Physiotutors Podcast

Nicol van Dyk is a physiotherapist and clinical researcher currently occupying the role of Injury Surveillance and Medical Research Officer with the Irish Rugby Football Union in Dublin, Ireland. In 2018 Nicol completed his PhD in Health Sciences at Ghent University, Belgium titled "Risk factors for hamstring injuries in professional football players." During this time Nicol was a physiotherapist at the Aspetar Orthopaedic and Sports Medicine Hospital.

In this episode we are joined by Nicol van Dyk. We discuss injury prediction and screening tests, individual risk factors for athletes at risk of injury, the importance of clinical reasoning and individualized approaches as well as why it rains so much in the Netherlands....

This was a great episode to record and we hope you enjoy it.

Content

00:00:00 Introduction

00:01:00 Screening tests and injury prediction

00:05:10 Importance of screening tests in injury prevention and building athlete trust

00:13:14 Importance of Previous Injuries

00:17:47 Role of Technology and Social Support in Rehab

00:21:35 The Significance of Sleep in Injury Prevention

00:26:41 Understanding individual athlete risk factors

00:30:10 Importance of clinical reasoning and individualized treatment

00:38:08 Using mixed methods approach for injury prediction

00:41:09 Injury prediction vs risk estimation

00:44:32 Focus on performance and robustness

00:46:24 Importance of communication and empathy in physiotherapy

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Welcome to episode 53!

In this episode we are joined by Adam Dobson who is working as a specialist triage & treat spinal physiotherapist for South Tees Hospitals NHS Foundation Trust. He is the author of "Lumbar Radicular Syndromes - At a Glance" and actively shares his knowledge around radicular syndromes on his Twitter (@adamdobson123) and as guest on various podcasts. We are very happy to have him on the microphone for this episode. Enjoy!

Content

00:00 Intro 00:40 Definition of Lumbar Radicular Syndrome 02:57 Signs & Symptoms of Sciatica 06:12 Red Flags 14:14 Cauda Equina Pathway 19:20 Facet Joint Stenosis Differentiation 21:54 K.I.S.S. 22:30 Motor Control Exercises 24:45 Opinion on Piriformis Syndrome 30:20 Minor Neurogenic Dysfunctions 35:17 Treatment for LRS 38:55 Advice. Anything Else? 44:16 Clinical Decisionmaking 45:52 Adam's closing thoughts 50:47 Encore - Stenosis 53:05 Outro

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Andrew is a consultant physiotherapist from the UK with a special interest in the upper limb and particularly the shoulder, which is also the reason he has created a course on the stiff shoulder, the elbow and wrist for Physiotutors together with Thomas Mitchell. He is in the process of finishing his PhD this year on imaging for musculoskeletal conditions in primary care at Keele University, so he's the perfect person to talk to about imaging!

Content

00:00 Intro 01:25 How far are we from ideal? 05:56 Scale of MSK Imaging 09:40 Why don't we stick to guidelines? 15:50 When imaging makes sense 21:35 Do Patients Expect Imaging? 23:49 Sponsor 24:59 The goal of Imaging 27:52 Risks of Imaging 30:27 Imaging Techniques 101 35:10 Should Physios use Ultrasound 37:56 Scan interpretation as a skill? 43:10 How to explain imaging findings 48:15 Andrew's closing thoughts 49:49 Outro

Sponsor

This episode is sponsored by the CSP student conference 2023. For more information and to sign up visit: https://www.csp.org.uk/studentconference23

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Hi and welcome to Physiotutors podcast episode 51 with Henrik Riel.

Henrik is a physiotherapist from Denmark and has obtained his PhD in the management of plantar heel pain. He is doing a post-doc fellowship at the university of Aalborg and he is an assistant professor at the physio department of the university of northern Denmark.

In this episode we will talk about plantar heel pain etiology, the risk factors associated with it, Henrik's approach to examination, imaging, and treatment. We will answer the question if there are prognostic factors for the condition, what mode of strength training is recommended and discuss the efficacy of adjunct treatment modalities for plantar fasciopathy. So make sure to listen to the entire episode.

