Note: This episode was recoreded in Dutch and can be listened to in English and other languages on the Physiotutors App. The next episode will be in English again!

Summary

In this episode, we discuss the journey of Ajan Elshof, a former physiotherapist who transitioned to a care-intensive advisor role. We explore the reasons behind his departure from physiotherapy, including changing perspectives on care, the challenges of practice management, and the relationship between physiotherapists and insurers. Ajan shares insights on the future of physiotherapy, the importance of innovation, and the need for collaboration in the healthcare sector.

Chapters

00:00:00 Intro and the big question: why does a passionate physiotherapist leave the profession?

00:03:42 Why physiotherapy was chosen: sports background, injuries, and early motivation

00:05:13 Workload, balance, and no burnout

00:06:40 Sponsor: Premium membership

00:07:17 From patient care to management: views on efficient, hybrid care and the right care in the right place

00:10:24 Overtreatment vs insured sessions: ethics and clinic policy

00:12:06 Ambition, ownership, and scale of impact

00:14:27 The purchasing plan: from the first years to the concrete process

00:16:09 Why the purchasing failed and business lessons learned, market fit, agreements, transition period

00:19:17 Considered paths, education, research, own practice, and the choice for a health insurer to increase impact

00:22:29 Sponsor: WriteUpp practice management software

00:24:20 Low rates, productivity, and admin work: the health insurer's view

00:27:29 Relationship between health insurer and therapist: shared goal and trust

00:30:53 New role at Zilveren Kruis: tasks and the value of a physio background

00:33:23 Clinic vs office: differences in workday, focus, and downtime

00:36:20 How do we keep passionate professionals? Perspective, career paths, and regional primary care cooperation

00:37:43 Sponsor: Physiotutors online courses

00:39:18 Career outlook and conditions for a possible return

00:41:21 Advice to the next generation, including his own children, about physiotherapy

00:42:30 Closing message: working together toward sustainable, accessible, local care

00:44:15 Closing

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Summary

This podcast explores the critical role of exercise therapy in oncology, highlighting its importance in cancer treatment, rehabilitation, and survivorship. Experts discuss the evolution of exercise in oncology, current practices, and innovative trials that examine the interactions between exercise and chemotherapy. The conversation also addresses the unique challenges faced by patients with head and neck cancer and the significance of tailored exercise programs in improving patient outcomes. This conversation delves into the critical role of exercise in cancer care, highlighting patient barriers, the importance of personalized exercise programs, and the need for better integration of physiotherapy in oncology. The speakers discuss the life-saving benefits of exercise, the challenges faced in clinical practice, and the necessity of addressing patient fears and misconceptions about exercise. They emphasize the importance of collaboration among healthcare professionals to ensure consistent messaging and support for cancer patients. Looking ahead, they advocate for more research, education, and advocacy to improve exercise oncology practices globally.

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Guests

Prof. Dr. Nele Adriaenssens from the Vrije Universiteit Brussel is an associate professor and leads the Rehabilitation Research group, focusing on cancer rehabilitation and exercise oncology, with a special interest in side effects of chemotherapy and immunotherapy and how exercise can help. She also coordinates cancer rehabilitation and survivorship at the University Hospital in Brussels and has been a key figure in building cancer rehab services and research infrastructure there.

Dr. Grainne Sheill, clinical specialist physiotherapist in cancer rehabilitation at St James's Hospital in Dublin. Grainne leads work on exercise for people treated for head and neck cancer, looking at the barriers they face and how group based programs can support recovery, fitness and daily function after treatment.

She is the head of the physiotherapy department at Tel Aviv Souraski Medical Center. She is a physiotherapist, educator and long standing leader in national and international physiotherapy bodies, with a strong focus on cancer care, exercise prescription and raising standards of practice and policy.

Time Stamps

00:00:00 - Intro and guest lineup: Exercise therapy in oncology overview

00:01:36 - Why is exercise part of cancer treatment, not just an extra?

00:04:04 - What "exercise" means in cancer care: cardio, strength, or both?

