Biomechanics matter just not how we always think. 1. High Loads. 2. Too much too soon 3. Stress Shifting & Symptom Modification 4. Movement Preparation 5. Performance
Solo mini show today. We often hear that hip bone is connected to the knee bone and pain in one area is a victim of a "dysfunction" somewhere else. Its a foundation of the kinesiopathological model and lead to the idea that if someone has joint pain you should train at a joint around that pain. Eg. If your knee hurts you train the hips as well. And we have plenty of pragmatic evidence that it helps. Hip exercises should be added to knee exercises when you have knee pain. The problem is that we d...
I talk with Dr Kim Hebert-Losier. An associate professor, biomechanist and physiotherapist out of The University fo Waikato. You can see her profile here . Some topics discussed: running as rehab her Calf App to evaluate plantar flexion strength and its potential relevance to clinical practice whether body weight training, as opposed to heavy resistance training, can improve running economy (Kim was involved in a paper that showed this!) whether you need to bend the knee to appropriately target ...
Dr Lori Michener (Professor of Biomechanics and Physical therapist) is a super expert on shoulder biomechanics and rehabilitation. Today we talked about: - the role of biomechanics in pain and injury - whether you need to be concerned with scapular movement/control - changes in her clinical opinion - shoulder "impingement" debates and so much more. More about Dr Michener The central theme of Michener's funded research is to define optimal treatment pathways for patients with musculoskeletal shou...
Dr Bas van Hooren discussing running injury prevention, running technique and running economy. Dr van Hooren is a true expert in running biomechanics. Blending critical thinking, a strong academic background of excellent publications and personal success in elite running Bas brings huge insights into this field. I said it numerous times in the podcast but Bas' PhD in this field should really be used as an exemplar for all PhD students. His work goes beyond the biomechanics of running and also te...
We had Dr Peter Malliaris on this week talking tendons. Its great to hear different researcher clinicians provide their different takes on the same topic. Dr Malliaris is a full time professor at Monash University with a keen interest in Tendinopathy. He teaches the popular online course Tendinopathy rehab. We talk about: The role of injections in tendinopathy (hint: not much) The limitations of the literature and research surrounding exercise and tendinopathy The role of load management in tend...
Kate Jochimsen, PhD, ATC is a Researcher at the Center for Health Outcomes and Interdisciplinary Research (CHOIR) at Massachusetts General Hospital and a Member of the Faculty in the Department of Psychiatry at Harvard Medical School. Her work "bridges the gap" between sports medicine and psychology by developing interventions to improve patient's pain-related cognitions ('how they think') and emotions ('how they feel') to improve their health behaviors and increase physical activity. She is pas...
Dr Stephanie Mundt (PT, PhD Candidate) is on talking about bone stress injuries and optimizing the health of athletes to keep them performing and living well. We talk about: - can you run with pain when you have a bone stress injury - why bone stress injuries occur - high risk versus low risk stress fractures - how to build bone and manage injury risk
Greg speaks with Jeff Beran of Evolution PT and Jeff's partner Frank Tardi. They run a successful private practice with exercise, health and optimal training as the foundation of their intervention. They teach a popular course on energy systems training to improve outcomes entitled "Practical Programming: A Clinician's Guide to Maximizing Physical Potential They share their thoughts on both exercise prescription and manual therapy AND offer mentorships to those looking to learn more about their ...
Dr Johan Lahti PhD is a strength and conditioning coach and an expert in the prevention and training on hamstrings. Johan is a great thinker related to all aspects of strength and conditioning but has a special interest in mitigating the risk of hamstring strains. In this episode we talk about: potential risk factors for hamstring strains how to best train the hamstrings for performance and injury risk using EMG to assess hamstring exercises and the role of technique in injuries Some relevant re...
Dr Gerard McMahon is a sports scientist out of Ulster University with a special interest in how we can train tendons for both performance and rehab. We talk: Partial range vs full range squats for vertical jump Partial range vs long range training to build tendon mechanical properties (e.g stiffness) Is there a sweetspot for tendon loading (e.g 4.5-6% strain) and why it may be greater than this range. Why knowing the actual tendon strain may not be required to prescribe exercises to increase ten...
Another very practical and pragmatic podcast. Dr Falk Mersmann is a leader in how tendons adapt to load and I would say an accidental leader in the minumum effective dose to get tendons to adapt. Some topics we covered: Why having a good balance between tendon stiffness and muscle strength is important for tendinopathy prevention and treatment How personalized tendon loading can address this potential risk factor Specifics of tendon loading to achieve tendon positive tendon adaptations (e.g incr...
We had Colin on today to primarily talk about the pragmatic aspects of rehabbing an Achilles tendon in the sporting population. Part of Colin's PhD thesis was looking at this specific topic. In my opinion, a lot of the researched tendon loading programs aren't pragmatic, are boring, are hard to stick to and just don't seem like they would contribute to performance. Colin's program is NOT like that. His simple, progressive, performance based and pragmatic tendon and lower extremity program should...
We talk what role Motivational Interviewing plays in working with patients. We talk about how to do it and of course how not to do it. Have a listen More about Guillaume: Graduated from Bordeaux (France) in 2005, Guillaume began his career as a physiotherapist working full-time for a professional football club in France. Since 2007, he has been practicing in private practice, specializing in the treatment of musculoskeletal conditions. He has developed a coordinated practice with general practit...
Dr Stu Phillips, Tier 1 Canada Research Chair in Skeletal Muscle Health, shares his expertise on the importance of strength, power and muscle hypertrophy for healthy aging. As is often the case Stu discusses how simple exercise programming can achieve the physical attributes that help us all age well. The fast recap is: - something is better than nothing strength train 2x/week, 2-4 sets, 5-20 repetitions with an effort of 8/10. progress this over time train power but moving a much lighter faster...
