Last week Amelia and I had a great catch-up and CPD session at our sports injury clinic in Bedale. We try to do this once a month, and work on various aspects of Sports Therapy, from the business side to joint assessment review (our last session was the wrist and hand). This session focussed on objective measures, in particular the use of a simple crane scale, clips and furniture lifting straps in measuring leg strength. This is as simple and effective way of obtaining a measure of the difference in strength between the right and left sides.
We devised set-ups for measuring knee extension and a seated calf raise, please excuse the faces we’re pulling, but the effort was real!
This was a simple and inexpensive way of getting a measure of the force generated during the movement and applied to the lifting straps. The benefits of this set-up lie in the objective measurement of injuries such as anterior crucial ligament reconstructions and Achilles’ tendon injuries. My thanks to Eric Meira (@erikMeira) for the idea and we’re looking forward to utilising it more during future sessions.
Just a quick post to let you know that the cost of sessions will be changing with effect from the 1st April 2019. The various costs of sessions can be found here.
Sessions with either Ed or Amelia include:
– Injury examination & assessment.
– Tailored rehabilitation to suit your needs and get you safely back to your chosen sport / activity as soon as possible.
– Bespoke exercise programmes, with video tutorials, and a free app so you can log your sessions.
– Follow up contact once you have finished your treatment / rehab to ensure your recovery is still progressing as planned.
– 12+ years of experience in treating sports injuries and working with athletes.
– Easy, quick online booking, with appointment confirmation and reminders.
– Both Ed and Amelia are members of The Society of Sports Therapists.
So the short answer is probably no, most of us would get injured eventually. But… there is an interesting discussion to have along the way and we can maybe reduce the risk of injury.
On Friday 22nd February 2019, I will be giving a talk at Northallerton Leisure Centre, where I will discuss running injuries and how we might reduce them. Including:
If you would like to attend the cost is £5, 100% of which will be donated to the British Heart Foundation (via the Rock Up In Red Ball), to help some good friends of mine in their fundraising efforts. Please let me know if you are going via the event page on facebook:
Happy New Year to you all, we are looking forward to 2019 and all it may bring!
Next week I am at Leeds Beckett University examining the BSc Sports & Exercise Therapy students. Therefore I have had to change some of the clinics. I will still be in on the Saturday morning, but Amelia will holding the fort with clinics on Wednesday & Thursday in Bedale and Friday in Northallerton. Booking appointments with Amelia could not be easier via the online booking button on this page or via the Facebook page. Simply select Amelia from the “team” drop down box and her availability will come up (see below).
We’re all wrapped up for Christmas now at Ed Pratt Sports Therapy! Ed and Amelia had a great planning session yesterday for some presentations and more videos coming in early 2019 (at least one of got in the Christmas spirit!).
We would just like to say a massive thanks to all the staff at Northallerton and Bedale Leisure and HElen at The Pilates Studio Yarm for all your help and support this year.
Most of all – thank you to all the people who have used Ed Pratt Sports Therapy! Over the last year we have continued to develop our links with local clubs including rugby, hockey, football and running. We have seen and treated people from elite sport, to gym users; rugby players to ballet dancers; acute injuries to long term chronic pain and it has been our pleasure.
Just a quick post to say that from the New Year we will accept all major credit / debit cards. Both myself and Amelia will be using SumUp to accept card payments, which will include Apple Pay and Android Pay.
The new terminal is really easy to use and will allow us to take most forms of payment.
Exercise prescription versus manual therapy, or do they work hand in hand? The aim of a sports therapist, or indeed any practitioner, is to rehabilitate an injury and help maintain and improve performance. This is done through the use of manual therapy and exercise prescription, but there is no hard and fast rule on how much manual therapy should be done versus exercise prescription. This article will explore current literature and aim to give insight into the basis for clinical decision making when it comes to methods of treatment.
Manual therapy includes massage, joint mobilization and joint manipulation; it aims to reduce pain and increase mobility of joints. Exercise prescription can be used in a reactive or proactive way, it will aim to improve the flexibility, stability, strength, endurance and power.
Chronic low back pain (CLBP) was prevalent in the research, one study by Aure et al. (2003) suggests that 60% to 80% of the western population will experience low back pain at some stage. The study had 49 participants, one group received manual therapy with the addition of 11 exercises for the spine, abdomen, lower limbs, spinal segments and the pelvic girdle. Another group performed general exercise therapy for 45 minutes; the programmes were individually designed. Results, with a one-year follow up, showed that there were significant improvements in both groups but the manual therapy group showed better results. A contrasting study by Geisser et al. (2003) found that CLBP was improved following manual therapy alongside a specific exercise program but it did not improve perceived function, stating that other psychological factors need to be addressed. Both studies were randomised control trials which are seen as the gold standard for research. However, neither study effectively blinded participants or therapists which is likely to influence the results.