Content

00:00 Intro 00:45 Plantar fasciitis, Plantar Fasciotpathy or Plantar heel pain? 02:41 Is it a tendinopathy? 03:33 The typical patient 04:40 Risk factors 07:13 Signs & Symptoms 09:05 Differential Diagnoses 10:10 Examination/Imaging & Testing 13:00 What about Heel spurs? 14:10 Prognosis 19:28 Isometrics for Plantar Heel Pain 22:04 Treatment Options 26:35 Load Management 28:15 Plyometrics/SSC Exercises 30:54 Henrik's Closing Thoughts 32:00 Outro

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In this episode we will talk about all things shoulder instability. You will learn more about the Stanmore classification and structural damage after dislocations. We will discuss the typical patient with shoulder instability and how an examination process looks like. We will touch on muscle activation patterns, surgery and how physiotherapeutic management of a patient with shoulder instability could possibly look like. So make sure to listen to the whole episode!

Our guest is Anju Jaggi. She is a physio consultant shoulder specialist at the royal national orthopedic hospital in stanmore, UK. She's a past president of the European Society of Shoulder & Elbow Rehabilitation (EUSSER) and a published researcher with a particular interest in shoulder instability.

Content

0:00:00 - 0:01:08 Introduction 0:01:08 - 0:02:32 What is Shoulder Instability? 0:02:32 - 0:05:50 What causes the shoulder pain? 0:05:50 - 0:13:44 TUBS/AMBRI/Neuromuscular 0:13:45 - 0:18:13 What gets damaged in the shoulder? 0:18:13 - 0:22:22 The typical patient fenotype 0:22:22 - 0:28:55 Examination Process 0:28:55 - 0:30:05 Special testing 0:30:55 - 0:34:29 How to test the cuff 0:34:29 - 0:37:16 When is the cuff weak? 0:37:16 - 0:40:05 Muscle activation patterns 0:40:05 - 0:43:30 Risk factors 0:43:30 - 0:46:14 Risk of Developing OA 0:46:14 - 0:47:58 Relocating a shoulder as physio 0:47:58 - 0:55:02 Shoulder Instability Rehab 0:55:02 - 1:00:21 Surgery vs. Physio 1:00:21 - 1:01:38 Anju's closing thoughts 1:01:38 - 1:03:10 Outro

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Welcome to episode 49!

Today's guest is Mike Reiman who is a physiotherapist, active clinical researcher, educator and mentor with a special interest in the hip. He is also an associate professor at Duke University and an adjunct professor at Wichita State University.

In this episode we will talk about femoroacetabular impingement abbreviated as FAI. You will learn more about FAI morphology and the development of FAI. Mike will elaborate on the epidemiolgy of FAI, what can trigger symptoms and the prognosis in regards to the development of hip osteoarthritis. Of course we will talk about diagnosis and physiotherapeutic treatment and finish of with a discussion about surgery for FAI.So make sure to listen to the whole episode! Enjoy!

Content

0:00:00 - 0:01:04 Introduction 0:01:00 - 0:02:50 What is FAI? 0:02:50 - 0:04:35 How FAI develops 0:04:35 - 0:08:10 Epidemiology of FAI 0:08:10 - 0:09:52 Asymptomatic FAI 0:09:52 - 0:13:13 Triggers for symptomatic FAI 0:13:13 - 0:18:13 Prognosis: Do patients develop hip OA? 0:18:13 - 0:21:34 Screening 0:21:34 - 0:25:35 History & Examination 0:25:35 - 0:28:13 Confirming the Diagnosis 0:28:13 - 0:29:45 Imaging necessary? 0:29:45 - 0:31:54 Muscle Strength Testing 0:31:54 - 0:45:10 FAI Rehab Start to Finish 0:45:10 - 0:48:45 How good is Physio for FAI? 0:48:45 - 0:53:40 How good is Surgery for FAI? 0:53:40 - 0:58:30 How to choose: Surgery or FAI 0:58:30 - 0:59:50 Mike's Closing Thoughts 0:59:50 - 1:00:29 Outro

