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Let’s get physical! It’s ‘Physical activity for life’ today on World Physiotherapy Day 2017

8 Sep, 17 | by atarazia

The Physical Activity and Population Health BJSM Blog Series 

By Sonia Cheng (@soniawmcheng)

Today, September 8 is none other than World Physiotherapy Day, and this year the World Confederation of Physical Therapy (WCPT) is celebrating the profession with the message ‘Physical activity for life’. This message builds on the World Health Organisation’s call for global efforts to reduce physical inactivity by 10% by 2025, and highlights the critical role played by physiotherapists in keeping people active.

Emma Stokes, President of the World Confederation for Physical Therapy, lends us her thoughts on how the physiotherapy profession can promote physical activity through the years and in the wider community.

Sonia Cheng (SC): Emma, we used to think that increasing physical activity was just a matter of “If you can move more, you will move more”. Then both clinical trials and clinical experience started to show us that you could not simply address pain, dyspnoea, or impairments in strength and mobility in isolation. Physical activity is a behaviour, and it is a complex behaviour. How do physiotherapists start to tackle this issue in everyday practice?

Emma Stokes (ES): Regardless of the reason why a person attends a physiotherapist, it represents an opportunity to have a conversation about physical activity. It’s important to be curious about how that person is meeting physical activity recommendations.

SC: Do you think it should become standard care for physiotherapists to set activity goals with their patients with respect to minutes of moderate-vigorous intensity physical activity per week, for example, or steps per day?

ES: It’s not necessarily about being prescriptive about practice, it’s more about raising awareness and exploring solutions to promote healthy levels of exercise and activity. This is a key responsibility for us as a profession as we respond to the challenges facing our communities in living active and healthy lives.

SC: What are some of the steps we can take as a profession to address physical inactivity on a population scale?

ES: World Physiotherapy Day 2017 is one component of the rich tapestry of solutions needed to promote physical activity across the lifespan and in all communities. As part of this year’s theme, the WCPT has a wonderful range of educational resources about the health benefits of physical activity. We also unpack the concept of metabolic equivalents (METs), and try to give examples of how different activities at different intensities can be combined over the course of a week to reach health-enhancing physical activity levels.

SC: How else can we get involved on our special day?

ES: Physiotherapists around the world can organise events in their workplaces and communities to promote “Physical activity for life”. We also come together on social media – last year, we had a rolling tweetchat across the twenty-four hours and three different time zones. See what celebrations and events have been organised in the past. The challenges of enhancing physical activity are enormous, and the solutions will require multifarious collaboration and coordination. World Physiotherapy Day is just one way the global physiotherapy community can come together to advocate for and celebrate our role in promoting health.

Well, you heard Dr Stokes. Get physical on September 8: discuss the physical activity guidelines with your patients and clients, put up posters in your workplace, check out the WCPT toolkit for some great resources about moving more and moving better.

Happy World Physiotherapy Day to all!

We invite you to share and support the Physical Activity and Population Health BJSM Blog Series. Join the conversation on ‘how change happens’ at #PAblogBJSM and #brightspotsBJSM.

If you have ideas for this series please contact: emmanuel.stamatakis@sydney.edu.au

Sonia Cheng graduated from The University of Sydney with a Bachelor of Applied Sciences (Physiotherapy) (Honours Class I) in 2014. Sonia is currently employed as a physiotherapist with Royal Prince Alfred Hospital and Westmead Hospital in Sydney. 

World Sports PT Team Concept Conference in Las Vegas: much more than gambling!

24 Jan, 17 | by BJSM

By Mario Bizzini

The notorious slogan “What happens in Vegas stays in Vegas” certainly did not apply for the recent Team Concept Conference, which was held in the renowned resort city in Nevada, US. Please just re-live the Twitter buzz on #TCC2016 to get a feeling of three exciting days (December 1 to 3, 2017) when over >400 participants gathered at the Planet Hollywood Hotel.

For the 2nd time since 2012, this Sports PT congress was a joint cooperation between the Sports Physical Therapy Section (SPTS) of the American Association of Physical Therapy (APTA) and the International Federation of Sports Physical Therapy (IFSPT). SPTS dedicated the first day to a Golf Symposium with several US speakers such as Mike Voight, Lance Gill (both involved with the Titleist professional golfers), Russ Paine (former PT of the Houston Rockets) and Sue Falsone (the first women to hold an Head ATC/PT position in US professional sports with the LA Dodgers). These speakers provided excellent presentations of developments in testing and treating golfers; one clear innovation is the sophisticated biomechanical swing analysis systems now readily available.

