This article proves useful and practical reading for alternatives to arthroscopy, it recommends not limiting treatment to one form of exercise therapy, looks at what will work best for the patient and explores combinations of different exercise therapies.
At least 10 randomised controlled trials and a systematic review attribute knee arthroscopy with a clinically insignificant benefit, and shows no benefit when compared with a cost-effective, supervised exercise therapy programme. The article covers information that practitioners need to know about their patient, weight management and what the patient should expect as part of their treatment.
A recent survey illustrated a lack of knowledge of current guidelines to recommend supervised exercise therapy and education. 44% of respondents were unaware of evidence against arthroscopy. The article recommends engaging with the evidence, attending courses to increase knowledge base and having confidence to provide appropriate exercise therapy. Key things to do now, to help patients, provides the summary of this very useful piece.
The Daily Mile is going from strength to strength with schools in 30 countries now participating, including Kamalii Elementary School in Hawaii and schools in Indonesia, Honduras, Egypt and Dubai. The Daily Mile Foundation will keep working on expanding internationally, supporting schools from around the world to join the movement.
Over the last few months, The Daily Mile has had many exciting successes. Here are some highlights:
- Alongside GO Run For Fun, the world’s largest children’s running initiative, The Daily Mile Foundation brought together 5000 primary school children from London and across Britain to take part in a 2 kilometre fun run in June. VIP guests including Olympians Denise Lewis and Colin Jackson cheered the children on at the event at the Queen Elizabeth Olympic Park.
- The Scottish government will work with The Daily Mile to look at increasing participation in schools and nurseries across the nation, with a view to help the Scottish Government achieve their ambition of becoming the world's first 'Daily Mile Nation'. "Our ambition is for Scotland to be the first ‘Daily Mile’ nation with roll out to nurseries, schools, colleges, universities and workplaces across the country, " states the SNP policy for encouraging physical activity. "Every school will be offered help to become a Daily Mile school."
- A recent study revealed that children who do The Daily Mile do better at school. Sports scientists Fitmedia Ltd monitored 76 year six pupils at Coppermill Primary School in Walthamstow for 12 weeks as they started The Daily Mile. Children who ran The Daily Mile performed up to 25 per cent higher than expected in reading, writing and maths SATs. They were also fitter, more confident and better behaved.
The Daily Mile is a popular health and wellbeing initiative, brainchild of former headteacher Elaine Wyllie, encourages children aged 2-11 years to run or jog/walk for 15 minutes every day in their schools and nurseries. In this time, most children average a mile or more distance. The idea is simple and profoundly effective; every child can take part, regardless of their age or personal circumstance and it's not competitive, so every child succeeds. It's free for schools and, most importantly, the children love it!
Parents of children who take part in The Daily Mile comment that their children are eating and sleeping better, are stronger and more resilient, and are calmer and more content. Teachers report that challenging behaviour is reduced, that the children are concentrating better and are quicker to settle into their schoolwork.
View our case study on Woodfield Primary School (Wigan Case Study) and how The Daily Mile is working well in the Wigan area. The school is a fantastic illustration of the difference The Daily Mile can make.
This is a valuable podcast which demonstrates the importance of psycho-social readiness, upper and lower limb quadrants and the kinetic chain in the rehabilitation of a shoulder injury. It explains that the rehabilitation process is about the body as a whole, not solely focusing on rehabilitation of the injured limb.
This 25-minute podcast by Jo Gibson, a top physiotherapist and specialist in shoulder rehabilitation and injury, focuses on recurrent shoulder injuries, pre and post-surgical rehabilitation, understanding psychological and psychosocial aspects alongside the emotive processes and apprehension.
In the podcast, Jo focuses on the importance of a pre-op assessment in terms of taking time to check the player’s understanding of their injury, the importance of listening to the patient and in turn understanding the patient’s psychosocial issues to help them engage in the rehab process.
In terms of rehab post-operation, Jo focuses on the need to consider the shoulder part of the whole kinetic chain. It has been demonstrated in contact sports, performance correlates of the upper limb are very highly correlated with lower quadrant performance, so adding kinetic chain exercises can reduce abnormal load on the shoulder. It was also demonstrated that working the unaffected arm at a high level can have a strength increase effect on the operated arm.
Jo then focuses on discharge criteria again in terms of psychosocial readiness and the upper limb and kinetic chain. Some examples of tests used for return to play include the upper extremity Y balance test and closed kinetic chain upper extremity stability test.
BJSM podcast: SoundCloud
Dr John Morgan, Clinical Director of Bucket and Sponge Medical Services and BASRaT committee member, has been made a Fellow of the Faculty of Sports and Exercise Medicine of the Royal College of Surgeons of Ireland and The Royal College of Physicians in Ireland. The award was made on 10th July 2017, to mark his outstanding contribution to sports and exercise medicine.
Dr Morgan, who has been practicing medicine for 19 years, is also a GP at Pennygate Medical Centre in Hindley, Wigan. Additionally, he is director of both Dr1ve Medicals (providing medical examinations for commercial drivers) and of Enrich Aesthetics.
Well known in the world of sport, Dr Morgan has acted as Physician to Lancashire Rugby Union and to Warrington and Widnes Rugby League Clubs. He is the current doctor of Orrell Rugby Union Club, Leigh Centurions Rugby League Club and of the Ireland National rugby team.
Dr Morgan said:
"It is an honour and privilege both to receive this accolade and to support and care for all of my patients within sports medicine and general practice. The work we have done in raising awareness that increased levels of physical activity can both prevent and treat disease has enhanced the lives of many people."
Dr Morgan joins a list of Fellows who represent the most respected sports and exercise experts in the country. He offered his congratulations to all other new Faculty Fellows and said: "During my career in medicine I have lived by the maxim that learning is lifelong and I have continued to learn and develop new skills, that has helped spur my interest in medicine and make me the person I am today."
Swim England's study of over 80,000 people showed that swimmers had a 28% lower risk of early death and a 41% lower risk of death due to heart disease and stroke.
The independent report demonstrated the health benefits of swimming. Swimming is great for physical and mental health from as young as 3 months to 65+ years.
