Page
ISSUE 5 l OCTOBER 2013
BULLETIN FEATURE TOPIC: Exercise and the Older Age Group
Welcome to the October Edition
www.spnz.org.nz SPNZ EXECUTIVE COMMITTEE President
Dr Angela Cadogan
Secretary
Michael Borich
Treasurer
Michael Borich
Communications
Hamish Ashton
Committee
Dr Tony Schneiders Bharat Sukha Dr David Rice Chelsea Lane Kara Thomas
EDUCATION SUB-COMMITTEE Chair:
Chelsea Lane
Dr Grant Mawston Dr David Rice
BULLETIN EDITOR Aveny Moore
SPECIAL PROJECTS Alex Ashton
Monique Baigent
Karen Carmichael Deborah Nelson Kate Polson
Amanda O’Reilly
Charlotte Raynor
Pip Sail
Louise Turner
LINKS
In this Edition: EDITORIAL: Recognising Advanced Levels of Clinical Practice: “What’s in it for me?” by Dr Angela Cadogan
2
LATEST NEWS
6
SPNZ SIDELINE COURSE / PODIATRY COURSES
7
SYMPOSIUM 2014
9
FEATURE:
10
Snow Sport Physiotherapist - Physiotherapist & elite athlete Ginny Rutledge talks to us about her work with snow sport athletes
CLINICAL SECTION Article Review: Neuromuscular Factors Associated with Decline in Long-Distance Running Performance in Masters Athletes
15
RESEARCH SECTION SPNZ Research Reviews: The Aging Athlete
17
List of Open Access Journals
JOSPT: Articles Ahead of Print
20
Asics Apparel and order form
Health Research Reviews
20
Sports Health - a Multidisciplinary Approach Vol. 5, No. 5, Sep/Oct 2013
21
ASICS SHOE REPORT
22
CONTINUING EDUCATION
23
APTA HOME STUDY COURSES
24
AUSTRALIAN PHYSIOTHERAPY ASSOCIATION CPD
25
CLASSIFIEDS
27
Sports Physiotherapy NZ
McGraw-Hill Books and order form Asics Education Fund information IFSPT JOSPT
CONTACT US Michael Borich (Secretary) 26 Vine St, St Marys Bay Auckland mborich@ihug.co.nz
Page 2
EDITORIAL RECOGNISING ADVANCED LEVELS OF CLINICAL PRACTICE: “ W HAT ’ S IN IT FOR ME? ” By Dr Angela Cadogan
One of the benefits of being the President of this group, is that I am occasionally let loose to write editorial pieces for this Bulletin. With the development of SPNZ Level 1 and 2 Courses, and the review of the NZ College of Physiotherapy that is currently underway, this provides me with the opportunity to write about something I have long felt strongly about. SPNZ recently ran a Membership Survey. Of the 300 respondents, 89% saw a need to recognise advanced levels of practice in Sports Physiotherapy, 64% said they were considering Physiotherapy Specialisation and 32% were considering becoming an “Advanced Practitioner” member of NZ College of Physiotherapy (NZCP). From these results, it appears the majority favour recognition of advanced levels of practice. However, only 21% reported being current members of the NZCP, and only 2% were “Advanced Practitioner” members of the NZCP. Despite believing it to be necessary, clearly there are still many physiotherapists out there who seem resistant to embarking on the process of recognition of advanced levels of practice. What is “Advanced Clinical Practice”? We have covered this in past editorials. However it is worth revisiting it briefly for the sake of clarity. As stated in the International Federation of Sports Physical Therapy (IFSPT) “Sports Physiotherapy for All” document, “the complexity and breadth of the physiotherapy profession has grown beyond the scope of general practice (Bennett & Grant, 2004) (p. 4). One physiotherapist cannot reach a great depth of knowledge and skill in the full breadth of clinical areas, so a graduate must be selective as their career progresses. Gradually, higher levels of skill and depth of knowledge are developed in a particular area. Sports Physiotherapy is one such area.” The IFSPT describe “Sports Physiotherapists” as “professionals who aspire to work at Master’s level” (Bulley & Donaghy, 2005) and, in the absence of a regulated title, they apply the term “Sports Physiotherapist” to those who have achieved this level of clinical practice. In New Zealand, attainment of the NZ College of Physiotherapy criteria Advanced Practitioner status (Sports and Orthopaedic) also indicates achievement of ‘advanced practice’ standards via Route A (Master’s Degree), or via Route B or C that require evidence of supplementary coursework and other material. The Physiotherapy Board of New Zealand also recently recognised a clinical Master’s Degree (vs research Master’s Degree) as the minimum threshold level of performance for “Physiotherapy Specialisation”. Advanced Clinical Practice in Sports Physiotherapy in NZ In New Zealand, there is one Sports Physiotherapy Master’s Degree programme available (through the University of Otago), and there are several physiotherapists in New Zealand who have attained Master’s Degree qualifications in Sports Physiotherapy from recognised overseas universities (mainly in Australia). Of the 700+ members of SPNZ, there are currently only 10 “Advanced Practitioner” members of the NZ College of Physiotherapy tagged with “Sports and Orthopaedic”. Although achievement of Advanced Practitioner status via Route A (Masters Degree) is more straight forward, there are many other physiotherapists with the knowledge, skill and experience who would most likely be eligible for Advanced Practitioner status with the NZCP via other Routes. So why is there such proportionally low uptake of the Advanced Practitioner status?
What’s in it for me? Nothing perplexes me more than the question posed in the title of this editorial. As a profession we are crying out for recognition in the sporting community and wider health sector, yet whenever the topic of recognising advanced standards of practice arises, i.e NZCP “Advanced Practitioner status” or “Physiotherapy Specialisation” it is, almost without exception, followed by the statement “Why should I? It doesn’t mean anything”. CONTINUED ON NEXT PAGE.
Page 3
EDITORIAL Recognising Advanced Levels of Clinical Practice: “ What’ s in it for me? ” continued….. CONTINUED FROM PREVIOUS PAGE.
This is a circular argument. Put simply, “it” won’t mean anything until “it” exists in a robust and recognisable entity. Nobody will commit to, seek, utilise or invest in a product that does not yet exist, or is not yet fully developed. You can guarantee that it will continue to ‘mean nothing’, if the profession fails to identify, recognise and utilise such practitioners in advanced roles. However, developing robust and recognisable Advanced Practitioner or Physiotherapy Specialist roles relies upon uptake of these levels of recognition by individuals within the profession. And uptake is dependent upon the individuals’ motivation to do so. So what are some of the key potential motivators? 1. Money. In many cases this question (“what’s in it for me”) refers to remuneration; “why should I pursue advanced practitioner status/specialisation when I won’t get paid any more for it?”. If money is your sole motivator, and is what keeps you turning up at work day after day in order to provide income for your family, fund your online shopping habit or pay for the Pacific Island holiday package, then “what’s in it for me?” is a valid question. At the moment the answer is nothing. If you’re in it for the money, then you should be prepared for a potentially long wait for financial recognition of advanced practitioner/specialist status from health funding authorities and insurers. The Australian experience of titling and specialisation suggests that there is likely to be a significant delay between the recognition of ‘specialists’ and increases in insurer remuneration for those who attain this status.
