Only a few more days to sign up for the early-bird rate (expires 1st Feb) – this is a conference committed specifically to football medicine and takes place in London on the 21st-22nd April 2012. It has a massive line-up of presenters which read like a who’s who of football medicine. For more info checkout the conference website/programme at this link >. If it appears in Italian, don’t worry, just click the Union Jack flag in the top right hand corner for a UK version. You can sign up for one or both days and there are also student discounts available. The conference organisers are expecting around 700 delegates so it’s going to be a biggie!
Dedicated football medicine conference – London April 2012
Posted in esportEX, General
Leave a comment
Massage research
Recent abstracts
These four recent abstracts were highlighted recently by the Soft Tissue Therapists’ group in Australia – click the links for more info. Each study is in a markedly different field but all have positive ramifications for our profession, in both physiological importance and job growth areas.
This type of study adds weight to the necessity of regular soft tissue work within the hospital arena – around the world. The amount of research that now provides evidence for not only health benefits and disease control but for monetary savings is substantial. It is now up to us, our associations, to collate this material and present it to the authorities in that format – health benefits and cost effectiveness/savings.
Childhood diabetes is in epidemic proportions around the westernised world. This study urges parents and the medical authorities to consider if not implement such strategies into mainstream child diabetes care. Minmise drug use in the child population.
The autonomic nervous system is implicated in many psychological conditions as well as musculoskeletal injuries (especially chronic pain). Here is some hard and fast evidence as to why STT and heat is of great benefit. Take this abstract and show your GPs. This is the type of evidence we need to reduce drug taking (pharmaceuticals won’t like us very much…) and get people back to drug free living.
This study is one of the most ground breaking we have seen. For the first time we have a measured analysis of how trigger points can mess not only with pain perception but antagonist, agonist relationships and reciprocal inhibition. This has huge implications to the sporting world that demands ideal physiology when competing. All you sports therapists out there, take this paper and show the coaches (maybe in a language they will understand!) to demonstrate the necessity not only for remedial work but for preventative work. Strength and Conditioning coaches and skill aquisition coaches will find this very interesting.
Posted in esportEX, General, Soft tissue research
Leave a comment
Coming up in the Jan 2012 issues…get your free sample copy
sportEX medicine contains the following articles:
- Medial tibial stress syndrome – a case study
- Medial tibial stress syndrome – rehab advice leaflet for patients
- Clinical reasoning and it’s role in rehabilitation
- Muscle injury and rehabilitation – an update on the evidence-base (inc. animations)
- The Spine: injury diagnosis and rehab refresher – last in series (inc. animations/videos and patient rehabilitation leaflet)
- Journal watch – round up of this quarter’s research
sportEX dynamics contains:
- High Intensity Training – when less is more
- Active release therapy for tissue adaptation following injury – case study
- Posterior calf pain – stop the clot (inc. printable poster)
- Massage practitioners: who are we?
- Achilles tendonitis: patient information and rehabilitation leaflet
- Journal watch – a round up of this quarter’s research
Remember if you don’t have a subscription and you haven’t received a recent sample issue, why not request one. Just click here – it’s totally free and no payment information is required – there’s no obligation to subscribe – nothing – we just want you to see how good the journals are in the flesh!
Order a free sample issue of sportEX medicine or dynamics.
We’d love it if you’d share this with your colleagues and friends too through Facebook and Twitter or via email – the more people who see the journals the better!
Posted in esportEX, sportEX updates
Leave a comment
Still a couple of printed copies of the Massage Survival Guide available
This is predominantly an online ebook/emagazine but we printed some physical versions and there are still a couple available to anyone purchasing the online product.
For more info click here or to purchase click here.
Posted in esportEX
Leave a comment
The Utilization (or overutilization) of Magnetic Resonance Imaging in the Diagnosis and Treatment of LBP
As medical professionals who treat painful conditions, one of our goals is figure out why our patients are in pain. In the United States, one of the ways in which we attempt to find the root cause is Magnetic Resonance imaging (MRI). This month’s edition of the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) has several articles which analyze the current recommendations for the use of imaging, the positive and negative effects of imaging and what the images tell us in relation to our patient’s complaints.
MRIs have been utilized for the past 35 years to provide clinicians with images, in all anatomical planes, of a variety of tissue characteristics, blood flow and metabolic functions. These images have led to an improved ability to confirm a diagnosis as well as identify serious pathology such as infection, fracture or tumor.1 The rate in which lumbar MRI’s are ordered in the United States is growing at an enormous rate. A recent study in the Journal of the American College of Radiology found that 26% of diagnostic images ordered were unnecessary.2 Flynn and colleagues believe that the overutilization of lumbar MRIs have led to a 2- to 3- fold increase in spinal surgical rates in the past ten years.3
The American College of Physicians and the American Pain Society have published the following guidelines in ordering diagnostic imaging in the management of low back pain(LBP):4
- Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific LBP.
