The rotator cuff and rotator cuff tendons are often involved in shoulder pain, and targeted with our treatment. Dr Chris Littlewood is a Physio and senior research fellow at the University of Sheffield, and spends a large portion of his time studying and treating shoulder pain, including rotator cuff tendinopathy. In this episode, Chris and I discuss how to identify rotator cuff tendinopathy and other types of shoulder pain, and how you can direct your treatment for rotator cuff tendinopathy. We also explore: Other sources of shoulder pain Clues that the cervical spine could be referring pain to the shoulder Unstable shoulder Red flags When to image the shoulder When bursal thickness or effusion is or isn’t a problem Shoulder assessment Stiff painful shoulders Treatment for rotator cuff tendinopathy Improving exercise adherence When to perform special orthopaedic tests Injections Surgery Is there really a rotator cuff exercise, compared to a scapular muscle exercise? Do exercises isolate the rotator cuff? Links of interest Enrol on the free webinar with Dr Chris Littlewood Download the handout from this podcast Subscribe to the podcast free on iTunes Dr Chris Littlewood on Twitter Dr Chris Littlewood Webinar with Tom Goom on Bone stress injuries Cervical spine assessment & treatment online course Clinical Edge Clinical Edge free trial David Pope on Twitter

Proximal hamstring tendinopathy (PHT) occurs in athletes, runners, weightlifters, and other athletes, as well as more sedentary patients, causing pain at the hamstring origin and limiting your patients ability to sit, run and continue to be active. There are a number of structures that can contribute to pain in this area, and in this podcast, Tom Goom and David Pope discuss how to clearly identify PHT and differentiate it from lumbar spine referred pain, hip pain, sciatic nerve pain and other conditions. Tom recently released an article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management with Peter Malliaras, Mike Reiman and Craig Purdam. We explore this article, and the research around PHT, and cover in detail: Subjective clues to guide you towards diagnosis Aggravating factors and 24 hour pain patterns Differential diagnosis Lumbar spine pain How the lumbar spine could contribute to development of PHT Hip pain SIJ pain Sciatic nerve pain Development of PHT Central sensitisation Diagnostic tests for PHT Hamstring tests Other assessment tests Functional tests The value of palpation Tests for involvement of the rest of the kinetic chain Running assessment/gait analysis Testing load tolerance Biopsychosocial aspects of tendon recovery Other advice for patients Whether stretching is helpful When your patient can return to running Cross training Does manual therapy have a role in the treatment of PHT? Starting treatment (Stage 1) When and how to progress rehabilitation (Stage 2) Further rehabilitation progressions (Stage 3) Advanced exercise progressions for high load sports Exercises you can incorporate during the various stages How long recovery will take   Free running injury assessment & treatment video series available now   Links Download the free handout summary of this podcast Tom’s website - Running Physio Tom on Twitter Running Repairs courses with Tom Article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management JOSPT Peter Malliaras Mike Reiman Craig Purdam VISA-H Become a Clinical Edge member to access Tom’s webinar and other great online education Tags: running, hamstring, tendinopathy, tom goom, podcast, proximal, peter malliaras, craig purdam, mike reiman, treatment, assessment

How can you treat your patient’s lateral elbow pain (lateral epicondylalgia (LE)/tennis elbow)? How and when should you progress your patient’s exercise program? Is pain during their exercise program ok? In this episode, which is Part 2 of Lateral Elbow pain with Dr Leanne Bisset, we explore in detail how you can differentially diagnose LE from other causes of lateral elbow pain, and treat it successfully. Discover: Diagnosis and differential diagnosis of LE How to get the best outcomes for your patients when treating LE Do isometrics work? How can you commence strengthening? Should your patient experience any pain during their exercise program? When and how can you incorporate Mobilisation with Movement into your treatment program? How to perform MWM’s for LE How to progress your treatment Identifying and treating radial nerve involvement Incorporating strengthening for the upper limb High level athletes and weightlifters with lateral elbow pain - is this likely to be LE or another condition? Identifying nerve root irritation with pain over the lateral elbow Taping methods to deload the lateral elbow when there is nerve involvement Clinical reasoning of your treatment Predictors of poor treatment prognosis When to order imaging Evidence for and against other treatment strategies including the Cyriax approach, massage, laser, ESWT, corticosteroids and PRP Validated screening tools for LE, including the PRTEE In this episode, Leanne answers a lot of your questions on LE, asked via Twitter and the Clinical Edge newsletter.  Dr Leanne Bisset is a Physiotherapist, Physiotherapy lecturer and researcher at Griffith University in Queensland, Australia who has extensively researched and published on lateral elbow pain, and spends a large proportion of her clinical time treating the upper limb and lateral elbow. This is a two part podcast, followup up Lateral Elbow Pain Part 1, episode 44 of the Physio Edge podcast, David Pope and Dr Leanne Bisset. Links of Interest Dr Leanne Bisset Dr Leanne Bisset on ResearchGate Dr Leanne Bisset on Twitter Download the Patient-Rated Tennis Elbow Evaluation (PRTEE) Download the free podcast handout Lateral Elbow Pain Part 1 with Dr Leanne Bisset Review the podcast in iTunes David Pope Clinical Edge Get your free trial of Clinical Edge online education

