Australian Sports Physiotherapy Seminar - Kandy, Sri Lanka

Elite Akademy Global Series
Sports Physiotherapy
Seminar
Kandy, Sri Lanka
Kusal Goonewardena
(MaSpPhysio, GradCertSpPhysio, BaPhysio)
Head of Sports Medicine and
Elite Athlete (APA) Sports Physiotherapist
University of Melbourne

15yearCareer
Founder/Directorof 3 SportsMedicineClinics
Australia

Over50,000 Treatment Sessionsin Sports
Injuries& Performance

MelbUniSportsPhysiosince2002
HeadofSportsMedicineatMelbUnisince2008

Lecturer, Consultant
Australia, China, Singapore, Sri Lanka

What makes a Good Sports
Practitioner
Definition 1
“Best Results in the Shortest Period of Time”
Make a Difference, or you make a Plan.
Make a Difference in 3 Sessions or Less.

Practitioner
Definition 2
“Australian Physiotherapy Council Requirements”
Safety ✔
Effective Treatment ✔
Exercises ✔
I want to go back ✔

Practitioner
Definition 3
Apply “THE 5 ELEMENTS” Each and Every Time
1. SUBJECTIVE
2. OBJECTIVE
3. ANALYSIS
4. TREATMENT
5. EDUCATION

Practitioner
Definition 4
“Exceptional Athlete Care (Customer Service)” – John Spence
1. Show up on time
2. Do what you say you will do
3. Finish what you start
4. Say “Please” and “Thank You”
5. Give a little more than expected
6. Smile
7. Make good eye contact
8. Be enthusiastic
9. Dress for success
10. Keep professional

Practitioner
Definition 5 -“Apply the Four Essentials”
– Brendon Burchard
COMPETENCE CONFIDENCE PD COMMITMENT

Which Definition Should I
Follow?
Choose the one that
Comes naturally.
Feels right inside.
Has worked for you through experience.

The Three C’s to be a
Successful Sports Practitioner
Sports
Practitioner
Success
Clinical Skills
Communication
Clinical
Reasoning

1. What makes for good Clinical Skills?
2. How do I improve my Clinical Skills?
3. How do I keep improving my Clinical
Skills and what should I keep in mind?
Clinical Skills |Communication|ClinicalReasoning

Excellent Handling Skills
Getting Objective information with your tests and manual
handling
Inter-tester, Intra-tester
1. What makes for good Clinical
Skills?

Eyes Closed - Palpation
Eyes Closed - Manual Handling
“If my pressure is a 10/10…how much was my senior/junior?”
“Am I on the same spot?”
Practice makes Perfect – Inter-tester, Intra-tester
2. How do I Improve my Clinical Skills

Get assessed by a Senior Practitioner every Month
Ask Senior Practitioners how to Improve
Practice Practical Skills every Week (small tests, quick
movements), every month Month (Masterclasses/Prac Sessions)
Video/ Self Analyse/Get FEEDBACK from your athlete
3. How do I keep improving my
Clinical Skills and what should I keep
in mind?

ClinicalSkills| Communication |ClinicalReasoning
1. What makes for good
Communication?
2. How do I improve my
Communication Skills?
Communication Skills and what should
I keep in mind?

The Essentials in the Subjective
Non verbal communication
Body Language
Empathy vs Sympathy
Active Listening
1. What makes for good
Communication?

Role Plays (3 is the perfect number)
Push yourself outside your comfort zone
Body Language - Open, Confident
Be in Control, In your mind first
2. How do I improve my
Communication Skills?

Video Analysis
Its not about you. Its about helping someone else.
The best communicators are listeners first
Practice, Practice, Practice
Communication Skills and what
should I keep in mind?

1. What is good Clinical Reasoning?
2. How do I improve my Clinical
Reasoning?
3. How do I keep improving my Clinical
Reasoning Skills and what should I
keep in mind?
ClinicalSkills| Communication|Clinical Reasoning

Great Results in the Shortest Period of Time
Symptom Improvement: 1. Intensity 2. Duration 3. Frequency 4.
Time taken to recover post aggravation.
Mastering 3rd Element in Physio – (Sx, Ox, Analysis, Rx, Educ)
Prioritizing Problem List
Being a Scientist first
1. What is good Clinical Reasoning?

Being Objective
Create a System, Stick to a plan and Procedure
Measure what you want changed/ improvement in
2. How do I improve my Clinical
Reasoning?

Keep asking yourself – What else is possible to get the best
results in the shortest period of time? (Ethical and Safe)
What can I learn from the systems used by other professionals/
industries?
Clinical Reasoning Skills and what
should I keep in mind?