Loading tissue for prevention and repair

The two main days of TCC featured several American and international speakers, covering lectures, debates and several courses & workshops. Karin Silbernagel (Sweden, and Delaware University, US) and Kristian Thorborg (Denmark) delivered an excellent overview on “Eccentrics or concentric exercise: is one better?” While Kristian illustrated the evidence behind the eccentric exercise to prevent and treat muscle injury (Nordic hamstring and Askling’s protocols), Karin stressed the importance to promote tendon healing (and reduce symptoms) by improving strength/endurance and function (using the different contraction types). Two particularly memorable quotes are: “Just handing out an eccentric exercise program is not appropriate” in tendinopathy, and it’s “time to focus on adjusting loading dose” individually to the specific tendon injury” (so Karin words).

ACL prevention – an uptake/compliance problem?

Holly Silvers (Santa Monica, US) and Mario Bizzini (Switzerland) summarized more than 20 years of research and dissemination of injury (focus on ACL) prevention (with programs as PEP, and 11+). The programs work! But we’d like to see more uptake by coaches. It seems the word has not reached all Sport PTs. Some audience members suggested that there may be a tendency for some clinicians to jump on “new” trends rather than to apply “old” evidence-based knowledge on injury prevention…

Return to play

Kevin Wilk (Birmingham, US), also among the authors of the BJSM Consensus paper on Return to Play, reinforced how the athlete who has been rehabilitated after ACL injury must be ready both physically and psychologically before returning to compete. The need to have valid/reliable sport specific (possibly also “position-specific” for team sports) is crucial, and there’s still “a long way to go on this”…

The former Wales Rugby professional player and now extreme environment athlete Richard Parks gave an inspirational talk on his rehab and training for extreme challenges. He also discussed his 15+ years work with his sports PT Nicola Phillips (Cardiff University, Wales, IFSPT President).

The last day of TCC saw a firework of stellar presentations in a special International Federation of Sports PT (IFSPT) Symposium “Return to Play” moderated by Mario Bizzini and based on the Bern 1st World Conference (2015) and on the BJSM Consensus paper published earlier this year.

It featured Nicola Phillips, Phil Glasgow (Northern Ireland), Clare Ardern (Australia, Sweden now), Kristian Thorborg , Karin Silbernagel  and Brandon Schmitt (US) in this together with Luciana de Michelis and Felipe Tadiello (Brazil), who were invited to present about the sport PT experiences at the Summer Olympics and Paralympics Games in Rio de Janeiro. This was the perfect occasion to welcome the Brazilian Sports PT Group (SONAFE) as the new Member Organization of IFSPT (Brazil being at the moment the only South American society among the 25 countries in IFSPT).

Clare Ardern underscored how much the mind matters in RTP, and that quality rehabilitation/training for an athlete should optimally comprise physical, psychological, social, tactical and technical aspects. Both questionnaires and performance tests should be evidence-based and relate to the athlete’s sports (the interdisciplinary cooperation with athletic trainers, coaches is therefore crucial). Kristian Thorborg highlighted-in his classical talk on RTP after groin injuries, that the “Copenhagen five-second squeeze test”, can add value in decision-making when dealing with athletes suffering from groin problems. (That paper was published online first in BJSM just a few days prior to TCC). Brandon Schmitt highlighted the lack of evidence for the use of MRI in the clinical exam of muscle injuries, and presented an interesting new approach in mapping the area of tenderness, which may help in determining the time to RTP after hamstring strain (this is an ongoing study at Scarsdale High School, NY).

These were just some pearls from #TCC2016, where interestingly –but not surprisingly-BJSM publications were often used as key references in several presentations. Maybe a Socrates citation (brought up by Kristian Thorborg) illustrates at best the spirit of this conference: “I cannot teach anybody anything, I only make them think”…

It has been a truly International Sports PT conference in Las Vegas, and yet another important step towards Belfast 2017, place of the 2nd World Congress of Sports Physical Therapy (October 6-7, 2017)!

*****

Mario Bizzini, Zürich, Switzerland, IFSPT Executive Board Member, BJSM Deputy Editor

 

BJSM Podcasts – a year in review

9 Dec, 15 | by BJSM

joint-inflammation

Fridays are good days. We hope BJSM podcasts add to that feeling.

