SPNZ Bulletin August 2012 by Sports & Exercise Physiotherapy NZ

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BULLETIN

ISSUE 4 l August 2012

View the SPNZ Bulletin online in flip-format http://issuu.com/sportsphysiotherapynz

Welcome to the August 2012 Bulletin.

SPNZ EXECUTIVE COMMITTEE President

Dr Angela Cadogan

Secretary

Michael Borich

Treas urer

Dr Gisela Sole

Website

Hamish Ashton

Committee

Dr Tony Schneiders Bharat Sukha Jim Webb David Rice

EDUCATION SUB-COMMITTEE Dr Gisela Sole

David Rice

Chelsea Lane

Dr Grant Mawston

Jim Webb

EDITORIAL ASSISTANT Aveny Moore

SPECIAL PROJECTS Monique Baigent

Kate Polson

Nathan Wharerimu

Karen Carmichael

Amanda O’Reilly

Deborah Nelson

Charlotte Raynor

ADVERTISING Advertising terms & conditions click here.

LINKS Sports Physiotherapy NZ List of Open-Access Journals SPNZ Research Reviews

The 2012 London Olympics have just finished, and we hope you enjoyed the article by Louise Johnson in SPNZ’s June Bulletin about her work with Valerie Adams. I’m sure Louise will come home with more amazing commentary following these hugely successful Olympic Games. We congratulate Val for eventually securing the gold medal status she deserved and hope she will have it to hang around her neck in the not too distant future. The 2012 Paralympic Games follow on from the summer Olympics (29 th August – 9th September) and in this edition we profile Chelsea Lane, a Christchurch-based Sports Physiotherapist who works with Sophie Pascoe (swimmer), one of New Zealand’s highest achieving young Paralympic athletes. Sophie joins a host of New Zealand Paralympic athletes and support staff travelling to the 2012 Paralympic Games in London, UK. We wish them all the best for another successful medal haul following their success in Beijing in 2008. The SPNZ Executive and the SPNZ Education sub-committee met in Wellington at the end of June. We had a series of very productive meetings, resulting in re-affirmation of our vision and mission statements for sports and orthopaedic physiotherapy, redefining our administrative processes and appointment of several sub-committees, as well as significant progress in development of our continuing education programme that will be rolled out in 2013. We also have several projects underway including development of public resources relating to injury prevention and management, development of a sports physiotherapy Code of Ethics, and also clarifying the ACC regulations regarding charging for services carried out at sports events and tournaments. More information will be provided on

Asics Apparel and order form McGraw-Hill Books and order form

INSIDE THIS EDITION:

Asics Education Fund information



Paralympic Special: We profile Chelsea Lane, a Christchurch-based Sports Physiotherapist who works with Sophie Pascoe (swimmer), one of New Zealand’s highest achieving young Paralympic athletes



Sports Physiotherapy NZ Research Reviews: Shoulder Injury: Testing,

Predicting, Diagnosing

mborich@ihug.co.nz 

SPNZ Website Update

AND MORE...

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CONTINUED ON NEXT PAGE ... CONTINUED FROM PREVIOUS PAGE each of these projects as it becomes available. We also discussed the possibility of combining our biennial Symposium with a Physiotherapy New Zealand National Conference, and this will be discussed further at the PNZ Branch/SIG meeting on 17th August. SPNZ also recently launched our new website http://www.spnz.org.nz/ . Thanks to Hamish Ashton for all his efforts in creating the new and improved design and format. Thanks also to the members who sent in photos for our home page display, it is great to see our members in action, and we soon hope to add â&#x20AC;&#x2DC;Find a Physioâ&#x20AC;&#x2122; to this site and all members will be given the opportunity to add their contact details to this. We congratulate all our Olympic athletes and their support teams on their wonderful performances and wish our Paralympic athletes and physiotherapy support staff continued success. As always, we welcome any feedback and suggestions from our members, and we are always looking for volunteers to help out with our Special Projects Group - contact our secretary (Michael Borich) mborich@ihug.co.nz.

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Deadlines: October bulletin : December bulletin: February bulletin:

30th September 30th November 30th January

IN THIS EDITION

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To locate a page quickly, click on the ’pages’ symbol at the top of the pdf reading panel at left of screen and select the required page.

LATEST NEWS

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SPNZ Website Update Welcome to our new look website. I hope you all enjoy the new and clearer format. Members Section: log in to the Members section with your email address and spnz2012 as your password. For security reasons please change your password in the ‘edit your profile’ section at the top right corner as soon as possible. If you forget your password request a new one on the log in page. Latest News: this is a new section at the bottom of the front page and on the right side bar of other pages. If anyone hears any news regarding Members of SPNZ or of interest to Members please forward to me at help@spnz.org.nz. SPNZ Calendar: this is a Google calendar so you can click on the events and add them to your calendar. If you hear of any events or courses let me know so I can add them. Find a physio: we are shortly looking to allowing our Members to list their contact details for public access. Look out for notification of this in the near future. FAQ: We now have a frequently asked questions section on the website. You will find the tab just to the left of the members section tab. Please use this section to look for answers to your problem before you contact Michael (secretary) or Hamish (web help)

International Journal of Sports Physical Therapy - Individual Subscriptions Available The IJSPT journal is available to purchase for individual members. SPNZ members interested in subscribing to this journal can purchase an individual subscription through the journal directly. To purchase a subscription go to the IJSPT website, and click on “subscriptions”. Subscription rate for 2012 is €20. To view contents of the current issue click here.

SPNZ Member Benefits Remember to take advantage of the full range of SPNZ member benefits: 

FREE online access to JOSPT (value approx. USD$275)



FREE Editions of the Quarterly APA “Sports Physio” Magazine



25% Discount on all McGraw-Hill book publications



Funding Support for continuing education and research (Asics Education Fund).



Substantial discount, Advanced Notice and preferential placing on SPNZ Educational Courses.



Access to website with clinical and relevant articles.



Sports Physiotherapy Forum to discuss ideas and ask questions



Bi-monthly NZSOPA Bulletin featuring Activity, Course and information updates.



FREE classified advertising in the NZSOPA Bulletin

Education Awards for 2012 Please note that the deadline for all applicants is as follows: ASICS Education:

30 August 2012

Student Research Prize (Auckland and Otago Schools of Physiotherapy):

20 November 2012

All applicants should visit the SPNZ website for further information and eligibility.

