PT Inquest

We love us some pain neuroscience and exercise for the treatment of chronic pain as a very plausible approach, but there is not very much research out there that truly tests it. This article compared that approach to a more "old style" approach to physical therapy management of chronic spine pain. The conclusions were promoted as promising, but the findings may not be as impressive as advertised. Special guest Kenny Venere joins us to take an exploration of pain neuroscience as an intervention! (Here you can find Kenny's blog and his Twitter profile)

Effect of Pain Neuroscience Education Combined With Cognition-Targeted Motor Control Training on Chronic Spinal PainA Randomized Clinical Trial. Malfliet A, Kregel J, Coppieters I, et al. JAMA Neurol. Published online April 16, 2018. doi:10.1001/jamaneurol.2018.0492.

Here is the pretrial registration: ClinicalTrials.gov

Here is the article that they cited that describes the exercise interventions: https://doi.org/10.1016/j.bjpt.2017.06.019

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Finally a randomized controlled trial comparing physical therapy management to surgery for femoroacetabular impingement syndrome (FAIS)!!! And what were the findings? Well, not impressive on either end. Of course this generates more questions than answers but that's what good research does.

Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up. Mansell NS, Rhon DI, Meyer J, Slevin JM, Marchant BG. Am J Sports Med. 2018 May;46(6):1306-1314. doi: 10.1177/0363546517751912. Epub 2018 Feb 14.

Here is the pretrial registration: ClinicalTrials.gov

Here is the article that they cited that describes the physical therapy interventions: https://doi.org/10.1186/s12891-016-0914-1

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Determining when to return to play after concussion requires the use of testing to make sure that the athlete has returned to baseline. But what if you don't have a baseline measurement? Can having a history of common mental illnesses like anxiety and depression have an impact in the true baseline for an individual athlete? What about other cognitive peculiarities? Erik also discusses what it is like to be on the autism spectrum.

Here is the test for Autism/Asperger's that Erik was referring to: https://psychcentral.com/quizzes/autism-test/

Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance. Weber ML, Dean JL, Hoffman NL, et al. Am J Sports Med. 2018 Apr 1:363546518765145. doi: 10.1177/0363546518765145. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Female Athlete Triad may be more common than you think, and it turns out many male athletes can have it too! We take a deep exploration of the condition, how it works, and how to screen for it with special guest, San Diego State University PT School Program Director Mitch Rauh!

Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes. Tenforde AS, Carlson JL, Chang A, Sainani KL, Shultz R, Kim JH, Cutti P, Golden NH, Fredericson M. Am J Sports Med. 2017 Feb;45(2):302-310. doi: 10.1177/0363546516676262. Epub 2016 Dec 30.

We also discussed one of Mitch's many article on the topic from several years ago that happens to be open access: Associations between the female athlete triad and injury among high school runners. Rauh MJ, Barrack M, Nichols JF. Int J Sports Phys Ther. 2014 Dec;9(7):948-58.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Do older runners run differently than younger runners? If they do, is it A GOOD THING OR A BAD THING?! Can this actually be used as a tool for training or useful information for return after injury? Join us with study co-author Blaise Williams from Nike!

Biomechanical Implications of Training Volume and Intensity in Aging Runners. Paquette MR, Devita P, Williams DSB 3rd. Med Sci Sports Exerc. 2018 Mar;50(3):510-515. doi: 10.1249/MSS.0000000000001452.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Many clinicians wonder is tests such as the quad index are good enough for returning an athlete to sport after ACLR. Turns out, clinicians aren't even doing that! In the episode we have special guests Allison Toole and Matt Ithurburn discussing their recent paper that looked at how athletes tested after they had already been cleared to return to play after ACLR. Spoiler - they didn't look very good.

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs? Toole AR, Ithurburn MP, Rauh MJ, Hewett TE, Paterno MV, Schmitt LC. J Orthop Sports Phys Ther. 2017 Nov;47(11):825-833. doi: 10.2519/jospt.2017.7227. Epub 2017 Oct 7.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

The scientific community has made some mistakes over the past couple decades, leading people to think many effects were much larger than they actually are, if they even existed at all! So what is the reason for this? How has the current process incentivized the publication of studies that may not be the best reflection of the truth? And what can we do about it? Turns out, there is a lot we can do about it! THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT!

The Weak Spots in Contemporary Science (and How to Fix Them). Wicherts JM. Animals (Basel). 2017 Nov 27;7(12). pii: E90. doi: 10.3390/ani7120090.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

In the episode we also reference this wonderful overview of "replication crisis" and p-hacking from Veritasium.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Injecting tendinopathies is a popular practice; everything from PRP to steroids to saline to even sugar. But is there any efficacy? What exactly do these things do? Could there actually be a mechanical effect or is it chemical or just good ol' placebo? When is a sham not really a sham and how do we know? We explore all these questions and more with special guest, Peter Malliaras!

Effect of High-Volume Injection, Platelet-Rich Plasma, and Sham Treatment in Chronic Midportion Achilles Tendinopathy: A Randomized Double-Blinded Prospective Study. Boesen AP, Hansen R, Boesen MI, Malliaras P, Langberg H. Am J Sports Med. 2017 Jul;45(9):2034-2043. doi: 10.1177/0363546517702862. Epub 2017 May 22.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Check out Peter's blog which includes his online tendinopathy course at TendinopathyRehab.com

In the episode we reference Episode 107 and that article's Checklist for Minimum Reporting for Clinical Studies Evaluating PRP.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Injuries to the hamstrings are more common than just about any other muscle injury in sport. And once you do it once, you are more likely to do it again. What is the problem here? Are some people just good at injuring that muscle and simple are destined to repeat it? Or are there deficits that just aren't fully rehabilitated prior to return to sport? Also, does anyone know how to pronounce Vodafone? THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT!

Change in knee flexor torque after fatiguing exercise identifies previous hamstring injury in football players. Lord C, Ma'ayah F, Blazevich AJ. Scand J Med Sci Sports. 2018 Mar;28(3):1235-1243. doi: 10.1111/sms.13007. Epub 2018 Jan 8.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

When it comes to using treatments which have effects that may be nothing more than placebo, the question that is often asked is "What's the harm?" Well, according to these authors, it could be more than you realize. If it works, who cares? Does it matter that you are accidentally treating a psychosocial issue with something claiming to be treating something else? THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT!

'Caution, this treatment is a placebo. It might work, but it might not': why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport. Rohrer JM. Br J Sports Med. 2017 Jul 19. pii: bjsports-2017-097747. doi: 10.1136/bjsports-2017-097747. [Epub ahead of print]

The two blog posts Erik refers to in the episode can be found here: Placebo-Fu Elite Level Placebos

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission