PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA Keeping British Columbians Moving For Life

Professional Development Calendar 16

in this issue All issues of Directions are available online at www.bcphysio.org/content/directions.

Simon Whitfield on His Career, Success and Physio 4

Honouring Physio Pioneer Clyde Smith 5

Hypopressives: The New Kid from Europe 7

Physios as Expert Witnesses 10

SPRING 2016

A publication of the Physiotherapy Association of British Columbia

Photo: Chris Stenberg

Olympic gold medal triathlete, simon Whitfield, is the keynote speaker at this year’s Physiotherapy Congress in Victoria. simon credits his career longevity to the role physiotherapists and sport medicine doctors have played as partners in his training.

Running hard and Running Long: simon Whitfield on how physiotherapy helped his careerby Emira Mears, PABC Director of Strategic Communications

read more on page 4

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PResiDent’s message

a strong Foundation for growth

Jason Coolen, BScPT, BSc(Bio)President

Hello folks,Spring is a busy time in the PABC calendar, with the Practice Forum in April, National Physiotherapy Month and Walk With Your Doc taking place in May, and of course CPA Congress coming to Victoria this year May 26-28th. With all this activity there are lots of opportunities for networking, reconnecting and increasing the profile of physiotherapy, and I hope you have a chance to get out and connect.

May’s CPA Congress will also mark our next Branch President’s meeting. CPA is currently working on a market analysis of the rehabilitation market in Canada with an eye to getting a better handle of where all the stakeholders are currently positioned, and where physiotherapy can play the most strategic role to support patients and the healthcare system. There are more and more professions getting involved in the rehab world, and we want to ensure we are leveraging opportunities and not losing ground as the field broadens.

In addition, we are in conversation with CPA on the possible coordination of a national communications project. There are many interests that come to the table in a national conversation, but we all have the common goal of wanting to ensure that physiotherapy is, first and foremost, well thought of and top of mind when someone needs rehabilitative care. We hope to see more collaboration with CPA on this front.

By now you may have met or heard from our new CEO, Kevin Evans. Kevin has been an excellent addition to our association. I have certainly enjoyed getting to know Kevin over the past few months, and I know he is working diligently to get to know more and more both of our members and our processes, and is also highly focused on continued improvement of our service base and the general operation of the PABC.

Kevin has been leading a project to look at options for improving our value proposition as an organization with an eye to the future. We continue to do well as an organization, but that doesn’t mean we can’t aim higher to ensure that as a profession we are always at the forefront of healthcare in BC.

Our communications plans are continuing to move forward to increase visibility for the profession, and we are looking to build on those efforts to extend our reach. We are also looking at how we can improve our standing in the advocacy realm through both communications and direct interaction with key stakeholders. The future for our Association, as always, looks bright.

Some other items in the works at PABC include some excellent initiatives led by our committees. Our Board relies heavily on the work done by task forces, committees and our three standing committees, all of which have people doing outstanding work. At the moment our Rural and Remote Committee is highly focused on improving our advocacy efforts for physiotherapy. A few projects on their agenda include telehealth, improving networking for our rural members, and improving access to physiotherapy in rural and remote regions. Your Board of Directors is committed to addressing the issues affecting our rural and remote members and I encourage anyone with

a perspective or thought, to share it with me any time at president@bcphysio.org.

Happy National Physiotherapy Month! Let’s all be proud of the work we do and take the month to acknowledge the great work we all do. Let’s share the value of physiotherapy and its outcomes with the world.

My email box is always open president@bcphysio.org so please drop me a line.

Jason Coolen co-owns Oakridge Physio, Vancouver Physio, and North Vancouver Physiotherapy clinics. He is the father of two young children. Jason has been on the PABC Board of Directors for six years and has presided over PABC in his voluntary leadership capacity since April 2013.

Thank You to our Physiotherapy 2016 Forum Sponsors for their support:

PABC AGM Title Sponsor Clinicmaster by ADDAtech

Lunch/Delegate Bag Sponsors

CBI Health Lifemark Health

Healthmed Mardon Insurance

Jane Clinic Management Software Derek Mah Law

Education Sponsor

The Robin McKenzie Institute

Break Sponsors MACS and the Active Passive Trainer Professional Orthopaedic Products

Telus Health Yocale

E-Med International Medical Ltd.

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Of nature’s miracles and gifts

CeO’s message

Spring has always provided me with a welcome reminder of nature’s miracles; all that blooming and renewal is inspiring and reassuring (though my allergies are perhaps not as enthused).

This spring—my first since plunging into the world of physiotherapy three months ago as CEO of PABC—the ever-abundant passion of my new-found physio pals has brought to my notice another of nature’s miracles: the human body.

Though I’ve been rather closely acquainted with my own for some time now, it’s only recently that I have come to see the light: Part of the miracle of the human body is that the key to keeping it healthy is to let it do what it was designed to do—move.

Kevin EvansChief Executive Officer

(By the by, this might make a great slogan for a physiotherapy association. Something like: “Physiotherapy—Keeping British Columbians Moving for Life.” But I hear it’s taken.)

It’s the understanding of how the body moves, what keeps it from moving well and how to restore mobility that underpins physiotherapists’ unique contribution to health care.

But there’s something more, something I noticed in my role as a longtime consumer of physiotherapy services, and that is the values that characterize this profession. On my first day at PABC, I asked members to help me out in how best to articulate those values. The response made me feel welcome and provided much food for thought, such as this one:

“Caring is a core value for me. As physiotherapists, we are privileged to work with people when they are most vulnerable. Physical injuries often influence

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a patient’s emotional and social state and can be an incredibly difficult time. We spend a great deal of face time with patients, and our ability to provide empathetic care and hear the story each patient brings to the table is an essential part of the healing process.”

Another response focused on the breadth, depth and specialization of knowledge:

“Not just helping people after surgery or a sprained ankle, but the huge variety of other roles – from vestibular therapy to women’s health/pelvic floor to infant development, primary care, preventative care, seniors care, fall prevention…”

Physiotherapy and physiotherapists may not be miracles of nature—but they sure are among nature’s gifts. And I’m pleased and proud to be associated with such a bunch.

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BC triathlete Simon Whitfield was Canada’s flag-bearer at the 2012 Summer Olympics at 37—an age when many elite athletes have long since retired. The keynote speaker at this year’s Physiotherapy Congress in Victoria credits this longevity in large measure to the role physiotherapists and sports medicine doctors have played throughout his extraordinarily successful career, which includes Olympic gold in 2000, Olympic silver in 2008, gold at the 2002 Commonwealth Games, twelve Canadian championships and fourteen World Cup victories.

In 2009, while training for the 2012 Olympics, Simon brought local sport physiotherapist and PABC member Marilyn Adams onto his support team. He still credits her as a standout member of his team in the last few years of his career. “She often knew my body better than I did,” Whitfield said in an interview with Directions. “She really helped me elevate my movement awareness and its impact on both my performance, and injury prevention.”

