Dr Lionel Chia joins Chelsea and Dan to bring his 2022 article in JOSPT, Beginning With The End In Mind: Implementing Backward Design To Improve Sports Injury Rehabilitation Practices, to life.

Lionel outlines 4 categories to consider when planning return to sport and performance: (1) deconstructing goals, (2) determining key performance indicators, (3) assessing the challenge point, and (4) using the control-chaos continuum to guide interventions.

We work through examples of why and where to use the concept of backward design during rehabilitation.

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RESOURCES

Find Lionel's paper here: https://www.jospt.org/doi/10.2519/jospt.2022.11440

More on designing effect exercise progressions during rehabilitation (Blanchard & Glasgow): https://pubmed.ncbi.nlm.nih.gov/28756390/

More on motor learning and the challenge point—where effective practice occurs: https://pubmed.ncbi.nlm.nih.gov/15130871/

The control-chaos continuum and progressing rehabilitation (Taberner and colleagues): https://pubmed.ncbi.nlm.nih.gov/30737202/

As a JOSPT Insights listener, you already know programs like the FIFA 11+, the PEP program and the GetSet app for reducing injury rates in team sports like soccer (football) and handball. When you're working with athletes, coaches and parents, how easy is it to get them set up with a warm-up program that athletes can follow and stick to a few times a week?

Today's chat might just give you a tool to make life easier for you and the athletes, coaches and parents you work with. Drs Hayley Root and Jeff Driban are here to tell us all about the new Remain in the Game toolkit.

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RESOURCES

Get access to the Remain in the Game toolkit: https://oaaction.unc.edu/remain-in-the-game-a-joint-effort/

Learn more about all the work of the Osteoarthritis Action Alliance: https://oaaction.unc.edu/standup2oa/

The YAHiR (Young Athletes' Hip Research) Collaborative takes over the JOSPT Insights podcast today with a deep dive into best practice for imaging the painful hip.

What is the best approach to imaging for young people with hip pain? When do you reach for radiographs? What are the pros and cons of MRI for hip pain? And how do you interpret and act on the information you gather from the scan?

Never fear, Dr Vasco Mascarenhas—radiologist and Assistant Professor at Católica Medical School, Portugal—is here to explain all you need to know to confidently use imaging for hip pain in clinical practice.

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RESOURCES

More on the methods of imaging for hip preservation: https://pubmed.ncbi.nlm.nih.gov/31163499/

Overview of the state of play for imaging in suspected femoroacetabular impingement syndrome: https://pubmed.ncbi.nlm.nih.gov/32845416/

In part 2 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield and Dr Laura Cutler, with Dr Jake Bleacher continue discussing how they used graded motor imagery to help a patient with low back pain.

Treatment sessions 3 and 4 include breakthroughs, progressions, graded movement exposure, and mindfulness training.

We discuss who finds pain neuroscience most helpful, and Dr Chris Hughes explains why this case was a perfect match for JOSPT Cases.

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RESOURCES

Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875

Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI

Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ

The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/

Find the Why I Hurt Flashcards and heaps of helpful information about pain neuroscience education here: https://whyyouhurt.com/WYH-why.html

Find out more about Headspace, and download the app for free: https://www.headspace.com/

Find "Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation" here: https://www.jospt.org/doi/10.2519/jospt.2018.0610

The NOI Group's website has plenty of courses and resources for clinicians on managing pain: https://www.noigroup.com/

Don't forget, JOSPT has a terrific series called Pain Science in Practice, which is all about helping you understand and link basic pain science to the clinic and quality musculoskeletal rehabilitation care. Find part 1 in the series (6 editorials, and more on the way!) here: https://www.jospt.org/doi/10.2519/jospt.2022.10995

In part 1 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield, Dr Laura Cutler, and Dr Jake Bleacher review their approach to supporting a patient with chronic low back pain.

First, they review the history, clinical assessment, and the interventions performed over the first 2 treatment sessions.

Next, the clinical team reviews how they decided when to leave the biomechanical world and when to focus on graded motor imagery and laterality training.

Dr Chris Hughes, Editor-in-Chief for JOSPT Cases, introduces the journal. He explains why case reports are important in musculoskeletal health and rehabilitation.