2015 marked an exciting year for sports physio / sports medicine podcasts. We loved listening to our colleagues’ podcasts – Jack Chew Physio Matters, Adam Meakins (@AdamMeakins), James MacDonald, the MACP, the Naked Physio and Dr Andy Frankyn-Miller. @BJSM_BMJ will feature on Karen Litzy’s New York-based physiotherapy podcast in 2016.

We tried to continually improve our podcasts for our listeners. Feel free to provide feedback. One BJSM goal was more consistent production quality and we feel we made progress over 2014. Thanks a lot to the very patient & dedicated James Walsh, sound engineer and @SportsOsteopath.  The field has progressed very well from the inception of regular sports physio / sportsmedicine podcasts in 2009.

Big, big thanks to our guests – they ARE the podcasts! http://bjsm.bmj.com/site/podcasts/. These guests are now drawing 10,000 listens per week to the > 200 podcasts on the BJSM channel alone!! We love reading tweets about your favourite episodes, and any pearls you learned while riding the tube or bus to work, so keep them coming! (Is cycling and listening to BJSM podcasts safe?). Big shout out to social media specialist Ania Tarazi for creating the BJSM app on top of everything else.

We welcome your suggestions for 2016: email karim.khan@ubc.ca or tweet @BJSM_BMJ

(you can also check out the mid-year podcast review in this BJSM print article: http://bjsm.bmj.com/content/early/2015/07/06/bjsports-2015-095140)

Below we highlight the 3 most popular podcasts in the last 2 months (Yep, they launched on Fridays). Stay tuned for part two of this series where we profile the most popular podcasts of ALL TIME.

#1. Gold Medal Professor Gwen Jull – Part 1 – Assessment and Management of Neck Pain. First of Two Conversations

Do you treat patients with neck pain? Do you have neck pain? Stop reading and start listening to the podcast. Professor Gwen Jull is one of the most lauded health professionals in the world right now and she shares pearls every minute of this podcast.

Timeline
0:00m – How do you approach the patient aged in the prime of life who complains of neck pain and bad cervical posture?

2:00m – “Big development in physiotherapy is the assessment /examination which then forms the basis of our treatment” – movement and also how the movement is performed. Facet joint tests, muscle coordination.

3:10m – Detailed specific assessment of posture in the patient with neck pain. Have the patient adopt the work positions. Aim to correct the posture to see if pain changes.

5:10m – How to distinguish the superficial and deep neck extensors

8:30m – 3 trajectories in whiplash patients; folks who get better fairly rapidly (50%), those who suffer persistent mild pain (> 2years, 30%), and ‘the major worry’ of those who have persistent moderate to high levels of pain for many months and sometimes going on for years. What predicts these trajectories? “The last group is a real stumbling block for all professions”.

11:00m – Predictors of the poor outcomes.

Follow THIS LINK for the complete timeline.

#2. Silver Medal Keeping runners running: the secrets of running assessment – advice and exercise progressions

Mo Farah has great running technique. You see it, you know it. But what are the elements of Mo Farah’s running style? Can we assess running patients and guide them to improve their technique? Might gait education prove more effective than medication to treat symptoms? Andy Cornelius has the answers. He’s a Graduate Sport Rehabilitator and head running coach who works in private clinics, premiership football and with high profile clubs and athletes. Posing the questions is Stephen Aspinall, Chairman of the British Association of Sports Rehabilitators and Trainers (BASRaT – www.basrat.org) and Lecturer in Sport Rehabilitation at the University of Salford, England.

Timeline
1:20m – What are the key elements of running assessment?

2:45m – What you can learn by watching the runner from behind (frontal plane) and the side (sagittal plane) on the track and on the treadmill.

4:08m – The runner with injuries related to overstriding. What is overstriding? What can the clinician advise?

6:00m – Assessing cadence and helping the athlete to make a change of between 5-10% in cadence.

Follow THIS LINK for a complete timeline

#3. Bronze Medal Prof Stephen Phinney on the science behind low carb diets for athletes: A rational approach

Consider the classic understanding that high carbohydrate intakes are necessary for optimal endurance performance. What if that failed to take into account the physiological changes that occur with adaptation to low carbohydrate diets? In this podcast, @JohannWindt interviews physician-researcher Dr. Stephen Phinney about his last 30 years of research into low-carb ketogenic diets. Highlights include the previously undocumented levels of during exercise fat oxidation seen in endurance athletes adapted to a low carbohydrate diet. He also touches on ketogenic diets’ potential benefits in other sporting contexts, addresses common criticisms, and looks ahead to future research questions in the field.

