Sports Medicine Project

with Dr Pat VallanceIn this episode:Bent knee versus straight knee calf raises for Achilles rehabWhy calf position changes muscle activationAchilles tendinopathy and tendon strainTendon stiffness and why it mattersWhether plyometrics build tendon stiffnessWhether running should be stopped during rehabLoad monitoring and pain guided rehabMuscular endurance testing with single leg heel raisesNormative values for calf endurancePsychological factors in tendinopathyKinesiophobia and pain catastrophisingCortical versus spinal inhibitionHow rehab may differ for Achilles compared with patellar tendinopathyResources mentioned:Tampa Scale of Kinesiophobiahttps://www.physio-pedia.com/Tampa_Scale_of_KinesiophobiaWhere to find Pat:Tendinopathy Circuit Breakerhttps://tendinopathycircuitbreaker.com/Instagramhttps://www.instagram.com/tendinopathy_circuit_breaker/Supercharge Your Tendon Rehab coursehttps://events.humanitix.com/supercharge-your-tendon-rehab-cutting-edge-tendon-injury-rehabPat's recent publications:Vallance, P., Kidgell, D. J., & Malliaras, P. (2026). Greater endogenous pain facilitation is associated with lower spinal excitability and maximal knee extension strength deficits in athletes with patellar tendinopathy. European Journal of Applied Physiology, 1-14.Vallance, P., Malliaras, P., & Kidgell, D. J. (2026). Temporal motor evoked potential decomposition reveals that cortico-reticulospinal excitability is increased in athletes with patellar tendinopathy. Preliminary evidence of compensatory adaptation for diminished motor drive. Journal of Electromyography and Kinesiology, 103142.Vallance, P. (2025). Neural deficits relevant to pain symptoms and functional impairments in individuals with Achilles or patellar tendinopathy (PhD Academy Award). British Journal of Sports Medicine.Vallance, P., Siddique, U., Frazer, A., Malliaras, P., Vicenzino, B., & Kidgell, D. J. (2025). Transcranial magnetic stimulation and electrical stimulation techniques used to measure the excitability of distinct neuronal populations that influence motor output in people with persistent musculoskeletal conditions: A scoping review and narrative synthesis of evidence. Journal of Electromyography and Kinesiology, 103011.Vallance, P., Kidgell, D. J., Vicenzino, B., & Malliaras, P. (2025). Endogenous pain modulation is not different in basketball or volleyball athletes with patellar tendinopathy compared to asymptomatic athletic controls. Musculoskeletal Science and Practice, 76, 103280.

Every major osteoarthritis guideline in the world lists weight management as core care. Ben Steele-Turner's scoping review pulled together 79 records on what physiotherapists do, and the picture is messy. Clinician surveys have 60 to 94 per cent of physios saying they include weight management. Notes audits and patient interviews put it closer to 8 to 22 per cent. Ben is a physiotherapist and PhD candidate at the University of Portsmouth, and he joins me to talk through why that gap exists and what to do about it. We get into scope of practice and why so many clinicians find the conversation awkward.We also cover the part I've always struggled with. Osteoarthritis is a whole system condition, inflammatory, metabolic, psychological, and yet the mechanical side is the bit I know how to do. Sets, reps, load, progression.. Ben and I dig into whether the lifestyle side actually outperforms what we're already doing, what someone can be offered for faster relief in the first few weeks, and where taping, footwear, orthoses and injections sit.Then there's the steroid question. If a knee is angry and inflamed we know what that environment does to cartilage, but the drug that settles it is itself chondrotoxic. Do we steer people away from it or put it on the table and let them decide? And can we really blame someone for wanting the pain gone now, when most of us wouldn't accept "just live with it" for our own injuries either.Ben finishes with how he selects exercise for someone with knee OA, whether he starts local or zooms out, and the one thing he wants every patient to walk away understanding about their knee.Papers discussed:Steele-Turner B, Gonçalves AC, Shepherd AI, Drummond H, Allison K, Bennell KL, Exell TA. Physiotherapist-led weight management for people with osteoarthritis: A scoping review. Osteoarthritis and Cartilage 2026;34:121-138. https://pubmed.ncbi.nlm.nih.gov/41276008/Moseng T, Vliet Vlieland TPM, Battista S, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024;83:730-740. https://pubmed.ncbi.nlm.nih.gov/38212040/

Muscle injuries remain one of the most challenging conditions in sport. In this episode, sports physiotherapist Murray Leyland joins us to discuss the latest evidence on muscle injury diagnosis, rehabilitation, and return to play. We cover muscle injury classification, the role of MRI, load management, eccentric training, calf and hamstring injuries, and how clinicians can make more informed return to play decisions. This episode is packed with practical, evidence-based insights for clinicians working with athletes and active individuals.Murray's Practice Below:https://www.valleyphysiotherapy.au/

Paper: https://bjsm.bmj.com/content/early/2026/05/03/bjsports-2025-110986In this episode, Professor Joanne Kemp discusses the latest evidence on femoroacetabular impingement (FAI) syndrome and challenges common assumptions about hip pain. We explore why structural findings such as cam morphology are often seen in pain-free individuals, how imaging should be interpreted alongside the clinical picture, and what the new PhysioFIRST randomised controlled trial tells us about strengthening versus stretching. Joanne also shares practical advice for clinicians on patient education, treatment decision making, and translating research into everyday practice. Whether you're a clinician, student, or interested patient, this episode provides an evidence-based perspective on the assessment and management of hip pain.Professor Joanne Kemp is a physiotherapist, researcher, and Professor at La Trobe University. She leads internationally recognised research in hip pain and femoroacetabular impingement (FAI) syndrome, with a focus on improving non-surgical management through high quality clinical trials. Joanne has authored more than 150 peer reviewed publications and is the lead author of the recent PhysioFIRST randomised controlled trial published in the British Journal of Sports Medicine.

Follow Kim https://www.linkedin.com/in/kim-hebert-losier/Summary Dr. Kim Hebert-Loser shares insights on calf muscle function, footwear technology, injury prevention, and the future of personalized shoe design. Discover how research, biomechanics, and individual preferences shape optimal running and rehabilitation strategies.