00:05:32 - How the role of exercise in oncology has changed since 2008–2009

00:08:42 - Sponsor: PhysioTutors Premium Membership (ad)

00:09:35 - Policy and health system view: Where oncology rehab stands and gaps

00:12:40 - How drugs/side effects shape exercise plans (exercise–pharmacology examples)

00:16:56 - PAPTOX and FORX trials: What's new vs classic cancer rehab studies

00:20:45 - Exercise goals in palliative care and oncogeriatrics

00:24:17 - Are palliative/fragile patients motivated to exercise?

00:25:30 - Sponsor: WriteUpp practice management (ad)

00:27:05 - Head & neck cancer: Why this group is different and challenging for activity

00:31:34 - National survey findings: Top barriers and surprises to exercise post–head & neck cancer

00:33:49 - Key exercise-oncology messages still missing in day-to-day practice

00:37:33 - Turning position statements into simple clinical routines

00:41:41 - Global online oncology course: Is it available yet?

00:42:15 - Sponsor: PhysioTutors online courses (ad)

00:43:10 - Screening and triage: Group vs 1:1 vs medical referral

00:46:16 - Addressing fear: How to talk about risk and safety to keep patients engaged

00:49:55 - One belief to change among doctors/nurses about exercise in cancer care

00:53:19 - Ten-year outlook: Priorities for research, education, and implementation

00:56:13 - Final messages: Getting physios on board and entry-level competencies

00:58:54 - Congress announcement and closing remarks

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Summary

In this conversation, Dr. Nick van der Horst, a sports physiotherapist, discusses the significant impact of hamstring and groin injuries in football, emphasizing the importance of pelvic control in injury prevention and rehabilitation. He highlights the prevalence of these injuries, the role of eccentric strength training, and the need for comprehensive screening and assessment methods. Dr. van der Horst shares insights on how to modify pelvic posture and control during rehabilitation, providing practical advice for integrating these concepts into injury prevention programs. The discussion also covers the relationship between pelvic mechanics and performance optimization, making it clear that understanding these factors is crucial for effective rehabilitation and injury prevention in sports.

Guest

Dr. Nick van der Horst is a sports physiotherapist and rehabilitation specialist with deep expertise in football medicine. He's currently part of the medical staff at PSV Eindhoven's first team, where he focuses on on- and off-field rehab, return-to-play strategies, and injury prevention.Nick earned his PhD at UMC Utrecht with a thesis on preventing hamstring injuries in male soccer players. Over the years, he has worked with organizations like the KNVB and Go Ahead Eagles, and he's the founder and CEO of SoccerDoc, a platform dedicated to improving football medicine through research, education, and clinical care.His work centers on maximizing football performance by reducing injury burden and creating evidence-based, player-centered rehab and prevention programs.

Timestamps

00:00:00 Intro and guest bio

00:01:00 How big are hamstring and groin injury problems (incidence and time loss)?

00:04:04 Clarifying the topic: SI joint issues vs pelvic position/control

00:04:42 Why are pelvic control and positioning key for hamstring and groin pain?

00:12:44 Sponsor: PhysioTutors Premium Membership

00:15:28 Screening and assessment: Go-to markers for pelvic posture/control issues

00:19:27 Do you need motion capture or other equipment to assess pelvic control?

00:22:17 How do you differentiate pelvic-mechanics-related hamstring issues from tissue-specific or neural problems?

00:27:12 Common lumbopelvic patterns in recurrent hamstring and groin injuries

00:25:38 Sponsor: WriteUpp Practice Management

00:37:54 Groin pain: Is pelvic posture/control a cause or a consequence?

00:41:50 How modifiable is pelvic posture and control?

00:44:51 Rehab progression: Early vs late stages when focusing on pelvic control

00:48:54 Do you use basic core/lumbopelvic exercises (bird dog, dead bug, pelvic tilts)?

00:52:13 Have improvements in pelvic control reduced hamstring/groin injuries in practice?

