Your comments

A marathon show

I am a 56 year old physiotherapist, based in Ringwood (Hants), currently training to do my first ever marathon. I have chosen to do it at the London Marathon on 28 April. I am not only running the marathon from a personal perspective but I hope to raise money for Diabetes UK. My family have always had an interest in this cause since I lost my little brother to diabetes back in the mid-70s. 

Finally, to make the event even more of a challenge I will be presenting a live online audio show whilst running the race. The show will feature great music (played centrally) and pre-recorded plus live interviews with people connected with the race. In particular, I want to raise awareness of diabetes and how things can be overcome, (some of my interviews will be with those who are running the marathon but who have type 1/11 diabetes). 

I will also give my personal reflections on the event as I run especially as I will have gone from a non-runner to a marathon runner. It should be quite an entertaining show all the way to the finishing line. I have set up a Facebook page (radiodavemate), web and Twitter @radiodavemate.

• Dave Lowen

The art of falling

I read your article “Falling Safely” [Frontline 6 March] with great interest.

I learnt some judo and underwent a number of parachute jumps 40 years ago while in my late teens and I have always thought that it helped protect me.

I have been a keen windsurfer, snowboarder and mountain biker, falling badly and not infrequently, and yet I have never seriously hurt myself. I discussed the rate of injuries and the distribution of injuries with a fellow biker, and we came to the conclusion that he and I were protected by our judo experience, and that some fellow riders clearly did not know how to fall. Some have had serious and repeated injuries, including broken vertebrae.

When falling, I naturally roll and keep my chin in contact with my chest and never let go of the handlebars, which further promotes a roll. Trying to avoid landing on one’s face by pulling one’s head up, or sticking an arm out, seems to me promote neck and arm injuries respectively.

My neighbour at the age of 85 fell the entire flight of steps when entering his basement flat. Halfway down he remembered his parachute training with Coastal Command during the war. Apparently, it worked and he had no significant injuries. This event seems to support the article’s assertion that when falling one does have time to think.

It does need significant amount of practice to ensure that if there isn’t time to think one’s reaction is automatic. My advice is start as young as possible.

• Francis Whiteley, Virginia Water, Surrey 

Critical care career development

The Intensive Care Society’s conference in late 2018 saw the launch of the allied health professions (AHP) critical care professional development framework for physiotherapy, dietetics, occupational therapy and speech and language therapy.

This multi-professional framework was commissioned and supported by the Intensive Care Society and Faculty of Intensive Care Medicine in recognition that a professional career pathway guidance for AHPs wishing to specialise in critical care has never been published.

It is intended to facilitate the structured development and career progression of post-registration AHPs working in a critical care environment.

This framework is endorsed by the CSP. 

• Gareth Cornell, clinical specialist physiotherapist critical care, Sheffield Teaching Hospitals NHS Trust

Training for first contact physio roles

Jonathan Picken’s response to the news that NHS England has announced a major expansion of first contact physio roles raises some interesting observations and queries (Frontline, 20 February). 

He notes that in the US, physical therapy training and assessment involves differential diagnosis between MSK and non-MSK causes.

Jonathan raises the question that, if we are going to have a first contact role in GP practices, shouldn’t this be part of our training too?

He further queries whether there should be post-grad external certification for the role?

As chair of the Society of Musculoskeletal Medicine and an advanced physiotherapy practitioner, I feel bound to respond that through developing physiotherapists’ clinical reasoning we have been teaching the assessment and diagnosis of musculoskeletal conditions for over 40 years and differential diagnosis has been at the very heart of that.  

We completely agree that the musculoskeletal medicine approach to assessment and diagnosis should be introduced at pre-registration level and we continue to campaign towards that.

At postgraduate level, we already have a well-established pathway that runs from our Foundation in Musculoskeletal Medicine module, through our advanced courses that support MSK CPD, towards completion of our clinically relevant practical skills-based MSc Musculoskeletal Medicine.  

All our courses are accredited by the CSP and validated by Queen Margaret University, Edinburgh. 

Shouldn’t they be on every first contact physio’s CV?

• Emily Goodlad