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The William Harvey Research Institute - Barts and The London

Professor Nat Padhiar

Nat

Consultant Podiatric Surgeon

Centre: Sports and Exercise Medicine

Email: n.padhiar@qmul.ac.uk
Telephone: +44(0) 20 8504 4546

Profile

Prof Nat Padhiar completed an MSc at University of East London in 1989 and a PhD in 1998 at Queen Mary, University of London. He is a Consultant Podiatric Surgeon currently working in the private sector having held a substantive NHS post at The Royal London Hospital until 2011. He joined the academic department of sports medicine in January 1989 and most recently appointed Honorary Clinical Professor of Podiatric Sports Medicine in the Centre for Sports & Exercise Medicine (CSEM), William Harvey Research Institute, Queen Mary University of London (QMUL). He is the course lead for Podiatric Sport Medicine (PSM) within Sports and Exercise Medicine (SEM) at QMUL, comprising of an inter-disciplinary team.

He is a keen sportsman continuing to play cricket, tennis and taking part in endurance sport (35 marathons). In his professional capacity he has been part of the medical team and has attended World Student Games (1991), Commonwealth Games (2002), Island Games (2003), Everest Marathon (1993,1995), Mongolian Sunrise to Sunset Marathon (2001-2003), Daily Telegraph/British Brain & Spine Foundation London Marathon Team (1999-2007), London Triathlon (2005) and London 2012 Olympic & Paralympic Games (2012).

Research

Group members

Prof Dylan Morrissey, Dr Simon Lack, Dr Stuart Miller, Mr Trevor Prior, Dr Manuela Angio, Dr Nikos Malliaropoulos, Dr Katrine Kryger, Mr Ian Griffiths, Dr Gemma Pugh, Dr Dev Pyne, Dr Angela Pakozdi, Dr James Sarkodieh, Dr Saira Chaudhry, Dr Brad Neil, Mr Zubair Haleem, Dr Roger Wolman, Dr Catherine Lester.


Summary

The main focus of his research is in the clinical field with innovations, development of validated questionnaires and challenging current concepts. The delivery model is one of small scale proof of concept studies, often involving students as co-researchers, leading to dissemination of findings through publications and various conferences. His particular focus of research has been in exercise-induced leg pain and Achilles tendinopathy. Innovation has included novel diagnostic, measurement, and management approaches through to award-winning contributions e.g. BASEM Gold Medal and papers in top ranked journals e.g. BJSM, BMJ, CJSM. He is regarded as a world leader in the field of Chronic Exertional Compartment Syndrome and he is currently collaborating with clinical researchers in Germany, Spain, Greece, Malta, and Australia.

His publications include 47 peer reviewed papers, 11 non-peer reviewed papers, 7 abstracts, 3 chapters in SEM books, 1 guest edited SEM journal and, 1 Co-edited a major textbook (in-press due June 2020).

He has presented in well over 250 conferences since 1993, in various cities in UK & USA and, 22 other countries. They were all by invitation with no financial inducement. These presentations do not include teaching and lecturing at various academic institutions in UK but mainly in London.

Key Publications

1. Lohrer H, Malliaropoulos N, Korakakis V, Padhiar N. Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies. Phys Sportsmed. 2019 Feb;47(1):47-59.

2. Leung R, Malliaropoulos N, Korakakis V, Padhiar N. What are patients' knowledge, expectation and experience of radial extracorporeal shockwave therapy for the treatment of their tendinopathies? A qualitative study. J Foot Ankle Res. 2018 Apr 5;11:11.

3. Malliaropoulos N, Bikos, G, Meke M, Korakakis V, Valle, X, Lohrer H, Maffulli, N, Padhiar N. Higher frequency of hamstring injuries in elite track and field athletes who had a previous injury to the ankle - a 17 years observational cohort study. Journal of Foot and Ankle Research (2018) 11:7,1-8.

4. Malliaropoulos N, Ghrairi M, Al Hashimi M, Padhiar N. Inspiring excellence in musculoskeletal sports medicine. Br J Sports Med 2017;51:1575.

5. Thompson D, Malliaropoulos N, Padhiar N. Sesamoid osteonecrosis treated with radial extracorporeal shock wave therapy. BMJ Case Rep. 2017 May 22;2017.

6. Chan O, Havard B, Morton S, Pritchard M, Maffulli N, Crisp T, Padhiar N, Perry JD , King JB, Morrissey D. Outcome of prolotherapy in intra-tendinous Achilles tears - a case series. Muscle Ligament Tendon J.,2017;7(1):78-87.

7. Chan O, Morton S, Pritchard M, Parkes T, Malliaras P, Crisp T, Padhiar N, Maffulli N, King JB, Morrissey D. Intra-tendinous tear of the achilles tendon – a new pathology? Analysis of a large 4 year cohort. Muscle Ligament Tendon J.,2017;7(1):53-61.

