Pilates is commonly known and used for rehabilitation of persistent low back pain, however Pilates principles and equipment can also be used for assessment and treatment of pain beyond the pelvis and lumbar spine. In episode 37 of the Physio Edge podcast, Lana Johnson, a former dancer and a Physiotherapist from BPS Tensegrity in Sydney and I discuss how you can use Pilates for knee and shoulder pain, as well as: Common misconceptions about Pilates Functional vs non-functional exercises Common errors made in Pilates training and rehabilitation Pilates for hip and knee pain Case studies using Pilates with shoulder and knee pain patients Patient progression Cues you can use with your patients for hip and shoulder retraining Exercise progressions Exercises to stay away from Links of Interest Lana Johnson BPS Tensegrity Clinical Edge Virtual conferences with Physio Edge and Clinical Edge Physioedge on Facebook David on Twitter

Mike Stewart and further explore persistent pain, helpful language you can use with your persistent pain patients, how you can use group sessions, as well as: How the bio fits into biopsychosocial How you can develop an educational toolkit Case study of a patient with persistent peripheral pain Language & communication recommendations Misconceptions about persistent pain education and much more Links of Interest Physio Edge podcast episode 35 – Know Pain part 1 with Mike Stewart Mike Stewart Know Pain Courses with Mike Stewart Mike Stewart on Twitter Clinical Edge online education Free Sports Medicine articles in the Aspetar Journal Headspace “Living in the moment” by Anna Black “Rainy brain, Sunny brain” by Elaine Fox Facebook David on Twitter Clinical Edge discounts for Undergraduate Physio students available by emailing verification of your student status to info@clinicaledge.co

Persistent pain can be a challenge, but also enjoyable to treat. In this episode of the Physio Edge podcast, Mike Stewart and I focus on specific examples and case studies of patients with complex or persistent pain, how you may approach persistent pain patients, explain their pain, use metaphors and explanations so they understand it, and help guide them through the recovery process. Mike and I get into the details on: Why Physios need a deep understanding of pain science How does the “bio” part come into bio-pscyho-social How can we identify if the patient needs pain education, further investigations, a biological approach eg specific exercise How can you incorporate pain science into the treatment of patients with acute pain Mike’s top tips when working with persistent pain Specific case studies of patients with persistent and complex back pain, and how Mike has worked with these patients, including their presentation, beliefs, Mike’s language used in their session, activity modification and results achieved with these patients How to develop our teaching skills to achieve the best results with our patients Links of Interest Mike Stewart Know Pain Courses with Mike Stewart Mike Stewart on Twitter Facebook David on Twitter Clinical Edge discounts for Undergraduate Physio students available by emailing verification of your student status to info@clinicaledge.co

The advanced stages of ACL rehabilitation are enjoyable to progress your patients through, and at the same time challenging to find the right exercises, and optimise the rate of progression through to return to training (RTT) and return to play (RTP). In this episode, Enda King from the Sports Surgery Clinic Dublin and David Pope discuss these later stages of rehabilitating your patients following an ACL Reconstruction. We discussed the prehabilitation and early stage ACL Rehab in the Physio Edge podcast episode 32, and episode 34 Enda and I cover in detail: Return to straight line running and change of direction Advanced Exercise Programming What exercises to choose Proprioception and motor control training Strength and power programming Periodisation Sports specific conditioning Plyometrics – readiness, what to use and timing of these in the training schedule Multi-directional performance Strength testing – what Enda uses, indicators of strength Decisions on return to training Return to contact Decision making on Return to play Bridging the gap between the gym and the field Advice for Physios rehabilitating athletes recovering from an ACL reconstruction When to discharge an ACL athlete and much more Links of interest Physio Edge podcast episode 32 – How to rehabilitate ACL Injuries with Enda King Enda King Enda on Twitter @enda_king Sports Surgery Clinic, Dublin SSC Research Foundation David Pope on Twitter Clinical Edge Review the podcast in iTunes