- Clinicians should perform diagnostic imaging and testing for patients with LBP when severe or progressive neurological deficits are present or when serious underlying conditions are suspected on the basis of history and physical examination.
- Clinicians should evaluate patients with persistent LBP and signs or symptoms of radiculopathy or spinal stenosis with MRI or computed tomography, only if they are potential candidates for surgery or epidural steroid injection.
Flynn further believes that the inappropriate use of lumbar spine imaging can lead to several harmful effects. He states that an MRI may facilitate the “medicalization” of low back pain (LBP).3 He sites a study which analyzed the lumbar MRI images of asymptomatic individuals 60 and older. This study found that 36% had a herniated disc, 21% had spinal stenosis and over 90% had a degenerated or bulging disc.5 Again, these results were found in individuals with NO PAIN. Other harmful effects noted include the increased risk associated with unnecessary surgeries as well as the nocebo effects related to labeling an imaging abnormality. This likely correlates with the patient focusing on the abnormality as the “source” of the pain when in reality, the two may not be related and may not improve despite provided interventions.
Information and education about low back pain is vital in improving the general public’s perception of why it exists. As stated in one of my earlier pieces, pain is an output from the brain and tissue damage is not necessary for pain; if the brain perceives there is a threat to the low back, it will send an output of pain to protect it. This is likely why the article cited by Flynn showed that individuals had abnormalities on MRI but experienced no pain. Their brain simply did not perceive a threat, despite the abnormalities present.
This months edition of JOSPT provides more studies which state that should not blame a disc herniation, stenosis, or arthritis as the cause of the back pain . Our patients may have had these issues for a while prior to the onset of their current symptoms. We should instead try to figure out why their brain perceives a threat and what we can do to modify it. Our increased usage of diagnostic imaging may actually be limiting our ability to effectively treat our patient’s pain and leading to unnecessary medical interventions. It may be leading us to blame the wrong things as the cause of their condition!
1. Strudwick MW, Anderson SE, Dimmick S, et al. Pearls and pitfalls of magnetic resonance imaging of the upper extremity. J Orthop Sports Phys Ther 2011; 41: 861-872.
2. Lehnert BE, Bree BL. Analysis of appropriateness of outpatient CT and MRI referred from primary care clinics at an academic center: how critical is the need for improved decision support? J Am Coll Radiol 2010;7:192-197.
3. Flynn TW, Smith B, Chou R. Appropriate use of diagnostic imaging in low back pain: A reminder that unnecessary imaging may do as much harm as good. J Orthop Sports Phys Ther 2011; 41: 838-846.
4. Chou R, Qaseem A, Owens DK, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007; 147:478-491.
5. Boden SD, Davis DO, Dina TS, et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990; 72: 403-408.
Posted in Article, Articles, esportEX, Sports medicine, Sports medicine research
Tagged flynn, jospt, lbp, mri, pain
Leave a comment
Come and fan us on Facebook
I love our Facebook page – I like talking to you guys through it – I put free articles on there, fan-only special offers, do polls, post funny stuff that makes me laugh – and all our blog posts and tweets feed onto there too – so you can keep up with everything we’re doing all in one place.
So when you’re next on Facebook – come and say hi – we’re at www.facebook.com/sportex.net
Posted in esportEX
Leave a comment
Latent myofascial trigger points and their effect on muscle activity by Paula Clayton, MSMA
There have been some cracking articles published in the last few months which are putting us firmly on the map when it comes to those questions, ‘yes, what you do is great … but where is the evidence?’
Latent Myofascial Trigger Points are Associated With an Increased Antagonistic Muscle Activity During Agonist Muscle Contraction
This study is one of the most ground breaking we have seen. For the first time we have a measured analysis of how trigger points can mess not only with pain perception but antagonist, agonist relationships and reciprocal inhibition. This has huge implications to the sporting world that demands ideal physiology when competing. All you sports therapists out there, take this paper and show the coaches (maybe in a language they will understand!) to demonstrate the necessity not only for remedial work but for preventative work. Strength and conditioning coaches and skill aquisition coaches will find this very interesting (more info…).
Travell and Simons clinically define a myofascial trigger point as “a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band.” These trigger points are associated with a number of causes/conditions including performing strenuous activity (Cheng, 1987). Fishbain et al.(1986), Horrowitz and Sarkin (1992) and Travell and Simons (1989) have suggested that myofascial trigger points can be brought on by macrotrauma and cumulative microtrauma (e.g. poor posture, repetitive motion or psychological stresses). Formation of trigger points has also been correlated with muscle pain, weakness, and movement dysfunction has also been suggested (Graven-Nielsne et al., 1991; Hong and Simons, 1998; Liley 1956; Mense, 1991, 1993, 1994, 1996; Simons et al., 1995a, b; Simons, 1996; Travell and Simons, 1989).