- Improves heart health
- Lowers blood pressure
- Improvea lung capacity
- Reduces joint pain
- Increases bone strength
A literature review demonstrates the individual physical health benefits on the cardiovascular, cardio metabolic, neurological and pulmonary systems, MSK health and benefits to specific populations such as disability, elderly and women. A systematic review demonstrates the effects of swimming on wellbeing and further systematic and literature reviews demonstrate the physiological effect, benefits to communities, public health benefits and swimming as a sport. This report containing a vast amount of up-to-date literature, evidence based research and information. There are huge benefits in incorporating swimming into rehabilitation such as individual therapy sessions, recovery, hydrotherapy or training sessions.
A small team led by triple amputee, Andy Reid are taking on a major physical challenge. Andy and Glenn Hughes, a former comrade, will cycle 500 miles from Lytham to Devizes and kayak 100 miles from Devizes to Westminster as they visit the graves of 6 soldiers killed on March 6th 2012.
Sport Rehabilitator Charlotte Bell is working with the Challenge. Charlotte states "I've got the fantastic opportunity of working with these amazing veterans on the warrior challenge, please take a look and any donations would be greatly appreciated.”
From 16 – 29 June 2017, the Warrior Challenge will cover 525 miles in 14 days through running, cycling and kayaking
The Warrior Challenge honours the memory of 6 men who lost their lives on the 6th March 2012 while serving in the Kandahar province, Afghanistan. All 6 died when their Warrior armoured vehicle was caught in an explosion. 5 of the men were from Andy’s regiment, 3rd Battalion 'The Yorkshire Regiment' with the final soldier being from 1st Battalion 'The Duke of Lancaster's.'
Andy and Glen are both veterans of the Afghan War, each with life changing injuries, some visible, others not so.
Visit www.warriorchallenge2017.com to find out more and click on Donate.
Published in the BJSM, a recent control trial assessed a pre-activity movement exercise intervention to reduce the incidence of rugby related injuries in schoolboys.
Major findings demonstrated that completing the intervention programme 3 times a week led to substantial reductions of injuries.
31 schools and 83 teams aged 15, 16 and 18 were used in the trial. They were randomly allocated to either an intervention or control group.
Both programmes contained 4 phases, beginning with their preseason training and were completed during the first 20 minutes of training or match warm up. The intervention group contained balance and perturbation training, resistance and plyometric training, sport specific landing, cutting and technique reinforcement. The control group contained exercises of stretching, mobility, change of direction and speed.
Completing the intervention programme 3 times per week led to substantial reductions of 72% in overall match injury incidence and 72% in contact-related injury incidence compared with the control programme. View the full article with a sample of the exercise programme at http://bjsm.bmj.com/content/early/2017/05/08/bjsports-2016-097434
COPA 2017 will be at the ExCeL, London on the 7th & 8th June and promises to be the trade event of the year for professionals from the rehabilitation sector.
Focusing on providing the best practice growth advice and showcasing the latest development and cutting edge technology from the field, COPA is Europe’s leading event for rehabilitation professionals.
Free tickets are available to all our members. http://copashow.co.uk/index
Share our essential new guide with your patients or colleagues - it will benefit both beginners and experienced runners.
BASRaT has just published the running guide which will help experienced runners to improve, giving tips to work on technique and improve ability. The guide also provides all you need to know for those who have never run before.
Covering training, distance, intensity, training planning, technique, strength training and injury prevention - this guide will enable users to start training safely, avoid injury and improve overall technique and performance.
A recent investigation looked at the effect of the FIFA 11 and 11+ injury prevention programmes in football.
Football is a widely popular sport played by an estimated 250 million people around the world. As footballers incur many injuries, FIFA developed the injury prevention programmes to reduce the risk of injury in players. The FIFA 11+ is the updated version of the FIFA 11 containing additional exercises.
The review looked at the effect of specific exercise-based football injury prevention programmes on the overall injury rate in football.
This systematic review and meta-analysis used 6 randomised controlled trials, comparing the use of the 11 and 11+ programmes with a control group among recreational or sub elite footballers, with the primary outcome looking at injury incidence.
The primary outcome demonstrated a 25% overall injury incidence reduction per 1000 hours of exposure in the FIFA injury prevention programmes group, compared to the control group. The total injury incidence for the intervention group was 3.99 injuries per 1000 hours compared to 5.57 for the control group. The secondary outcome demonstrated a reduction in lower limb injuries in favour of the FIFA 11+ programme, specifically; the hamstring, hip/groin, knee and ankle.
This is an excellent review demonstrating the importance of a complete warm up programme for athletes and recreational players to reduce injury rate. This programme can also be adopted and adapted across a wide range of sports. As Sport Rehabilitators this is a crucial element to ensure players remain healthy and injury free during the season.
The FIFA 11+ warm-up programme can be found here: http://f-marc.com/11plus/exercises/
Thorburg, K., Kuhn Krommes, K., Esteve, E., Bek Clausen, M., Bartels, E. and Rathleff, M. (2017). Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes. British Journal of Sports Medicine (51)7: pp. 562-571
A study published recently in the BMJ has shown that cycling to work can considerably lower your chances of dying.
It was found that cycling to work was associated with a 41% lower risk of dying overall compared to commuting by car or public transport. Cycle commuters had a 52% lower risk of dying from heart disease and a 40% lower risk of dying from cancer. They also had 46% lower risk of developing heart disease and a 45% lower risk of developing cancer at all.
The study looked at 263,450 people with an average age of 53 who were either in paid employment or self-employed, and didn’t always work at home. The commuters were grouped into five categories: non-active; walking only; cycling; mixed-mode walking; and mixed-mode cycling.
The study followed people for around five years, counting the incidences of heart disease, cancers and death, adjusting for other health influences including sex, age, deprivation, ethnicity, smoking, body mass index, other types of physical activity, time spent sitting down and diet. Any potential differences in risk associated with road accidents was also accounted for, while participants were excluded who had existing heart disease.
We are very proud to say thank you to the 60 Sport Rehabilitation students and 7 staff from St Mary’s Uni who volunteered their time and amazing skills at the London Marathon on Sunday.
Claire McLoughlin supervised the students alongside 7 staff members to help the recovery of runners at the Marathon. In total they gave 350 massages to 700 legs and worked over a 12 hour period for 16 charities!
Well done St Mary’s.