Anterior knee pain can occur in your elite sports patients right through to office workers and weekend warriors. In this podcast with Kurt Lisle, we discuss anterior knee pain, the causes, how to diagnose the source of the pain, and the best ways to treat and rehabilitate these patients. Kurt Lisle is the Australian Socceroos Physio and co-owner of The Knee Joint Physio in Queensland. Kurt and I discussed acute knee injuries on the Physio Edge podcast in episode 29, and I really wanted to get Kurt back on the podcast to discuss the anterior knee. In this fantastic, detailed episode of the Physio Edge podcast, Kurt and I explore: Subjective clues that give you ideas about differential diagnosis Fat pad - location of pain, activities that irritate Patellofemoral joint - aggravating activities and DDx Patellar tendon - subjective clues, location of pain Objective examination of the anterior knee Tests for PFJ Functional tests first or examination on the treatment table? Palpation of the anterior knee Fat pad palpation and tests Is the fat pad tender medial and laterally, or can it be tender only on one aspect Neuromuscular patterning Squat and one leg squat examination What causes “catching” pain on movement Chondral defects - identifying Is there value in the grind test When to refer for MRI and other imaging Important factors that may contribute to AKP Gait contributors to AKP Treatment of PFJ pain Modifying PFJ aggravating activities Using EMG Quadricep rehabilitation and strengthening When to incorporate squats into your rehabilitation program The role of taping for PFJ or fat pad irritation Red flags causing knee pain Links of Interest Kurt Lisle The Knee Joint Physiotherapy, Bokarina, QLD Socceroos Review the Physio Edge podcast in iTunes Clinical Edge