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In this episode we will talk about different rheumatological conditions that can mask as musculoskeletal pain and how to recognize them. Our guest is Jack March, a physiotherapist specialising in rheumatology who provides CPD courses on the recognition, investigation and management of rheumatological conditions. We will shine a light on imaging and medical tests for different conditions and cover differences between genders. At last, we will discuss how patients with rheumatism are best treated, talk about precautions during exercise and how to positively influence their prognosis. So make sure to listen to the whole episode! Enjoy!

Content

00:00 - 00:58 Introduction 00:58 - 02:18 What is Rheumatism? 02:18 - 03:47 Rheumatological diseases to know 03:47 - 05:28 When to think it's Rheumatic 05:28 - 08:16 Screening for Rheumatoid Disorders 08:16 - 11:46 How Rheumatoid Inflammation is different 11:46 - 15:32 What are the Signs & Symptoms 15:32 - 17:04 How helpful is Imaging? 17:04 - 18:55 Difference in males vs. females 18:55 - 22:10 Testing for Rheumatoid Disorders 22:10 - 27:11 Referral to Specialist Management 27:11 - 35:45 What Physios can do in RD 35:45 - 37:55 Jack's Closing Thoughts 37:55 - 38:54 Outro

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In this episode we will talk about the demonization of and the future of manual therapy with Chad Cook. Chad is physiotherapist, a professor at Duke University and a clinical researcher who has published over 330 peer-reviewed papers. One of the latest papers he has published is called "The Demonization of manual therapy" where he evaluated common critique on manual therapy based on the current literature.

We wish him all the best and his British accent will be dearly missed.

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Content:

00:00:00 - 00:01:46 : Introduction

00:01:46 - 00:02:48 : Chad's definition of MT

00:02:53 - 00:04:54 : The Pendulum has swung too far

00:04:55 - 00:07:20 : How is MT different from other modalities?

00:07:25 - 00:09:04 : Does hypomobility assessment still have a place?

00:09:05 - 00:10:26 : Do we need to be specific with MT?

00:10:28 - 00:13:44 : How to know when to use MT in a patient

00:13:48 - 00:16:37 : Is the cost of current MT education justified?

00:16:40 - 00:21:31 : Time to embrace the placebo effect?

00:21:34 - 00:24:42 : The biggest critique on MT

00:24:44 - 00:26:11 : Are we sending the wrong message to patients?

00:26:14 - 00:32:10 : The value of Costs vs. Patient Satisfaction

00:32:16 - 00:36:05 : How MT education needs to change

00:36:06 - 00:39:24 : The future of MT

00:39:25 - 00:40:34 : Outro

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Research and evidence based practise are the cornerstone of the modern clinician - ensuring that we use the best, up to date methods to support our clients and patients. With that said however, there's so much out there, how can you be sure what you're reading is worthwhile, is relevant or of any half decent quality. We have to understand the limitations of the research we're reading to understand the implications and potential application of that research too. It's unfortunate, but when working with people - whatever your discipline - there's no one size fits all approach and there's always nuance. With that said, myself and James spoke about why we need to dig further than *just* the abstract before we make up our minds on a research paper, to fully gage whether it is of clinical or statistical significance! We discuss what are some of the things you should look out for when reading and discerning research as well as some of the wider elements of research to better understand that world.

I speak with the amazing Dr Melissa Farmer, Clinical Psychologist, Neuroscientist, researcher, CCO & co founder of Aivo Health! Melissa and I talk about chronic pain and the influence that has on both the brain & body as well as what we can do in clinic to both utilise these changes as well as how we can manage our patients with chronic pain with our approach to help them both feel seen and heard. We discuss her approach as to how she applies her research in clinic and what the importance is of getting research into clinics quicker rather than how it now trickles down! We touch on a lot of different topics throughout the hour, tune in and find out!