IFSPT REPORT

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International Federation of Sports Physical Therapy (IFSPT) Report IFSPT website

ALL EYES TURN TO LONDON AS THE OLYMPIC GAMES BEGIN Welcome to another edition of our IFSPT newsletter! We have a range of articles, including details about our upcoming Global Goals Program November 29 in Las Vegas, NV, followed by member organization SPTS's Team Concept Conference November 29-December 1. Support the IFSPT and hear the latest from world sports physical therapy leaders at this exciting event! Learn more about Denmark, one of our member organizations, and a student opportunity in Australia. Of course, the biggest news over the next few weeks will be the Olympic Games in London! We're planning a special issue of the newsletter to cover the games through the eyes of our members. Are you attending the games, either for work or pleasure? Send your stories to Mary Wilkinson for inclusion! Pictures, stories, experiences and articles are all welcome. The newsletter is for you, the members, so let us know what sorts of things you'd like to hear about. Watch your e-mail box for communications from the IFSPT. If you would like to receive communications directly rather than through your member organization, simply click the "Subscribe" box in this newsletter or send an email to Mary Wilkinson. We'll be happy to add your name!

Register Now for the Global Goals IFSPT Program at Team Concept Conference! The International Federation of Sports Physical Therapy, in cooperation with the Sports Physical Therapy Section, APTA, is excited to announce its first pre-conference program at the renowned Team Concept Conference. This program will be held in the Bally's Las Vegas Resort and Casino in Las Vegas, Nevada, USA on November 29, 2012, from 8 am to noon. The IFSPT program will highlight sports physical therapy involvement at the Olympic Games, F-MARC projects in soccer, and focus on the latest clinical guidelines on selected topics in various international sports. Don't miss this opportunity to meet international speakers from Europe, Australia, New Zealand and the USA, and to get the latest update on IFSPT activities worldwide. Cost is only $50 USD. Price includes breaks and materials. Complete information and program details may be found at this link.

PhD Studentship on Regenerative Injection Therapies for Tendinopathy Professor Michael Yelland and Dr Leanne Bisset in The Centre for Musculoskeletal Research (CMR) of the Griffith Health Institute are offering a PhD scholarship in a study program on chronic lateral epicondylosis (tennis elbow). This academic program that will take place at Griffith University's Gold Coast Campus will involve the coordination of a highlevel clinical trial involving regenerative injection and exercise therapies for tennis elbow while allowing the candidate to explore their own areas of interest within the diverse range of outcome measures used in this project, including: CONTINUED ON NEXT PAGE...

IFSPT REPORT

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CONTINUED FROM PREVIOUS PAGE

   

Electromyography, Acoustoelastographic assessment of tendon mechanics using diagnostic ultrasound, 3-dimensional ultrasound modelling of the elbow Quantitative sensory testing and grip strength for assessment of sensorimotor function.

Research program support of AUS$23,728 per annum will be provided to the qualified candidate for a 3 year period. Supplementary funding is available for teaching conditional on qualifications. Funding may be available to assist international applicants. Application requirements: a bachelors degree with first-class honours or second-class honours (Division A), or a masters degree incorporating a significant research component, from a recognised institution; or a record of research, or a qualification granted by a professional or other body deemed by the Dean, Griffith Graduate Research School, to be of a standard comparable to a bachelor's degree with second-class honours (Division A). Applicants with postgraduate coursework or who are familiar with research methods, have significant research experience, and/or have postgraduate clinical qualification are strongly encouraged to apply. English language requirements (IELTS 6.5) apply to International applicants and other applicants whose previous study was undertaken in a language other than English. We reserve the right to not appoint. To apply, please forward your CV and a letter of support from two referees to michael.ryan@griffith.edu.au. For informal questions, please contact: Michael Ryan PhD Centre For Musculoskeletal Research Griffith University Gold Coast Campus Soutport, QLD 4222 michael.ryan@griffith.edu.au

the sights and sounds of Las Vegas!

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IFSPT REPORT CONTINUED FROM PREVIOUS PAGE

Register Now! Combine your trip to the US for the IFSPT Sports Program with the Team Concept Conference. Light your passion for sports physical therapy with Team Concept Conference 2012! The 2012 Team Concept Conference is the SPTS's 35th annual event. Conceived by the founders of SPTS as a way for all members of a sports medicine team to work together for the benefit of the individual patient, attendance at this event has doubled in only the past four years. This year, SPTS has gathered the leaders in sports physical therapy from across the nation and around the world for an all-new TCC! Make your plans now to join us in Las Vegas, November 29 through December 1 at the Bally's Las Vegas Resort and Casino. Discounted cost for IFSPT members is only $500 USD for the 2-1/2 day event. Price includes breakfast daily, breaks, welcome reception on Thursday evening, access to the exhibit hall, all materials and conference handbook. Bring a Friend As a further discount, IFSPT members who register together under the SPTS "Bring a Friend" program save an additional $50 USD each. Details on the "Bring a Friend" discount can be found at this link. It's easy to do through online registration! All the information about Team Concept Conference may be found at this link. Agenda Registration Access to discount hotel rates may be accessed through this link for the Bally's Resort and Casino. Don't miss this rare opportunity to learn from US and international physical therapy leaders and enjoy the sights and sounds of Las Vegas!

Caption This Photo Competition

IFSPT Board Members Tony Schneiders (New Zealand) and Maria Constantinou (Australia) are shown on their way to Las Vegas to attend the IFSPT's Global Goals Program and SPTS Team Concept Conference. Using this mode of transportation, they should arrive in time for the November 29 through December 1 events. We would like you to come up with a caption for this photo. Email your captions to: Michael Borich at mborich@ihug.co.nz The best caption (or captions!) will be published in the next issue of the Bulletin!

FEATURE

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PARALYMPIC SPECIAL ————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————— ————————