Nobody will commit to, seek, utilise or invest in a product that does not yet exist, or is not yet fully developed. Developing robust and recognisable Advanced Practitioner or Physiotherapy Specialist roles relies upon uptake and utilisation of these levels of recognition by the profession.
However, in private practice there is currently nothing preventing advanced practitioners/specialists charging higher fees, and many are now doing exactly that for their own patients, as well as providing ‘consultation services’ or second opinions (‘one-off’ appointments) for other physiotherapists. Patients and other medical practitioners value the expertise of advanced level physiotherapists and they are willing to pay for it. I know this, because I do it myself, and this is a consistent message coming from patients, referring doctors and the physiotherapists who send patients for a ‘second opinion’. When it comes to negotiating contract payments for positions within sporting organisations, if you have attained higher levels of clinical practice in Sports Physiotherapy, you should be recognised and remunerated accordingly. In my experience, many sporting organisations believe physiotherapists are interchangeable and all have similar levels of skill and ability. It is up to you to inform and educate the organisation of your point of difference and advanced level of clinical skill. Nobody else will do it for you. 2. Achievement and Recognition Physiotherapists invest more time and personal income in continuing education than any other health profession I know. While GPs are paid to attend continuing education courses, and many surgeons are funded by large companies to attend international conferences, physiotherapists spend proportionally large amounts of their income on continuing education and post-graduate education. I have recently been updating my CV. Since graduating, it turns out I have spent 4 years in full-time post-graduate study, 5 years in part-time post-graduate study and attended over 50 continuing education courses or conferences. With the exception of 3 years of scholarship funding for my PhD studies, these endeavours have been entirely self-funded. I reluctantly did the sums, and realised all this amounted to over $40,000 of personal investment in post-graduate and continuing education. And I am not alone. I now have the privilege of teaching on courses for both SPNZ and the NZMPA, and the same faces are regular attendees at many of these courses.
CONTINUED ON NEXT PAGE.
Page 4
EDITORIAL Recognising Advanced Levels of Clinical Practice: “ What’ s in it for me? ” continued….. CONTINUED FROM PREVIOUS PAGE.
Identification of advanced practitioners For those of you out there with similar CVs, and I know there are many of you, if there is a way of recognising the significant investment of time, money and family sacrifices, as well as the additional knowledge, skill and experience you have gained as a result, in my opinion not only would you be a fool not to take it, but you are doing both patients, and the profession a disservice if you don’t. Patients and the profession would love to know who you are so we can all benefit from your increased level of knowledge and expertise, which in turn has the potential to benefit you in the way of more referrals. Utilisation of advanced practitioners As a profession, we need to sharpen up our act and make much better use of within-profession referrals, utilising the skill and expertise of our peers for If we, as a profession, don’t recthe benefit of the patient, client or sporting organisation, and those funding ognise and utilise each other’s their management. As the IFSPT clearly states, “one physiotherapist cannot advanced level of clinical skill, reach a great depth of knowledge and skill in the full breadth of clinical arehow on earth can we expect as”. We need to shelve our professional jealousy, start referring outside our those outside the profession to clinics and sporting organisations if necessary, and start utilising those with recognise it, let alone to fund it? proven abilities in various areas (including Sports Physiotherapy). If we, as a profession, don’t recognise and utilise each other’s advanced level of clinical skill, how on earth can we expect those outside the profession to recognise it, let alone to fund it? 3. Advancement and Growth In addition to financial reward and recognition of achievement, the opportunity for career advancement and growth is another motivating factor for some. In the area of Sports Physiotherapy, career advancement has been historically based, to a large extent, upon opportunity, history/longevity in a sport and also on “who you know” rather than a proven advanced standard of clinical practice. The paucity of post-graduate education in Sports Physiotherapy in New Zealand has a lot to do with this necessitating people to learn ‘on the job’. The ability to establish clear and measurable criteria for the minimum threshold of performance for advanced Sports Physiotherapy practice, and to apply formal recognition to this level of achievement is the first step in creating a clear and transparent career pathway. (This is one of the reasons behind development of the SPNZ Level 1 and Level 2 Sports Physiotherapy Courses). “Advanced Practitioners” are currently employed and utilised effectively within District Health Boards and, with recognition of advanced practice in Sports Physiotherapy, there is no reason why sporting organisations won’t, over time, begin to recognise the value of, and seek Sports Physiotherapists who have achieved an advanced level of clinical skill (Masters Degree and/or Advanced Practitioner status) as a minimum basic requirement.
Some other Misconceptions: Clinical versus Academic Clinical and academic competencies and career pathways are distinctly different. There is some confusion that “Advanced Practitioner” and “Physiotherapy Specialist” status requires advanced ‘academic’ abilities and that if you’re not an ‘academic’ you’re not eligible. While research informs clinical practice, the two skill sets are not interchangeable, and both the NZCP Advanced Practitioner and the Physiotherapy Specialisation criteria are weighted much more strongly in favour of demonstration of advanced levels of clinical practice. Masters Degree programmes do contain a research component, however there are many “clinical” Masters Degree programmes offered around the world where the focus is on clinical practice. Universities have their own separate pathways for recognising those with advanced skill in the academic research area, namely levels of promotion within the university that follow pathways leading to “Professor” status. NZ College of Physiotherapy The perception by some is that the NZCP is there simply to log CPD hours and accredit courses. I joined the NZCP Board in 2012 and I can tell you that this is incorrect. With the advent of the Health Practitioners Competency AssurCONTINUED ON NEXT PAGE.
EDITORIAL
Page 5
Recognising Advanced Levels of Clinical Practice: “ What’ s in it for me? ” CONTINUED FROM PREVIOUS PAGE. continued…..
ance Act, the role of the College in monitoring CPD activities changed, and has since aligned with the mandatory requirements of the HPCA to reduce duplication of this task. The NZCP are required to monitor the CPD of their Advanced Practitioners to ensure the nature and extent of the activity aligns with their tagged clinical area, for quality assurance and credibility of the Advanced Practitioner status, but monitoring CPD activities is not their core purpose. The structure and future role of the NZCP is currently under review. This is timely given the increasing need for a clear and robust method of recognising advanced levels of practice in all practice areas within the profession, including Sports Physiotherapy. Although there is still work to be done on the final structure of the NZCP, it is already clear that a critical component will be links with Special Interest Groups to further expand the ability of the profession to recognise those who have demonstrated advanced levels of ability in specific clinical practice areas. The Advanced Practitioner may become more valuable than ever, given that the small number of Physiotherapy Specialists in a limited number of ‘specialty areas’ will not be sufficient to cover the demand for advanced level physiotherapists across the many clinical practice areas that the health and sporting industry currently service.
Summary In summary, the governing bodies can only do so much. Clear criteria have been established for the attainment of both Advanced Practitioner status with the NZCP, and more recently for Physiotherapy Specialisation. To gain widespread acceptance and recognition of our advanced practitioners and specialists outside the profession, we first need to get our own house in order, and that includes recognising and utilising those with advanced levels of clinical skill within our own practice area. To do that, we need to know who they are. Either stand up, be recognised and contribute, or if you do not fit the criteria or do not have the means to do so, start engaging with ad- What’s in it for you, is up to you. vanced practitioners within your clinical area to provide concrete evidence of how this may benefit patients/clients, sporting organisations, the profession and the funders of health care. It’s up to you whether you want to be part of this exciting time, and to contribute to the next chapter in the evolution of the physiotherapy profession.