Sporting stars and public health experts are joining forces today to officially launch The Daily Mile in Wales. Team GB weightlifter Michaela Breeze and sprinter Christian Malcolm, adventurer Tori James, Public Health Minister Rebecca Evans, founder of The Daily Mile Elaine Wyllie, and head of physical activity at Public Health Wales Robert Sage, will officially launch the initiative at Pontllanfraith Primary School in Blackwood.
The Caerphilly primary school is the latest school in Wales to sign up to The Daily Mile – an easy, fun way to improve children’s health and wellbeing. The initiative sees primary-aged children run, walk or jog for 15 minutes every day in school. It is inclusive, simple and free, with no equipment or set up required.
Christian Malcolm, World and European 200m Medallist, said:
"Within a month the children are much fitter, and feel happier and more confident in themselves. By instilling these healthy habits at a young age, we're helping our children to live full and healthy lives."www.thedailymile.cymru
Trending on twitter in the healthcare world is the hashtag #EndPJparalysis
Healthcare professionals across the country are beginning to recognise the importance of getting patients up, dressed and getting them active. This social media campaign is trying to raise awareness of the harm of deconditioning caused by bed rest:
- One week of bed rest results in 10% of muscle loss
- 10 days of bed rest in hospital is equivalent to 10 years of muscle ageing in people over 80 years old
- Two days of bed rest leads to 2-5% loss of muscle strength
- Patients have increased risk of infection, and loss of aerobic function
All the factors above can make the difference between dependence and independence. Getting patients active can help maintain both their physical and their mental health which can be imperative in helping to reduce hospital stay time. Preventing deconditioning is crucial for patient safety, wellbeing and reducing the risk of further infection or illness. Maintaining mobility and muscle strength can make the difference in a patient’s recovery.
Sport Rehabilitators can help to get people moving again. Ending PJ paralysis is important because it is not only the elderly population who decondition; any patient or athlete who may require periods of rest and inactivity will become deconditioned and experience atrophy. Therefore, recognising this and getting patients back on their feet, maintaining mobility and getting active is a pivotal part of recovery. "Use it or lose it".
Professor Jane Cummings, Chief Nursing Officer in England is backing this new campaign to get patients active. Article Here
Three time gold Olympic medal winner, Ed Clancy credits Sport Rehabilitator
Ed Clancy won his third cycling gold medal in the Team Pursuit at the 2016 Rio Olympics. He may not have been there if it hadn’t been for the dedication of his medical team, including Sport Rehabilitator Hannah Crowley.
Ed said that Hannah was involved from beginning. Ed stated
"I had my initial prolapse Hannah was my first point of contact. I was in touch with Hannah three to four times a day, before and after being on the bike."
"After surgery I had two weeks at home and then was driven into Manchester on a flat bed. I saw Hannah three times a week for manipulation."
"Hannah and the medical team were crucial to my recovery. Hannah listened and evaluated and monitored my progress and put together a core stability programme."
Ed goes on to say
"The team almost became my coaches more than my own training coach. They stated what training my back could and couldn’t cope with. It made a massive difference and was on the forefront on my mind to mention the team after my win."
"Without the medical team, between the 3 of them….. I spent more time with them and was led by how much training my back could and couldn't cope with. Hannah was my 'go to' person."
Sport Rehabilitator Hannah Crowley stated
“It was a whole medical team effort. My main responsibility was his off bike rehabilitation. Ed was fantastic to work with, he put a significant amount of hard work into his rehab to strengthen his back post-surgery enabling him to support his position on the bike.”
This BJSM podcast from Dr Eammon Delahunt is based on chronic ankle instability (CAI) and is a worthwhile listen. Ankle injuries have a 14% prevalence in male professional association football, they also account for 25% of all injuries in NCAA basketball and volleyball.
This podcast is highly informative and contains an overview of the features, mechanism of injury and signs for CAI. It also contains the management for a sustained ankle injury. Furthermore, a brief discussion of the modified Ottawa Rules and lateral ligament laxity assessments. The use of taping and bracing to reduce the rate of rear foot inversion is also discussed in this BJSM podcast.
The two main diagnostic techniques to assess the integrity of the lateral ligament complex are the anterior drawer test and Ottawa rules.
Following a lateral ankle sprain, balance and postural control is reduced bilaterally so training postural control on both limbs is important. For example, hopping and landing exercises with cushioned landings. Progressions include a more dynamic step forward, or taking off and landing on the injured limb. Distance and environment can be modified, for example, landing on an uneven surface or responding to a stimulus e.g. kicking a ball.
Ankle sprain management and chronic instability (2017) British Journal of Sports Medicine (released 10 February 2017) [podcast: BJSM]. Available at: Here
Rare Disease Day is a public health initiative to raise awareness about rare diseases and their impact on patients’ lives. It takes place on the last day of February every year.
Get involved with Rare Disease Day by exploring the links below and spread the word to your fellow clinicians about this public health initiative.
Myofibrillar myopathies are a group of rare genetic neuromuscular disorders that may be diagnosed in childhood but most often appear after 40 years of age. These conditions are highly variable but are characterised by a slowly progressive muscle weakness that can involve skeletal and smooth muscle. Some signs and symptoms include: muscle stiffness, aching, cramps or atrophy. Some patients may also experience: pain, loss of sensation, inability to control muscles or cardiomyopathy.
Find out more about this and other rare diseases at http://nordphysicianguides.org/. The NORD Online Physician Guides provides resources for clinicians about certain rare disorders, which may help you within your practice as a Sport Rehabilitator.
Front Line Medical Communications also provide information about rare diseases for healthcare professionals. View recent publications at https://rarediseases.org/
This year’s Bill McLoughin prize has been awarded to Judith Firth, the prize recognises outstanding achievement.
Judith studied at the University of Bolton and completed a three year Honours degree in Sport Rehabilitation. Judith has set up her own clinic JB MSK Manual Therapies where she is treating clients with sporting and non-sporting injuries and conditions.
Judith praised her course "My degree was exciting and challenging and provided me with a broad range of skills and knowledge that I could apply to both sporting and non-sporting contexts. There was an emphasis on practical application, I especially enjoyed working with a range of clients and a wide variety of conditions."
Judith’s placements were very varied, she built up experience treating both acute and chronic conditions and developed a range of skills including the use of Hydrotherapy and Pilates in rehabilitation. Judith worked at Bolton Wanderers Football Academy which greatly improved her ability to diagnose and treat acute sporting injuries.