Sports Physiotherapist Chelsea Lane

Introduction Following the feature article in the April 2011 edition of the SPNZ Bulletin, in which we profiled Jacqui Kerins (NZ Paralympic Physiotherapist) during the International Paralympics Athletics World Championships, and our June 2012 Bulletin in which we featured the 2012 Summer Olympic Games, in this edition we profile Chelsea Lane, a Christchurchbased Sports Physiotherapist who works with Sophie Pascoe (swimmer), one of New Zealand’s highest achieving young Paralympic athletes. Sophie joins a host of New Zealand Paralympic athletes and support staff travelling to the 2012 Paralympic Games in London, UK. We wish them all the best for another successful medal haul following their success in Beijing in 2008. Background to the Paralympic Games The first organized athletic event for athletes with a disability that coincided with the Olympic Games took place on the day of the opening of the 1948 Summer Olympics in London, United Kingdom. Dr. Ludwig Guttmann of Stoke Mandeville Hospital hosted a sports competition for British World War II veteran patients with spinal cord injuries. Dr. Guttman's aim was to create an elite sports competition for people with disabilities that would be equivalent to the Olympic Games. The games were held again at the same location in 1952, and Dutch veterans took part alongside the British, making it the first international competition of its kind. These early competitions, also known as the Stoke Mandeville Games, have been described as the precursors of the Paralympic Games. The Paralympic Games is now an elite sporting event for athletes with physical and visual disabilities. This includes athletes with mobility disabilities, amputations, blindness, and cerebral palsy. The London Paralympics will be the first Games since the 2000 Summer Paralympics in Sydney in which athletes with intellectual disabilities will also be authorised to compete following a decision by the International Paralympic Committee in 2008. The Paralympic Games are held every four years and the 2012 Summer Paralympic Games will be the fifteenth Paralympics due to take place between 29 August and 9 September 2012 in London, England. The number of athletes participating in Summer Paralympic Games has increased from 400 athletes from 23 countries in Rome in 1960, to over almost 4000 athletes from 146 countries in Beijing in 2008, competing in more than 20 sports. Since 1968, New Zealand has a proud history of winning medals at both the Summer and Winter Paralympic Games. In 2008, New Zealand was represented at the Beijing Paralympic Games by a team of 30 athletes, who competed across seven sports, winning a total of 12 medals (five gold, three silver and four bronze). Three of New Zealand’s five gold medals in 2008 were won by Sophie Pascoe (swimming) in the 100m backstroke, 100m breaststroke and 200m individual medley events. Paralympic Disability Categories The IPC has established six disability categories. Athletes with one of these physical disabilities are able to compete in the Paralympics though not every sport can allow for every disability category. These categories apply to both Summer and Winter Paralympics.  Amputee  Cerebral Palsy  Intellectual disability  Visually Impaired  Wheelchair  Les Autres (French: “the others”) Athletes with a physical disability that does not fall strictly under one of the other five categories, such as dwarfism, multiple sclerosis or congenital deformities of the limbs.

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FEATURE PARALYMPIC SPECIAL Chelsea Lane – Sports Physiotherapist and SPNZ Member

Chelsea Lane is an Australian Physiotherapy Association (APA) Titled Sports Physiotherapist. Chelsea graduated from Sydney University in 1999, and also has a Masters Degree in Sports Physiotherapy from Sydney University and has 12 years experience in sports physiotherapy. Chelsea is currently a key physiotherapy provider for High Performance Sport New Zealand, and works as a private practitioner at Precision Physiotherapy in sunny Christchurch. What is your background in sports physiotherapy? I have lived in NZ for the past five years. In that time I have been extremely fortunate to be involved in with HPSNZ in a few different guises. In 2009/10 I traveled for several months with the NZ Skeleton Racing Team during their World Cup season through Europe and the USA. This tour culminated with the team competing at the Vancouver 2010 Winter Olympics. In that same year I was lucky enough to attend the Delhi Commonwealth Games as part of the NZOC Health Team working with summer sport athletes from a number of sports. As a key provider for the HPSNZ Winter Performance Program in recent years I have been treated to working on the Professional Freeski tour, their pinnacle event being the Winter XGames. In my day to day work I am equally as thankful for the opportunity to work with a mix of high performance summer and winter athletes, gifted enthusiast and weekend warriors.

You are currently working closely with Sophie Pascoe, Paralympic swimmer. Can you provide some background on Sophie’s classification and achievements. Sophie Pascoe is a Paralympic swimmer. With a below knee amputation she is classified as an S10 athlete (physical disability).

At the Beijing Paralympics Sophie, the youngest member of that NZ Paralympic team at only 15, won gold in the 100m backstroke, 100m breaststroke and 200m individual medley and silver in the 100m butterfly. Sophie, now 19, set two new world records in the 100m freestyle and 100m butterfly whilst competing at the British Disability championships in Sheffield this year. This was a qualifying event for the London Paralympics, which Sophie will now attend as part of the NZ team in August. Sophie is the first ever recipient of the Halberg Disabled Sportsperson of the Year award, which she was awarded earlier in 2012.

What is your role in working with Sophie? When we are at home in Christchurch (between competitions) my role as Sophie’s physio is four fold:  developing and managing her rehab program to minimise injury from the load of training in the pool and in the gym  liasing between all members of Sophie’s core support team, "Team Sophie", as well as her wider health professional providers.  assisting Sophie with the maintenance of optimal joint ROM and kinematics specific to her sport and her training requirements  acute injury management as needed

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FEATURE PARALYMPIC SPECIAL In July I will be lucky enough to travel with Sophie, her training partner, Alex, and Roly to Flagstaff, Arizona, to complete a pre-games altitude training camp. Whilst on tour my role as Sophie's physio involves all of the above responsibilities with the addition of:  overseeing her Strength and Conditioning programme

is taken to minimise this risk. For example I might attend the filming session at the pool with Matt so we can work together on improving a concerning hand placement, or Todd may attend a physio session so we can work out how to best incorporate Sophie’s rehab work into her gym sessions if we’re seeing undesirable postures creeping in with heavy lifting.

 managing her recovery strategies including massage  management of our "mini-team" including logistics whilst in the USA

What are the major challenges in working with this sport/athlete?

 liasing with ParaNZ Medical Director, Ian Murphy, and Team Physiotherapist, Jacqui Kerins, in the lead up to the games

As with all elite athletes one of the major challenges is balancing the need to train hard to maximise power output, with the need for recovery strategies and rehab commitments to help prevent injury.

 liasing with any local American medical providers as needed to ensure all WADA rules are adhered to if pharmaceuticals are prescribed

Who else is involved in the ‘support team’ that you communicate with regarding athlete status? "Team Sophie" is one of the most integrated multidisciplinary teams I’ve ever had the pleasure of working with. The core support team consists of Sophie’s Swim Coach (Roly Crichton), Biomechanist/analyst (Matt Ingram), Strength and Conditioner (Todd Andrews), and Physio (me!). We meet monthly to clarify the upcoming month’s goals, highlight any risks and identify what each of our roles are in order to meet those goals. Outside of the core support team, Sophie will also be expected to attend nutrition, massage, sports med, podiatry, and prosthetics appointments. The information from which is shared amongst her core support team as is appropriate. During international competition, Sophie travels with PNZ medical coordinator and physio, Jacqui Kerins. So, once a week I also touch base with Jacqui so that all Sophie’s key support providers are in the loop well in advance of her arriving to compete.

