Episode 028 Central Sensitization in a Nutshell with Jo Nijs

Summary In this conversation, Dr. Nick van der Horst, a sports physiotherapist, discusses the significant impact of hamstring and groin injuries in football, emphasizing the importance of pelvic control in injury prevention and rehabilitation. He highlights the prevalence of these injuries, the role of eccentric strength training, and the need for comprehensive screening and assessment methods. Dr. van der Horst shares insights on how to modify pelvic posture and control during rehabilitation, providing practical advice for integrating these concepts into injury prevention programs. The discussion also covers the relationship between pelvic mechanics and performance optimization, making it clear that understanding these factors is crucial for effective rehabilitation and injury prevention in sports. Guest Dr. Nick van der Horst is a sports physiotherapist and rehabilitation specialist with deep expertise in football medicine. He's currently part of the medical staff at PSV Eindhoven's first team, where he focuses on on- and off-field rehab, return-to-play strategies, and injury prevention.Nick earned his PhD at UMC Utrecht with a thesis on preventing hamstring injuries in male soccer players. Over the years, he has worked with organizations like the KNVB and Go Ahead Eagles, and he's the founder and CEO of SoccerDoc, a platform dedicated to improving football medicine through research, education, and clinical care.His work centers on maximizing football performance by reducing injury burden and creating evidence-based, player-centered rehab and prevention programs. Timestamps 00:00:00 Intro and guest bio 00:01:00 How big are hamstring and groin injury problems (incidence and time loss)? 00:04:04 Clarifying the topic: SI joint issues vs pelvic position/control 00:04:42 Why are pelvic control and positioning key for hamstring and groin pain? 00:12:44 Sponsor: PhysioTutors Premium Membership 00:15:28 Screening and assessment: Go-to markers for pelvic posture/control issues 00:19:27 Do you need motion capture or other equipment to assess pelvic control? 00:22:17 How do you differentiate pelvic-mechanics-related hamstring issues from tissue-specific or neural problems? 00:27:12 Common lumbopelvic patterns in recurrent hamstring and groin injuries 00:25:38 Sponsor: WriteUpp Practice Management 00:37:54 Groin pain: Is pelvic posture/control a cause or a consequence? 00:41:50 How modifiable is pelvic posture and control? 00:44:51 Rehab progression: Early vs late stages when focusing on pelvic control 00:48:54 Do you use basic core/lumbopelvic exercises (bird dog, dead bug, pelvic tilts)? 00:52:13 Have improvements in pelvic control reduced hamstring/groin injuries in practice? 00:54:46 Sponsor: PhysioTutors Online Courses 00:56:13 Case experience: Moments that shifted perspective on pelvic role 01:03:08 Practical advice for integrating pelvic control into prevention/rehab in football 01:05:49 Where to find Dr. Nick van der Horst 01:06:29 Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify |  Apple Podcasts  

Summary In this podcast episode, neuroathletic performance and pain coach Jannik Schuster discusses neurocentric training, a method focusing on the brain and nervous system to enhance performance and alleviate pain. Schuster explains how he discovered this approach through personal experience with injuries and highlights its effectiveness in reducing inflammation and pain. He defines neurocentric training as targeting brain and nervous system interactions to improve performance, distinguishing it from traditional training methods that focus on biomechanical structures. Schuster emphasizes the significance of understanding the nervous system's role in pain and movement limitations, advocating for individualized approaches to address specific nervous system needs. He also discusses the integration of neurocentric training with traditional practices, the impact of visual, vestibular, and proprioceptive inputs, and the potential for neurocentric training to become more prevalent in both athletic and therapeutic settings. The conversation underscores the importance of neuroplasticity and suggests resources for those interested in exploring neurocentric training further. Guest Jannik Schuster — Neuroathletic Performance and Pain Coach, M.Sc. in Sports Science, educator, and former elite footballer. After training in the youth academy of FC Augsburg and the professional squad of FC Schweinfurt, Jannik discovered neurocentric training as a breakthrough method to unlock performance, prevent injury, and resolve pain. Educated through Z-Health and grounded in sports science, he now helps others apply neuro-based strategies for pain-free movement and optimal function Content 00:00:00 Introduction 00:00:47 Yannick's Background and Introduction to Neuroathletic Training 00:02:49 Definition and Differentiation of Neurocentric Training 00:04:36 Scientific Foundation of Neurocentric Training 00:08:39 Common Misconceptions in Neurotraining 00:10:23 Role of the Nervous System in Pain and Movement Limitations 00:11:55 Neurocentric Training in Rehab 00:14:42 Assessment and Testing in Neurocentric Training 00:21:46 Role of Visual, Vestibular, and Proprioceptive Inputs 00:25:19 Typical Neuroperformance Training Session 00:28:17 Effects Observed in Performance-Oriented Athletes 00:31:01 Athlete Feedback on Neuro Training 00:35:38 Prevalence of Neurocentric Training in Elite Sports 00:37:29 Integration with Traditional Training and Therapy 00:40:08 Incorporating Neurocentric Elements in Daily Work 00:47:03 Striking Changes Observed Through Neuro Training 00:49:23 Resources for Learning About Neurocentric Training 00:51:27 Conclusion and Final Thoughts Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