Alongside her private clinic, Judith is still working for Bolton Wanders Football Club Academy. She is continuing to further her knowledge with a wide variety of courses including ‘stages of rehabilitation for football injuries’ and courses in Pilates and Acupuncture.
Torah Browne has won the LFC Graybrook prize for achieving the highest marks on a BASRaT undergraduate degree, Torah’s exam result was an impressive 89%.
"I am shocked to win! The course was amazing, I loved how practical it was. I got an opportunity to work with loads of different people in a variety of sports."
The LFC Graybrook prize recognises outstanding achievement. Torah attended Middlesex University and completed a three year Honours degree in Sport Rehabilitation. Torah completed her second year in California.
Torah went on to say
"All my lecturers supported me during my course and kept in contact whilst I was away. I had some invaluable experiences, I enjoyed working with different clients, it was challenging working with a variety of people and sports.
Torah is now doing a masters in Physiotherapy at Brunel. Torah is pictured with Steve Aspinall, BASRaT Chairman.
How the first contact with a patient can be the most important moment of all
Steve Aspinall (BASRaT) speaks to Richmond Stace @painphysio about the importance of compassion and active listening in the treatment of pain.
Richmond will present the keynote speech at this year's Symposium, covering an in-depth look at the topics explored in this podcast. You can view the full conference programme here. basrat.org/home/agm
Listen to the podcast here
Steve Aspinall, BASRAT Chairman speaks to the daily mile founder Elaine Wylie on BJSM’s podcast.
This simple game changing initiative provides massive public health benefits though a simple philosophy of non-competitive outdoor fun for all children regardless of age, gender, ability or socioeconomic background. Over the last 20 years the increasing toll of sedentary behaviour on young people’s physical and mental wellbeing is a well-documented phenomenon. Different policy initiatives have failed to tackle the problem.
There are so many benefits of children completing the daily mile including increased attention, building self esteem and fitter, healthier children.
Listen to Steve and Elaine discuss this inspirational initiative and find out how you can get involved here.
Physical inactivity as a public health problem is comparable to smoking, increasing the risk of serious conditions such as cancer, heart disease, stroke and diabetes. It also heightens the burden on healthcare professionals, leading to expanding costs and lengthening waiting times.
Dr John Morgan has been recommending the clinical use of physical activity, like walking, for a number of years.
John states “By helping patients to get and stay active we have noticed 30% to 50% reductions in hypertension, ischemic heart disease, dementia and depression.”
Using physical activity referrals can help empower patients to take control of their health.
Read the full article at www.walkingforhealth.org.uk/case-studies/john-morgan-gp-wigan
The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome.
FAI syndrome is a motion-related clinical disorder of the hip with a triad of symptoms, clinical signs and imaging findings. It represents symptomatic premature contact between the proximal femur and the acetabulum.
22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on diagnosis, treatment principles and key terminology. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery.
Read more at http://bjsm.bmj.com/content/50/19/1169.full
Sport Rehabilitator, Hannah Crowley was praised yesterday by Ed Clancy after winning gold at Rio.
Ed Clancy won his third gold medal as part of the men’s team pursuit in a nail-biting race against Australia.
Ed personally mentioned Hannah and his doctor after the race. His medical team have put in over 1000 hours to rehabilitate his back after surgery for a slipped disc.
Congratulations to the team and all those who work with British cycling; we look forward to enjoying more races over the next few days.
Sport Rehabilitator, Lindsay Whitaker is cheering on her team in the play offs. Rugby Union side, the Doncaster Knights are through to the Championship play off finals later this month.
Lindsay took time out to update us on life with the Knights -
How is the atmosphere at the club at the moment?
"The atmosphere is incredible, there's such a buzz around the place. Everyone is excited for the first leg at home on 18th May. Training is going well, and luckily we don't have too many long term injured players left so the squad is pretty much all together in every training session."
Why do you think they have done so well this season?
"There is a great sense of family amongst the team, and that unity throughout the whole season has been key. The coaching staff are exceptional and we have extended the medical department slightly. Also having Sport Rehabilitator students from the University of Salford has helped as we've been able to offer more recovery soft tissue work and look at preventing more injuries, as well as giving the injured players longer treatment and rehab time which is leading to quicker recovery times."How are you feeling about the playoffs?
"I can't wait, they will be the biggest games I've been involved in. If the crowd is anything like our semi-final game, it will be an amazing day."
The Doncaster Knights will play Bristol at home and away on the 18th and 25th of May respectively. We wish the Knights and Lindsey the best of luck for these two games.
Kyle Simpson has won the LFC Graybrook prize for achieving the highest marks on a BASRaT undergraduate degree.
The LFC Graybrook prize was initiated in 2013 to recognise outstanding achievement. Kyle attended the University of St Mark and St John and completed a three year Honours degree in Sport Rehabilitation. Kyle is now running his own clinic 'KS Sports Therapy' which offers both rehabilitation and personal training.
"I enjoyed the hands on aspect of my course and the fact that the skills I learned were directly transferable to my job. I also enjoyed the expert teaching and various volunteering opportunities I undertook, particularly my 3 years spent working with the Plymouth Argyle Football Club first team.
"I love the fact that I get to help people with Sports Rehabilitation, as well as the fact that I see a variety of issues so my job is constantly stimulating. I really enjoy running my own clinic and will hopefully give something back to the profession which has been very good to me."
"Kyle really deserves this prize and the recognition. Kyle was an excellent, hardworking student and embraced every opportunity offered to him on the degree programme."
The Professional Standards Authority, the overseeing body for the Accredited Registers, announced earlier this month that the General Medical Council has amended its explanatory guidance on Good Medical Practice. This guidance is specifically aimed at GPs, and explains how doctors can put best practice principles into action when, for example, delegating care and making referrals.
The guidance now directly references the Accredited Registers as an example of how GPs could satisfy themselves that systems are in place to assure the safety and quality of care provided to their patients.
This is an excellent step forward in the recognition of professionals on an Accredited Register, including all BASRaT graduate members.
For more information, please see the section on Referrals at: http://www.gmc-uk.org/guidance/ethical_guidance/21187.asp
The theme for 2015 is one of our most exciting yet. In both workshops and lectures, there will be a special focus on performance, training and rehabilitation for extreme events involving running, swimming and cycling and how this information can also be transferred to more general training. As usual there will also be a range of fantastic hands on workshops covering rugby, football and more!