How do you integrate/work with the trainer/coach with respect to injury prevention or rehabilitation? Injury prevention and maximising time in the pool is one of the main goals for “Team Sophie”, so working with Roly and the rest of the team on this comes pretty easily. It’s sort of like a sports physio’s dream environment! Outside of our monthly meetings it is common place for the core support members to attend each others sessions with Sophie. If areas of risk to Sophie’s performance or musculoskeletal health have been highlighted in the meeting it tends to follow that a multidisciplinary approach

More specifically to Sophie's physiology is the challenge of the asymmetries created by her amputation and needing to be creative with her rehab and training in an attempt to minimise the impact this has on her musculoskeletal health and her performance in the pool. It’s sort of like throwing the text book away and making it up to suit Sophie's specific needs as you go.

What are the key attributes you feel are required to work with elite level athletes?  being truly open to the benefits of a multidisciplinary approach  a commitment to and passion for the cause  adaptability and a sense of humour as things never go exactly to plan in sport!  a firm grasp of the concept that your role is to support an athlete in achieving their goals of greatness, and that you are fortunate to have the opportunity to be involved. Interview with Chelsea Lane by Dr Angela Cadogan

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CLINICAL SECTION ARTICLE REVIEW

Strengthening and Optimal Movements for Painful Shoulders (STOMPS) in Chronic Spinal Cord Injury: A Randomized Controlled Trial Sara J. Mulroy, Lilli Thompson, Bryan Kemp, Patricia Pate Hatchett,Craig J. Newsam, Dee Gutierrez Lupold, Lisa Lighthall Haubert, Valerie Eberly, Ting-Ting Ge, Stanley P. Azen, Carolee J. Winstein, James Gordon; for the Physical Therapy Clinical Research Network (PTClinResNet) ABSTRACT Background Shoulder pain is a common problem after spinal cord injury (SCI), with negative effects on daily activities and quality of life (QOL). Objective The purpose of this study was to determine the effect of an exercise program and instruction to optimize performance of upper-extremity tasks on shoulder pain in people with paraplegia from SCI. Methods/Design Eighty individuals with paraplegia from SCI and shoulder pain were randomly assigned to receive either an exercise/movement optimization intervention or an attention control intervention. The exercise/movement optimization intervention consisted of a 12-week home-based program of shoulder strengthening and stretching exercises, along with recommendations on how to optimize the movement technique of transfers, raises, and wheelchair propulsion. The attention control group viewed a 1-hour educational video. Outcome measures of shoulder pain, muscle strength (force-generating capacity), activity, and QOL were assessed at baseline, immediately after intervention, and 4 weeks later. Results Shoulder pain, as measured with the Wheelchair User’s Shoulder Pain Index, decreased to one third of baseline levels after the intervention in the exercise/movement optimization group, but remained unchanged in the attention control group. Shoulder torques, most 36-Item Short-Form Health Survey questionnaire (SF-36) subscale scores, and QOL scores also were improved in the exercise/movement optimization group, but not in the attention control group. Improvements were maintained at the 4-week follow-up assessment. Limitations Many of the outcome measures were self-reported, and the participant dropout rate was high in both groups. Additional studies are needed to determine whether the results of this study can be generalized to individuals with tetraplegia. Conclusions This home-based intervention was effective in reducing longstanding shoulder pain in people with SCI. The reduction in pain was associated with improvements in muscle strength and health-related and overall QOL. Reference: Physical Therapy (2011) vol 91: 3 pg 305-325

Article Review: Introduction While this is a clinical review section, this article is of very sound clinical value to explore management of shoulders in wheelchair patients. The article is one of the first RCT’s to really look at painful shoulder management in paraplegics and although it presents with a number of limitations it is still laying the foundation for evidence based practice. Paralysis of the lower extremities (resulting from traumatic or non traumatic causes) mandates increase in shoulder load from repetitive weight-bearing activity, which increases further if vocation, recreational and sporting pursuits result in further upper extremity use. Untreated or undermanaged, shoulder pain may lead to reduced function and participation in ADL and recreational/social activities. There is evidence that shoulder strengthening and stretching exercises can assist in shoulder pain management in both non -wheelchair and wheelchair users. However there is little research that identifies specifically what exercises are applicable to what specific shoulder pain or diagnosis in wheelchair users. Additionally there is evidence that education on modification

of task performance around painful shoulder management is also beneficial in reducing shoulder pain, specifically ‘stopping the wrongs’. Wheelchair users who have good knowledge on how to transfer properly, propel efficiently and manage wheelchair mechanics are known to have better preservation of upper extremity function. The authors designed a research where Strengthening and stretching and education on Optimal Movement for Painful Shoulders (STOMPS) were compared with just a video education session in paraplegic patients. Intervention The key clinical features of this RCT were that a series of home based exercises were devised that were performed three times a week for a 12 week period plus education on optimising wheelchair performance. The exercises included: stretching phase, a warm up phase and a resistive shoulder exercise phase Stretching phase:

 stretching the anterior shoulder (bilaterally and in the doorway)

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CLINICAL SECTION ARTICLE REVIEW CONTINUED...  posterior shoulder joint structures (horizontal adduction)  upper trapezius muscle (holding spikes on wheel and stretching the cervical spine in contralateral side bend with the contralateral hand) Warm up phase:

 4 non-resisted active movements in the same exercise as for resisted exercises Resisted exercise phase:

 both strength (3 x 8 rep max) and endurance (3 x 15 rep max) parameters Strengthening exercises:

 Shoulder adduction using bungy in door (PNF pattern)  Shoulder external rotation in neutral with bungy Endurance exercises:

 Shoulder elevation in the scapular plane (full can) using a dumbbell

 Scapular retraction or low row with bungy resistance Education on optimal movement performance were aimed at reducing the risk of shoulder injury, specifically topics were covered that assisted with more efficient propulsion of the chair, propulsion technique and energy conservation. There is evidence that inefficient propulsion and poor wheelchair design or set up contribute greatly to increase load through the shoulder. Whilst this article did not go into the recommendations, as these would be individual to patients and to any specific sporting chair, if you are a therapist managing wheelchair patient or athlete, chair mechanics will need to be addressed. Every time a patient transfers there is also additional force though the shoulder, ensuring that the height of transfer surface is optimal and placement of hand, arm and trunk is essential as transfers can occur numerous times a day, additionally consideration of body ergonomics needs to occur with depression raises (lifting the body to relieve pressure on the buttocks). Scrutiny of any task performance that causes shoulder pain was also reviewed and the patient was accordingly guided to use better ergonomics during painful tasks.

