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SA Symposium reflects on the art of exercise prescription

James McLoughlin
7 December 2016

The SA Symposium was an enormous success, bringing together all of the components that make involvement in a professional association so valuable. It provided an opportunity to hear about current research, balanced with examples of excellent clinical application, as well a chance to reinforce old friendships, meet new colleagues and to mix experience with fresh ideas to build a stronger professional network.

We were very fortunate to recruit a great selection of speakers. Professor Paul Hodges, FACP, kicked off the proceedings with a discussion on ‘Pain, the brain and motor control: what are the implications for exercise prescription’. Paul has the exceptional ability to present deep scientific research on the neurophysiology of movement and pain, and apply it to our day-to-day clinical reasoning as physiotherapists. Paul has an enormous pool of research to draw from, and was able give us a fantastic up-to-date summary of how pain and chronic pain influences movement. I particularly enjoyed Paul’s measured and balanced view of how both nociception and chronic pain alter motor control, and the many overlapping ingredients that might influence movement behaviour in any individual. It certainly gives us confidence that physiotherapists are well placed to assess and explore movement through individualised exercise prescription for those people troubled by pain.

Dr David Spurrier, APA Sports and Musculoskeletal Physiotherapist, followed next with his presentation titled ‘Exercise prescription for bone stress pathologies’. David’s enthusiasm for bones is infectious. Bone stress pathologies have historically been very tricky to manage. David’s research and overall insight into bones gave us plenty of food for thought. David impressed all with his ability to draw on his vast clinical experience with numerous patient groups, including children and adolescents. David also advised us to consider both bone health and neuromuscular control when designing exercises for both preventative and rehabilitation programs. In addition, diet and activity and rest regimes were also discussed, with further insight into the long-term consequences to consider, such as osteoporosis and osteoarthritis.

After morning tea, Kate Beerworth, APA Sports Physiotherapist, presented ‘The role of exercise prescription in injury prevention programs for female elite athletes’.

Kate drew upon her experience as a sports physiotherapist in Adelaide, in addition to her role as lead physiotherapist for the Westfield Matildas over the past decade. Kate provided a convincing argument for increasing our understanding of injury prevention strategies. Kate explained the enormous cost of ACL injuries, and the many ways to promote further buy-in to improve and develop optimal injury prevention programs. Kate explained that ACL injury, and often repeat ACL injury, can have a significant effect on both the short- and long-term health trajectories in young female athletes. Education is obviously critical, but Kate highlighted the many challenges faced by the physiotherapist in the elite sport setting. Working with parents, coaches, other health professionals and athletes under high demand is certainly an art form.

Mathew Beard, APAM, is an experienced physiotherapist and a leading developer of advanced practice physiotherapy roles in orthopaedic and spinal services here in South Australia. Matthew was therefore well qualified to interview a select panel of four therapists. The special panel of experienced therapists was selected from number of domains within physiotherapy, and included Kate Beerworth, APA Neurological Physiotherapist Dr Michelle McDonnell, Dr Emily Ward, APAM (paediatrics) and Edwina Shannon (chronic pain). As physiotherapists, we have common themes that challenge exercise prescription, and Matthew skilfully extracted some of the many creative and innovative ideas used by our panel members. Motivation, compliance, training specificity and technology were all topics of great interest.

In the final session before lunch, Jess Trengove, APAM, a physiotherapist and dual Olympian, entertained and inspired us with her talk ‘The road to Rio—competitive advantage of being a physiotherapist’. Jess recently did Australia proud, competing in the Marathon at the Rio Olympics. Jess gave us an entertaining insight into her childhood dream of being an Olympian, and the many challenges facing athletes who compete in, arguably, the most gruelling of Olympic events. Jess provided an honest account of the many trials and tribulations along her journey, and the ways in which she has combined her physiotherapy and elite sporting career. It was fascinating to listen to a first-hand account of the adaptable strategies Jess needed to use to manage injury while increasing training loads in preparation for such an important event. It was an ideal way to sum up many of themes discussed throughout the morning, especially ‘moving and pain’, ‘managing stress fractures’ and ‘injury prevention’.

The afternoon was a terrific blend of topics in several breakout sessions which included exercise in the older person, pelvic floor pain and continence, technology for activity monitoring, plyometrics, mindfulness, physical activity in chronic conditions and Crossfit and training with injury.

The turnout for this symposium was tremendous, with an excellent mix of ages. As usual the cocktail function was most enjoyable and provided an opportunity to catch up with many colleagues from around the state. Incoming APA President Phil Calvert, who opened the day, was certainly correct in his comments about the APA in South Australia. We are, without doubt, a passionate bunch of physios, with a great sense of community. 


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