References Bennett, C. J., & Grant, M. J. (2004). Specialisation in physiotherapy: A mark of maturity. Australian Journal of Physiotherapy, 50(1), 3-8.
LATEST NEWS
Page 6
Corrections: Comments made by Madeline Hernon in the SPNZ Bulletin, August 2013 In the August Bulletin, we featured an article by Madeline Hernon in which she discussed issues surrounding hip resurfacing. In response to that article, we received information from Smith and Nephew indicating that an orthopaedic surgeon has raised concerns with them about inaccuracies in the article. The inaccuracies were in relation to the use of metal on metal hip prostheses. In particular: 1. On page 9 of the Bulletin, Ms Hernon states that “metal on metal heads have been discontinued and surgeons have completely abandoned resurfacing”. In fact there are a number of metal on metal hip prostheses which remain on the market and continue to be used by surgeons in appropriate cases. 2. Ms Hernon used a picture of a Smith and Nephew Birmingham Hip Resurfacing System (BHR) with a caption that suggests it has now been discontinued. This is not the case as BHR devices continue to be implanted in New Zealand and elsewhere in the world. Over 150,000 BHR’s have been implanted worldwide. In the article, it was not disclosed that Madeline is employed by DePuy Synthes. We regret any anxiety these errors may have caused for patients, physiotherapists and surgeons.
Sports Physiotherapy Australia Ratify Closer Working Relationship With Sports Physiotherapy New Zealand SPNZ members can now access APA/SPA courses at membership rates SPNZ have been in negotiations with Sports Physiotherapy Australia (SPA) and their parent body the Australian Physiotherapy Association (APA ) over the last 6 months and can now announce that we have successfully engaged in a symbiotic relationship with Sports Physiotherapy Australia on a wide range of issues including continuing professional development which allows each group reciprocal access to the others educational courses, APA/SPA webinars/podcasts and conferences at local domestic rates. This means that you as a member of SPNZ will be treated as a SPA/APA member when you register for, and attend these courses. SPNZ members can now search for events via the APA website. https://www.physiotherapy.asn.au/APAWCM/LearningDevelopment/event_search.aspx To register, SPNZ members should download a registration form and forward it to the relevant branch office. Add your PNZ number and state you are a SPNZ member on the form. https://www.physiotherapy.asn.au/APAWCM/Learning%20and%20Development/LD9_EventRegistrationForm_Writable.pdf
SPNZ Member Benefits Remember to take advantage of the full range of SPNZ member benefits:
FREE online access to JOSPT (value approx USD$275)
FREE Editions of the Quarterly APA “Sports Physio” Magazine
25% Discount on all McGraw-Hill book publications
Discount on ASICS shoes and clothing
Funding Support for continuing education and research (Asics Education Fund).
Substantial discount, Advanced Notice and preferential placing on SPNZ Educational Courses
Access to website with clinical and relevant articles
Sports Physiotherapy Forum to discuss ideas and ask questions
Bi-monthly SPNZ Bulletin featuring Activity, Course and information updates
FREE classified advertising in the SPNZ Bulletin
Page 7
SPNZ LEVEL 1 COURSE
SIDELINE MANAGEMENT (2 day course) A course for physiotherapists who work with individual athletes, or on the sideline at sports games or events who want to upskill in the areas of pre-game preparation, first aid, acute injury assessment and management, indications for radiology referral and post-event recovery strategies. This course will give you the tools you need to manage teams and individual athletes from pre-event preparation, to post-event recovery.
Date:
Location:
Course Fee:
Burwood Hospital Physiotherapy Department
Saturday 2nd November
SPNZ Member
$395
Burwood Hospital (click for map)
Sunday 3rd November
PNZ Member
$450
255 Mairehau Rd,
Times:
Non-PNZ Member
$592.50
Burwood, Christchurch
9am—5pm (both days)
The Course Will Cover: Ethics and Professional Issues in Sports Physiotherapy
On-field injury assessment and management
Sports First Aid and Wound Care
Hand and finger injury assessment & basic splinting
Pre-event warm-up
Indications for radiology referral
Strapping
Return-to-play decision making Post-event recovery
Concussion assessment, management and return-to-play criteria
Presenters: Fiona de Jongh Registered Nurse Chelsea Lane Australian Titled Sports Physiotherapist Dr Tony Schneiders Physiotherapist—Sports-related Concussion Kelly Davison Hand Therapist Dr Mark Coates Radiologist Dr Angela Cadogan Sports Physiotherapist (Dr Deb Robinson (Sports Physician) will also be present for the Concussion section)
Please Note: Places will be strictly limited to 24 participants.
To Register: Download the Registration Form from the SPNZ website and return with payment to:
Physiotherapy New Zealand, PO Box 27 386, Marion Square, Wellington 6141 nzsp@physiotherapy.org.nz Fax: 04 801 5571
Page 8
PODIATRIC ASSESSMENT AND MANAGEMENT OF THE FOOT AND ANKLE: A PRACTICAL WORKSHOP FOR SPORTS & MUSCULOSKELETAL PHYSIOTHERAPISTS This course will provide you with the advanced skills needed to effectively and efficiently assess and manage foot and ankle pathologies from a combination of sports podiatry and physiotherapy perspectives. It is also a useful update course for those already trained in sports and musculoskeletal physiotherapy of the lower limb. Wellington: Saturday 9th November 2013 New Plymouth: Sunday 10th November 2013 Tauranga: Saturday 30th November 2013 Auckland: Sunday 1st December 2013 Presenters Richard van Plateringen:- Sports Podiatrist Dr Tony Schneiders:- Sports and Manipulative Physiotherapist Contents 1-day intensive course- Topics covered include: *Current theories of foot function; *Skeletal foot and lower limb surface anatomy and palpation; *Arthrokinetics of the foot and ankle; *Foot and ankle mobilisation techniques; *Foot, ankle, lower limb strapping/taping/padding techniques; *Foot orthoses; features and fitting for pathology; *Common case studies, foot and ankle. Pricing SPNZ Member
$195.00 +GST
Other PNZ Member
$250.00 +GST
Non PNZ Member
$292.00 +GST
NOTE: Numbers are strictly limited to the first 22 registrants so please register early. Cost includes the course manual, supervised training sessions, and morning and afternoon tea. To Register: Complete the attached Registration Form and return to Physiotherapy New Zealand Fax 04-801 5571 or email: nzsp@physiotherapy.org.nz For information on how to join SPNZ: http://www.physiotherapy.org.nz
SPNZ Symposium 2014
ACRS THE
Page 9
LIFESPAN
SPNZ Symposium Rotorua 15-16 March 2014 SPORT AND EXERCISE ACROSS THE LIFESPAN Key Note Speakers: Professor Craig Purdam (Australia) HEAD OF PHYSIOTHERAPY, AUSTRALIAN INSTITUTE OF SPORT Craig Purdam is the Head of Physical Therapies at the Australian Institute of Sport. He has worked as a clinician in elite sport for over 30 years and has been a physiotherapist at five Olympic Games (1984-2000) and a longstanding physiotherapist to the Australian National Men’s Basketball team over that period. He has also had other associations with the Australian national swimming, track and field and rowing teams. He was awarded the Australian Sports medal in 2000 and in 2009 was appointed an adjunct Professor to the University of Canberra. His undergraduate qualification was gained in 1975, a postgraduate diploma in Sports in 1992, a Masters in Sports in 2000. He was awarded specialist status in Sports Physiotherapy through Fellowship of the Australian College of Physiotherapists in 2009.