A 1991 graduate of the University of Alberta, Marilyn recounts, “I met Simon when he was going into his last few years of preparation for his fourth Olympic games. He was acutely aware of the need to manage an athlete’s aging body, and he and his coach sought out a physiotherapist to support his training. I was fortunate enough to be recommended and the relationship opened up a whole new world to me as I spent large blocks of time with them at training camps and races.”

nBa Came CallingMarilyn’s work with Simon caught the attention of the NBA’s San Antonio Spurs, who later hired her as that team’s director of rehabilitation. Simon said of Marilyn, in an interview at the time, “She understands winning. She understands the commitment it takes. She understands the nature of the sacrifice required. She knows how to keep an athlete fine-tuned.” The admiration was evidently mutual. When Simon retired from professional sports in 2013, Marilyn tweeted: “All the best in your retirement, Simon. I’m a better physio and person for having worked with you.”

Simon Whitfield sounds like a physiotherapist’s star patient particularly when he talks about his devotion to extensive warm-up and warm-down stretching regimes anytime he trained. “I knew other elite athletes who were surprised by just how long I would spend warming up or warming down in my training. But it paid off in a lack of injury throughout my career and a longevity that not everyone gets to enjoy.”

The current focus of Simon’s professional life is Relentless Pursuit Partners, an investment and consulting firm that helps grow technologies, consumer products and services that enhance health and wellness (www.relentlesspursuitpartners.com).

Your 80 Year Old CoachSimon sees active living as a lifelong commitment—made easier, he admits, by his surroundings where he lives with his family on Vancouver Island. “I like the idea of being coached by your 80-year-old self. Your 80-year-old self has a right to a healthy body and mind. I’m really proud of the fact that I made it to forty years old after an elite athletic career and I’m not paying for the things I did earlier.”

Simon has sage advice for people at every level of physical activity: “It doesn’t matter where you start, as long as you do start taking the steps to living a healthier life and taking care of your body and mind in the process.”

“Getting guidance from a physiotherapist in how to take care of yourself in the long term is going to pay off. You only get this one instrument for the rest of your life, and being proactive about how you take care of that instrument is the greatest gift you can give yourself.”

Could a physiotherapist have said it any better!

Simon Whitfield is the Keynote Speaker at the 2016 Congress in Victoria on May 28th. For more information: www.physiotherapy.ca/congress

by Emira Mears, Director of Strategic Communications

Running hard and Running Long: simon Whitfield on how physiotherapy helped his career

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Clyde smith: a Lifetime of Pioneering Physio achievementby Kevin Evans, PABC CEO

As Clyde Smith recounts that hot afternoon in July 1976, his eyes tell you he’s there again – reliving the thrill of parading into Olympic Stadium with Canada’s athletes as a rookie member of the medical support team. As he marvels at the moment, he wonders, “How does a kid from a tiny little town in Oregon end up strolling into the Olympic Oval in front of 76,000 people? Physiotherapy,” he answers.

In fact, Clyde Smith credits physiotherapy for just about every opportunity he’s had since he began his extraordinary career in 1972.

On April 23rd, at the Annual Practice Forum, Clyde will be honoured by his peers with a PABC Lifetime Achievement Award. He says it will be the proudest day of his life – and that’s saying something coming from a guy who has been to three Olympic Games, three Pan American Games, and 22 countries with teams as varied as field hockey to wrestling.

He’s been active behind the scenes as well – a member of the PABC team that helped change MSP billing rules to enable patients to go directly to a physiotherapist without the need for a doctor’s referral.

Football BeginningsHis introduction to physiotherapy was personal – as a football player at Oregon State. He eventually migrated north where he played with the Edmonton Eskimos and enrolled in rehab medicine at the University of Alberta. Clyde recalls getting accepted a week before his grades transcript arrived. “Jock Faulds, the head of the school, said, “I already think you’re smart enough to be a physiotherapist. My job is to figure out if you’ve got the rest of it.” Evidently, Clyde did.

In his first class, he was instructed to gently manipulate the big toe of a classmate then bring him a glass of water ‘as if he were your mother’. “It was an early lesson in the

caring side of what we do that I’ve never forgotten.”

His first job was as a staff physiotherapist at Edmonton’s Misericordia Hospital with a salary of $590 month. “I quickly learned that to access a better salary I’d have to go into administration, but I got into physiotherapy to treat people not to administer.”

taping With the KidsSo with that, it was off to Sheridan College in Oakville and an offer to help establish Canada’s first program designed to train professional sports team trainers. “I was the least qualified guy there. I had to learn how to tape along with the kids. I guess I pulled it off because I had enough guts to stick to it.” The Sheridan College course has since developed into a three-year diploma program.

Upon his return to Vancouver, Clyde Smith did not sit still for long. He teamed up with a group of doctors and co-founded the Allan McGavin Sports Medicine Clinic at UBC. It was one of the first sports medicine clinics in the province. He’s treated celebrity athletes from the Vancouver Grizzlies and the Canucks, but perhaps the athlete with the greatest personal impact was wheelchair competitor Rick Hansen. Clyde became a member of the Man in Motion’s Medical Advisory Committee and accompanied Rick on many of his globe-spanning adventures.

For all he’s done, Clyde credits his “10 Life Goals” for keeping him on course. “One of my goals was to have my own practice and the flexibility to spend time with my kids,” he said. “Every morning for years, I would repeat those 10 Life Goals in front of the mirror. That little ritual prevented me from getting distracted by the almost too numerous opportunities that are out there for physiotherapists.”

Personal DisciplineThe achievement, at age 45, of one particular life goal speaks to the personal discipline that also played an important role in Clyde’s professional success. He remembers the morning on which he started down the driveway on his bicycle for a solo journey that would end in Halifax. He had so much fun he did it again with a group of friends when he turned 50.

Of the future of physiotherapy, Clyde sees a day in the not-too-distant future when physiotherapists will be referring directly to medical specialists and prescribing imaging tests and drugs. “Physiotherapy has come a long way in the 44 years since I began, and the pace of change continues and is accelerating.”

Clyde offers up a wink and a twinkle when he says he’s “semi-retired” these days because you’ll still find him doing what he loves. “I love being around people who have a passion for fitness and I want to help them to meet their goals of an active and healthy lifestyle.”

As we leafed through old photographs and the pages of his CV recently in the PABC meeting room, Clyde asked suddenly, “If you took my name off the top here and asked would I want this life? You bet I would!”

Spoken like a true recipient of a Lifetime Achievement Award.

Clyde Smith, BSc, Diploma Sport Physiotherapist

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block off a few days of every week to work on your systems and strategic plans.

Best advice you would give to a new graduate? For a new graduate looking to start a business, I would advise you to spend at least two to five years consolidating all your clinical skills and knowledge you obtained in school. Get involved with your professional association or college. This will expose you to industry trends and networking. And try to work in a variety of settings or places. Over seven years, I worked in five locations in public health and with three private companies before starting Physio2U. Having the inside knowledge and exposure to how different businesses operate gives you a lot of insight into what NOT to do as a business owner. And, make sure to dream big.

The best way you can predict your future is to plan for it!

