Deficits in quadriceps strength after ACL reconstruction are a well known problem. Is this specific to the quadriceps or is this just an example of general weakness throughout the lower extremity? What about hip strength? Does this change as well? Is JW smarter than a sea cucumber? In this episode we are joined by Ohio State researcher and clinician Matt Ithurburn ! Hip Strength in Patients with Quadriceps Strength Deficits after ACL Reconstruction. Bell DR, Trigsted S, Post EG, Walden CE. Med S...
Aug 16, 2016•1 hr 8 min
When treatments don't seem to work for a diagnosis we will often try to see if they work for particular subgroups. Sure, that's a thing, but that is a very difficult thing to determine that demands a very specific process. How have we done with subgroup analysis regarding low back pain? Have JW and Erik found the Ultimate Prime Number?! A systematic review reveals that the credibility of subgroup claims in low back pain trials was low. Saragiotto BT, Maher CG, Moseley AM, Yamato TP, Koes BW, Sun...
Aug 09, 2016•43 min
JW and Erik are having a lovely conversation about Bozeman, handball, and the number 86 when they are rudely interrupted by Adam Meakins from The NAF Physio Podcast to talk about preventing shoulder injuries. Can we prevent overuse shoulder injuries? If we can prevent them, do we know what about the program actually worked? Is it specific to the program? How do numbers needed to treat and time investment play into all of this? Preventing overuse shoulder injuries among throwing athletes: a clust...
Aug 02, 2016•53 min
Systematic reviews are a great tool to boil down decades of research into a single paper. But what if those decades of research were full of low quality studies? Can we make strong "Level 1a" statements from that? Well, as long as those statements are vague it looks like you can. What should we do when the evidence doesn't support or refute something? (HINT: Be skeptical!!!)
Jul 26, 2016•45 min
Running is bad for your knees. It will wear them down and lead to arthritis. We've all heard it and it makes sense, right? But does that really happen? And what does this have to do with Uranus?!
Jul 19, 2016•43 min
Can we predict injuries in athletes? Is it like screening for disease or is this kind of screening a different animal? Will this episode be the greatest thing since sliced bread?!
Jul 12, 2016•59 min
What is required for rotator cuff tendinopathy? Scapular stability? Manual therapy? What if you just gave exercises? How about just one exercise? In this episode we explore all of that as Erik explores living in an apartment again for the first time in 15 years.
Jul 05, 2016•54 min
When engaging in athletic activities, many physical therapists recommend bracing with the abdominals for stability as a better way to manage loads, but is it? Is it possible that bracing actually increases forces through the body? How might that be? Is Erik's singing in any way tolerable to our listeners?
Apr 05, 2016•1 hr 1 min
If your patient has completely torn their supraspinatus, then their humeral head must translate superiorly during arm elevation. Or does it??? In this episode JW and Erik look at a novel kinematic study that found the exact opposite. Remember, there is always more to a hypothesis than, "It makes sense."
Mar 29, 2016•48 min
Some patients complain of severe pain after rotator cuff repair way more than others. Is this something that can be predicted? Does the extent of the injury have any correlation to postoperative pain? What about specifics of the surgery? Or is it something else? Find out all that and more by listening to "The Gold Episode"!
Mar 22, 2016•54 min
Erik and JW have a history of skepticism regarding the use of platelet rich plasm (PRP) injections for tendon injuries, but can it have an effect on osteoarthritis? What would they need to see in order to be convinced? Does this article provide that? Or do Erik and JW just hate every new thing no matter what?
Mar 15, 2016•59 min
Can hamstring injuries be predicted? Does sustaining an injury permanently change something about its function? Is it just a matter of strength or is there something else? How does strength training effect it? Or does it? Time to buy a mfMRI! (Does not stand for "motherf**king MRI" by the way.)
Mar 08, 2016•52 min
Is eating salt a good thing or a bad thing?! Why do we as physical therapists care? This study actually has to do more with the problem of opinion infiltrating the evidence in what appear to be unbiased studies. How common is this in physical therapy literature? How can we spot it? Is it more than financial bias? Is JW turning into Batman...again?!
Mar 01, 2016•1 hr 2 min
Jill Cook and Karim Kahn gave a very interesting lecture on understanding tendinopathy at APTA's Combined Sections Meeting (CSM) in February 2016. PT Inquest decided to take a deeper look. Can disorganized tendon tissue change? If it can't does it matter? When we understand the true nature of tendinopathy, certain treatments become much more plausible and others appear almost silly. Also, Erik provides a poor man's homemade doughnut recipe. Or is it donut?
Feb 23, 2016•57 min
Uncertainty is not just a reality in life it is a reality of professional practice. The ability to embrace uncertainty is known to have a positive effect on critical thinking and avoiding errors in judgement. That's all great, but do medical professionals acknowledge uncertainty in their practice? Is this harmful to patients? Does it raise healthcare costs? What about informed consent? As William Osler once said, "The greater the ignorance, the greater the dogmatism."...