Further reading and papers discussed in the podcast are included below.

Vermont and MIT Study Dr. Phinney’s original two studies on low carbohydrate performance. Original two low carb performance studies.
www.metabolismjournal.com/article/0026…5-1/abstract
www.ncbi.nlm.nih.gov/pmc/articles/PMC371554/

Phinney SD et al. The human metabolic response to chronic ketosis without caloric restriction: physical and biochemical adaptation. Metabolism 1983;32:757-68.
www.metabolismjournal.com/article/0026…5-1/abstract

Phinney SD et al. capacity for moderate exercise in obese subjects after adaptation to a hypocaloric, ketogenic diet. J Clin Invest 1980;66:1152-61.
www.ncbi.nlm.nih.gov/pmc/articles/PMC371554/

The gymnast study mentioned in the podcast: Paoli et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts.
J Int Soc Sports Nutr 2012; 9: 34.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3411406/

Significant decrease in inflammation shown in low carb diets by Forsythe, Phinney, et al.Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation. Lipids 2008;43:65-77.
link.springer.com/article/10.1007/…7?no-access=true

Prof Phinney’s recent BJSM Editorial: Noakes T, Volek JS, Phinney SD. Low-carbohydrate diet for athletes: what evidence? Br J Sports Med 2014
bjsm.bmj.com/content/early/2014…014-093824.extract

Prof Phinney and Volek’s website– Art and Science of Low Carbohydrate Living/Performance www.artandscienceoflowcarb.com/

In the August 2015 issue of BJSM you’ll find a series of paper on weight loss and physical activity: bjsm.bmj.com/content/49/14.toc

Dr Aseem Malhotra’s paper: It’s time to bust the myth of physical inactivity and obesity: you can’t outrun a bad diet (if you want to be thin) bjsm.bmj.com/content/49/15/967.full (OPEN ACCESS) Coauthors are Professor Phinney and Professor Timothy Noakes (@ProfTimNoakes).

Professor Stephen Blair’s rebuttal: Physical inactivity and obesity is not a myth: Dr Steven Blair comments on Dr Aseem Malhotra’s editorial bjsm.bmj.com/content/49/15.toc

Professor Kamal Mahtani’s editorial: Physical activity and obesity editorial: is exercise pointless or was it a pointless exercise? bjsm.bmj.com/content/49/15/969.extract

Two relevant BJSM podcasts include:

1) Professor Tim Noakes interviewed by Professor Peter Brukner ow.ly/PQlld
2) Dr Aseem Malhotra discussing the debate around his editorial above ow.ly/PQlNL

BJSM editors appreciate that nutrition is a controversial issue (not sure why, but that’s OK) so please note the Prof Phinney’s competing interests are listed in bjsm.bmj.com/content/49/15/967.full BJSM revels in debate and publishes quality material. Hence, you can see divergent views represented above and we have commissioned an editorial from respected scientists who feel that protein, or carbohydrate, deserves greater prominence. Your submissions are welcome via the BJSM’s various channels – ‘print’, rapid response, blog, Google plus community, twitter, Facebook. Or email karim.khan@ubc.ca

To MSc or not to MSc? Deliberations from two physiotherapists

6 Aug, 14 | by BJSM

Undergraduate perspective on Sports & Exercise Medicine – a BJSM blog series

Part 1 of a 2 part series on making your post-graduate plans.

By Jonathan George (@J_George85) & Gruff Parsons

Is a SEM Masters degree worthwhile for physiotherapists? To get the lowdown we sourced opinions from two up and coming  UK physiotherapists currently enrolled in the Cardiff SEM MSc.

Firstly, Mr. Jonathan George

I’ve always wanted to do a Master’s degree, to challenge myself academically and open new doors. Passionate about Sports Physiotherapy, Sport & Exercise Medicine (SEM) was my obvious choice. After researching different UK courses, Cardiff’s structure fitted with my desire to learn about the breadth of SEM in addition to focused knowledge and skills training.

A final decision I had to make was whether to take the course full time or part time: full time allows you to immerse yourself completely into the course with one module continuing seamlessly into the next; this means an immense amount of work in a short space of time. In contrast, part-time takes the workload pressure off slightly, but does mean an overall longer commitment. You’ve got to ask yourself – do I want a sprint or a marathon?