counterproductive in an already loaded shoulder where there is little relative rest. This is an important consideration when working with athletes whose shoulders will be subjected to additional forces such as falling out of the chair, collision injuries and sport specific training schedules. Whilst this paper did not specifically address this issue it did highlight the role of a simple exercise prescription performed three times a week in improving chronic shoulder symptoms that may not have over burdened a wheelchair patient. Planning an exercise programme to both prevent and manage existing shoulder is important. What specific exercises are required obviously needs more research and this will need to be done in conjunction with improved diagnosis of the shoulder pathology that is causing the symptoms. This article didn’t define the diagnosis of shoulder pathology other than the participants had chronic shoulder pain. There is growing evidence of determining shoulder pathology with clinical assessment in non wheelchair users and this knowledge has yet to be extrapolated into wheelchair population as the demands on the shoulder in spinal cord patients are different due to the special loads and forces associated with propulsion and modified ADL requirements. There is evidence that wheelchair patients experience a large range of shoulder conditions. The therapist managing wheelchair patients (both athletic and non-athletic) needs to be vigilant about shoulder management, preferably early in the management of wheelchair use and in a preventative manner. Therapists need to have knowledge on wheelchair set up and mechanics so as to assist in preventing and managing to reduce load and forces through shoulders. Having good knowledge on optimal movement and being able to discuss sound movement ergonomics with tasks such as transfers is also necessary to mange how much repetitive load the upper extremity experiences. Finally, use of a wheelchair specific upper limb functional outcome measure such as the Wheelchair User’s Shoulder Pain Index (WUSPI) is a validated and reliable instrument to measure self reporting upper limb function in wheelchair patients. A free copy is available on the internet.

Discussion and Clinical Application

Conclusion

Patients who received the intervention had a significant reduction of shoulder pain and improved function as measured by self reported functional outcome measures and strength in shoulder. It was not possible to separate out which component of the intervention (the home exercise programme or education on ergonomics and shoulder care) made a difference as participants were exposed to both simultaneously. It was noted by the authors that previous studies had not had the same significant results and it was hypothesised that previously exercise programmes were requested to be performed daily. Insight into life of a wheelchair user indicates that ADL, work and sporting pursuits are more burdensome and not only does performing a daily exercise programme add to this but it may also be

Whilst this study has a number of limitations, it is still an important research to indicate the efficacy of a home based exercise programme and education on managing painful shoulders in the wheelchair population. It is beyond the scope of this commentary to discuss individual pathologies and exercise prescriptions specific to wheelchair users due to the complexity of diagnosis and individualization required. However physiotherapists are well placed to have this knowledge and clinical skills to benefit optimal management of the wheelchair population. References available on request. Reviewed by Kate Polson, MHSc(Hons); Dip Phty, Dip MT, MNZCP; MNZSP, July 2012

CLINICAL SECTION

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ARTICLE REVIEW Prevention of injury-related knee osteoarthritis: Opportunities for the primary and secondary prevention of knee osteoarthritis Ratzlaff, C.R., & Liang, M. H. (2010). Prevention of injury-related knee osteoarthritis: Opportunities for the primary and secondary prevention of knee osteoarthritis. Arthritis Research & Therapy, 12(215), 1-8. doi: 10.1186/ar3113 This review looks at the common risk factors for developing osteoarthirits (OA) of the knee and the efficacy of methods of prevention. Three significant risk factors for developing OA in the knee are previous injury, obesity and an older population. Joint injury is a large predictor for the development of knee OA. Approximately 50% of individuals that sustain an anterior cruciate ligament (ACL) or meniscus injury go on to develop OA. It is estimated that prevention of joint injuries would result in a 14-25% reduction in OA incidence. Risk factors for sustaining a knee injury include intrinsic (anatomical, neuromuscular, hormonal) and extrinsic factors (environmental, bracing, shoe surface interface, weather). Intrinsic risk factors have a significant role in the etiology of knee injuries. Biomechanical impairments such as excessive valgus collapse, decreased core and trunk control, less knee flexion, increased hip flexion and landing flat footed contribute more to injury than the actual contact or collision. A meta-analysis that looked at six interventions for reducing ACL injuries in females found that neuromuscular training is effective if plyometrics, strength and balance training are incorporated and if sessions are more than once a week for at least six weeks. The hypothesis is that ACL injuries are modifiable. There is strong level one and two evidence to support the reduction in ACL injury by up to 41-88% through training neuromuscular control and addressing biomechanics. This review goes on to address secondary prevention strategies, once a joint has been injured, to avoid the development of OA. Biomechanical impairments are a major catalyst for developing OA post injury. Knee alignment can contribute to disease progression; surgical re-alignment by osteotomy can unload an arthritic compartment and slow joint deterioration. Following knee injury common impairments are diminished quadriceps strength, poor lower limb positioning and proprioception and impaired postural control. These factors interfere with normal joint protection mechanisms, such as anticipating load and pre-activation of muscles, leaving the joint vulnerable to compression and shear forces. While ACL reconstruction restores joint stability it does not restore normal mechanics. There is some evidence that conservative treatment of ACL or meniscus injury could result in a lower rate of OA compared with surgical repair; especially if patients are willing to modify their pre-injury activities. There is also evidence that moderate neuromuscular exercise and being physically active improves joint symptoms and function and cartilage quality in those at high risk of developing OA. More research needs to be done here but the general trend is towards non-operative rehabilitation. An article by Bass et al. (1998) suggests that knee OA prevention might start in childhood. School age children who participate in vigorous sports have substantially higher articular cartilage growth rates. Participation in sport also reduces childhood and possibly adult obesity â&#x20AC;&#x201C; another leading risk factor for knee OA. The recommendation from this review is to recruit groups at risk of injury or OA for exercise interventions, activity modification and education. This could be done by targeting school and university aged students through physical education curriculums and improved sports associations. An evidence-based neuromuscular and biomechanics screening tool would be required to identify those at risk of developing knee OA later on in life. Reviewed by Monique Baigent BHsc (physiotherapy)

