Dr Jean-Francois Esculier is a leader in injury prevention & treatment for runners. He explains the findings of his randomized controlled trial (RCT) from his recent PhD in knee cap pain below. As he explains, education should be the cornerstone of your treatment.
Dr Christian Barton – PhD, BPhysio(Hon)
Dr Christian Barton is a physiotherapist who graduated with first class Honours from Charles Sturt University in 2005, and completed his PhD focusing on Patellofemoral Pain, Biomechanics and Foot Orthoses in 2010. Dr Barton’s broad research disciplines are biomechanics, running-related injury, knee pathology, tendinopathy, and rehabilitation, with a particular focus on research translation.
Dr Barton has published over 40 papers in Sports Medicine, Rehabilitation and Biomechanics journals, and he is an Associate Editor for the British Journal of Sports Medicine.
Read about all of our PFJ Symposium presenters by clicking here.
Professor Bill Vicenzino – PhD, MSc, BPhty
Bill Vicenzino is the Chair of Sports Physiotherapy, Director of the Master of Physiotherapy (Musculoskeletal and Sports) programs and Director of the Sports Injuries Rehabilitation and Prevention for Health (SIRPH) research unit at the University of Queensland. Bill’s research interests include musculoskeletal health, pain and injury with an emphasis on sport and physical activity, with a focus on establishing evidence based approaches to rehabilitation and prevention. His latest research aims to gain a better understanding of persistent musculoskeletal conditions and impairments (including patellofemoral pain) and their management; these projects include a number of randomized clinical trials attracting NHMRC funding that are being published in high impact medical journals (BMJ, Lancet, JAMA).
Read about all our PFJ Symposium presenters by clicking here.
Dr Jean-Francois Esculier – PT, PhD, Cert. Sport Physiotherapy (SPC)
Jean-Francois Esculier completed his bachelor of physiotherapy at the University of Ottawa, Canada, before undertaking graduate studies (Masters and PhD) at Laval University, Canada. Over the past few years, he has conducted studies on patellofemoral pain in runners (treatment approaches, biomechanics, footwear), and shows particular interest for clinical research. Jean-Francois is also an active clinician and currently practices as a physiotherapist at the Allan McGavin Sports Medicine Clinic in Vancouver, Canada. He is currently a post-doctoral research fellow at the University of British Columbia. Given his interest for knowledge translation, Jean-Francois enjoys teaching continuing education courses pertaining to the prevention and treatment of running injuries through The Running Clinic.
Read about all our PFJ Symposium presenters by clicking here
Professor Kay Crossley – PhD (Melb), BAppSci(Physio)
Professor Kay Crossley is the Director of the La Trobe Sport and Exercise Medicine Research Centre. Kay’s main research focus is on the prevention and management of patellofemoral pain and early-onset osteoarthritis after sports-related injuries. Kay is a physiotherapist with many years of experience in clinical sports physiotherapy. She has contributed to a number of sports medicine and physiotherapy texts, including every edition of “Brukner and Khan’s Clinical Sports Medicine”. Kay maintains a strong research interest in optimising treatments for patellofemoral conditions (pain and osteoarthritis). Additionally, she has developed a new focus of research, which encompasses three major fields. The major focus is on the development and prevention of osteoarthritis following sports related injuries, with fields in patellofemoral osteoarthritis following patellofemoral pain, knee osteoarthritis following ACL reconstruction and hip OA following hip-related injuries (including FAI and labral tears).
Read about all our PFJ Symposium presenters by clicking here.
Tempero-mandibular dysfunction (TMD) or jaw dysfunction is a common issue that effects between 10-15% of the population. Symptoms of TMD include headaches, pain in the region of the jaw, face and neck, as well as, ear blockage and pain.
There are many causes of TMD including clenching and grinding your teeth or direct trauma to the face or jaw from impact during sport and activity. TMD can also arise following extensive dental work and surgery.
The pain associated with TMD may be due to spasm in the muscles surrounding the jaw or from dysfunction inside the joint. The pain may also be referred from the muscles in your neck and head.
Common signs of TMD to watch for include:
- Clicking or cracking sensations inside your mouth
- Locking or seizing of the jaw in either the closed or open position. Pain and discomfort with chewing or yawning
- Persistent facial pain and headaches.
Physiosports Brighton Physiotherapist Angus McDowell has completed professional training in regards to management and treatment of TMD and headaches. If you’re suffering any of these symptoms or have any questions feel free to give us a call on 03 9596 9110.
Strength or resistance training involves much more than simply going to the gym a couple times a week. To gain the most from strength training it’s crucial to understand the science behind exercise choice, dosage and planning. This is the foundation of designing a strength training program.
In fact, strength training is more about the design of the program than the exercises themselves. Recent evidence highlighting the significance of concepts such as load management and periodization emphasize this point. These concepts include progressively building your training volume and intensity, providing appropriate variety in the program and accounting for the physical profile and injury history of the patient.
The idea of strength training can make some people who’ve been previously or currently injured apprehensive. However, the risk of aggravating an injury must be balanced with the risk of staying in a deconditioned state and maintaining a higher re-injury risk. Which brings me to one of the most common questions I get asked by patients, ‘what can I do to prevent this happening again?’ Thankfully these days my answer is both simple and based on sound scientific evidence – improve your strength.