Clinic Owner success story – Kim hall, Physio�u

Kim Hall, owner and founder of Physio2U, was recently interviewed by Rick Lau of Clinic Supplies Canada about what it takes to build and run a successful physiotherapy business. Kim has grown Physio2U from a one-person show to a team of 14 people in under four years. The team provides in-home visits from Vancouver to Abbotsford and mainly helps seniors and orthopedic trauma clientele. Here are some of the highlights from that interview:

tell us about Physio�u. What prompted you to start the business?After working in the public health care system for seven years and watching the funds for community-based physiotherapy decrease every year, the growing need for private-pay in-home physiotherapy services became increasingly obvious. There was no company established in BC providing such a service. The opportunity was there for me to create a business plan, work hard, find better ways and grow an innovative health care business which became Physio2U.

After starting out with just myself, it took me 14 months to find another physio willing to take a risk and join me.

By 22 months, the Physio2U team had grown to five therapists. It will be four years in March 2016; now we have an office manager, clinical leader, and 11 physiotherapists plus myself providing home visits.

What do you do to build culture at your clinic?Every month we have a team meeting. We alternate between breakfast business meetings and evening clinical inservices. We all strive for continuous growth and learning. We also have family events two to three times a year. In the past this has included hiking, sailing, stand-up paddle boarding lessons, and ice skating.

What has been your biggest mistake to date and do you have any lessons learned to share?Biggest mistake: not having signed agreements in writing. Always have agreements in writing. A lawyer can be your best friend.

Lesson learned: the more time you spend working on the business, the faster you will grow. As a health care provider, it is so easy to fill our days with patients and clinical hours. Sometimes you just have to

A longer interview can be read on the Clinic Supplies Canada website: http://blog.clinicsuppliescanada.com/clinic-owner-interview-series-2-kim-hall-dream-big-plan-ahead

by Rick Lau, Clinic Supplies Canada

Kim Hall, Registered Physical Therapist and Physio2U Owner

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What if you were told never to do another Kegel or abdominal crunch? What if we could address pelvic floor issues with only postures and breath?

PABC recently hosted Trista Zinn and Tamara Rial as instructors for “Hypopressives/Low Pressure Fitness for Pelvic Health” at UBC. Many who attended the course were pelvic floor rehab specialists. Many who attended the course also had personal reasons for being there. If our current pelvic/core rehab model is effective, why are there physios with prolapses, cystoceles and pessaries? It seems we’re still looking for the ‘right’ answer.

The Hypopressive Theory is based on the concept that the abdominal pressures we generate with curl-ups, planks, jumping and Pilates-type strengthening are often too great for the pelvic floor. As a consequence, we are literally pushing our organs out the bottom.

The intention of the Hypopressive exercise is to generate negative pressures in the abdominal cavity to literally traction the pelvic organs upwards, enabling the pelvic floor and transversus abdominis to work in shortened ranges.

Hypopressive training is a global approach to the core/pelvic floor. It is not based on strength of the pelvic floor on its own, but concentrates on the function of the pelvic floor’s intricate relationship with the core as a whole.

The other significant difference between traditional pelvic floor strengthening and the Hypopressive exercise is Type II muscle fiber recruitment.

hypopressives: the new kid from europe, coming soon to a clinic near you…maybe yours?by Katharine Hasz BMR(PT)

The key core muscles are 70% slow twitch fibers, which increase their volume and recruitment only with sustained contraction, (unlike a Kegel which emphasizes reps/sets with resting phases – Type I fiber training).

Along with serratus anterior and posterior, multifidi, the thoracodorsal fascia, transversus abdominis, and the pelvic floor, the real key player in these exercises is the diaphragm.

Using rib and diaphragm mobilization techniques, we free up the rib cage to enable improved lateral costal breathing. Then, the patient is instructed through a combination of spinal stabilization cues that are sustained, aiming to pull the diaphragm’s central tendon upwards. In the exhalation phase, relaxation and lengthening of the diaphragm occur. At this point the patient performs a prolonged apnea, drawing the abdomen inwards and upwards, whilst maintaining the postural cues.

The exercises progress to a series of sustained poses with the apnea, some of which are capable of generating negative 20-30 mm Hg as measured in the pelvic floor. In first attempts, the exercise is very challenging, and requires repeated cueing by the therapist. However with repeated practice it becomes comfortable and habit-forming.

The list of conditions which will benefit from this technique include, but are not limited to: urinary incontinence, uterine/bladder prolapse, erectile dysfunction, fibroids, hemorrhoids, pelvic pain, nocturia, cervical cell dysplasia, rectus diastasis, inguinal and abdominal hernias, constipation and low back pain. It is estimated that greater than 40%

of women experience pelviperineal pathophysiology, and LBP incidence is twice that.

Other beneficial effects include improved alignment and postural stabilization, increased lumbar mobility, increased hamstring expandability, decreased cervical and lumbar lordoses, decreased thoracic kyphosis and scoliosis correction. Waistlines also shrink, which explains why the Europeans are keen to integrate the technique.

This is an invaluable tool which not only has the potential to generate above-average results with our pelvic health patients, but also has the ability to transform our entire client population. It is a risk-free, preventative, global exercise system, which improves well-being, aesthetics and physical performance. If spinal health is a measure of our longevity, the Hypopressive technique is a ‘game changer’.

Become an instructor—let’s generate a Canada-wide Hypopressive movement. We will be the new kid on the block and our patients will shine.

Katharine Hasz B.M.R.(P.T.) a 1993 University of Manitoba grad, currently lives in Tofino, B.C., with a home-based practice, integrating manual therapy, acupuncture, cranio-sacral and visceral techniques.

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Lateral Epicondylalgia (LE) is a common condition typically affecting middle aged adults. Although once believed to be an overuse injury with an inflammatory component, more recent evidence suggests a continuum of changes in the local tissue termed angiofibroblastic hyperplasia, which suggests the following: 1) increased cell numbers and ground substance; 2) vascular hyperplasia or neovascularisation; 3) increased concentration of neurochemicals; and 4) disorganised and immature collagen.1 Furthermore, LE results in changes to the motor system decreasing pain-free grip (PFG) and alters the pain system resulting in neurogenic inflammation and/or central sensitization. This new knowledge prompted the renaming of the condition from lateral epicondylitis to lateral epicondylalgia.

Cortisone injections (CSI) were once a commonly used treatment for LE, but two recent clinical trials suggest that physical therapy may provide superior outcomes for the condition. In 2006, Bisset et al. compared three groups: 1) CSI; 2) physiotherapy-based treatment that included mobilizations with movement (MWM) and exercise; and 3) a wait and see group.2 Although those patients treated with CSI demonstrated a significant improvement at six and 12-week follow-up, they demonstrated the worst outcomes at one year. The physiotherapy group demonstrated superior outcomes than the wait and see group at six and 12 weeks, but the differences were no longer significant at one year follow-up. A closer look at the data suggests that most patients in both the physiotherapy and wait and see group had fully recovered at one year, suggesting that LE may be a self-limiting condition but that physiotherapy treatment can accelerate recovery.

