Academy physiotherapist, Jacqueline Hamilton, works alongside head of academy sports science and medicine, and sport rehabilitator, David Hartley. They provide a multidisciplinary approach to rehabilitation at a St. Mirren Football club near Glasgow.
Jacqueline Hamilton, physiotherapist
Our collaborative approach, and common language, mean we can involve the wider coaching team in the rehabilitation process. We all bring different views to provide a safer and more effective return-to-play process. In a multi-professional team, understanding our own scope of practice together with the knowledge, skills and attributes of other professions is critical.
'Historically, different professions worked in silo and lacked collaboration', says David Hartley. 'The expansion of our team to include a sports scientist, strength and conditioning coach and sport rehabilitator working with our four physiotherapists, meant the way to provide seamless rehabilitation was to reduce barriers and collaborate'.
The academy uses a criteria-based approach to rehabilitation. All team members are familiar with this, and their role within it, to ensure consistent messaging. 'Clear lines of communication between professionals, a clear rehabilitation progression process with key milestones have been essential to success' says Jacqueline.
Physiotherapists lead on assessment from the initial injury, and screening for red flags utilising their broad knowledge of musculoskeletal, neurological, respiratory and circulatory systems. Combined assessments with the sport rehabilitator mean a rehabilitation plan can be formulated quickly. Indications for referral for investigations or specialist opinion are discussed as a team and actioned by the head of academy.
David Hartley, sport rehabilitator
Our physiotherapists are the experts in dealing with multiple issues and spotting serious conditions.
David continues, 'My main role is to coordinate the process of injury management and return to high-level sport. The strength and conditioning coach will focus on end-stage rehab and re-integration into training. The rehab team liaises closely throughout all phases of rehabilitation and we have regular joint clinical discussions so players get the best of our combined knowledge and skills.
Their multi-professional CPD programme, where each professional commits to leading a training session, embeds this collaborative approach. The team also provides school pupils with physiotherapy work experience opportunities and offers practice placements for strength and conditioning and sports science students from the University of Glasgow.'
Ben* sustained an ankle injury in a tackle and was unable to continue playing. A fracture was ruled out with x-ray and no immediate orthopaedic input indicated.
'Jacqueline (physiotherapist) and David (sport rehabilitator) looked at my ankle together after my injury. The physio explained everything to me, why it was so painful and what I could do to help it heal. When it wasn’t improving as expected, there was a meeting to decide on next steps and I was sent for some more investigations. I had completely torn the ligaments.”
Ben’s rehabilitation was delivered by a physiotherapist, sport rehabilitator and strength and conditioning coach with load metrics monitored and reported by the sports scientist to help guide and inform progressive training exposure.
'At the beginning, Jacqueline helped get my ankle moving and we started strengthening. She was constantly re-checking my ankle alongside David and both added to my exercise programme. When I could do more, I mainly worked with the strength and conditioning coach, but the rest of team were always on hand and would often join my sessions.
When I felt I was ready to play again, I met with the whole team to discuss whether I was ready based on their criteria as well. There was always someone with the expertise I needed for whatever problem I had at that time. It was a team effort from start to finish, and without it I don’t think I would have been able to play again this season.
*Player’s name changed for anonymity
Benefits of collaborative working with exercise professionals
- Safer, more effective rehab and return to play
- Access to the right rehab professional at the right phase of their rehab
- Increased confidence in the rehabilitation team due to range of expertise.
For individual staff members
- Enhanced learning and development through the multi-professional team
- Broader clinical support for complex patients
- Wider options for onward referral if treatment outside of an individual’s scope of practice is required
For the wider medical team
- Increased rehab capacity
- Improved integration of the rehabilitation team and the coaching staff
Key learning points
- Understanding the knowledge and skills of all professionals forms the foundations of collaborative working
- Establish clear channels of communication
- Dedicated time together for CPD, handovers, joint sessions
- Allow fluidity in the rehab pathway to allow cross referral between professions at ALL stages.