Clifton is a Canadian Power Lifter and Chiropractor. I worked with a Clifton a few years ago to help him with his concussion symptoms, low back and hip pain. Working with health care professionals is often interesting. You will feel the pressure to "fix them" but when you get to listening to them you often realize that they have the answers and the knowledge. They just need help and sometimes coaching. I think (IIRC) I was once told that I can't comment on low back pain and lifting until I "fix"...
Rachel Hannah talks about her own experience as a runner dealing with Relative Energy Deficiency (REDs) and her recovery from bone stress injuries (BSIs). And Greg (Rachel's former Physiotherapist) talks about his professional failings as a therapist helping Rachel with her first Bone Stress Injury. If you want help with all things diet, healthy weight and REDs then you can work with Rachel here: https://rachel-hannah-registered-dietitian.ca1.cliniko.com/bookings Or See Rachel on IG here: https:...
Dr Malfliet was on today discussing her PhD thesis paper which deserves a lot of attention. We discussed her RCT entitlted "Effect of Pain Neuroscience Education Combined With Cognition-Targeted Motor Control Training on Chronic Spinal Pain: A Randomized Clinical Trial" where we focused on the importance of nudging into pain (Time Contingent Exercise), reframing motor control exercises as movements that you get comfortable and confident in moving and how to progress these exercises with a graded...
We have Erik Meira (The Science PT) talking ACL injury, the importance or not of strength, whether valgus is a true risk factor for injury or a sign of something else and who technique matters for primary or secondary injury prevention. Please go to Erik's website not just for his links to what he offers but excellent blogs and resources that really explain complicated topics in clinically applicable ways. Erik's website is here
Greg and Alex delved into a wide-ranging discussion about the science of endurance and fitness, with a focus on injury prevention and treatment. They explored the effectiveness of strength training in injury prevention, the inconsistencies in the research, and the debatably importance of stretching in the prevention of injury. Alex shared his personal experiences with a hamstring injury and his approach to running injury prevention and some of the limitations of our current research base. As usu...
Dr Neil Meigh is a physiotherapist and associate professor at Bond University (Gold Coast Australia). Neil conducted a pragmatic exercise intervention in insufficiently active older adults. The intervention was a hard style kettlebell program in those aged 60-80. These people were not life long athletes but many of them thrived in his program. They got the type of results and improvements in fitness where an independent observer could be skeptical. We talk details of the program and the resilien...
Jo Nijs, PT, MT, PhD, [1] is a Belgian professor of physiotherapy at the Vrije Universiteit Brussel and physiotherapist/manual therapist at the University Hospital Brussels. He has published more than 200 peer reviewed journals and has been strong proponent of some of our favourite topics on this podcast. We talk about: - classifying pain based on mechanisms (nociceptive, neuropathic, nociplastic) - what nociplastic pain is - the utility of understanding nociplastic pain - how lifestyle interven...
One of the hardest discussions to have with people in pain is shifting our focus from trying to "fix" pain to living well with pain. Because, if we are very honest there are a huge number of people who might always have pain. Sometimes the goal for healthy rehab is to shift from eliminating pain to living well with pain. This is a fundamental of Acceptance and Commitment Therapy (ACT). Dr Bronnie Lennox Thompson is an expert in this area and she takes us through the importance of this approach a...
Dr Feigenbaum is a medical doctor, strength and conditioning coach, strong dude, wicked golfer and motocross expert. He co-runs Barbell Medicine catering to both health care professionals and clients. We talk: technique and injury risk (duh) the ideas behind the "orthopaedic cost" of lifting the role of excess body weight on health and Osteoarthritis the need for specificity of training when we can forego specificity and be very general in our training and the importance of healthy debate and cl...
Dr Pak has a PhD in minimal effective dose training in powerlifters. So, guess what we talked about? Dr Pak is a powerlifting coach, scientist and science communicator in the world of strength and conditioning. His PhD specifically focused on the minimum that a power lifter could do to increase their strength. We talked about: - adults >50 and their powerlifting safety and performance gains - minimal and optimal approaches to improving strength and hypertrophy - when, how and whether techniqu...
Physios have been lambasted awhile for not understanding the basics of strength and conditioning principles. I reject this idea. There two areas we explore in this podcast. 1. The idea that strength and conditioning basics are relevant for rehabilitation 2. Whether physios actually know these basics. I make an attempt at trying to understand the arguments againsts physios and try to provide a competing view. Here is how the AI summarized it (not really accurate but I don't want to piss off the r...
Today we take a bit of a detour and talk a little bit about the business side of Physical Therapy. We don't do justice to our speakers knowledge but I hope that if this a topic you need to know more about I've introduced you to the right person. Karen Litzy is an excellent physical therapist out of New York City, owner of a concierge physical therapy business, host of the very popular podcast "Healthy, Wealthy and Smart" and she is the creator the Strictly Business Blueprint. Links Karen's Websi...
Antony Lo (aka The Physio Detective) is an elite physiotherapist with a special interest in the pelvic floor and the female athlete. Antony is an amazing clinical educator and provides a lot of insight into how our profession can keep moving forward. We discuss: his evolution from the kinesiopathological model to movement optimism the role of movement technique in injury risk reduction (he hates this question) when we need to be clinically specific in our interventions (specific examples related...
Once again we are lucky to have another leader in our physio and rehab space. Dr Ebonie Rio PhD, researcher (>100 peer reviewed publication), big thinker and practicing sports physiotherapist (with the Victorian Institute of Sport and The National Ballet). Ebonie discusses her dual role as a researcher and as a practicing clinician. She shares her insights on: manual therapy the role of heavy resistance training in tendinopathy the importance of a diagnosis for both rehab and in research when...
