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Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. In part 2 of this series, Dr de Vos covers the multitude of options for treatment, outside of exercise therapy. Should you and the patient consider corticosteroid injections, PRP injections, heel lifts, shockwave, NSAIDs, or surgery? And when? What are the important clinical considerations when patients choose these options? Part 2 has it all! ------------------------------ RESOURCES Terminating corticosteroid injection in tendinopathy? https://www.jospt.org/doi/10.2519/jospt.2023.11875/ Dutch multidisciplinary guideline on Achilles tendinopathy: (https://pubmed.ncbi.nlm.nih.gov/34187784/ Platelet-rich plasma injection for chronic Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/20068208/ Time to put down the scalpel when treating tendinopathy? https://pubmed.ncbi.nlm.nih.gov/31653777/ Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/ Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/ Clinical tool for identifying spondyloarthropathy: http://tinyurl.com/3my87hma More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/ Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/ Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review. In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy. ------------------------------ RESOURCES Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/ Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/ Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/ Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/ Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Sports Corner is back for 2024! Today, we revisit ice hockey, and focus on acute injuries—preventing and managing them. Dr Joe Robinson is the head physical therapist for the National Hockey League’s Boston Bruins. He skates into Sports Corner to explain the physical demands of hockey, the typical acute injuries he sees and how to prevent them, and runs through how the medical team responds during emergency scenarios.

Does the thought of managing elbow pain leave you reaching for your orthopaedics textbook? Maybe you've got lateral elbow tendinopathy sorted, but how confident do you feel about managing elbow fractures and dislocations? Today, Val Jones, Clinical Lead Physiotherapist at the Sheffield Shoulder and Elbow Unit at the Sheffield Teaching Hospital Foundation Trust, shares practical advice to help you feel confident about managing elbow pain. ------------------------------ RESOURCES CT versus MRI for assessing osteochonritis dissecans of the capitellum: https://pubmed.ncbi.nlm.nih.gov/36342019/ Shoulder arm return to sport test battery: https://pubmed.ncbi.nlm.nih.gov/31203142/ Lateral elbow pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2022.0302 2022 Bern shoulder consensus: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952 JOSPT Insights episode 136 (lateral elbow pain with Drs Lucado and Day): https://podcasts.apple.com/us/podcast/ep-136-lateral-elbow-pain-2022-clinical-practice-guideline/id1522929437?i=1000617533681 JOSPT Insights episode 103 (baseball pitching biomechanics with Wake Forest Pitching Lab): https://podcasts.apple.com/us/podcast/ep-103-baseball-pitching-biomechanics-with-the-wake/id1522929437?i=1000581372250

Did you know that calf injuries are one of the most common soft tissue injuries in team sports? How comfortable do you feel assessing and managing calf pain, especially designing and progressing a program to help someone get back to their sport? Today, Dr Seth O'Neill from the University of Leicester, joins us to blend the latest science in calf injury with high-level clinical reasoning. You'll get something out of today's chat whether you're beginning in your clinical career or whether you're looking for suggestions for advanced clinical practice.

Two (gentle) giants of physiotherapy/physical therapy research and practice join JOSPT Insights today. Associate Professor Peter Kent and Professor Peter O'Sullivan (Curtin University, Perth, Australia) share, on behalf of the whole trial team, the results of their RESTORE trial. Does cognitive functional therapy herald a revolution in how clinicians can support people to live well with back pain? Let's find out. ------------------------------ RESOURCES For the published trial: https://pubmed.ncbi.nlm.nih.gov/37146623/ Find out lots more about the RESTORE trial, including how patients and clinicians feel about cognitive functional therapy: https://www.restorebackpain.com/

Someone walks into your clinic with a sore shoulder. Are you dealing with a stiff shoulder? A rotator cuff problem? The acromioclavicular joint? Or something else entirely? Today, Dr Angela Cadogan (PT, PhD) - Specialist Physiotherapist and clinical consultant - is helping you hone your clinical reasoning in differential diagnosis of subacromial pain. Dr Cadogan shares her practical approach to diagnosing subacromial pain in a way that you can take straight to the clinic tomorrow.

