Sports Rehabilitators

[physiobob]

I was just wondering what peoples opinions were of the Sports Rehabilitators was? Are you aware that they exist? How do you think their skills compare to Physios?

We actually have had this discussion before on this forum. You cannot compare even on the application of a rehabilitation technique as the technique in itself is not the major component in a rehabilitation plan! It would be like comparing a junior athlete to an Olympic champion. Excuse my rather opinionated answer. But there is nothing to compare.

A sports rehabilitator lacks the depth of clinical anatomy and disease process required to make the very best judgments on all sorts of injury mechanism. This is both at a high level client (e.g. professional athlete and at junior level e.g. a young male with Perthe's diesease). Disease being a major factor and the identification of both red and yellow flags as well as identification of serious pathologies (e.g. tumors) that must always be considered.

Now outpatient physiotherapy practice is but a minute part of the physiotherapy profession which includes, neurology, cardiac rehabilitation, cardiopulmonary medicine, paediatrics, gerontology, mental health, developmental disability, wound care, plaster application, various respiratory suctioning and supportive breathing techniques including working in the intensive care units etc etc.

So comparing the two is no better than comparing an Osteopath to a Physio. You can only compare on the skill level of the components in the Sports Rehabilitators remite that are also used in the Physio Profession. In that regard there are some very good practitioners on the rehabilitators side. In Canada we always had Athletic trainers as part of the staff as they were very proficient at carrying out the rehabilitation plan that was developed by the physio team. This is where the issue lies. You might be very good at teaching a specific exercise and also at encouraging the client but most of these courses lack the reasoning behind what exercises should be given and when. For this you need a team approach.

I am sure of course not all will agree with my comments but this is what a healthy debate is all about

[karen.hankey]

A sports rehabilitator lacks the depth of clinical anatomy and disease process required to make the very best judgments on all sorts of injury mechanism.

In Canada we always had Athletic trainers as part of the staff as they were very proficient at carrying out the rehabilitation plan that was developed by the physio team. This is where the issue lies. You might be very good at teaching a specific exercise and also at encouraging the client but most of these courses lack the reasoning behind what exercises should be given and when. For this you need a team approach.

A Sports Rehabilitator does not just do exercises with a patient. They have the clinical skills to complete a full subjective and objective examination from which to make a diagnosis. They can then treat with manual therapy, electrotherapy, massage therapy along with following that up with exercises to strengthen the injured area to reduce re-injury risk.

The anatomical knowledge is as good as a physio's, the whole first year is taken up by anatomy, physiology of injury, types of injuries (including mechanism of injury, signs and symptoms) and basic treatment techniques. All this is built on in the subsequent years.

I actually think that a sports rehabilitators choice of exercises is very specific to the patient. It is about tailor the exercises to the patients activities/lifestyle and being as imaginative as possible. I wouldn't give any exercise that I wasn't able to reason its use - I think that comment is unfair.

I believe that sports rehabilitators get bad press and that can be down to a lack of understanding from the other therapy professions and patients about what we can do. I have been given a great chance to work with a highly respected physio who recognises my talents, and to him it doesn't matter that I am not a physio, just that I am good at my job and get people better. Surely that is all that should matter, not the letters after your name.

[physiobob]

The anatomical knowledge is as good as a physio's, the whole first year is taken up by anatomy, physiology of injury, types of injuries (including mechanism of injury, signs and symptoms) and basic treatment techniques. All this is built on in the subsequent years.

Clearly you do not have any idea of the depth of anatomy that physiotherapists study. It is the same in Australia of that in medicine, the only difference being we don't actually learn the surgical cutting and have less in the pharmacology. To give an idea it goes on for 2 year or intense study and examination not just of normal anatomy but diseased anatomy as well. It also includes many hours in the lab working on cadavers, each and every week. I think that the sports therapist does not have such knowledge although please do correct me if they also train to the level of a surgeon.

I have read all the point above and would like really to keep the replies to the original posting which was can you compare. The answer is that there is NO comparison. Sports injury management is a small subsection of the field of physiotherapy. Physiotherapy itself covers a multitude or areas from neurology, paediatrics, gerontology, women's health, orthopaedics, musculoskeletal/outpatients,vascular surgery, cardiopulmonary rehabilitation etc etc. As a result the physio has to learn a large amount and in depth about a lot of things that can affect the human organism. Thus they have a lot of knowledge when assessing a client that is important.

A sports therapist or rehabilitator may well be great at their skill set however they should always consider consulting a physiotherapist for advice as and when it is required.

I will provide a classic example from 2 years ago.

I assessed a client for a "back sprain" following a schoolboy rugby injury. They had been told it was a strength issue and to get to the gym and do squats, cleans etc etc. One of the first things I did as part of the assessment was a full neurological check for brian, reflex, cord problems etc. It was there that I noted something was not quite right.

After an hour of assessing I was still not clear what was going on. I explained this to the boys father and asked for another hr to assess him later in the week. In between I brushed up on everything neuro that I thought is might be. Later that week I finished the assessment and sent him to a neurologist with my findings.

It turned out he had muscular dystrophy. The result of which was a very different treatment plan to a tackle injury from rugby. It was my grounding in many areas as a physio that lead me to this diagnosis, fairly quickly and easily. This was impt. for the boy who until then was being placed at more and more risk of further injury.

I think this illustrates that some courses might be good at teaching exercises and how to perform them (even assessing a ligament strain/sprain), but it is a very different thing to really nut out whether or not they are indicated as the appropriate treatment strategy or not.