I went for the sprint and jumped in at the deep end balancing my degree with full time work in professional rugby union.

My experience

At times it has been immensely challenging getting home from work after a 12 hour day or a weekend match day and then sitting down to do work whilst your mates go to the pub! However, if you (like me) enjoy expanding your SEM knowledge, this isn’t as hard as it sounds. Still, my advice is, before you apply, think carefully about your time management. There is no point trying to complete the program in one year and falling at the final hurdle because you can’t meet deadlines!

Really, whether it is full time or part time, any Masters level degree is going to be a lot of work,.

Tips for success

Keep a diary! You have to be extremely well organised and efficient with your time. Managing your work commitments, studying, reminding your friends you exist, and keeping peace with your better half is not easy. I generally aim to do a few hours of work each evening during the week, then on non-match days at the weekend I split between work and relaxing – that’s the aim anyway! Overall, I’m happy to have chosen to be a full-timer and I think that a SEM MSc will help me improve enormously as a physiotherapist in sport.

Next, Mr. Gruff Parsons

As a determined junior in pursuit of my dream job, my seniors made it blatantly clear that a post-graduate qualification is a key to succeeding in sports physiotherapy. Three years after graduating and finding my feet, I began looking at avenues to develop my knowledge and understanding of SEM and further my career.

The big question that lay before me – a degree in sports physiotherapy or sports medicine?

This decision depends on your own personal strengths and weaknesses as a clinician – don’t let others make it for you!

I had been fortunate enough, through my job in elite sport, to learn some excellent cornerstone physiotherapy skills – manual therapy and specific rehabilitation methods. However, I lacked a depth of knowledge and understanding of pathology and the medical techniques used in sport. Often these approaches are managed by the sports doctor, but I was aware that under more recent financial strains a lot of jobs for physios in sport meant working independently from medics. Therefore, a sound diagnostic reasoning and broad understanding of medical intervention is essential, especially when going for more managerial roles. With these factors in mind, I felt that the Sports and Exercise Medicine course, with its more medically-focused approach, suited my goals as a junior physiotherapist.

I was going to do it, but where?

I knew I wanted to complete the course as a full time student as I had the opportunity to live at home with my parents for another year – the holy grail of money saving. Also, I wanted to continue to work while studying — for  financial and professional reasons. So I needed a course that offered some flexibility in its lecture programming. Cardiff Metropolitan University ticked all these boxes. The course, like many others across the UK, offers lectures for an entire eight week module presented in an intense five-day residential on-campus. The gaps in between modules allowed me time to balance my current job as a sports physiotherapist with coursework & clinical logbook commitments.

You need to do your research to find a course that suits your timetable!

To give a brief overview for any Undergrad for newly-qualified physios considering a SEM MSc, I’m just over halfway through the year long course as I write this and I’ve already covered MSK pathologies, Sports Science (Physiology, Psychology, Biomechanics, Nutrition and S&C) and Sports Medicine (Environmental Medicine, Radiology, doping, medical conditions in sport) modules – the breadth of topics covered is fantastic!

How am I assessed?

Case studies, essays and critical evaluation of recent research are used to assess my critical reasoning and ability to write coherently. Viva voce examinations and clinical OSCE-style stations also assess oral presentations and showcase MSK examination skills. Finally, my year-long Research and Methods module will conclude in the form of a dissertation, hopefully transforming my Post-Graduate Diploma into a Master’s of Science Degree. That’s the plan anyway…

I believe as a Physiotherapist seeking to build a career in sport, a substantial post-graduate qualification will certainly improve my prospects and opportunities – you’ve got to stand out from the crowd!

This degree need not be SEM, find out where the gaps in your knowledge lie and take initiative to fill in the blanks!

 ********************************************

The member society for UK physios in sport is…..Physios in Sport (@PhysiosInSport) (Absolute bargain at only 21 GBP/year for students)

Jonathan George BSc (Hons) Sport & Exercise Science, BSc (Hons) Physiotherapy, MCSP, is the first team Physiotherapist at Saracens Rugby Club 

Gruff Parson BSc (Hons) Physiotherapy, MCSP, ACPSM, is physiotherapist for the Wales Sevens and Cardiff Blues Academy Rugby teams

Liam West BSc (Hons) MBBCh is a junior doctor in Oxford, England. He coordinates the “Undergraduate Perspective on Sports & Exercise Medicine” Blog Series for BJSM.

