As part of our quality of client care, most allied health practitioners maintain their annual CPR. But what about your first aid skills? Q: Given our range of deadly snakes and V8 lawnmowers with fins, what animal kills the most humans each year? (answer below) As a kick off you will most likely enjoy this if you haven't already viewed - "Video Come to Australia" As part of our quality of client care, most allied health practitioners maintain their annual CPR. But what about your first aid skills? Q: Given our range of deadly snakes and V8 lawnmowers with fins, what animal kills the most humans each year? (answer below) As a kick off you will most likely enjoy this if you haven't already vie...
You may have seen this picture on Instagram (https://www.instagram.com/p/BmtadOungGB/) and it does show obvious issues with pillows, however, when it comes to educating our clients about making good decisions in regards to sleep, we need to have an broader understanding of the situation on the complexity of sleep posture and symptoms. Here are some thoughts. "Hi guys nice pics, but there are some broader points worth considering for our clients' benefits. True, 57.3% of healthy people wake with cervical symptoms while sleeping on their normal pillow – so potentially not a good choice (Gordon and Grimmer-Somers 2010). True, the pillow functions to support the head and maintain a neutral cervi...
At the start of our Strive & Thrive in Private Practice course, we ask participants to look into the future and list the three most important wishes they want to achieve from completing the course; sort of a goals list. Most of us are in different phases of live, and this means we are often seeking different outcomes. However I believe strongly that regardless of your phase is life, if you want to achieve positive change and lead a fulfilling life, then you need to consider what this means to you. No map, no direction. Here is what Ken wrote when he started the course, and I love it. Ken, through experience, has identified several 'sensitive spots' about being a private practitioner and ...
Never, ever attempt this technique One of the most common areas in which I am asked to provide a professional opinion, is in regards to needling and pneumothorax or haemopneumothorax. The cause is poor or no technique and is usually due to a lack of specific training. If you have learnt manipulation of the thoracic spine, you would not then assume you have the skills to manipulate the cervical spine. Different anatomy, Different precautions. In much the same way practitioners, that have learnt to needle supraspinatus are not qualified to move an extra couple of centimetres to needle upper trapezius or levator scapulae. Now, if this picture had occurred in just about any other publication and...
So you're a manual therapist health professional. Congratulations, it is an incredibly rewarding career. There are 27543 physiotherapists and 4998 chiropractors (plus 9097 and 1894 students respectively) in Australia. The graph shows the relative number of registered physiotherapists in Australia across 5 year periods. Given the average practitioner takes about 5 years to develop reasonable competency in clinical practice, we can break down their working life into two major epochs of 20 years each, so 25-44 years and 45-65 years. What becomes startlingly obvious, is that only a small percentage of physiotherapists transition from the fir...
This edition of Clinical Kit focuses on the less common but generally more troublesome 'high' ankle sprain - that involving the syndesmosis. New research looks at the correlation between MRI and palpation and finds that with a good knowledge of anatomy, your palpation skills are extremely diagnostic. Something that I am always banging the drum about. Oh - if you were wondering, you are welcome to attend one of our Living Anatomy Wet Labs to assist you in upskilling :) To start with some background information on how to conduct a comprehensive assessment. Good review article on ankle on assessment techniques and their relevance can be found here; Assessment of the Injured Ankle in the Athlete Then by way of an...
You maybe aware of the simmering debate about dry needling and acupuncture. One point of view is provided here; Dry needling versus acupuncture another here; Dry needling is acupuncture When it comes to the broad family of needling techniques the obvious common element is the use of a thin, solid, metallic needle inserted into tissue to create a desired effect. There are a few needle types but a plethora of needling techniques. Translated acupuncture means needling, needle prick or needle insertion. Dry needling is a name used to describe the insertion of a needle without injection of other substance cf. wet needling. Dry needling has occurred for thousands of years in Asia and China. Appare...
Hi First up, these next two Clinical Kits are an aggregation of ideas that have been brewing for several years and brought about from clinical observation and trying to make sense of the available research in regards to trigger points and myofascial pain syndrome. Many of you will appreciate there is plenty of discussion going on about the nature and relevance of trigger points. For this reason don't take these ideas as gospel. We can’t deny the existence of trigger points, but the how and why is very much under discussion. I happily confess to have mostly looked at this from a clinical standpoint, and then gone looking for information that might explain what I see - so there is a...
Hi Comparison of the short-term outcomes between trigger point dry needling and trigger point manual therapy for the management of chronic mechanical neck pain: a randomized clinical trial. Llamas-Ramos R, et al. J Orthop Sports Phys Ther. 2014 Nov;44(11):852-61. doi: 10.2519/jospt.2014.5229. Epub 2014 Sep 30. Weblink: http://www.ncbi.nlm.nih.gov/pubmed/25269764 Abstract Objectives: To compare the effects of trigger point (TrP) dry needling (DN) and TrP manual therapy (MT) on pain, function, pressure pain sensitivity, and cervical range of motion in subjects with chronic mechanical neck pain. Background: Recent evidence suggests that TrP DN could be effective in the treatment of neck pain. However, no studies have directly compared the outcomes of TrP DN and TrP MT in this population. Methods: Ninety-four patients (mean ±...
Hi Grading & Recording Your Dry Needling Treatment Following many years of implementing dry needling into different practices, two questions repeatably arise. How do I quantify the amount of needling treatment and how do I succinctly record needling treatment in my notes? First lets look at quantifying your needling treatment in this Clinical Kit. The aim of an intervention is to use the minimum amount of input to achieve your treatment goals. Whether you are a superficial needler, a fascia needler or deep muscle needler, you are using dry needling techniques that evoke chemical reactions in your client’s body. Like reactions to bee stings or drinking alcohol, the result varies from person to person and we don’t unnecessarily want to provoke...
Hi What do you do about latent trigger points? By definition there are active and latent trigger points. They both exist in a taut band of tissue, are hypersensitive on palpation (pressure stress), display a local twitch on needling and palpation and have spontaneous electrical activity at rest (on EMG), but only active trigger points produce symptoms that the client is familiar with. In undergraduate days the active trigger point was a holy grail in regards to the requirement of ‘thou shalt reproduce the patient’s pain'. Like other holy grails, there didn’t seem to be many around, for me at least. So if a latent trigger point isn’t producing pain, is it of clinical significance? I am guessing that some would...
Hi Another Possible Mechanism of Action for Dry Needling Dr. Ben Wand blogged on the Body in Mind site recently about a research project, that his team has just published in British Journal Sports Medicine. Method They looked at 25 people with chronic low back pain who were enroled in a randomised cross-over experiment. They compared the effect of acupuncture (using 14 needles in commonly agreed TCM points for back pain) delivered when sensory discrimination was optimised (by asking participant to locate on a picture where their needles were placed) to acupuncture delivered when it is not optimised (asked participant to relax and ignore the needling), on movement-related back pain immediately after each intervention. Outcome They reported that the average pain...
Hi, Over the past few months I have been in communication with the WA Health Department in an attempt to clear up the situation of what regulations dry needlers and acupuncturists need to be aware of in WA. While physiotherapists and chiropractors are registered under Australian Health Practitioners Regulation Authority (AHPRA), in WA there is also a separate "Skin Penetration Code of Practice” (the Code) written in 1998 and based upon a NH&MRC 1986 document. The base NH&MRC document has since been updated several times, most recently in 2011. The Skin Penetration Code of Practice specifies who the code covers and specifically who it excludes. It reads; "APPLICATION OF THIS CODE, This Code applies to:a) All persons who perform skin penetration...