CLINICAL SECTION

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ASICS SHOE REPORT Gel-Cumulus 14 The 14th edition of the Gel Cumulus has key changes in weight reduction and responsiveness to improve the overall ride of the shoe. Cumulus 14 is built on a lower platform (23mm heel and 13mm forefoot) which immediately shaves weight from the shoe and makes the shoe more responsive because each foot movement has less shoe resistance. A new Trussic system incorporated into the Full Guidance Line further reduces weight and allows faster movement from heel to toe. Less Trussic in the arch allows the foot to plantarflex and resupinate easier meaning the foot can move from heel to toe quicker. These features have improved responsiveness and ride (feel from heel to toe) whilst enhancing performance through weight reduction. Allowing the foot to plantarflex faster is important for resupinating the foot in midstance. A key feature is allowing effi cient flex in the forefoot. Cumulus 14 has moved to a ¾ length 45 Solyte and a new forefoot gel configuration designed to improve forefoot flex. These technical changes have reduced further weight and will suit midfoot/forefoot strikers as there is less resistance and energy required to move forward during toe off. The midsole uses ASICS lightweight Solyte foam with new gender specific cushioning to accommodate the anatomical and physiological differences in woman. The Upper has minor changes to the lateral side to reduce irritation over the 5th digit and improve durability. PHF memory foam (personal heel fi t) improves customization of the heel and with a 2E in the men’s and D in the woman’s fitting is enhanced for all foot widths. In summary Gel Cumulus has been a no fuss neutral shoe and continues its reputation with major improvements in weight reduction in this year’s edition. Reducing weight enhances the ride and responsiveness which will improve the overall feel and comfort of the shoe. Cumulus maintains its reputation and with improvements in weight and fit avid followers will find the new changes a step forward in performance. Cumulus fits the neural runner, with minimal injuries looking for a cushioned ride.

asics.co.nz

Product Review by Justin Chong Bigfoot Podiatry

RESEARCH SECTION

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SPNZ PHYSIOTHERAPY RESEARCH REVIEWS Shoulder Injury: Testing, Predicting, Diagnosing www.sportsphysiotherapy.org.nz/resources

Clinical and arthroscopic findings in recreationally active patients Fowler E, Horsley I, Rolf C (2010). Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology 2:2. Article Summary This cohort study examined the diagnostic accuracy of standard clinical tests for the shoulder in recreational athletes with activity related pain. Over a six year period a total of 101 recreational athletes were involved in the study. The athletes were examined by an orthopaedic consultant using a battery of routine shoulder tests. These included O’Brien’s test, Jobe’s test, Hawkins-Kennedy test, Palm-up test, Apprehension-relocation test and Gerber’s lift off test. Following the examination a clinical diagnosis was formulated. Some of the athletes also went on to have further investigations. Later, all of the athletes had an arthroscopy by performed by the same orthopaedic consultant. The sensitivity, specificity, likelihood ratio and over-all accuracy of the clinical examination was examined retrospectively and compared to the arthroscopy findings. In this study O’Brien’s test was found to be the most accurate for detecting SLAP lesions. Hawkins and Gerber’s lift off test were the most accurate for rotator cuff pathology. Gerber’s test, Palm -up test and Apprehension test were the most accurate for labrum tear whilst Apprehension test was the most accurate for detecting Bankart and Hill Sachs lesions. The results demonstrated an over-all very poor diagnostic accuracy of isolated shoulder tests however isolated pathology was rare with most patients having more than one injury. The accuracy of the tests increased when combined with other tests. Clinical Applications This is a clear and well- constructed study that links nicely with previous literature. The accuracy of diagnostic tests in this study varied widely but this is similar to the results of previous studies. As with most assessment techniques a combination of tests was found to be superior to isolated tests. In this study a high proportion of subjects had more than one injury of one or both shoulders. This affected the overall accuracy of individual shoulder tests. This has important clinical implications with tests potentially providing mixed results. The authors suspect some of these concomitant injuries are missed in general practice that may lead to a delay in treatment. The authors recommend that a systematic evaluation of the shoulder that includes a combination of tests should be used to establish a working diagnosis for shoulder injuries. Reviewed by Nathan Wharerimu

Shoulder pain in elite swimmers: primarily due to swim-volume-induced supraspinatus tendinopathy Sein M, Walton J, Linklater J, Appleyard R, Kirkbride B, Kuah D, Murrell G (2010). British Journal of Sports Medicine 44:105-113. doi 10.1136/bjsm.2008.047282 Article Summary This article looked at testing Jobe’s hypothesis that repetitive swimming leads to shoulder laxity and in turn to shoulder impingement pain. Eighty elite swimmers, completed questionnaires on their swimming training, pain and function and were then assessed with a standardised shoulder examination and tested for glenohumeral laxity with an electronic laxometer. 52/80 participants also had a shoulder MRI. Ninety-one per cent (73/80) of the swimmers reported shoulder pain with 84 per cent presenting with a positive impingement sign. Of the 52 participants who had an MRI 69 per cent had supraspinatus tendinopathy. The authors found positive correlations between; impingement sign and MRI diagnosed tendinopathy and increased tendon thickness and tendinopathy. Laxity and impingement pain had a weak correlation, but was not associated with

RESEARCH SECTION

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SPNZ PHYSIOTHERAPY RESEARCH REVIEWS CONTINUED….. Article Summary continued supraspinatus tendinopathy. Supraspinatus tendinopathy was also correlated with hours of swimming and mileage, but no link was found with swimming stroke. Clinical Applications This is an interesting article that looked a broad spectrum of swimmers and concluded an alternate hypothesis to Jobe’s. The authors reported that laxity has only a minimal relationship with shoulder impingement and that supraspinatus tendinopathy is the major cause of pain in swimmers which the amount of time in the pool being a mitigating factor. The treatment of the affected tendon should be paramount along with education to the patient, if the accumulative effect of overuse/intrinsic/extrinsic factors leading to tendinopathy is to be halted or reversed. Reviewed by Charlotte Raynor PGDipPhty, BSc(Hons), NZRP, MNZSP

Shoulder Muscle Endurance: the development of a standardized and reliable protocol Roy J, Bryan M, MacDermid J, Woodhouse L (2011). Sports Medicine, Arthroscopy, Rehabilitation Therapy & Technology, 3:1 Article Summary Many daily tasks at the workplace and in sporting or leisure activities require repetitive arm movements. It has long been hypothesised that muscle fatigue during repetitive activities results in altered motor recruitment patterns and joint mechanics therefore leaving the shoulder vulnerable to rotator cuff disorders. The purpose of this study is to develop a standardized and reliable clinical protocol of shoulder endurance. Baseline measurements of 5RM isokinetic mean peak torque and isometric MVC were taken pre and post endurance test. The endurance test entailed each subject performing 60 continuous repetitions of IR/ER on a Biodex System 3 dynamometer. The subjects then performed the test again two days later. Three values were taken from the endurance test: 

Mean peak velocity in degrees/second

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Total work performed in joules (J)

