John Orchard Profile picture
Sport and exercise med (SEM) physician, load management/exercise, injury prevention/safety,🏏, sports cardiology, tendinopathy, OA, ♀️sport , climate emergency
Public Exercise Med Aust Profile picture 1 added to My Authors
21 Feb
Great that @CJSMonline has made our Systematic Review of the safety and use of local anaesthetic injections in sport a free view and download journals.lww.com/cjsportsmed/Fu…
Limited data, but we did find 1970 injections in 540 athletes from 10 studies in the Sports Medicine literature. Only from football codes at elite level - nothing at amateur level or outside football (where hopefully use is uncommon anyway)
Data on safety best for A/C joints injections, iliac crest, some finger injuries. However safety data not generally verified by independent study methodology
Read 13 tweets
5 May 20
Thread: If the Australian Medical Association (AMA) wants to have some input on safe return to sport during the pandemic, their first step should be to recognise Sport & Exercise Medicine (SEM) as a specialty.
AMA and their President Tony Bartone made a media release earlier this week cautioning the NRL against an early return to play and said that the NRL should heed “expert medical advice” ama.com.au/media/ama-urge…. I have comments!
Unfortunately, Tony and the AMA are speaking from a position of ignorance about the level of expert medical advice that the professional sports are receiving. There is plenty of expert medical advice going to the NRL and all other pro sports
Read 19 tweets
29 Mar 20
The specialty of Sport & Exercise Medicine (SEM) in Australia and Telehealth. Thread spoiler: SEM physicians have effectively not (yet) been included. For SEM Telehealth, the patient will have to pay the full fee with no rebate.
It is already know that SEM specialists do long consults with few procedures – a very detailed MBS Review document (via SCPCCC) proved this in 2019
SEM is therefore a specialty with good potential to do Telehealth consults, as Exercise Prescription/loading is our signature treatment and can safely be done over Telehealth.
Read 15 tweets
25 Mar 20
@ACSEP_ @ESSA_NEWS media release - Boot Camp groups of 10 are not recommended as safe during the Coronavirus Pandemic. Alternate safer exercise options are advised in this media release
Outdoor exercise in groups up to 10 people (such as with “boot camp”) is permitted under Australian Stage 2 restrictions, however, there are good reasons why we should NOT be participating in such activities.
Exercise, indoors or outdoors, remains safe and beneficial during the COVID-19 pandemic unless you are subject to quarantine. Keep a distance of 4 metres between people when walking, running or doing activity where you are puffing hard
Read 12 tweets
24 Mar 20
Thread on Sport & Exercise Medicine (SEM) specialists in Australia and Telehealth. SEM physicians need to be included in Greg Hunt's plan for Telehealth and I'll explain why..... 1/thread
Example: Low back pain accounts for 2% of all Australian Emergency Dept visits ncbi.nlm.nih.gov/pmc/articles/P… that is 160,000 ED visits annually or 400 per day; back pain is the 5th most common ED diagnosis aihw.gov.au/reports/hospit…
Far too many ED patients get medications and scans (although some need these) and far too few get prescribed exercise ncbi.nlm.nih.gov/pmc/articles/P… researchgate.net/publication/33… thelancet.com/series/low-bac… but in the current climate the worst thing about LBP is unnecessary clogging of EDs
Read 12 tweets
12 Feb 20
One of these muscle strains is not like the others, out of hamstring quadriceps, calf and groin. Read through this short thread to find out which from our latest @BJSM_BMJ paper.....
But pre-poll (no peeking below) which of the “Big 4” has the most differences from the other 3 from an Epidemiology perspective? [be brave and have a guess....]
....if you answered “groin” it was the best incorrect answer, as you can argue that diagnostically it is the least pure and therefore perhaps the most polluted dataset of the 4. But actually the correct answer is “Calf strains” - behave differently from the others
Read 9 tweets
11 Feb 20
This is a reprised thread to celebrate some of the outstanding female Sport & Exercise medicine physicians in Australia who are on Twitter, as part of
@WomenScienceDay #WomenInScience #WomenInSTEM @ACSEP_ @womenandmed
@WomenScienceDay @ACSEP_ @womenandmed @ACSEP_ now has a female President
@DrLouiseTulloh who is providing terrific leadership. As well as ♀️ President, ACSEP has female CEO @hoover22
, 50% board representation acsep.org.au/page/about/acs… >50% office staff and Gender dashboard to try to increase equity on other metrics
@WomenScienceDay @ACSEP_ @womenandmed @DrLouiseTulloh @hoover22 @DrLouiseTulloh will leave a legacy of actively increasing the female representation across leadership of all levels of the College and making sure prospective ♀️ SEM physicians have visible role models
Read 15 tweets
25 Jan 20
I’m very proud and grateful to be named an AM in the 2020 Australia Day Honours list. Sincere thanks to all who have passed on congratulations and to collaborators in research & sports safety lobbying over the years
I’m lucky to have chosen to work in Sport & Exercise Medicine at a time when professional sport, in particular, has rapidly evolved to appreciate the value of high level specialist medical care and been very open to improvements in sport safety
The sports I’ve worked with, particularly cricket, AFL and rugby league, have been at the forefront of improvements to player safety with rule changes and funding higher levels of medical care, and I’m privileged to have had a part to play
Read 12 tweets
4 Jan 20
Knee osteoarthritis (OA) in Australia 2010-2019: A decade of (mainly) mismanagement. Updated Tweetorial for the New Year. Sadly, many other Western countries are also bad. 1/thread
How would we know whether we are managing knee OA well? Let’s start with the latest data we have on knee OA, from aihw.gov.au/reports/arthri… and aoanjrr.sahmri.com/documents/1018…
Over the last decade we’ve seen an ongoing increase in the incidence rate of knee replacement in Australia. And this is coming off a rate which is already very high by world standards
Read 33 tweets
1 Oct 19
Why do poorer Australians have shorter life expectancy than wealthy ones? Exercise and opiates as comparative risk factors: a flaming 🔥🔥🔥 hot long thread including the #RedRoosterLine 1/many
@JudkinsSimon @stephenjduckett @CroakeyNews @DrChrisBarton @ACSEP_ @apaphysio @ESSA_NEWS @Kaubo We’ve known for a while than life expectancy is slightly worse (4-6 yrs) in poorer Australians with smoking status, diet, exercise and maybe less access to “good” medical care being potential explanations healthstats.nsw.gov.au/Indicator/bod_…
@JudkinsSimon @stephenjduckett @CroakeyNews @DrChrisBarton @ACSEP_ @apaphysio @ESSA_NEWS @Kaubo Exercise is now receiving its due as a very important lifestyle factor bmj.com/content/366/bm…. @BMJ has just urged us to include Exercise as a routine part of medical consultations, saying it is perhaps the only “medical” treatment with only benefit vs no substantial harm
Read 27 tweets