Sports
Practitioner
Success
Clinical
Skills
Communication
Clinical
Reasoning

The Ridgway Method
Originated in Australia
95% Success Rate in Musculoskeletal Injuries in 2-12 Days
The Elite Akademy Performance Pyramid™
Developed over 2 years
Originated at Elite Akademy - University of Melbourne

1.What is it?
2. Where did it
originate?
3. How does it
work?
4. Why is it
different?
5. What are the
steps to learn?
6. What are the key
areas to
concentrate on?
7. What should I do
first and continue
to keep in mind?
ClinicalSkills| Communication| Clinical Reasoning
The Ridgway Method

The Ridgway Method
Founded by Sports and Manipulative Physiotherapist – Michael
Ridgway, Brisbane Australia
14th Clinical Reasoning Process in Australia
Fastest growing and very popular process to find the cause of
the problem
Very thorough, systematic, step-by-step process
1.What is it?

The Ridgway Method
Brisbane, Australia
Michael Ridgway – is a practitioner, researcher, lecturer and
inventor
www.ridgwaymethod.com
2. Where did it
originate?

The Ridgway Method
Helps practitioners find the underlying cause of the problem
“Diagnosing a problem is a good start, however finding the
underlying cause that led to the diagnosis is the secret to a rapid
and long lasting recovery!” – Ridgway Method International
2. Where did it
originate?
3. How does it
work?

The Ridgway Method
Results based
Holistic
“The fastest and most complete way to solve your condition is
to immediately change and fix all the significant factors.”
- Ridgway Institute International
2. Where did it
originate?
4. Why is it
different?

The Ridgway Method
2. Where did it
originate?
5. What are the
steps to learn?

The Ridgway Method
2. Where did it
originate?
6. What are the
key areas to
concentrate on?
Neural Dynamic Testing
Collecting ‘#’ Signs (Objective Signs)
Combine:
(Treatment + Functional Test) = Treatment Directional Test ‘TDT’

The Ridgway Method
2. Where did it
originate?
Collect ALL # Signs during the Objective Ax
Be Objective (Measure Everything) – eg. PSFS
Assess Function DURING Treament
7. What should I do
first and continue
to keep in mind?

The Ridgway Method
Questions and Answers…

The Ridgway Method
2. Where did it
originate?
Practical Session – Demonstration
Any Athletes, Volunteers from the Audience to be our
first for the day?

The Ridgway Method
2. Where did it
originate?

Understanding Pain
OLD
Pain is a Feeling
New
Pain created by
Brain
- As a warning
- Neuroscience and
physiotherapy
research - pain is not a
feeling.

The Warning Signal
*
... The Car
*Painful Yarns - Metaphors & Stories to help understand
the biology of pain. By - Lorimer Mosely

How do we Fix the Engine??
What if we checked everything in the engine...?
Ie. Find the CAUSE of the
Dysfunction = Reason for the
brain creating pain
Or
Remove the Light??
Ie. Treating the SYMPTOMS

The Results
0
1
2
3
4
5
6
7
8
9
10
Session1
Session2
Session3
Session4
Session5
Session6
Session7
Session8
Traditional
Old
0
1
2
3
4
5
6
7
8
9
10
Ridgway Method
New

Understanding Pain
OLD
Pain is a Feeling
Treat the Symptoms
The Ridgway Method
Pain created by Brain
-As a warning
Find the CAUSE of the
Dysfunction = Reason
for the brain creating
pain

Number of Sessions for Full
Healing
0
1
2
3
4
5
6
7
8
9
10
Old
New

The Ridgway Method
2. Where did it
originate?
Notes:
Neural Sensitivity can be the cause of 75% problems
going unsolved

The Ridgway Method
2. Where did it
originate?
Notes:
If it’s NOT neural – It’s Somatic
ie. Objectively look at Muscle, Joints and Ligament
Where 75% of Problems Come From

The Ridgway Method
2. Where did it
originate?
Notes:
Combine- (Treatment + Functional Test) = Treatment
Directional Test ‘TDT’

The Ridgway Method
2. Where did it
originate?
Notes:
Treatment will Include: MRWM, MWM, MAWM, BCWM

The Ridgway Method
2. Where did it
originate?

1.What is it?
2. Where did it
originate?
3. How does it
work?
4. Why is it
different?
5. What are the
steps to learn?
6. What are the key
areas to
concentrate on?
7. What should I do
first and continue
to keep in mind?
Elite Akademy Performance Pyramid™

Outlines all the fundamentals required for success with
musculoskeletal injuries in sport
Answers the Question, “What will you do to help me?” and “How will
you help me?”
Process for comprehensive treatment and rehabilitation
Improves objectivity, increases understanding (increase compliance)
Increases awareness of what you do as a practitioner
1.What is it?

1.What is it?
S&C
FUNCTIONAL
CORE
FUNCTIONAL CONTROL
FUNCTIONAL RANGE
BIOMECHANICS

Originated in 2014 at Elite Akademy Sports Physiotherapy-
University of Melbourne
Founded by Kusal Goonewardena and his sports medicine
team’s pursuit of
‘Making a Difference in 3 Sessions or Less’
2. Where did it
originate?