If you would like to contribute to the Undergraduate Perspective on SEM BJSM Blog, please contact Dr. Liam West at liamwestsem@hotmail.co.uk

Archive: 20 min podcast re: Mechanotherapy paper (>89,000 views)

26 Oct, 13 | by Karim Khan

mechano picMany BJSM followers know about mechanotherapy – so skip this blog.

If you aren’t aware that you know about it, there is a BJSM podcast – here’s the link.

Relevant background —  I have a ‘competing interest’ – I’m blogging about a paper I coauthored. It’s my 2nd such post since we started blogging seriously at BJSM (2009). The objective measure is that the paper has been downloaded almost 90,000 times in full text and PDF. And I have been encouraged by colleagues – so here goes…

There is substantial level 1 evidence that exercise is a powerful therapy for musculoskeletal conditions – for muscle strains, joint degeneration, sciatica, tendinopathy. The historical rationale to explain the mechanism was ‘strengthening’.

‘Strengthening’ as a mechanism for tissue repair didn’t make sense to me when I was in my busy clinical phase. How did ‘strengthening’ the hip external rotators remove the pain of ITB friction syndrome? What was it about ‘strength’ that would remove the pain of a hamstring strain? There is more to tissue repair than ‘strength’.

Mechanotransduction is a well-recognized physiological principle that should have much more traction in physiotherapy/physical therapy courses and in sports medicine. This is how the body adapts to load. Why are Arnold Schwarzenegger’s muscles bigger than mine? His workouts signal his cells to hypertrophy and and multiply as needed and he gets bigger muscles. Why does an elite distance runner have  larger blood vessels than a sedentary academic about to have a cardiac arrest? Mechanotransduction is the process.

A negligent sawmiller – who has lost his distal phalanx — has a vastly smaller proximal phalanx than his or her proximal phalanges on the intact fingers. Same hand, same genetics — less loading. Mechanotherapy trumps genetics! Note examples from different tissues – mechanotherapy is a universal principle.

When clinicians prescribe exercise, the loading signals cell to repair and to function in response to load. Turning movement into repair.

Clinicians see the power of mechanotherapy daily. Mechanotherapy is when you apply the principle of mechanotransduction as a treatment – analogous to the use of ‘electotherapy’ or ‘pharmacotherapy’ (but way more powerful than either of those!). Medial ligament rehab – how does it work? Mechanotherapy. Normal physiology = mechanotransduction; Prescribing targeted exercise = mechantherapy. Simple.

Mechanotransduction has a very well-established scientific basis underpinning the success. Incontrovertible. (5077 citations in Pubmed). Stick with exercise loading– it can take time to work fully. Avoid the temptation to switch to snake-oil formulas or funky treatments. Trust in millions of year of evolution. The folks who couldn’t heal their own injuries while moving on to the next feeding grounds aren’t with us any more. Mechanotherapy provides a powerful survival benefit!

Click here for open access to the paper: Mechanotherapy–How physical therapists’ prescription of exercise promotes tissue repair

And I discuss this paper with BMJ MultiMedia editor @HarrietVickers on this podcast link: https://soundcloud.com/bmjpodcasts/bjsm-podcast-mechanotherapy

And you can upload of the graphics from the paper for free as powerpoint slides.  If you enjoy the podcast or have tips as to how we can make it better – tweet @BJSM_BMJ

Turning movement into repair!

**BJSM has over 230 podcasts on SoundCloud with over 900,000 listens** Check them out at http://bjsm.bmj.com/site/podcasts/

Professor Michael Kjaer has a great podcast on pathology and treatment options: It’s much better than this mechanotherapy one but don’t tell anyone I said that.

Practical tips for a future in sports physiotherapy

19 Apr, 13 | by Karim Khan

Association of Chartered Physiotherapists in Sport and Exercise Medicine blog series

(The ACPSEM is a BJSM member society – see January’s ACPSM issue of BJSM here; all ACPSEM members have full access to BJSM for free through the ACPSEM website)

Getting involved in Sport and Exercise Medicine, a physiotherapist graduate’s perspective

By Natalie Morgan

My career as a Sports Physiotherapist began less than 1 year ago and I have already learned a lot about transitioning into the workforce. Here are my tips for students and newly qualified physiotherapists to get to work in sport.

