SEPNZ Bulletin June 2021

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SEPNZ BULLETIN

ISSUE 20, JUNE 2021

DING DING!! p5

ALEXIS PRITCHARD’S FIGHTING TALK

p8 BACK TO THE GRAM

p14 CLINICAL REVIEW

p17 PLINTH TO PODIUM AGENDA

www.sepnz.org.nz


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SEPNZ EXECUTIVE COMMITTEE

Members Page

President - Blair Jarratt Vice-President - Timofei Dovbysh Secretary - Michael Borich Treasurer - Timofei Dovbysh Website - Hamish Ashton Sponsorship - Emma Lattey Committee Emma Clabburn Justin Lopes

EDUCATION SUB-COMMITTEE Emma Lattey (Chairperson) Emma Clabburn Justin Lopes Dr Grant Mawston Dr Gisela Sole Lauren Shelley John Love

Visit www.sepnz.org.nz

Join us on Facebook

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ADDITIONAL USEFUL WEBSITE RESOURCES: List of Open Access Journals Asics Apparel - how to order McGraw-Hill Books and order form Asics Education Fund information

BULLETIN EDITOR Emma Clabburn

Journal of Orthopaedic & Sports Physical Therapy (JOSPT)

International Federation of Sports Physical Therapy (IFSPT)

SPECIAL PROJECTS Karen Carmichael Amanda O’Reilly Pip Sail

BULLETIN ADVERTISING DEADLINES:

February Bulletin: 31st January April Bulletin: 31st March June Bulletin: 31st May August Bulletin: 31st July October Bulletin: 30th September December Bulletin: 30th November Advertising terms & conditions click here.

CONTACT US Michael Borich (Secretary) 26 Vine St, St Marys Bay, Auckland secretary@sepnz.co.nz


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CONTENTS SEPNZ MEMBERS PAGE See our page for committee members, links & member information

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EDITORIAL: By SEPNZ President Blair Jarratt

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FEATURE ARTICLE: ALEXIS PRITCHARD GIVES AN INSIGHT INTO THE MIND OF A FIGHTER

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GRAM REVIEW: Back to the Gram! USA edition

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MEMBER BENEFITS: Asics Professional Buyers Program

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ASICS FOOTWEAR REVIEW: CHARCOT MARIE TOOTH DISEASE: Nimbus Lite V2

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COURSE ADVERTISEMENT

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CLINICAL REVIEW: Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta–analysis

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STUDENT NIGHT REVIEW

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AGENDA PLINTH TO PODIUM

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UPCOMING SEPNZ COURSES

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RESEARCH PUBLICATIONS: April 2021 - Volume 55 - Issue 7

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CLASSIFIEDS & FURTHER MEMBER BENEFITS

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EDITORIAL Our latest edition to the SEPNZ bulletin brings us into the middle of the year. Our major event for this year is the joint SEPNZ and MZMPA symposium - Plinth to Podium on the 25th of September. For the first time, these two special interest groups have collaborated to bring together a mixed media format of hosting International and National speakers in a one-day flagship event. You have the opportunity to be involved in this unique piece of Physiotherapy CPD history. Only one year ago, we would never have dreamed of having this opportunity, and I encourage you all as our members to engage in this event to help make it a success. In an example of the turning of time, accelerated by our virtual interface world - attendees of Plinth to Podium can be part of this symposium in person or virtually. To keep with the fundamental elements of learning, practical sessions, and social interaction with colleagues, we have virtual and live presentations, practical workshops, a social hour, and a dinner. Back to this Bulletin: we continue to expand on previous editions, delving into the diverse environments available for sports Physiotherapists. Our feature article from Alexis Pritchard walks us through her path to physiotherapy and contains some practical tips on mindset with our clients. I agree with Alexis on her comments around our words with clients and using the mind as a tool to aid recovery. Emma Lattey contributes with her last APP review (read on to find out why), discussing the American social media influencers and tips on who to follow. Our Bulletin is completed with an ASICS contribution from Anthony Ng, on Charcot Marie Tooth Disease and the Nimbus Lite V2 shoe and a clinical review comparing the effectiveness of treatments for patellofemoral pain.

If you are thinking of helping out SEPNZ - we would be interested to hear from you. We are on the hunt looking for a technically savvy and forward-thinking member with a strong interest in social media and apps for our next "APP reviewer". Last but not least, there have been some changes in the SEPNZ executive since our previous Bulletin. Becs Longhurst has stepped down as chair of the Education committee, and Emma Lattey has taken up the chair role. Becs has been a powerhouse for SEPNZ education for the past 5 years. She was instrumental in changing the narrative of our program, guiding the development of the final SEPNZ courses. Becs also started new initiatives, opening dialogue with APA to try and set up the first APA course in NZ. She launched the popular SEPNZ "student night," which ran successfully again this year. Becs rallied our course presenters, locked in dates and venues to get a cohesive education program, and saw through the first of our members to achieve the SEPNZ certificate. From the Executive and I, we thank you for all your hard work and wish you all the best in your future endeavours in Physiotherapy - you will be missed.

Enjoy this latest Bulletin. If you cannot join us in person in Auckland for Plinth to Podium - please join us virtually on the day. Early Bird finishes in August, and at the time of writing, this one workshop is already almost at capacity.

We will be back in another couple of months with the next bulletin but in the meantime, stay tuned to our social media for details and ticket sales to the 2021 Symposium - From Plinth to Podium.