Preparations to this year’s conference 'Prepare to Perform' are off to a flying start and we are pleased to announce that it will take place on Friday 20th November 2015 at Manchester City’s impressive Etihad Stadium. Our keynote Speaker Ian Horsley is kicking the conference off and due to popular demand we have James Dunne returning with exciting new workshops. We also have cycling expert Richard Salisbury joining us as well as Man City's Head Physio Lee Nobes. Lee Herrington has been confirmed to lead workshops - this conference is not one to be missed!
This year the conference will be taking place on a Friday to accommodate members and delegates working in professional sport on weekends, we hope this is a welcome change and follows lots of feedback to move our annual event from a Sunday.
This is definitely not an event to miss out on, there will be lots of take home nuggets for you to implement in your day to day practice. For our early bird offers and more details please register your interest via firstname.lastname@example.org. We will be announcing further details soon.
Interested in being an Exhibitor or Sponsor at our Etihad conference? Contact email@example.com for more information.
Introducing Dr Lucy Hammond as Student Liaison Officer
Dr Lucy Hammond was elected in to the BASRaT Executive Committee at the November AGM.
Dr Hammond is a Graduate Sports Rehabilitator and a Senior Lecturer at University of Bedfordshire. In addition to her academic role, she currently works within a multidisciplinary clinic. She has worked in Higher Education for the past 11 years and chairs a Professional Practice Working Group, which has strong links with employers and careers services. She is also currently responsible for teaching professional practice and professional ethics, and has been recently awarded a teaching fellowship at the University of Bedfordshire to develop her work in developing professionalism and ethical understandings in students. She looks forward to being able to implement the benefits from this work both locally, and extending this across BASRaT institutions.
Chris Wilcox: Quality Officer
Chris Wilcox, formerly the Student Liaison Officer, has taken on a new role as Quality Officer for the BASRaT Executive Committee. This role has been specifically developed to increase our standards of governance as a professional body and ensure that the Committee adheres to high standards of practice. The Quality Officer undertakes the administration, oversight and responsibility for the quality functions of the BASRaT Executive Committee. Chris will continue to work closely with colleagues at the University of Hull, in particular with the BASRaT Registrar and Secretary. He will be leading on projects and writing groups which will deliver defined policy and procedure documentation and guidelines for BASRaT practice as a regulatory and professional body. The addition of this role is an important step forward for the Committee following the Accredited Register status with the Professional Standards Authority. To contact Chris in his new role, details can be found on the website or you can email him directly: QualityOfficer@basrat.org
BASRaT and the British Journal of Sports Medicine will be running a series of podcasts over the coming months. Our first one will feature BASRaT Chair Steve Aspinall and Executive Committee Member Dr Allan Munro. If you’ve not listened to BJSM podcasts they are a great resource and can contribute to your CPD hours. Download via iTunes or Soundcloud: http://bjsm.bmj.com/site/podcasts/
Recent BJSM podcasts include:
- Physiotherapist Chris Swier on the ATP World Tour
- Effective treatments for back pain: Kieran O’Sullivan’s practical tips within a guiding framework
- Dr Jeppe Bo Laurensen talking about exercise interventions to prevent sport injuries
63,000 health practitioners stand ready to help transform nation's health, says Professional Standards Authority
The UK now has a real opportunity to get more out of its health and care workforce, the Professional Standards Authority said today. Acknowledging widespread recognition that we need new ways to deliver integrated care fit for the 21st century and tackle national health problems, Harry Cayton, the Authority's Chief Executive, called for people in charge of health and care services to use a wider range of occupational groups.
Mr Cayton made the comments as the Authority published its first report on the Accredited Registers programme, the Government programme to promote safety and quality in a wide range of health and care services across the UK. BASRaT is one of these accredited registers. The extra level of assurance the programme offers gives commissioners and employers the confidence they need to make wider use of a workforce focused on prevention and wellbeing.
The report published today sets out how the programme gives service users, employers and commissioners the confidence they need to use a wider range of practitioners. The benefits of the programme include:
- all Registers which have been accredited to date have made improvements to their working practices to gain accreditation from the Authority, improving overall quality across the different sectors
- if a practitioner is removed from one Accredited Register they cannot join another, protecting patients and consumers from malpractice
- all Accredited Registers are required to carry out careful risk assessments to ensure they understand the risks their occupation may pose to the public and to ensure that they are managing those risks effectively.
A Look Back at 2014 ....It has been a very busy year at BASRaT. Here is a snippet of what we have been up to;
- Appointment of an experienced PR consultant to help engage with members of the public and service users to improve information on what we do and our accreditation.
- Launched a communications toolkit for all members to use when communicating sport rehabilitation and accreditation.
- The BASRaT website has undergone re-development recently (all feedback welcome)
- Introduced new roles to the committee with two lay members to ensure all decisions of the committee are in the best interests of the members.
- The Annual Symposium was held at the University of Hull with some very exciting keynotes. Thanks to all who attended. Next year we are coming to the 'ETIHAD' stadium in Manchester and are very excited about the line up.
- We are currently working with the RFU on future employment opportunities for members.
- Appointment of a professional consultant to aid in gaining recognition with private medical insurance companies.
- Renewal of our accreditation with the Professional Standards Authority (please turn over for more information on what the PSA means to you)
At our 2014 AGM, we announced our first ever winners of two new prizes.
Congratulations to our first award winners of the student prizes:
The first award - Graybrook Prize was awarded to Cemil Yesilyurt for achieving the highest overall percentage grade upon degree completion.
The second award - Bill McCloughlin Prize was awarded to Shannon Barnes for her outstanding achievements and efforts within Sport Rehabilitation. Named in memory and honour of the late Bill McCoughlin for is contribution to education within sport rehabilitation.
"The Rehab Continuum" - Symposium 2014 Research Presentation
We are currently looking for some GSR's to present their postgraduate research at this year's "The Rehab Continuum" symposium. If you have something exciting to share with everyone then please get in touch!
You would need to be able to present the research in poster format within a 30 minute time slot. In return you will be provided with a free ticket to both days of the symposium and the dinner!
If you are interested please send a brief summary of your research to the following before 15th August 2014:
Lindsey Woolstencroft - firstname.lastname@example.org
Dr Hollie White - email@example.com
BASRaT needs your photos!
