Bags, bags, bags!

How much kit do you carry around with you? Be honest now, it's probably more than you need, I know it is for me. Having recently taken on the role of club therapist for local rugby club I've found myself looking at bags, specifically pitch-side bags, to carry all the first aid and other stuff around. There are a lot of bags out there to do this job, but I've got three I've been using for a variety of things.

First up is the pitch-side bag from Physique. This is a great bag. I inherited this one at the club and I've been using for a couple of weeks. The shoulder strap has gone missing, but that's not too important.

The bag itself is just the right size (42 x 28 x 25cm) for everything I seem to need to carry, especially when we're off to an away match and I have to leave the cupboard behind! There are front and rear side pockets, one with an internal mesh pocket and dividers in the main compartment. Unlike the other bags, these dividers are fixed and simply fold out to create separate spaces. There are also two handy mesh pockets on the outside for a bottle and a spray.

This one has been through at least one season given the dirt it's accumulated, but it's still okay and all the zips work.

Next up is a similar bag from Physioroom. This bag is similar in size (45cm x 26cm x 27cm) to the Physique bag but lacks the external mesh pockets. Inside it has all sorts of pockets and holders to keep you organised. I haven't tested this in the field as they say, but it's certainly seems to be well made and I use it to keep my personal stash of first aid supplies. The main compartment can be divided using two velcro panels, giving some organisation but not as much as the other bag.

The third bag comes from Firstaid4sport. At 45cm x 25cm x 31cm it's by far the largest of the bags, which is both a plus and a minus depending upon what you put in it! It's also bright orange (as you may have noticed!)

I like this bag for a variety of reasons. First the size. As a First Aid bag I think it might be a bit big (there is a smaller version that measures 41cm x 27cm x 23cm-a little smaller than the other two above), but for carrying my massage stuff this is a great bag.

The central compartment can be divided using two velcro partitions and there is a very useful zip pocket on the end of the bag as well as both the front and the back. Additional to these compartments are a couple of velcro fastening pockets on the front and back.On the opposite end to the pocket is a mesh pocket for a water bottle or spray.

The side pockets have the usual internal mesh pockets and zipped compartments that you find in a field bag.

The colour is the most obvious and in some ways useful distinctive characteristic of the bag. It's certainly unlikely to get missed amongst a pile of rucksacks and holdalls.

Out of the three, the Physique bag is certainly robust and a good size with those handy external mesh pockets. If you don't need or want the mesh pockets, then the Physioroom bag offers great value for money at the moment (as of Sept '14 it's on a promotional price under £20!) If you're looking for a more compact touchline bag then have a look at Firstaid4sport's touchline bag.

You can buy any of these bags empty or fully equipped as a first aid bag. But beware, the contents are similar yet with some very clear differences. It would take too long to analyse the contents, but again I think Physique probably just has the edge over the others for value and range. Whichever you choose you will probably need to supplement the supplied contents, so check carefully what you get and think about what you need.

If you just want a bag for you're own stuff, I'd definitely consider the bright orange offering.

New Role

Last night I started my new role working with a local rugby club. We're not talking high flying professional stuff here, just a local club made of folk who love rugby and love playing. One thing this means is that there's no money, so I'm not about to make my fortune here, but I get the opportunity to broaden my skills and build connections. And I love rugby too, so it's not a big hardship to give up some time and effort working with them.

My role is to look after the players, primarily the first team, and to provide pitch-side assistance on match days. I set up my "clinic" on one of the training nights and assess and treat within the scope of my knowledge and practice. Already I've sent a couple of players off to see their GP's to get a proper medical assessment of their injuries.

It is really important to me to be professional about what I do. There might not be a lot of money involved, but that is no reason to do a poor job and what's more my reputation is on the line. If at the end of the season I've done a good job, then that bodes well for the future. The fact that the pay isn't going to cause me any great problems with the tax man is neither here nor there. There are other things to take into account. The opportunity to advertise for free at the club for one, and the possibility of getting involved with the other sports clubs that run on the same site. There's a cricket club and football and there are some tennis courts that are being brought back into service!