Kind Regards Blair Jarratt SEPNZ President

https://pnz.org.nz/Event? Action=View&Event_id=3159 Early Bird: Until Aug 20th 2021 SEPNZ members: $300 (to receive the SEPNZ member price, please use the discount code provided). Non PNZ members $450 Virtual access also available: https://pnz.org.nz/Event? Action=View&Event_id=3160


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FEATURE ARTICLE

Boxing Edition: Ding Ding!! Alexis Pritchard An insight into the mind of a fighter, how we as physiotherapists can help influence a more optimistic recovery mindset and a few cents on career progression from Olympic and Commonwealth boxer Alexis Pritchard. Growing up, little me dreamt of being a doctor, I had my sights set on being a paediatrician and if mum and I hadn’t immigrated to New Zealand in 2000, it is highly probable that is what I would now be. As much as moving to a new country felt like an adventure to the then sixteen-year-old me, I didn’t realise how tough the transition would be. Being a conscientious and diligent secondary school student became less of a priority and a gap year after high school felt far more exciting than the prospect of more study. I had plans of working over the summer, saving enough and doing a quintessential O.E. like all other young New Zealanders did but I didn’t do that either. Instead, I found myself walking into a boxing gym in central Auckland and getting swept up into a whole new world, I was 19 years old at the time, working as a bartender and my self-confidence and self-esteem certainly needed work. I was searching for something but could not articulate exactly what but when I hit the boxing bag for the first time I found what I was looking for. I felt powerful, I felt strong, I felt capable, I felt the joy of movement and I was hooked. I had no intention of being an athlete let alone a boxer when I started but it just felt right so I kept going back to that boxing gym for the next 16 years. I proudly represented New Zealand at the 2012 Olympic Games and the 2014 and 2018 Commonwealth Games. You don’t always end up where you think you will – and that is absolutely ok. If you have never stepped through the ropes and got yourself punched in the face, we have experienced boxing very differently. As a spectator, what you see is people punching each other. You see blood, black eyes, cuts, split lips and you may even see knock outs. This is the outer picture; what is inside is so much more. To me boxing is art. It is beautiful. It is brutal. It is violent. It is challenging. It is pure. It reveals your soul. It reveals what you are made of. Everything about you is tested over and over again. Your will, your heart, your courage. Your ability to rise. Boxing is not for everyone. You must face your darkness, your demons, your insecurities and your self-doubts. It makes you go to places you didn’t think you could go. If

you are not willing to figure that out and struggle through the pain of it, you will not last, you will not succeed. Boxing will chew you up and spit you out. You need to conquer your own fears, doubts and insecurities before you can ever overcome and beat an opponent. If you are not able to stop the negative voices inside your head you are beaten before you ever step into the ring. This is where the beauty lies for me. Cam, my boxing coach encouraged me to get going with higher education or at least find a more suitable job (than bartending) if I was going to take boxing seriously. I needed a better routine and fewer late nights. As a young athlete I ended up at the physio clinic a few times, these interactions sparked my interest in the idea that I could be a physiotherapist so after completing a Bachelor of Sports Science at Auckland University I went straight into physiotherapy. I found my groove at AUT and thrived in my studies. I had a great group of university physio friends, we shared knowledge and work, we tested each other, we supported each other, we knew we would all be CONTINUED ON NEXT PAGE >>


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FEATURE ARTICLE better if we pushed each other and worked together. They are part of the reason I succeeded. After learning the ropes in a supportive environment, I found the courage to go out on my own. I wanted my patients to leave my care in better shape than they were in before they injured themselves. As physiotherapists we know movement is medicine for our tissues, and as an athlete I knew that movement and progressive loading was paramount to getting my patients into great shape after their body healed from the initial injury. My sports science knowledge was vital to helping me be a better practitioner. I would absolutely encourage further study in sport and exercise science for physiotherapists.

Adaptability is being able to adjust to new conditions. Survival (and ability to thrive after we feel safe) for all animals including humans is dependent on how well we can adjust to whatever is thrown at us. In our patients often it is the way they think which is either going to help or hinder them in their healing and recovery. We all have the ability to be flexible and adaptable in the way we think.

I am extremely glad I found physiotherapy and practiced for 9 years. It is a wholesome career, we get to help people and make a difference to patient’s quality of life. The magic I found wasn’t always in how much we knew, but in how we made our patients feel, and if we made them feel heard. As physiotherapists we must remember we have so much influence in how our patients navigate mentally, physically and emotionally through injury and on their journeys to recovery.

Our patients may not have had to call upon their adaptability superpower before, but it is there waiting for them to utilise it, to help them ride out a period of injury with the least amount of mental and emotional turmoil and suffering. And we can show them how. As physiotherapists we have influence in the way our patients approach their recovery, especially in the words and language we use. Are you adding to their mental and emotional suffering (which we know affects the physical body) or are you empowering them to help themselves? For our patients, we must remember their injury is unique to them. There are many unknowns as they may not have had this injury before. We need to remember that, especially because we often see many similar injuries so it is not new to us. Ask them what they are feeling about the injury and the recovery journey ahead - whatever they are feeling is valid. I believe a big part of our work is to influence our patients' mindset, not only fix body parts. How we can help with mindset: Influence Radical Acceptance – They can either accept their current situation or they can push and fight against it. Resistance will probably lead to more feelings of frustration, fearfulness, annoyance, unfairness, anger, sadness, resentment, bitterness… and the list can go on. Rejecting reality does not change it; rejecting reality turns pain into suffering. When there is no way to change the immediate situation we can influence radical acceptance. This means accepting the things we cannot change even if we don’t like them. We need to stop fighting and accept CONTINUED ON NEXT PAGE >>


