In this episode of the ClinicalAthlete Podcast, we discuss how patient beliefs and expectations of care can have a significant effect on patient outcomes. We also discuss how we can manage, potentially reframe, and measure patient expectations clinically. We finish the show discussing a case study of an injured athlete, and how to incorporate patient education as it relates to appropriately framing patient expectations of care.

Peer-Reviewed References:

Bialosky JE et al. Individual Expectation: An Overlooked, but Pertinent Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain. 2010

Geurts JW et al. Patient expectations for management of chronic non-cancer pain: A systematic review. 201

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That is the question we attempt to answer in this episode. What does “self-myofascial release” do and how does it do it? Is it worth spending time on? Does it effect recovery, performance, or injury? What does the research say? Here’s our take..

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In the first edition of the ClinicalAthlete debate series, we are joined by Dr. William Brady, DC of: integrativediagnosis.com.

During this professional debate, we discuss the biopsychosocial model of pain and injury. What effect does a clinician have on the “bio”? When and how should the “psychosocial” element be addressed? Should we take a “structuralist” or “pain science” approach when diagnosing and managing injury? Is it a dichotomy?

We also discuss, at length, the existence and management of fascial adhesions. What are adhesions? Can we identify them with palpation? Can we make structural changes with manual interventions?

We would like to thank Dr. Brady for coming on this show. Professional discussion and debate is what helps to push our fields forward. To suggest future debate topics or possible guests, please use the contact email below.

References mentioned by Dr. Brady:

Flexor tendon adhesion in rats: goo.gl/qQf1p2
Tensile properties of collagen matrices: goo.gl/F42YB9
Endoscopic treatment of sciatic nerve entrapment: goo.gl/DdQ8SG

Referenced mentioned by Derek Miles:

Assembly and mechanical properties of extracellular matrix: goo.gl/Ysz5zu
Looking back on back pain: goo.gl/JCe931

Referenced by Michael Ray:

STarT Back and low back pain: goo.gl/5kir6j
Effect of denervation on pain intensity: goo.gl/69ix8C
Relieving pain with expectation interventions: goo.gl/1iLfgM
The logic of Rehab blog on pain science: goo.gl/VEZeGj

For resources and education in sports medicine, athletic rehabilitation, & performance: www.clinicalathlete.com

For questions and comments: info@clinicalathlete.com

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What is “pain”? Does pain mean tissue damage? Can we, or should we, treat pain directly? Does the approach change in acute versus chronic cases? In this episode, we attempt to talk through the complex topic of pain science, as it relates to clinical application.

Logic of Rehab pain science blog:
goo.gl/f9PZG6

Peer-Reviewed References:
Williams AC. Craig KD. Updating the definition of pain. Pain. 2016.
Hauck M et al. Top-down and bottom-up modulation of pain-induced oscillations. Frontiers in Human Neuroscience. 2015
Smith BE. et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. BJSM. 2017
Sullivan MJL. et al. The influence of communication goals and physical demands on different dimensions of pain behavior. Pain. 2006

For resources and education in the fields of sports medicine, athletic rehabilitation, and performance:
www.clinicalathlete.com

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In this episode of the ClinicalAthlete podcast, we are joined by Jason Eure, DPT, to discuss the physiology and current best practice for the management of Tendinopathy.

Follow Jason on Twitter:
twitter.com/jmeure

Read Jason’s awesome blogs on Tendinopathy:
Squatting with Patellar Tendinopathy
Training with Biceps Tendinopathy

Find your nearest ClinicalAthlete Provider or ClinicalAthlete Event at www.clinicalathlete.com

Peer-Reviewed references used in the show:
1. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Cook JL. 2016
2. Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Bohm S. 2015
3. Heavy-Load eccentric calf muscle training for the treatment of chronic achilles tendinosis. Alfredson H. 1998
4. Heavy slow resistance versus eccentric training as treatment for achilles tendinopathy: A randomized controlled trial. Beyer R. 2015

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In this episode of the ClinicalAthlete Podcast, Quinn Henoch, DPT, Michael Ray, DC, and Derek Miles, DPT discuss the current evidence for a popular modality – the infamous “voodoo” bands.

Reference:
www.ncbi.nlm.nih.gov/pubmed/28254581

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Epistemology – the theory of knowledge. How do we know what we know?

In the very first episode of the ClinicalAthlete Podcast, Quinn Henoch, DPT, Michael Ray, DC, and Derek Miles, DPT discuss the past, present, and future of evidence-based practice.

References:
www.ncbi.nlm.nih.gov/pmc/articles/PMC2349778/

www.researchgate.net/publication/29…_David_Sackett

www.researchgate.net/publication/31…ter_century_on

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