Feb 16, 2016•1 hr 3 min
A couple years ago, Alessandro Lelli described his new test for ACL insufficiency via YouTube . Originally known as "Lelli's Test", he first published it in the literature as the "Lever Sign" in late 2014 reporting 100% accuracy. Ok - seemed a little TOO perfect. Now the literature has its first independent study on the Lever Sign so let's take a closer look at this test.
Feb 09, 2016•40 min
Sure, we know that ACLs get torn and the vast majority of those mechanisms are non-contact. So what EXACTLY happens in those knees? We have some plausible ideas like dynamic valgus, but how does that tear the ACL without any injury to the MCL? How would we answer such a question? Will JW survive the current heatwave in Minnesota?
Feb 02, 2016•46 min
When dealing with a high ankle sprain (syndesmosis injury) Grade I never requires surgery whereas Grade III always requires surgery. But what about Grade II? In this episode we explore predictors of syndesmotic instability when assessing a Grade II sprain and the return to sport prognoses. All this while JW approaches absolute zero!
Jan 26, 2016•50 min
Sports-related concussions have been getting more and more attention over the past decade. The growing understanding of the potential for developing chronic brain disease is creating a cause for concern. Are sports medicine professionals managing concussions differently today? How well do we understand this process? Has Erik had too many concussions over the years to form a complete sentence? Here is a link to the NATA Position Statement on Management of Sport Concussion....
Jan 19, 2016•1 hr
It's that time of year again and the PT Podcast Network crew are in the holiday spirit! The gang got together, as best they can scattered across the world, to share a little eggnog and make fun of each other. So pour yourself a drink, sit by the fire (or pool in the Southern Hemisphere), and enjoy a little holiday cheer.
Dec 14, 2015•1 hr 1 min
It is well known that quadriceps strength asymmetries are commonly seen in subjects who have difficulty returning to sport after anterior cruciate ligament reconstruction (ACLR), but does that asymmetry correlate to a specific presentation on landing mechanics? What do we know about second injury in these subjects? Can we do anything about it? We ask these and many other questions when we chat with lead author from The Ohio State University, Laura Schmitt, PhD, PT ! Also, this is the last podcas...
Oct 27, 2015•1 hr 20 min
There is a belief out there that weak hips may cause patellofemoral pain, but this article found the opposite. How can we make any sense out of all the ambiguity? If only we had a Masters in Biomechanics. Luckily special guest Greg Lehman does! For more info on Greg including his teaching schedule, visit his website!
Oct 20, 2015•50 min
Orthopedic surgeons have a lot to consider when they are deciding whether or not to recommend surgery for rotator cuff tears, but how do they implement that decision process in practice? What makes a surgeon more or less likely to go towards early surgery vs physical therapy? Will JW take "the Bard-Parker solution"???
Oct 13, 2015•56 min
There are a maze of treatment options for people with pain, "each backed by enthusiastic and highly motivated advocates, all of whom lay claim to 'evidence'". How do clinicians wade through all the different ideas out there and get a handle on effectiveness? Or is it efficacy? Confused? Even if you're not, listen to this episode with special guest Neil O'Connell!!!
Oct 06, 2015•1 hr 1 min
Exercise-based interventions are known to be most effective for patellofemoral pain but how good are they really? Do adolescents with patellofemoral pain respond in a similar manner? What do we know, what don't we know? Can you handle the dueling Barry Whites???
Sep 29, 2015•57 min
When talking about whether or not to repair someone's rotator cuff, we often consider the Goutallier/Fuchs category which is a grading of the amount of fat infiltration in the muscle. Should we start doing the same when considering repairs of the gluteal tendons, the "rotator cuff of the hip"? Might it predict outcomes better than the size of the tendon tear? Can JW pass on his disease to Erik via the internet???
Sep 22, 2015•49 min
80 years ago Ernest Codman proposed that calcific tendinopathy was initiated by tendon degeneration. This has never been validated. In recalcitrant cases, would surgical decompression lead to better outcomes than simple debridement of the calcium? Is this another case of "makes sense" turning out to be wrong?
Sep 15, 2015•47 min
There is a lot of talk about "inflammation", or lack thereof, around tendinopathies; but what does that even mean? Could this still be present in chronic conditions? Are NSAIDs pure evil or are they the ultimate answer??? This episode includes Peter Gettings, one of the authors of this systematic review and someone you should follow on Twitter!!!
Sep 08, 2015•54 min
The idea of hip strength having an effect on lower extremity dynamics is not new. Is there actually a correlation between the two? What is the difference between kinematics and kinetics? Is the gluteus medius as important as we used to think? Can JW break down the number 60 into its component prime numbers???
Sep 01, 2015•56 min
There is some evidence that repeated loads can fatigue an ACL in a cadaveric model. There is some other evidence that lack of hip internal rotation is a risk factor for ACL injury. This episode explores these ideas and asks how these factors might play a role in this common yet serious injury. How does one tear an ACL? Assuming they matter, is there anything we can really do proactively about these concerns? Can JW afford a new bike? Does Erik have a thing for foot piercings?
Aug 26, 2015•54 min
