BJSM

Isabel van Obergen and Hannes Cleppe discuss their prevention platform for sports: a software program (SpartaNova) that is in the ‘e-Health’ category for physiotherapy and sports medicine. We begin with an obvious competing interest disclaimer. BJSM has no financial interest or association with SpartaNova. Because clinicians use specific products, such as ‘Theraband’ ® for example, BJSM will report on the utility of such products while being open about any competing interests. Have you considered using software in your practice? Feel free to suggest what we should assess. We love to share ‘success stories’ – and if a commercial product adds value for you we’d report that information. Our guests in this podcast are the CEO of SpartaNova, (IvO) who was attending London’s ‘Leaders in Performance’ conference in 2013, and Hannes Cleppe, who trained as a physiotherapist in Belgium and the US before focusing on developing the injury prevention module for this product. The team includes active clinical advisors as well as experts in computer sciences and maths and closely co-operates with science partners from its founding universities and a broader network of researchers. See also: Developing an injury tracking software system specific for volleyball: a case example: http://bjsm.bmj.com/content/45/6/545.3.abstract Visual or computer-based measurements: important for interpretation of athletes’ ECG: http://bjsm.bmj.com/content/48/9/761.full

With Rob Swire (Manchester United) and Stijn Vandenbroucke (Moscow Dynamo). ‘You always start off the season with a masterplan of what you are wanting to do but we’ve never had a master plan that works or goes anywhere near where it is supposed to, but you just try your best’. Given this validation of what you are doing, listen and see how you CAN make prevent injuries and improve team performance by working as a team with your other health professional as well as strength and conditioning colleagues. It’s all about load monitoring and here you can hear from two very experienced physios in the field. What role GPS? What role other software? This is a scenario where ‘e-Health’ or ‘M-health’ meets performance. Our guests speak about how to customise training and monitor players’ adaptation – What are the things to watch out for? When can a player return to training after an injury spell? Is the coach the greatest risk factor – and can the GPS help communicate load messages to the coach? See also: General practitioners’ perceptions and practices of physical activity counselling: changes over the past 10 years: http://bjsm.bmj.com/content/43/14/1149.full Technology in Paralympic sport: performance enhancement or essential for performance?: http://bjsm.bmj.com/content/44/3/215.full Planning and implementing a nationwide football-based health-education programme: http://bjsm.bmj.com/content/46/1/6.full Monitoring stress and recovery: new insights for the prevention of injuries and illnesses in elite youth soccer players: http://bjsm.bmj.com/content/44/11/809.full Reproducibility of computer based neuropsychological testing among Norwegian elite football players: http://bjsm.bmj.com/content/39/suppl_1/i64.full

Rob Swire has had 22 years of experience at Manchester United. BJSM asked him ‘How do you screen a professional football team pre-season?’ He shares how it’s done, as well as the challenges of being a team clinician and struggling to keep up with continuing education. In the most recent season, Manchester United have moved to include a software package to simplify their screening data entry, risk calculation and the offer of advice as to what might be appropriate exercises in specific settings. ‘I’m a pragmatic (physio) surfing on a wave of science’ was how Steyn Van der Bruggen described his role. Previously at West Ham and more recently at Moscow Dynamo, he shares his approach on how to evaluate players’ functional capacity and then address limitations with targeted exercise. See also: Impact energy attenuation performance of football headgear: http://bjsm.bmj.com/content/34/5/337.full Dehydration of football referees during a match: http://bjsm.bmj.com/content/37/6/502.full Reductions in pre-season training loads reduce training injury rates in rugby league players: http://bjsm.bmj.com/content/38/6/743.full The effect of pre-season dance training on physical indices and back pain in elite cross-country skiers: a prospective controlled intervention study: http://bjsm.bmj.com/content/38/2/148.full Community football players’ attitudes towards protective equipment—a pre-season measure: http://bjsm.bmj.com/content/38/4/426.full Concussion, risk assessment, and practical steps to reform: Learning from the Hugo Lloris example: http://blogs.bmj.com/bjsm/2013/11/21/concussion-risk-assessment-and-steps-to-reform-learning-from-the-lloris-example/