8. Abdulhussein H, Chan O, Morton S, Kelly S, Padhiar N, Valle X, King JB, Williams S, Morrissey D. High Volume Image Guided Injections with or without Steroid for Mid-portion Achilles Tendinopathy: A Pilot Study. Clin Res Foot Ankle.2017,5:3. DOI: 10.4172/2329-910X. 1000249.

9. Malliaropoulos N, Ghrairi M, Zerguini Y, Padhiar N. Soft tissue injuries are still a challenge in musculoskeletal sports and exercise medicine. Br J Sports Med 2016;50:1487.

10. Chatterjee R, Malliaropoulos N, Padhiar N. Diagnosis and management of plantar plate tear in an elite 400m hurdler. J. Musculoskelet. Res,2016,19(2),1672002.

11. Malliaropoulos N, Jury R, Pyne D, Padhiar N, Turner J, Korakakis V, Meke M, Lohrer. Radial extracorporeal shockwave therapy for the treatment of finger synovitis (trigger digit).Open Access Journal of Sports Medicine,2016,7,143-151.

12. Malliaropoulos N, Crate G, Meke M, Korakakis V, Nauck T, Lohrer H, Padhiar N. Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy: A Retrospective Study. Biomed Res Int. 2016;2016:9415827.

13. Alagha B, Padhiar N. Partial tear of plantar fascia in a professional dancer. J. Musculoskelet. Res. 2015,18,1572001,[5 pages] DOI: 10.1142/S021895771572001X.

14. Korakakis V, Malliaropoulos N, Baliotis K, Papadopoulou S, Padhiar N, Nauck T, Lohrer H. Cross-cultural Adaptation and Validation of the Exercise-Induced Leg Pain Questionnaire for English- and Greek-Speaking Individuals. J Orthop Sports Phys Ther. 2015 Jun;45(6):485-96.

15. Nauck T, Lohrer H, Padhiar N, King JB. Development and validation of a questionnaire to measure the severity of functional limitations and reduction of sports ability in German-speaking patients with exercise-induced leg pain. Br J Sports Med. 2015 Jan;49(2):113-7.

16. Malliaropoulos N, Korakakis V, Christodoulou D, Padhiar N, Pyne D, Giakas G, Nauck T, Malliaras P, Lohrer H. Development and validation of a questionnaire (FASH--Functional Assessment Scale for Acute Hamstring Injuries): to measure the severity and impact of symptoms on function and sports ability in patients with acute hamstring injuries. Br J Sports Med. 2014 Dec;48(22):1607-12.

17. Aweid O, Gallie R, Morrissey D, Crisp T, Maffulli N, Malliaras P, Padhiar N. Medial tibial pain pressure threshold algometry in runners. Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1549-55.

18. Pegrum J, Crisp TA, Padhiar N. Diagnosis and management of bone stress injuries of the lower limb in athletes. BMJ (Clinical research ed.). 01/2012; 344:e2511.

19. Papalada A, Malliaropoulos N, Tsitas K, Kiritsi O, Padhiar N, Del Buono A, Maffulli N. Ultrasound as a primary evaluation tool of bone stress injuries in elite track and field athletes. Am J Sports Med. 2012 Apr;40(4):915-9.

20. Aweid O, Del Buono A, Malliaras P, Iqbal H, Morrissey D, Maffulli N, Padhiar N. Systematic review and recommendations for intracompartmental pressure monitoring in diagnosing chronic exertional compartment syndrome of the leg. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 05/2012; 22(4):356-70.

21. Pegrum J, Crisp T, Padhiar N, Flynn J. The pathophysiology, diagnosis, and management of stress fractures in postmenopausal women. Phys Sportsmed. 2012 Sep;40(3):32-42.

22. Crisp TA, King JB, Chan, Padhiar N. Crisp-padhiar syndrome. Br J Sports Med 2011;45:e1.

23. Davis A, Pemberton T, Ghosh S, Maffulli N, Padhiar N. Plantar pressure of clipless and toe-clipped pedals in cyclists - A pilot study. Muscles Ligaments Tendons J. 2011 Oct 30;1(1):20-4.

24. Curtin M, Crisp T, Malliaras, Padhiar N. The effectiveness of prolotherapy in the management of recalcitrant MTSS: a pilot study. Br J Sports Med. 2011,45(2),e1-e1.

25. Padhiar N, Jones PR, Curtin M, Malliaras P, Chan O, Crisp TA. The effectiveness of prolotherapy for recalcitrant medial tibial stress syndrome: a prospective case series. British journal of sports medicine. 12/2011; 45(15):A16.

26. Zhang JM, Bader D, Twycross-Lewis R, Padhiar N. A prospective cohort study of vertical pressure on hands of sitting volleyball players using Tekscan pressure mat. Br J Sports Med. 2011,45(2),e1-e1.