The implementation of an effective treatment for trigger points is challenging especially when the pathophysiology remains in question. Simons (1996) and Simons et al (1995) suggest that the formation of the ‘taut band’ is the result of an end plate dysfunction with excessive acetycholine release. Consequently, the hypothesis that trigger points are an “energy crisis” that lasts until the viscious cycle is interrupted (Simons 1996; Simons et al 1995). Ischemic compression is one of the many options that can be used to interrupt the cyclic pathology of a myofascial trigger point. So, this is where the soft tissue therapist (STT) comes in, after all, this is our bread and butter. Those of us trained in the art of neuromuscular techniques (NMT) positional release (PR) and just plain old myofascial trigger point therapy (MTrptT) will of course have already seen the great results these techniques produce with our athletes and private patients and will have lots of empirical evidence through case studies. However, rightly or wrongly this type of evidence does not seem to hold as much weight as the types of articles that show hard quantitative results.
In my opinion the soft tissue world needs to either adopt the mixed method approach (quantitative + qualitative) or concentrate on the qualitative where not only visible and measurable results such as improved range of movement (ROM) are calculated but also what the athlete and coach report with regards to performance impact and improved technical ability. Whilst this may be viewed as purely subjective, it holds weight particularly in the sporting world. Performance impacting solutions produce gold medals.
This is my first blog article written for sportEX and I will be writing one a month for the next three months. Whether you agree or disagree with my comments, let’s get talking about the soft tissue therapy & massage therapy community. Who are we? What do we have to offer? The fact that more and more soft tissue therapy research is being pumped into the ‘therapy’ community is making people stand up and take notice because you can’t ignore the results. Others are now beginning to believe what we have known since the first day we laid our hands on someone. We are artists in palpation and if just one person reads this and goes out and hires either a soft tissue therapist or a massage therapist, I will consider this article a success.
Please visit and ‘LIKE’ my facebook page (www.bit.ly/stt4performance) where you can follow this blog and get information on my upcoming shoulder, hip & pelvis and advanced STR masterclasses.
Until next month. Paula
14 printed copies of Massage Survival Guide available free with online purchase
Been tempted to purchase Rob Granter’s superb Massage Therapist’s Survival Guide? If so, now is the time to do it. The first 14 people to purchase the online guide will also get a copy of the printed version included at no extra cost. But there are only 14 copies available so you’ll need to act fast to catch one. Click here for more info.
Posted in esportEX, Resources, books, websites
1 Comment
50% discount to UKSEM conference – 23-26th Nov 2011
Special Offer to anyone reading this email: Get a 50% discount on the full conference now using code memberoffer11 to book. Just £300 for four full days (£150 per day rate available) at www.uksem.org
ASICS UKSEM 2011 at ExCel, London from Wednesday 23 November to Saturday 26 November
Following the success of last year’s event, ASICS UKSEM, Europe’s largest interdisciplinary medicine, science, sport and performance conference, is going to be even bigger this year as it returns to ExCel London for four days from November 23 to 26.
With a lecture programme featuring speakers such as Dr Craig Duncan from Sydney FC, author of The Talent Code Daniel Coyle, Darren Burgess from Liverpool FC, UK Athletics Head Coach Charles van Commenee and the father of functional sports training Vern Gambetta, and a range of over 50 workshops there will be something to cover all areas of sport and exercise medicine.
The partnership with ASICS proved to be a winning formula in 2010 and their support has led to exciting new developments this year including a 60m indoor running track, boxing ring, fencing piste and judo area in the new exhibition hall alongside a wide range of exhibitors from all areas of the industry. We are working with BASRaT and ACPSM to run specialist sessions during the conference and will provide CPD accreditation through Skills Active.
For further information, a full programme and online booking visit www.uksem.org or follow us on Twitter @uksem and facebook.com/uksem
Posted in Conference and courses, esportEX, Sports medicine
Leave a comment
CPD quizzes/eLearning section is up and running
At the moment the quizzes are only available to people with subscriptions. I will create a couple to appear free under the trial subscription and will post when these are up and running. For those of you with subscriptions, just log into the website, click on Online Access and in addition to a section called Subscriptions, you’ll also now see a section called eLearning (see image below).
Click on eLearning and you’ll see the quizzes you have access to in this section. We will be adding new quizzes regularly with each issue.
Take the test and as soon as you pass, you’ll see the banner below appear across the quiz and even better….under the Print my CPD certificates section which can be found under the My Account area – you will find a downloadable/printable PDF outlining the content of the quiz you have completed along with your score/pass mark.
We hope this adds new functionality to your subscription, that you’ll find useful.
Posted in eCPD/eLearning, esportEX
1 Comment