Are you an exercise advocate? Dr Mike Loosemore, leader of the ‘Exercise is Medicine’ task force in the UK shares recent advances in this field. He spearheaded a most successful conference in that topic in 2013 and shares highlights with BJSM Editor Karim Khan. He previews the 2014 Exercise Medicine conference which you can catch at the Royal Society of Medicine in London on Friday June 20 and Saturday June 21. Keynote speakers include Professors Steven Blair and Greg Whyte. Here is the link for the meeting; themes include the role of technology, digital health and influencing behaviour change. http://www.rsm.ac.uk/academ/spe02.php BJSM’s special 2014 issue on Exercise is Medicine, edited by Professors Steven Blair and Stewart Trost can be found here: http://bjsm.bmj.com/content/48/3.toc See also: Developing a strategic research framework for Sport and Exercise Medicine: http://bjsm.bmj.com/content/48/14/1120.full Developing learning outcomes for an ideal MSc course in sports and exercise medicine: http://bjsm.bmj.com/content/39/1/20.full Leisure-time aerobic physical activity, muscle-strengthening activity and mortality risks among US adults: the NHANES linked mortality study: http://bjsm.bmj.com/content/48/3/244.full Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects: http://bjsm.bmj.com/content/42/8/636.full Intensity of leisure-time physical activity and cancer mortality in men: http://bjsm.bmj.com/content/45/2/125.full CT scans and X-rays increase risk of cancer – changing the goal posts in sports medicine: http://blogs.bmj.com/bjsm/2012/09/19/ct-scans-and-x-rays-increase-risk-of-cancer-changing-the-goal-posts-in-sports-medicine/ Physical activity more likely to prevent breast cancer in certain groups: http://blogs.bmj.com/bjsm/2008/05/18/physical-activity-more-likely-to-prevent-breast-cancer-in-certain-groups/

This 12-minute podcast relates to a special 2013 Consensus Meeting on Anti-Doping in Sports & its summary in BJSM’s Special Issue on Anti-Doping (May 2014). On November 29, 2013, FIFA hosted a meeting of representatives from key Anti-Doping stakeholders. Represented were sports physicians, athletes, legal experts, biomedical scientists, as well as leadership of international sports federations, the IOC and the Word Anti-Doping Agency. To take a ‘giant leap' forward in the battle to ensure a level playing field in sport the group addressed two key questions. (1) ‘Are we doing the right thing?’ and (2) ‘What contemporary methods can move beyond the simple testing strategy that was begun in the 1960s?’ Listen to the ebullient Professor Dvorak analyse anti-doping options and share with you the reasons drug-cheats are either stopping or very nervous. Read the full consensus statement: http://bjsm.bmj.com/content/48/10/801.full See also: Monitoring of biological markers indicative of doping: the athlete biological passport: http://bjsm.bmj.com/content/48/10/827.full FIFA’s approach to doping in football: http://bjsm.bmj.com/content/40/suppl_1/i3.full Gene doping: an overview and current implications for athletes: http://bjsm.bmj.com/content/47/11/670.full Anti-doping programme and physicians: http://bjsm.bmj.com/content/45/2/e2.2.abstract Do drug cheats ever prosper?: http://bjsm.bmj.com/content/36/2/79.2.full A doping sinner is not always a cheat: http://bjsm.bmj.com/content/42/7/549.full Super athletes or gene cheats?:http://bjsm.bmj.com/content/37/3/192.full Why we should allow performance enhancing drugs in sport: http://bjsm.bmj.com/content/38/6/666.full FIFA’s future activities in the fight against doping: http://bjsm.bmj.com/content/40/suppl_1/i58.full Ruling from the Court of Arbitration for Sport brings consistency, but anti-doping debate will rumble on: http://blogs.bmj.com/bjsm/2012/04/30/ruling-from-the-court-of-arbitration-for-sport-brings-consistency-but-anti-doping-debate-will-rumble-on-2/ Hot Topic: The Truth Behind Doping Scandals: https://soundcloud.com/bmjpodcasts/jiri-dvorak-on-the-future-of/edit Hot Topic: Current Anti-Doping Policies: http://blogs.bmj.com/bjsm/2008/08/07/hot-topic-current-anti-doping-policies/ Guest Blog: Peter Brukner on Drugs and the London Olympics: http://blogs.bmj.com/bjsm/2012/08/20/guest-blog-peter-brukner-on-drugs-and-the-london-olympics/