A more recent trial appears to support these findings. Coombes and colleagues produced a high-quality four arm trial comparing physiotherapy with CSI,

Putting Physiotherapy First: What can we do for Lateral epicondylalgia?by Steve Young BHSc PT, DPT, BA; Sean Overin MPT, BHK; Curtis Tait MPT, DPT, BSc

physiotherapy with placebo injection, CSI alone, and placebo CSI.3 Similar to the Bisset trial, the physiotherapy treatment included the use of a MWM technique (a lateral glide at the elbow) along with an exercise program. Again, a significant improvement was noted in those patients receiving cortisone over the first few weeks, but at one year follow-up 55% of CSI patients had a recurrence compared with only 5% of those receiving physiotherapy. At one year, all groups demonstrated a greater than 80% recovery rate with the physiotherapy group demonstrating a 100% rate of recovery. Notably, at four weeks, 39% of the physiotherapy group with placebo injection demonstrated recovery compared to 0% of the placebo injection group, which again suggests that physiotherapy has a role in speeding recovery.

There is also a developing body of literature to support the use of manual therapy to the cervico-thoracic region in conjunction with standard treatment for LE. Cleland et al. found that those patients treated for LE with both local and cervical spine treatment demonstrated faster recovery.4 In a pilot randomized trial, Cleland demonstrated improved outcomes with those patients receiving manual therapy to the cervical region along with concurrent elbow treatment when compared to a group receiving only elbow treatment.5 Fernández-Carnero et al. found that a single cervical manipulation caused an immediate decrease in pain pressure thresholds (PPT) and increase in pain-free grip (PFG) in ten patients presenting with LE.6 Vicenzino et al. conducted a randomized controlled trial performing a lateral cervical glide combined with a neurodynamic technique compared to a sham technique and no intervention.7 They found a significant and immediate improvement in PPT, PFG and retesting of neurodynamics in only the lateral cervical glide group. It should be noted that while many of the trials looking at the

influence of cervical-based treatment are small or have short follow-up durations, the findings are promising. There is also some evidence to support the use of distal interventions in the form of wrist mobilizations.8

It has been postulated that hyperalgesia and altered motor control occur secondary to LE. Perhaps manual therapy can be used as a “primer” to allow greater pain-free loading of the musculotendinous system and improved motor patterning prior to exercise-based interventions.9 A recent systematic review of eccentric exercises for LE found that there is limited research investigating if eccentric or concentric loading was superior for LE, but the available research concluded that eccentric loading programs as part of a multimodal treatment program consistently decrease pain and improve function.10

Clinical Bottom Line: CSI for the treatment of LE appears to increase the chance of symptom recurrence long-term. Regional manual therapy directed at the cervico-thoracic spine and upper extremity in conjunction with an exercise program may produce optimal results when treating LE.

1. Coombes BK, Bisset L, Vicenzino B. A new integrative model of lateral epicondylalgia. Br J Sports Med 2009;43:252–258.

2. Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006; 333:939.

3. Coombes BK, Brooke K et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA 309.5 (2013): 461-469.

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4. Cleland J, Whitman JM, Fritz JM. Effectiveness of Manual Physical Therapy to the Cervical Spine in the Management of Lateral Epicondylalgia: A Retrospective Analysis. J Orthop Sports Phys Ther 2004;34:713-724.

5. Cleland J, Flynn T, Palmer J. Incorporation of manual therapy directed at the cervicothoracic spine in patients with lateral epicondylalgia: A pilot clinical trial. J Manual Manipulative Ther 2005;13:143–151.

6. Fernández-Carnero J, Fernández-de-las-Peñas C, Cleland JA. Immediate Hypoalgesic and Motor Effects After a Single Cervical Spine Manipulation in Subjects With Lateral Epicondylalgia. Journal of Manipulative and Physiological Therapeutics Volume 31, Issue 9, November–December 2008, pp675–681.

7. Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain 68.1 (1996): 69-74.

8. Struijs PAA, et al. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Physical Therapy 83.7 (2003): 608-616.

9. Vicenzino B. Tendinopathy: Evidence-Informed Physical Therapy Clinical Reasoning. J Orthop Sports Phys Ther 2015;45(11):816-818.

10. Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil 2014 Jan;28(1):3-19.

adieu stephanie, thank You!After 17 years of dedication to PABC, Stephanie Dutto, CEO’s Assistant and Event Planner, is moving on to new horizons. We are, of course, going to miss the efficiency and grace with which she organizes everything, from the Forum to education events and staff birthday celebrations, but we’ll also miss her love of the profession, staying active and of course her infectious laugh. On such a momentous occasion we had to ask Steph a few questions about her time at PABC, what’s changed over the last nearly two decades, and what she’ll take forward into her post-PABC life.

are there any notable changes that have taken place in the world of Physio in the nearly two decades since you started working at PaBC?

When I started at PABC back in 1999, it was a different world. The majority of my day was spent faxing out the job postings list to those who would call and request it! All we had in those days was dial-up internet in the office. Now the job postings are one small part of what you’ll find on www.bcphysio.org, and there are so many resources for PABC members, it’s difficult to keep track of them all.

What is one of your earliest fond memories of life at PaBC?

One of my earliest memories was the first Trade Show I organized at the AGM. I was so nervous. Everything went well enough, but only about 120 physios attended! I still organize the Trade Show, and it always makes me nervous, but now we have 400 attendees, and there is an electricity in the air at the Forum that seems to increase each year. I think the physio passion is growing in BC.

any other highlights over your time at PaBC?

Having the World Congress of Physiotherapy in Vancouver in 2007 was quite an experience. It was a lot of work, more than any of us could have expected, but it was a truly exciting experience. I learned a lot about event organization, and it was great to meet so many PABC members in person in such a thrilling environment.

What will you miss most about PaBC after you’ve gone?

I will miss working with my awesome colleagues in the office, Fiona, Kimberley, Kevin, Emira, Sheana, and Andrea, and I will miss being a part of the physiotherapy community. Physios are great people to work for!

any parting words of wisdom for members?

Working with physios has made me a healthier and more active person! Thanks to you, I intend to Keep Moving for Life.

PABC office staff and members will all miss you Steph, come back to visit us soon!

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Put Your money Where Your mind isby Alim Dhanji & Bradley Roulston, CFP’s of Health Care Financial Group

It is becoming more common for my clients to ask me what stocks their mutual funds hold. Or, more commonly: “What kind of companies am I invested in?” As a fund broker, this has led me over the past 15 years to do more research into Socially Responsible Investments (SRI). These are Mutual Funds that only buy stocks in companies that are socially responsible. Socially Responsible Investing is nothing more than integrating your values and social concerns into your investment decisions.

Initially I was concerned (like many Certified Financial Planners, CFP) that ethical investing was a way for tree-hugging hippies to make a bit of money while comforting their social consciences. I have found this to be completely untrue. You could have concerns over the nature of a business, environmental practices, labor practices, human rights or community relations. Why not voice your concerns through your investment decisions? Over the past 20 years, SRIs have grown tremendously. In fact, since the mid 1990s, SRI assets have grown at twice the rate of traditional mutual funds.

