Many of you will know of my interest in sleep and the role we as primary contact practitioners can have on influencing our clients health, wellbeing and recovery, by providing evidenced based advice on improving sleep. An article published in the August edition of Sleep by Fiese et al, titled 'Bedtimes, bedtime routines, and children's sleep across the first 2 years of life', explores the benefits of establishing a bedtime routine (and what type of routine) on sleep quality. The relevance? We have a better understanding about the relevance of what we do in the first 5 years of our life. Critical brain development, habit forming, and learning all occur in these early years, which influences t...

I have been involved in many legal cases and AHPRA reports, but recently received a request for information on a client from the Government of WA Criminal Injuries Compensation (CIC) department about a client that attended our clinic 2 years prior. I had not heard of this department before and guess many others have likewise not heard, so I did some further investigation that I thought I would share. While this is a WA department, I am guessing there exist similar ones in other states and territories. The WA Government Criminal Injuries Compensation Scheme enables victims of crime to apply for compensation for injury or loss as a result of an offence or an alleged offence. Persons are eligib...

An early 20s male recently presented with unilateral, polyneuropathy that was non-dermatonal and associated with leg weakness, foot dysfunction and pain. While peripheral, it wasn't bilateral or nocturnal, lessening the likelihood of a diabetic neuropathy. With further investigations it was determined to be a hereditary motor and sensory (HMS) neuropathy, also called Charcot-Marie-Tooth disease (it is named for the three physicians who described it in 1886). I prefer the former term, as it is clinically descriptive. Hereditary motor and sensory neuropathy Hereditary motor and sensory neuropathy is one of a group of disorders that cause damage to the peripheral nerves, affecting both sensory ...

As soon as someone finds out my interest in sleep, the next statement usually involves a flick of their wrist and something like, 'last night my XX brand smart watch told me I had 4.5 hours of deep sleep, 1.5 hours of light sleep and 2 hours of dreaming, isn't that amazing'. After them outlaying upwards of $500+ what else can I say but ....amazing.... That conversation aside, millions and millions of people are wearing and taking note of a mountain of biometric data generated by smart watches, so when it comes to sleep, is it accurate? Well, the gold standard in sleep research is polysomnography (PSG). Here is a picture of a PSG getup and you wonder how in a sleep centre, with all this gear ...

Nope, not talking about my increasing age or the AM rise men supposably have. This topic came up during our last Level 1 Dry Needling course when penetration of infraspinatus was proving difficult for some participants. I have listed a range of suggestions that depend on technique, tools and patient factors. Patient Let's start in reverse. If your patient has tight fascia (infraspinatus is a good example), through positioning and support of their arm, the fascia can be loosened and made softer before needle insertion. Also if their body is supported and they are mentally relaxed, this will make it easier.  Tool Enter your text hereIt helps to start with a high quality needle like a...

Safety Acupuncture and dry needling have received much examination on the dual fronts of safety and lack of evidence. The former has largely been answered in the past two decades, with reports noting that in the hands of an adequately trained and competent practitioner, the incident of a severe adverse event (requiring hospitalisation) is very low and that minor adverse events range between 7-10% (Haake et al., 2007; Macpherson, Scullion, Thomas, & Walters, 2004; White, 2006). Training, including a high degree of anatomical knowledge remain critical. Research The quality of acupuncture and dry needling research has continued to improve over the past 20 years. Initially reportings were do...

As a health advocate for your clients, the following might be of interest to you. It is common practice to quote that we spend a 1/3 of our lives sleeping. But do we? In the US between 6-10% of people are taking sleeping medications. I have been researching and writing a Medications section for my upcoming The Sleep Mastery Course. The findings have caused me to reconsider this global statement about sleeping and to share my findings with you. Basically, I am a 'good' sleeper, even though I am writing this at 3am and became interested in sleeping not due a lack of it, rather because clients would present to the clinic with spinal pain after a night of sleeping. But you can't interact wi...

COVID has affected us all in short and long term ways. Some still playing out. With presenters from around the world, I thought it would be a great opportunity to find out in more detail how physiotherapists in different countries and regions have been affected. Europe - Italy - Julie Day Let's start with Italy, where an early explosion of COVID showed us how fast it could spread. Julie presents the Level 1 and Level 2 Fascial Manipulation courses for AAP Education. Julie was literally on the tarmac in March, heading to Australia when the Italian government closed all airports. Bam. Here is Julie's account of current life as a physio in Italy. Well here in Italy life is very gradually return...

Monash I admit to have had little knowledge of WW1 (the so-called Great War) and stumbled into it after enjoying a fiction book authored by Roland Perry. My Dad pointed out that the same author had penned several biographies featured influential Australians from WW1. Influential was an understatement, I was soon to realise and by then I was hooked. I started with 'Horrie, the War Dog'. Horrie was a mongrel pup found in the middle eastern campaign that had the life-saving capability of hearing Stuka dive bombers several minutes before they pitched out of the sky, bombing and strafing men and vehicles. Once his antics were understood, Horrie was treated with reverence, inducted into the machin...