Happy Anniversary @SpaceClinics

It was 8 years ago this week that Edinburgh's West End saw a new show in town! SpaceClinics opened the doors for the first time in 2005 with a fulltime physio from New Zealand called James fronting up the medical team, with less frequent but essential appointments available with Stuart, Stephen, Gillian & Gordon. All, of course, helmed by Sharon whom had previously been engaged by Scottish Rugby.

Our rugby theme was prevalent in those early days: few clubs had staff well versed in rehab, and we had shiny new kit imported from the US that we were only too keen to display and use in the gym with the much-admored sprung flooring.

The kit has been well used in that time, but our demographic has certainly changed: one of our taglines was " you don't have to be a star to be in SPACE" and we have appealed to various sectors of Edinburgh, Fife, the Lothians and the borders to a greater and lesser degree over the years.

Requests from our audience led us to create the 'cube' behind frosted-style glass panels downstairs to add to our more private suites, but the majority have embraced the opportunity to banter with other patients and staff, often as an antidote to the treatments and soft tissue techniques offered up.

Upskilling has always been key to our success, and all of our physio staff have skills in dry needling with a passing resemblance to acupuncture, and many have the basic courses in kinesiotaping passed in addition to the myriad of Masters post-graduate qualifications and supplemental courses to keep updated with the latest in assessment and rehabilitation.

When Stuart and Stephen conceived a practice that would have staff actively involved in sport, they could not have foreseen that SPACE would have spent this past year caring for members of the volleyball, hockey, netball communities as well as for both sexes in rugby. See who's who in SPACE Staff at SPACE here.

SPACE is also justifiably chuffed at having had four members of staff at the Games of London 2012 including Paralympics. In addition to being terrific experiences in their own right, these events led to great many changes in the way that patients are assessed and treated as a result of the many different practitioners that were met within the polyclinic and at Games venues.

We have great aspirations for the future, and look forward to sharing them as is appropriate. In the meantime, thanks to all whom have passed through those West End doors! Especially the batch of special folk whom have been staff over the past 8 years! 

Scottish Touch - Home Nations Opportunities knock!

This summer's Home Nations is to be held in Dublin.

The SPACE sponsored Scotland team were triumphant in the European Championship in Treviso last September:

2012 European Champions-SCOTLAND

Now the search is on for coaches to take on the Home Nations in June in Ireland.

This is seen as a tournament when fresh talent can be blooded across various squads, and remember that international Touch includes mixed teams across a variety of ages.

As ever, the coaching staff will be expected to have strong leadership and demonstrate communication skills along with appropriate coaching experience.

More fulsome details are carried on the STA website here at :     STA Coaches Role Profile & Application form.

Closing date for applications is Friday 22nd February.

Migraines: a headache for research

Are migraines a real pain in the neck? Or do bright lights act as a trigger for an attack? Are headaches part of life, with diet and alcohol affecting you?

Studied have examined and turned up multiple causes for migraine-like symptoms. Yet many of these are based on questionnaires dreamed up to generate answers based on self-reporting. Triggers are therefore suspected causes, and rarely tested. How seriously then should the research be treated, and the cited causes that come out of them?

A Japanese study into links with alcohol is based on a questionnaire asking 5408 a series of questions based on perceived locations, duration, characteristics, frequency & also aggravation by routine exercise.

J Headache Pain. 2012 March; 13(2): 137–145. Japanese study into Migraines & Alcohol

Their own conclusions commence with the issue of self reporting: citing possible causations being 'highly speculative'. This further demonstrates the difficulty of examining data from migraine research.

We make the point as we at SPACE are highly sensititive to headache research just now, and linking it to jaw pain. For all the limitations of this self reported information, however, it does reflect how we conduct our initial examination with patients when they arrive for an appointment: we always ask about triggers as well as duration and frequency to establish causes and generate options for treatment.

A recent study, albeit of just 27 participants has attempted to actually test self reported triggers Provocation of migraine with aura using natural trigger factors Neurology January 29, 2013 80:428-431; published ahead of print January 23, 2013. Results from the study suggested that headaches are preceeded by a warning sign, often visual in nature. Light exposure did not seem much of a trigger (intimating that lying down in a darkened room may have alternative benefits other than light denial) but that exercise may be a reliable cause for a group of migraine sufferers.

All in all better quality research into the testing of perceived triggers would help enlighten the issue of migraine-type headaches: don't be in any way surprised if you have to answer a raft of questions at the clinic however as we are truly interested in your headaches and jaw pain. 

We will make no apology in trying to link signs and symptoms to get a pattern and potential personal treatment plan-and that is critical: it really is all very personal! It's how we roll!

Six Nations: Let the Games Begin

In the deep midwinter, a sporting beacon shines on western Europe!

The capitals of the rugby nations of Great Britain & Ireland, and more recently France and Italy combine in a seven week explosion of patriotism & jingoism depending on which side of the borders you hail from!

Senior men and women, plus the under 20s teams of both genders face off across the continent with supporters and spectators mingling before, during and after. Parents meet up for sons and daughters, friends pair up days and nights before then afterwards for the great dissections. 

Sounds of the Championship

Five matches per team, and all in a Lions season (as Sky Sports are obliged to tell you every ad break and each rugby programme) which adds spice to this annual event. Gladitorial combat of the highest sporting order all across the BBC from this weekend, with matches in Cardiff, London & Rome.

The phoney war is nearly over: let the games begin!

NFL appoints independent pitchside Docs to manage concussion from 2013 Season

The NFL have made an intriguing announcement regarding concussion.
Starting from next season, the National Football League(NFL) will have unaffiliated neurological consultants for pitchside assessment of suspected concussive injuries during matches.

Jeff Pash is the executive vice president of labour and general counsel for the NFL, and believes that the players will benefit from this independent additional 'set of eyes on the game'. He spoke at the NFL Health & Safety news conference in New Orleans in the Thursday prior to the Super Bowl.

Pro Football Weekly report

"They will work with the team medical staffs. The unaffiliated neurological consultant will assist in the identification, diagnosis and management of players who have had concussions" adding that they will " assist in making sure that we (the NFL) provide uniform and highest-level care for players who have experienced concussions. The goal is to have expertise, the highest-quality care, make sure that we're administering protocols that have been put in place in a thorough, comprehensive  way, and we think this additional physican will accomplish that".

Pash also then implied that these injuries are somewhat different to most injuries, and that these are harder for the team medics to manage: " The team physician is in the best position to make these evaluations because of the unique knowledge that the team physician has of the player. A concussion is a different kind of injury. Sometimes there may be obvious signs, but sometimes more subtle."

There is a feeling that team-employed medical staff have clashed with team coaching staff in the past, highlighted by the Washington Redskins'/RG3 injury issue in the latter part of the season. Team-affiliated Doctors clash highlights need for culture change

This blog has reported on the increased attention that have been reported over the past two years, and this stance could be seen as a response to the increasing demands on the NFL to respond.

Concussion controversy

Ex-players sue NFL over concussion

Pash also revealed that the NFL was addressing issues in the game with the replacement of older helmets with new ones in partnership with USA Football last year in a pilot study, and there is an encouraging partnership with the Centers for Disease Control and Prevention.

These events cannot be seen as a panacea, but are welcome changes to the sport at the highest level of what can be a brutal game, and the minimising of risk is a very positive move for those who sometimes need protection from themselves.