But what about returns? The best part is that you don’t have to sacrifice returns for ethics. Companies that exhibit diligence, prudence and responsibility for long-term social and environmental advancement are far more successful. Why shouldn’t a company with good environmental track records that saves money through good waste management, less litigation and speedy government approval do better? It is a reward for good behavior.

All this being said, the primary role of your CFP is to help you to develop a plan and portfolio that will meet your objectives. If this can be done even partly with socially responsible investing, we may as well feel better about making money!

Alim Dhanji and Bradley Roulston are CFP’s of Health Care Financial Group. Please contact Alim directly at 604) 604-818-4112 or at adhanji@hcfinancialgroup.com

Back in the 1960s, in the days of TV lawyer Perry Mason, “expert” medical testimony generally meant you’d expect to see a medical doctor on the witness stand in the courtroom. These days, in another sign of how health care and the law are evolving, the courts are increasingly using and accepting expert medical testimony from “non-traditional” medical experts – including physiotherapists.

If someday you should decide to take the opportunity to have “your day in court” as an expert witness, there are a few things to know that will help ensure your effort is a success. The most important is that it is your duty as an expert to assist the Court in relation to matters that are considered to be of a technical nature and requiring such expert assistance. It is not to be an advocate for a particular party. Expert witnesses must provide certification that they are aware of this duty and are prepared to comply with it.

A common certification used by experts, which meets the Court’s formal expert certification requirements, is as follows:

“I certify that I am aware that my duty as an expert witness is to assist the Court and that I must not be an advocate for any party when giving my expert opinion to the Court. I have prepared this report in conformity with that duty. I will, if called upon to give oral and/or written testimony, give that testimony in accordance with this duty.”

In addition to the certification, an expert’s written testimony must include:• The expert's qualifications and

employment and educational experience in his or her area of expertise;

Physios as expert Witnessesby David J. Wallin

• The lawyer's instructions provided to the expert in relation to the proceeding;

• The nature of the opinion being sought and the issues in the proceeding to which the opinion relates;

• The expert’s reasons for his or her opinion, including:

• A description of the factual assumptions on which the opinion is based;

• A description of any research conducted by the expert that led him or her to form the opinion;

• A list of every document, if any, relied on by the expert in forming the opinion.

And finally, of course, the expert must sign his or her report.

Ultimately, it is the responsibility of the engaging lawyer to ensure that his or her expert understands such matters and to ensure that all formal requirements are met by the expert, in order that the expert report is accepted into evidence at trial.

However, it behooves any expert preparing expert reports to be used at trial to have a fundamental understanding of both the procedural and substantive underpinnings in relation to expert reports, in order to ensure that such reports may be successfully utilized at trial.

Just ask Perry Mason.

David J. Wallin is a Barrister & Solicitor and Director of Whitelaw Twining Law Corporation, Vancouver.

Keeping British Columbians Moving For Life 11

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Communication is an interactive process and one of the most important aspects of practice that all health care professionals have to master. Many physiotherapists work as part of a multidisciplinary team, and as such, can spend more direct time with clients than other members of the team. Verbal and non-verbal communication goals should be focused around both education and empowerment. It’s not only what you say to a client, but how it is conveyed that can determine success, the building of trust and patient compliance/satisfaction.

Communication can directly impact the client. Satisfaction of care, adherence, recall/understanding, coping and quality of life can all be affected and influenced by our words and actions. To facilitate communication, consider the following: positioning, use of gestures and posture, facial expressions/eye contact, the environment and touch. Another important communication tool is goal setting. This process involves setting specific attainable goals with your client during the initial assessment and re-visiting during subsequent sessions.

Below is a brief checklist for effective communication that can enhance client satisfaction.

• avoid medical jargon and ensure clarity to generate understanding for the patient.

• Cover important information slowly and confirm understanding frequently.

• show basic courtesy. Building trust is key to determining success with patients. You can start building trust within minutes. Acknowledge the patient—greet them professionally, introduce yourself, look them in the eye, and tell them what to expect.

a Checklist for effective Communication that enhances Customer satisfactionby Cassandra Basi, Curtis Wong and Francisco Gatchalian

• Be repetitive if needed. Many patients do not remember what they are told. Repeating key points and asking if the client has questions/understands increases recall.

• Listen. Ask about the patient’s concerns and paraphrase what they’ve said. All this promotes trust and understanding.

• Culture. Everyone has a unique mix of experiences and backgrounds that influences how they feel about pain, fears, injury and disability. Consider tailoring your approach and communication to meet the individual needs of your patients.

• explain your treatment plan and goals. This gets you on the same page. Outline the expected timeframe and frequency of treatment and plans for reassessment. Most patients are more compliant to your treatment plans if they understand what goals they are working towards. This may seem obvious, but sometime we forget to communicate our “plans” and this can lead to non-compliance and misunderstanding.

• An ongoing dialogue is imperative. Revisit your common goals and expectations continually as a patient’s perspective and state of mind may change over time.

• Follow up with your patient. Inform your patient of your open policy for them to communicate with you if they have problems or concerns after they leave your office. If a patient does not

return when expected, consider a follow-up communication (according to your company policy) to ensure that they are doing well or if they need further assistance.

Simple gestures, such as walking a new client back up to reception after their visit, is an easy way to “close” your session and build trust. This tip can be especially helpful if you work in a large, busy clinic. Many clients may never have attended physiotherapy before and can find their initial assessment overwhelming, not to mention the fact that they are usually also in pain.

Overall, effective communication can support better history-taking, increase patients’ adherence, influence patients to adopt positive/preventative behaviours, improve self-management of conditions and increase patient satisfaction. Being conscious of simple verbal and non-verbal tips and adapting them into your practice will definitely have a positive impact on your practice.

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Promoting the Value of Physiotherapy for everyone

stRategiC COmmuniCatiOns uPDate

Emira Mears, BA Director of Strategic Communications

I had the distinct pleasure of interviewing Simon Whitfield for this issue’s cover story, an opportunity brought about by his upcoming keynote talk at CPA Congress. Simon was incredibly generous with his time and words of wisdom, and with his praise of physiotherapy, which he credits as a tool that helped to keep him in elite condition and injury-free. Many points from our conversation have stuck with me, but one in particular—making physical activity accessible to everyone —stands out. He spoke at length about wanting more people to understand that you only get this one body for your journey through life; this creates the responsibility to ensure you take care of it every chance you get. Of course as an elite athlete, he has had to get to know and listen to his body at a level few of us will ever achieve, but what struck me most was his deeply-held belief that an active lifestyle—whatever that means to each individual—is something we should all strive for. I could not agree more, and continue to be inspired by the work that the profession of physiotherapy does to help improve every patient’s access to a more active and healthy life, regardless of whether that means supporting elite levels of fitness, or small steps that have great meaning in the lives of each patient. I’m inspired by the work you all do for patients across the spectrum. With that in mind, here are some of the highlights for how PABC is promoting the value of physiotherapy for all British Columbians this season:

national Physiotherapy monthThis year for National Physiotherapy Month we, like other branches, have partnered with CPA to get access to their promotional materials to put up in our clinics and worksites. You should already have received an email to get access to the posters and other print materials, but if not please contact the CPA office. This year’s NPM theme is healthy aging, which builds on the Seniors’ Strategy/Position

Paper from CPA, the theme for Congress 2016, the quality PT initiative, and also the Canadian Medical Association’s call for a National Seniors’ Strategy. In addition to the materials coming from CPA, we will be broadcasting our own messaging to raise awareness about physiotherapy, help to drive people to find a physio in their region, and stay active during the month of May.