Mary Magarey (Australia) SPECIALIST PHYSIOTHERAPIST APA SPORTS AND MUSCULOSKELETAL PHYSIOTHERAPIST Mary is a Fellow of the Australian College of Physiotherapists as a Specialist Musculoskeletal and Sports Physiotherapist, the only Fellow in Australia in two areas of specialty. She also has a Doctorate (PhD) in Physiotherapy. Her area of particular specialty is the shoulder but she is also passionate about injury prevention, particularly for those athletes in throwing sports. Mary has over 20 years experience examining and managing complex shoulder problems, in particular problems with shoulders of athletes who throw. She has been teaching physiotherapy at the University of South Australia for over 30 years.
More speakers to be announced once finalised. For up-to-date information on the Symposium check out the Symposium website.
Page 10
FEATURE SNOW SPORT PHYSIOTHERAPIST PHYSIOTHERAPIST - GINNY RUTLEDGE ( BUSH )
Ginny Rutledge graduated from Otago in 1982 with a Dip Phty Otago and is the current owner of Wanaka physiotherapy, lead physiotherapist NZ Winter Performance Programme, and a HPSNZ Provider. She has 25 years (plus wrinkles!) experience in sports physiotherapy, including Winter Performance Programme lead physiotherapist for eight years. She has been living in Wanaka since 1997 but took time away to study sports medicine at Curtin University, complete research methods and applied sciences papers at Otago, and the Dip MT in 1992. Ginny has been privileged to be physiotherapist at the past three Winter Olympics in 2002, 2006, and 2010, and is currently in the planning stages, or a few months out, from the 2014 Olympics in Sochi, Russia. She has worked and travelled with the NZ Ski Team internationally and has recently taken a role with the USA Alpine Ski Racing team travelling on the World Cup Circuit in Europe for four weeks per year. Ginny has an interest in knee injuries and was grateful to receive a Prime Minister’s Scholarship to attend the World Injury Prevention Conferences in 2008 Norway and 2010 Monaco. Following this, Ginny and her crew have been focusing on minimising the risk of lower limb injuries in snow sports athletes who compete in the high risk sports of free ski, snowboard and ski racing. Ginny’s own sporting achievements include being a NZ speed ski title holder so she understands the frustrations of not being able to continue competing in snow sports because of injury. But by switching her commitment and competitive focus to multisports she has been able to continue to compete at a top level and has been rewarded with success being five times winner of the Coast to Coast open teams event.
NZ has two key funded snow sports - free ski and snowboard. Currently we have 11 athletes who have reached Olympic qualification standards. Free ski is a new discipline debuting in Russia as is slope style for snowboard. We bode well internationally in these more freestyle sports and while ski racing has certainly been my passion, we may struggle to qualify a ski racer for Sochi. Both snowboard and free ski are high risk. With the Olympics being just a few months away the bar is rising. Athletes are performing more difficult and technical tricks; the amplitude athletes reach off the lip of the pipe is higher. The injuries reflect this and for NZ have proved to be in one instance this year, severe. How did you become involved in your current role? Honestly, I grew into it. Following the 2002 Salt Lake Olympics there was an obvious gap in provision of sports science/medicine services to snow sports. The Dunedin Academy of Sport responded by starting weekend dryland training camps and provided some basic sports science. From this the Winter Performance Programme began. (I self - appointed my role as physiotherapist back then.) Fast forward to 2013 whereby we have a snow sports/ HPSNZ satellite base in Wanaka. This includes a fully equipped gym, full service provision of coaches, support staff, and domestic and travelling physiotherapists. CONTINUED ON NEXT PAGE.
FEATURE
Page 11
Snow Sport Physiotherapist continued... CONTINUED FROM PREVIOUS PAGE. What are your specific tasks/responsibilities? Primarily I am physiotherapist at the base coordinating physiotherapy and medical services. This includes management of athletes injured overseas - bringing them home, etc. We now have three physiotherapists travelling on rotation with the teams and one domestic physiotherapist, so I do less travelling but spend time with them in an emersion role in NZ. Roles include: weekly medical team meetings and communication to the coaches and support team case management meetings, screenings / return to snow plans and assessments keeping up to speed with what is occurring internationally. What are your specific tasks/responsibilities during competitions/events? During competition and key events I am usually in the start area on the end of a radio with a medical pack receiving coms from coaches. It is important to understand your role on competition day and have a good handle on athlete performance states as well as being prepared for course holds/weather calls/cold/nutrition/clothing, etc. What are the types of injuries you commonly see? 2013 has been a terrible year for severity of injury and time loss for returning to performance. Four of these include: Back injury - young athlete competing at X Games in Jan 2013. She sustained a fracture dislocation T12/L1. (x- ray included with permission) Lumbar disc injury and sacral fracture - April 2013. Four months off snow struggling to return to performance. ACLR - December 2012. Second ACLR with first occurring in 2008. In spite of our efforts we have five ACLRs amongst our 11 athletes. Re-ruptures feature here, as expected. These tend to be our greatest time loss injury as we don’t allow return to performance jumping until 8 to 9 months.) Bilateral Patella Tendonopathy Other injuries we see include shoulder and ankle injuries, e.g. traumatic subluxations/SLAP/cuff injuries and ankle injuries (high ankle in the snow boarder).
Xrays showing fracture /dislocation T12 L1 and subsequent internal fixation of snow sport athlete, reproduced with permission CONTINUED ON NEXT PAGE.
FEATURE
Page 12
Snow Sport Physiotherapist continued... CONTINUED FROM PREVIOUS PAGE. What have you found to be the key elements of success in dealing with these injuries? I think key is that the athlete has a clear understanding of the rehabilitation process and the expectations of what milestones they need to achieve along the way. As there are usually many support staff involved, and in particular the coach, there has to be clarity and communication amongst all. We use a simple graph (see below) to ensure you know your role from injury to performance. This works well for us. Our RTS assessments are strict and include baseline scores (hard data plus movement patterns) of which they must achieve 85% prior to on-snow training and 92% prior to return to jumping and performance. Also important are confidence scores. We use the IKDC 2000 which seems to work well for us and we strive for 92% - hard to reach What do you think are important aspects for physiotherapists to consider when trying to help clients with knee pathology (injury related) to regain their ability to compete? As a physiotherapist we must understand the sport requirement to guide high end rehabilitation. For example, a free ski athlete with an MCL injury must be able to tolerate jumping single leg on and off benches (vertical jump) and onto Bosu balls (uneven surface) and off benches into a drop squat (eccentric component) and into rotation off bench or ball (rotation control) - all with perfect neuromuscular control. How do you integrate/work with the trainer/coach with respect to injury prevention or rehabilitation? We are now funded to deliver proactive physiotherapy. Around 50% of our contact time is dedicated to this. This starts with the screening process which is carried out in conjunction with S/C. From this drops out risk assessment and athlete pre-hab plans. This then feeds into the (IPP) athlete performance plans and discussion around on snow/ off snow balance is worked on with the coach. Are you involved in performance aspects for this athlete/team? We have just completed our 180 days out review of each athlete. Each support person provides on track/off track performance data. Following these reviews recommendations are made. So indirectly – yes. What are the major challenges in working with this sport/athlete/event? It becomes challenging when we identify athletes at being at high risk of an injury - balancing time in the gym v time on snow trick/training progression. We need them to be strong and crash robust with perfect landing patterns. But they need to be on snow where they get injured - simple as that. What are the key attributes you feel are required to work with elite level snow sport athletes?