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FEATURE ARTICLE our situation with our hearts, minds and bodies. Suggest, when they speak about their injury, they speak with a halfsmile and position their hands palms facing upward (willing hands). Life is worth experiencing as best as we

do this, I usually make space to move my body, perhaps putting on some music and dancing either on the floor or seated. Distraction is also a good tool to employ – encourage them to do something they enjoy, draw, bake, clean, listen to music – whatever feels good to them. Our Language matters – Not only the words we use but how we express them, the tone and body language are equally important, they can significantly influence our patients thoughts and feelings. So, let’s mind our language to others and ourselves (our thoughts). What words are you choosing to use when describing an injury? What words are chosen when talking about recovery? Are you fear-mongering? Are you catastrophizing? My hope is you are not. Lastly career wise, you don’t need to have it all sorted and know exactly where you are going to end up, everything you do is a stepping stone to the next. Being a physiotherapist has helped shape my work as a Mental Skills and Performance Coach. My message is to continue doing the work that makes you feel good, that gives you joy and fits within your values as a human. Continue to trust your instincts, be bold and courageous. Do things differently. Want more for yourself. Know your worth. Look after your health and wellbeing and lastly move your bodies!

Alexis Pritchard lex@rebuildwithlex.co.nz Facebok: Alexis Pritchard - Rebuild with Lex | Facebook possibly can even with painful events in it. Encourage Optimism – Optimism is defined as seeking ways to emphasise the good parts of a situation and nurture hopefulness for the future. Cultivating an optimistic outlook has been proven to reduce the effects of stress on our bodies and minds, our immune systems cope better and it can decrease the levels of anxiety. Being injured and in pain can take us to a miserable place if we let it, which does not help our recovery. Those who lean into optimism are not delusional, they see and accept the truth of the reality and look forward to a different and brighter future, this hope keeps them moving forward. We can help create optimism by encouraging them to acknowledge the good parts of their situation and helping them to be kind to themselves. Here are two ways they can try the kindness to self: One, consciously change negative self-talk: teach them to flip the thoughts in their head immediately by replacing the unhelpful ones with more supportive ones. E.g. I trust myself and my body to heal and I will get back to my normal activities. Two, intentionally stop unhelpful rumination: To help me

Linked In: Alexis Pritchard OLY | LinkedIn Instagram: https://www.instagram.com/ alexis.rebuildwithlex/


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APP REVIEW

Back to the Gram ... The U.S.A. by Emma Lattey This month I review my top five brief picks of American sports physio/medicine influencers on Instagram. This has not been an easy piece to prepare for as there are so many American “influencers” out there in the sports medicine space. Here are five of my favourites which have been useful to help me introduce new rehabilitation exercises, can provide access to recent papers, and help to further educate my patients on latest trends and research from the other side of the world. •

rehabscience

Dr Tom Walters is based in southern California and his posts address a wide variety of physical therapy and training topics. Tom demonstrates most of the exercises himself in a really slick manner, and he also does a great job of curating content from others in the field.

evidencebasedmvmt

What I enjoy the most about this instagram handle is the catchy, straight to the point graphics and messaging based on recent evidence-based research. Their posts are almost daily and cover many aspects of sports medicine life, with research “reviews” and research “rapid fire” providing a quick and easy to understand evaluation of recent papers.

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APP REVIEW

theprehabguys

The prehab guys are three doctors of physical therapy who specialise in strength and conditioning. The content here is effective and easy to understand with each of the “guys” taking turns to demonstrate exercises. They identify common flaws that most people make in the gym and give simple, easy to follow solutions with corrective exercises and appropriate progressions and regressions.

dr.caleb.burgess

Dr Caleb Burgess is a doctor of physical therapy who specializes in strength and conditioning. His Instagram account gives helpful tools and strategies to deal with common injuries. Caleb demonstrates the exercises mostly himself and with helpful graphics and simple instructions on screen for each exercise.


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APP REVIEW

mariespano

Marie Spano is a sports dietician with a both nutrition and exercise sports science degrees. She consults with professional, recreational, and collegiate athletes and her posts are catchy and to the point – with good evidence to back it up. Marie doesn’t has as many followers as the others but the content is top quality and is useful to keep up with the current updates in sports nutrition and how it affects performance.

Finally….. for a bit of light-hearted physio related insta love try physiogram...


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MEMBER BENEFITS

There are many benefits to be obtained from being an SEPNZ member. For a full list of Members’ Benefits visit http://sportsphysiotherapy.org.nz/benefits/

In each bulletin we will be highlighting individual member benefits in order to help members best utilise all benefits available.