3. How does it
work?
Each needs to
improve by 85%
for best outcome
S&C
4.0
F-CORE
12.0
F-CONTROL
20.0
F-RANGE
28.0
BIOMECHANICS
36.0

3. How does it
work?
Any Pyramid is as strong as its base
Keep working from the bottom up to complete the Pyramid
Start on 1. Biomechanics then 2. Functional Range 3. Functional
Core 4. Functional Core and finally 5. Strength and Conditioning

EACH step of the process is measured
Same process is applicable for ANY athlete in - Rehabilitation,
Prehabilitation, Performance Enhancement and Screening
Communication ‘Currency’ between players, coaches and other
practitioners is the SAME
4. Why is it
different?

Identifying When to Climb the Pyramid
Identifying When to Refer on
(All covered in Clinical Demonstration…next)
5. What are the
steps to learn?

5. What are the
steps to learn?
The 5
Fundamentals
Step by Step
The Weighting
Score on each
S&C
4.0
F-CORE
12.0
F-CONTROL
20.0
F-RANGE
28.0
BIOMECHANICS
36.0

1. Tests to Measure and Improve Biomechanics (Ridgway Method)
2. Tests to Measure and Improve Functional Range and Control
(Ridgway Method)
1. Tests to Measure and Improve Functional Core (Clinical Pilates)
2. Tests to Measure and Improve Strength and Conditioning
(Numerous!)
6. What are the
key areas to
concentrate on?

1. Master how to measure and Improve Biomechanics – The
Base of the Performance Pyramid
1. Communicate the Performance Pyramid to Coaches,
Athletes, Athlete’s Parents, Other Practitioners
2. Refer back to the Performance Pyramid when identifying
‘How Your Athlete Is Going?’
7. What should I do
first and continue
to keep in mind?

1.hat is it?

1.hat is it?
Any Athletes, Volunteers from the Audience to be our
second for the day?

Application of the Ridgway Method for best results
Objectively measure:
Neural Dynamics
Muscle ( Tight and Weak)
Joint (Stiff and Lax)
Behavioural
BIOMECHANICS
36.0

Objectively measure and Use of Technology here
Show Your Athlete their Deficits and Areas of Improvement
FUNCTIONAL RANGE
28.0

Objectively look at the quality of movement
FUNCTIONAL CONTROL
20.0

Used at Elite Akademy Sports Physio – Uni of Melbourne:
Clinical Pilates
Use current tests in individual sports or create tests for core
assessment
FUNCTIONAL CORE
12.0

Individual Programs (Strength vs Endurance vs. Sports Specific)
Personal trainers, Gym Instructors
Strength &
Conditioning
4.0

1.hat is it?

1.hat is it?
Application and
Understanding it Further

ClinicalSkills|Communication|Clinical Reasoning
Elite AkademyPerformancePyramid™
FUNDAMENTAL %
YOUR PERFORMANCE
SCORE
NORMAL VALUES
Biomechanics
[36.0]
3.4 - 3.8
Functional
Range [28.0]
10.2 - 11.4
Functional
Control [20.0]
17.0 - 19.0
Functional
Core [12.0]
23.8 - 26.6
Strength &
Conditioning
[4.0]
30.6 - 34.2
Your Peak
Performance score:
_____________
Peak Performance
85.0 - 95.0

Loading Tolerance
When your Peak Performance Score is >85.00 your Loading
(intensity of training, competing) matches your Tolerance. Result
is no pain, no symptoms. The body is a well oiled machine.

Loading Tolerance
7-14 DAYS
20%
Once your Peak Performance Score is >85.00 you can
increase your Loading (training, intensity) by 20% over a
period of 7-14 days, and your body will be able to Tolerate
it. For elite athletes, you can increase your Loading by
~30% over a period of 5-10 days.
(I.e. you tolerate things faster).

Loading Tolerance
>20%
PAIN/SYMPTOMS
If you increase your Loading by >20% the body finds it
difficult to Tolerate this amount of change. When your
body's Tolerance does not match the Loading then
pain/symptoms are the result.

Our Mission
1. Help Practitioners Achieve their Best
2. To help Athletes Achieve the Best Results, in the Shortest
Period of Time.
We love What We Do and We love Sport. (And So Do I!)
Here’s Wishing You A Career and a Lifetime of Success!
Final Thoughts

If you have any questions at all please do not hesitate to send a note or
call our clinic +613 8344 4948
My email address is: kusal@eliteakademy.com
My twitter address is @kusalkumar
The Elite Akademy twitter address is @EliteAkademy
We share practitioner and athletes success stories and advice on our
Facebook site www.facebook.com/EliteAkademy
Lastly these slides have been uploaded to
www.slideshare.net/KusalGoonewardena
Here’s Wishing You A Career and a Lifetime of Success!
Thank You

Australian Sports Physiotherapy Seminar - Kandy, Sri Lanka

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Australian Sports Physiotherapy Seminar - Kandy, Sri Lanka