LacrosseWith next to no practical knowledge or experience, I started searching the internet for answers. As a new graduate I expected to be qualified for a sporting job but quickly learned that experience is just as important as a degree. Now, a year later, I work part time for an Academy Football Team and as an intern for a Regional U16 Rugby Club whilst working full time as a NHS physiotherapist. Working in sport has its challenges which university courses do not prepare you for; a high pressured environment estimating return to play timescales, communicating with coaches and managing acute injuries.

The all important first experience

My first experience, like so many of my peers, was voluntary. Don’t expect to get paid because ultimately they are paying you in experience; take it as a bonus if you do. Sports such as rugby and hockey are great to get involved in because you get a larger number and variety of injuries. Apply to work in sports that interest you. It is critical that you have a knowledge base of the epidemiology, rules of the game and yearly season plan etc. Be prepared to work long, anti-social hours with lengthy travelling times; there is no such thing as a five day week in sport.

It is critical to apply for roles where you have easy access to an experienced physiotherapist to advise you and provide some mentoring. Internships are great because you can also benefit from professional development sessions. If working alone for a local club is the best you can arrange it’s better than nothing but of course in that setting you lack support, professional development and you don’t get to build your professional network.

The big question is ‘how do I get my first experience in sport’?

Be proactive in gaining experience. There is no one correct method; sending emails, networking, the list is ongoing. I have found using the internet effective for getting my current positions. Many voluntary roles are advertised online through the Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM) and the Sports and Exercise Medicine page on the Chartered Society of Physiotherapy (CSP) interactive page. In addition, positions are advertised on the UK Sport and respective sporting teams’ and organisations’ websites. I know that some universities have placements within sport so look for those if you are still a student. In addition, there are other organisations that have opportunities for both students and graduate to gain experience within sport e.g. British Universities and Colleges Sport.

Professional development

There are so many courses and conferences out there with soaring prices; attend the ones which you think are going to be most of value within your practice e.g. taping and sports massage. You are far better spending more of your time gaining experience than attending every course under the sun. One of the biggest requirements of working within sport is having a recognised qualification in pitch side trauma management. They can be a bit pricey but they are so invaluable, covering the essentials of sports trauma from concussions to fractures. The ACPSEM have recently started running evening lectures, An Introduction to Sports Physiotherapy, a great opportunity to get a taste of the specialty.

Becoming an ACPSEM member gives you a range of benefits, one of which is receiving emails about courses, conferences and job opportunities within your area. As part of your continuing professional development the ACPSEM have international recognised accreditation levels. Getting familiar with the levels and starting to think about working towards them would be good preparation for the future.

Take away tips

–        See volunteering as a terrific opportunity – you learn about physio, sport and you start your network

–        Undertake a recognised sports trauma course

–        Be proactive in gaining experience – network, network, network

–        Become a member of the ACPSEM for the education and the networking

–        Remember how ACPSEM helped you later and pay back – teach & mentor

And Here’s a link from a contemporary news source: Some specific tips for formal job interviews. But in sports physio your ‘interview’ is likely to be in a much more formal setting – pitchside, in the clinic. That’s where you’ll earn your job!

**************************************************************

Natalie Morgan BSc is a NHS and Cardiff City Academy Football team physiotherapist, U16 Scarlets Rugby team physiotherapy intern

Extreme Physical Activity Promotion: Doc Murray to run 7 Ultra Marathons on all 7 continents within 7 days

19 Nov, 12 | by Karim Khan

In the spirit of extreme physical activity promotion, Doc Andrew Murray is off today (weather permitting in Antarctica) to run 7 Ultra Marathons on all 7 continents within 7 days. He’s doing this to raise awareness of the benefits of exercise (he now works on this issue for the Scottish Government) and also for The Scottish Association for Mental Health.

His route is here

He massively appreciates the support he’s had for his previous challenges. If you and/or people you know are interested in supporting Andrew, you have the opportunity to do this in two ways:

1) BE PART OF IT with Andrew and a few well known faces. Visit www.5×50.co.uk <http://www.5×50.co.uk/>  for full information and to join the challenge . By running, walking, cycling 5k a day for the 7 days from 23rd to 29th November we aim to cover the equivalent distance of 5 times round the world. Personally, I’ll be on the running, walking or cycling 5 km for those days to keep up my personal challenge of accumulating 60 minutes of physical activity daily. But this isn’t about me!

It’s about getting people engaged with all physical activity abilities

Please pass this onto your friends and colleagues, they can register here http://5×50.co.uk/register and take the Challenge with you – you can even create a team together.

