- Hamish's thoughts on his experiences working as a head Physio in both professional rugby and the AFL
- What to expect from Hamish at the Upper Limb Rehabilitation in Sport course in the Gold Coast
- Posterior dislocation- what are the tell tale signs?
- Where early management is different between posterior & anterior dislocations
- Common imaging findings following both posterior & anterior shoulder dislocations
- Decision making around surgical Vs non surgical management following instability episodes (see further detailed notes below)
- Differences in post surgical management for anterior and posterior repairs
- Post surgical rehabilitation
- Early exercises & targets
- Time based expectations on restoring ROM and strength
- How & when to introduce pushing, pulling and over head
- How and when to take the athlete into venerable positions (Abd/ ER
- Testing or benchmarking in readiness for a return to play
- What is often missed in shoulder rehabilitation
- Contact based conditioning
- Occupation: overhead/manual labour vs sedentary
- Sporting demands – collision sports
- Co-morbidities/physical inactivity – prolongs recovery
- Evidence based surgical indications (reduces the chance of recurrence): Male <25 y/o with traumatic MOI, requires relocation + high functional demands = EBP supports surgical repair. Generally the risk factors from the literature for recurrent instability include: young age (<40 = 13x higher; majority occurring <25), being a male, contact sport. I would also include young females in collision sports in this category. However it is a discussion and as we discussed there is evidence that people in this group can have a positive outcome without surgery.
- Hypermobility:
- I always question the patient about their episode(s) – patients can use the words dislocation and subluxation synonymously. True dislocation or instability in the absence of dislocation. I always I always question the patient around the MOI and do they have imaging evidence of the dislocation (in ED)/needed someone to relocate the shoulder… If their story is accurate for the MOI then I generally believe them when they say their shoulder dislocated. If they haven’t had true dislocation, rather instability episodes – conservative treatment. Especially if you’re dealing with someone who has more mobility than the average (>4 Beighton’s).
- Traditional classification include the TUBS (Traumatic, unilateral, Bankart, Surgery) and AMBRI (Atraumatic, Multidirectional instability, Bilateral, Recurrent, Inferior Capsular Shift), however this 2nd population doesn’t do as well with surgery as was initially intended with this classification, so conservative path is the best here. A further classification system – The Stanmore Classification (diagram below) further stratifies it into 3 groups and the relationship between trauma, structure and muscle patterning – article attached. In short, group I relates to traumatic dislocation and structural failure, group II with structural laxity that can pre-dispose them to instability with or without trauma, group III to muscle patterning issues causing instability/resting subluxation. Surgery is indicated in group I and only considered in group II with structural failure and who have failed a good rehab program.
Reference article: Jaggi & Lanbert 2010, Rehabilitation for Shoulder Instability
- The current state of Sports Physiotherapy
- Tendinopathy
- Spraino & lateral ankle sprain prevention
- Hip ABDuctor & ADDuctor strength and it's relation to groin pain
- Adductor strengthening - why the adductors?
- The Copenhagen- How much is enough and is it sufficient for groin pain prevention?
- How should the groin terminology consensus be used to guide management?
- The HAGOS
- Return to Sport post Hip Arthroscopy
- What are the most important aspects of ACL prevention?
- How to facilitate an optimal learning environment at courses & conference
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- Developments in ACL surgical considerations
- Anatomical risk factors
- Bone bruising in ACL injuries & implications
- Chondral defects of the knee & management strategies
- Surgery Vs non operative management for ACL injuries
- Surgery for degenerative meniscus pathology
- Adolescents & ACL surgery
- Female sports and ACL rupture rates
- Physiotherapy & Rehabilitation considerations with post knee surgery
- PCL surgery
- Posterior lateral corner injuries of the knee
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In this 13th Episode of The Sports MAP Podcast we chat with Chris Perkins about Athletic Lower Back Pain. Chris is s specialist sports Physiotherapist and has worked at the West Coast Eagles (AFL) for past 16 years. He has also worked extensively with world renowned back pain expert Peter O'Sullivan. In this episode we discuss:
- Chris's professional Journey
- The challenges of blending work in professional sport and running a private clinic
- Managing an athletic lower back pain presentation
- Subjective cues
- Objective assessment
- Common contributing factors and how to address these
- Managing work load
- Imaging & red flags
- The use of non threatening language & communication
- Gym based exercises and low back pain
- And more
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We hope you enjoy this episode of the Sports MAP Podcast. If you do, please let us know by leaving a review and sharing via Twitter & Facebook.