Summary In this episode, Melvin Pitz and Cornel Tol from the Headache, Pain, and Concussion Training Institute (HPCTI) delve into the intricacies of managing concussions and post-concussion symptoms. They advocate for using the term "prolonged post-concussion symptoms" over "mild traumatic brain injury" to reduce the nocebo effect associated with the latter. The discussion highlights the importance of a multidisciplinary and biopsychosocial approach in diagnosis and treatment, emphasizing the significance of early intervention and patient education. Melvin and Cornel share insights into diagnostic criteria, the impact of framing on patient outcomes, and the gaps in current practices, particularly in the Netherlands. They stress the need for physiotherapists to be proactive in education and networking to bridge the knowledge gap in concussion management. The episode also touches on the neurophysiological aspects of concussion, the shortcomings of monodisciplinary approaches, and the potential of a treatable traits approach for better patient outcomes. Listeners are encouraged to rethink the role of physiotherapy and consider the broader implications of prolonged symptoms, including psychological and social factors. The episode provides practical advice for physiotherapists and healthcare professionals on how to improve their practice and patient care in the context of concussions. Guests Today's guests are Melvin Pitz and Cornel Tol from the HPC-TI — short for Headache, Pain & Concussion Training Institute. They're on a mission to educate and empower healthcare professionals with cutting-edge, evidence-based strategies to manage headache, pain complaints, and mild traumatic brain injury. With a strong clinical background and a critical view on how care is currently delivered, they're pushing for a multidisciplinary and biopsychosocial approach that actually works — in the clinic, and beyond Content 00:00 Intro 00:41 Definition of PPCS 03:06 Diagnostic Criteria 06:35 Gaps in recognizing PPCS 09:47 Why patients are misdiagnosed 14:24 Sponsor 15:00 Prognostic Factors to develop prolonged symptoms 18:48 Rethinking Physiotherapists' role in treating PPCS 24:40 Neurophysiology of PPCS 28:28 Why monodisciplinary approaches fail 33:12 Diagnosis & Decisionmaking 35:48 Sponsor 37:04 Biggest pitfalls 38:44 Treatment 50:48 Interesting Case Studies 57:38 Return to work/play 01:03:21 Opinion on high-impact sports 01:05:25 Myths to bust 01:06:26 Closing thoughts 01:07:37 Contact info & Outro Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

Summary In this episode, we welcome Dr. Sue Mayes, a distinguished physiotherapist and senior lecturer at La Trobe University, who is renowned for her expertise in injury prevention and rehabilitation, particularly in elite dancers and athletes. Dr. Mayes discusses the significance of foot intrinsic muscles, focusing on their role in ballet and sports injuries. She explains common issues like hallux valgus and foot arch control, emphasizing the importance of intrinsic muscle strengthening to enhance performance and reduce injury risk. Dr. Mayes shares insights into effective foot strengthening techniques, such as banded exercises and stair running, while highlighting the limitations of traditional exercises like toe doming. She also explores the impact of footwear, advocating for a gradual adaptation to minimalist shoes. The conversation covers the role of intrinsic muscles in chronic conditions like ankle instability and shin splints, and the need for a comprehensive approach that includes calf and hip strengthening. Listeners gain practical tips on creating foot strengthening programs, selecting appropriate exercises, and understanding the nuances of rehabilitation across different sports. Dr. Mayes underscores the importance of balancing foot strength and emphasizes the need for proper footwear to prevent stress fractures. The episode concludes with a call to acknowledge the lateral foot muscles and their role in distributing load effectively. Content 00:00 Intro 01:01 What are Foot Intrinsics? 01:40 Most common foot/ankle injuries in Ballet 02:20 Hallux Valgus 04:30 Taping for Hallux Valgus 06:12 Quantifying intrinsic muscle strength 08:03 Foot Arch 09:45 Sponsor 10:35 The dome exercise 12:30 Common misconceptions 13:43 Footwear 17:40 Intrinsic Foot muscle weakness as risk factor 19:50 Performance Impact 22:25 Building a foot strengthening program 27:32 Sponsor 28:44 Strength program progression 30:50 Balance program 32:43 Focus on Abductor Hallucis 34:42 What else to focus on? 36:15 Plyometrics 38:25 Footballer are like Ballerinas 41:12 What clinicians should know about feet 42:26 Sue's closing thoughts 44:10 Contact info & Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