Watch for new Website summer of �01�It is time for a tune up on the technical end of the PABC website (www.bcphysio.org) and so we are using that catalyst to make some improvements to how both members and the general public access our information. While the current site does a good job of speaking to members, there’s a gap in content for the general public or others who might be interested in knowing more about physiotherapy. In addition, we want to make sure we’re capturing those people in the province who go online looking for general health information to give them reliable information on everything from chronic back pain to tips for maintaining an active lifestyle at every stage of life. The new website will have expanded content for this broader audience, and will be tied to outreach strategies that will help drive the public to the site to get evidence-supported health information and to help with finding a physio in their region.

For members, the new site will also make finding our resources in the library more accessible. The site will continue to provide in-demand tools like course listings, the job board and classifieds with improvements to make use of those tools even more user-friendly.

Physio in the news and On the airIf you listen to TSN Radio at all—particularly during the Canucks games —you will probably have heard our PABC

ads which position a physio, Timberly George, in conversation with well-known host Scott Rintoul tackling topics like chronic back pain, staying safe during ski season, how a physio can help keep you injury free during running season and other accessible topics. All of these ads drive traffic to the Find a Physio tool, and we’ve had good traffic and great feedback from people hearing the ads and shifting their thinking about the role physiotherapy can play beyond acute injury rehabilitation. We also have our sights set on getting into some print publications (newspapers and magazines) to address health topics that physiotherapy can support while continuing to position physiotherapists as experts for the treatment of many common injuries and conditions. Keep your eye out for more physiotherapy talk in print, on radio and online as we continue to share the value of physiotherapy with British Columbians and direct them to find a physiotherapist in their community.

Finally, I would like to thank members who send on their ideas and thoughts for how we should be talking about physiotherapy and where we should be focusing. I’m always open to new ideas, so please email me any time with your thoughts. communications@bcphysio.org

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LiBRaRY anD inFORmatiOn teChnOLOgY uPDate

Choosing Wisely to stay ahead of the Curve

Fiona Chiu, MLIS, BA Clinical Librarian and Member Services Manager

As physiotherapists, you take an evidence-informed approach in your clinical decision making—especially when it comes to tests, treatments, and procedures that are open to discussion. To help you stay ahead of the curve in your field, we work closely with our Physical Therapy Knowledge Broker (PT KB) to help members adopt research into practice. A primary way in which we do this is by developing timely toolkits, guides, and webinars.

In a recent health initiative by Choosing Wisely Australia1 in which the Australian Physiotherapy Association took part, a list of six recommendations was developed based on the best available evidence of physiotherapy interventions that clinicians and patients should question. These recommendations are addressed through our PT KB resources and librarian services available to you through the PABC Library:1. Don’t request imaging of the

cervical spine in trauma patients, unless indicated by a validated decision rule.

What we did – The C-Spine Rule Project: http://bit.ly/cspinerule

2. Don’t routinely use incentive spirometry after upper abdominal and cardiac surgery.

What we did – The Incentive Spirometry resource: http://bit.ly/incentivespirometry

1 Choosing Wisely is led by Australia’s medical colleges and societies, and facili-tated by NPS MedicineWise. The Austral-ian Physiotherapy Association (APA) is the only allied health profession amongst twelve medical colleges and societies taking part in Choosing Wisely. Together, they have developed a list of six recom-mendations based on the best available evidence of interventions that clinicians and consumers should question.

3. avoid using electrotherapy modalities in the management of patients with low back pain.

What we did – Electrophysical Agents Resources: http://bit.ly/electrophysical

4. Don’t provide ongoing manual therapy for patients with adhesive capsulitis of the shoulder.

What we did – The Frozen Shoulder webinar: http://bit.ly/frozenshoulderwebinar

5. Don’t request imaging for patients with non-specific low back pain and no indicators of a serious cause for low back pain.

Contact your PABC Librarian to work with you on a customized literature search to see the latest research on low back pain http://bit.ly/pabclibrarian. You can also refer to the evidence from a list of citations compiled by Choosing Wisely:http://bit.ly/choosingwiselyPT.

6. Don’t request imaging for acute ankle trauma unless indicated by the Ottawa ankle Rules. (localized bone tenderness or inability to weight-bear as defined in the Rules)

Visit the Ottawa Hospital Research Institute website for a copy of the Ottawa Ankle Rules for Ankle Injury Radiography poster: http://bit.ly/ottawaankle. Contact your PABC Librarian to work with you on a customized literature search to see the latest research on acute ankle trauma http://bit.ly/pabclibrarian. You can also refer to the evidence from a list of citations compiled by Choosing Wisely: http://bit.ly/choosingwiselyPT.

Have you been choosing wisely to stay ahead of the curve? Stop by the PABC Library to find the clinical toolkits, webinar recordings, databases, and services we

offer to help you continue in exercising your evidence-informed decision making: http://bit.ly/PABClibrary. For more information about the Choosing Wisely Campaign, visit: http://bit.ly/choosingwiselyPT

Questions? Please feel free to contact me at http://bit.ly/pabclibrarian.

Free upcoming PaBC Webinars

PaBC Knowledge team Webinar series – tech talks Tuesday, May 17, 2016 at 7:30 pm

Learn about video gaming technology specifically for rehab, what gaming apps that can facilitate your physio practice, and whether or not active video games can provide enough intensity for fitness benefits.Register: http://bit.ly/WebinarTechTalks

how do we get evidence info clinical practice? Tuesday, May 24, 2016 at 6:30 pm

This event is held by the BC Neurosciences Division in partnership with PABC.

Dr. Louise Connell, a senior research fellow at the University of Central Lancaster (UK) who conducts her research in implementation science, will be the guest speaker. Her lecture will focus on the implementation of evidence-based programs into clinical practice, for example the GRASP (graded repetitive arm supplementary program) in stroke rehabilitation.

Register: http://bit.ly/webinarBCNSD

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auditor’s Report for �01�

Physiotherapy association of British Columbia (a branch of CPa)YeaR enD FinanCiaL statements as at DeCemBeR �1, �01�

to PaBC members:This condensed financial report has been extracted from the audited financial statement for the year ending December 31, 2015 as reported by our auditors RHN Chartered Professional Accountants. Full financial statements for 2015 are posted on the PABC Members Only Site at www.bcphysio.org.

