BJSM

Tom Best, co-medical director of Ohio State University Sports Medicine and professor of Family Medicine, OSU College of Medicine, talks about his work on the treatment of hamstring injuries.1.00 - Clinical scenario: acute hamstring injury4.15 - Recovery time9.34 - Considerations before returning to sport17.00 - Recurrence19.30 - Use of NSAIDs23.30 - Role of massage in sports medicine injuries26.20 - American College of Sports Medicine 2012 meeting in San Francisico30.30 - Other hamstring injury resourcesSee also:Carl Askling’s BJSM podcast on hamstring injuries http://bit.ly/zFjobUBJSM article: Do you consider two types of injury? http://bit.ly/15Dzv8aFeb 2012 issue of BJSM http://bjsm.bmj.com/content/46/2.tocTom also mentioned:Gisela Sole’s paper http://bit.ly/10aHLnRJan Ekstrand http://bit.ly/ZMbrHWTom’s book is Evidence Based Sports Medicine

Pregnancy is hardly an uncommon condition in women, so what are the ins and out of exercise during those nine months? Harriet Vickers (BMJ’s assistant multimedia producer) talks to Bronwyn Bell (consultant obstetrician and gynaecologist) about the benefits and risks of physical activity from conception to postpartum, and how to look after women at different levels of fitness.0:00 Conception: Getting in shape before becoming a mum and optimising your chances of conception2:16 BMI and pregnancy2:40 Benefits of exercise during pregnancy4:00 Does exercise put the fetus at risk? The role of core temperature.5:40 Contact sports and preventing injury during pregnancy6:00 Absolute contraindications to exercise during pregnancy8:34 Physiological changes - energy balance and body changes11:30 Case management - initiating an exercise program in the unfit and newly pregnant woman12:50 Case management - advising the regularly exercising woman to exercise. The ‘talk rule’ and heart rate as guides.15:44 Case management - the professional athlete and exercise during pregnancy17:15 Post-natal exercise advice. Breast feeding and breast support.See also:Royal College of Obstetricians and Gynaecologists - Exercise in pregnancy statement http://bit.ly/ZMaYphBMJ editorial - Exercise during pregnancy http://bit.ly/17Um2br

In this podcast, also recorded at UKSEM, Babette Pluim (BJSM deputy editor) interviews Glen Hageman (president of the South African Sports Medicine Association). They discuss the work of SASMA, and plans for the future.

Karim Khan talks to Michael Turner about his career as chief medical advisor for the British Horse Racing Association.

In anther podcast recorded at the UKSEM conference held in London in November, Karim Khan (BJSM editor) talks to Lars Engebretsen (head of science and research for the International Olympic Committee). They discuss the IOC’s work in trauma research, health promotion, and the BJSM-IOC special issues.2:32: The launch of the IOC’s focus on injury prevention and health promotion (IPHP).4:00 - Periodic health exam - should athletes be screened prior to major competition? Can we prevent high level athletes from dying on the field?6:20 - The IOC Centres of Excellence program - advancing applied sports and exercise medicine research7:43 - Conference opportunities in the field - what is coming up?

Hamstring injuries are the most prevalent muscle injuries in sport. Symptoms can be particularly prolonged, healing response poor, and the risk of re-injury high.Carl Askling (Karolinska Institute, Stockholm) has been trialling a new way of categorising these injuries, thinking about them as high-speed running or stretching types. He explains to Karim Khan how these types can be diagnosed and the different treatment and monitoring they require. He also describes how to assess athletes post hamstring injury for return to sport.See also:High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis http://bit.ly/15Dzv8aHamstring strain injuries: are we heading in the right direction? http://bit.ly/LfwK2IHamstring issues in sports: still a major clinical and research challenge http://bit.ly/JTzgb7February’s BJSM has a special focus on hamstring injuries, so there’s even more related content in the issue and on the website.

BJSM editor Karim Khan talks to Michael Turner about his time as chief medical adviser of the Lawn Tennis Association, including the medical scandals that have cropped up and the advances he’s seen in the game’s sports medicine.Dr Turner is also chief medical adviser for the British Horseracing Authority, but more of that in a future podcast…

We’re well down the road to London 2012, but getting here has taken a herculean feat of organisation. In this BJSM podcast Richard Budgett, Chief Medical Officer British Olympic Association, explains how LOCOG has prepared to meet the medical needs of the olympians, their entourage, and their fans.

Coming together at the UKSEM conference in London, Professor Lars Engebretsen (Oslo Sports Trauma Research Center and IOC medical commission) talks to Dr Richard Frobell (Lund University, Malmo, Sweden) about his work on return to exercise after ACL (anterior cruciate ligament) injury.Dr Frobell describes the evidence already on this issue, and his recently published randomized trial on whether surgery or rehabilitation improves pain, symptoms, function in sports and recreation, and knee-related quality of life post-injurySee also:A randomized trial of treatment for acute anterior cruciate ligament tears http://bit.ly/rrS51YThe BJSM Warm up about this injury http://bit.ly/tBNdiuOur 2010 interview with Richard Frobell and coauthors of the NEJM paper above http://bit.ly/99leZd

Diagnosing chronic exertional compartment syndrome relies on measuring intramuscular pressure, however Andrew Franklyn-Miller (Sports Surgery Clinic, Dublin; education director at BASEM) has shown the criteria for this are flawed (2.51). He talks to BJSM editor Karim Khan about what clinicians can do to get round this, his theory the condition is caused by biomechanical overload and his work looking at running re-education to alleviate symptoms (6.13).He also gives us his views on barefoot running (10.44) and talks about his research on orthotics (17.57).Finally, as UKsem’s director, Dr Franklyn-Miller gives us an update on the speakers and programme of the upcoming conference (21.04).See also:Foot Orthoses in the Prevention of Injury in Initial Military Training http://ajs.sagepub.com/content/39/1/30.abstractThe validity of the diagnostic criteria used in chronic exertional compartment syndrome: A systematic review http://bit.ly/10aEvc9Chronic exertional compartment syndrome testing: a minimalist approach http://bit.ly/ZkXNBcChronic exertional compartment syndrome http://bit.ly/oNUhJEBJSM podcast: July’s BJSM and the UKsem Congress, with Andrew Franklyn-MillerUKsem http://bit.ly/13rUCpJ