Description In this episode, Dr. Jack Hickey, a leading researcher in hamstring injuries, shares valuable insights into the complexities of hamstring rehabilitation and injury prevention. He discusses the common misconceptions surrounding hamstring rehab, emphasizing the importance of understanding the adaptations targeted by specific exercises rather than simply mimicking injury mechanisms. Dr. Hickey also delves into the significance of hamstring muscle architecture, particularly the role of fascicle length as a modifiable risk factor for injury. He highlights recent research comparing the effectiveness of exercises like Nordic hamstring exercises and Romanian deadlifts in enhancing fascicle length. Dr. Hickey further explores his pioneering work in pain threshold rehabilitation, explaining how allowing low to moderate levels of pain during rehab can lead to better strength and muscle adaptation without delaying return-to-play timelines. He also touches on the fragility index as a measure of the robustness of risk factors associated with hamstring injuries. Throughout the conversation, Dr. Hickey underscores the importance of individualized rehab programs, incorporating both on-field and gym-based conditioning, and the need to prioritize fundamental principles such as load management and athlete well-being. He also provides a glimpse into ongoing and future research endeavors aimed at advancing our understanding of hamstring injury mechanics and prevention strategies. This episode is packed with practical advice and evidence-based approaches for clinicians, making it a must-listen for those involved in sports medicine and rehabilitation. Guest Jack Hickey is a leading researcher in the field of hamstring injuries. Jack is currently based at Maynooth University in Ireland, where he joined in 2023 as the first academic in the Department of Sport Science and Nutrition.Before that, he was a Senior Lecturer at the Australian Catholic University in Melbourne and part of the SPRINT Research Centre, focusing on sports performance, injury, and rehab. His PhD centered on hamstring strain injuries and pain-threshold rehab – a body of work that earned him multiple national awards, including the ESSA Medal for best PhD thesis in Exercise and Sport Science.Beyond academia, Jack is an accredited Exercise Physiologist with over a decade of experience treating athletes from all levels—especially those dealing with hamstring injuries and ACL reconstructions.   Content 00:00 Intro 01:31 Why the interest in the hamstrings? 03:41 Transitioning from Australia to Ireland 06:05 Common Misconceptions in Hamstring Rehab 13:09 sponsor 13:46 How to measure fascicle length 16:07 Pain threshold rehabilitation explained 21:55 But there's more than pain levels 27:51 How to modify fascicle length 30:01 Nordic Hamstring Curls vs. RDLs 35:05 sponsor 36:08 Which exercises favor different parts of the hamstrings 40:54 Ideal eccentric loading parameters 43:40 What is the Fragility Index? 49:49 Describing Return to Play Criteria 52:47 Hamstring Rehab in the ideal world 5 6:15 Current Hamstring Research Highlights 59:32 Jack's closing thoughts 01:00:26 Contact Info & Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

Summary In this episode, we explore the innovative world of Runeasi, a company co-founded by Dr. Kurt Schütte, which is revolutionizing the assessment of running and jumping in both clinical and athletic settings. Dr. Schütte shares how Runeasi bridges the gap between lab-based biomechanics research and real-world application, offering affordable, evidence-based analysis tools. The episode delves into the workings of Runeasi's AI-driven 3D gait analysis and its jump module, highlighting their key metrics and practical applications in reducing injury risk and enhancing performance. Additionally, the podcast covers the benefits of using Runeasi for clinicians and coaches, its validation process, and its future developments, including remote rehabilitation and mobile app advancements. The discussion emphasizes Runeasi's mission to make data-driven insights accessible and actionable for everyday physiotherapists, coaches, and athletes. Guest Dr. Kurt Schütte, PhD in biomechanics, CEO, and co-founder of Runeasi — a company that's shaking up how we assess running and jumping in both clinical and athletic settings. After completing his PhD, Kurt saw a gap between the lab and the field — and a clear need for affordable, evidence-based biomechanics analysis that could be used in the real world. That realization became Runeasi. His mission? To empower clinicians and coaches to use data-driven insights to reduce injury risk and enhance performance — and to make this the standard within the next three years. Resources Andreas Halfmarathon Case Study with Runeasi Runeasi Website Content 00:00:00 Introduction of Dr. Kurt Schütte and Runeasi 00:01:06 Discussion on the origin of Runeasi 00:02:09 Motivation from research to entrepreneurship 00:04:11 Vision for data-driven insights in clinical practice 00:08:25 Core of Runeasi's AI-driven 3D gait analysis 00:09:50 Difference from traditional lab-based systems 00:12:27 Ensuring closeness to the gold standard 00:14:58 Main metrics from gait testing 00:22:02 Who uses Runeasi and for which scenarios 00:27:18 Typical test session walkthrough 00:32:24 Running on a treadmill vs. outdoors 00:38:11 Jump testing module 00:41:11 Main metrics in the jump module 00:44:26 Ensuring accuracy compared to force plates 00:48:34 Special cases in return to sport testing 00:52:59 Future developments for Runeasi 00:57:26 Message to physios hesitant about biomechanics tech 01:01:51 Final thoughts and how to get Runeasi Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