As far as the players are concerned, they see me as the club physio. I know that's not what I am, I'm a sports and remedial massage therapist, but they don't make that distinction. It's up to me to stay inside my professional boundaries, to know my limits and refer on without worrying about what people might think.

As a group, they seem great. There's the usual banter and colourful language of a dressing room.

I suspect that many a small, local sports club is the same position of needing some support but not having the funds. Volunteering your time or working for expenses is one way of helping them and helping yourself.

First Aid Training

My knees ache and my brain is exhausted. I've been on another First Aid Course!!

I know many of us end up on FA training because our certification or professional body require us to do it. Every three years we dutifully attend a one day EFAW or similar course to satisfy those requirements and tick another box. But what about the skills you are learning? FA shouldn't just be about ticking a box and moving on to the next checkbox. I found that out a couple of years ago when I came across and apparently unconscious non-breathing casualty on a train. It's then that you realise how important the FA training you did is. I could almost hear my trainer's voice in my head saying, "Asses the situation, consider personal safety/cross contamination, alert response, airway..." as I tried to stay calm, control the situation and look after the casualty.

So, although I hate the idea of role playing, I see real value in doing high quality FA training. Because I've recently been asked to get involved with a small local rugby club, and because that will involve pitch-side first aid, I decided to do a specific pitch-side course. Over the weekend I spent two days going through all the basic stuff again and then extend that into pitch-side scenarios.

It's my third FA course in two years and my second with ReactFirst. It began with a requirement of my Sports Massage course followed by the need to do a different course for the LTA and then this weekend doing the pitch-side course.

The major difference between the EFAW (Emergency First Aid at Work) course and the sports specific courses lies in the extra material covered. Even the one-day course offered a more in-depth exploration of injuries and how to handle them than the EFAW course that I attend was able to cover. EFAW is a really good qualification to do, but if you are involved in a sporting environment then I's strongly urge you to consider a sports specific course. Like me, you may end up needing to do both because of regulatory requirements, but it might just be worth the extra investment.

The ReactFirst courses I've attended have been physically, emotionally and mentally draining. In truth, they've been tough. But you wouldn't really want sail through FA training without being put under some pressure because when it comes to the real thing, every FA situation is stressful.

The learning process is quite simple. Build a reliable, repeatable and systematic approach to dealing with a casualty and keep doing until it's fixed in your brain. As you progressively add elements to the process you keep practising. When you make an error, you go back to the start and do it again until you can get from finding the casualty to handing them over to the ambulance without a mistake. That probably sounds demanding and it is, but it's worth the effort because it helps embed the process in your head.

But there's fun too, just in case you are tempted to think it's like sitting your exams all over again! We laugh a lot, once we've got used to it! By the middle of the day folk are walking into the training room, stretching wide their arms and announcing, "I'm assessing the situation!"

On the two-day course we spent the afternoon of the second outside with different pitch-side scenarios. Casualties were no longer neatly arranged on their backs unresponsive but had a range of injuries from a casualty entangles in the nets of a goal to a clash of heads with casualties bleeding, fainting and generally passing out around you! Hectic, challenging and stressful? Definitely! Useful, thought-provoking and confidence building? Absolutely!

So, if your looking for First Aid training that will inspire you, motivate you, teach you, equip you and ultimately give you the confidence to take control of a casualty while professional help comes, then check out FirstReact's courses. They are among the best, if not the best FA courses available.

If you're involved in sports, working with sports people or involved in outdoor activities, FirstReact have a course for you. Check out their website and read some of the testimonials, then book yourself on a course!

Niel Asher Technique

After listening the the talk and chatting to folk on the Niel Asher stand at the COPA Show the other week, I decided to go ahead and do the access course for this technique. For those who don't know, it's a massage based routine to relieve frozen shoulder (adhesive capsulitis).

