In this week's podcast,  Dr Nathan Gibbs and I discuss managing sports injuries in a team setting. Dr Nathan Gibbs has worked with many professional sports teams, including the Sydney Swans for 15 years, 10 years with South Sydney Rugby League Football club and is one of the owners of South Sydney Sports Medicine, and in episode 27 of the Physio Edge podcast, we discuss: Ideal working relationships between Physiotherapists and Sports Physicians The role of a Sports Physician Hamstring injury - common factors involved, imaging and return to play Injections - cortisone, PRP Use of PRP in ligament injury, with chondroplasty and OA Links of Interest Dr Nathan Gibbs Sydney Swans South Sydney Rugby League Football club Review the Physio Edge podcast in iTunes Download the Physio Edge podcast from iTunes Clinical Edge

Gymnastics places some fairly unique demands on fairly young bodies. In episode 26 of the Physio Edge podcast, I discuss these demands with Kingsley Gibson, a Sports Titled Physiotherapist that has worked with Australian Diving, Synchronised Swimming, Shooting and Hockey teams at a number of Commonwealth and Olympic games, and works with elite gymnasts on a daily basis. For his services to gymnastics, in 2000 the Commonwealth awarded Kingsley with a Sports Services Medal. So Kingsley has a lot of experience to draw on, and we got into detail on a number of topics. In this podcast we discuss: Common injury patterns in the various gymnastic disciplines Important factors to consider when returning gymnasts to training and competition Factors that can influence your gymnasts treatment outcome Communication with parents and coaches How to best implement load management strategies Various motor control patterns in gymnasts that contribute to injuries Screening gymnasts Designing specific upper limb rehab programs Lower limb and lumbar spine rehab programs Management of acute vs chronic injuries Stress reactions in the Lumbar spine Apophyseal injuries – hip flexors, hamstrings, calcaneus (Sever’s) and Osgood-Schlatter’s Management of apophyseal injuries compared to tendinopathy Motor control/“stability” patterns in gymnasts When to order imaging Growth plate injury management – particularly in the wrist The effect of other factors such as training surfaces and equipment on injury Links of Interest Become incredibly flexible by subscribing to the Physio Edge podcast or giving it a review on iTunes Kingsley Gibson Sydney Sports Medicine Centre at Homebush Sydney Wests Sports Medicine at Rooty Hill Clinical Edge

How can you identify the reason your patient has groin pain and the structures that may be causing it? Groin pain is one of the most common issues in a lot of sports, particularly the football codes, and in episode 25 of the Physio Edge podcast, David Pope talks to Dr Kristian Thorborg about assessment of the groin. Some of the topics we discuss on this podcast include: Types of groin injuries Identifying and diagnosing groin pain and injury Groin vs hip pain Tests you can perform to identify the irritated or painful structures The relevance of diagnostic imaging, and when to refer for this Hip and Groin Outcome Score (HAGOS) Using the HAGOS in your clinic Adductor related groin pain Hip flexor related groin pain Abdominal related groin pain The hip joint Pubic symphysis Sports Hernias Testing hip strength Assessment of function and much more! Links of interest Dr Kristian Thorborg Dr Kristian Thorborg on Twitter HAGOS Studies that Dr Kristian Thorborg has completed or been involved in Review the Physio Edge podcast in iTunes Clinical Edge Kristian Thorborg’s editorial on BJSM Kristian Thorborg’s PhD Thesis

The thorax is often considered stiff and stable by Physiotherapists and manual therapists, and precious little of our undergrad or postgrad training incorporates motor control of this area. Is it really important? In episode 24 of the Physio Edge podcast, Dr LJ Lee and David Pope explore the function of the thorax, the impact the thorax can have, not only on thoracic pain, but also on other parts of the body. We discuss the  Thoracic Ring Approach™ created by LJ, which incorporates manual techniques to assess and treat the thoracic rings, and integrates motor control training for this area. In this podcast you will learn: What bones and joints make up a “Thoracic ring” What is the Thoracic Ring Approach™   Is the thorax inherently stiff? What is ideal motor control of the thorax? How can listeners identify non-optimal control of the thorax in their patients How can motor control of the thorax be trained? Identifying articular/joint restriction vs neuromuscular factors interfering with normal thorax movement How can the thorax impact on other areas of the body eg the hip When is manipulation of the thorax ideal? What are some guidelines for manipulation of the thorax? Links of Interest Have an awesome holiday, and review the Physio Edge podcast on iTunes Physio Edge podcast episode 2 – “Analysing movement, and clinical expertise or research” with LJ Physio Edge Podcast episode 6 – TA, “Core Stability”, Drivers and going beyond the pain experience” with LJ Lee

Tendinopathies are a hot topic, and there are lots of new developments in research and treatment. Dr Peter Malliaras, a Physiotherapist with a PhD studying tendinopathy, has a special interest in the treatment of tendinopathy, and treats elite basketball and volleyball, EPL football, rugby, and cricket players, the Royal Ballet and track and field athletes. Peter has also published numerous studies on tendinopathy. In this episode of the Physio Edge podcast, Peter and David Pope discuss The latest research on tendinopathy Different types of loading programs for tendinopathy Outcomes for various types of loading Tendinopathy on Doppler Ultrasound or other imaging, and what changes with a loading program The tendon pathology continuum by Dr Jill Cook and Craig Purdham Mid portion Achilles tendinopathy Insertional Achilles treatment Patellar tendinopathy treatment, and a loading program for this that may challenge your preconceptions! Tenosynovitis Biomechanics contributing to tendinopathy Return to sport following tendinopathy Injury reduction/prevention Injections Links of Interest Be. Awesome. Write a review on iTunes Dr Peter Malliaras Studies with Dr Peter Malliaras as one of the authors Physio Edge podcast episode 5 with Dr Jill Cook Clinical Edge Subscribe to the Physio Edge podcast on iTunes