STATEMENT OF FINANCIAL POSITION AS AT DECEMBER 31, 2015

2015 2014 ASSETS

Cash $ 51,946 $ 28,257Temporary investments (Note 3) 992,857 1,024,603Accounts receivable (Note 4) 84,602 61,211Prepaid expenses 15,911 9,208Inter-fund receivable 236,625 272,006

1,381,941 1,395,285TANGIBLE CAPITAL ASSETS (Note 5) 3,283 720 $1,385,224 $1,396,005

LIABILITIESAccounts payable and accrued liabilities (Note 6) $ 46,699 $ 50,723 Inter-fund payable 236,625 272,006 Deferred revenue 296,273 288,879

579,597 611,608 FUND BALANCES

Unrestricted 565,719 511,671Invested in tangible capital assets 3,283 720Internally restricted 236,625 272,006

805,627 784,397 $1,385,224 $1,396,005

STATEMENT OF OPERATIONS FOR THE YEAR ENDED DECEMBER 31, 2015

2015 2014 REVENUE Extraordinary $ 7,239 $ 10,024 Website 24,955 28,222 Interest 8,512 10,616 Newsletter 10,240 10,588 Practice forum 19,201 19,065

Professional development 66,951 72,336

Provincial fees 596,751 582,050

733,849 732,901

EXPENDITURES AGM 24,798 19,730 Amortization 707 308 Awards 500 706 Bad debts - 499 Board and executive 17,502 22,953 Committees 27,476 29,202 Communications 123,465 77,596 Computer systems 34,512 5,791

Congress and conferences 11,662 7,260

Regional allotments 3,000 - Government relations - 571

Newsletter 20,618 18,584 Office 32,832 32,473

President's and officer's 10,276 7,787 Professional development 38,442 43,146

Professional fees 39,605 65,565 Salaries and benefits 272,936 236,094 Staff development 3,517 1,695 Staff expenses 4,191 3,519

Strategicdevelopment 4,393 2,705

Student support 5,181 3,171 Prior year operating surplus 37,006 48,944

712,619 628,299

EXCESS (DEFICIT) OF REVENUE OVER EXPENDITURES $ 21,230 $ 104,602

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PaBC awards of excellence �01�Each year, PABC members nominate their peers for Awards of Excellence, which are then handed out at the Physiotherapy Practice Forum on April 23rd. This year a new category, the Physiotherapy Champion Award, was created by the awards committee in order to establish a means of recognizing champions for our profession who are not themselves a physiotherapist. For 2016, PABC’s Awards Committee has selected the following recipients from among the nominations:

LiFetime aCCOmPLishment aWaRD:This award recognizes physiotherapists who have made ongoing contributions to the physiotherapy profession throughout their career (for a period of at least 25 years).

Clyde smithClyde Smith has touched so many people throughout his exemplary career as a physiotherapist. His roles as a mentor, teacher, advocate and clinician have set standards for excellence in our profession from which we can all benefit. His passion to share his expertise is evidenced by the many years he has spent mentoring new graduates, a contribution that has shaped so many young physiotherapists careers. Among his many accomplishments, Clyde helped establish the Sport Physiotherapy framework in our industry and his influence on patient care and how our profession treats patients both in and outside of the clinic has been transformative for rehabilitation, injury assessment and setting guidelines for activity modification. Throughout his career Clyde remained involved in all levels of patient care: everyday patients, athletes and on-field teams. His skills as a clinician and physiotherapy coach were honed by his Olympics, Commonwealth Games, and professional sports positions. A physiotherapist must excel beyond clinical expertise to achieve the recognition Clyde has garnered; his teamwork, quiet persuasion, and firm belief in and advocacy for his profession has propelled a career that is admired by all.

PhYsiOtheRaPY ChamPiOn:The Physiotherapy Champion Award is a new award category that has been developed in 2016 to recognize the extraordinary contribution of a non-physiotherapist to advancing our profession.

Rebecca B tunnacliffeRebecca B Tunnacliffe led the Physiotherapy Association for 15 years as it’s CEO, and during that time her passion for physiotherapy and our members was unparalleled. She has been a tireless advocate on our behalf, and her enthusiasm ignited physiotherapists in BC to strengthen our profession both provincially and nationally, as shown by near doubling of association membership during her tenure. Dedicated to both public and private practice, students, new graduates, retired and practicing physiotherapists, Rebecca worked tirelessly to support all members in advancing their practice, raising the profile of our profession and advocating on our behalf to critical stakeholders.

PaBC BursariesPABC has two educational bursaries that are awarded annually. These $1000 awards are in memory of members we have lost; PABC members apply for the bursaries. The Awards Committee has chosen Kim Hall to receive the Peter Huijbregts Memorial Bursary, and Sam Hughes to receive the Ruth Byman Memorial Bursary.

For more information on the awards and bursaries, and how to nominate or apply, see the Members Only site at www.bcphysio.org/content/awards-bursaries.

Clyde and Rebecca were presented with their awards of excellence at the Physiotherapy Forum on april ��rd.

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PaBC Professional Development �01�/�01�

�01�/�01� Weekend Coursesessential manual therapy techniques for Cervical spine DysfunctionOctober �� – ��, �01� with Robert PowlsUBC Friedman Building, Vancouver

mobilisation of the myofascial system – Lower Quadrant november 11 – 1�, �01�, with Doreen Killens and BetsyAnn BaronUBC Friedman Building, Vancouver

mobilisation of the myofascial system – upper Quadrant, (prerequisite – Lower Quadrant Course)april �8 – �0, �01�, with Doreen Killens and BetsyAnn BaronUBC Friedman Building, Vancouver

To register for the above courses, follow these three easy steps:1. Go to www.bcphysio.org and click Courses2. In Type box, choose PABC Education3. Under the Event column, click the course title you want

To browse and purchase PABC Archived Vodcasts (video recordings of past PABC evening lectures):

1. Go to www.bcphysio.org and click Courses2. Select Vodcasts for Purchase from the left navigation bar3. Under the Event column, click the vodcast title you want

For more information, call PABC at 604-736-5130 or email education@bcphysio.org

I would like to take this opportunity to introduce myself as the incoming PABC Education Manager. I have slowly been transitioning into this position with the outstanding guidance of the ever-capable, exceptional multi-tasker Andrea Reid. Andrea has held the PABC Education Manager position for the last eight years and has cultivated outstanding professional development in many shapes and forms for the benefit of PABC members. She has dedicated much of her time and expertise to providing us with quality education opportunities and to paving the way for the future of PABC Education. I would like to express my appreciation for all that she has done for our members and wish her all the best in her future endeavors.

I am very excited to take on this leadership role with great enthusiasm and creative thinking. PABC has already hosted four amazing courses in 2016. These included:• Mobilization of the Myofascial

System – Lower Quadrant with Doreen Killens and BetsyAnn Baron

• Hypopressives/Low Pressure Fitness for Pelvic Floor Health with Trista Zinn and Tamara Rial

• The Mulligan Concept – Mobilizations with Movement, NAGS, SNAGS and other Kiwi Tricks (Upper Quadrant) with Jack Miller

• Manual Therapy Treatment for Lumbar Spine and Pelvis Dysfunction with Bob Powls

I highly recommend all these courses. In the fall of 2016, Bob Powls will join us again for Essential Manual Therapy Techniques for Cervical Spine

Sheana Lehigh, Registered Physiotherapist, BScPT, FCAMPT, CGIMS, PABC Education Manager

Dysfunction (Oct 22/23, 2016), and we will be bringing Doreen and BetsyAnn back to do another Mobilization of the Myofascial System – Lower Quadrant (November 11-13, 2016) as this course was so well-received and is a pre-requisite for the Upper Quadrant course.

