Marcus Mangan

@DrJN_SportsMed @marklaslett_NZ So interesting. Thank you for sharing.

Consent ✅ Retired nurse, 60s Decade of flank / loin pain - perceived around thoracolumbar junction (blue cross) Extensive MSK, renal and GI investigations - no diagnosis forthcoming CT and MRI of spine reported normal On systematic palpation / PA glide in prone, her pain is actually provoked more inferiorly (green cross) POCUS video - calcific changes at 12 rib interface with spine, correlating with her pain - there is no true costotransverse joint at this level, rather ligamentous attachments- so this represents an enthesopathy / 'ligamentopathy' US guided LA & CSI - complete abolition of pain after 10 years! (see enthusiastic gyrating - sound on)

🌽 Husker Power… the MASTERY of strength & conditioning Boyd Epley is often thought of as the “godfather of strength & conditioning.” His program at Nebraska 4 decades ago changed the game & we can STILL learn from it Here, he details some of his speed development tools

🚨 Biomechanical & neuromuscular performance requirements of horizontal deceleration… 📌 High Impact Forces ⚡️ (2.7 x ⬆️ than acceleration) 📌 Braking for Rapid COD 🔑 📌 High Eccentric Muscle Forces 🟰 Risk of Damage 📌 Braking Kinematics 🦵 🔐 link.springer.com/article/10.100…

Speed isn’t built in one lane… You need exposure across the entire load–velocity spectrum, from true max velocity work to heavy strength, each serving a different adaptation. Most programs overemphasize one end and ignore the rest. Inside Speed Kills, I break down

🚨 BRAKING step forces in a 505 change of direction test (high speed deceleration) Here we show data on ALL braking steps… 🔎 Brake Step 1 🔎 Brake Step 2 🔎 Brake Step 3 🔎 APBS 🔎 PBS 🔎 FFC Forces highest in early braking steps!! Read here: link.springer.com/article/10.100…

@DrJN_SportsMed So interesting as always. Thank you for sharing.

Consent ✅ Runner - Relative Energy Deficiency in Sport (REDS) and prior eating disorder High grade calcaneal stress fracture (with almost completed fracture line) - see MRI image Immobilised in Aircast boot (ACB) for prolonged period based on persistent heel pain, despite follow up MRI showing appropriate healing and regression of bone marrow oedema Patient adamant nature and location of pain now different Now - burning, ‘horseshoe shape’ around heel and radiating into lateral plantar foot (see patient's pain map; red - medial, blue - lateral) Finally, out of AirCast boot and off crutches after third MRI - but pain persisting on return to longer walks and jogging Found amitriptyline helpful in modifying what is clearly neuropathic pain in the interim OE - Calcaneal squeeze negative Tinel’s along lateral plantar nerve (LPN) and anteromedial heel (Baxter’s nerve (BN) inferior calcaneal nerve course) very provocative Images from first MRI (axial T2s) show LPN oedema and possibly BN which are immediately adjacent to the areas of calcaneal periostitis and inflammation POCUS video of hydrodissection with low potency soluble dexamethasone and local anaesthetic (note - LPN thickened at point of maximal tenderness, provoked with hockey stick probe pressure) As injecting – “Ouch! that’s the exact pain I’ve been having” At follow up pain intensity reduced by 60-70% despite tentatively weaning off amitriptyline For second hydrodissection, this time with 5DW

@SmallerFishGAA When you jump & lose your footing without reason it's called play acting, credit to the ref for not falling for it.

82 nóim @DingleGAA 0-23 @StBrigidsRos 1-19 Mikey Geaney leis an iarracht agus Geaney leis an scór chun an chluiche a bhuacaint!😱🤯🤝 After a titanic battle, Dingle are All Ireland Club Champions after extra time!! BEO/LIVETG4 AR @TG4TV 📺 #GAABEO

🚨NEW PAPER🚨 Resisted sprint training🏃‍♀️, FINALLY (was about time) a detailed meta addressing LOAD as a key variable: as for 🏋️‍♀️, "resistance training" means nothing without this nuance💡 Great team🤝work by @Xukai382031 From now on, a reference paper✅ researchgate.net/publication/39…

Hamstring injuries in multi-directional speed sports...not all SPRINT related❗️ ⚽️ 31 % Braking Stopping 🏉 18% Decelerating 🔎 Trunk & hip flexion with knee extension 🟰High eccentric strain Braking movements with high eccentric force could be tools in hamstring injury ⬇️

@DrJN_SportsMed Thanks for sharing. I suspect I have a client that may be similar. Would love to send him your way if that would be possible?