27. Divani K, Chan O, Padhiar N, Twycross-Lewis R, Crisp T, Morrissey D, Maffulli N. Site of maximum neovascularisation correlates with the site of pain in recalcitrant mid-tendon Achilles tendinopathy. Manual therapy. 10/2010; 15(5):463-8.

28. Tsintzas D, Ghosh S, Maffulli N, King JB, Padhiar N. The effect of ankle position on intracompartmental pressures of the leg. Acta Orthop Traumatol Turc. 2009 Jan-Feb;43(1):42-8.

29. Padhiar N, Allen M, King JB. Chronic exertional compartment syndrome of the foot. Sports medicine and arthroscopy review. 10/2009; 17(3):198-202.

30. Humphrey J, Chan O, Crisp T, Padhiar N, Morrissey D, Twycross-Lewis R, King JB, Maffulli N. The short-term effects of high volume image guided injections in resistant non-insertional Achilles tendinopathy. Journal of science and medicine in sport / Sports Medicine Australia. 11/2009; 13(3):295-8.

31. Padhiar N, Al-Sayeagh H, Chan O, King JB, Maffulli N. Pennation angle of the soleus in patients with unilateral Achilles tendinopathy. Disability and rehabilitation. 06/2008; 30(20-22):1640-5.

32. Crisp T, Khan F, Padhiar N, Morrissey D, King JB, Jalan R, Maffulli N, Chan O. High volume ultrasound guided injections at the interface between the patellar tendon and Hoffa's body are effective in chronic patellar tendinopathy: A pilot study. Disability and rehabilitation. 06/2008; 30(20-22):1625-34.

33. Chan O, O'Dowd D, Padhiar N, Morrissey D, King JB, Jalan R, Maffulli N, Crisp T. High volume image guided injections in chronic Achilles tendinopathy.Disability and rehabilitation. 06/2008; 30(20-22):1697-708.

34. Sharma P, Padhiar N, Kyriakides C. Popliteal cystic adventitial disease causing intermittent claudication in a young athlete: a case report. Southern medical journal. 12/2008; 101(11):1154-6.

35. Tzortziou V, Maffulli N, Padhiar N. Diagnosis and management of chronic exertional compartment syndrome (CECS) in the United Kingdom. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 06/2006; 16(3):209-13.

36. D Pyne, A S M Jawad, N Padhiar. Saphenous nerve injury after fasciotomy for compartment syndrome. British journal of sports medicine. 01/2004; 37(6):541-2.

37. Birtles DB, Rayson MP, Jones DA, Padhiar N, Casey A, Newham DJ. Effect of eccentric exercise on patients with chronic exertional compartment syndrome. Eur J Appl Physiol. 2003 Feb;88(6):565-71.

38. Jawed S, Jawad AS, Padhiar N, Perry JD. Chronic exertional compartment syndrome of the forearms secondary to weight training. Rheumatology (Oxford). 2001 Mar;40(3):344-5.

39. Padhiar N, King JB. Foot orthoses can change compartmental pressures in the leg. BJSM. 1998;32(1).

40. McGuinness M, Padhiar N. Necrobiosis lipoidica diabeticorum. The Foot. 1997;7(1); 47–51.

41. Crisp TA, Padhiar N, King JB, Allen M, Barnes M. Compartment syndrome of the lower leg – Underwater hockey. J Med & Sci in Sports & Exercise.1997;29(5),S233.

42. Padhiar N, Bader D, King JB. A pilot study to identify pathomechanical factors in exercise induced leg pain. JBritPodMed. 1997;52(1),3-8.

43. Lee S, Padhiar N, Barker JR. Delayed presentation and ultrasonography evaluation of a false aneurysm following acute trauma to the ankle. The Foot. 1997;7,174-175.

44. Padhiar N, King JB. Exercise induced leg pain-chronic compartment syndrome. Is the increase in intra-compartment pressure exercise specific? Br J Sports Med. 1996 Dec;30(4):360-2.

45. Sandhu MA, Khan F, Padhiar N. A benign solitary Schwannoma in the foot. JBritPodMed. 1995;50(7),105-106.

46. Padhiar N, Bristow W. Autonomic Dysrelexia – a serious consideration in Podiatry, illustrated by 2 case histories. JBritPodMed. 1995;50(6),89-90.

47. Padhiar N, King JB. An overview of chronic compartment syndrome: commonest exercise induced leg pain in young athletes. JBritPodMed. 1995;50(4),50-53.

48. Padhiar N, Cowley E, Prior TD, Rome K. Roundtable discussion - plantar heel pain. Podiatry Now. 2016,19(3):18-23.

49. Nikos M, Valle X, Tsapralis K, Lohrer H, Padhiar N, Maffulli N. My experience from ECOSEP Bauerfeind Travelling Fellowship 2013. Muscles Ligaments Tendons J. 2014 Feb 24;3(4):359.