Please stay tuned to the PABC-hosted course webpage (www.bcphysio.org/courses) to see what is in store for 2017. Also, please remember that you can always learn from the greats, anyone from Rick Celebrini to Diane Lee, from the comfort of your own home by purchasing any of our many Vodcasts (www.bcphysio.org/archived-vodcasts).

Speaking of quality information at our fingertips, how many people have accessed a wonderful resource called Physiopedia Plus (Physiopedia+) through your CPA membership? This is an amazing resource that is available

to CPA members FREE of charge. All you have to do is log into your CPA Member Centre, click on Physiopedia Plus under Practice Resources and sign in under Access Physiopedia+ Now. It provides you with exclusive access to a number of resources such as videos of patient examinations and clinical techniques, audio interviews with international experts, self-study courses, clinical practice guidelines and much more. I am so impressed by the clinical applicability and breadth of information on this site. It is very user-friendly and I feel that it is probably very under-utilized. I hope that this sparks an urge in you to check it out.

Lastly, if you would like to attend very worthwhile professional development opportunities, please sign up for the Practice Forum April 23, 2016. Happy springtime!

Sheana Lehigh is the owner of Sheana Physiotherapy in White Rock, BC

eDuCatiOn uPDate

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Kadi nicholson gave the keynote speech at the BC Arthritis Society’s 10th Annual Gala in February of this year. Kadi is advocate for arthritis awareness and is passionate about helping people with chronic illnesses overcome barriers to enjoy a physically active life.

The BC Arthritis Society was thrilled to have Kadi give the keynote address at their event and noted that the audience was captivated by her story. The gala helped raise over $65,000 for the Society.

L-R: Cheryl Leia (left background), Joan Johnston, and Patricia Grohne

members say Farewell to RebeccaMembers gathered at Brock House in Vancouver at the end of January to fete our former CEO Rebecca B Tunnacliffe. We had a fabulous turnout of both new and long time members who were keen to thank Rebecca for her years of dedication to the association. Hosted by Board Member, Chiara Singh, it was a heartfelt evening of speeches, hugs

and shared memories as the membership gathered to thank Rebecca and recognize all she has done for our profession over the past 15 years. Rebecca in turn gave her own speech recognizing the changes she has seen in our profession over those years and the highlights for her in her time at the helm of the association. We wish Rebecca all the best in her new role and know that the impacts she had on PABC will have positive ripples for many years to come.

PaBC’s WorksafeBC Liaison updateby Jeremy McAllister, BScPT, MHA

I occasionally hear colleagues say the treatment of injured workers can present values challenges not found in other areas of physiotherapy practice—particularly when it comes to determining when a worker can return to work. But is the practice of physiotherapy with the focus on the patient’s health really at odds with the interests of insurers like WSBC or ICBC in controlling the costs of worker rehabilitation through safe and effective return to work processes?

Health is often looked at from the view of ‘social determinants’, or the variety of personal, economic, or social factors that

influence health status. Unemployment as one of these factors has been studied extensively and it is now universally accepted that unemployment does indeed have significant negative effects on health.

As physiotherapists we need to remember that, in doing our part to reduce the duration of unemployment due to injury, even within the framework and pressures of an insurance system, it is very likely that we are contributing to an individual’s longevity and long-term life quality by helping them return to work. Durable return to work serves both compensation system efficiency and injured worker health.

It would be naive not to acknowledge there are times when the interests of the insurer are not precisely aligned with

what is best for the patient, or that there are not times when insurers push too hard for the sake of their bottom line. We stay true to our values through our commitment to conducting thorough and accurate assessments of functional ability and communicating that information clearly and concisely to employers and case managers.

Because of the critical importance of getting that communication link right, PABC has been working with WSBC on an information booklet for physios and case managers to assist in the process. Watch for it.

Jeremy McAllister is a registered physiotherapist who has volunteered as PABC’s WSBC liaison.

PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA 18

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Come for the job. Stay for the team.

Photo: VCH Employees, Early SupportedDischarge & Community Integration.

Vancouver Coastal Health (VCH) is dedicated to the professional development of our Physiotherapists. Our physiotherapy team has both site leaders and dedicated fulltime clinical resource therapists who will provide mentorship, regular education, and one on one supportto help you achieve your professional goals. We encourage and support staff to expand their skills by being involved in research, teaching, and leadership development. With excellent benefits, fantastic location, and a supportive team – VCH is considered a leaderin healthcare.

To find out more and to apply, visit:

careers.vch.ca

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Directions in Physiotherapy

Directions is published three times a year: Winter, Spring and Autumn.

Articles on members’ clinical practice are welcome. The editor retains the right to determine content. Unless specifically indicated, statements do not reflect the views or policies of PABC. Services or goods advertised are not endorsed by PABC.

Published by:PABC, 402-1755 West Broadway Vancouver, BC V6J 4S5 P: (604) 736-5130, E: info@bcphysio.org Website: www.bcphysio.org

Production: Heather MacNeil

For Advertising rates, please contact the office at: office@bcphysio.org.

Board of Directors

�01�-�01�

Jason Coolen: President

Aart van Gorkum: Vice President, Greater Vancouver/Sunshine Coast Director, Private Practice Liaison

Chiara Singh: Greater Vancouver/Sunshine Coast Director, Public Practice Liaison

Joanna Sleik: Kootenay Director

Jen Bay: Fraser Valley Director, Finance Chair

Janet Lundie: South Fraser Director

Kevin Bos: Okanagan Director

Patrick Jadan: Vancouver Island Director

Jenny Hogan: Northern Director, Rural & Remote Practice Liaison

Diane Rizzardo: MPT2 Student Director

Stanley Hung: MPT1 Student Director

Bill Mackie, MD: External Director

Kevin Evans: PABC CEO

Changes in the Board and CommitteesPABC greatly values the contribution of all board and committee members who give their time, energy, and professionalism to support the goals of the association. We wish to recognize the contributions of the following members, both incoming and outgoing, for their dedication to the organization.

Board: The Board wishes to recognize the dedication and contribution of Craig sully as the Kootenay Director and Rural & Remote Practice Liaison. We are delighted to welcome Joanna sleik to the Kootenay Director. Jenny hogan, our Northern Director, is taking on the role of Rural & Remote Practice Liaison.

The Board has nominated Patrick Jadan, Vancouver Island Director, as the incoming President Elect.

Business Affairs Committee: Ramsey ezzat is the new Chair of the Business Affairs Committee.

Rural & Remote Committee: Bryce Kelly is the new Chair of the Rural and Remote Committee.

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David Wallin: 604.891.7211

Dan Shugarman: 604.891.7243

Gaynor Yeung: 604.891.7204

Jean-Marc HŽbert 604.891.7204

Sanjeeta Johal 604.891.7234

Claire Haaf 604.891.7291

Outside theLower Mainland:

1.866.982.9898