JOSPT Insights

Muscle strength is a core focus of many sports injury rehabilitation programmes, and often a prominent discharge criterion. Today's guest has an important message about the uninjured limb in ACL rehabilitation: "beware the moving target of strength".

Olivia Barbosa is a sports physiotherapist with over a decade of experience in soccer and rugby. She currently works at the Aspetar Orthopaedic & Sports Medicine Hospital where she contributes to the concussion and the ACL clinical teams, and does research focused on muscle activation and strength recovery in ACL rehabilitation.

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RESOURCES

More on changes in quadriceps and hamstrings muscle strength over rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2023.11961

Aspetar ACL rehabilitation clinical practice guideline: https://www.aspetar.com/en/professionals/aspetar-clinical-guidelines/recommendations-on-rehabilitation-after-aclr

Ever wondered what a day in the life of a busy sports medicine clinic and research unit looks like?

Dr Enda King combines his roles as a sports physiotherapist, strength and conditioning coach, researcher, and educator through his work with individual athletes and elite teams across a spectrum of sports and disciplines.

Currently, he is the Head of Elite Performance and Development at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar.

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RESOURCES

For more on the Aspetar International Sports Medicine Conference - complete guide to thigh muscle injuries (November 2024): https://www.aspetar.com/en/professionals/our-events/complete-guide-to-thigh-muscle-injuries

Today's episode is all about running load and injuries. Dr Rasmus Nielsen (Aarhus University, Denmark) leads the RUNSAFE research group, and today he provides an update on the latest research in running-related injuries.

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RESOURCES

Garmin-RUNSAFE Study (injury data from >7000 runners in 87 countries): https://www.jospt.org/doi/10.2519/jospt.2023.11959

Garmin-RUNSAFE Study protocol: https://pubmed.ncbi.nlm.nih.gov/31494626/

Changing distance and the association with injuries: https://www.jospt.org/doi/10.2519/jospt.2019.8541

Andrew Mitchell (RB Leipzig) knows a thing or two about supporting athletes to return to play after injury, especially in professional football/soccer.

Today, Andrew explains his return to performance pathway, which is a criteria-based approach to help you and the athlete keep focused on the athlete's return to performance goal.

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RESOURCES

Andrew's return to performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240

Clinical pearls for supporting return to performance: https://www.jospt.org/doi/10.2519/josptcases.2021.0103

Control-chaos continuum for progressing rehabilitation: https://pubmed.ncbi.nlm.nih.gov/30737202/

On-field rehabilitation progression (part 1): https://www.jospt.org/doi/10.2519/jospt.2019.8954

On-field rehabilitation progression (part 2): https://www.jospt.org/doi/10.2519/jospt.2019.8952

A thirty-year-old woman, who plays social basketball once each week and goes to the climbing gym at least twice each week, has been diagnosed with a traumatic medial meniscus tear.

The woman was told that surgery is the only way to 'fix' her knee so she can get back to basketball and climbing. But is that really what the research evidence says?

Professors Jonas Thorlund and Søren Skou (University of Southern Denmark) share the key findings of their DREAM trial, and its clinical implications for managing traumatic meniscal tears.

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RESOURCES

DREAM trial report: https://pubmed.ncbi.nlm.nih.gov/38319181/

STARR trial report: https://pubmed.ncbi.nlm.nih.gov/35676079/

Comparing treatment strategies for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245

Should symptom onset guide treatment choice for meniscus tears? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/

Dr Kala Flagg of the Washington Mystics answers the classic Sports Corner questions for high-level women's basketball. She covers the demands of the sport, the most common injuries, and key things to plan for during injury rehabilitation.

Considering playing style, shoe fit, and physical fitness are all in a day's work when supporting high-level women's basketball athletes to perform at their best.

Today's episode builds on last week's discussion of how changes in the way that the nervous system works after injury can compensate for impairments like joint instability, pain and muscle inhibition.

Dr Meredith Chaput (University of Central Florida) extends the 5 phases of the visual-cognitive control chaos continuum, to link the ways to assess for cognitive compensations and how to progressively load the visual-cognitive system during sports injury rehabilitation.

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RESOURCES

From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443

The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Sports injury rehabilitation has moved well beyond simply focusing on physical function and recovery. There's various emphases on psychological responses to injury, mental readiness to return to sport, and now, the visual-cognitive components of recovery and return to sport.

Today, Dr Meredith Chaput (University of Central Florida) introduces the visual-cognitive control chaos continuum as a framework for sports injury rehabilitation. Her research uses functional MRI to evaluate neuroplasticity after knee injuries, focusing on understanding how people use visual attention to compensate for motor control, and how rehabilitation may better target these compensations.

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RESOURCES

From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443

The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees.

Maybe you've had someone in the clinic who worries that running will wear their joints out? My guest today has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement.

Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy.

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RESOURCES

Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/

Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767

Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149

Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731

Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/

The relationship between musculoskeletal pain and mental distress is complex. Sometimes it can feel challenging to know where to start when supporting people to get their life back when they're struggling with chronic or persistent pain.

Today, Dr Pavlos Bobos (Western University, Canada) shares his own story of recovery from serious musculoskeletal injury, and how that experience drives the work he does now as a researcher. He discusses the results of a network meta-analysis of digital interventions for managing musculoskeletal pain and depression.

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RESOURCES

Network meta-analysis of digital interventions: https://www.jospt.org/doi/10.2519/jospt.2024.12216