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Decrement in work measured as the percentage difference between the first third and last third of the repetitions performed for the endurance protocol Decrement in work showed a 42% drop from the first third to the final third. Maximal isometric strength reduced 17% pre to post test. Both indicating fatigue was produced by the endurance test. Clinical Applications This study achieved what it set out to do. It established a standardized and reliable objective assessment to evaluate local shoulder musculature endurance. The results of fatigue were reproducible on repeat tests. The methodology was thorough and well explained enabling readers to be able to reproduce the test. The authors state that as the test was performed with ease in less than 10 minutes that it could be taken into the clinical setting. The use of a Biodex to take the measurements significantly limits the use of this objective test to the clinical setting. The authors also looked at impact of standardization on results. The subjects in the high standardized group were given an extra strap to ensure proper posture and balance, the same ROM for the endurance protocol was used on the test and retest and consistent verbal encouragement was given. This group showed 25% increase in mean peak velocity and greater fatigue during the test. Practically this limits the study when trying to extrapolate to sporting, leisure or wor k situations, where there is no particular standardization when it comes to balance, posture, ROM or verbal commands. A standardized and reliable test for muscle fatigue in the clinical setting would be beneficial, especially with those client s who complain of significant pain during work or sport yet with who simple static testing does not reproduce their symptoms. A protocol using tools commonly found in a clinical practice would be of more benefit. Reviewed by Deborah Nelson BPhty, PGD Musculoskeletal

RESEARCH SECTION

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www.spts.org/ijspt Volume Seven, Number Four, August 2012 ORIGINAL RESEARCH Lower extremity kinematics in running athletes with and without a history of medial shin pain. Authors: Loudon JK, Reiman M

The effects of a daily stretching protocol on passive glenohumeral internal rotation in overhead throwing collegiate athletes. Authors: Aldridge R, Guffey JS, Whitehead MT, Head P

Swiss ball abdominal crunch with added elastic resistance is an effective alternative to training machines. Authors: Sundstrup E, Jakobsen MD, Andersen CH, Jay K, Andersen LL

Immediate effects of localized vibration on hamstring and quadricep muscle performance. Authors: Dickerson C, Gabler G, Hopper K, Kirk, D, McGregor CJ

Effects of different warm-up programs on golf performance in elite male golfers. Authors: Tilley NR, Macfarlane A

Prevalence of anterior knee pain in 18 to 35 year-old females Authors: Roush JR, Bay RC

SYSTEMATIC REVIEW Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Authors: Kivlan BR, Martin RL, Rangos JG

CASE REPORT Eccentric training for the rehabilitation of a high level wrestler with distal biceps tendinosis: a case report. Authors: Jayaseelan DJ, Magrum EM

CLINICAL COMMENTARY - DIAGNOSTICS CORNER Persistent wrist pain in a mature golfer. Authors: O’Grady W, Hazle C

CLINICAL COMMENTARY Comprehensive assessment and management of athletes with sport concussion. Authors: Stewart GW, McQueen-Borden E, Bell RA, Barr T, Juengling J

INVITED CLINICAL COMMENTARY – ON THE SIDELINES Recognition and management of abdominal injuries. Author: Barrett C, Smith D

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RESEARCH SECTION RESEARCH REVIEWS Register (FREE) and download the latest “NZ Research Reviews”

http://researchreview.co.nz

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Acute-phase response after zoledronate infusion Nitroglycerin ointment modestly improves BMD 3 vs 6 years of zoledronate? Low-dose zoledronate in osteopenic postmenopausal women Whole-body vibration therapy has no impact on BMD Ronacaleret increases trabecular but not cortical bone Vitamin D does not prevent COPD exacerbations Vitamin D and calcium have no sustained effects on cancer Plasma 25(OH)D levels drop after inflammatory insult Vitamin D ± calcium for prevention of cancer and fractures

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Rebuilding functional CNS networks Stroke rehabilitation: what happens in practice Detecting emotional changes after stroke Improving walking after stroke Early supported discharge after stroke Teaching self-regulation to people with selfregulatory deficits

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Blood cultures unhelpful in post-arthroplasty fever Squeaking 3rd- and 4th-generation ceramiconceramic THA Preserving the cement mantle in two-stage revision of infected THA Contralateral hip and knee gait biomechanics unchanged in THA ACL rupture: single- vs doublebundle reconstruction Outcomes of proximal tibial osteotomy in the young with OA Cartilage injury after acute, isolated ACL tear TKA vs UKA for knee arthritis

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Foot pain in the older adult Rear foot posting: effect on frontal plane biomechanics Plantar pressure alterations with medial heel skive Fat feet or flat feet? Weight loss and foot structure in the obese Total contact cast: load transfer Effects of jandals on children’s feet Textured insoles for older fallers Foot loading in Africans

Preoperative pregabalin useful after transperitoneal nephrectomy, but not after foot or ankle surgery Adductor-canal-blockade reduces pain after total knee arthroplasty Mechanisms involved in the pathology of fibromyalgia Pain catastrophising and sleep disturbance Management interventions for obese patients with knee osteoarthritis Placebo manipulations reduce hyperalgesia in neuropathic pain Cane use improves pain and function in patients with knee osteoarthritis Rest vs exercise in patients with low back pain and Modic changes Occipital nerve blocks are effective in craniofacial neuralgias

Running injuries: trends and demographics Rising medical practice costs Intracompartmental pressure testing Community/family-based interventions Primary care referrals to orthopaedics Static stretching and muscle performance Keeping cool: mechanisms in the heat Adherence to injury prevention recommendations Medial tibial stress syndrome Kinesiotape: a review

http://www.researchreview.co.nz

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RESEARCH SECTION JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY

August 2012; Volume 42, Number 8

www.jospt.org

Click on the article title for a direct link to the abstract

Comparison of Longitudinal Sciatic Nerve Movement With Different Mobilization Exercises: An In Vivo Study Utilizing Ultrasound Imaging Richard F. Ellis, Wayne A. Hing, Peter J. McNair

DMA Clinical Pilates Directional-Bias Assessment: Reliability and Predictive Validity Evelyn Tulloch, Craig Phillips, Gisela Sole, Allan Carman, J. Haxby Abbott

Short-Term Effects of Kinesio Taping Versus Cervical Thrust Manipulation in Patients With Mechanical Neck Pain: A Randomized Clinical Trial Manuel Saavedra-Hernández, Adelaida M. Castro-Sánchez,Manuel Arroyo-Morales, Joshua A. Cleland, Inmaculada C. LaraPalomo, César Fernández-de-las-Peñas

Lessons to Be Learned: A Retrospective Analysis of Physiotherapy Injury Claims Gillian M. Johnson, Margot A. Skinner,Rachel E. Stephen