For a fantastic opportunity to get yourself a FREE ticket to both days at the 2014 conference send us your snaps. We are looking for the perfect photos to represent BASRaT in our new campaign. We are looking for a range of themed photos:
- Manual Therapy
- Exercise Therapy
- Military Work
Any photos used in our Spring/Summer campaign will be winners of the competition and awarded with a 2014 Conference Ticket. Please look on our website for terms and conditions. Send your photos to firstname.lastname@example.org. All photos required a release form which can be obtained from BASRaT directly or can be downloaded here.
The Canadian Athletic Therapists Association has recently published a consensus statement on Concussion in Sport. The full text is available via the British Journal of Sports Medicine: here
BASRaT has now submitted an application to the Professional Standards Authority (PSA) with the aim to become accredited and join the Accredited Voluntary Register. The PSA are currently reviewing our application and we shall keep members and visitors updated as to our progress.
Starting in September 2012, the University of Cumbria has become the latest institution to offer a BASRaT accredited degree programme for Undergraduate Sport Rehabilitators.
Programme lead, Dr Katie Small, herself a Graduate Sport Rehabilitator (GSR), explained the importance of this recent accreditation:
"There is increasing public awareness regarding rehabilitation of sporting and exercise based injury, particularly following the recent success of the London 2012 Olympic Games. As a result, and along with the Government agenda for increasing the level of physical activity in the nation, there is a greater requirement to provide a high standard of healthcare professionals. Thus, nationally, and internationally, there is greater recognition of sport rehabilitation and growing need for well regulated graduate practitioners via organisations such as the Council for Health Care Regulatory Excellence (CHRE). The governing body BASRaT only accredits programmes that train graduate level professionals within the sports medicine field, thus helping ensure the highest possible standard of quality from its members."
Check out the course and institution HERE.
BASRaT is pleased to announce the location of the 13th Annual Symposium and Annual General Meeting will take place on Sunday the 18th November 2012 at the University of Bolton at their new £31 million health, leisure and research centre, built through a partnership between Bolton Council, NHS Bolton and the University of Bolton.
BASRaT will announce further details in the coming weeks of what promises to be an exciting schedule of keynote lectures and practical workshops in the field of sports medicine and exercise rehabilitation.
Check back soon on the Symposium Page.
Developing, assuring and recognising the highest standards in Sports and Exercise medicine has always been a founding tenet of BASRaT and we are proud to be working with many leading organisations in this field. ARTI is one such recently formed body that represents high quality graduate Athletic Rehabilitation Therapists whose main role is to promote and maintain the health and physical wellbeing of individuals in all sporting, physical and occupational activities. As the standards, core values and beliefs of ARTI and BASRaT are so closely related, both organisations will be working much more closely together in the future to develop and promote excellence in our field. We both have a strong drive to promote and develop our sports medicine and rehabilitation professionals who can work alongside, as well as complement, existing healthcare practitioners. We will also continue to work in partnership with other leading organisations in this field that all share similar goals, including the BOC, WFATT, NATA, CATA and ESATT.
Looking forward to a fantastic year in Athletic Therapy and Sport Rehabilitation!
Changing lives - its not only sports people that benefit from sport rehabilitation!
80 year old Edith had spent several years being shuffled around the healthcare system, with progressively deteriorating severe low back pain. It had reached the stage where she was trapped on her ground floor, no longer able to climb the stairs, with walking being a slow, painful and increasingly infrequent chore. Sadly, no one was able to help, she couldn’t lie down for treatment, couldn’t do any exercises and everyone she saw was unwilling to touch someone when even the lightest pressure resulted in severe pain.
It was at this point in early 2010 that her next-door neighbours brought her into the University of Salford Sports Injury and Rehabilitation Clinic. Second years Kelly Clinton and Charlotte Burns were the Sport Rehabilitation students who treated Edith from the very beginning. With compassion and care she was treated with reassurance, education, then gentle massage in a seated position.
The students gradually progressed this until gentle mobilisation, spinal stability exercises and finally lower limb and whole body balance / strengthening could be added. The results were remarkable and in Ediths words, “I’ve gone from an old woman, bent, with a stick, who couldn’t go up or down stairs. Now I can walk faster without pain, go up and down stairs, I can leave my stick at home. I feel great, 15 years younger and like I’ve been given my life back!”
Angela Clough, a liaison to the BASRaT Executive Committee and Hull University’s Director of Sports Rehabilitation has been made a member of the International Academy of Musculoskeletal Medicine (IAMMM).
Angela Clough has been invited to join the academy after serving for the past four years as co-editor of the International Journal of Musculoskeletal Medicine. She will now work alongside other experts, clinicians and universities from around the world in helping to shape the future of the industry.
Angela Clough from the Department of Sport, Health and Exercise Science at the University of Hull says: “Getting the chance to work with the academy is a real honour. From a personal perspective, I will be able to help shape professional teaching methods and form links with the best experts in the field.
We have a strong department at the University and our work with the academy will help to bring further academic kudos - ensuring we continue to attract top quality candidates and produce excellent sport rehabilitators.”
Following the latest news about statutory regulation, it is now clear there are a number of issues that need to be addressed / resolved prior to this progressing through the legislative processes in a timely fashion. The Health Professions Council (HPC) made a surprising decision in February, and to all intents and purposes they did miss a number of stages of the statutory regulation process, there are obviously organisations who have significant concerns about the validity of this decision. It is also clear from the coalition government's following white paper (see below for a link to the paper) that the goal posts have moved, but whether that affects our profession is also dependent upon the perceived potential for public harm by our professional area. there have obviously been discussions about the timing of the hpc announcement followed almost immediately by the release of the white paper, whether it was deliberate or coincidence remains to be seen. regardless, the hpc currently do not know yet how this will proceed, they have a meeting on the 31st march to discuss and further examine all of these issues, i will pass on any news shortly after that. it is also worth noting that the coalition proposed voluntary registers for future healthcare regulation, detailed in the white paper, will be carried out by existing regulators (hpc for our field) and could be an effective way to regulate, it really would depend on the execution.>
" Enabling Excellence: Autonomy and Accountability for Health and Social Care Staff " - LINK TO DEPT. OF HEALTH WEBSITE PAPERS .