Welcome to part 2 of our masterclass with Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia) on understanding, talking about and shifting the narratives we all carry about musculoskeletal pain. We are exploring the explicit and implicit messages that you communicate with your words and actions when you work with patients. Drs Bunzli and Caneiro share tips on communicating, and on developing your own practice as a musculoskeletal rehabilitation clinician. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

We're wrapping up the 2023 JOSPT Insights year with a 2-part chat with physiotherapists, researchers and educators, Dr Sam Bunzli (Griffith University, Brisbane, Australia) and Dr JP Caneiro (BodyLogic Physiotherapy, Perth, Australia). In part 1, we discuss the way that patients understand pain. Dr Bunzli kicks off by summarising the best research evidence, and Dr Caneiro shares some compelling clinical examples to explain how to apply the research to deliver quality musculoskeletal rehabilitation practice. ------------------------------ RESOURCES For more on pain narratives, check out the 3-editorial series led by Dr Bunzli, "Broken Machines or Active Bodies", including 5 recommendations to shift the way you communicate with people in pain: https://www.jospt.org/doi/10.2519/jospt.2023.11879 and https://www.jospt.org/doi/10.2519/jospt.2023.11880 and https://www.jospt.org/doi/10.2519/jospt.2023.11881 More on how people communicate about knee osteoarthritis (qualitative review): https://pubmed.ncbi.nlm.nih.gov/33502513/

In part 2 of this series, we continue chatting about designing and implementing a rehabilitation program after cervical discectomy with Drs Justin Lantz, Jessica Evaristo and Joseph Derian. Today we work through phases 3 and 4 in the rehabilitation program: re-modeling and maturation occurring around 12-weeks after surgery. We cover nerve glides and how to dose them, the goals and areas of focus for manual therapy and therapeutic exercise, incorporating proprioception training, and important clinical milestones to consider along the way. The patient’s goal was to return to manual labor, and we talk about how healing timelines impact on clinical decisions in the later stages of rehabilitation. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608 Catch part 1 here: https://podcasts.apple.com/us/podcast/ep-158-planning-a-rehabilitation-program-after/id1522929437?i=1000637409917 or https://open.spotify.com/episode/0Ci1ya1CHXB8FgYYBO4Q3q?si=94b548f8e3bd4b4e

Join a group of experienced orthopaedic clinicians as they review the background of anterior cervical discectomy and fusion surgery in a 2-part podcast series. In part 1, we cover who does well with surgery, the indications and surgical procedure, plus a deep dive into evidence-based pre- and post-operative rehabilitation. There's not much hard research evidence to guide your decisions on how to structure and deliver, so tune into hear how expert clinicians approach things. You'll learn about the phases of rehabilitation (we tackle the first two in today's episode), what’s normal, what’s not, strategies for collaborating with surgeons, and suggested interventions. ------------------------------ RESOURCES Read more about the case: https://www.jospt.org/doi/10.2519/josptcases.2023.11608

Dr Jeremy Graber joins us to help answer the question: how often should patients with total knee arthroplasty come to rehabilitation? To answer this and more, we dive into the 2023 JOSPT article, “Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study.” ------------------------------ RESOURCES Dr Graber and his colleagues led a expert consensus process to establish recommendations for how often and for how long you might consider scheduing rehabilitation visits. The group also discussed discharge planning, how to implement telerehabilitation, and monitoring the patient's progress to guide clinical decisions Check out the JOSPT article: https://www.jospt.org/doi/10.2519/jospt.2023.11840 For more on predicting outcomes after total knee replacement: https://www.medrxiv.org/content/10.1101/2023.10.23.23297404v1 (preprint)