In this podcast episode, Dr. Leanne Bisset, a musculoskeletal physiotherapist and associate professor at Griffith University, shares valuable insights on lateral epicondylalgia, also known as lateral elbow tendinopathy. She discusses the anatomy and function of the affected muscles, highlighting the importance of stability in wrist movements and the role of the extensor carpi radialis brevis. Dr. Bisset emphasizes the shift in terminology from epicondylitis to tendinopathy, debunking misconceptions around inflammation in the condition and providing a comprehensive overview of diagnostic considerations, risk factors, and red flags to look for during assessment.

Furthermore, Dr. Bisset delves into the management of lateral elbow tendinopathy, emphasizing the significance of tailored exercise programs focusing on isometric loading initially, progressing to incorporate global upper limb strengthening for comprehensive rehabilitation. She also addresses the limited efficacy of modalities like shockwave therapy and the potential benefits of orthoses in pain management. Dr. Bisset's evidence-based approach underscores the importance of patient education, individualized treatment plans, and monitoring pain responses to optimize outcomes in the management of lateral epicondylalgia.

Guest

Dr. Leanne Bisset is a musculoskeletal physiotherapist and an associate professor at Griffith University at the gold coast, Australia. She has published over 100 papers on a variety of topics and has done extensive research on lateral epicondylalgia.

Chapters

00:00 Intro

00:44 Definition of lateral elbow tendinopathy

05:39 Why Inflammation is inaccurate

11:49 Risk factors

13:46 The typical patient

17:34 Red Flags

27:30 Diagnostic tests

29:49 Leanne's Diagnostic Approach

32:27 Treatment

38:15 Details on Isometric Loading

49:29 Other treatments

54:02 Treatment Progressions

58:45 How much pain to allow

01:01:28 Shockwave and Dry Needling

01:03:56 Elbow Braces

01:05:50 Contact Info

01:06:58 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.

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In this episode of the Physiotutors podcast, Tom Goom, also known as the Running Physio, provides valuable insights into medial tibial stress syndrome (MTSS) and its management. He discusses the pathophysiology of MTSS, Risk factors, and emphasizes the importance of gradual training progression and proper footwear selection to prevent MTSS. Tom also shares his approach to assessing and treating MTSS, focusing on finding a pain-free level of loading, incorporating strength training, and carefully guiding patients through a structured return to running program.

It's a value-packed episode so tune in to master your approach to treating shin splints.

This episode is sponsored by Lindy.ai - your A.I. medical scribe. Try Lindy for free by going to lindy.ai/physiotutors and receive 1 week of unlimited patient notes.

Content

00:00 Intro

01:06 What is MTSS?

02:19 Risk Factors

03:34 Typical Patient

04:20 Specific Training Errors

05:40 Influence of Footwear

06:58 Forefoot Running

08:40 Red Flag Diagnoses

12:08 MTSS DIagnosis

13:06 Assessing the Patient

15:45 Muscle Testing

17:18 Sponsored Segment

18:55 Other Strength Parameters

21:05 Running Analysis/Technique

26:15 Treatment

29:29 Strengthening Exercises

31:58 What about Tibialis Anterior?

33:12 How to manage a flare-up?

35:25 Return to running

38:02 Different Mx for Different Sports

40:20 Duration of MTSS

41:35 Adjunct Treatments

43:30 Can MTSS become a Fracture?

44:25 Tom's closing remarks

46:25 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.

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Follow our Podcast on:

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In this podcast episode, Barbara Cagnie, a physiotherapist and manual therapist, discusses the topic of dry needling, providing valuable insights into its definition, physiological effects, and clinical applications. Dry needling is described as a technique used by physiotherapists to treat myofascial pain, with the insertion of thin filiform needles into specific trigger points aiming to reduce pain and restore muscle function. Barbara highlights the physiological basis of dry needling, emphasizing its effects on peripheral and central systems, as well as its potential impact on pain and inflammation.

The discussion delves into the differences between active and latent trigger points, reliability in identifying trigger points, and the mechanism of referred pain. Barbara also addresses the evidence supporting the efficacy of dry needling in various musculoskeletal disorders, particularly in neck pain, highlighting the need for ongoing research to further explore its clinical applications.

The conversation touches on the contraindications and potential risks of dry needling, emphasizing the importance of proper training and anatomical knowledge to minimize adverse events. The future of dry needling is also considered, with mentions of ultrasound-guided and electrical dry needling techniques.

Barbara's expertise and comprehensive explanations serve to demystify dry needling and shed light on its clinical relevance. Her insights not only provide valuable information for physiotherapists but also instill curiosity about the potential of this technique in optimizing patient care.

Chapters

• 00:00 Intro
• 00:46 Defining Dry Needling
• 01:49 The Physiology
• 07:26 Difficulty of human studies
• 08:15 Active vs. Latent Trigger Points
• 10:05 Reliability Issues of TP Therapy
• 12:00 Referred pain in Trigger Points
• 15:40 The local twitch response
• 17:50 In-situ vs. winding technique
• 18:36 Research vs. Clinical Practice
• 20:22 Dry Needling for Tendinopathy?
• 23:58 Evidence for MSK Complaints
• 28:01 Contraindications and Risks
• 30:45 Needles vs. Hands
• 32:16 Kai's Dry Needling Anecdote
• 33:06 Are we chasing short-term effects?
• 35:26 Top 3 Reasons to learn Dry Needling
• 40:01 Closing thoughts
• 41:06 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