Following on from the statutory regulation process recently grinding to a halt at the end of 2010, with the Health Professions Council (HPC) sending out communications to that effect, the HPC agreed last week to make a formal recommendation to the Secretary of State for Health and to Scottish Ministers for the regulation of the professional area of Sport Rehabilitation and Sports Therapy.
The History of Statutory Regulation for Sport Rehabilitation and Sports Therapy
Back in 2005 both BASRaT and the Society of Sports Therapy (SOST) submitted applications to the HPC for statutory regulation of their respective bodies. Although both bodies had met to discuss working together on this process, BASRaT's minimum standards of a high quality BSc (Hons) degree were incompatible with the variable level of qualifications to enter the SOST register at that time, hence two separate applications were advised by the HPC. Following the submission of the documents, the SOST application was heard first, and there was a subsequent decision by the HPC that only one application would be accepted for the professional area that covers both Sport Rehabilitation and Sports Therapy, so the application and subsequent documents continue from this document.
It is important to note at this stage that the statutory regulation application is not made for a professional body, but for a professional area and scope of practice. All professional bodies working in this field are involved in the statutory regulation process at every step of the way, in this case both BASRaT and the SOST have been attending regular meetings and working parties to move this process forwards, along with other interested parties including the Chartered Society of Physiotherapy. There were a number of issues to address which all parties worked on, and culminated in the SOST submitting a document to the HPC examining the overlap between our area and other Allied Health Professions in July 2010. This is when the process appeared to come to a stop, to be resurrected last week.
The process is now in the hands of the politicians, but this is obviously a major and timely development in the process. The regulated titles for this profession, for Sports Therapists, Sport Rehabilitators and others, is still open to debate, but we will keep you updated. BASRaT will obviously work to ensure that these future standards are not just focused on the minimum requirements of a BSc (Hons) degree, but commensurate with those of a safe and effective healthcare professional, which has always been the standard in our accredited programmes. The proposed register will be open to all professionals who can meet the minimum standards, although the majority of appropriate courses in this area come under the auspices of either the British Association of Sport Rehabilitators and Trainers or the Society of Sport Therapy.
Link to HPC Website - detailed of minutes and documents.
This last year has certainly been a time of demanding change, and 2011 promises to offer not only bigger challenges, but also opportunities for positive change that we haven’t seen for a long time. The NHS and our health service are being completely restructured, with a very clear emphasis on de-centralisation and a shift to local control. The recent white paper, “Healthy Lives, Healthy People: Our strategy for public health in England”, gives a clear indication of where the governments priorities lie for the future and they acknowledge that they can “no longer sit back while so many people are suffering severe lifestyledriven ill health and such acute health inequalities”. In practice, this means that local government are going to have the freedom, responsibility and funding to develop ways of improving public health with rewards and incentives for positive results. This will go hand in hand with a much simpler new public health service, ‘Public Health England’.
There is a clear plan to work hand in hand with industry, both in specific work related health issues and general health, and it’s clear to see why this needs to happen by considering just a few of the frankly astronomical health related costs the UK faces. For example, just by reducing working age ill health, the UK could save up to a staggering £100 billion a year, add to this the £4.2 billion per year cost of obesity related illness to the NHS alone and you can start to see the fi nancial drivers for the future of healthcare. Another key fact of crucial importance in the area of physical capacity and good health, some 17% of people claiming incapacity benefit have a musculoskeletal condition, many of which are preventable. Then there is the aging population to consider.Hip fractures are currently the most common injury resulting from falls in older people, with the cost of hip fractures being a staggering £1.4 billion per year, and these are just the black and white costs, the personal and emotional costs can be much higher. Again, a substantial portion of risk factors for falls can be addressed.
Where is our place in this? Although we are a comparatively tiny profession, we occupy a key place in the healthcare team. Our in depth education and focus in the area of exercise therapy and rehabilitation allows us to make an invaluable contribution to all the above areas, and many more, working alongside GP’s, Physiotherapists, Podiatrists, exercise and health practitioners and fitness instructors. We are currently working on a number of national strategies to develop effective and appropriate exercise referral schemes and healthcare practice frameworks, sitting on committees alongside other national regulators, the DoH and numerous Royal Colleges amongst others. As well as these areas, we also have important roles to play in vocational and occupational rehabilitation. These are specific areas that will become more and more prominent in the coming years.
On a final note, I wish you all well for 2011 and urge you to focus on our strengths and how successful we can be when working not only individually, but more importantly as part of a comprehensive healthcare team, as that is where the patients will receive the greatest benefit, and that, at the end of the day is what it’s all about.
BASRaT are pleased to announce that Military Medical Personnel have been awarded approved supplier for the provision of Sports Rehabilitators to the Ministry of Defence.
With effect from January 2011 MMP will be one of only three locum agencies able to supply locum healthcare staff to the Army, Navy, RAF, and British Forces Overseas. For information on current and future vacancies or more information about the ERI role please contact Jenny Scott on 08459000196 or via email mailto:email@example.com.
BASRaT Members should log in to their homepage for current employment opportunities.
Twenty five students from Winona State University
(WSU), Minnesota, travelled across the Atlantic to experience student life at Salford.
The semester-long exchange is part of the ongoing partnership between Salford and WSU to enhance student experience, combine expertise by facilitating Faculty exchanges and open up collaborations over particular research projects involving biomechanics in sport.
The group was made up of students from exercise science, athletic training, physiotherapy and nursing disciplines. During the exchange students were able to experience social education with experiential learning to get a real insight into student life at Salford. One WSU students said, “We had a big group discussion comparing our schools and culture in general. It was fascinating to learn the differences between the two.”
Sports students visited University partners grounds, including Salford City Reds,
Sale Sharks, Lancashire County Cricket Club (LCCC), Manchester City and Sportcity.
Students also enjoyed tours of the Human Performance Lab Sports Injury and Podiatry
Dr Brian Zeller, Lead Tutor at WSU commented, “The technology is amazing; it was really interesting how much they could determine just by looking at the different body mechanics.”
But it wasn’t all hard work, the WSU students also enjoyed the social scene
Salford has to offer and were taken to a Twenty20 game at Old Trafford, courtesy
of LCCC, allowing them to contrast this exciting form of cricket with their own
experiences of baseball!
It is envisaged that a number of students from the School of Health, Sport and Rehabilitation Sciences will be taking up the opportunity to study at WSU for a semester this coming academic year.