50. N Padhiar, D Pyne. Guest Editors of the Special feature of BASEM Today, 2013, Issue 25, winter.

51. Morton S, Crisp, T, Morrissey, D, Chan, O, Padhiar, N. Autosomal dominant type 2 accessory navicular: a family of crisp-padhiar syndrome? SportEX Medicine. 2012,52, p7-11.

52. Padhiar N, Acharya N, Chan R, Divani K, Chan O, Crisp O, Goodier WD, Jalan R, King JB, Morrissey, Maffulli N, Webborn N. Achilles tendinopathy Part 1 – Pathophysiology and Clinical features. SportEX Medicine.2010,45(7),23-30.

53. Padhiar N, Acharya N, Chan R, Divani K, Chan O, Crisp O, Goodier WD, Jalan R, King JB, Morrissey, Maffulli N, Webborn N. Achilles tendinopathy Part 2 – Management. SportEX Medicine.2010,46(10),6-10.

54. Padhiar N. Chronic Compartment Syndrome of the leg. SportEX Medicine.2009;40(4),16-22.

55. Padhiar N. The biomechanics of gait and running. SportEX Medicine.2000;4(4).

56. Padhiar N, Morrissey D. Leg and related ankle injuries – a differential diagnosis. SportEX Medicine.2000;4(4).

57. Padhiar N. Foot orthoses and their role in injury prevention. SportEX Medicine.2001;8(4).

58. Padhiar N. Injuries to the foot in endurance sport. SportEX Medicine.2001;8(4).

59. Dixit V, Pegrum J, Padhiar N, Nugent I. The new algorithm for the management of stress fractures of the foot. Osteoporosis International,2018,29,S561-S561.

60. Morton S, Chan O, Pritchard M, Parkes T Malliaras P, Maffulli N, Crisp T, Padhiar N, King JB, Morrisey D. 70 Intratendinous tears of the achilles tendon- A new pathology? Br J Sports Med,2014,48(2),A45-A46.

61. Malliaropoulos N, Padhiar N, King JB, Maffulli N. The effect of physical exercise on musculo-skeletal metabolism: a systematic review of the role of rank/rankl/opg pathway. British journal of sports medicine 07/2013; 47(10):e3.

62. G Schiffer, O Chan, R Jalan, N Padhiar. Retrospective review of injection therapy in Morton's neuroma. British journal of sports medicine 07/2013; 47(10):e3.

63. Keramaris N,Malliaropoulos N, Padhiar N, King JB, Maffulli N. The effect of physical exercise on musculoskeletal metabolism: A systematic review of role rank/rankl/opg pathway. Br J Sports Med,07/2013, 47(10)e3-e3.

64. Malliaropoulos N, Padhiar N, King JB, Maffulli N. The effect of physical exercise on musculo-skeletal metabolism: a systematic review of the role of rank/rankl/opg pathway. British journal of sports medicine 07/2013; 47(10):e3.

65. Malliaropoulos N, Ritsioudi M, Finellis V, Padhiar N, Maffulli N. Dynamic foot pressure measurements in elite track and field athletes. British journal of sports medicine 07/2013; 47(10):e3.

 

Published books and chapters in books/textbook

 

1. Chan O, Crisp TA, Padhiar N, King JB, Maffulli N. 2010. Conservative management of tendinopathy of the main body of the achilles tendon with high volume image guided injection (HVIGI). In: Calder J, Karlsson, Maffulli N, Thermann, Niek van Dijk C. ed. Achilles Tendinopathy-Current Concepts.Surrey,UK: DJO Publications, 119-130. ISBN:978-0-9558873.

2. N Padhiar, D Pyne. Guest Editors of the Special feature of BASEM Today, 2013, Issue 25, winter.

3. Padhiar N, English B. Podiatric Medicine & Surgery; In Oxford Textbook of Musculoskeletal Medicine; Hutson M, Ward A (2nd Ed),492-514; New York, USA, Oxford University Press; 2016. ISBN 978-0-19-967410-7.

4. English B, Padhiar N. Biomechanics of the foot; In Oxford Textbook of Musculoskeletal Medicine; Hutson M, Ward A (2nd Ed),458-468; New York, USA, Oxford University Press; 2016. ISBN 978-0-19-967410-7.

5. Burrow G, K Rome, N Padhiar. Neale’s Textbook - Disorders of the Foot 9th Edition, 2017-2019. ISBE 978-0-702-06223-0.

Collaborators

Prof Heinz Lohrer (Germany), Dr Nikos Malliaropoulos (Greece), Dr Xavier Valle (Barcelona), Prof Nicola Maffulli (Italy/UK) and Dr Kirill Micallef Stafrace (Malta), Prof Scott Wearing (Australia).

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