Podcast 13: Glaros Charilaos (Physiotherapist at Panathinaikos Basketball Team, Greece)
? In the thirteenth episode of “Thermography: Science, Health and Sport” we introduce Glaros Charilaos, physiotherapist at Panathinaikos basketball team, Greece.
? Glaros Charilaos offers us a very interesting testimony during our podcast about the application of thermography for Basketball’s daily routine. He brings an expert perspective about thermography in the applications of rehabilitation and on-field use of thermography in the decision-making process of the workload manage of his basketball team.
? Indeed, one of the most interesting statements from Charis Glaros is the one about how thermography can combine with clinical information to identify the best treatment to apply to athletes. In this sense, Charis Glaros explained us the way he uses it as a complementary testing tool during his evaluation process.
“I usually use thermography in cases where I have doubts in the diagnostic process, to confirm my clinical reasoning.”Glaros Charilaos
I: Hello everyone, welcome to our podcast about Thermography, Sports Science, and Health. We are very happy to have onboard today a very special professional so, “Kalimera” a Glaros Charilaos. Thank you for being here, good morning. Let me introduce you, Glaros. Glaros is a physiotherapist and he’s currently the head of Physiotherapist department at Panathinaikos BC basketball team and previously he has been in charge of the medical department, recovery department, and physical therapy department of various high-performance teams, mainly in basketball in different European leagues as UNICS Kazán and I’m very happy to have you on board because as we always try to do is to bring you the testimonials of different professionals that have been working with thermography in different disciplines and with different backgrounds, so thank you very much for being here Glaros.
G: I mean you know; the pleasure is mine because we started talking about this project many years ago and I was really happy to be able to use it and it is something that I’m really like, I really like its potential, I will like that changes so it makes me happy to talk about that that is added.
I: that´s exactly what we want, to share the normal conversations that we have and to share your experience, so actually, the first question is to know, when do you know about thermography?
G: I cannot really answer this question because it has been many years, maybe mainly I mean, right now 6-7 years ago I started to starting for to give examples for the medical department to become a doctor, and there was something inside you have to study physics and when I started studying on physics, there was something that has to do with this type of thermography that they use that it´s more specific to breast cancer as diagnostic methods and this was I mean… maybe the first time I thought that this is something in methods. I start searching about it, as such finding some studies, after that, I found some books, I start speaking with different people, not only with you, I mean, with other specialists, I was searching to buy a camera by myself anyway, and I mean I think this was a process. At first, you have some like a stimulus can, something that gives you full thoughts, and then you start searching so, this is why I think this is how basically.
I: Because we first met, I think, three years ago in 2018 or 2019.
G: 3-4 years ago.
I: But you are the kind of professional that I call, “early a doctor”, you really look for new things and you like to be open to innovation, right?
G: Yes, because to be honest, we met when I start using the thermography three years ago, but we have started to exchange emails a couple of years even before that, but I have to find myself how I am going to move in this field.
I: And since then, obviously you have been… because you purchase it on your own a camera which is quite I mean, is very interesting because obviously as a professional you were interesting not only in thermography but probably none of the technologies, and you decide to invest on your own and you start using that in UNICS Kazán, that’s correct? and since then, my second question, is how are you using thermography on a daily basis, in your routine?