ACL injuries can be career ending, or they can be an opportunity to sort out movement efficiency, motor control and and technical skills, coming back from the rehabilitation process with more power, speed and efficiency than they had before they injured their ACL. In this podcast, Enda King from the Sports Surgery Clinic in Dublin currently completing his PhD in 3D biomechanical analysis after ACL reconstruction, with the aim to assist in RTP decision making and identifying fully rehabilitated athletes, and David Pope discuss ACL injuries, and the most important factors in pre-operative management and post-operative exercise programming to get your patients back to sport with improved sporting performance. Going deep on the details involved in ACL Rehabilitation, including: 01:20 Enda King and SSC, and working with ACL athletes PhD in 3D biomechanical analysis after ACL reconstruction, aim to assist in RTP decision making and what a fully rehabilitated athlete looks like What does a fully rehabilitated athlete look like? Incorporating performance goals into the rehab process Can athletes achieve better performance post ACL rehab than they were pre-injury Types of ACL grafts Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery Preoperative education Restoring knee extension, balancing pain and improved range of movement, empowering your patient Guidelines for pain, swelling when restoring range of movement Restoring quadriceps activation, normalising gait patterns Clinical Edge Clinical Edge’s free webinar program Preoperative length of time Post-op - initial management To use or not use co-contraction exercises of quads and hamstrings Should you use squatting style exercises Week 1 post op Activating quadriceps - internal quadriceps cues or external exercise focus How much pain should a patient experience during or after an exercise Week 2 post-op When can heavy gym training commence Changing movement patterns throughout the kinetic chain Advice for patients in the early stages of rehab Frequency of exercise Week 2 onwards - exercises incorporating balance and proprioception Open vs closed chain exercises Advice for patients in weeks 2–6 Nutrition and dietary advice for patients Gym based rehabilitation Choosing and modifying exercises for middle stages of the rehabilitation process Various types of squatting movement, and progressing the types of squats Goblet squats Retraining ideal squat patterns Progressing squats, deadlifts and lunges Front squats Front squats and trap bar deadlifts vs back squats during rehabilitation When can an athlete start cycling Disadvantages of using cycling as the main part of a rehabilitation program Hamstring rehabilitation after semitendinosis/gracilis graft Strength and power development Strength testing - mid thigh pull, leg press Should we use open chain strength tests When to perform strength tests Strength vs power and rate of force development Running - incorporating into the program. When can your patient start running? Preparation for running Running drills Ideal movement patterns in running Enda King and SSC, and working with ACL athletes Podcast timeline 3:35 What does a fully rehabilitated athlete look like? 5:40 Incorporating performance goals into the rehab process 6:50 Can athletes achieve better performance post ACL rehab than they were pre-injury 8:20 Types of ACL grafts 11:10 Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery - an opportunity to prepare your patients knee, ROM, strength and educate them on the rehabilitation process 14:20 Preoperative education 14:40 Restoring knee extension, balancing pain and improved range of movement, empowering your patient with 15:40 Guidelines for pain, swelling when restoring range of movement 16:15 Restoring quadriceps activation, normalising gait patterns 17:10 Clinical Edge 18:45 Clinical Edge’s free webinar program 19:30 Preoperative length of time 20:35 Post-op - initial management 23:20 To use or not use co-contraction exercises of quads and hamstrings 24:50 Should you use squatting style exercises Week 1 post op 25:25 Activating quadriceps - internal quadriceps cues or external exercise focus 26:30 How much pain should a patient experience during or after an exercise 27:30 Week 2 post-op 28:30 When can heavy gym training commence 29:30 Changing movement patterns throughout the kinetic chain 31:00 Advice for patients in the early stages of rehab 32:10 Frequency of exercise 32:55 Week 2 onwards - exercises incorporating balance and proprioception 34:10 Open vs closed chain exercises 35:40 Advice for patients in weeks 2–6 37:15 Nutrition and dietary advice for patients 37:45 Gym based rehabilitation 38:50 Choosing and modifying exercises for middle stages of the rehabilitation process 41:00 Various types of squatting movement, and progressing the types of squats 41:45 Goblet squats 42:30 Retraining ideal squat patterns 43:25 Progressing squats, deadlifts and lunges 44:00 Front squats 46:00 Front squats and trap bar deadlifts vs back squats during rehabilitation 47:25 When can an athlete start cycling 48:00 Disadvantages of using cycling as the main part of a rehabilitation program 48:30 Hamstring rehabilitation after semitendinosis/gracilis graft 49:45 Strength and power development 51:00 Strength testing - mid thigh pull, leg press 53:15 Should we use open chain strength tests 54:20 When to perform strength tests 55:00 Strength vs power and rate of force development 55:50 Running - incorporating into the program. When can your patient start running? 57:30 Preparation for running 58:35 Running drills 1:00:30 Ideal movement patterns in running Links: Enda King Enda on Twitter @enda_king Sports Surgery Clinic, Dublin SSC Research Foundation David Pope on Twitter Review the podcast in iTunes

CrossFit is a very popular form of improving strength and fitness, and CrossFit athletes have a variety of common injuries. Training errors and the athlete’s biomechanics often contribute to these injuries, and identifying incorrect biomechanics and other contributing elements in their training is often the key to helping your patients recover from injury, train pain free and importantly for your patients, ultimately get stronger and fitter. In episode 30 of the Physio Edge podcast, David Pope discusses CrossFit injuries, training, biomechanics and injury recovery with Antony Lo. Antony is a Musculoskeletal Physiotherapist with a number of clinics within CrossFit gyms across Sydney, and a large proportion of his patient population are CrossFit athletes. In this podcast Antony and David explore: The most common injuries in CrossFit Factors that contribute to injuries in the Shoulders, Neck, Back, Knees, and lower limb Specific exercises performed in CrossFit Squats Pullups/Chinups Pushups Overhead exercises Double unders Overhead squats Snatch Running Ideal biomechanics for each of these movement Common movement errors and ways to assess each movement Rest from training vs continue training Manual therapy on cross fit athletes Modifying training loads Rhabdomyolisis Urinary continence while training Advice for Physios treating CrossFit athletes Links of Interest Review the podcast in iTunes Clinical Edge – fantastic online and face to face education for Physiotherapists Antony Lo Antony’s Website – physiodetective.com Antony on Twitter CrossFit  Hide

