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Society Member Kate Evans Reflects on Her Bruce Hobbs Travelling Scholarship Trip to Calgary

Society Member Kate Evans, Sports Therapy Programme Director and Senior Lecturer at the University of Wales Trinity Saint David, was the 2017 winner of The Society of Sports Therapists’ Bruce Hobbs Travelling Scholarship to Calgary in Canada. Kate’s winning application afforded her the opportunity to study a Continuing Professional Development course in ‘Prolonged Sports Related Concussion’ with Associate Professor, Dr Kathryn Schneider at the University of Calgary.

Kate, who is also Sports Therapist to Newport Gwent Dragons, takes up the story:

‘I had met Kathryn at an in-service training event organised by the Welsh Rugby Union (WRU) and the timing of it could not have been better; I had just supported two professional rugby players in their unsuccessful rehabilitation from a Prolonged Sports Related Concussion (PSRC) and subsequent retirement, and unfortunately, was on my way to the same outcome with a third player. That was until Kathryn’s one-day workshop revolutionised the way I approached the rehabilitation of players with PSRC symptoms. The one-day training course allowed me to rehabilitate the third player to return to full sports participation and competition. I was well aware that the one-day course was just the tip of the iceberg and whilst I was trying my best to apply my newly acquired skills, I was desperate to learn more by attending Kathryn’s CPD course in Calgary.

‘Whilst the majority of Sports Related Concussions resolve in less than 2 weeks for adults and 4 weeks for under 18s, the number of PSRC is becoming more prevalent. For sports related concussions, headache and dizziness are the most commonly reported symptoms. However, Dr Schneider’s research indicates that 85% of patients with cervical pain and vestibular signs, will have a prolonged recovery. These symptoms are often difficult to articulate with the athlete simply reporting they ‘don’t feel right’ or ‘something isn’t right’. This becomes frustrating for both the athlete and the medical team as the cause of the symptoms is not clear and treatment therefore becomes very difficult. Athletes are normally referred for a neurological consultation and prescribed a prolonged period of rest, which does not alleviate these feelings and symptoms. A prolonged period of rest away from the camaraderie of the team sports environment can subsequently lead to feelings of isolation and in some cases, psychological factors such as depression can further compound symptoms.

‘As soon as I knew I had won the award I made arrangements with Kathryn to attend her course. I was lucky enough to spend some time with Kathryn at the IOC Injury and Illness Prevention Course in Monaco in March and we agreed to meet again in Calgary for her course.

‘The course and trip to Calgary exceeded all my expectations. I acquired new techniques and approaches and was lucky enough to see Kathryn’s lab and its high specification equipment and meet her PhD students. To say the course is intense would be an understatement. I arrived well read in the field of concussion rehabilitation – but even so, it was overwhelming and the amount of new information was vast. Kathryn discussed at length the new SCAT5 protocols, the consensus meeting and subsequent systematic literature reviews that informed the new protocols. Whilst Kathryn’s laboratory facilities were impressive, I felt there was much to be gained from developing a simple (and low tech!) assessment strategy to help diagnose the potential root cause of the PSRC symptoms.

‘With this in mind, I have subsequently developed a short course in PSRC, which I hope to trial with some peers from the Society. It covers:

Incidence and predisposing factors for PSCR,
A detailed assessment of PSRC including Vestibular and Oculomotor assessment strategies,
Red flags and criteria for onward referral
How to develop a framework for rehabilitation of vestibular and Oculomotor dysfunction
Case Study examples

‘I have successfully used this information to help a further 5 professional rugby players return to sport following PSCR and I feel that this knowledge – given to other Graduate Sports Therapists will assist other athletes suffering with the vague, hard to describe symptoms associated with PSCR. In the long term, my hope is to have this specific field added to The Society of Sports Therapists’  competencies, so that all universities, and therefore graduates are competent in the assessment, treatment and rehabilitation of PSRC, as I feel strongly that this area is currently heavily underserviced. Our role is to work with all areas of illness and injury in the sport and exercise environment – and none are more topical than Sports Related Concussion.

‘Thank you all for the opportunity to deepen my understanding of this area. Without the support of the Society of Sports Therapists this would not have been possible’.

Professor Graham N Smith, Chairman of The Society of Sports Therapists said:

`The application for this trip was one of those considered by the selection panel for the Bruce Hobbs Travelling Scholarship and stood out not only for the quality of the application but because this is such a topical and important subject area. Kate`s undoubted experience in professional rugby and as an academic, also meant that not only would The Society of Sports Therapists get value from the knowledge she would gain from such a trip, but the players and students with whom she comes into contact, would do too.

The more we as therapists understand about this topic area then the more comprehensive and relevant the care we provide can be. `

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