The ASICS Professional Buyers Programme is designed to enable Sport & Exercise Physiotherapy New Zealand members the opportunity to experience our shoes first hand and to assist in referring the most suitable shoe/s to your patients. By registering for the Professional Buyers Programme, you will: ASICS Performance Footwear/ASICS Sportstyle Footwear Receive 4 voucher codes per year, 2 every six months. Each voucher will give you 40% off the retail price of one pair of shoes up to $300 Recommended Retail Price. Vouchers must be redeemed online at www.asics.co.nz Additional Product Offers: Birkenstock Footwear Receive 2 voucher codes per year, 1 every six months. Each voucher will give you 30% off the retail price of one pair of shoes up to $200 Recommended Retail Price. Vouchers must be redeemed online at www.birkenstock.co.nz Smartwool Socks Receive 2 voucher codes per year, 1 every six months. Each voucher will give you 30% off the retail price for your choice of socks (Recommended Retail Price). Vouchers must be redeemed online at www.smartwool.co.nz

Register Here Full terms and conditions can be found on the Professional Buyers Programme registration page. If you are already a member of the Professional Buyers Programme you will receive your vouchers in July and February. For first time registered member, we run a report at the end of each month which picks up the newly registered members. You should then receive your vouchers by the middle of the following month. REGISTER HERE


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ASICS

Charcot Marie Tooth Disease: Nimbus Lite V2 Thanks to Asics for this latest footwear review from Anthony Ng. Charcot Marie Tooth Disease (CMT) is a hereditary motor and sensory neuropathy disease that affects the peripheral nervous system. The lower limb adopts an altered gait due to diminished muscle power resulting in muscle atrophy which affects limb flexibility and strength, along with skeletal deformities. This ultimately presents as a pes cavus foot structure.

gait problems. Proper footwear like the new Nimbus lite V2 can address the symptoms of CMT, aiding ambulation and successfully accommodating lower limb foot and ankle anomalies. The lighter weight construction offers increased cushioning along with a supportive plantar platform for improved balance, foot alignment and increased stability. The midsole wider flared design enables initial foot contact to accomplish enhanced structural support through-out the entire gait cycle compared to suboptimal footwear. Nimbus chose a midsole material which provides the required cushioning to reduce GRF, while maintaining efficient energy return to foster pronation, reduce plantar pressure under prominent metatarsal heads worsened by retracted digits and relieve pressure produced under plantar heels, commonly associated with a pes cavus foot structure. The heel and forefoot offers depth and width to accommodate any additional ankle and foot orthotics to be placed without the need to alter or adjust the shoe internal profile.

The foot having the characteristic of a high arch is dominantly fixed in a varus angulation. The cavus foot will not flatten during weight bearing; hence natural foot pronation is inhibited to aid shock attenuation throughout the lower limb. Foot muscle weakens and stability during locomotion is compromised leading also to the development of clawed digits. Patients with CMT have a high frequency of tripping directly related to the negative effects CMT has during gait. The lower limb and foot complications from CMT can progressively become worse over time. This will result in further changes to the lower limb with additional difficulties in walking or potential running. A slower gait will affect normal stride length and cadence and patients will often present with a wider step to provide enhanced balance.

Nimbus Lite V2: Solid constructed rear, a wider over-all base of gait improving stability. Offers a lighter, more balanced feel to enhance corrective alignment from proximal to distal throughout the entire gait cycle.

Treatment decisions are based on correct footwear choices to be worn continuously. Footwear is key in slowing the progression of this condition and improving CONTINUED ON NEXT PAGE >>


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ASICS

COURSE ADVERT

Integrating pelvic health into musculoskeletal physiotherapy practice. Location Auckland, Wellington, and Christchurch

Other conditions that this Nimbus will benefit include: Metatarsalgia: Pain in the plantar region of the forefoot. This condition causes mechanical over load of the metatarsals, affecting normal gait. Increase cushioning at forefoot will help relieve forefoot pain. Sesamoiditis: Pain affecting the sesamoids. Conservative management allows the propulsive phase of gait to be unrestricted to allow foot to move in the correct alignment. Nimbus lite has a wider base at the forefoot, with an unrestricted propulsive phase allowing a smooth transition required to help manage this pain. Heel spur syndrome: A bony overgrowth from the calcaneal tuberosity. Symptoms vary among individuals, although most include a dull ache in heel throughout the day, with associated inflammation. Nimbus offers an effective gradient pitch to shift peak forces away from heel, along with a highly absorbent plantar cushioning to relive pressure with reduce pain. Underpronation: Excessive supination, caused by a high arch and muscle weakness. Stress occurs to the outside side of foot, predisposing to sprained ankles and often leading to other additional foot complications. Nimbus provides, cushioning, flexibility to allow the foot to pronate to aid this biomechanical complication.

Anthony Ng

B.Sc (Pod), B.Ed, Dip Tch

Dates Auckland 3 July 2021 Wellington 31 July 2021 Christchurch 30 October 2021 Dr Melissa Davidson Specialist Physiotherapist in Pelvic Health Registered with the Physiotherapy Board of New Zealand under Specialist Scope of Practice Brief summary of content Do you want to learn more about pelvic health but you aren't ready yet to do internal examinations? • Do you want to advance your knowledge of both women's and men's health? • Do you feel you are missing a piece of the puzzle when it comes to patient care? • Do you treat both female and male patients for general musculoskeletal issues? This course will cover common conditions and issues for both women and men that you see in the clinic. The course covers: • How to complete a basic screening for pelvic health conditions • How to externally palpate the superficial pelvic floor muscles safely through clothing with patient consent • Return to exercise for post-partum women • DRAM management • Recurrent back, hip, and groin injuries and their relationship to the pelvic floor • Post-prostate surgery return to exercise • Pelvis fracture rehab – addressing the bottom of the pelvis • Adjusting programmes of care to account for pelvic health conditions • How to initiate training of the pelvic floor muscles • Respiratory conditions and the pelvic floor • Pelvic girdle pain during pregnancy • Sportswomen and hormones • When to refer onwards to a pelvic floor or women’s and men’s pelvic health physiotherapist who completes internal examinations as part of their standard assessment and treatment •