Professor Philippe Neyret from Lyon, France, is a renowned sports orthopaedic surgeon. Following from his talk at the Isokinetic Football Medicine Conference in Milan, BJSM editor Karim Khan reached him via mobile phone. Prof Neyret discusses patellar dislocation in the setting of football and explains that certain anatomic variations (including trochlea dysplasia) make the condition more likely to occur. For players who have suffered patellar dislocation, next steps are not straightforward. Professor Neyret explains which players he would recommend have surgery. See also: Injuries of the sporting knee: http://bjsm.bmj.com/content/34/6/467.1.full Patient Information Sheet: Patellar Instabilities (dislocation or subluxation of the kneecap): http://blogs.bmj.com/bjsm/2008/10/16/patient-information-sheet-patellar-instability-dislocation-or-subluxation-of-the-kneecap/

Welcome to the Sports Medcast, brought to you in association with the American Medical Society for Sports Medicine.In this episode, AMSSM members discuss the recently published 'Overuse Injuries and Burnout in Youth Sports: A Position Statement from the AMSSM' with statement authors Dr John DiFiori, Dr Joel S Brenner and Dr Neeru Jayanthi.Read the statement: http://goo.gl/lczEHoPlease feel free to contact us at thesportsmedcast@gmail.com regarding this or any other Sports Medcast.

Dr Alex Kountouris is the physiotherapist or the Australian men’s cricket team, a position he has held for 8 years. He has just completed his PhD on the relationship between quadratus lumborum and lumbar stress fractures. In this podcast he discusses strategies for the prevention and treatment of lumbar spine injuries in cricket. The interesting questions posed to him come from our twitter followers, so hear his responses to your questions! See also: Biomechanics of lumbar spine injury in young Australian fast bowlers: http://bjsm.bmj.com/content/44/Suppl_1/i4.3.abstract MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players: http://bjsm.bmj.com/content/41/11/836.full A stress fracture of the lumbar spine in a professional rugby player: http://bjsm.bmj.com/content/41/5/337.full Injuries in West Indies cricket 2003–2004: http://bjsm.bmj.com/content/40/2/119.full @PeterBrukner discusses today’s major headline: Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/ Book Review: Clinical anatomy of the lumbar spine and sacrum: http://blogs.bmj.com/bjsm/2008/10/16/book-review-clinical-anatomy-of-the-lumbar-spine-and-sacrum/

Dr Alex Kountouris tries to stay out of the limelight despite his position as physiotherapist to the Australian Men’s cricket team. Despite his attempts, he finds himself in the media talking about players’ injuries and the reasons behind their inclusion or exclusion from the team. Listen to him discuss injury prevention and treatment in cricket, and for the first time hear the questions posed by our twitter followers. See also: Batting head injury in professional cricket: a systematic video analysis of helmet safety characteristics: http://bjsm.bmj.com/content/47/10/644.full International cricket injury surveillance: a report of five teams competing in the ICC Cricket World Cup 2011: http://bjsm.bmj.com/content/47/10/637.full Injuries in West Indies cricket 2003–2004: http://bjsm.bmj.com/content/40/2/119.full Methods for injury surveillance in international cricket: http://bjsm.bmj.com/content/39/4/e22.full

