We had Colin on today to primarily talk about the pragmatic aspects of rehabbing an Achilles tendon in the sporting population.

Part of Colin's PhD thesis was looking at this specific topic.  In my opinion, a lot of the researched tendon loading programs aren't pragmatic, are boring, are hard to stick to and just don't seem like they would contribute to performance.  Colin's program is NOT like that.

His simple, progressive, performance based and pragmatic tendon and lower extremity program should be used as your "recipe" for care.

Have a look at his paper here that outlines the full rehab program. More about Dr Colin Griffin

Colin is a strength and conditioning coach at the UPMC Sports Surgery Clinic with a role that includes the rehabilitation of lower-limb injuries and the delivery running performance services.

He completed a degree in Strength and Conditioning with Setanta College in 2015 and completed Masters Degree in Coaching and Exercise Science in University College Dublin in 2016. He is an IAAF Level 4 certified endurance coach, coach eduaction tutor with Athletics Ireland and an accredited professional member of the Sport Ireland Institute in High Performance Sport Strength and Conditioning.

He has over 15 years experience in high performance sport having represented Ireland at the 2008 and 2012 Olympic Games in the 50km walk as well as a number of top 12 perofrmances at world and european level. He has also coached other Irish athletes to Olympic level.

In 2011 he founded The Altitude Centre Ireland and pioneered the development of Irelands first residential altitude training centre at the University of Limerick.

His main areas of interest include the rehabilitation of tendinopathies and muscle overload injuries, biomechanics, physiology and athletic development.

Colin is undertaking a PhD on the biomechanics of muscle-tendon interaction at the achilles during exercise, working under JB Morin at the University of Côte d’Azur and in collaboration with SSC Sports Medicine.

We talk what role Motivational Interviewing plays in working with patients.  We talk about how to do it and of course how not to do it.

Have a listen

More about Guillaume:

Graduated from Bordeaux (France) in 2005, Guillaume began his career as a physiotherapist working full-time for a professional football club in France. Since 2007, he has been practicing in private practice, specializing in the treatment of musculoskeletal conditions. He has developed a coordinated practice with general practitioners to provide patients with his expertise in musculoskeletal rehabilitation. He now focuses exclusively on shoulder pathologies.

Guillaume holds an MSc in Physiotherapy and Education from the University of Brighton (UK). During this Master's program, he explored and synthesized literature on the prescription of home therapeutic exercises, shared decision-making and reflective practice which was the subject of his final dissertation.

As a trainer, he teaches Motivational Interviewing, Reflective Clinical Practice, and his course titled "Motivating Patients to Do Their Home Exercises." He also hosts the French podcast "Evidence Based Physio Podcast." Lastly, Guillaume is the co-founder and co-manager of l'Agence EBP, a continuing education organization for healthcare professionals that offers training based on the latest scientific evidence.

Dr Stu Phillips, Tier 1 Canada Research Chair in Skeletal Muscle Health, shares his expertise on the importance of strength, power and muscle hypertrophy for healthy aging.

As is often the case Stu discusses how simple exercise programming can achieve the physical attributes that help us all age well.  

The fast recap is: - something is better than nothing

• strength train 2x/week, 2-4 sets, 5-20 repetitions with an effort of 8/10.  
• progress this over time
• train power but moving a much lighter faster!
• eat a little bit of protein within 24 hours of your workout.
• easy peasy

Clifton is a Canadian Power Lifter and Chiropractor.  I worked with a Clifton a few years ago to help him with his concussion symptoms, low back and hip pain.  Working with health care professionals is often interesting.  You will feel the pressure to "fix them" but when you get to listening to them you often realize that they have the answers and the knowledge.  They just need help and sometimes coaching.  I think (IIRC) I was once told that I can't comment on low back pain and lifting until I "fix" elite level powerlifters.  Besides this being an absolutely silly and anti-science statement I guess by this standard I can never talk about low back pain again.  Because it's true.  I don't "fix" anyone.  No one does. We work with people where they are and problem solve solutions together.  Working with people is often about coaching, reassurance and being there for that person.

Clifton shares his experience with pain, his recovery, how he helps his own patients and his fundamentals of rehab.

Rachel Hannah talks about her own experience as a runner dealing with Relative Energy Deficiency (REDs) and her recovery from bone stress injuries (BSIs).  And Greg (Rachel's former Physiotherapist)  talks about his professional failings as a therapist helping Rachel with her first Bone Stress Injury.

If you want help with all things diet, healthy weight and REDs then you can work with Rachel here: https://rachel-hannah-registered-dietitian.ca1.cliniko.com/bookings

Or See Rachel on IG here: https://www.instagram.com/rachelhannahrd/

Dr Malfliet was on today discussing her PhD thesis paper which deserves a lot of attention. We discussed her RCT entitlted "Effect of Pain Neuroscience Education Combined With Cognition-Targeted Motor Control Training on Chronic Spinal Pain: A Randomized Clinical Trial" where we focused on the importance of nudging into pain (Time Contingent Exercise), reframing motor control exercises as movements that you get comfortable and confident in moving and how to progress these exercises with a graded exposure/activity approach.

We also talked about the role of losing weight (specifically adipose tissue) and its potential role in managing persistent pain.  Weight loss is a difficult topic to broach with patients and providers and we touched on these issues.  We didn't spend too much time on this contentious topic and its certainly worth exploring more in detail

Our Guest - Anneleen Malfliet Anneleen Malfliet is an assistant professor and postdoctoral researcher at the Vrije Universiteit Brussel. She is also a member of the Pain in Motion international research group. Her research and clinical interest goes out to chronic pain with a special interest in chronic spinal pain, pain rehabilitation, central sensitization, nutrition and diet. More info at our Pain in Motion website: www.paininmotion.be

We have Erik Meira (The Science PT) talking ACL injury, the importance or not of strength, whether valgus is a true risk factor for injury or a sign of something else and who technique matters for primary or secondary injury prevention.

Please go to Erik's website not just for his links to what he offers but excellent blogs and resources that really explain complicated topics in clinically applicable ways.

Erik's website is here

Greg and Alex delved into a wide-ranging discussion about the science of endurance and fitness, with a focus on injury prevention and treatment. They explored the effectiveness of strength training in injury prevention, the inconsistencies in the research, and the debatably importance of stretching in the prevention of injury. 

Alex shared his personal experiences with a hamstring injury and his approach to running injury prevention and some of the limitations of our current research base.

As usual, we also talked about the role of technique in injury risk reduction.  Greg did get confused and brought up technique and performance so that was nice accidental discussion point.

Alex's Outside Magazine Profile 

Alex's website

Dr Neil Meigh is a physiotherapist and associate professor at Bond University (Gold Coast Australia).

Neil conducted a pragmatic exercise intervention in insufficiently active older adults.  The intervention was a hard style kettlebell program in those aged 60-80.  These people were not life long athletes but many of them thrived in his program.  They got the type of results and improvements in fitness where an independent observer could be skeptical.  

We talk details of the program and the resiliency seen in this population while performing high intensity exercise.

Neil's paper is here