00:54:46 Sponsor: PhysioTutors Online Courses

00:56:13 Case experience: Moments that shifted perspective on pelvic role

01:03:08 Practical advice for integrating pelvic control into prevention/rehab in football

01:05:49 Where to find Dr. Nick van der Horst

01:06:29 Outro

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Summary

In this podcast episode, neuroathletic performance and pain coach Jannik Schuster discusses neurocentric training, a method focusing on the brain and nervous system to enhance performance and alleviate pain. Schuster explains how he discovered this approach through personal experience with injuries and highlights its effectiveness in reducing inflammation and pain. He defines neurocentric training as targeting brain and nervous system interactions to improve performance, distinguishing it from traditional training methods that focus on biomechanical structures. Schuster emphasizes the significance of understanding the nervous system's role in pain and movement limitations, advocating for individualized approaches to address specific nervous system needs. He also discusses the integration of neurocentric training with traditional practices, the impact of visual, vestibular, and proprioceptive inputs, and the potential for neurocentric training to become more prevalent in both athletic and therapeutic settings. The conversation underscores the importance of neuroplasticity and suggests resources for those interested in exploring neurocentric training further.

Guest

Jannik Schuster — Neuroathletic Performance and Pain Coach, M.Sc. in Sports Science, educator, and former elite footballer. After training in the youth academy of FC Augsburg and the professional squad of FC Schweinfurt, Jannik discovered neurocentric training as a breakthrough method to unlock performance, prevent injury, and resolve pain. Educated through Z-Health and grounded in sports science, he now helps others apply neuro-based strategies for pain-free movement and optimal function

Content

00:00:00 Introduction

00:00:47 Yannick's Background and Introduction to Neuroathletic Training

00:02:49 Definition and Differentiation of Neurocentric Training

00:04:36 Scientific Foundation of Neurocentric Training

00:08:39 Common Misconceptions in Neurotraining

00:10:23 Role of the Nervous System in Pain and Movement Limitations

00:11:55 Neurocentric Training in Rehab

00:14:42 Assessment and Testing in Neurocentric Training

00:21:46 Role of Visual, Vestibular, and Proprioceptive Inputs

00:25:19 Typical Neuroperformance Training Session

00:28:17 Effects Observed in Performance-Oriented Athletes

00:31:01 Athlete Feedback on Neuro Training

00:35:38 Prevalence of Neurocentric Training in Elite Sports

00:37:29 Integration with Traditional Training and Therapy

00:40:08 Incorporating Neurocentric Elements in Daily Work

00:47:03 Striking Changes Observed Through Neuro Training

00:49:23 Resources for Learning About Neurocentric Training

00:51:27 Conclusion and Final Thoughts

Bonus Material

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Summary

In this episode, Melvin Pitz and Cornel Tol from the Headache, Pain, and Concussion Training Institute (HPCTI) delve into the intricacies of managing concussions and post-concussion symptoms. They advocate for using the term "prolonged post-concussion symptoms" over "mild traumatic brain injury" to reduce the nocebo effect associated with the latter.

The discussion highlights the importance of a multidisciplinary and biopsychosocial approach in diagnosis and treatment, emphasizing the significance of early intervention and patient education. Melvin and Cornel share insights into diagnostic criteria, the impact of framing on patient outcomes, and the gaps in current practices, particularly in the Netherlands. They stress the need for physiotherapists to be proactive in education and networking to bridge the knowledge gap in concussion management.

The episode also touches on the neurophysiological aspects of concussion, the shortcomings of monodisciplinary approaches, and the potential of a treatable traits approach for better patient outcomes. Listeners are encouraged to rethink the role of physiotherapy and consider the broader implications of prolonged symptoms, including psychological and social factors. The episode provides practical advice for physiotherapists and healthcare professionals on how to improve their practice and patient care in the context of concussions.

Guests

Today's guests are Melvin Pitz and Cornel Tol from the HPC-TI — short for Headache, Pain & Concussion Training Institute. They're on a mission to educate and empower healthcare professionals with cutting-edge, evidence-based strategies to manage headache, pain complaints, and mild traumatic brain injury. With a strong clinical background and a critical view on how care is currently delivered, they're pushing for a multidisciplinary and biopsychosocial approach that actually works — in the clinic, and beyond