G: I support, let’s say, that we’ve all without technology I mean at the same time or whatever it is new, you know that in the beginning maybe it can be a little bit confusing, because it does more information in the way that you are only thinking, but you evolve along with it so the way I was using it and I was understanding thermography 3-4 years ago, it is different than the way I’m understanding it now and of course this has not only to do with the fact that we have more studies about thermography but with the fact that you have more thinks about, more information about different things that has to do with physiotherapist because that´s my field. So for me, there are two different main ways to use thermography, there are obviously more but what has to do with an athlete and muscular-skeletal system. So, at the beginning of the season, I always make an evaluation that it is the initial valuation, and this is just a part of my screaming of the athletes at the beginning of the season. Along with this, I have so functional test that has to do with ROM, or endurance, evaluation of muscles, functions, and strength. I use some dynamometers to check the strength and this gives me in the initial evaluation, I combined all this and I’m trying to build a players profile to understand why he has this thermography picture although we know that one evaluation is not very valid and it cannot be very value, but in most of the cases it give you information and in most of the cases it is value, so I combined them, I created a profile of the player that has to do with his injury risk on the one hand, but mostly on how we can prevent his injuries in the future based on that, so this is the first part and this is a discussion I mean that it can never ends and on the second part, okey is something that is more obvious, before practice every day or maybe not every day but you know every second day time to do it every day or the players they come here I have a they had their everyday picture, I mean they got used to this you know, in the beginning they look at you a little bit like you are a strange but they get used to this if you explain them, they are happy to do it and actually base on that, because you are not always able you know to modify what you come out based on some information, I’m trying to modify their workload, let say in order to avoid any potential injuries, so these are the two big basic ways I think .
“I always make an evaluation that it’s the initial evaluation at the beginning of the season […] I combined it with other methods of measurement and I try to build a player profile to understand why he has this thermography picture […] and to created a profile that has to do with his injury risk ….”Glaros Charilaos
I: That’s very nice, because as you mentioned and I’m always asking this question because depending on the profile and depending on the main maybe the discipline every single professional is using the tool the way he thinks or they think is the better, so now the question is, this methodology that you are using with this baseline that you did you take at the beginning of decision and then the days daily routine, which part is the most interesting added value from thermography, which kind of information is for you the most interesting that is providing thermography for you?
BENEFICTS OF THERMOGRAPHY INFORMATION
G: Okay, so I already forgot I mean to mention that obviously, I should use thermography in case I have something that I’m not very sure about the diagnosis. I mean I have one case very, very close not long time ago that I was in between that something creative is coming from a tender or it´s coming from neurological issue and it looked to me more like a neurological issue but then the neurologist what´s telling no, we don´t have the basic symptoms and all this stuffs, but at the same time, even before taking the picture I have this feeling that has to do with this, but the thermography told me more than it was maybe something there. I know it was not working as it should be so instead of working in the area of the tendon only, I start working a little bit more in the area of the nerve and it was something that helps the athlete more, it looks like that or even you know in the recovery process when you make every step when you have a muscle strain or something like that, I always or most of the time I use the technology I mean, to help my evaluations, although OK if this is something that I think I can do it by myself you know, it’s experienced and if they should give you just one more confirmation that the more sure so this is a I already forgot to mention this will be four but the question was that what is for me the most impressive, the most how you express the question is?
I: the question is for you, what is thermography providing you that is adding value to your practice?
G: This is a very easy question. Except for all that already have mentioned. For me, it’s better to prevent an injury, I mean instead of rehabbing it or having to take it. Injury prevention it´s a huge field that is getting more and more and more valuable as we are progressing and in the future it will be even more so, one of the main ways to prevent injuries not prevent, reduce injuries, you cannot really prevent all kinds of injuries has to do with the workloads because according to the last intervention models, you cannot have an injury if you don’t have a workload and there is an ongoing conversation about workloads, about methods, GPS external workloads or internal workloads, but at the end of the day many of these methods they have been shown not work so good, fast and second, not be able to be specific for me, there is no internal workload method that it is specific, and thermography I would say maybe or probably is this method, I mean when you use it every day it is a method check the internal workload of the athlete even if she wants to tell you or if even if she wants to hide, because you know when we’re having this, the main methos has to do with internal workloads, with internal questions so they can change them a little bit and then they can modify them.
“For me, it´s better to prevent an injury, […] instead of rehabbing it […]”Glaros Charilaos
I: subjective, obviously.
G: This is a little less objective.