Cost Auckland $300 Wellington $340 Christchurch $340 Registration and information contact details. Full course details and how to register is on www.drmelissadavidson.com


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CLINICAL REVIEW

Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta–analysis Marinus Winters , Sinéad Holden, Carolina Bryne Lura, Nicky J Welton, Deborah M Caldwell, Bill T Vicenzino , Adam Weir, Michael Skovdal Rathleff. British Journal of Sports Medicine 2021: 55:369-377. doi:10.1136/bjsports-2020-102819

By Karen Carmichael Abstract: Objective: To investigate the comparative effectiveness of all treatments for patellofemoral pain (PFP). Design a living systematic review with network meta-analysis (NMA). Data sources: Sensitive search in seven databases, three grey literature resources and four trial registers. Eligibility criteria: Randomised controlled trials evaluating any treatment for PFP with outcomes ’any improvement’, and pain intensity. Data extraction: Two reviewers independently extracted data and assessed risk of bias with Risk of Bias Tool V.2. We used Grading of Recommendations, Assessment, Development and Evaluation to appraise the strength of the evidence.

Primary outcome measure: ’Any improvement’ measured with a Global Rating of Change Scale. Results: Twenty-two trials (with forty-eight treatment arms) were included, of which approximately 10 (45%) were at high risk of bias for the primary outcome. Most comparisons had a low to very low strength of the evidence. All treatments were better than wait and see for any improvement at 3 months (education (OR 9.6, 95% credible interval (CrI): 2.2 to 48.8); exercise (OR 13.0, 95% CrI: 2.4 to 83.5); education+orthosis (OR 16.5, 95% CrI: 4.9 to 65.8); education+exercise+patellar taping/mobilisations (OR

25.2, 95% CrI: 5.7 to 130.3) and education+exercise+patellar taping/ mobilisations+orthosis (OR 38.8, 95% CrI: 7.3 to 236.9)). Education+exercise+patellar taping/ mobilisations, with (OR 4.0, 95% CrI: 1.5 to 11.8) or without orthosis (OR 2.6, 95% CrI: 1.7 to 4.2), were superior to education alone. At 12 months, education or education+any combination yielded similar improvement rates. Summary/conclusion. Education combined with a physical treatment (exercise, orthoses or patellar taping/mobilisation) is most likely to be effective at 3 months. At 12 months, education appears comparable to education with a physical treatment. There was insufficient evidence to recommend a specific type of physical treatment over another. All treatments in our NMA were superior to wait and see at 3 months, and we recommend avoiding a wait-and-see approach. The idea behind this paper was to create a “living systematic review” using network meta-analysis (NMA), to keep up to date with the research into the most effective treatment strategies for patella-femoral pain. The question the paper sought to answer was: “Which treatment(s)/treatment category is most likely to be effective for patella-femoral pain (PFP) on any improvement (measured by a Global rating of change Scale) and patient-rated pain (measured by a pain scale)?” Using a NMA allows them to update the systematic review as new research comes out. The minimum criteria for inclusion were studies describing patients with retropatellar or peri patella pain, of at least 6-week duration and a non-traumatic onset. Patella dislocations, patellofemoral OA, patellar tendionopathy, Osgood-Schlatters, ITB and Sinding-Larsen-Johanssson were all CONTINUED ON NEXT PAGE >>


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CLINICAL REVIEW excluded. There were no age restrictions. Studies measuring the treatment effect after a minimum of 6 weeks were included. Treatment was put into several different categories including: • Education • Education+exercise therapy + Patellar taping/ mobilisations • Education + orthotics • Education + exercise therapy + patellar treatments + orthosis • Wait and see • Exercise Therapy A definition of each of the categories was outlined in the paper. 22 Randomised Controlled trials were included in the review. Eleven of the RCT’s used a global rating of change scale and nineteen trials used a worst pain scale or measured pain during a specific activity. Altogether 1472 patients with PFP were included. There was a high risk of bias in most of the studies. Most of the certainty for evidence was rated low to very low. It was reassuring to see that all treatments were better than a wait and see approach at 3 months. Education + exercise + patella taping/ mobilisations, either with or without orthosis was the best combination of treatments for PFP at 3 months. Unfortunately, the pooled findings for “worst pain” showed that none of the treatments was superior to a wait and see approach. At 12 months, Education combined with modalities were better than education alone. For pain descending stairs at both 3 and 12 months a programme of hip, knee and trunk exercises was superior to hip and knee exercises alone (and superior to arthroscopy at 12 months).

It is interesting to see that a global rating of change found significant differences between treatment regimes, but “worst pain” did not. This means reported outcomes can have a bearing on study findings. In this review they asked 7 people with PFP what outcome measure was more important to them, and 6 out of 7 preferred the global rating of change. It is also easier to compare studies if a “gold -standard” outcome measure is used, and perhaps more research is needed for this in PFP. As with any studies there are several flaws and limitations. Quality of studies included in the review and inherent bias in studies are an issue. The treatment groupings are quite broad, other studies have found conflicting results – notably with the education alone. The type of education given needs to be defined.