Content

00:00 Intro

00:41 Definition of PPCS

03:06 Diagnostic Criteria

06:35 Gaps in recognizing PPCS

09:47 Why patients are misdiagnosed

14:24 Sponsor

15:00 Prognostic Factors to develop prolonged symptoms

18:48 Rethinking Physiotherapists' role in treating PPCS

24:40 Neurophysiology of PPCS

28:28 Why monodisciplinary approaches fail

33:12 Diagnosis & Decisionmaking

35:48 Sponsor

37:04 Biggest pitfalls

38:44 Treatment

50:48 Interesting Case Studies

57:38 Return to work/play

01:03:21 Opinion on high-impact sports

01:05:25 Myths to bust

01:06:26 Closing thoughts

01:07:37 Contact info & Outro

Bonus Material

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Summary

In this episode, we welcome Dr. Sue Mayes, a distinguished physiotherapist and senior lecturer at La Trobe University, who is renowned for her expertise in injury prevention and rehabilitation, particularly in elite dancers and athletes. Dr. Mayes discusses the significance of foot intrinsic muscles, focusing on their role in ballet and sports injuries. She explains common issues like hallux valgus and foot arch control, emphasizing the importance of intrinsic muscle strengthening to enhance performance and reduce injury risk.

Dr. Mayes shares insights into effective foot strengthening techniques, such as banded exercises and stair running, while highlighting the limitations of traditional exercises like toe doming. She also explores the impact of footwear, advocating for a gradual adaptation to minimalist shoes. The conversation covers the role of intrinsic muscles in chronic conditions like ankle instability and shin splints, and the need for a comprehensive approach that includes calf and hip strengthening.

Listeners gain practical tips on creating foot strengthening programs, selecting appropriate exercises, and understanding the nuances of rehabilitation across different sports. Dr. Mayes underscores the importance of balancing foot strength and emphasizes the need for proper footwear to prevent stress fractures. The episode concludes with a call to acknowledge the lateral foot muscles and their role in distributing load effectively.

Content

00:00 Intro

01:01 What are Foot Intrinsics?

01:40 Most common foot/ankle injuries in Ballet

02:20 Hallux Valgus

04:30 Taping for Hallux Valgus

06:12 Quantifying intrinsic muscle strength

08:03 Foot Arch

09:45 Sponsor

10:35 The dome exercise

12:30 Common misconceptions

13:43 Footwear

17:40 Intrinsic Foot muscle weakness as risk factor

19:50 Performance Impact

22:25 Building a foot strengthening program

27:32 Sponsor

28:44 Strength program progression

30:50 Balance program

32:43 Focus on Abductor Hallucis

34:42 What else to focus on?

36:15 Plyometrics

38:25 Footballer are like Ballerinas

41:12 What clinicians should know about feet

42:26 Sue's closing thoughts

44:10 Contact info & Outro

Bonus Material

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Description

In this episode, Dr. Jack Hickey, a leading researcher in hamstring injuries, shares valuable insights into the complexities of hamstring rehabilitation and injury prevention. He discusses the common misconceptions surrounding hamstring rehab, emphasizing the importance of understanding the adaptations targeted by specific exercises rather than simply mimicking injury mechanisms. Dr. Hickey also delves into the significance of hamstring muscle architecture, particularly the role of fascicle length as a modifiable risk factor for injury. He highlights recent research comparing the effectiveness of exercises like Nordic hamstring exercises and Romanian deadlifts in enhancing fascicle length.

Dr. Hickey further explores his pioneering work in pain threshold rehabilitation, explaining how allowing low to moderate levels of pain during rehab can lead to better strength and muscle adaptation without delaying return-to-play timelines. He also touches on the fragility index as a measure of the robustness of risk factors associated with hamstring injuries.

Throughout the conversation, Dr. Hickey underscores the importance of individualized rehab programs, incorporating both on-field and gym-based conditioning, and the need to prioritize fundamental principles such as load management and athlete well-being. He also provides a glimpse into ongoing and future research endeavors aimed at advancing our understanding of hamstring injury mechanics and prevention strategies. This episode is packed with practical advice and evidence-based approaches for clinicians, making it a must-listen for those involved in sports medicine and rehabilitation.