 A 40 sec video explains why .

2) Andrew is raising money for Scottish Association for Mental Health- GetActive program. This is a great charity that he’s passionate about. His JustGiving page is here.

For a bit of a laugh here is a trailer for some TV he’s making about the trip.

Enjoy.

And remember to also the share the ‘7 investments’ link for a balanced 🙂 comprehensive approach to eradicating physical inactivity.

Message to Andy – if you are looking for something to do, we have a new BJSM podcast up for you – sports cardiology – which includes a paper on whether too much exercise can be harmful. And other podcasts in the editing suite…enjoy!  A personal best wish to you – k2

New series on Career Development: Considering a Master’s of Physiotherapy?

27 Mar, 12 | by Karim Khan

BJSM is will highlight various career options in a series of blogs.  The first in this series is about the University of Western Australia but we hope that principles from various blogs apply broadly to those considering further education.

 

UWA Master of Manual Therapy: More job satisfaction for Physiotherapists

Modern physiotherapy has many underlying specialities. As new graduates, physiotherapists are faced with important decisions upon graduation. Career direction may be influenced by personal interests, work availability, salary and family considerations. Within a few years of practice, it becomes clear to most physiotherapists that, although their undergraduate course experience has given them broad knowledge and experience in physiotherapy, more is required to move them to the next level in their chosen field. Indeed one recent study had found that physiotherapists who had accrued more continuing professional development hours after graduation had higher salaries and were more satisfied within the profession (Mulcahy 2010). Specialising in musculoskeletal practice can provide greater autonomy, a more diverse range of clientele, multiple opportunities for professional development and allows physiotherapists to work within a multidisciplinary team.

A postgraduate degree in musculoskeletal physiotherapy can offer graduate physiotherapists greater understanding of a patient’s presentation and therefore greater job satisfaction. Confidence in management decisions can be attained through in-depth clinical assessment, incorporating evidence based practice, and higher clinical reasoning skills.

The Centre for Musculoskeletal Studies, at The University of Western Australia, offers a Master of Manual Therapy degree for both local and international students.  This contemporary postgraduate course is designed to meet the needs of busy clinicians. With a flexible framework, the course provides each postgraduate student the opportunity to complete learning modules remotely, enabling them to continue to manage full-time case loads while completing the distance study packages. Research assignments teach the fundamental principles of evidence-based practice and acknowledge recent developments within the musculoskeletal field. Participation in a case conference as part of the clinical residency in Perth, Western Australia provides a platform for further career development.

An intensive 12 week clinical residency semester is undertaken at the University to build on existing  experience  and enforce clinical relevance of new learning. Focusing on clinical reasoning and manual therapy skills, the residency helps students incorporate what they’ve learnt from their previous modules. Clinical practice is performed under the supervision of highly experienced postgraduate trained clinicians. Anatomy wet-lab dissection allows students to refresh and maximise their anatomical knowledge, further improving clinical reasoning.

Mentoring by experienced clinicians, many of whom are Fellows of the Australian College of Physiotherapists, along with medical specialists, offer students challenging, up to date, and clinically relevant, skill development within a safe learning environment. It also allows students the opportunity to travel to Perth and experience a part of Australia famous for beaches, excellent wine, sunshine and wide-open space.

Professor & Director of the Centre for Musculoskeletal Studies, Kevin Singer states “Our aim is to provide a clinically relevant Masters program that is flexible yet challenging and meets career development needs of excellent manual skills based upon sound clinical reasoning and available evidence.”

For more information please contact Professor Singer:  kevin.singer@uwa.edu.au   cms.uwa.edu.au

 

Reference:

Mulcahy AJ, Jones S, Strauss G. et al. ‘The impact of recent physiotherapy graduates in the workforce. Australian Health Review, 2010, 34: 252-259

Competing interest: BJSM editor Karim Khan is an honorary Professor at the University of Western Australia; he receives library privileges but no salary for this position. The textbook Clinical Sports Medicine is used at the UWA MSc course and Professor Kevin Singer is the coauthor of the Thoracic and Chest Pain chapter for which he receives no payment or royalty. BJSM welcomes contributions for this series which aims to help clinicians consider options for professional development.

2nd International Scientific Tendinopathy Symposium, Sept 27-29, 2012

23 Jan, 12 | by Karim Khan

More information, and call for abstracts coming soon!

Contact: alex.scott@ubc.ca

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