It would be wonderful if improving strength were an easy process. Though physical and mental effort is required to complete the actual strength program, it’s structure need not be complicated. With the guidance from an appropriately qualified Physiotherapist, a simple yet highly effective strength training program can be designed to progress your injury rehabilitation and reduce your injury risk.
In summary there are three main reasons you should strength train following an injury:
1. Resistance Training is a valid treatment option for musculoskeletal rehabilitation.
A recent systematic review using data from 1545 rehabilitation patients demonstrated that strength training improved outcomes in chronic low back pain, knee osteoarthritis, chronic tendinopathy and post hip replacement patients (Kristensen and Franklin-Miller, 2012. Other studies have shown that a structured resistance training program can reduce pain and improve function in neck pain (Gross, 2015), groin pain (Jensen, 2012), shoulder pain (Andersen, 2014) and also osteoporosis (Gomez-Cabello, 2012).
2. Strength training reduces sports injury risk
A recent systematic review using data from over 26000 patients showed that ‘strength training reduced sports injuries to less than a third’ and suggested that strength training may also halve overuse injuries (Lauersen et al, 2014).
3. Strength Training is easy to start
As most patients following injury are starting from a low base of fitness, strength training doesn’t need to involve large weights, squat racks, benches or sweaty mats in a gym with blaring music. In most cases to achieve an appropriate training stimulus simple bodyweight training is ideal.
IN SUMMARY, RESISTANCE TRAINING:
- is effective in treating a range of common musculoskeletal conditions
- is effective in reducing sports injury risk
- is easy to perform.
APA Sports Physiotherapist, S&C Coach, Pilates Instructor
Find out more about John’s Strength & Conditioning Essentials for Physiotherapists Course
With marathon and triathlon season fast approaching we often see an increase in injuries around the foot and ankle, in particular Achilles tendon pain. Last weekend Physiosports hosted a weekend conference for physios and sports doctors run by the world’s best tendon experts. Here are their 5 super important tips for anyone who thinks they have Achilles Tendinitis (although we call it Tendinopathy).
1. Ensure a correct diagnosis.
There are lots of tendons and other structures around the back of the ankle that can get sore with running. Given that management of tendon injuries is very different from injuries to joints and other structures, being sure it is your tendon that is the problem is vital before undertaking any treatment plan.
2. The findings of your scans are inconsequential to your recovery.
Often those with tendon complaints will have an MRI or ultrasound reporting partial tears or degeneration. The latest evidence suggests that these same findings often exist in pain-free tendons and is an expected tissue response. Furthermore, it has been found that these altered tissues can be rehabilitated back to normal function through exercise.
3. A specific loading program is vital.
Your Achilles tendon acts like a giant spring; this is why only performing calf raises for your exercise will not be enough to get you back to running and jumping sports. A carefully graduated exercise program, starting with low load activities (calf raises) and eventually progressing to dynamic jumping/hopping exercises are needed to prepare the tissue for the demands of your sport.
4. Complete rest and passive treatments (injections, needling etc) will not fix the issue.
As for point 3, tendons act like springs. Any treatment that stops you loading the tendon is ultimately making the tendon less capable of being a spring and this, in turn, makes it harder to rehabilitate the tendon back to normal strength. While sometimes injections and medications can reduce the pain, they do not ever help to restore the tendon’s strength or function and should be used very carefully.
5. Do not stretch the tendon.
Achilles tendon problems exist where the tendon wraps around the heel bone. The injury is a result of a combination of tensile (stretching) and compressive forces on the tendon that are too large for it to cope with; as a result the tendon makes itself stiffer through changing its cellular structure. Even though the tendon feels tight walking around (especially in the morning or when you start running) – remember this is a response in the tissue to protect itself. When you try and stretch the tendon to loosen it up you are actually placing a compressive and stretching force on the tendon and actually making it worse.
Professor Jill Cook – JC
Craig Purdam (FACP) – CP
Ebonie Rio - ER
Sean Docking – SD
MASTERCLASS – PRESENT EVIDENCE/LATEST RESEARCH
|7:30||Revisiting the continuum of tendinopathy…again? – CP/JC|
|7:50||Characteristics and evidence around pain in tendons – ER|
|8:30||How do tendons adapt to load? SD|
|8:50||Management of tendinopathy in season – ER/CP|
|9:10||What to do if it’s not working? – JC/CP|
Saturday 9:00am – 5:00pm
|9:00||Tendinopathy – basic science and clinical presentations– SD/CP|
|9:45||The pain of tendinopathy – bottom-up, top-down where are we at?– ER|
|11:00||Tendon imaging – SD|
|11:45||Understanding load – CP|
|1:30||Assessment of tendinopathy and differential diagnosis – JC/ ER|
|2:15||Phases of rehabilitation – JC/ER/CP|
|3:30||Adjunct therapies and adolescent tendons – JC/SD|
Sunday 9:00am – 4:00pm
Rotating 4 workshops:
1. JC – Achilles/Glut tendons
2. ER – Patella
3. CP – Hamstring
4. SD – Imaging – when, how, what does it tell us?
|11:45||Clinical presentations and other tendons|
|3:30||Q&A / concluding remarks|