Consent✅ - this is a beauty 🤓 Elite runner Crampy, aching lateral knee pain - onset at around 20-30 mins Seen multiple clinicians - had numerous injections including ITB plus extensive rehabilitation - refractory Almost 'claudicant' in nature - settles quickly on cessation of exercise - spreads both proximal & distal to lateral joint line No spinal symptoms & LSp assessment clear No lateral compartment pathology eg meniscal tear Had popliteus tendinopathy on US, but minimal response to my initial diagnostic injection POCUS video - The inferolateral genicular neurovascular bundle ('pepper pot' structure) is seen compressed under the distal ITB on active knee flexion : terminal extension Patient localises pain in this area with probe pressure Injection - hydrodissection (CSI, LA) - fluid seen separating plane just superficial to NV bundle 100% pain relief on extended treadmill test beyond 45 mins 👍 I wonder how many recalcitrant 'ITB' cases are actually neurovascular in aetiology? 🧐 Plan - considering angiography, MR neurography & possible distal ITB release at Gerdy's tubercle if not responsive to injection

Paul Geaney’s leadership today was a template for every player. In the swell of the Bars’ surge, he stood up and asked for the ball. Took his goal with certainty, took his knocks without pause. Patched up, back on, and never once hid from the moment. A leader in the truest sense, present, persistent, unshakeable.

For the people at the back - 1. Distance runner with ramp in load +/- REDS risk factors 2. Positive hop test 3. Positive FADDIR 4. Weak / painful on iliopsoas testing This is 99.9% likely to be a neck of femur stress injury IT ISN'T A TIGHT HIP FLEXOR

💪 Deep squats = stronger legs & happier knees! A 10-week RCT found that full-depth squats led to greater strength, jump, and sprint gains — while half squats caused more stiffness & knee pain 😬 👉 Go deep, not half-hearted! pubmed.ncbi.nlm.nih.gov/31092132/

Great to see proofs of our latest manuscript.. Assessing Deceleration Performance: Methodological & Practical Considerations 📌In past, focus on assessing acceleration & max velocity capabilities 📌Evolution of sports,⬆️necessity to DECELERATE & assess this movement skill👇

Consent ✅ Footballer - ACL recon & MCL tear 12 months ago Uneventful rehab process & RTP ...... but then developed focal pain over medial joint line & restricted flexion Sore on side passing & cutting / change of direction drills OE - Palpation pain at proximal MCL Stiff & painful into EROM flexion MRI - no medial pathology reported - but on closer inspection, subtle medium signal focal change in deep MCL on T1 & T2 (always check the scan yourself) POCUS - obvious large heterotopic calcific deposit in previously injured proximal MCL fibres - Pelligrini-Stieda lesion Video - needle barbotage / fenestration of deposit, finished with a soupçon of CSI 🫰 Post procedure, complete abolition of pain in gym & typical provocative movements ✅ Ultrasound is much better than MRI in identifying calcific pathology (as is plain x-ray)

Brentford are one of a handful of Premier League clubs who use wearable devices like ours to monitor their players in-game, rather than rely on optical tracking camera data. But why? And does it matter? First thing’s first - likely habit. The likes of Brentford and Brighton were promoted from the Championship where they wore devices in training AND games every week, as not every stadium has optical tracking set up. But there’s a little more to it than just habit. Especially with Brentford (and Brighton) being data-led clubs. By using athlete monitoring during games, Brentford’s analysts get something important that most clubs don’t: data continuity, and in-game physical performance data. The data captured on matchday is identical to what’s captured in training. Same hardware, same sampling rate, same thresholds. That means they can directly compare performance metrics across every session, every fixture, and every player. No need for time-consuming regression analysis post-game when the OTD comes in. In practical terms, that consistency changes everything. It means all physical data sits on one unified dataset and database. That allows staff to more easily spot subtle shifts in a player’s physical output, which may impact player availability. It also allows the clubs to build proprietary algorithms of their own across a range of different levels from injury prevention to talent ID. And with live STATSports beacons installed at the Gtech Stadium, those GPS units connect automatically on matchday. That means coaches can view live data on their iPads - monitoring work rate, intensity, and spotting potential fatigue as it happens. So instead of relying solely on the eye or post-match reports, they can make informed in-game calls: when to rotate, when to push, when to protect. Over time, that level of consistency and accuracy builds a true performance model. It helps them understand what “Premier League intensity” really looks like for their style of play. It informs player development, return-to-play timelines, and even recruitment, ensuring new signings can meet the physical demands of Brentford’s system. So yes, it matters. That’s what being data-led actually looks like.

2x Olympic champion and former world record holder Eliud Kipchoge teases that he will have a “huge announcement” on Sunday after the New York City Marathon. Olympics.com reported that New York would be the final elite marathon of his career. He did not confirm or deny it today when asked by @jgault13. On Sunday, Kipchoge will complete the original six World Marathon Majors. He has won in London, Berlin, Chicago and Tokyo.

LET Thursday! Combined ACLR and LET demonstrates a decreased risk for revision ACLR without an increased risk for complications compared to patients treated with isolated ACLR. #ACLR #LigamentReconstruction ow.ly/3a7050Xab0i