Julian Hatcher, Programme Leader for BSc Sports Rehabilitation, and one of the organisers of the visit said, “The visit has been a great success and we look forward to repeating it again in Olympic year 2012.”
UWE hosted the eighth European Touch Rugby Championships this summer, the biggest tournament since its inception in 1996 in the southern hemisphere.
Each team played up to four 40 minute games a day of fast competitive Touch Rugby and therefore required some much needed therapy to keep going! UWE provided a therapy and sports massage clinic manned by Undergraduates from the BASRaT accredited BSc Sports Therapy and Rehabilitation (STaR) programme and supervised by Martin Ward a Senior Lecturer from the STaR programme.
Two groups of Sports Rehabilitation students from The University of Bolton and The University of Salford, came together to help participants complete the challenge of walking 50miles across the Pennines. MEGAHIKE is a team fundraising event in aid of the MedEquip4Kids charity based in Manchester, which helps children with ill-health access the very best healthcare facilities. The aim of the event is to raise £90,000 for the charity.
The students who attended the event camped at the venue and worked through the night to provide support for the teams of participants who were striving to finish the gruelling hike. The students were supervised by Salford graduate Mike Carolan and Adam Naylor from Bolton University. Mike commented that the students worked exceptionally hard and the participants were grateful for their efforts throughout the 24 hour event.
The event allowed students to apply therapy skills they learn in Sport Rehabilitation practical lectures at University in an intense but enjoyable environment.
Sports Rehabilitation students from the University of Salford helped ease pre-race niggles and post-race aches for runners at the Manchester 10k, all in aid of the RNLI. The Great Manchester Run attracts more than 10,000 participants each year and is the UK’s premier 10k race.
A team of nine 2nd and 3rd year BSc (Hons) Sports Rehabilitation students rewarded the efforts of the lifeboat charity fundraisers with a revitalising post-race massage, whilst other participants were able to enjoy a massage in return for a small donation. Lisa Rutter, RNLI Events Manager, North, thanked the students for their efforts for the third year running.
Salford graduate Allan Munro,
who supervised the students at the event, said “
It’s great that we can
help a charity like the RNLI. The students enjoyed the experience and were more
than happy to give their time to help the runners who raise a huge amount of money
for the charity.
“ It was also great to be able to raise further contributions from other runners at the event and the atmosphere around the tent was fantastic .”
Summer 2010 saw Great Britain’s U20 women’s team embark on a new development with a new management team in place in preparation for the upcoming division B European Championships in Macedonia.
As part of this team graduate Sports Rehabilitator Michael Carolan was drafted in
as medical support working in conjunction with the team physio Michelle Angus. This
initially encompassed pre camp fitness testing alongside Allan Munro and a group
of Sports Rehabilitation students from Salford University.
During the initial selection camp at Leigh Sports Village, Manchester, Mike was consulted on player fitness and appropriateness for selection by the head coach Damien Jennings.
Allan Munro was also present to help with both the Men and Women’s teams whilst identifying any potential areas for individual improvement from the initial fitness screening and testing session.
After this Mike worked independently seeing to the teams needs regarding injury management, recovery from training and appropriate hydration and nutritional intake, in constant communication with the staff regarding player fitness and maintaining a good rapport with the players to ensure an elite level service to the team and for Great Britain. The team was then based in three camp locations in Leigh, Bristol and Surrey where the girls played against several different opposition, finishing with Mike being part of an excursion to Austria to play their U20 women’s team in two matches.
This was a proud experience that Mike will cherish and never forget and will see him strive for further achievements and to work at this level in the future. With thanks to Lee Herrington, Allan Munro, Damien Jennings, Matt Johnson, Marlies Keiffer, David Bailey, Michelle Angus and congratulations to the players on winning the Division B European Championships and gaining promotion to Division A.
A new text book released recently by Wiley-Blackwell, written for students and graduates of sport rehabilitation and related professions, features several contributions from Graduate Sport Rehabilitators and BASRaT members.
“The past three years have seen the emergence of degree courses devoted to sports rehabilitation and the number is growing,” said Co-Editor Earle Abrahamson of Middlesex University. “Currently students, graduate sports rehabilitators and sports therapists have to rely on textbooks within physiotherapy, medicine and physiology. This will be the first book written specifically for them.”
“With growing numbers of people participating in both competitive and recreational sporting and fitness activities, there has been an increase in both major and minor sport related injuries,” said Co-Editor Paul Comfort of the University of Salford. “The trained sport rehabilitator is concerned with the scientific evaluation, diagnosis, treatment and management of injuries as a result of sports and exercise participation, and this is the first time all of these areas are brought together in one book.”
Military Medical Personnel and BASRaT are pleased to be working together to provide fantastic locum opportunities for Graduate Sport Rehabilitators to work within the MOD.
MMP specialize in providing healthcare locums to the MOD and our recruiters have a combined experience of over 20 years.
For more information please contact Jenny on 08459000196 or you can view their website at www.militarymedicalpersonnel.com
BASRaT Members should log in to their Member homepage to check for employment opportunities.
Linsey Woolstencroft, a student of Salford University Sport Rehabilitation went on an exchanged trip to Minnesota, USA and gave us this account of her trip.
" Setting off to the States early in January this year kicked off my 2010 with a great deal of excitement. I studied for a whole semester at Winona State University in Minnesota on an exchange program with the Athletic training department, along with 2 other students from the University of Salford. Whilst there, we worked with the whole range of college teams, including American Football, Soccer, Volleyball, Basketball, Gymnastics, Softball and Baseball.
The Athletic Training room pretty much became a second home for 4 months, where ice,
electrical stimulation and taping became our best friend. We were also able to exchange
the different techniques between the Athletic Trainer and the Sports Rehabilitator,
and see how we could improve each other’s practice.
I also attended their normal college lectures, experiencing college life in the USA as well as attending external placements in a variety of settings, from the surgical to rehabilitation centres.
The time in the athletic training room really was a fabulous opportunity to see what
a difference you can make to the lives of athletes when you are there for them on
a daily basis. They are able to build a great relationship between their athletes
and coaches, and in turn that communication and trust means that you are able to
do far more than just ‘fix an injury’.
Overall though, I realised that the main difference between our professions and educational programmes are only in the techniques used; our goals are still the same. It has made for an unforgettable experience, which has helped shape my role as a Sports Rehabilitator ".