In this episode we were joined by the “Doctors of Running” (Matt Klein, Nathan Brown & David Salas) to have one final nerd out for the year about some of the shoes 2020 brought us, with special shouts to Atreyu for a new subscription model (and a really fun shoe), Saucony for crushing it with their Endorphin range, Nike’s Infinity React (which defintely decreases your injury by 52%), and of course the two muscle cars that have been battling it out for WR’s in the Nike Aphafly and Adidas Adizero Adios Pro. We also ask the Doctors what their favourite shoes are and why, and what we should all be excited about looking forward into 2021.
In this episode we were joined by Dr Farrah Jawad who is a Consultant in Musculoskeletal, Sport & Exercise Medicine at Pure Sports Medicine in London (and within the NHS), has worked extensively in elite sport, and has undertaken research at the Royal Ballet looking at seasonal variation in Vitamin D levels among its dancers. We talked about how important Vitamin D is, how common insufficiency is, where we can source Vitamin D, and its link with foot and ankle pathology.
In this episode we were joined by Christian Barton. Christian is a Physiotherapist who completed his PhD in patellofemoral pain and is now a post-doctoral researcher at LaTrobe University, Associate Editor at the BJSM, leads the TREK and GLA:D initiatives and also works in private practice where he specialises in knee pain in runners. He talked through how to differentiate between the most common knee complaints we see, the importance of not ignoring the psychosocial factors during the history taking, the evidence behind foot orthoses for PFP, hip level rehabilitation/exercises and what good and bad management of knee pain may look like in general. He also touched on load management, training habits and gait retraining. Some serious ground covered in this hour!
In this episode we took a deep dive into hallux valgus with two consultants; podiatric surgeon Mr Ian Reilly (Ian Reilly) and orthopaedic surgeon Mr David Gordon (The Bunion Doctor). They shared how they perform a clinical work up for a bunion, along with the answers they give to to the most common patient questions (What is a bunion? What causes bunions? Will it get worse and over what time period?) They each perform hundreds of operations a year, but differ in their approach to this (open surgery Vs minimally invasive/keyhole) so we discussed this, along with some of the most common non-surgical management options for bunions as well. Hope you enjoy.
In this episode we were joined with Dr Bronnie Lennox Thompson and we discussed some of the beliefs that underpin when and why a person seeks care, and why a clinician should take the time to investigate this and also make sure the check their own assumptions. Bronnie also touched on why pain reduction/resolution is not always the primary goal, and discussed her research which looked into how some individuals live well with pain whilst others do not. This episode gestures toward the importance of history taking, motivational interviewing, pain science and human psychology (as as such has immediately become Ian’s favourite episode!)
In this episode we were joined by Physiotherapist and elite runner Anna Boniface to talk about RED-S. She discusses what it is, and the myriad of health implications on multiple body systems along with the performance implications which contributed to the renaming/evolution of this condition from its previous moniker; the female athlete triad (not to mention that males are not immune either!) Anna also covered the key, and often sensitive, questions to ask (about weight, periods and libido) and gave some tips for how to ask them. She also shared with us her own personal story of being diagnosed with it around the time she earnt her vest to represent England in the marathon. Finally, she highlighted how to manage this complex condition within the MDT.
Paul Ingraham is a Vancouver science journalist and creator of PainScience.com, a website about the science of pain, injury, treatment, and rehab with about a million monthly readers. In this episode he discussed the reasons people ritualistically stretch (beliefs about flexibility, injury reduction, improving performance etc) and the whether the scientific literature backs them up. He also made reference to certain structures which are biomechanically awkward/impossible to stretch, some of the sensory adaptations/neurology that may be involved, and whether stretching is indeed as beneficial as it society believes it to be.
In this episode we were joined by Richard Blake from his home in San Francisco for a trip down memory lane back to 1981 and the genesis of his inverted orthotic technique. He talks us through the responses he got from Drs Root & Weed when he began inverting devices by 25 degrees or more, the response he got from JAPMA when he submitted his first paper on it, and how by 1983 Dr Root was one of his biggest supporters. Rich stated the most he has ever inverted a device was 70 (seventy) degrees, and also how one of his fresh faced young students by the name of Kevin Kirby was part of the group that helped him at the time.
In this episode we were joined by Sports Podiatrist (and 2:14 marathoner) Thomas Do Canto to talk through his approach to taking a thorough history from an injured runner. Given the current global climate it is reasonable to assume there may be an increase in running injury rates: The Running “Coverload” Injury Phenomena – Griffiths (2020). Combine this with more remote/online consultations (where we may have to prioritise the subjective over the objective) and it should become clear why taking a good history from a runner is so important. Thomas talked us through his 4 page form which he sends to all runners for them to fill out before the consultation; and the rationale behind many of the questions on there and how they may really help him formulate a provisional diagnosis and management plan before he has even met the patient.
In this episode we were joined by JFAR editor in chief Professor Keith Rome to be taken on a deep dive of Gout. What is gout, and what important comorbidities should be considered? What is Pseudo-gout? How might it clinically present in acute and chronic contexts? Are blood tests helpful? What theories explain its prevalence in the 1st MTPJ, and should we consider it as a differential of midfoot pain more than we do? Along with a discussion on its management this is an hours revision we’d recommend to clinicians of all levels of experience.
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