Guest

Jack Hickey is a leading researcher in the field of hamstring injuries. Jack is currently based at Maynooth University in Ireland, where he joined in 2023 as the first academic in the Department of Sport Science and Nutrition.Before that, he was a Senior Lecturer at the Australian Catholic University in Melbourne and part of the SPRINT Research Centre, focusing on sports performance, injury, and rehab. His PhD centered on hamstring strain injuries and pain-threshold rehab – a body of work that earned him multiple national awards, including the ESSA Medal for best PhD thesis in Exercise and Sport Science.Beyond academia, Jack is an accredited Exercise Physiologist with over a decade of experience treating athletes from all levels—especially those dealing with hamstring injuries and ACL reconstructions.

Content

00:00 Intro

01:31 Why the interest in the hamstrings?

03:41 Transitioning from Australia to Ireland

06:05 Common Misconceptions in Hamstring Rehab

13:09 sponsor

13:46 How to measure fascicle length

16:07 Pain threshold rehabilitation explained

21:55 But there's more than pain levels

27:51 How to modify fascicle length

30:01 Nordic Hamstring Curls vs. RDLs

35:05 sponsor

36:08 Which exercises favor different parts of the hamstrings

40:54 Ideal eccentric loading parameters

43:40 What is the Fragility Index?

49:49 Describing Return to Play Criteria

52:47 Hamstring Rehab in the ideal world 5

6:15 Current Hamstring Research Highlights

59:32 Jack's closing thoughts

01:00:26 Contact Info & Outro

Bonus Material

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Summary

In this episode, we explore the innovative world of Runeasi, a company co-founded by Dr. Kurt Schütte, which is revolutionizing the assessment of running and jumping in both clinical and athletic settings. Dr. Schütte shares how Runeasi bridges the gap between lab-based biomechanics research and real-world application, offering affordable, evidence-based analysis tools. The episode delves into the workings of Runeasi's AI-driven 3D gait analysis and its jump module, highlighting their key metrics and practical applications in reducing injury risk and enhancing performance. Additionally, the podcast covers the benefits of using Runeasi for clinicians and coaches, its validation process, and its future developments, including remote rehabilitation and mobile app advancements. The discussion emphasizes Runeasi's mission to make data-driven insights accessible and actionable for everyday physiotherapists, coaches, and athletes.

Guest

Dr. Kurt Schütte, PhD in biomechanics, CEO, and co-founder of Runeasi — a company that's shaking up how we assess running and jumping in both clinical and athletic settings.

After completing his PhD, Kurt saw a gap between the lab and the field — and a clear need for affordable, evidence-based biomechanics analysis that could be used in the real world. That realization became Runeasi. His mission? To empower clinicians and coaches to use data-driven insights to reduce injury risk and enhance performance — and to make this the standard within the next three years.

Resources

Andreas Halfmarathon Case Study with Runeasi

Runeasi Website

Content

00:00:00 Introduction of Dr. Kurt Schütte and Runeasi

00:01:06 Discussion on the origin of Runeasi

00:02:09 Motivation from research to entrepreneurship

00:04:11 Vision for data-driven insights in clinical practice

00:08:25 Core of Runeasi's AI-driven 3D gait analysis

00:09:50 Difference from traditional lab-based systems

00:12:27 Ensuring closeness to the gold standard

00:14:58 Main metrics from gait testing

00:22:02 Who uses Runeasi and for which scenarios

00:27:18 Typical test session walkthrough

00:32:24 Running on a treadmill vs. outdoors

00:38:11 Jump testing module

00:41:11 Main metrics in the jump module

00:44:26 Ensuring accuracy compared to force plates

00:48:34 Special cases in return to sport testing

00:52:59 Future developments for Runeasi

00:57:26 Message to physios hesitant about biomechanics tech

01:01:51 Final thoughts and how to get Runeasi

Bonus Material

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In Episode 77 of the PhysioTutors podcast, we welcome Hedwig Neels, a renowned physiotherapist from Belgium who specializes in pelvic health. Hedwig is a professor at the University of Antwerp and founder of the Pelvic Floor platform, which aims to break taboos and make pelvic health accessible and understandable for women. During the episode, Hedwig discusses her journey in creating the Pelvic Floor platform and the common misconceptions around pelvic health, such as the overemphasis on Kegel exercises. She emphasizes the importance of education, awareness, and a holistic approach to pelvic health. The conversation also covers pelvic health during pregnancy and postpartum, highlighting the need for pelvic floor training and the challenges in returning to high-impact sports. Hedwig shares insights into male pelvic health, particularly saddle pain in cyclists, and the significance of relaxation over strengthening in certain cases. The episode concludes with a discussion on the future of pelvic floor rehabilitation and the importance of open communication and education in the field. Hedwig provides valuable resources and advice for physiotherapists and individuals looking to understand and improve pelvic health.