Dr Bert Mandelbaum is the team doctor for Team USA (soccer), the LA Galaxy, and Director of Research for Major League Baseball. He shares his optimism about the role of PRP in various injuries, while cautioning that stem cells, despite their promise, may still be like a ‘Ferrari without a steering wheel’. He was a pioneer in ACL prevention research and believes that programs successful in women may well translate across to men in sport such as NFL football. He takes 2 questions from @BJSM_BMJ Twitter followers. You can catch him next at the 23rd Isokinetic Football Medicine Conference in Milan, March 22-23, 2014 www.footballmedicinestrategies.com/en/ Read two of Dr Mandelbaum's prominent papers: A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players bit.ly/1fWWCfu Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes bit.ly/1lwfzt8 See also: Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial bit.ly/1iXJRmS Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial bit.ly/LSeWgb Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial bit.ly/1fWWjRF Growth factor delivery methods in the management of sports injuries: the state of play: http://bjsm.bmj.com/content/42/5/314.full The PRP debate: http://blogs.bmj.com/bjsm/2010/11/15/the-prp-debate/ IOC consensus paper on the use of platelet-rich plasma in sports medicine: http://bjsm.bmj.com/content/44/15/1072.full What constitutes the safe use of PRP in sports injuries? Continuing the PRP debate: http://blogs.bmj.com/bjsm/2010/11/25/what-constitutes-the-safe-use-of-prp-in-sports-injuries-continuing-the-prp-debate/ No magical therapeutic benefit of PRP in Achilles tendinopathy — JAMA paper follow-up and BJSM podcast: http://blogs.bmj.com/bjsm/2011/10/18/no-magical-therapeutic-benefit-of-prp-in-achilles-tendinopathy-jama-paper-follow-up-and-bjsm-podcast/ Platelet-rich plasma: a ‘feeling' and ‘hope' ailing athletes: http://bjsm.bmj.com/content/44/Suppl_1/i1.2.abstract Airway injury during high-level exercise: http://bjsm.bmj.com/content/46/6/385.full PRP within the wider context of regenerative medicine: http://blogs.bmj.com/bjsm/2010/12/07/prp-within-the-wider-context-of-regenerative-medicine/

Dr Jonathan Drezner, BJSM Senior Associate Editor (Sports Cardiology) is the team physician for Seattle Seahawks in the National Football League. Speaking in the week after his team’s first Super Bowl appearance, he shares thoughts with Karim Khan about a typical week at the Seahawks, the season’s climax in New Jersey, and what budding sports medicine clinicians might do if aspiring to work in the top levels of professional sport. Off the playing field, Professor Drezner served as President of AMSSM in 2012, contributes to the Primary Care Sports Medicine Fellowship at the University of Washington, Seattle and heads the Sports Cardiology Centre. To find more related to sports cardiology (not the subject of this podcast), please go to this BMJ Learning site – over 10,000 educational modules have been completed. http://tinyurl.com/o5jcc5v See also: Peter Brukner on – Lessons from 30 years as a team physician http://bjsm.bmj.com/articleusage?rid=47/10/610 The use of local anaesthetic injections in professional football: http://bjsm.bmj.com/content/35/4/212.full Super Bowl: Two ACL tears and the landmark paper still under review: http://blogs.bmj.com/bjsm/2012/02/13/super-bowl-two-acl-tears-and-the-landmark-paper-still-under-review/

After a patient has undergone ACL surgery, rehabilitation is bread and butter in many physiotherapy/sports medicine clinics. Many BJSM podcast listeners will be expert in this role. If you are less expert and wondering if there is an ‘optimum’ way to guide the patient back to sport, Dr Andy Franklyn-Miller provides some food for thought. He discusses some novel ways of assessing a patient’s progress after ACL reconstruction, advocates for the use of video in the clinic, and shares the dynamic tests he uses before allowing a player to return to sport. He shares exercises that both test, and help rehabilitate athletes in this setting. Dr Franklyn-Miller is a sports physician at the Sports Surgery Clinic in Dublin, Ireland. He has published widely in sports medicine and his book, Clinical Sports Anatomy (2011), co-authored with Eanna Falvey and Peter Brukner, is an international best-seller. You can follow him on Twitter @AFranklynMiller and his blog provides great resources (www.drAndyFranklyMiller.com) including a further series of podcasts. See also: His previous podcasts on BJSM relating to running injuries (http://bit.ly/1bqMh8C) and groin pain (http://bit.ly/1fo2TAW). Consensus criteria for defining ‘successful outcome’ after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation: http://bjsm.bmj.com/content/early/2013/07/23/bjsports-2013-092299.full Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years: http://bjsm.bmj.com/content/47/15/980.full