It is important that we understand the sport requirements and the performance states of our athletes. Is an athlete about to drop in and repeat a trick that injured her ACL last time she did it? Strong relationships based on trust and earned respect communication with coach/ athlete team - plan well behind the scenes so there is no room for miscommunication Stay relaxed and fun because these athletes love what they do, but stay focused
You have been involved in competitive sport now for many years. Do you have any gems to share in terms of looking after our bodies so we can continue to enjoy an active later life? We have just finished Winter Games in Wanaka. This World Cup is a qualifier for Sochi and the fields were therefore Olympic class. During the slopestyle event we observed two ACL ruptures in completion and one in the training course. Their dreams gone just like that, never mind the known longer term consequences. My suggestion is that you keep your children away from the terrain parks and half pipes!
CONTINUED ON NEXT PAGE.
FEATURE
Page 13
Snow Sport Physiotherapist continued... CONTINUED FROM PREVIOUS PAGE.
Return to Snow Decision Making Injuries affect athletes in many ways.
Frustration and uncertainty during diagnosis Lack of relatedness and social support Loss of identify as a team member and as an athlete Increased autonomy and responsibility = personal growth - can confound sport focus to new life possibilities Resumption to race is dependent on TRUST in body: this comes from all, self, physiotherapy, S&C, coach - approach and environment (Doyle-Baker et al 2010)
Return to Snow Programmes: Guiding Principles
Engagement is critical
Logical + individualised + progressive
Acknowledge and gauge risk
(athlete/coach/physiotherapist/medical/S&C) educationawarenessaccountabilityresponsibility
Scope athletes opportunities and work-ons Holistic cause and effect factors taken into account:
Return to Snow Decision Making Stages
Coach
Level of Decision Making
Strength & Conditioning
Physio
Initial Injury
Return to Exercise & Education
Return to Snow
Return to Competition
Return to Progression
CONTINUED ON NEXT PAGE.
FEATURE Snow Sport Physiotherapist continued... CONTINUED FROM PREVIOUS PAGE. Decision Making Stages INITIAL INJURY PHYSIOTHERAPIST & MEDICAL DECIDE and inform coach, athlete and support team Physiotherapist and medical provide diagnosis, timeframes and milestones Coach: provides tactical competition timeframes RETURN TO EXERCISE & EDUCATION Group discusses but PHYSIOTHERAPIST DECIDES: Physiotherapist: rehab stage, risk and timeframes Coach: specific skills which could be worked on, planning Conditioner: specific skills and general fitness Support providers: planning and education RETURN TO SNOW Group discusses but PHYSIOTHERAPIST DECIDES: Physiotherapist: capability and risk of re-injury Coach: on snow skills and drills Conditioner: specific skills and general fitness Support providers: planning and education RETURN TO COMPETITION Group Discusses and GROUP DECIDES TOGETHER with equal weight Physiotherapist: capability and risk of re-injury, preparation requirements Coach: on snow skills and drills Conditioner: specific skills and general fitness Support providers: planning and education RETURN TO PROGRESSION Group Discusses but COACH DECIDES Physiotherapist: capability and risk of re-injury, preparation requirements Coach: on snow skills and drills Conditioner and support providers: normal business.
Page 14
CLINICAL SECTION
Page 15
ARTICLE REVIEW Neuromuscular Factors Associated with Decline in Long-Distance Running Performance in Masters Athletes Brisswalter J, Nosaka K (2013). Neuromuscular Factors Associated with Decline in Long-Distance Running Performance in Masters Athletes. Sports Medicine 43:51-63 doi 10.1007/s40279-012-0006-9
ABSTRACT This review focuses on neuromuscular factors that may affect endurance performance in masters athletes. In the last decade studies have attempted to identify metabolic factors associated with the decrease in endurance, especially long-distance running performance and its relationship with ageing. Neuromuscular factors have been studied less despite the well-known phenomena of strength loss with ageing. For masters athletes to perform better in endurance events, it is important to reduce muscle fatigue and/or muscle damage, improve locomotion efficiency and facilitate recovery. Some recent studies indicate that masters athletes have similar muscle damage to young athletes, but require a longer recovery time after a long-distance running event. Further analyses of these parameters in masters athletes require more experimental and practical interest from researches and coaches.
ARTICLE REVIEW The American College of Sports Medicines Position Stand states that regular participation in a physical exercise programme is an effective means to reduce or prevent the functional declines associated with ageing. To date, few studies have been done on the aging athlete and what has been is limited to training methods. Research conducted on this population would be useful, by studying older people who have been athletes their whole lives, researchers have an opportunity to investigate the effects of regular physical exercise on human biological systems without the complications generally associated with an ageing population (eg obesity, diabetes).This review looked at how ageing impacts muscular forces associated with endurance performance. Performance Changes with Ageing “Masters� athletes refer to those over the age of 35 years, who continue to train regularly and participate in competitions with the aim of maintaining or even improving performance levels. Generally this age marks the start of the decline in physical performance. Data from the literature indicates a moderate decline in endurance performance between the ages of 20 and 50, followed by a marked alteration after 70 years of age. Most studies also report a decline in running performance for athletes over 35 years of age. Muscular Function in Masters Athletes Endurance performance depends upon (i) metabolic factors such as maximal oxygen consumption (VO 2max) or lactic threshold; and (ii) muscular factors such as the number, type and size of muscle fibres, strength production capacity or locomotor efficiency. Within the sedentary population at the age of 60 years there is a 15-35% reduction in maximal voluntary force which increases to an 80% strength reduction in people over 80 years of age. Age related strength decline is seen in both men and women, muscles in both the lower and upper limbs and whether the mode of contraction is isometric or dynamic. The authors of the review state that some studies involving masters athletes report similar decreases in agerelated strength to those found in sedentary populations, which suggests little or no beneficial effects of regular endurance training on maintenance of maximal voluntary contraction (MVC strength). Only masters athletes who intensively train their muscles (e.g elite weightlifters) appear to present higher strength levels than sedentary subjects. The reasons behind the age related decline may be linked to both structural and functional modifications within the muscle.
CONTINUED ON NEXT PAGE.