I'n not about to describe the process, but in it's simplest form it's about trigger points and following a set routine that apparently works. I haven't put it to the test yet, although I am treating a tennis player who has problems with his dominant arm and lack full ROM in that shoulder (as I understand it, frozen shoulder typically occurs in the non-dominant shoulder). However, I thought applying NAT might help and so we are experimenting with a series of treatments. Practice for me and hopefully improved ROM for him!

Omni Massage Roller

Omni Massage Roller

There are lots of self-help massage products around from foam rollers to spikey balls. There are home-made solutions too from tennis balls taped together to bits of drain pipe used in place of a roller! The latter doesn't bear thinking about for me but some people who like pain seem to enjoy rolling around on them.

As a therapist I know that not everyone wants to spend a lot of money on paying someone to treat them, so knowing about what devices for self-massage are out there and how to get the best out of them seems to be a good idea to me. That way I know what my clients are trying to do and I can advise them appropriately.

The Omni Massage Roller consists of a solid ball that rolls freely inside a cup. There is a hole in the cup through which you can pour massage lotion to aid the glide of the roller. There's a band around the cup for a sound grip.

Because the contact area between the ball and the soft tissue is quite small, it's quite easy to overdo the pressure. Having said that, used well it can be very precise. That it turn suggest to me that you need to know what you're trying to do with it to get the best out of it.

The advantage of the roller over a simple ball is the ease with which you can move it around compared to lying on a tennis ball for example. Of course the downside is that creating pressure can be difficult and even potentially bad for you if you're trying to apply leverage through your arm, shoulder and wrist.

I paid £8.99 for one from FirstAid4Sport, but they are also available from the likes of Amazon.

COPA Show, Conferences and CPD

It's been a busy few weeks what with one thing and another. I went to the COPA Practice show again this year. Much the same as year as far as I could tell. Some very expensive equipment on show alongside some high-tech stuff too. Beyond that there was enough to make the day worthwhile.

As a result of the show I decided to investigate the Niel Asher Technique for frozen shoulders. I've got a guinea-pig to volunteer for treatment, and will see how it goes.

One interesting piece of kit I saw was called the bodyblock. It's a useful looking support tool with a wide range of applications. The surface is wipe clean and the block is soft enough to give under pressure but not so soft that it collapses.

You can get them direct from the website, bodyblock.co.uk.

If you buy stuff from Physique, they are planning to trial stock them in the very near future, or so I'm reliably informed!

Having signed up for the NAT (Niel Asher) cod, I downloaded the files, did the reading and watched the videos. The basic reasoning behind the technique is that frozen shoulder arises from an inflammatory response in the tendon of the long head of the bicep, to put it simply. It's certainly interesting and I'm looking forward to see how it works in practice.

Lastly I went to the SMA Conference on Saturday. A really useful and interesting day. Met a few people I knew and a lot of people I didn't! The venue was good and the talks interesting and informative. In the end I was glad I went.

It looks like I may be working with a local rugby club for the upcoming season. This will be at training and pitchside. I've booked myself on a two-day pitchside first aid course, and while daunting,  it will be good to expand my knowledge and experi

Modified Thomas Test

I have to confess that I don't use the Thomas Test as much as maybe I should given how useful it can be. I think that's because when we were introduced to it there was so much information going into my brain that I react rather negatively to it! Well I'm over that now and it's about time I reminded myself about how to do this simple test.

This video is interesting because it extends the Thomas Test but it also reminds you of how important it is to get the pelvis in the correct position in order to make a proper assessment. It's also interesting to hear what John has to say about psoas, testing adductors and abductors and how you can use the Thomas Test position to stretch and do STR.

He also talks about testing ITB if you're interested!



 John has got a new book coming out soon about the glutes called: The Vital Glutes: Connecting the Gait Cycle to Pain and Dysfunction. It's available to pre-order from his website.