Guest

Hedwig is a physiotherapist specializing in pelvic health, with a particular focus on education and awareness. She is a professor at the University of Antwerp, where she combines academic research with clinical practice at the University Hospital of Antwerp. Hedwig is also the founder of The Pelvic Floor, an information platform and community designed to break taboos and make pelvic health accessible and understandable for all women. She teaches both medical and paramedical professionals through the Women's & Pelvic Health Professionals network and is the author of Het Bekkenbodemboek — a beautifully illustrated, accessible guide to pelvic floor health for women. Her clinical expertise also extends to athletes, including both women and men, with a special focus on cycling-related saddle pain and its impact on performance.

Content

00:00 Intro

01:12 Why she started her Pelvic Health Platform

03:19 Misconceptions about the Pelvic Floor

06:42 Sponsor

07:19 Lowering the barrier to start talking about pelvic health

12:00 Pelvic Health during and after pregnancy

15:40 Return to sport post-partum

20:00 Quantifying pelvic floor function in practice

23:37 Pelvic Floor Problems among top reasons women stop playing sports

26:52 Male pelvic pain

31:43 More about letting go than holding in

34:12 Pelvic health skills for non-pelvic health practitioners

37:01 Sponsor

38:02 Go beyond Kegels

42:54 Don't forget the pelvic girdle

46:34 The biggest innovation in pelvic rehab

49:32 What every physio should know about pelvic health

51:02 Hedwig's closing thoughts

53:18 Contact info & Outro

Bonus Material

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In episode 76 of the podcast, we engage with Dan Elias, a seasoned physiotherapist with over 15 years of experience, specializing in youth athletes. Dan works with the England athletics team and runs the Youth Physiotherapy Clinic in Bath, focusing on athletes aged 8-18. During the episode, Dan discusses his journey into youth physiotherapy, emphasizing the unique approach required for treating young athletes compared to adults. He highlights common misconceptions about physiotherapy for children and the importance of adapting communication and treatment strategies to suit their developmental needs.

Dan elaborates on the challenges of managing injuries during growth spurts and the significance of bone health and appropriate strength training for young athletes. He also addresses the phenomenon of overtraining, offering insights into recognizing early signs and mitigating risks through proper rest, nutrition, and diversified physical activities. The conversation underscores the role of fun and engagement in rehabilitation and the necessity of establishing healthy long-term habits for injury prevention. Dan stresses the importance of understanding each child's unique circumstances and fostering a supportive environment that encourages confidence and communication. The episode is a comprehensive discussion on the nuances of youth physiotherapy, offering valuable insights for parents, coaches, and practitioners involved in youth sports.

Content

00:00 Intro

01:14 Dan's Journey into Youth Athletics

04:34 What are the biggest misconceptions on Youth Athlete Physiotherapy

08:03 Tips on communicating with children & adolescents

10:08 How Growth Spurts affect Injury Risk

16:19 Sponsor

17:20 What does a typical Assessment look like

22:20 What are common injuries in this population?

25:05 Are avulsion fractures prevalent?

26:13 How to recognize early signs of overtraining

30:30 How to deal with overtraining symptoms

33:01 Specific sports that have the most injuries

35:35 Resistance Training in adolescents

38:02 How to design "fun" rehab plans

41:15 Sponsor

42:03 How to help adolescents create healthy habits

45:26 Physical and mental advice for young patients

50:25 Parents' biggest mistakes in youth development

52:54 Early sports specilization

54:05 Dan's closing thoughts

55:47 Contact Info & Outro

Bonus Material

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