Libsyn Directory

163. ACL treatment options and cross-bracing with Clare Walsh

Release Date: 04/17/2024

180. Patellofemoral pain 4 - How to get runners back on track (and trails, hills and anywhere else they run!) with Tom Goom

Physio Edge podcast

Patellofemoral pain (PFP) rehabilitation doesn’t end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice’s journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals,...

179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms with Tom Goom

Physio Edge podcast

Strengthening exercises are a key part of successful patellofemoral pain (PFP) rehabilitation. Squats, lunges and single leg squats are often painful early on and can aggravate your patients pain, but on the flip side, we want to build up their tolerance and confidence with these movements. If you introduce an exercise your patient isn’t ready for, progress too quickly, or overload the knee too early, you’ll often flare your patients pain and set their rehabilitation back. In this episode, Tom Goom (Running Physio) and David Pope explore the third pillar of successful PFP treatment:...

178. Patellofemoral pain 2 - What to do when runners won't reduce their training with Tom Goom

Physio Edge podcast

Many runners patellofemoral pain (PFP) is aggravated by the activity they love. They either stop running to let their pain settle, and then it returns as soon as they start back up again, or keep running despite the pain getting worse. They may know (and you may have told them) they should reduce their training….but what happens when they can’t? Or won’t? In this episode, Tom Goom (Running Physio) and David Pope explore the second pillar of successful PFP rehab: education and empowerment. Using the real case of Alice, a HYROX athlete preparing for competition, you’ll discover how and...

177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss with Tom Goom

Physio Edge podcast

Patellofemoral pain (PFP) is one of the most common running injuries, and the high recurrence rate can make it a frustrating injury for patients to experience and clinicians to treat. In this episode, Tom Goom (Running Physio) and David Pope break down why PFP has such a high recurrence rate, and what most rehab plans miss. You’ll also discover: The "Four pillars" framework Tom uses to treat PFP and other running injuries How and when to keep patients running or exercising when it is essential for their mental health and social life How to find a manageable starting point when a...

176. Neck-driven shoulder pain - 5 common misunderstandings. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

When is your patient's shoulder pain from their neck? Are you missing a cervical spine component in your shoulder patients? After a day in clinic reviewing patients with years of unresolved shoulder pain, Shoulder Specialist Physiotherapist Jo Gibson breaks down the five most common mistakes clinicians make when ruling in — or out — the neck. In this podcast, Jo covers: Why you don't need neck pain to have neck-driven shoulder pain (and which pain locations are most pathognomonic) Why referred symptoms below the elbow don't automatically point to the cervical spine Why active range of...

175. Tendinopathy treatment: Your guide to isometrics, isotonics & plyometrics with Dr Ebonie Rio

Physio Edge podcast

Should you prescribe isometric or isotonic exercises for your patient's lower limb tendinopathy? When is it safe to add plyometric loading, and how do you progress running or jumping without flaring your patients tendon pain? Why do some "tricky tendons" refuse to respond to your best loading programs? Dr Ebonie Rio (Post-Doctoral Senior Research Fellow, La Trobe University) reveals the evidence-based answers as she guides you through the clinical reasoning and practical strategies for managing patellar, achilles, and other lower limb tendinopathies. In this conversation, you'll follow...

174. ACJ - The hidden culprit behind stubborn shoulder pain? Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Have any of your shoulder patients improved and then plateaued, unable to regain their full range of movement, or get rid of their painful arc? Sometimes it’s not the cuff, capsule, nerves or neck—it’s the acromioclavicular joint (ACJ) holding things back. In this episode, Jo Gibson sheds light on this often-overlooked contributor to persistent shoulder pain. From real patient case studies to the latest research and simple clinic-ready symptom modification tests, Jo shares practical strategies you can use immediately. Learn how to identify ACJ involvement, and use targeted rehab...

173. Hip flexor pain in runners: Diagnosis, myths, and rehab. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

Anterior hip pain is often blamed on the hip flexors, but in runners, that’s rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You’ll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies...