CLINICAL SECTION
Page 16
ARTICLE REVIEW CONTINUED... (i) Structural Modifications Age related reduction in muscle mass is one of the main factors attributed to the decline in muscle strength. Decreases in muscles appear to be linked with a loss of muscle fibres typically type 2 fibres (fast twitch fibres/ glycolytic fibres) and motor units of the masters athletes, which may be triggered by modifications to the nervous system. It has been shown however, that regular endurance training appears to preserve the number of functional motor units despite advancing age as masters athletes. Regular endurance training could preserve or even increase the proportion of type 1 fibres for masters athletes, while resistance training appears to affect type 2 fibres more than type 1. (ii) Neuromuscular Modifications A masters athlete may also lose muscle strength due to alterations of neural factors. The integrity of muscle function is generally based on the response to electrical stimulation of the motor nerve. M-Wave amplitude indicates how excitable the muscle membrane is, and how well the action potential is propagated at the neuromuscular junction. M-Wave amplitude indicates how excitable the muscle membrane is, and how well the action potential is propagated at the neuromuscular junction. The M-Wave is 20-40% reduced in the untrained population compared with younger subjects. Other physiological modifications can also occur such as alterations to the sodium-potassium transport system and reduced numbers of muscle structures responding to the action potential. Locomotion Efficiency Locomotion efficiency corresponds to the body’s capacity to effectively use oxygen to produce energy and convert it into muscular work, leading to movement. Efficiency predicts performance in endurance events. The authors stated that variations were found in masters age and young swimmers and cyclists. They concluded that age-related reduction in efficiency appears to be linked to a reduced strength production capacity. Muscle Fatigue/Damage and Recovery Muscular fatigue is indicative of how the body functions under physiological stress. Muscular fatigue in masters athletes can be amplified due to the combined series of intense physical exercise and physiological changes linked with advancing age. Muscle recovery can also be delayed. One study found that recovery of muscle function following eccentric contractions of the elbow at speed, was delayed in the older men group compared to the younger group. The authors acknowledge that the research into masters athletes is relatively new and therefore needs to be extended to explain the effect of training on the capacity to maintain muscle function and the role of neuromuscular forces in endurance performance. The authors commented that they chose each study in the review for their relevance and quality of design and findings, although they don’t state what criteria is used. Some of the studies included do not seem very relevant. The authors refer to long-distance running in the title and abstract, though there is little written on this in the review itself and when they do, it is called endurance. However, the article raises some interesting points on masters athletes even with the limited research available on this topic and highlights areas for future research. The article would be useful to the sports physiotherapist as a background literature review on masters athletes and their changing neuromuscular function.
Reviewed by Charlotte Raynor MPhty, BSc(Hons), NZRP, MNZSP
SPNZ RESEARCH REVIEWS
Page 17
The Aging Athlete www.sportsphysiotherapy.org.nz/resources
The Aging of Elite Male Athletes: Age-Related Changes in Performance and Skeletal Muscle Structure and Function Faulkner JA, Davis CS, Mendias CL, Brooks SV (2008). The Aging of elite male athletes: Age-related changes in performance and skeletal muscle structure and function. Clinical Journal of Sports Medicine 18(6): 501-507. Article Summary Age related muscle atrophy begins at approximately 50 years of age. Data from males from childhood to age 90 indicate that the average number of motor units remain stable until the age of 50 where following this there is a linear decline. The purpose of this article was to address if elite male athletes experience the same loss of muscle. Comparisons between elite athletes and untrained controls show parallel declines in strength, power and VOâ‚‚max, however, there is a significant difference between the two groups initially. Thus the attainment of elite athlete status does not protect skeletal muscle from the loss of muscle fibres and units and it is this loss that is responsible for declines in athletic performance. It is particularly troublesome for those whose performance is dependent on high power output. Repair and regeneration of muscle tissue is important particularly as athletes age. Satillite cells are activated in tissue injury and proliferate and fuse with the damaged fibre. There is a decrease in the proliferative capacity of satellite cells with age, a decrease in density around type 2 fibres and an increase in density around type 1 fibres. Hence the aging muscle has a slower recovery time along with a decreased ability to produce power.
Clinical Significance / Applications Recognition of the losses that occur in elite athletes and untrained individuals as they age allows us as physiotherapists to anticipate and help adjustment to these changes. The loss of type 2 fibres results in a loss of power, the movements become less rapid, less powerful. Loss of power is troublesome for athletes who depend on power for performance such as in shotput, discus, and weight lifting or sports that require repeated contractions such as sprinting. The implications for older athletes is that having less type 2 muscle leads to a decrease in the ability to produce short concentric contractions and an increase in lengthening contractions, hence less explosive power. Hence a reduction in performance and brings on a situation where younger athletes can overpower older athletes in one to one contests. As physiotherapists being aware of these changes within muscle we are in a position to educate athletes and coaches and other people involved in performance enhancement of these changes and influence training programmes and rest periods. This study suggests training with protocols that include plyometric training. Plyometric training can increase strength, power and prevent further injury. This occurs through the hypertrophy of the remaining muscle fibres. It is important to note that this article only looked at male elite athletes and untrained individuals.
Reviewed by Louise Turner B App Science (Physiotherapy), Masters of Health Practice (Musculoskeletal Physiotherapy)
SPNZ RESEARCH REVIEWS
Page 18
The Aging Athlete continued‌ www.sportsphysiotherapy.org.nz/resources
Rehabilitation Concerns of the Middle Age Athlete with Knee Pathology Uhl, T. L., Harrison, A., English, T., & Rothbauer, J. (2003). Rehabilitation Concerns of the Middle Age Athlete.
Sports Medicine and Arthroscopy Review, 11(2), 155–165. Retrieved from http://journals.lww.com/sportsmedarthro/pages/default.aspx Article Summary This narrative review focused on the management of physically active, middle-aged individuals with knee pathologies. In this population the therapist needs to take into account not only the physiology of the injury, but also the lifestyle of the individual and physiological changes that occur during the aging process. There is evidence that regular physical activity is a risk factor for developing knee osteoarthritis (OA). Studies demonstrate decreased quadriceps strength in people with radiologic evidence of OA. Quadriceps inhibition contributes to this finding, and occurs in the presence of even minimal knee joint effusion. Age related changes include a decrease in the number and size of muscle fibers, and the loss of fast twitch type II fibers. There is an age-associated decrease in tensile strength of tendons and ligaments, as well as a loss of elasticity. Other changes include muscle stiffness due to an increased ratio of connective tissue to muscle tissue and declines in joint proprioception associated with normal aging. These changes can predispose injury and prolong rehabilitation. Recent reviews of exercise interventions conclude that aerobic exercise is effective in significantly improving function in an OA knee population. Due to the effects of neural inhibition of muscle, faulty movement patterns and disuse; strength training is essential for patients with knee pathology. These exercises should include strengthening the core, hip, and ankle and progress to functional closed chain exercises. Loss of fast twitch fibres, changes in proprioception and slowing of nerve conduction velocity may make the middle-age athlete more at risk of injury in sports that require a rapid reaction or complex coordination and balance such as basketball. Rehabilitation therefore should include voluntary and reflexive balance training and limb awareness. Flexibility is also an important component to address to meet the requirements of a sport or activity. Other factors to consider are weight loss and the use of braces to minimize varus and valgus stresses and potentially provide joint protection during sporting activities. Obesity is a significant risk factor for developing radiographic and symptomatic evidence of knee OA, and for the progression of this process. This review also looks at management in post-surgical knees and outlines key milestones and exercise prescription for common surgical procedures. Four management stages are described: the immediate postoperative period, the early healing phase, the late healing phase and the conditioning phase. Post-operatively the goal is to eliminate joint effusion, reduce pain, re-establish range of motion, and minimize muscle inhibition. Due to this quadriceps inhibition after surgery it is important to reduce effusion, and begin working on early quadriceps activation. Transcutaneous electrical stimulation and ice are useful methods of facilitating muscle activation. Goals in the early healing phase should concentrate on restoring a normal gait pattern, protection of the joint surfaces, and progressing patients to strengthening and functional exercises. In the late healing phase the focus is restoring normal function and neuromuscular control activities of the trunk and entire lower extremity. Light agility and ballistic activities can be introduced if single leg activities are tolerated well. Finally the conditioning phase focuses on return to sporting activities with continued emphasis on dynamic closed kinetic chain exercises. Rehabilitation of any athlete is multifactorial; age related changes in the middle-age athlete will alter physiotherapy management compared to when treating a younger adult.