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RESOURCES

Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875

Dr Lorimer Moseley on the role of the brain in chronic pain (snake story): https://www.youtube.com/watch?v=bj9CUGzw6fs&t=26s

Dr Peter O’Sullivan and “Jack” sharing how Jack regained his life: https://www.youtube.com/watch?v=j4gmtpdwmrs&t=214s

Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI

Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ

The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/

Melissa Haberfield, very patiently, takes Chelsea and Dan through all things Australian Rules Football. From the field, scoring, and rules, to the punching, kicking, and tackling required to play—it’s a crash course in the game of footy.

Melissa breaks down the demands of the sport, the common injuries, and key things for clinicians to keep in mind when working with Australian football athletes.

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RESOURCES

More on the Prep2Play injury prevention program, including player, coach and clinician resources: https://www.play.afl/coach/resources/prep-to-play/

Intro to footy video: https://www.youtube.com/watch?v=u_SqfNNfhmM&authuser=0

Tayla Harris and the landmark AFLW photo: https://www.abc.net.au/news/2019-03-21/tayla-harris-aflw-photo-could-be-landmark-moment-in-australia/10921892

Kids are resilient, but that doesn't mean they don't struggle with pain. Sometimes it can feel daunting to know how best to support a child in pain, and their family, as everyone navigates school, sport and other environments.

Physiotherapist, researcher and educator at University of Technology Sydney, Dr Joshua Pate, is on a mission to help kids and clinicians work better together when it comes to understanding and managing musculoskeletal pain. Today he shares the latest on pain neuroscience, and tips for honing your listening and communicating skills.

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RESOURCES

More on assessing children's understanding of pain: https://pubmed.ncbi.nlm.nih.gov/32960825/ (Concept of Pain Inventory) and what paediatric pain experts think https://pubmed.ncbi.nlm.nih.gov/29342976/

More on the pGALS (paediatric Gait Arms Legs and Spine) quick musculoskeletal assessment tool: https://pubmed.ncbi.nlm.nih.gov/24219838/

https://www.zoeandzakspainhacks.com is the free online portal for kids, clinicians, parents and teachers. You'll find the books at: https://www.noigroup.com/product/zoe-and-zaks-pain-hacks/

More from Josh on his website: https://joshuawpate.com/

Look no further for the latest information on assessing, diagnosing, treating and making a prognosis about, lateral elbow pain!

CPG authors Dr Ann Lucado and Dr Joseph “Matt” Day review the key take-aways from the CPG. They share the important differential diagnoses to consider, the outcome measures to use, and impairment measures to track.

Clinicians will love the clever approach to classifying the irritability stage of elbow pain, to guide both treatment and prognosis and liberate you to decide what's best for tailoring your recommendations throughout rehabilitation.

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RESOURCES

Read the full CPG for free: https://www.jospt.org/doi/10.2519/jospt.2022.0302

One-page summary of the key points for clinicians (including decision tree): https://www.jospt.org/doi/10.2519/jospt.2023.0501

One-page summary of the key CPG points for patients: https://www.jospt.org/doi/10.2519/jospt.2023.0504

Dr Mitchell Selhorst continues his chat about spondylosis/spondylolysis/spondylolisthesis in adolescent athletes. After reviewing the who, why, and what in part 1, today’s episode is full of clinical pearls about rehabilitation and return to sport.

Dr Selhorst presents a 3-stage approach to rehabilitation, and shares how he thinks differently when planning rehabilitation for an acute vs. a chronic injury. Another big take-home message: how important it is to consider the psychological aspect of these injuries for youth athletes.

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RESOURCES

More on rehabilitation for spondylolysis in youth athletes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134351/

Micheli Functional Scale: https://pubmed.ncbi.nm.nih.gov/22382433/

Today, Dr Mitchell Selhorst dives in the world of pediatric spondylosis/spondylolysis/spondylolisthesis injuries with Chelsea and Dan. And it’s not all about female gymnasts!

You can expect about 3 in every 10 adolescents with low back pain to have a spondy. So, knowing the population, risk factors, and key things to look for on examination are incredibly important.

Dr Selhorst reviews the epidemiology, shares the current evidence on the effects of bracing and surgery, and explains how imaging findings can influence rehabilitation decisions.

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RESOURCES

More on rehabilitation for spondylolysis in youth athletes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134351/