172. Shoulder pain assessment & clinical reasoning. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple,...

171. Achilles tendon ruptures: Rehab & recovery with Prof. Peter Malliaras

Physio Edge podcast

Your patient is running, playing sport, or jumping or lunging forward - an activity with fast eccentric or concentric activity in dorsiflexion,and suddenly they feel like they’ve been kicked in the back of the leg. They might hear a snap and have difficulty weightbearing, walking and pushing off. What’s your likely diagnosis? You picked it - an Achilles tendon (AT) rupture. AT ruptures are a devastating injury that can drastically impact a patient’s ability to walk, run, or return to sport. Despite their frequency, there’s a lot of uncertainty among clinicians, patients, and even...

More Episodes

ACL injuries result in significant time away from sport and distress for patients. The variety of management options, from surgical intervention to non-surgical management and rehabilitation protocols, often makes us uncertain when educating and helping patients choose the most appropriate care for their needs and goals.

Recently, a new non-operative ACL injury management pathway called the “Cross bracing protocol” has been pioneered and developed by Dr Tom Cross and Tom’s father (the late Orthopaedic surgeon) Dr Merv Cross. This protocol offers a promising alternative for patients with ACL injuries who are suitable for non-surgical intervention, where the ACL injury may heal or repair itself.

Not all patients with an ACL injury are suitable for the Cross bracing protocol or non-surgical management, so how can you identify whether your patient is suitable, and which treatment options are best for each patient?

In this insightful podcast episode, we discuss the complex challenge of ACL injury management and Cross bracing with Clare Walsh (Specialist Sports & Exercise Physiotherapist, FACP).

Clare treats a lot of patients with ACL injuries with prehabilitation, post-op rehabilitation, or non-surgical management including Cross bracing. Clare works alongside Dr Tom Cross and other Sports Medicine Doctors, Orthopaedic surgeons (including the late Dr Merv Cross) and leading Sports Physiotherapists at Stadium Sports Physiotherapy and The Stadium Clinic.

Clare teaches on the Cross bracing course conducted in Australia for Physiotherapists and health professionals, and is a Senior Educator & Presenter here at Clinical Edge.

In this podcast we explore:

Cross bracing
- What it is and how it developed.
- What research has been performed to date, and what it shows about the chances of ACL healing with the Cross bracing protocol.
- Assessment tests & specific imaging that are used to assess patient suitability.
- Why patients might opt for Cross bracing rather than surgery.
- Who isn’t suitable for Cross bracing.
- Potential negative outcomes of Cross bracing.
- Which patients are more likely to be suitable and successful with Cross bracing - eg. injury type, age, level of sport, goals, psychosocial factors.
- Medical factors that impact suitability.
- Psychosocial factors that impact whether a patient can undergo the protocol.
- Which leg (right or left) is better suited to bracing and why.
- Which type of braces are commonly used.
- How soon the protocol needs to commence after injury to be successful.
- Which concomitant injuries can still heal in a brace and which need surgery e.g. meniscus injuries, bucket handle tears of the meniscus, MCL tears.
- How long patients remain in a brace.
- Exercises and activities that can and should be performed throughout Cross bracing.
- How patients can move or walk around throughout the Cross bracing period.
- How Cross bracing has changed and evolved.
- Whether the ACL is at increased risk of re-rupture following the protocol.
- Essential medical management during the protocol.
- Whether therapists can put a patient in a brace, or manage the protocol independently.
- What to you do if you think a patient may be suitable for Cross bracing.
- How to refer patients for Cross bracing
- Followup imaging at the end of the protocol.
- Functional assessment tests used at the end of the protocol.
- Return to training (RTT) and return to play (RTP) following the protocol.
Which patients require surgery instead of conservative management.
Early surgery vs delayed surgery.
Spontaneous ACL healing - what the research says.
How to use patient-centred decision-making to guide patients into the most suitable recovery pathway - surgery, bracing or non-surgical management.
Case studies and comparisons of patients that underwent either Cross bracing or ACL reconstruction.

This podcast is packed full of great information on this emerging ACL injury treatment. You’ll finish this podcast with a deeper understanding of ACL injury management and Cross bracing plus practical knowledge, solutions and insights you can apply into your practice.

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