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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In this episode of the podcast, we are joined by Shrey Vazir, an advanced physiotherapist and founder of Mind Body Horizons. Shrey shares his personal journey of managing fibromyalgia and discovering the intersection of mindfulness and physiotherapy. He emphasizes the importance of integrating mindfulness practices into healthcare, particularly for managing chronic pain, stress, and burnout.

Shrey discusses the science behind mindfulness, its benefits for patients and healthcare professionals, and offers practical steps for incorporating mindfulness into physiotherapy practice. He also addresses common misconceptions and barriers to adopting mindfulness and shares success stories of patients and professionals who have benefited from these practices. Listeners will get book recommendations for those interested in learning more about mindfulness and information on how to connect with Shrey.

Content

00:00 Intro

01:33 Shrey's Background

05:16 Founding Mind Body Horizon

07:40 Defining Mindfulness in Healthcare

14:05 Effects of Chronic Stress

20:24 How to integrate Mindfulness in Practice

28:10 Mindfulness Tips to prevent Clinic Burnout

32:15 Barriers to implementing Mindfulness

35:55 Athletes swear on Mindfulness

38:00 Dealing with Skepticism

43:15 Success Stories

50:56 Mindfulness Movement

52:50 Shrey's closing thoughts

54:25 Book Recommendations

56:32 Contact Info & Outro

Bonus Material

Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.

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In Episode 74 of the Physiotutors podcast, host Kai is joined by Dr. Erik Thoomes, an expert in musculoskeletal conditions, particularly cervical radiculopathy. Dr. Thoomes provides an in-depth discussion on cervical radiculopathy, distinguishing it from nonspecific neck pain. He explains that cervical radiculopathy involves radiating arm pain due to nerve root irritation or compression, often caused by disc herniation or spondylotic changes, contrasting it with lumbar radiculopathy.

The episode emphasizes the importance of thorough patient history in diagnosis and suggests a cluster of tests including Spurling's test and neural tension tests to improve diagnostic accuracy. Dr. Thoomes also challenges the reliability of traditional dermatomes and myotomes, advocating for individualized assessment and treatment strategies.

The conversation covers various treatment options, highlighting the ineffectiveness of cervical traction and suggesting neurodynamic mobilization, spinal manipulative therapy, and targeted exercises. Dr. Thoomes advises adapting management strategies from acute to chronic stages and stresses the role of patient education and self-management. The episode also touches on the limited role of imaging unless necessary and discusses the importance of differentiating cervical radiculopathy from other conditions.

Dr. Thoomes calls for more research in areas like epidemiological data and neurodynamic mobilization and shares clinical gems for effective management. The episode concludes with an emphasis on individualized patient care and encourages questions and further discussion from listeners.

Content

00:00 Intro  00:52What is Cervical Radiculopathy? 04:05 Cervical vs Lumbar Disc Herniation 05:29 Clearer Terminology needed 07:15 Prevalence and Risk Factors 08:26 Most useful Tests 10:33 Crucial History Findings 11:56 Dermatomal/myotomal examination 13:13 Treatment Options 18:27 Manipulations? Mobilizations? 21:29 Motor Control Training 24:55 Directional Preference in the Cervical Spine? 26:03 Higher Level Exercises 27:01 Self-Management 28:52 Diagnostic Mistakes to Avoid 31:30 Red Flags and Imaging 33:15 Lessons to learn from LRS 34:25 Future Research Directions 37:45 Top Tips 39:27 Outro & Contact Info

Bonus Material

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In episode 73 of the Physiotutors podcast, we talk to Philipp Andersson, a seasoned physical therapist and strength and conditioning coach who heads the medical department for IFK Värnamo in Sweden's top football league. Philipp shares insights into his unconventional journey into sports physiotherapy, starting with a passion for working in professional sports, leading to volunteering opportunities that paved his way into elite sports teams. Despite lacking initial connections, his determination and strategic volunteer work helped him secure his current role.

Philipp discusses the unique challenges of working with both women's and men's football teams and the differences between training high-profile clients and professional athletes. He emphasizes the importance of sport-specific training and the need to connect gym work with on-field performance. The conversation also touches upon common injuries in soccer, particularly the prevalence of ACL injuries in women and muscle injuries in men, and the balance between performance and recovery.

Philipp talks about the realities of working in professional sports, debunking myths about glamour and high salaries, and highlights the rewarding aspects, such as forming strong connections with players. He also shares his leadership philosophy, stressing the importance of listening and open dialogue within a multidisciplinary team. The episode concludes with insights into Philipp's daily routine and the demands of balancing personal life with a career in professional sports.

Philip Andersson is a Physical Therapist and Strength & Conditioning Coach leading the medical department for IFK Värnamo in Sweden’s top football league. With experience in elite women’s football and training high-profile clients, Philip brings a wealth of knowledge on athlete care and performance.

Content

00:00 Intro

00:35 Philip's Journey into Professional Sports

03:13 Challenges of working with Athletes vs. Celebrities

05:05 How he landed his clients

06:00 Most common injuries he sees

07:45 Different injuries in men's vs. women's sports

08:22 Decision-making for RTP in professional sports

09:46 What's physio really like in professional sports

12:07 Common misconceptions

14:35 Most rewarding moments

18:13 Differences working with high profile clients

19:17 Leadership lessons

20:45 Philip's Advice to land a job in professional sports

23:30 Use of non EBP in professional sports

28:08 Philip's work philosophy

29:20 A typical day/week

32:20 Career Plans

34:30 Bonus Story

37:50 Bonus Story 2

39:29 Contact Info & Outro

Bonus Material

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In Episode 72 of the Physiotutors podcast, we interview Dr. Daniel Belavy, a professor with a prolific research background in muscle, bone, and joint health, specifically focusing on low back pain. The discussion explores various aspects of back pain research, including disk herniations in astronauts, the role of mechanical loading in disk health, and the challenges of classifying non-specific low back pain.

Dr. Belavy shares insights from his studies on physical exposure and spine postures, contextual effects in treatment, and exercise training for back pain. He emphasizes the importance of understanding how treatments work to optimize clinical care and highlights the ongoing quest to identify subgroups and optimal exercise prescriptions for back pain. The episode underscores the complexity of back pain and the multifactorial elements influencing it, advocating for continued research and collaboration in the field.

Content

00:00 Intro

00:57 Disc Herniations in Astronauts

04:08 Discs need (de-)loading

08:04 Is there a U-curve for loading?

10:15 NSLBP Classification Challenges

19:20 SI Joint Pain Classification Challenges

24:30 Physical Exposures and Low Back Pain

29:04 Physical Function/Activity and Low Back Pain

31:40 Contextual Effects in Low Back Pain

40:09 How to harness contextual effects in treatment

41:21 Which type of exercise is best for LBP

47:01 Exercise variables and pain reduction

50:29 Daniel's closing thoughts

53:00 Contact info

55:52 Outro

Bonus Material

Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.

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