I: Okey, okay. And then then on the other hand the other question is obviously on and that’s where we like to be let’s say critical as well which factors from demography you considered like the worst which are the main limitations of the model field from your perspective OK in the patients do for sure it cannot be this specific yet I will tell we will get more and more specific ah maybe in the beginning and for the athletes delete to do it then still you are not sure when you see something if it was a whole process of normally because if you do it on your private practice you are more able to tell somebody who comes 15 minutes of acclimatation time, still you are not sure if it was something changes or something like that so, the main limitation I will tell that is that you are not so sure that you are following the process effetely so, not modify the results, not affect the results in the game, so for me which this is the main limitation because there are many times that I see something and I say OK, this is something that it’s not happening, and after that okey, you have an information but you are not sure about the information that´s telling you. I think this so far. if you know how to use it and leave you to give it the value that you want to buy it because somebody uses thermography. Using longer mean things that it will solve all the problem that hasn’t been given diagonals by itself and obviously has limitations, but this is the normally the limitations of the technology, so this is what I have seen in my practice more.
I: So Glaros, you have mentioned that for you there are three main applications, so the first evaluation that you build with other technologies to create this player profile and then obviously the daily routine to prevent the support diagnosis is in complicated cases, right? So, from these three main applications, do you remember any special cases where the thermography really helps you out to maybe prevent or to detect something that was significant or that you didn’t notice before?
G: A lot, how much time do I have to talk.
I: No, maybe it’s not one case at least that the typical case is where thermography really helps you out.
G: You know, one case, I mean, I already mentioned one case. Anyway, I had in my mind but fell more comfortable about that. What I like, I mean I really like about the injury prevention, I will answer also that you will never know if you really prevent an injury.
G: so I had an athlete that sometimes I saw something and I told coach let´s modifies this practice, he felt good with the modification and he was a little bit injured minor muscle injury but I have seen it. Actually because at the same time he had some lower back pain, he was not going to go as hard as he went, but you know in sports happens to change even during practice he wanted to help the team, the coach gave a good speech, he was OK I will do it and he has injured, I have seen this and maybe he will get injured, but you know you’re not always able to modify anything even in the software or maybe to see something that looks like he’s going to get injure and he doesn’t get injured, so you can never really know that you really prevented injury, okey. But in the initial evaluation, for me is very helpful to understand the way the players are moving and it is really interesting to see that especially you know, you take a picture, the pictures of the athletes, you take the medical history and you measure their strengths and while I am using thermography, the worldwide you start to understand this but this is my personal experience, I start to understand that as physiotherapists we are not good so far and we have faith so far in maintaining our athletes in the condition that they should repair after their injuries and I’m telling this, I’m very, very confident in this because you are able to see that most of the past injuries in athletes they are obvious in thermography, more muscle strength evaluation you are able to see if you either see a big difference on strength more than it should be, we’re talking about balance, all you are able to see increased in metabolisms in an area that it´s weaker.
“I start to understand that as physiotherapist we are not good so far and we have faith so far in maintaining our athletes in the condition that they should repair after their injuries. […] because you are able to see in thermography the most of the past injuries in athletes […]Glaros Charilaos
I: Very interesting.
G: So, you know, we do not wish you have always to make a summary in a rout to understand it what you see it has to do because he’s using the limb more or if it is because this part is weaker. There are even more complicated cases that he is using one limb more, maybe because of an old jury but in the other limb there is something injury and it´s also weak, so it is getting more increase metabolism in compared to the average, so you see that it is a full used more but you don’t see this asymmetry for example, in the quads because they are different, the opposite, the limb quad it´s compensating more, so we have more balance in your account and find the pattern but it is very, very interesting for me.
I: Another question it´s very interesting to me to know because obviously, we have been interviewing mostly people related to soccer, to football, also track and field but from basketball, you’re the first professional that is the interview and I would like to know, which are the most typical issues that you find? I mean in the upper body, lower body, muscle problems, bone problems, ligament problems, which are the typical issues that you find?
