Are the "Jack of all trades" all they're made out to be?

So what's better someone who is a "jack of all trades" or a specialist?

I began asking myself this question as I pondered over the variety of CPD courses I could take over the next year. Do I expand my portfolio into coaching or perhaps a personal training qualification? There are many options for sports therapists and other therapists out there to choose from. But what is best?

My dad used to say he could fix anything except the crack of dawn and a broken heart. And I reckon he could, except for a vacuum cleaner once. He was a skilled mechanic and, even though he had no degree, an excellent engineer. He used his decades of experience to fix cars, planes and pretty much anything with an engine. He had skills that could translate to other areas without changing his occupation. And for me his advice led me to the decision to expand my sports therapist skill set rather than take on a new skill.

I have a tiny aversion to people who try to do everything all the time. I think it's great that they're ambitious, but to me it just means that some skills may be lacking or not fully developed. For example, if you train to do osteopathic techniques, hypnotherapy and personal training is it possible to stay highly skilled in all those areas without letting one slip? We are all allotted the same 24 hours in a day, but I can't imagine anyone is using all their skills all the time or even giving each skill the same amount of work.

Some skills work well together such as sports massage, acupuncture, mobilisations/manipulations, strength & conditioning and rehabilitation exercises. Those are skills that can be used in a variety of settings and can be honed, in some cases, at the same time. But other skills would require a different setting or in some cases could cause a conflict of interest.

I once came across a rugby club whose coach was also their physio. To me this is a blatant conflict of interest as he had no way to separate his desire for his players to play and his need to think of their health and welfare. There were many players that should not have been playing that day, but still did even after suffering concussions. I feel the same way about personal trainers who also do sports massage or sports therapy, and continue to be a personal trainer. Is it not feasible that one could make their clients work out harder than prescribed so they're sore and then suggest they see them for a sports massage? I'm not saying these things happen, but these are the things I think about when deciding my own CPD pathway. Could my clients perceive a conflict of interest in what I do?

For me the welfare of my clients is the most important part of my clinic. This means providing them with quality, knowledgeable information with regards to sports injuries and ways to treat their injuries. So this is where I will focus my future CPD endeavours.

I have already attended a Movement Screening & Strength Training for Runners course in order to provide my running clients with better analysis and techniques for their rehabilitation. And the best part about this course is that the instructors (both physios) had specialisms. One is a hip/running specialist and the other is a strength & conditioning specialist.

I am also a firm believer in the referral. If a client comes in and I feel acupuncture might help or perhaps they would like advise on a personal trainer I am happy to refer to other professions. I think it's important to collaborate with other sport injury professionals so that we can all provide the best care with the best techniques for our clients. If an injury is out of my skill set I have a responsibility to refer onwards.

So, why be a "jack of all trades, master of none" when you can be the best sports therapist, osteopath, chiropractor, physiotherapist, sports massage therapist or personal trainer that you can be for your clients!

If you have any questions on CPD, sports therapy or conflict of interests  please feel free to email me on sara@prestigesportinjury.co.uk

Can sports injuries really be prevented?

As a sports therapist reducing the likelihood of an injury is just as important as injury diagnosis and rehabilitation. As stated above, no injury is 100% preventable there are guidelines that we can follow to attempt to reduce the likelihood of an injury occurring in any given sport.

The first rule is to know your sport. This seems like a no brainer, but it is important to understand the biomechanical, external and internal factors that exist within any given sport. For instance, I work with a local rugby team so a variety of players will be sprinting, tackling, scrummaging and rucking on an outdoor surface in a variety of weather conditions.

When identifying risk factors, we must first look at the athlete(s) internal risk factors such as age, gender, body composition and fitness level. In my sport the risk factors associated with a forward will be very different when compared with a back. There are modifiable (body composition, fitness level) and non-modifiable (age, gender) risk factors. When targeting any intervention, we need to look at both factors. Modifiable risk factors such as fitness level can be improved, and thus keep the player from sustaining injuries due to exhaustion. Non-modifiable risk factors such as age, cannot be changed, however, we can use methods to help reduce the risk of injury (see later below).

The next risk factors to identify are external risk factors such as playing outdoors or on a court. If participating in sport out on a pitch when it’s been very dry can be very different then when it is very wet. Knowing how to adjust your interventions will help keep your players safe. In my experience I’ve had players sprain their ankles on hard ground more than soft. And the likelihood of injury when tackling or jumping is increased.

The final piece is knowing the mechanism of injury (MOI). This is learned through experience and research. For a sports therapist it is often the MOI that is the key to what the injury likely is. As before with ankle sprains the key note is a plyer will tell me “I rolled over on my ankle”. I then perform the normal ankle joint, muscle, ligament and special tests to confirm my diagnosis. But this is also useful with overuse injuries. For instance, an athlete might tell you “The pain has become worse over time” or they’ll not no actual injury incident occurred.

As a sports therapist involved with team sports we need to map all the risk factors and MOI’s and use a variety of techniques to reduce the likelihood of injury, which may include the following:

Warm up: A simple warm up plan may reduce risk to injury by 50%. And while there is little research on the duration or intensity of a warm up it is best to allow the players to determine it individually. Some benefits of a warm up include increase ROM of joints, relaxation and concentration and speed of nerve impulses and a decrease of muscle stiffness. All those factors that can potentially reduce the risk of injury, especially in older players. A very good example of this is the FIFA 11+ program which uses a structured warm up of 10 exercises 1-2 times per week and has been proven to reduce injuries in football.

Taping/Bracing: In rugby we use tape frequently. It is often used to restrict undesired movement such as inversion of an ankle or to protect the acromial clavicular joint from injury during tackles. This often applies to players returning from an injury after a thorough rehabilitation program.

Protective equipment: This includes helmets for cycling or horse-riding and mouth guards for collision sports, common sense really!

Suitable equipment: It is imperative that your athletes are wearing appropriate equipment, even for running. A trail runner will not be wearing the same trainers as a road runner or sprinter. It also includes ensuring racquets for tennis or squash are of the right grip size otherwise an athlete may over grip the racquet and incur an overuse injury.

Recovery: This is the biggest issue I see in my clients. It is important to allow your muscles to recovery after any strenuous activity. The can include using active recovery and walking for ten minutes after a hard run, using cold water immersion, massage and eating properly after exercise.

When starting a new training program, it is advised to get appropriate advice from your GP first, then a professional such as a sports therapist or personal trainer for exercise guidance. Graduate sports therapists can perform an injury prevention screening which uses functional tests to measure any biomechanical dysfunction and if any adjustments are required, will issue you exercises, stretching or other methods to help improve any dysfunction. After a screening it would be advisable to see a personal trainer to introduce you to exercises at the proper level of your fitness.

Sports therapists can also perform sports massage which is an excellent way to recover after hard training sessions.

If you have any questions about injury prevention or other services that sports therapist can provide, please do not hesitate to contact me.

Sara Green, Sports therapist, BSc (Hons)

sara@prestigesportinjury.co.uk

www.prestigesportinjury.co.uk