Whether to opt for exercise treatment, new ‘biological therapies’ like platelet-rich plasma (PRP), or surgery is a clinical challenge. Sweden’s Professor Håkan Alfredson has unique experience in considering these options for patients with Achilles pain. He has 15 years experience as an international leader in sports and exercise medicine.In this podcast, he tells BJSM’s editor Karim Khan how to manage both straightforward (0.37) and complicated (7.34) Achilles tendinopathy. He shares novel insights into the contribution of the aberrant plantaris tendon to chronic medial leg pain (12.40).Prof Alfredson also provides a memorable clinical story to underscore the effectiveness of heavy loading eccentric training in one particularly stubborn patient (3.49). He argues against the use of PRP (17.37) and considers cortisone to be a short-term fix but long-term liability (15.24). The podcast concludes with discussion of both jumper’s knee (19.35) and lateral elbow tendinopathy (24.44).Related paper:Midportion Achilles tendinosis and the plantaris tendon http://bit.ly/11y79bcRelated podcasts:Robert Jan de Vos and Adam Weir on platelet rich plasma injections http://bit.ly/JdmFkJProfessor Jill Cook on managing tendinopathies in 2011 http://bit.ly/15DM8Qp

Zoals u weet heeft de VSG deze zomer een samenwerking gesloten met de British Journal of Sports Medicine.Door de samenwerking heeft sportarts Adam Weir een podcast opgenomen met directeur Anja Bruinsma van de Vereniging voor Sportgeneeskunde. Anja Bruinsma gaat in op: Samenwerking VSG en BJSM, erkenning sportgeneeskunde, wetenschapsdomein, centraal stellen van de sporter en de toekomst van de sportgeneeskunde. Voor meer informatie zie ook www.sportzorg.nl, www.sportgeneeskunde.com.

VSG’s (the sports medicine society of the Netherlands) editor-in-chief Hans Tol and congress committee member Adam Weir highlight the October issue of BJSM and preview the VSG Annual Meeting on 1-2 December 2011.The first paper highlighted is from Collard et al [http://bit.ly/ZFQS3U], who have calculated the economic costs of organised sports, leisure time physical activities and physical education classes of 10-12 year old Dutch children (1.26). The outcomes are intriguing!A second paper of interest is from Malliaras and Cook [http://bit.ly/ZkULNj], who contend that the longitudinal changes in antero-posterior patellar diameter support a continuum of pathological changes (2.02).Two new theories on Achilles tendinopathy are presented in this issue. Firstly, Alfredson proposes [http://bit.ly/qyxi2W] there is an important role for the plantaris tendon (2.45). The second paper, presented by Andersson et al [http://bit.ly/15DwlRQ], highlights the role that substance P plays in tendinopathy (3.25). A must-read for those interested in tendon pathology and food for thought for all sport physicians!Visiting the VSG Annual Meeting in Kaatsheuvel, Netherlands, is a decision you won’t regret. Hans Tol and Adam Weir explain in their warm-up why this is a must-visit for sports medicine enthusiasts. However, the conference language is Dutch, so make sure you master this in time! Dr Weir discusses the main topics of interest in the second half of the podcast (5.44).

Ultrasound is rapidly revolutionising point-of-care medicine in many specialties. The last few years have seen technological advances make musculoskeletal ultrasound more practical, opening up opportunities for diagnostic and therapeutic interventions.In this podcast, BJSM’s editor Karim Khan investigates the value of musculoskeletal ultrasound and how to integrate it into practice, with Kim Harmon, director of the Sports Medicine Fellowship at the University of Washington, US, and Sean Martin, Clinical Faculty at Eglin Airforce Base, US.They discuss their experiences of the technique in clinical practice (0.44), which procedures it’s useful for (4.22), how to get started (12.03), using musculoskeletal ultrasound in the training room (13.33), the value of collaborating with radiologists and orthopaedics (15.58) and credentialing (17.46).See also:Musculoskeletal ultrasound education for sports medicine fellows: a suggested/potential curriculum by AMSSM http://bit.ly/XSYhwiAmerican Institute of Ultrasound in Medicine (AIUM) http://www.aium.org/BJSM podcast: What is the future in sports imaging? Bruce Forster, David Hancock and John Orchard http://bit.ly/ZM6Q8C

In this BJSM podcast, Karim Khan talks to Anthony Beutler (Injury Prevention Research Lab, Uniformed Services University, Bethesda, Maryland) about the JUMP-ACL study http://www.iprc.unc.edu/jumpacl/. It is a large prospective cohort study which investigates risk factors for ACL injury - results will be published soon.They discuss the mechanism of ACL injury in different athletes, the risk of recurrence, and plans to turn the results into practical steps to prevent this injury.Related articles in BJSM include:the IOC current concepts statement on ACL injuries http://bit.ly/ZkTHJ4Roald Bahr’s editorial - ACL injuries - problem solved? http://bit.ly/13TDrBmas well as previous podcasts if you missed them - Tim Hewett and Lars Engebretsen/Liza Arendt.Topic timecodesMain findings - 02.35Frequency of occurrence - 07.45Prevention - 11.30Link with BMI - 18.00