In Episode 77 of the PhysioTutors podcast, we welcome Hedwig Neels, a renowned physiotherapist from Belgium who specializes in pelvic health. Hedwig is a professor at the University of Antwerp and founder of the Pelvic Floor platform, which aims to break taboos and make pelvic health accessible and understandable for women. During the episode, Hedwig discusses her journey in creating the Pelvic Floor platform and the common misconceptions around pelvic health, such as the overemphasis on Kegel exercises. She emphasizes the importance of education, awareness, and a holistic approach to pelvic health. The conversation also covers pelvic health during pregnancy and postpartum, highlighting the need for pelvic floor training and the challenges in returning to high-impact sports. Hedwig shares insights into male pelvic health, particularly saddle pain in cyclists, and the significance of relaxation over strengthening in certain cases. The episode concludes with a discussion on the future of pelvic floor rehabilitation and the importance of open communication and education in the field. Hedwig provides valuable resources and advice for physiotherapists and individuals looking to understand and improve pelvic health.   Guest Hedwig is a physiotherapist specializing in pelvic health, with a particular focus on education and awareness. She is a professor at the University of Antwerp, where she combines academic research with clinical practice at the University Hospital of Antwerp. Hedwig is also the founder of The Pelvic Floor, an information platform and community designed to break taboos and make pelvic health accessible and understandable for all women. She teaches both medical and paramedical professionals through the Women's & Pelvic Health Professionals network and is the author of Het Bekkenbodemboek — a beautifully illustrated, accessible guide to pelvic floor health for women. Her clinical expertise also extends to athletes, including both women and men, with a special focus on cycling-related saddle pain and its impact on performance.   Content 00:00 Intro 01:12 Why she started her Pelvic Health Platform 03:19 Misconceptions about the Pelvic Floor 06:42 Sponsor 07:19 Lowering the barrier to start talking about pelvic health 12:00 Pelvic Health during and after pregnancy 15:40 Return to sport post-partum 20:00 Quantifying pelvic floor function in practice 23:37 Pelvic Floor Problems among top reasons women stop playing sports 26:52 Male pelvic pain 31:43 More about letting go than holding in 34:12 Pelvic health skills for non-pelvic health practitioners 37:01 Sponsor 38:02 Go beyond Kegels 42:54 Don't forget the pelvic girdle 46:34 The biggest innovation in pelvic rehab 49:32 What every physio should know about pelvic health 51:02 Hedwig's closing thoughts 53:18 Contact info & Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts    