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain Gary Brooks, Michelle Dolphin, Patrick VanBeveren, Dennis L. Hart

Comparison of Reliability and Responsiveness of Patient-Reported Clinical Outcome Measures in Knee Osteoarthritis Rehabilitation Valerie J. Williams, Sara R. Piva,James J. Irrgang, Chad Crossley, G. Kelley Fitzgerald Intramuscular Temperature Changes During and After 2 Different Cryotherapy Interventions in Healthy Individuals Kimberly A. Rupp, Daniel C. Herman,Jay Hertel, Susan A. Saliba

Diagnosis of Primary Task-Specific Lower Extremity Dystonia in a Runner Shane McClinton, Bryan C. Heiderscheit

Disruption of a Patellar Tendon Repair Kevin D. Harris, Gail D. Deyle, Liem T. Bui-Mansfield

T1 Radiculopathy Gilbert M. Willett, Timothy L. Buresh

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CONTINUING EDUCATION Upcoming courses and conferences in New Zealand and overseas in 2012. www.sportsphysiotherapy.org.nz/calendar.html LOCAL COURSES & CONFERENCES When?

What?

Where?

More information

22 August

Bounce Back Optimising Motor Control Workshop

Wellington

www.bbclasses.com.au

23 August

Bounce Back Optimising Biomechanics in Cycling & Running

Wellington

www.bbclasses.com.au

25 August

Mulligan Concept – Part B – Lower Quartile

Nelson

jillian.mcdowell@xtra.co.nz

25 August

Polestar Pilates Mat Course

Auckland

http://www.polestarpilates.co.nz/ mat.php

25 August

Bounce Back 3 Dimensional Assessment and Taranaki Treatment of the Lumbar Spine and Pelvis

www.bbclasses.com.au

30 August

Screening and Training the Female Golfer: A Physiotherapy perspective

https://alliedhealthwebinars.com/

01 September

Kinesio Taping Course KT 1 & 2

Hamilton

linley@handsongroup.co.nz

01 September

Back In Motion Pilates – Mat Level 3

Auckland

See PNZ Website

08 September

The Australian Physiotherapy and Pilates Institute – Matwork Level 1

Auckland

www.appihealthgroup.com

11 September

STOTT Pilates Intensive Mat Plus Course

Auckland

info@corepilates.co.nz

14 September

STOTT Pilates Intensive Mat Plus Course

Auckland

info@corepilates.co.nz

15 September

Stability Plus Pilates – Reformer 2

Auckland

See PNZ Website

17 September

STOTT Pilates Intensive Mat Plus Course

Auckland

info@corepilates.co.nz

20 September

STOTT Pilates Advanced Mat Course

Auckland

info@corepilates.co.nz

21 September

The Shoulder: Theory and Practice (8th Edition)

Dunedin

pnzotago@gmail.com

22 September

PAANZ – Sport Acupuncture

Dunedin

www.paanz.org.nz

2012

CONTINUED ON NEXT PAGE ...

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CONTINUING EDUCATION Upcoming courses and conferences in New Zealand and overseas in 2012. www.sportsphysiotherapy.org.nz/calendar.html CONTINUED FROM PREVIOUS PAGE

LOCAL COURSES & CONFERENCES When?

What?

Where?

More information

2012 22 September

CEF Seminars: Sacroiliac Joint Motor Control Auckland Training

www.cef.co.nz

22 September

The Australian Physiotherapy and Pilates Institute – Matwork Level 1

www.appihealthgroup.com

23 September

CEF Seminars: Sacroiliac Joint Motor Control Wellington Training

www.cef.co.nz

29 September

STOTT Pilates Intensive Mat Reformer Course

Auckland

www.corepilates.co.nz

27 October

Kinesio Taping Course KT3

Hamilton

linley@handsongroup.co.nz

27 October

Back in Motion Pilates – Mat Level 3

Dunedin

See PNZ Website

27 October

Solving Lower Limb Injuries

Te Aroha

See PNZ Website

What?

Where?

More information

The IFOMPT Conference

Canada

www.ifomptconference.org

31 Oct - 2 Nov Be Active 2012 (Sports Medicine Australia)

Sydney

beactive2012

Auckland

INTERNATIONAL COURSES & CONFERENCES When?

2012 30 September

16 November

10th Sport Symposium

29 Nov – 1 Dec Team Concept Conference 2012

Bern, Switzerland Las Vegas, USA

http://www.sportfisio.ch/index.php/ main/getNews http://www.spts.org/education/teamconcept-conference

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SPNZ WEBSITE SPNZ MEMBER SECTION

www.sportsphysiotherapy.org.nz/members

SPNZ Member Login Login: Your login is your email address that you supplied to Physiotherapy NZ. Change Your Password: Your initial password will be “spnz2012”. For security, please change this immediately to a password of your choice. In the top right hand corner hover your mouse over your name / email address. Go to “Edit My Profile”. At the bottom of the page there is a new password box. Type in your new password. Retype it. Click the “Update Profile” box. Lost Passwords: Click on “Lost Passwords” in the login box.

MEMBERS SECTION: Copies of all clinical article reviews and SPNZ Research Reviews that appear in the SPNZ Bulletin editions will be placed in the new “Resources” section, as well as an updated list of Open Access Journals. These will be available for all members to access at any time.

SPNZ’s Research Reviews

Clinical Article Reviews



Osteoarthritis



Barefoot running and the minimalist shoe debate



Injuries in Cricket



Bench pressers’ shoulder—overuse tendinosis of pectoralis minor



Medical Exercise



Blood clots and plane flights



Sport and Athlete.



Heat acclimatization guidelines for high school athletes



Management of hamstring injuries—issues in diagnosis



Sideline evaluation of bone and joint injury



Occular injuries in basketball and baseball



Clinical and MRI features of a cricket bowlers side strain

the

Disabled

List of Open Access Journals (full text available to all members) 

Sports physiotherapy



Sports medicine



Sports science

AND MORE...

Quick Links to Members Section Resources Copies of SPNZ’s Research Reviews, a list of open-access journals (full-text available), clinical article summaries and other sports physiotherapy related articles. Vacancies Sports Team Positions and Clinic Positions available. Asics Education Grant Information Application form, guidelines and instructions.

Book Reviews Book reviews on sports physiotherapy topics

Snippets Quick sports physiotherapy tips

Calendar Calendar of upcoming courses and conferences.

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www.facebook.com/SportsPhysiotherapyNZ Website Gems Links to Video Clips Online interviews of interest

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