03 Dec 2019

Winter 2019 - Sport, exercise and practice

Physiotherapy has long been at the forefront of promoting safe and healthy activity in the UK population. This edition of In Touch covers the range of the active population from the elite sporting individual and how to keep them on the field of play, to tips on how to encourage members of your local community to increase their activity without the risk of injury. Within those two extremes, we also cover the important topic of patient management and behaviour change in the aim of achieving adherence to training and rehabilitation programmes.


The curse of being a cricket fast bowler: low back injuries and pathomechanics

Low back injuries are common in the cricket fast bowling population. Inertial sensors, a novel technique for “in-field” fast bowling biomechanical analysis, have been employed to study the pathomechanics of such injuries, and have shown those studied to have exhibited limited range of spinal rotation or lateral flexion, and softer back foot impact at the start of their delivery stride which may lead to compensatory and potentially damaging motions in order to generate ball release speed later in their bowling. Excessive lumbar extension at the later stage of bowling may place undue compression on the vertebrae. Strategies to address these risk factors without compromising performance are described in this article.

Jonathan Williams, Billy Senington & Raymond Lee


Designing meaningful experiences: a point of view on clinical reasoning

Evidence and scientific paradigms of reasoning are important elements of physiotherapy. These paradigms are based on the premise that a “reality exists” and that this reality can be measured to reduce the uncertainty around decision making. This article explores a topic that is less easily measurable as its sits in the subjective domain; the area of designing meaningful human experiences, and the relevance of experience design to clinical reasoning, patient management and behaviour change. Addressing context and perception to clinical problems is important, and the development of professional expertise in this area may help move the patient experience from the ordinary into the realm of the most meaningful.

Glenn Hunter


How important is muscle strength and are we training it correctly?

Muscle strength is of fundamental importance for dynamic joint stability, function and quality of life. Over the past few years, a new set of terminologies have emerged to describe muscle strength performance, which can be confusing to the non-strength and conditioning coach and threaten the efficacy of rehabilitation endeavours. Adaptation of muscle strength, the maximal force generation capacity of a muscle in a single contraction, is unlikely to be optimal with generic exercise prescriptions such as three sets of 10. Much heavier loads and fewer repetitions are likely to be more efficacious and offer the rehabilitation professional, and patient, an opportunity for improved efficiency, i.e. greater gains for the time and effort invested.

Claire Minshull


Promoting childhood activity levels and preventing sports injuries

For physiotherapists, the promotion of lifelong physical activity is very much on our radar. The term “lifelong” means that, even if we don’t treat children in our clinics, we should be reaching out in our communities to address the issues of childhood inactivity, taking a leading role in encouraging safe activity levels and advising on how to reduce injury incidence in children’s sports.

Sarah Morton


The psychology of patient buy-in: why do patients struggle?

A patient comes to you for a programme of rehabilitation that will help them with an ongoing issue or injury. The home exercises you prescribe will undoubtedly help them, and yet again and again they fail to adhere to the programme and do the work. Why? Adherence is an important issue when it comes to achieving successful patient outcomes. As Glenn Hunter discusses the design and meaningful human experience of behaviour change on p10, this article explores, from the psychologist angle, the research and theory behind reasons for lack of self-motivation and adherence and considers practical solutions that can be implemented by clinicians to help achieve results.

Serena Simmons


Conference 2020 taster article: Can we reduce the burden of patellofemoral pain across the lifespan?

Patellofemoral pain is a prevalent, chronic knee pain condition that frequently presents to physiotherapy. Physiotherapists should understand the prevalence of patellofemoral pain and its burden across the lifespan. We should aim to reduce the patient’s pain severity early, to improve prognosis. Identifying individual contributors to patellofemoral pain will help guide targeted, evidence-informed treatments, and most likely will need to be adjusted over the patient’s recovery journey. Lifestyle approaches may be needed, and the patient is an important member of the patient journey. This article has been adapted for Physio First from Crossley et al (2019).

Kay M Crossley, Marienke van Middelkoop, Christian Barton & Adam Culvenor