G: So most of the athletes, they have them with them, I mean you are able to see the previous injuries that they had, you are able to see them, so this has to do with previous muscle injuries because joint injuries maybe they’re not very precise in the ThermoHuman software, so you are not sure, you sometimes can see them, but sometimes there are more methods you know. You cannot find the typical injuries, you can see maybe they use more ankles, you can see from the ankle sprains that they have increased the temperature of the weak foot, you are able to see what it is also impressive for me you know, that after an ankle sprain there´s a pattern, after it we find the decreased stiffness of the gastrocnemius lateralis measures the stiffness not me, I mean the staff is measured the stiffness and they have seen that after an ankle sprain, lateral stiffness is increased which means for me that the gastrocnemius lateral is weak, so it has to compensate and it´s also that you are able to see on the thermography.
G: Many times, you are able to see them because I mean ankle sprains…
I: it’s something that it’s not just affecting the area but also it’s very interesting what you mentioned by the way.
G: Yeah, it is something that you see but you have to go or always you have to combine the information that you have, because sometimes we see the pain in a hot, cold area, or in the strong or weak area, so maybe this is what I should think and follow.
I: The last question that I wanted to do is, regarding the future, so as you mentioned at the beginning of the interview and obviously you are not using thermography the same way today as you did three years ago so, how do you see thermography in the future, which is the main let´s said in research line and application lines that should be explored?
FUTURE OF THREMOGRAPHY
G: This is a difficult question.
I: In other words, how do you see thermography in let’s say five years
G: You know, we all discussed this with me when I was in the physiotherapist school. I have read about blood flow restriction technology, I have some papers in other studies and after 15 years now, you see that 5% of the specialist are using it, so any new technology needs more and more time, so let´s say in the meantime what I see in the future for thermography it´s to be used by more people because there is a reason for me to use it in your everyday practice if you are able to, because not everybody is able to but if you are able, it will be used more and we will cut this because now I am thinking….
I: That’s good, no worries
G: How would be in the future? Okey, I start. There are a lot of studies coming more and more that they’re going to explain us the situations about the about how the body is reacting, that y you explain in your newsletter, you know that people they react differently, some of them get colder. These are more information coming again will help build more and better practice for me to understand why we’re doing things and understanding why you’re doing things. At the end of the day, every new method you know, you want MRI which is something that you can see a picture and it is supposed to be something very specific, needs many times to understand, you need a lot of data to put it in the pod so you will have a better result that will be more specific because the specificity and how accurate we are now, results in every diagnose method with the experience that we are getting from them so, this is something that the more that we have to value the more specific we will be able to be and we will be able to understand things, but that may be right now we are not able, I mean I see they’re doing studies about the tong temperature for example, or many people make it sound like in same but I have started a traditional Chinese medicine to understand that this is something that give us information and the more information we have, the more data we have, will have more specific and more accurate results and this is what I’m expecting, I’m sure that it will get some surprised that we are not thinking right now. The more adoption that will have will start getting better, you know. It is the same, tens myography which is opposed to being the best method for the injury you know, for evaluating the property of the muscle, they have data, they need data and data needs time and people and after you have data, you are able to use statistics and to know where we start and which direction you need to take in your practice. This is what I’m expecting, I’m trying to talk simply.
I: Is very nice because obviously so, the answers to those questions I tried to address the same questions always in the podcast and it’s very interesting and what the thing that is a very enriching and positive is, every single professional has a different approach and a different also perspective regarding the future so it is very interesting what you were mentioning an obviously I thank you very much Glaros for your time and your testimony.
G: This was my pleasure.
I: Thank you very much.
G: I mean, I like to talk about things that I like.
I: I like to speak with people like you that are using that on your daily basis and obviously things so, obviously when we do the training and we show the technology but the most interesting thing for me see how you have done your technology with your own method and your own approach and that’s there when it is really interesting so, thank you, thank you very much and we will keep in touch, thank you.
G: Yeah, for sure, for sure.
I: Bye, bye
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