Dr Kieran O’Sullivan is back on the Physio Edge podcast after talking previously about hamstring injuries, this time discussing his other big area of interest and expertise – chronic low back pain (CLBP). In this episode, Kieran and David Pope discuss Recent research on chronic low back pain Central vs peripheral contributions to CLBP Sitting postures and behaviours, and the relationship of this to pain Is there an ideal sitting posture, and does changing sitting behaviour change CLBP? Manual therapy in CLBP Lumbar kyhposis/lordosis Physical and psychological interventions for CLBP The effect of exercise on CLBP Movement patterns and retraining in chronic pain states The challenges of talking to patients about chronic pain states Links of Interest Show your love of feeling great, and also the podcast by writing a review on iTunes Kieran O’Sullivan Kieran on Twitter Pain Education website with Peter O’Sullivan, Kieran O’Sullivan, Wim Dankaerts, Kjartan Vibe Fersum University of Limerick The role of muscle strength in hamstring injury. Kieran O Sullivan and Cian McGinley. 2010. Nova Publications Clinical Edge

Shoulder pain – what are the causes, and how can you treat it? Are your special tests around the shoulder really isolating and identifying pathology? How can the rotator cuff still function with small and large tears? In Episode 21 of the Physio Edge podcast, Jeremy Lewis and David Pope discuss these questions and more including: What is the value of special tests around the shoulder? What diagnosis can you provide your patients for their shoulder pain How can you identify if you need to focus your treatment on the scapula, glenohumeral joint, cervical spine or thorax? How can you identify a rotator cuff tendinopathy? What is the Rotator Cable, and how is it important in rotator cuff tears? Is the acromion really the cause of “impingement” or subacromial pain? If a patient has a biceps tendinopathy and a rotator cuff tendinopathy, which should be treated first? What contributes to biceps tendinopathy? Theraband – valuable? When imaging of the shoulder is valuable, and when it is a waste of time Frozen shoulder – what treatments work well and much more.   Podcast links Dr Jeremy Lewis London Shoulder Clinic Courses with Jeremy Lewis Clinical Edge Review the Physio Edge podcast on iTunes

Is “peeing while you work out” in Crossfit or any other type of exercise ok? When does your patients pelvic floor need more muscle activation, and when does it need less work? Does Stress Urinary Incontinence (SUI) need addressing, and if so, how? In episode 20 of the Physio Edge podcast, I talk to Lori Forner, a Physiotherapist with a special interest in Women’s Health in Brisbane, Queensland, about all of these topics, and more, including: The role of Physio’s that specialise in Women’s Health, and when it is a good idea to refer to one Common conditions seen clinically When real-time ultrasound can be used to assess pelvic floor function, and what you should see on US Pelvic floor overactivity and underactivity Treatment for SUI Antenatal and postnatal advice Advice on exercising during and after pregnancy and much more Links of interest Lori Forner Lori on Twitter Pelvic Mafia on Twitter Crossfit – “Do you pee during workouts” video The place to go to give the Physio Edge podcast a rave review on iTunes!

What are the best ways to avoid hamstring injuries? What are the main factors to consider in hamstring rehabilitation? How does muscle strength relate to hamstring injury? How can we screen for or predict hamstring injuries? In episode 19 of the Physio Edge podcast, Kieran O’Sullivan, PhD of the University of Limerick, Physiotherapist and co-author of the book “The role of muscle strength in hamstring injury.” Kieran O Sullivan and Cian McGinley. 2010. Nova Publications and David Pope get stuck into hamstrings and the many facets of this important muscle group, including: Injury reduction Rehabilitation – early stages, and return to sport Return to Sport Flexibility Eccentric training Predicting hamstring injury Assessing readiness of return to sport Stretching – Static vs Dynamic vs PNF etc, and the clinical implications Links of Interest Love the podcast by writing a review on iTunes Kieran O’Sullivan Pain Education website with Peter O’Sullivan, Kieran O’Sullivan, Wim Dankaerts, Kjartan Vibe Fersum University of Limerick The role of muscle strength in hamstring injury. Kieran O Sullivan and Cian McGinley. 2010. Nova Publications Clinical Edge

How can the pelvis contribute to pain and dysfunction? Is the SIJ the main pain producer around the pelvis, or what is? What is the state of current research around the pelvis? Is it possible to feel “unlocking” of the SIJ? Do Pelvic Upslips exist? In episode 18 of the Physio Edge podcast Diane Lee of Diane Lee & Associates and David Pope discuss the pelvis and SIJ in detail, including: palpation around the pelvis how can you palpate for unlocking of the SIJ what role the pelvis has in low back pain how the pelvis can be affected by other areas of the body does the current research support unlocking of the pelvis how can the thorax affect the pelvis when should you perform deep abdominal or multifidus training And then we dive into Paediatric musculoskeletal development, including footwear for kids sporting activities for kids should kids sit in chairs or on the floor is a simple ankle sprain all that simple advice for parents children’s furniture and lots of other great info that will help you when treating or bringing up kids Links of Interest Love the show by writing a review on iTunes Diane Lee Diane Lee on Twitter The Pelvic Girdle, 4th Edition by Diane Lee Clinical Edge David on Twitter Physioedge on Facebook Clinical Edge on Facebook