The clinical message from this paper is overall reassuring that treatment for PFP is generally better than a wait and see approach on a global change scale and there are several modalities that can be used. As always clinical judgement is needed to evaluate what is likely to be best for your client. Education in combination with a physical treatment (exercise, othoses or patella taping/mobilisation) is likely to be effective at 3 months. A full set of references is available on request.

RESEARCH REQUEST Experiencing and living with a shoulder dislocation We are seeking participants for a research study exploring experiences of people with a shoulder dislocation. We ask them to share their experiences about the injury, health care, and how they manage potential recurrences and fear or anxiety about recurrence. We are inviting individuals who have had a traumatic shoulder dislocation within the past 6 months to 5 years and are between 16 and 35 years old. Participants will be asked to complete an electronic questionnaire and attend an interview with the researchers (in person, or by Zoom/ Skype or telephone). Researchers: A/Prof Gisela Sole, Dr Margie Olds The study is supported by a grant from the NZ Manipulative Physiotherapy Association. Approved by the University of Otago Human Ethics Committee (Health) Please find information here:

https://www.otago.ac.nz/physio/research/ otago824639.html Or contact Gisela Sole, Gisela.sole@otago.ac.nz


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STUDENT NIGHT REVIEW This year the second annual SPENZ Education evening was held in April. This event was available to all physiotherapy students in New Zealand, both in person at the respective universities and polytechnics and online via zoom. There was a great turn out of students which indicated a high level of interest in a Sport and Exercise Physiotherapy career. The presenters consisted of Nigel Beach (Mind-Body Physiotherapist, Knee and Spinal Clinic), LeeVan Santos (Hurricanes Physiotherapist), Margie Olds (Physiotherapist Specialist - Flawless Motion), Thomas Wardhaugh (Highlanders Physiotherapist) and Sarah Gillespie (High Performance Sport NZ Physiotherapist - Snow Sports). The speakers either joined in person at the respective campuses or online via zoom, this gave students the opportunity to ask questions and get guidance in the field of sport and exercise physiotherapy. This fantastic lineup of speakers provided in depth advice surrounding their unique career journeys. It allowed the students to gain insight into some of the various opportunities available to them once graduating. From a personal perspective it was very interesting hearing from such a variety of people and the varying pathways they have gone on to get to where they are today. A stand out speaker for me personally was Margie Olds. It was inspiring to see how Margie’s personal interests and passions have helped to shape her physiotherapy career. Overall the event provided informative and interesting information for their futures. The feedback from other students was all very positive. The student night inspired physiotherapy students from all over the country. This annual event is a great way to showcase the many ways that a sports physiotherapy career can develop, and the different roles that therapists can do. Often luck and good fortune can play a part in securing roles, however planning your career pathway can make a big difference when it comes to taking up the opportunities that do happen to fall into your lap. If you are interested in working in sports physiotherapy here are some key tips from the speakers that might help: • •

• • •

Never stop learning: there is always more to know about your sport or your athlete. Listen to your athletes: Taking time to get to know our athletes will help you make calls about their fitness and builds trust in the therapeutic relationship. Put yourself out there: Volunteer or seek out people who are doing jobs you would be interested in and see if you can shadow them or assist them. Do the groundwork: Get the qualifications you need to do the job you want. Once you have graduated do the SEPNZ Certificate in Sports Physiotherapy Courses, they are a great foundation to continue to develop your sports physio skills.

Student night winner Emma O’Connell with her ASICS voucher Prize winners on the night were … • Anneka Kooyman (online – Wintec) • Emma O’Connell (AUT) • Christine Van Niekirk (Wintec)


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AGENDA PLINTH TO PODIUM


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SPEAKERS: PLINTH TO PODIUM


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SPEAKERS: PLINTH TO PODIUM


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SPEAKERS: PLINTH TO PODIUM

https://pnz.org.nz/Event?Action=View&Event_id=3159 Early Bird: Until Aug 20th 2021 SEPNZ members: $300 (to receive the SEPNZ member price, please use the discount code provided). Non members $450 Virtual access also available: https://pnz.org.nz/Event?Action=View&Event_id=3160


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WORKSHOPS: PLINTH TO PODIUM


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WORKSHOPS: PLINTH TO PODIUM


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UPCOMING SEPNZ COURSES

Please note these are the proposed courses for 2021. With the current COVID-19 situation this could also change. Once we are confirmed to go ahead registrations will be open via PNZ. Promotion and Prescription of Physical Activity and Exercise This course is suitable for physiotherapists wanting to improve their knowledge and skills in assessment and prescription of physical activity and exercise to use with patients on a daily basis. This course provides a bridge to Level 2 SPNZ courses and important background information for those considering university postgraduate study. The course will provide a combination of lectures, practical demonstrations, practical assessments and case studies and will cover the following topics: Principles of exercise prescription, Promotion and assessment of physical activity, Assessment of neuromuscular performance, Aerobic and functional capacity testing ,Strategies to enhance exercise adherence, Screening for return to sport, Exercise risk screening and goal setting, Physiological effects of disuse and ageing

This course is TBC for August 2021 The Sporting Lower Limb This course is for registered physiotherapists who work with individual athletes or teams in which lower limb injury is common. The focus of the course is on pathomechanics and kinetic chain deficits as they relate to injury prevention and performance.