Lateral elbow pain (lateral epicondylalgia/tennis elbow) affects a lot of athletes, manual workers and office workers, and can respond fantastically to Physiotherapy treatment, or in other patients with a similar presentation, not at all.  Dr Leanne Bisset is a Physiotherapist, Physiotherapy lecturer and researcher at Griffith University in Queensland, Australia that has extensively researched and published on lateral elbow pain, and spends the majority of her clinical time treating the upper limb and lateral elbow. This is a two part podcast, and in Part 1, episode 44 of the Physio Edge podcast, David Pope and Dr Leanne Bisset discuss: Why is Lateral Epicondylalgia (LE) difficult to treat? What tissue pathology exists in LE Pain pattern for LE Patient reports that will help your diagnosis of LE Important aspects to communicate with your patients regarding their LE Objective tests that you can perform Patient advice Should you rest your patients or provide exercises? How is tendinopathy in the Upper Limb different to the Lower Limb? Commencing treatment How to incorporate manual therapy into your treatment Exercises you can start your treatment with Should you include isometric exercises for lateral elbow pain How often should your patients perform their exercises Exercise into pain, or avoid pain? Links of Interest Dr Leanne Bisset Dr Leanne Bisset on ResearchGate Dr Leanne Bisset on Twitter Review the podcast in iTunes David Pope Clinical Edge Get your free trial of Clinical Edge online education

Shoulder pain and injury in overhead athletes is very common and has a high recurrence rate. In this podcast with Jo Gibson we discuss sporting shoulder injuries and rehabilitation, including: The role of the Rotator Cuff Train strength or efficiency in the Rotator Cuff? Rotator Cuff muscle balance When is (and when isn’t) surgery necessary for Rotator Cuff or SLAP tears Assessment of shoulder stiffness Bursal involvement Imaging of the shoulder How you can help improve Rotator Cuff activation What role does manual therapy have in shoulder treatment? The importance of the postero-superior cuff What stretches can you perform for the postero-superior Rotator Cuff Treating pain in loaded and overhead activities Exercises you can use in shoulder treatment with your athletes Incorporating the kinetic chain in shoulder rehabilitation Managing shoulder load Central sensitisation Treating throwing athletes The role of the thoracic spine in shoulder pain Communication tips with your shoulder pain patients Podcast handout Free video series “Frozen shoulder assessment & treatment” with Jo Gibson Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Links associated with this episode: Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Jo Gibson Download your free handout on the Sporting Shoulder Jo Gibson’s courses David Pope Clinical Edge Get your free trial of Clinical Edge online education Jo Gibson’s video - Gym ball rollout Jo Gibson’s video - Wall squat o Gibson’s video - Step up with V Physio Matters Podcast with Jo Gibson Skills for Communicating with Patients Book Key communication skills and how to acquire them - Article in BMJ by Peter Maguire, Carolyn Pitceathly EUSSER

In Episode 41 of the Physio Edge podcast, Dr Christoph Spang and I discussed how Plantaris may play a role in Achilles tendinopathy. In this episode of the Physio Edge podcast, I discuss with Seth O’Neill how you can identify Plantaris involvement in your patients, and adjust and progress your conservative treatment of Achilles pain and tendinopathy with Plantaris involvement.  Seth O'Neill and I discuss:  What indicates Plantaris involvement and helps you differentiate from mid portion Achilles Tendinopathy Where do patients have pain with Plantaris tendinopathy What history do patients with Plantaris involvement or tendinopathy present with Objective tests and findings for Plantaris tendinopathy and involvement Biomechanics contributing to Plantaris tendinopathy Is treatment successful for Plantaris How to treat Plantaris tendinopathy and involvement in midportion Achilles How to perform a loading program Running adjustments aping Manual therapy Links of Interest Download your free handout on Treatment of Plantaris & Achilles Tendinopathy with Seth O'Neill Access to the Lower Limb Tendinopathy free videos, including Seth’s presentation on Achilles Tendinopathy Lower Limb Tendinopathy Virtual Conference with detailed, practical presentations: Dr Jill Cook will cover “Structure, function and pain in tendinopathy” Dr Sean Docking is then going to take us through “The role of imaging in the diagnosis and monitoring of tendinopathy”. Dr Peter Malliaras is presenting “Staged rehabilitation of Patellar Tendinopathy”. Craig Purdam takes you through “Staged rehabilitation of Hamstring Tendinopathy” Seth O’Neill will help you understand “Achilles Tendinopathy Exercise & rehab progressions. Risk factors and the importance of Soleus in Achilles tendinopathy” Dr Ebonie Rio will conclude the Virtual Conference with “Tendon pain and the brain – what do we know and can we change it?” CLICK HERE for more information on the Lower Limb Tendinopathy Virtual Conference Seth on Twitter Seth’s website on Achilles Tendon Research David on Twitter Subscribe to the podcast on iTunes Physio Edge podcast episode 41 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang  Hide