Reviewed by Monique Baigent BHsc (Physiotherapy)
SPNZ RESEARCH REVIEWS
Page 19
The Aging Athlete continued… www.sportsphysiotherapy.org.nz/resources
Effects of Aging in Masters Swimmers: 40 Year Review and Suggestions for Optimal Health Benefits Robert T Rubin and Richard H Rahe (2010). Journal of Sports Medicine 1: 39-44 Article Summary In May 1970 the first National Masters Swimming competition was held in Amarillo, USA. Four years later the first International Masters Swim Competition was held in Auckland, NZ and Sydney, Australia. Performance has been measured since the start of these competitions through swim times. The comparatively few competitors especially in the over 60 category initially made this data less accurate. But by the mid1990s thousands of swimmers were participating and the age groups included 90+ years. Many studies have looked into the effects of physiological aging on the competitive swimmer, using rate of performance decrement as a measure. The results are consistent across studies and race distances. Performance decrement is reasonably linear for both male and female of 0.6-0.7% each year up until the age of 70. After 70 the plotted graphs show a more exponential curve with performance decrement accelerating to 1.5-1.6% per year. A major focus of these events is the promotion of healthy exercise. There were initial disillusions that regular exercise may somehow reverse the aging process. As competitors have increased and competition improved their swim training, health benefits of reduced body fat, increased muscle strength and decreased blood pressure have been noted. The performance decrement was still noted in these trained swimmers and despite having reached performance levels of a higher standard, their best times continued to decrease as the years went by. Coaches are becoming more aware of the special requirements for this age group. Longer warm up periods, longer rest periods between swim sets, less overall distance, less emphasis on breath control and more rest days, as well as including land based flexibility is recommended for the over 60. Overall Masters Swimming is to be used as motivating force for regular training of a healthy nature in an aerobic sport which imposes little strain and is particularly suitable for the elderly.
Reviewed by Deborah Nelson BPhty, PGD Musculoskeletal
What ’ s your favourite physiotherapy app? Let us know what your favourite physiotherapy app is. Send to Hamish help@spnz.org.nz Include the name of the app, whether it’s iOS, Android or Microsoft, and a brief blurb about why you like it. Any contributions will be put on the SPNZ website and published in a future issue of the bulletin.
Page 20
RESEARCH PUBLICATIONS
JOSPT Articles Ahead of Print www.jospt.org
Does quadriceps atrophy exist in individuals with patellofemoral pain? A systematic literature review with metaanalysis Lachlan S. Giles, Kate E. Webster, Jodie A. McClelland, Jill Cook
Whole Body Vibration Versus Eccentric Training or Wait-and-See Approach for Chronic Achilles Tendinopathy Thomas Horstmann, Holger M. Jud, Vanessa Fröhlich, Annegret Mündermann, Stefan Grau
The Association of Foot Arch Posture and Prior History of Shoulder or Elbow Surgery in Elite-Level Baseball Pitchers Luis A. Feigenbaum, Kathryn E. Roach, Lee D. Kaplan, Bryson Lesniak, Sean Cunningham
Middle and Lower Trapezius Strengthening for the Management of Lateral Epicondylalgia: A Case Report Jiten B. Bhatt, Randal Glaser, Andre Chavez, Emmanuel Yung
Kinesiophobia After Anterior Cruciate Ligament Rupture and Reconstruction: Non-copers Versus Potential Copers Erin H. Hartigan, Andrew D. Lynch, David S. Logerstedt, Terese L. Chmielewski, Lynn Snyder-Mackler
Health Research Reviews Register (FREE) and download the latest “NZ Research Reviews”
http://researchreview.co.nz SPORTS MEDICINE AND PHYSICAL ACTIVITY
ORTHOPAEDICS AND HEALTH
Diabetes and Obesity
Bone Health
Foot and Ankle
Hip and Knee Surgery
Pharmacy
Mental Health– Behavioural Disorders
Rehabilitation
Pain Management
Sports Medicine Travel Medicine Wound Care
RESEARCH PUBLICATIONS
Page 21
SPORTS HEALTH
A Multidisciplinary Approach Volume 5, Number 5 (September/October 2013) Sports Health EDITORIAL The 2013 Sisk Awards SPORTS PHYSICAL THERAPY Axillary Artery Thrombosis in a Major League Baseball Pitcher: A Case Report and Rehabilitation Guide Achilles Tendon Rupture: Risk Assessment for Aerial and Ground Athletes ATHLETIC TRAINING Basketball Coaches’ Utilization of Ankle Injury Prevention Strategies Dynamic Balance Performance and Noncontact Lower Extremity Injury in College Football Players: An Initial Study PRIMARY CARE Cutaneous Infections in Wrestlers Incidence, Nature, and Pattern of Injuries to Referees in a Premier Football (Soccer) League: A Prospective Study Update on Banned Substances 2013 ORTHOPAEDIC SURGERY Intramuscular Hemangiomas “I Went to a Fight the Other Night and a Hockey Game Broke Out”: Is Professional Hockey Fighting Calculated or Impulsive? Sports Hernia Treatment: Modified Bassini Versus Minimal Repair IMAGING Magnetic Resonance Imaging Findings of Snowboarding Osteochondral Injuries to the Middle Talocalcaneal Articulation
SPNZ is on Facebook
Check us out at:
www.facebook.com/SportsPhysiotherapyNZ Website Gems Links to Video Clips Online interviews of interest
ASICS
Page 22
ASICS SHOE REPORT
This season the Fuji Sensor 2 has seen some significant changes to its tooling. Firstly, a new look, more breathable upper equipped with a protective toe box has been added as well as a Clutch Counter system in the rearfoot that customises the rear of the shoe to the individual heel shape of the wearer. As a result fit is enhanced with the aim of reducing the potential for irritation on the foot. Furthermore, the GEL Fuji Sensor 2 is now set on a new low profile 18mm (rear) to 8mm (forefoot) platform. This functions to maintain a lower overall center of gravity which in turn increases stability. A new two layered Solyte midsole that employs a softer density top layer and slightly firmer density underneath combined with a Solyte 45 lasting improves cushioning facilitating an incredibly plush under foot feel. By embedding an internal Trusstic system into the midsole ASICS have given the shoe greater protection and strength. This provides a very stable platform from heel contact right through to the end of midstance. Add to this the new rearfoot GEL unit, that has been improved to enhance cushioning, and a forefoot configuration utilising impressive flexibility in all directions and you have a shoe that protects the foot, supports natural motion and allows a greater contact with the ground for improved grip.