This course is TBC for 2022 Injury Prevention & Performance Enhancement. This course will provide you with the key skills used in the enhancement of sporting performance and prevention of injury. It covers the analysis of physical, biomechanical and technical needs of sport, identifying key factors affecting performance and injury prevention. You will learn how to assess athletes and implement an individualised programme designed to optimise movement efficiency, performance and minimise injury risk. You will learn how to develop a sport–specific screening assessment, how to monitor injury rates and target injury prevention strategies within different sporting contexts.

This course is TBC for November 2021


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RESEARCH PUBLICATIONS

British Journal of Sports Medicine April 2021; Vol. 55, Issue 7 ORIGINAL RESEARCH High genetic contribution to anterior cruciate ligament rupture: Heritability ~69% (7 December, 2020) FREE Karin Magnusson, Aleksandra Turkiewicz, Velocity Hughe s, Richard Frobell, Martin Englund

Nine typical injury patterns in German professional male football (soccer): a systematic visual video analysis of 345 match injuries (26 August, 2020) Christian Klein, Patrick Luig, Thomas Henke, Hendrik Bloc h, Petra Platen Complete resolution of a hamstring intramuscular tendon injury on MRI is not necessary for a clinically successful return to play (19 June, 2020) Robin Vermeulen, Emad Almusa, Stan Buckens, Willem S ix, Rod Whiteley, Guus Reurink, Adam Weir, Maarten Moe n, Gino M M J Kerkhoffs, Johannes L Tol Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, metaanalysis and metaregression (21 December, 2020) FREE Liliana Laranjo, Ding Ding, Bruno Heleno, Baki Kocaballi, Juan C Quiroz, Huong Ly Tong, Bahia Chahwan, Ana Luisa Neves, Elia Gabarron, Kim Phuong Dao, David Rodrigues, Gisela Costa Neves, Maria L Antunes, Enrico Coiera, David W Bates Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete: a study of 6812 exercising women recruited using the Strava exercise app (16 November, 2020) Georgie Bruinvels, Esther Goldsmith, Richard Blagrove, A ndrew Simpkin, Nathan Lewis, Katie Morton, Ara Suppiah, John P Rogers, Kathryn E Ackerman, John Newell, Charles Pedlar Randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support for inactive adults with chronic health conditions: the ecoachER trial (27 November, 2020) Adrian Taylor, Rod S Taylor, Wendy Ingram, Sarah Gerard Dean, Kate Jolly, Nanette Mutrie, Jeff Lambert, Lu cy Yardley, Adam Streeter, Colin Greaves, Chloe McAda m, Lisa Price, Nana Kwame Anokye, John Campbell EDITORIALS The 11+ of the future: a primary injury prevention framework for sub-elite football (15 October, 2020) Matthew Whalan, Ric Lovell, Kristian Thorborg, John Andrew Sampson Why a dearth of sports and exercise medicine/ physiotherapy research using hospital electronic medical records? A success story and template for researchers (21 May, 2020)

Gustavo C Machado, Mary O'Keeffe, Bethan Richards, Chris Need s, Hannah Storey, Chris G Maher Estimating unbiased sports injury rates: a compendium of injury rates calculated by athlete exposure and athlete at risk methods (30 September, 2020) Joseph El-Khoury, Steven D. Stovitz, Ian Shrier g

CONSENSUS STATEMENT Sleep and the athlete: narrative review and 2021 expert consensus recommendations (3 November, 2020) FREE Neil P Walsh, Shona L Halson, Charli Sargent, Gregory D Roach, Mathieu Nédélec, Luke Gupta, Jonathan Leeder , Hugh H Fullagar, Aaron J Coutts, Ben J Edwards, Samuel A Pullinger, Colin M Robertson, Jatin G Burniston, Michele Lastella, Yann Le Meur, Christophe Hausswirth, Amy M Bender, Michael A Grandner, Charles H Samuels GUIDELINES World Health Organization 2020 guidelines on physical activity and sedentary behaviour Fiona C Bull, Salih S AlAnsari, Stuart Biddle, Katja Borodulin, Matthew P Buman, Greet Cardon, Catherine Carty, JeanPhilippe Chaput, Sebastien Chastin, Roger Chou, Paddy C Dempsey, Loretta DiPietro, Ulf Ekelund, Joseph Firth, C hristine M Friedenreich, Leandro Garcia, Muthoni Gichu, Russell J ago, Peter T Katzmarzyk, Estelle Lambert, Michael Leitzmann, Karen Milton, Francisco B Ortega, Chathuranga Ranasinghe, Emmanuel Stamatak is, Anne Tiedemann, Richard P Troiano, Hidde P van der Ploeg, Vicky Wari, Juana F Willumsen REVIEWS

Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network metaanalysis (26 October, 2020) Marinus Winters, Sinéad Holden, Carolina Bryne Lura, Nicky J Welton, Deborah M Caldwell, Bill T Vicenzino, Adam Weir, Michael Skovdal Rathleff Is patellofemoral pain preventable? A systematic review and meta-analysis of randomised controlled trials (28 October, 2020) Adam G Culvenor, Marienke van Middelkoop, Erin M Macri, Kay M Crossley

http://bjsm.bmj.com/content/55/7

All articles are accessible via our website https://sportsphysiotherapy.org.nz/members/bjsm/


