Wales Exercise Medicine Symposium 2018

I recently had the pleasure of attending the 2018 annual Wales Exercise Medicine Symposium with Marjon. the trip was organised by Ben Jane and attended by Vicki Evans and a strong squad of 2nd and 3rd year students and myself, a lonely 1st year.

In addition to exeriencing the rather shady Kiwi bar in Cardiff and Elliot’s razor sharp dance moves, I took away some incredible information. Here’s what I remember…

Prof. Peter Brukner – “Why are we getting fatter and sicker?”

Peter opened the Symposium with an extended version of his workshop as the original speaker was unable to attend. In true Aussie fashion, he swore and presented in a way that didn’t pull too many punches (I appreciate this style). He started by discussing the state of the nation, both ours and his own, as they’re very similar in respect to obesity and diabetes. He explained how diabetes is the largest epidemic in human history and in the last 18 years cases have tripled. In addition to this, non-alcoholic fatty liver disease is now prevalent in 1/3 people in the UK.

He talked about where we wrong… well, it was about 30 years ago, in the 80’s when the government low fat guidelines were released. A dietician involved has since admitted that the research was funded by the committee of agriculture and the guidelines were based on no evidence but instead politics. In fact, he went as far as stating that animal fat does not cause heart disease and saturated fats are ok. With low fat products, typically comes high sugar – you gotta get the flavour somewhere, right? The idea that we’ve been fooled for all these years, which has hugely impacted our health makes me really angry!

Finally, he talks about what we can do. Carb intake really depends on an individuals insulin sensitivity. However, in the obese and certainly diabetic you can assume they’re not insulin sensitive. So, a LCHF (low carb, high fat) diet is the way to go. He uses himself as a prime example in this. There was a point where he was overweight with a fatty liver. By adopting a LCHF diet, in just 3 months, he lost 13kg, reduced his ALT from 65-25 and improved his Triglyceride/HDL ratio.

Recommended Reading:


Dr. Aseem Malhotra – “You can’t outrun a bad diet”

Aseem continued on the same tune as Peter Brukner, discussing the incorrect idea that a low fat diet is how we should be eating and supported the idea that saturated fat is not the issue. Aseem came from a clinical background as an intervention cardiologist. His journey began when he suffered the embarrassment of giving a patience a pep talk about nutrition and life style, following a recent heart attack, as they were served a load of junk food in their hospital bed. He was asked “Dr., why are you telling me to eat one thing but then serving me another?” to which he had no answer for.

He made some interesting admissions about hospitals and the NHS. “50% of all NHS workers are obese”, “Medics learn nothing about nutrition in med school” and “have about a days worth of training on exercise prescription”. He notes how modern hospitals have a toxic food environment with branding opportunities for food companies, shops selling confectionary and trolleys even bringing sugary products to people in their beds. One study showed that people are more likely to eat junk food if they go into hospital than if they didn’t.

Aseem, like Peter promotes the idea of a LCHF diet as the way to improve the state of the nation. He references an Italian town, Pioppi where the average life expectancy is 90 years old. Unlike common belief in the UK, these Italians have a low carb diet where Spaghetti is a small starter before a main of meat or fish and veggies. With dessert being a once a week, weekend treat. He promotes his book, the Pioppi Diet, which is a science book (despite the name) and encourages pretty much cutting out all starchy carbs and sugars for the initial 21 days.

Recommended Reading:

  • Action on Sugar – BMJ
  • The Pioppi Diet – Aseem Malhotra


If you made it this far, you deserves this…

What does it mean to be a professional in Sport Rehabilitation.

There are many facets to being a professional in sports rehabilitation. The intention of this post is to clarify what skills and attributes are required for an existing fitness professional or personal trainer (PT) to transition into becoming effective as a Sport Rehabilitator (SR). Also, the expectations of the governing body, The British Association of Rehabilitators and Trainers (BASRaT) in regard to qualifications and conduct.

Within sports rehabilitation there are many key attributes and skills required to be effective. For an experienced PT with existing level 4 qualifications in low back pain and strength & conditioning, moving into the sport rehabilitation, many of these key attributes and skills may exist and are transferable. These might include: a basic to intermediate understanding of human anatomy and physiology (A&P), basic to intermediate ability to conduct a movement screen and postural analysis, the ability to prescribe relevant, effective and safe exercises for fitness and skills in communication, interpersonal effectiveness and organisation. These existing attributes and skills will contribute to becoming effective but alone will not qualify a professional to be a SR. BASRaT requires their members to hold a bachelor’s degree level qualification (BSc). Once this qualification has been achieved by an individual they would then be considered “a graduate level autonomous healthcare practitioner specialising in musculoskeletal management, exercise based rehabilitation and fitness” (2017 – BASRaT).

An SR’s level of A&P knowledge should be well beyond that which is basic and should be evidence-based in order to underpin their practice as alluded to by Archer and Nelson (2013:vii). With this knowledge an SR is able to offer a correct diagnosis and evaluation of an individual’s injury. Also, evidence-based knowledge of available techniques within their scope of practice should be very clear. All this should be applied knowledge supported with at least 400 hours clinical experience. Once achieved, safe, relevant and effective corrective interventions can be delivered or prescribed and clinical reasoning (CR) can be given if challenged. The importance a SR’s ability to offer CR is supported by Abrahamson et al. (2012), as is the importance of CR in the curriculum of any rehabilitation degree.

So what does being effective really refer to. Simply taking a definition of the word from Oxford University Press (2017) “Rehabilitation: the action of restoring something that had been damaged to its former condition” offers some insight. In a sporting context this would be the process of taking an injury through therapy and treatment in order to restore full function or as near to it as possible. Full function can be defined through range of movement of the affected joint, contractual force of the affective muscles, motor control of the nervous system and overall performance of the patient’s ability to complete their day to day tasks. These tasks could be as simple as walking for some individuals or a high velocity change of direction for others.

Based on the evidence, being a professional in sport rehabilitation means, in order to be effective one must have suitable education. This can be none less than a BSc in sports rehabilitation and accredited by BASRaT. Suitable experience in the form practical experience gained from placement throughout their education. Proven knowledge of human anatomy and physiology that is acceptable by the accrediting body, BASRaT and the university delivering the course. Knowledge in assessment and diagnostic tools and rehab techniques and interventions. Finally, the ability to confidently communicate, which would include receiving and delivering critical information and note taking.


  1. Abrahamson, E., Egan, K. and West, L. (2012) Towards a conceptual model of clinical reasoning development in an undergraduate sports rehabilitation curriculum. SportEX Medicine. Vol. 51: 16-21.
  2. Archer, P. and Nelson, L. (Eds.) (2013) Applied Anatomy & Physiology for Manual Therapists. (1st ed.) Philadelphia: Lippincott Williams & Wilkins.
  3. Oxford University Press. (2017) Oxford Living Dictionary. [Online] Available from: [accessed 24 October 2017].
  4. Designed and built by timb. 2017. Basratorg. [Online]. [12 October 2017]. Available from: