Your comments: 7 December 2016

It was wonderful to see international collaboration on the topic of dance medicine and science, as featured in the news item ‘Physio travels to Brazil for dance medicine conference’. 

 

As dance naturally evolves, there are many colleagues in the field who are passionate, and strive to optimise the dancers’ performances and reduce injuries, and injury risk, in line with our sports medicine colleagues.

 

The article states that ‘there is not much physiotherapy in dance school’. It should be noted that all the large dance schools in the UK have physio or similar professionals within their staff. These schools ensure students have access to knowledgeable practitioners. Many student researchers are also investigating the pre-professional field analysing trends, developing evidence-informed pathways and aiming to validate our outcomes. 

 

The Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM) has been proactive in having dance medicine specialists present at their conferences and their continuing professional network pathways are a great way for clinicians to plan, develop and hone skills in the area.

 

The Twitter feed @ACPSEMdance regularly highlights up-to-date topics.

 

Yes, we can always improve, but there is no doubt the UK is leading the way internationally in this expanding field, at both academy and professional levels.  

 

As course leader of the Society of Musculoskeletal Medicine’s injection therapy module, I am confronted on a regular basis by students who tell me of rigid practices among physios relating to patient group directives (PGDs). 

 

For those who don’t know, PGDs provide a legal framework for non-prescribers to access and administer prescription-only medicines (POMs) to patients. Rightly, there are tight regulations around PGDs and many physios in the UK use them to expedite patient care. Back in 2006 the MHRA  produced a statement about the mixing of drugs, which created confusion in our profession. I have been involved subsequently with the CSP’s successful strategy to gain independent prescribing rights for physiotherapists. 

 

Many physios who regularly use medicines have yet to undertake independent prescribing training and still use PGDs routinely. PGD regulations stipulate that two licensed drugs (Kenalog and Lidocaine) cannot be mixed prior to patient delivery as this creates an ‘unlicensed’ drug. 

 

The CSP issued guidance about this in 2009 and produced a definitive guide to delivery techniques for each injection to assist students’ decision making. Using two syringes should not be the starting point when complying with regulations – it should be the last resort. Thankfully, physios can now sidestep these issues by training as independent prescribers. But, in the meantime, can physios working under a PGD look at the CSP’s guidance and stop all this two-syringe nonsense?  

 

Paul is correct that the CSP issued guidance on this topic several years ago, and it is now matter of professional judgment for individual clinicians to act reasonably and follow conventional logical practice. From a CSP perspective, we’ve refreshed all our medicines information to members.  See the CSP website here.