Shoulder pain patients often have poor scapula control. Is their shoulder pain caused by poor scapula control, or is their scapula dysfunction caused by shoulder pain?   When your patients present with shoulder pain, should your focus be on scapula control, glenohumeral control, or treatment of the neck and thorax? In this podcast, David Pope talks to Ann Cools, a Physiotherapist and Head of Education for Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium, and is also the founding member and president (2010–2012) of EUSSER - European Society of Shoulder and Elbow Rehabilitation. We discuss in detail assessment of the scapula, the role of the scapula in shoulder pain and how to retrain unruly scapulae. Other topics covered in this podcast include: Research by Ann Cools What we currently know from the research about the role, movement and control of the scapula Scapula dyskinesis - what is it Static vs dynamic assessment of the scapula Altering muscle balance and timing with specific exercises How altering scapula mechanics effects muscle balance around the shoulder Important parts of the subjective history Scapula vs glenohumeral joint How subjective will guide your objective assessment and treatment Red flags around the shoulder, nerve pathology and frozen shoulder Frozen shoulder imaging Nerve injuries - symptoms, objective examination and treatment Assessment of the scapula, Type 1 scapula dyskinesis Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula) Testing GHJ IR Clinical Edge and online education on the shoulder Stretching and shoulder joint mobilisation Palpation, stretching and manual therapy for pec minor Type 2 scapula dysfunction Handheld dynamometry - serratus Handheld dynamometry - middle and lower traps Pain when strength testing Type 3 scapula dysfunction Dynamic assessment of the scapula To retract and depress the scapula or not? Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis Special tests around the shoulder Laxity tests for the GH joint Posterior GHJ laxity Anterior GHJ laxity Explanations of scapula dysfunction to your patients Links of Interest Anne Cools on Linked In Ann Cools’ Research Ann Cools at Ghent University Ann on Twitter Clinical Edge Show your love for the Physio Edge podcast with a review on iTunes

Specialist Sports Physiotherapist Kurt Lisle joins David Pope on this episode to discuss assessment and management of acute knee injuries. They cover topics such as initial management of ligament injuries, bracing, referrals for orthopedic consults, swelling during treatment, ACL injury management, different types of ACL grafts, post-op rehab, return to training criteria, and PLC injuries.

David Pope and Dr Kristian Thorborg (Physiotherapist, PhD) discuss screening and rehabilitation of groin injuries. Find out in this podcast: Which tests to use when screening for potential groin injuries Prevention tactics Acute groin injuries - initial management and exercise progressions Rehabilitation of adductor related groin pain Rehabilitation of hip flexor related groin pain Rehabilitation of long standing groin pain Conservative management of hip related groin pain and FAI Pubic symphysis Management of acute compared to long standing groin pain Role of manual therapy in the treatment of groin pain Stretching Adductor tendinopathy Load management for groin pain and much more! This episode follows on from Episode 25 of the Physio Edge podcast on Groin Assessment with Dr Kristian Thororg. I hope you enjoy Kristian sharing his experience, research and knowledge of the evidence with us on the treatment of groin pain. Links of Interest Case Study of Adductor tear rehabilitation Dr Kristian Thorborg Dr Kristian Thorborg on Twitter HAGOS Studies that Dr Kristian Thorborg has completed or been involved in PE #025 Groin Assessment with Dr Kristian Thorborg PE #016 Preventing hamstring injuries with Dr Kristian Thorborg Kristian Thorborg’s editorial on BJSM Kristian Thorborg’s PhD Thesis Review the Physio Edge podcast in iTunes Clinical Edge