of early sideline diagnosis. He also answers 4 key questions: (i) knee haemarthrosis - to drain or not to drain?, (ii) mensical tear - arthroscopy or wait?, (iii) is surgery always indicated after ACL tear, and (iv) first time patellar dislocation - conservative or surgical management? Please note that Professor Hutchinson’s shoulder podcast will be released next week! What this space, BJSM’s Facebook page, or our Twitter feed for updates!

Professor Lars Nordsletten, from the Olso Sports Trauma Research Centre, talks to Karim Khan, BJSM editor, questioning the role of NSAIDs and COX-2 inhibitors in sport. He discusses how mediation of inflammatory response may not be in an athlete’s best interest. He shares data on NSAIDs delaying fracture healing, and discusses which drugs are most appropriate at various points during recovery. See also: Professor Nordsletten’s biography page http://bit.ly/10aK8XL Abuse of medication during international football competition in 2010 – lesson not learned. Philippe Tscholl and colleagues. http://bit.ly/Y1smw1 Nonsteriodal anti-inflammatory drug use in sports medicine: Guidelines for practical but sensible use. Jason Paoloni and colleagues. http://bit.ly/10aV6MY