Plantaris tendinopathy and compression of Plantaris on the Achilles has been shown to play a role in some cases of Achilles Tendinopathy, slowing down their rate of rehabilitation progress. Dr Christoph Spang is a Biologist and Sports Scientist, and completed a PhD on “The plantaris tendon in relation to the Achilles tendon in midportion Achilles tendinopathy”. In this podcast we discuss the interaction of Plantaris in patients with midportion Achilles Tendinopathy, including: Why consider Plantaris in Achilles Tendinopathy patients? How can Plantaris cause or be involved in Achilles pain? Anatomy, function and role of Plantaris What interaction does Plantaris have with the Achilles and calf? Do patients with Plantaris involvement respond to a loading program? What is the clinical presentation of a patient with Plantaris involvement? How can Ultrasound or Ultrasound Tissue Characterisation (UTC) be utilised to identify Plantaris? The role of injection therapy Surgical treatment Links of Interest Get your free access to videos on Lower Limb Tendinopathy Dr Christoph Spang at UMU Dr Christoph Spang’s PhD Thesis Dr Christoph Spang on Research Gate David Pope on Twitter Out very soon…. Conservative management of Plantaris involvement in Achilles Tendinopathy with Seth O’Neill

How complex does your shoulder assessment need to be? How can you can simplify your shoulder assessment and treatment? Find out in episode 40 of the Physio Edge podcast with Adam Meakins, where Adam and I discuss: Common mistakes Physio’s make in assessment and treatment of the shoulder Adam’s classification of shoulder pain Subjective clues to guide your objective and treatment How to identify weak and painful shoulders Red flags with shoulder pain Frozen shoulders Objective assessment Subacromial impingement GIRD (Glenohumeral Internal Rotation Deficit) The use of US in shoulder pain Surgical treatment for shoulder pain Treatment for weak and painful shoulders Loading the rotator cuff for pain relief and strength Gym junkie shoulder pain and how to adapt their weight training programs Links of Interest Download your free handout on The Shoulder Simplified Follow Adam Meakins on Twitter Adam’s website Adam’s Shoulder courses Adam’s presentation on “When is a GIRD not a GIRD” Shoulder Pain Virtual Conference Follow David on Twitter Access practical Online Courses for Physiotherapists with a Free Membership Trial of Clinical Edge Download your free handout on the Shoulder Simplified

Patellofemoral joint pain (PFJP) is very common in adolescents, and in the Physio Edge podcast episode 39, I discuss causes, assessment and treatment with the author of numerous studies on PFJP in Adolescents, Dr Michael Rathleff. You will explore:  Different types/groups of Adolescents that suffer with PFJP Common reasons for failure of Physiotherapy Diagnosis and DDx of PFJP Examination of the knee Treatment of PFJP How to tailor and progress your exercise programs The use of orthotics Taping The usefulness of stretching Prognosis & predictors of recovery Biomechanics and more. I have also created a free handout to supplement and help you get the most from this podcast, which you can download here Dr Michael Rathleff also provided great insights into Loading Programs for Plantar Fasciopathy on the Physio Edge podcast episode 38, also well worth a listen if you haven’t already.    Links of interest Download your free handout on Patellofemoral Pain in Adolescents to go along with this podcast Dr Michael Rathleff’s publications on PFJP in Adolescents Dr Michael Rathleff on Twitter Free Shoulder Assessment & Treatment videos with leading international presenters 2015 Patellofemoral research retreat David Pope on Twitter Other related Physio Edge podcasts: Plantar Fasciopathy with Dr Michael Rathleff Anterior Knee Pain with Kurt Lisle Download your free handout on Patellofemoral Pain in Adolescents

Plantar Fasciopathy (Plantar heel pain) can be a stubborn condition to treat, or you can learn to love treating it like Dr Michael Rathleff, incorporate the right loading program and activity modification and get some great results. In episode 38 of the Physio Edge podcast, I talk to Dr Michael Rathleff, author of the RCT “High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up: HL strength training and plantar fasciitis”. We discuss: Common mistakes in the treatment of plantar fasciopathy (PF) How we can improve our treatment of PF Why call it plantar fasciopathy instead of plantar fasciitis? Research on PF Loading programs for PF Patient advice Activity modification Running load modification Short and long term results from loading the plantar fascia Considerations when treating PF Who is not suitable for a loading program Who respond the best to this program, and who responds the least How to modify the loading program Development of PF Running technique Treatment or strengthening of other areas Stretching Orthotics Cortisone Plantar fascia tears Links of interest Subscribe to the Physio Edge podcast in iTunes Dr Michael Rathleff on ResearchGate Dr Michael Rathleff on Twitter “High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up: HL strength training and plantar fasciitis” BJSM Blogpost by Michael Rathleff on Plantar Fasciopathy Clinical Edge Online Education Virtual conferences with Physio Edge and Clinical Edge Physioedge on Facebook David on Twitter