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CLASSIFIEDS

Physiotherapist Auckland City – Grey Lynn A: Full time or part time job share We’re looking for a talented, hardworking MSK physiotherapist to join our small -dedicated team. Our modern, friendly rehabilitation clinic is just off Williamson Ave, close to the shops, cafes, businesses and transport links of Grey Lynn and Ponsonby. You’ll work closely with two physiotherapists (director with 23 years’ experience, and two skilled Pilates instructors. You must be: a fantastic people person and a natural team player highly motivated and passionate about the job confident, organised and able to work independently dedicated to learning and developing as a professional ready to put down roots and reap the rewards of longevity in the role In return we offer: a highly rewarding role in a supportive team environment, with tons of room to grow plenty of flexibility re work schedule and hours a loyal, appreciative client base with strong word of mouth growth a varied caseload including manual therapy, rehabilitation and clinical Pilates one-on-one mentoring in spine care, rehab and diagnostic ultrasound extensive CPD opportunities, including courses, conferences, in-service training, case study meetings and research review a starting CPD allowance of $1000 a year (FTE), increasing annually You’ll work on a per-hour basis, with 30 or 60 minute treatment times. Our work has a strong active rehabilitative focus, treating acute and chronic spine clients, shoulder and hip pathologies, running and cycling injuries, general physiotherapy and post orthopaedic care. Pilates experience is an advantage but not essential. This could be a full-time role or two part-time positions. We also have capacity for a dedicated weekend-only physiotherapist. You must be New Zealand registered, but we offer visa support if you need it. If you think this sounds like you, contact Sarah at sarah@bodyreform.co.nz.

Physiotherapist (Full-Time) - Morrinsville, Waikato A full-time position is available to join an excellent physiotherapy team in an inspiring practice, treating a wide variety of clients. An emphasis on accurate assessment, manual therapy and exercise prescription, are the hallmarks of our practice. The principal is an experienced physiotherapist who enjoys mentoring and sharing his knowledge wih staff, undergraduate and postgraduate physiotherapy students from AUT. He has postgraduate qualifications in both Manipulative Therapy and Sports Medicine. He also has extensive experience with high performance sport athletes, having been involved with two New Zealand National Men’s Sports Teams (Hockey and Football), and attending three Olympic Games and three Commonwealth Games, as a Team Physiotherapist, over a ten year period. Opportunities to be involved with local sports teams are available. In-service training and professional support is provided regularly. Morrinsville is a provincial town in the Waikato region of New Zealand's North Island, with a population of approximately 7,000. The town has excellent facilities and is an easy 25 minute commute to Hamilton, with a population of 152,000. The Waikato region is easily accessible to both East and West coast beaches, bush walks, mountain biking, water sports, fishing and snow sports, so you can optimise your weekend activities and down time. If this opportunity interests you, and you enjoy working in a positive, fun environment, I would love to hear from you. New graduates welcome. A full time physiotherapy position is available to start as soon as possible, but we would be happy to wait for the right person. Please email your CV with a cover letter – in confidence to Gavin at: gavin@morrinsvillephysio.co.nz or contact Gavin if you have any questions regarding the position via email or phone 07 889 7474 All applicants must have a current New Zealand Annual Practicing Certificate. Check out our website: www.morrinsvillephysio.co.nz


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CLASSIFIEDS


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MEMBER BENEFITS


MEMBER BENEFITS

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Clinical Sports Nutrition, 5th Edition Louise Burke & Vicky Deakin ISBN: 9781743073681, NZ$164.99 Clinical Sports Nutrition fifth edition is a cornerstone of the Sports Medicine series offered by McGraw-Hill. This complete practical and clinical ref-

erence provides the latest sports nutrition information, drawing on scientific research from around the globe. All chapters have been substantially revised and updated with contributions from leading academics, physicians and sports dietitians in Australia, Canada, the United States and the United Kingdom.

Dutton's Orthopaedic: Examination, Evaluation and Intervention, 5th Edition ISBN: 9781260143874, NZ$290.00 Dutton’s Orthopaedic: Examination, Evaluation and Intervention provides readers with a systematic logical approach to the examination and intervention of the orthopedic patient. This comprehensive and up-to-date fifth edition strikes the perfect balance in its coverage of the continuum of care of an orthopaedic patient. The content emphasizes the appropriate use of manual techniques and therapeutic exercise while outlining the correct applications of multiple adjuncts to the rehabilitative process.


MEMBER BENEFITS

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As a member of IFSPT - SEPNZ members can register to obtain free direct delivery of the International Journal of Sports Physical Therapy. Please see link below in order to sign-up for this free benefit. International Journal of Sports Physical Therapy (IJSPT) The International Journal of Sports Physical Therapy is a peer-reviewed journal relating to all aspects of sports physical therapy. The American Academy of Sports Physical Therapy (AASPT), formerly the Sports Physical Therapy Section (SPTS), created the North American Journal of Sports Physical Therapy to address current physical therapy trends and practices to improve the care of the recreationally active individual. It was designed as a benefit of membership for the Sports Physical Therapy Section of the American Physical Therapy Association. The first issue was released February 1, 2006. Beginning V4N1, the Journal became an online publication and all archives were posted on the NAJSPT website. Members and subscribers have immediate access to the publication and articles are available for purchase by non-members. Subscriptions are also available for non-members. On January 1, 2011, the journal became the International Journal of Sports Physical Therapy, and serves as a benefit of membership for countries around the world. It is an official publication of the International Federation of Sports Physical Therapy (IFSPT). Beginning January 1, 2021, the IJSPT will be published by NASMI as an open access publication. In order to access IJSPT issues first, please register at this link. This free subscription is available to IFSPT and AASPT members and will allow advance access to the IJSPT.


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