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In this 12th Episode of The Sports MAP Podcast we chat with Edel Fanning (Phd Candidate) from the Sports Surgery Clinic in Dublin about Shoulder Rehabilitation and RTP from surgery for collision based sports. In this episode we talk to:
- Findings from Edel's recent study in RTP for Shoulder injuries
- Functional testing using force plates to guide decision making
- Isokinetic Vs isometric testing for Rotator cuff strength measures
- Addressing joint position sense in shoulder rehabilitation
- Force plate functional tests Vs ASH test
- Common errors in Shoulder Rehabilitation
- Targeting specific muscle function in Shoulder Rehab
- Laterjet Vs traditional stabilization surgery
- Psychological readiness to return to play
- Edel's key career influences
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In this 11th Episode of The Sports MAP Network Network we chat with previous Head Physiotherapist for the England Rugby League team Dave O'Sullivan around Syndesmosis Injury Rehabilitation & Dave's Return to Play Systems for lower limb Injury.
- Early focus area's in rehabilitation of a Syndesmosis injury
- Strength assessment & criteria
- Dynamic calf assessment
- Lunge progressions & the importance of the peroneas tertius
- Hopping progressions
- Agility /offline progressions
- Troubleshooting
- Return to running prescription
- Return to play
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In this 8th Episode of the Sports MAP podcast we chat about athlete monitoring and prevention strategies for hamstring and groin injuries in sport with Martin Wollin PhD. In this episode we cover:
- Injury prevention systems- What is primary, secondary & tertiary prevention?
- Adductor strength and ADD:ABD ratio's - relevant to injuries?
- Adductor strength monitoring- key components
- Hamstring power testing as a monitoring tool to mitigate injury risk
- How to manage to an athlete with reduced hamstring strength
- Is hamstring power asymmetry important for injury risk?
- Is monitoring athletes in a team sport setting really worth it?
- Martin's key career influences
- And more
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Show Notes/ References
- Athlete monitoring: a complementary prevention strategy for groin and hamstring injuries in elite football (PhD Academy Award)
- Effects of match congestion on hamstring strength & lower limb flexibility
- Monitoring the effect of football match congestion on hamstring strength and lower limb flexibility: Potential for secondary injury prevention?
- The effects of football match congestion in an international tournament on hip adductor squeeze strength and pain in elite youth players
- In-season monitoring of hip and groin strength, health and function in elite youth soccer: Implementing an early detection and management strategy over two consecutive seasons
- Reliability of externally fixed dynamometry hamstring strength testing in elite youth football players
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In this Episode #7 of the Sports MAP Podcast we chat with Enda King around his approach to the Rehabilitation of Complex Athletic Groin Pain using a case example.
- Determining if this athlete is suitable for Rehabilitation
- Assessment protocols
- Addressing & identifying movement based impairments
- Assessment of speed & power in Athletic Groin Pain
- Imaging & the significance of bone marrow edema
- Diagnosis and the entity based approach
- Rehabilitation strength measures
- Return to running & change of direction
- Return to Sport
- Key influences in Enda' career
- And more
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Show Notes/ References
Clinical & Biomechanical outcomes of Rehabilitation targeting intersegmental control
Enda King Groin Rehabilitation Video Series
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Shane Kelly is the Head Physiotherapist of the British Athletic Team
In this episode of the Sports Map Podcast, Shane is presented with a case study of an acute calf strain injury and talks us through his process of rehabilitation back to competition levels. Shane touches on the following area's:
- Acute Calf Injury assessment
- Imaging for calf injuries
- Prognostic factors
- Adjuncts for early rehabilitation
- Early loading & building calf capacity
- Foot intrinsic training
- Key criteria in calf rehabilitation
- Return to Run criteria
- Early running prescription
- Training periodization & speed progressions
- Re training acceleration mechanics
- Monitoring response to loads
- Thoughts on ACWR
- Multidisciplinary team involvement for RTS
- Key influences
- And more
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Article
British Athletic Muscle Injury Classification
Scott Epsley is the Director of Physiotherapy & clinical diagnostics at the Philadelphia 76er's in the NBA.
In this episode we chat about:
- Scott's journey from Australia to working in the NBA
- The pro's & cons of working in the NBA
- The Rehabilitation system and structure at the 76er's
- Rehabilitation of 5th metatarsal fractures/ stress fractures
- Using ultrasound to improve diagnostics
- Ultrasound guided dry needling
- Technology advances used in rehabilitation*
- Some interesting early work tendon stiffness in tendinopathy
We hope you enjoy this episode of the Sports MAP Podcast. If you do, please let us know by leaving a review and sharing via twitter & Facebook.
Listen to this Podcast via your favorite platform including Apple, Spotify, Player FM & Stitcher.
This is episode is brought to you by IMeasureU