Moving away from CLBP, a study by Hoeksma et al. (2004) looked at the use of manual therapy versus exercise therapy in osteoarthritis of the hip. The graph below (Figure 1) details the effect of manual therapy versus exercise therapy, it shows that manual therapy had better results on range of joint motion from flexion to extension. This result is unsurprising as the manual therapy group included manipulation and ‘vigorous stretching’ while the exercise therapy group included exercises to improve muscle function and joint motion. Diercks et al. (2004) found the opposite in a contrasting study looking at manual therapy for frozen shoulder versus exercise therapy.
Figure 1 – Results on range of motion from flexion to extension (Hoeksma et al, 2004)
The manual therapy group (physical therapy) received passive stretching and manual mobilisation and the exercise therapy group (supervised neglect) received exercises within pain limitations. Results (Figure 2) showed that the exercise therapy group had better outcomes up to 24 months after injury. This is depicted by the graph below, which shows the difference in treatment over a 24 month period; the exercise therapy group was more successful in this case.
Figure 2 – Results of both groups (Deircks et al, 2004)
Hoving et al. (2002) conducted an alternative study, investigating the use of manual therapy, exercise therapy and care by the GP for neck pain. Neck pain is common in the general population and this study found that the success rates after 7 weeks for manual therapy, exercise therapy and care by the GP were 68.3%, 50.8% and 35.9% respectively. Although it would appear that manual therapy was the most successful, patients were allowed to continue exercises at home throughout the trial and continue taking medication which makes it difficult to control the outcome measures in isolation. Figure 3 shows that manual therapy was most successful. However, the outcome measures (perceived recovery, severity of physical dysfunction score, average pain intensity score and neck disability index score) are subjective measures relying on the patients to report how they feel. This is an unreliable way to measure due to a potential lack of understanding, dishonesty or outside influence from the patient,
Figure 3 – Manual therapy, neck pain and GP care (Hoving et al, 2002)
In conclusion, from a brief look at the literature it is clear that manual therapy and exercise prescription work in varying degrees depending on the injury. There is no one course of treatment that is best overall and the choice depends on the stage and severity of the injury. It is also important to note, when using a patient-led approach to therapy, manual therapy may be more appropriate for one person but another may prefer exercises. It is not necessarily a question of manual therapy vs exercise prescription, but instead using a patient-led approach and selecting the most appropriate course of treatment.
I’m really pleased to announce that Amelia Gill is joining Ed Pratt Sports Therapy! I’m really excited to be working with Amelia, she brings with her a great work ethic and patient centred focus. Amelia spent some time working in the clinics as a student and for me it was a no brainer, when she applied after she had qualified. Amelia graduated with a masters degree in Sports Therapy in 2017, which she completed whilst finishing her time in the military.
Amelia Gill, MSc, MSST
Amelia served 6 years, with 4 as a physical training instructor, she therefore brings with her a wealth of knowledge and experience in exercise prescription. Take a look at her full bio on the about page.
Amelia will be starting officially in September and working out of the Bedale clinic two afternoons a week. Before the official start she will be covering a couple of days for me whilst I am on annual leave – Friday 10th August at Northallerton and Wednesday 15th August at Bedale. The slots are available via the online booking portal.
An exciting opportunity has arisen for a graduate Sports Therapist / Physiotherapist, working alongside an experienced sports therapist in both the clinical and pitch side environment. The therapist will be required to help in the development of three busy clinics and therefore must be flexible and available for evening and weekend work. The successful candidate will also be required to provide match day cover for a local rugby team and as such, a pitch side first aid qualification is essential and a sports trauma qualification desirable.
Candidates must be able to demonstrate excellent interpersonal skills, patient communication, moving & handling skills, strong exercise prescription and manual therapy skills and a patient centred approach to rehabilitation.
Ed Pratt Sports Therapy is a well established sports therapy business in the local area with an excellent reputation. The successful candidate will initially be working part-time, but opportunities are a available for further hours based on performance and feedback. In-house CPD takes place on a regular basis.
How to apply: email CV & cover letter (demonstrating why you are suitable for the post) to firstname.lastname@example.org.