After a patient has undergone ACL surgery, rehabilitation is bread and butter in many physiotherapy/sports medicine clinics. Many BJSM podcast listeners will be expert in this role. If you are less expert and wondering if there is an ‘optimum’ way to guide the patient back to sport, Dr Andy Franklyn-Miller provides some food for thought. He discusses some novel ways of assessing a patient’s progress after ACL reconstruction, advocates for the use of video in the clinic, and shares the dynamic tests he uses before allowing a player to return to sport. He shares exercises that both test, and help rehabilitate athletes in this setting. Dr Franklyn-Miller is a sports physician at the Sports Surgery Clinic in Dublin, Ireland. He has published widely in sports medicine and his book, Clinical Sports Anatomy (2011), co-authored with Eanna Falvey and Peter Brukner, is an international best-seller. You can follow him on Twitter @AFranklynMiller and his blog provides great resources (www.drAndyFranklyMiller.com) including a further series of podcasts. See also: His previous podcasts on BJSM relating to running injuries (http://bit.ly/1bqMh8C) and groin pain (http://bit.ly/1fo2TAW). Consensus criteria for defining ‘successful outcome’ after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation: http://bjsm.bmj.com/content/early/2013/07/23/bjsports-2013-092299.full Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years: http://bjsm.bmj.com/content/47/15/980.full

Julien Périard is a Canadian research scientist. After racing on the International Triathlon Union Circuit, he completed a PhD at the University of Sydney, investigating the mechanisms that limit prolonged exercise in the heat. He continues to be intrigued by the mechanisms that mediate performance and fatigue in adverse conditions and is now based in Qatar, an ideal place conduct heat studies in athletes. In this podcast he talks about a study he led with tennis players competing in both hot (37ºC) and cool (22ºC) conditions. He discusses the thermal, physiological and perceptual strain associated with match-play tennis in these conditions, as well as fatigue from a physical and neuromuscular performance perspective. He further discusses the impact of playing in the heat on oxidative stress, and the role of an individualized hydration regimen on performance under heat stress. He gives several important take home messages for coaches and players who plan to compete in the heat. See also: Heat stress does not exacerbate tennis-induced alterations in physical performance: http://bjsm.bmj.com/content/48/Suppl_1/i39.full Coping with heat stress during match-play tennis: Does an individualised hydration regimen enhance performance and recovery?: http://bjsm.bmj.com/content/48/Suppl_1/i64.full Increase in tennis injuries at the Australian Open – media hype or evidence based: http://blogs.bmj.com/bjsm/2014/01/28/increase-in-tennis-injuries-at-the-australian-open-media-hype-or-evidence-based/ Australian Open – Hot Tennis. To play or not to play? That is the question: http://blogs.bmj.com/bjsm/2014/01/18/australian-open-hot-tennis-to-play-or-not-to-play-that-is-the-question/ Thermal, physiological and perceptual strain mediate alterations in match-play tennis under heat stress: http://bjsm.bmj.com/content/48/Suppl_1/i32.full Hydration and thermal strain during tennis in the heat: http://bjsm.bmj.com/content/48/Suppl_1/i12.full Core body temperature during competition in the heat: national boys’ 14s junior tennis championships: http://bjsm.bmj.com/content/41/11/779.full An integrated physiological and performance profile of professional tennis: http://bjsm.bmj.com/content/41/8/531.full The impact of match-play tennis in a hot environment on indirect markers of oxidative stress and antioxidant status: http://bjsm.bmj.com/content/48/Suppl_1/i59.full Neuromuscular adjustments of the knee extensors and plantar flexors following match-play tennis in the heat: http://bjsm.bmj.com/content/48/Suppl_1/i45.full

Mark Huizinga, a Dutch judoka, is 5 time European and Olympic Champion. Mark won the gold medal in the men’s under 90 kg class at the 2000 Summer Olympics and took bronze at both the 1996 and 2004 Summer Olympics. He retired after the 2008 Olympic Games and is currently national coach of the juniors in the Netherlands. In this podcast he talks to BJSM deputy editor Babette Pluim about the most memorable moment during his distinguished judo career, about the traditions in judo, dealing with injuries, weight classes and weighing in and injury prevention in judo. He ends with an important lesson for sports physicians, which you will hear when you listen to this podcast! See also: Injuries in judo: a systematic literature review including suggestions for prevention: http://bjsm.bmj.com/content/47/18/1139.full Energy demands during a judo match and recovery: http://bjsm.bmj.com/content/37/3/245.full The common mechanisms of anterior cruciate ligament injuries in judo: a retrospective analysis: http://bjsm.bmj.com/content/44/12/856.full