The outsole uses multiple flex points that enable a decoupling of the shoe on uneven terrain. This allows it to adapt to all surfaces as well as results in enhanced surface friction. An aggressive outsole and Xgroove flex system in the forefoot improves uphill and downhill traction also. In short the ASICS Fuji Sensor 2 is more stable from the rearfoot through the midfoot. This will be most noticeable when running on flat trail. As the runner transitions more onto the forefoot during propulsion greater flexibility and traction will be more evident as a result this shoe climbs beautifully. With changes such as these it is with anticipation that we wait to see what exciting changes future development holds. It is easy to see why the Fuji Trail Sensor is a premium shoe for trail runners looking for durability and cushion on longer runs.
FORERUNNER September 2013
Page 23
CONTINUING EDUCATION CALENDAR
For a list of sports related courses see the SPNZ calendar
For a full list of local courses visit the PNZ Events Calendar
LOCAL COURSES & CONFERENCES When?
What?
Where?
More information
2-3 November 2013
Sideline Management
Christchurch
SPNZ website
9 November 2013
Podiatric Assessment & Manage- Wellington ment of the Foot and Ankle: A New Plymouth Practical Workshop for Sports & Musculoskeletal Physiotherapists Tauranga
2014
10 November 2013 30 November 2013 1 December 2013
Fax 04-801 5571
Or email nzsp@physiotherapy.org.nz
Auckland
14-15 November 2013
SPRINZ Strength & Conditioning Auckland Annual Conference
Click Here
15-16 March 2014
3rd SPNZ Symposium
Symposium Website
Rotorua
See Physiotherapy NZ Website
Click Here
INTERNATIONAL COURSES & CONFERENCES When?
What?
Where?
More information
World Congress on Low Back and Pelvic Pain
Dubai
Click Here
2013 27 Oct 2013
2013 SESNZ Conference Registration Exercise Science for Health and Sports Performance The SESNZ Annual Conference will be held 29-30 November 2013 in association with the University of Canterbury, Christchurch. This year’s theme is “Exercise Science for Health and Sports Performance”. Guest speakers include: Alex Baumann (High Performance Sport New Zealand), Gary Hermansson (Massey University, Palmerston North) Sandy Mandic. The Conference Programme is now available online http://www.sesnz.org.nz/Conference/ Registrations are now open for the 2013 SESNZ Conference in Christchurch
CONTINUING EDUCATION
Page 24
Sports Physical Therapy Section (APTA) HOME STUDY COURSES Learn from home and gain CPD points. The SPTS offer a variety of downloadable learning packages that are available to SPNZ members at IFSPT member prices. Each home study course consists of a series of 5-8 chapters, each 15-30 pages in length and each requiring 4-6 hours to complete. This is followed by an examination. If the examination is completed with a score of more than 80%, a certificate will be issued for “continuing education credit hours”.
Example: “RUNNING COURSE”: Chapter 1: Epidemiology of Running Injuries Chapter 2: Running Mechanics and Clinical Analysis Chapter 3: Evaluation and Management of Lumbopelvic, Hip and Knee Running-Related Injuries Chapter 4: Foot, Ankle and Lower Leg Injuries in Runners Chapter 5: Footwear and Foot Orthoses Chapter 6: The Female Runner Chapter 7: Nutrition for the Runner Chapter 8: Return to Running (IFSPT / SPNZ Member Price for “Running Course”: $300 USD)
Other Courses Available from the Home Study Course Store: NEW! CURRENT CONCEPTS IN SHOULDER REHABILITATION Chuck Thigpen PT, PhD, ATC PEDIATRIC AND ADOLESCENT SPORTS MEDICINE: MANAGEMENT AND PREVENTION OF INJURIES UNIQUE TO THE YOUNG ATHLETE Donna L. Merkel, PT, MS, and Joe Molony, PT, MS. CURRENT CONCEPTS IN EVALUATION, EXAMINATION AND REHABILITATION OF THE KNEE Robert C. Manske, PT, DPT, Med. REHABILITATION OF THE HIP Lori Bolgla, PT, PhD, ATC and J. Craig Garrison, PT, PhD, ATC THE SPINE IN SPORTS Barb Hoogenboom PT, EdD, SCS, ATC INJURY PREVENTION IN SPORTS MEDICINE Mike Mullaney, PT REHABILITATION OF THE AGING ATHLETE J. W. Matheson, PT CURRENT CONCEPTS IN THE EXAMINATION AND TREATMENT OF THE SHOULDER Timothy F. Tyler, PT, MS, ATC REHABILITATION CONCERNS FOR THE FEMALE ATHLETE Teresa L. Schuemann, PT, SCS, ATC, CSCS CURRENT CONCEPTS IN THE REHABILITATION OF THE KNEE Kevin Wilk, PT EMERGENCY RESPONSE FOR THE PHYSICAL THERAPIST Danny D. Smith, PT, DHSc, ATC
To Purchase a Course: Create an Account then select course from the Home Study Course Store (when purchasing, select “IFSPT member”)
For more information go to the Sports Physical Therapy Section Home Study Page
Page 25
APA CPD Event Finder
SPNZ members can now attend APA SPA (Sports Physiotherapy Australia) courses and conferences at APA member rates. This includes all webinars and podcasts (no travel required!). To see a list of courses and conferences visit the APA and SPA Events Calendar To register, download a Registration Form and forward to the relevant Branch Office (listed on the Registration Form).
Snow Sport Physiotherapist continued...
Search for more courses, conferences, webinars and podcasts on the APA and SPA Events Calendar
CONTINUING EDUCATION OPPORTUNITIES
Page 26
DOWNLOAD CONFERENCE PROGRAMME
Early-bird Registrations are
OPEN NOW
Don’t count the days, make the days count. MOHAMMED ALI
It’s what you get from games you lose that is extremely important. PAT RILEY
Page 27
CLASSIFIEDS POSITION VACANT TAURANGA Foundation Sport & Rehabilitation Clinic Sports physiotherapy position in Tauranga CBD
Here is a unique and exciting opportunity to work in a recently established sports physiotherapy and rehabilitation clinic situated in the Tauranga CBD. Due to a rapidly expanding clinic “Foundation” is in need of another high quality sports physiotherapist. The position will involve working with one of the Bay of Plenty’s top premier rugby clubs as well as an international rugby and cricket academy. Generous appointment times allow for an emphasis on manual/manipulative physiotherapy and exercise prescription encompassing full rehabilitation in the onsite rehabilitation gym. Clinical team consists of physiotherapists, massage therapists, nutritional advisor, fitness trainer and full time reception. Work along-side physiotherapists who have experience working with national and international athletes and sports teams. The successful applicant will receive on-going support as part of our mentoring program. The position is permanent full time. Start date is negotiable, but sometime before December 2013. Employees will be paid a base retainer, so there’s no stress about income as you grow your patient list. Allowance for CPD also included. We are looking for a competent, hard-working individual with high work ethic, excellent communication and enthusiasm who is keen to learn and enhance their clinical skills. New Grads with appropriate musculoskeletal and/or sports experience welcome to apply.
All applications will be treated with utmost confidentiality. Forward your CV and covering letter to Craig Newland: craig@foundationclinic.co.nz
ADVERTISING Deadlines for 2013: February Bulletin: April Bulletin: June Bulletin: August Bulletin: October Bulletin: December Bulletin:
31st January 31st March 31st May 31st July 30th September 30th November
Advertising terms & conditions click here.
Advertisements appearing on this page are not necessarily endorsed by SPNZ