In episode 76 of the podcast, we engage with Dan Elias, a seasoned physiotherapist with over 15 years of experience, specializing in youth athletes. Dan works with the England athletics team and runs the Youth Physiotherapy Clinic in Bath, focusing on athletes aged 8-18. During the episode, Dan discusses his journey into youth physiotherapy, emphasizing the unique approach required for treating young athletes compared to adults. He highlights common misconceptions about physiotherapy for children and the importance of adapting communication and treatment strategies to suit their developmental needs. Dan elaborates on the challenges of managing injuries during growth spurts and the significance of bone health and appropriate strength training for young athletes. He also addresses the phenomenon of overtraining, offering insights into recognizing early signs and mitigating risks through proper rest, nutrition, and diversified physical activities. The conversation underscores the role of fun and engagement in rehabilitation and the necessity of establishing healthy long-term habits for injury prevention. Dan stresses the importance of understanding each child's unique circumstances and fostering a supportive environment that encourages confidence and communication. The episode is a comprehensive discussion on the nuances of youth physiotherapy, offering valuable insights for parents, coaches, and practitioners involved in youth sports.   Content 00:00 Intro 01:14 Dan's Journey into Youth Athletics 04:34 What are the biggest misconceptions on Youth Athlete Physiotherapy 08:03 Tips on communicating with children & adolescents 10:08 How Growth Spurts affect Injury Risk 16:19 Sponsor 17:20 What does a typical Assessment look like 22:20 What are common injuries in this population? 25:05 Are avulsion fractures prevalent? 26:13 How to recognize early signs of overtraining 30:30 How to deal with overtraining symptoms 33:01 Specific sports that have the most injuries 35:35 Resistance Training in adolescents 38:02 How to design "fun" rehab plans 41:15 Sponsor 42:03 How to help adolescents create healthy habits 45:26 Physical and mental advice for young patients 50:25 Parents' biggest mistakes in youth development 52:54 Early sports specilization 54:05 Dan's closing thoughts 55:47 Contact Info & Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

In this episode of the podcast, we are joined by Shrey Vazir, an advanced physiotherapist and founder of Mind Body Horizons. Shrey shares his personal journey of managing fibromyalgia and discovering the intersection of mindfulness and physiotherapy. He emphasizes the importance of integrating mindfulness practices into healthcare, particularly for managing chronic pain, stress, and burnout. Shrey discusses the science behind mindfulness, its benefits for patients and healthcare professionals, and offers practical steps for incorporating mindfulness into physiotherapy practice. He also addresses common misconceptions and barriers to adopting mindfulness and shares success stories of patients and professionals who have benefited from these practices. Listeners will get book recommendations for those interested in learning more about mindfulness and information on how to connect with Shrey.   Content 00:00 Intro 01:33 Shrey's Background 05:16 Founding Mind Body Horizon 07:40 Defining Mindfulness in Healthcare 14:05 Effects of Chronic Stress 20:24 How to integrate Mindfulness in Practice 28:10 Mindfulness Tips to prevent Clinic Burnout 32:15 Barriers to implementing Mindfulness 35:55 Athletes swear on Mindfulness 38:00 Dealing with Skepticism 43:15 Success Stories 50:56 Mindfulness Movement 52:50 Shrey's closing thoughts 54:25 Book Recommendations 56:32 Contact Info & Outro   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts  

In Episode 74 of the Physiotutors podcast, host Kai is joined by Dr. Erik Thoomes, an expert in musculoskeletal conditions, particularly cervical radiculopathy. Dr. Thoomes provides an in-depth discussion on cervical radiculopathy, distinguishing it from nonspecific neck pain. He explains that cervical radiculopathy involves radiating arm pain due to nerve root irritation or compression, often caused by disc herniation or spondylotic changes, contrasting it with lumbar radiculopathy. The episode emphasizes the importance of thorough patient history in diagnosis and suggests a cluster of tests including Spurling's test and neural tension tests to improve diagnostic accuracy. Dr. Thoomes also challenges the reliability of traditional dermatomes and myotomes, advocating for individualized assessment and treatment strategies. The conversation covers various treatment options, highlighting the ineffectiveness of cervical traction and suggesting neurodynamic mobilization, spinal manipulative therapy, and targeted exercises. Dr. Thoomes advises adapting management strategies from acute to chronic stages and stresses the role of patient education and self-management. The episode also touches on the limited role of imaging unless necessary and discusses the importance of differentiating cervical radiculopathy from other conditions. Dr. Thoomes calls for more research in areas like epidemiological data and neurodynamic mobilization and shares clinical gems for effective management. The episode concludes with an emphasis on individualized patient care and encourages questions and further discussion from listeners.   Content 00:00 Intro  00:52What is Cervical Radiculopathy? 04:05 Cervical vs Lumbar Disc Herniation 05:29 Clearer Terminology needed 07:15 Prevalence and Risk Factors 08:26 Most useful Tests 10:33 Crucial History Findings 11:56 Dermatomal/myotomal examination 13:13 Treatment Options 18:27 Manipulations? Mobilizations? 21:29 Motor Control Training 24:55 Directional Preference in the Cervical Spine? 26:03 Higher Level Exercises 27:01 Self-Management 28:52 Diagnostic Mistakes to Avoid 31:30 Red Flags and Imaging 33:15 Lessons to learn from LRS 34:25 Future Research Directions 37:45 Top Tips 39:27 Outro & Contact Info   Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now   Follow our Podcast on: Spotify | Apple Podcasts