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A day in trade with Mr Daniel Meyerkort – Orthopaedic surgeon

January 4, 2021

As an Exercise Physiologist we normally see our patients in the sub-acute to chronic stages of post-operative rehabilitation. I recently had the pleasure of observing Mr Daniel Meyerkort from Perth Orthopaedic and Sports Medicine Centre in theatre at Hollywood Hospital in Perth. I was lucky enough to witness three procedures during the afternoon observations, two of which will assist with understanding the process of post-operative exercise prescription for my patients in the workers compensation system who have undergone these surgeries. I was able to witness a lateral ankle ligament and tendon repair, chronic exercise-induced compartment syndrome fasciotomy and an ACL reconstruction with meniscal root repair.

It was humbling to see the professionalism of the team in the room from wheeling the patient in and going through pre-op procedures to wheeling the patient out for post-operative recovery. The team run like clockwork whilst still taking the time to ensure every patient is safe. It was amazing to see the differences in skills required from delicate stitching through to pulling through new ACL grafts that are required with some force! It is easier to appreciate why some patients pull up with more pain than others due to the invasiveness and force of some of these procedures. I have quickly learnt over my time that two patients will not recover from the same surgery in the same way. I also learnt that a lot of the patients will present quite sore not only from the surgery but also the tourniquet applied above the surgical site.

Mr Meyerkort explained that despite patients presenting with the same injuries, advice will change depending on the patient themselves. Not only the amount of injury sustained is taken into account but their age, associated risks and comorbidities, the occupation of the person as well as their standpoint on having surgery. This is always why I encourage my patients not to “Dr Google” as the advice is never going to be the same for every person. Every person’s rehab journey post-surgery is never going to be the same either. It was also great to hear the amount of education that is given to the patient’s surrounding their surgery.

It was surprising to see that even with viewing the imaging of the patient’s knee prior to surgery it is sometimes never fully clear to see the extent of what is going on until you are in the surgery. Mr Meyerkort kindly talked through each of the surgeries whilst able to repair on the go. During the ACL reconstruction he was able to go through the knee and find out the exact parts of the meniscus that needed repairing and his team where able to demonstrate and explain the thread work required and the importance of positioning and precise drilling required through the tibia and femur. The ACL procedure was the longest and most technical of the three with the aim of restoring stability to the knee. Mr Meyerkort demonstrated the extraction of the hamstring graft first using a long instrument to take the semitendinosus and gracilis to use for the graft. Careful inspections of the tendons is a must to make sure the thickness is of exact amount to provide stability. While Mr Meyerkort was repairing the meniscal damage and clearing the fat pad of the knee, the hamstring graft was being meticulously prepared. Throughout the surgery the knee was regularly tested through flexion and extension to ensure everything was on track. This is something that as an exercise physiologist I can draw on, as functional testing should be intermittently performed on the patient to ensure treatment is effective. Through fine and technical threadwork along with some brute strength, the ACL graft was pulled through the knee and secured in a tight position to restore the patient’s stability with the entire surgery lasting approximately two hours.

It was fabulous to see the acute stages of injury repair and the start of a patient’s rehab journey. I was able to draw comparisons in Mr Meyerkort’s work which rings true in the exercise physiology world.

1. You always have to consider the patient as an individual and no one treatment will have the same effect on that patient.

2. No person will have the exact same outcome and it is important to consistently test and check along the way

3. To always have respect and care for the patient and listen to their needs and concerns and be able to adapt in your approach where possible.

It is important to empower the patient through their recovery. If you have a question surrounding pre or post-operative rehabilitation, you can contact an Accredited Exercise Physiologist.

Taylor Downes

Accredited Exercise Physiologist

BSc/GradDipClinExPhys | B.Ed. Human Movement | (ESSAM, AEP)

November 22, 2024
So why is skincare important when we exercise… here is everything you need to know! Increase Blood Flow - circulate oxygen and nutrients to the skin and other areas of the body. Oxygen accelerates the wound-healing process and aids cell regeneration so that the skin can maintain a healthy, beautiful glow. Flush Out Toxins – from UV, smoke/pollution can cause inflammation, acne, eczema. Exercise increases lymphatic drainage, removes toxins. Decrease Stress - release of endorphins (hormones that make us feel happy) which can help decrease stress and anxiety. Decreased levels of cortisol (the stress hormone) also help the immune system function so that it can effectively combat skin damage and keep your entire body healthy. Prevent Signs of Aging - Decreased stress levels, oxygenation in the skin, and healthy sleep regulation are all essential to maintaining a healthy, youthful look. You’re probably thinking, “Why should I care about my skin before I go have a sweat sesh if I plan to shower afterward?” A pre-workout skincare routine because working out with dirt, debris, or even makeup on your face can wreak havoc on your skin. Likewise, your additional post-workout skincare routine will rid you of leaving sweat, dirt, and debris that could lead to a potential breakout if left unattended. Recommend following these steps pre-workout to guarantee a fresh face and clear skin: Step 1: Cleanse Face and Remove Makeup Regardless of whether you have on makeup, you want to wash your face so that you have a clean complexion before you start your workout. A quick and simple solution recommend is a gentle cleanser or micellar water - lift away pore-clogging dirt and debris from the surface of your skin & waterproof makeup, too. If you are running out of time to clear your skin between a lunch break dermatologist have said, “You’ll sweat and it’ll get a little messy, but it’s not all that bad to have makeup on your face during exercise." If you’re about to workout, it’s best to do so with a clean, makeup-free face. As your body heats up during a workout, your pores open and you definitely don’t want all the surface grime to settle into your pores. Step 2: Apply A Facial Mist Hydrating is key during any workout – internally as you drink H2O during your workout, as well as externally on your face! Apply a facial mist to provide your skin with a boost of hydration. Will improve the overall texture of your skin and leave it feeling soft, smooth, and refreshed during your workout. Step 3: Hydrate with A Moisturiser Stick with a moisturizer that is lightweight and absorbs quickly. Using a mineral-rich moisturiser can boost the skin’s moisture barrier function. Step 4: Apply SPF If you plan on getting your fitness on outdoors, plan on applying to all exposed areas of your body. Sunscreen protection is one of the most important steps in any and all skin-care routines! Advice applies even if you’re working out in a gym with windows that let light in. “Anytime there’s visible light, you’re exposed to some part of the electromagnetic spectrum,” “Growing evidence is showing that all light is important when it comes to skin damage and aging.” Post-workout: Cleansing Is Key Remove sweat, bacteria, and impurities accumulated during the session. Gentle cleanser suitable for your skin type to remove sweat without stripping away essential oils - helps prevent breakouts, skin feel fresh. Hydration and Replenishment Sweating can dehydrate the skin, making it essential to restore lost moisture. Incorporate a hydrating moisturiser or serum. Preventing Breakouts and Acne The combination of sweat, oil, and bacteria can clog pores and lead to acne flare-ups. If you're prone to acne, consider using products with ingredients that slightly exfoliate like pineapple fruit extract or lactic acids. Protecting Your Skin Even after your workout indoors, your skin might still be exposed to harmful UV rays. Apply sunscreen if you're heading out post-exercise. Sun protection is crucial to shield your skin from premature ageing, pigmentation, and other sun-related damage. The Importance of Timing It's ideal to cleanse and moisturise your skin within 30 minutes of finishing your workout. This time frame allows for efficient removal of sweat and prevents it from settling into your pores, reducing the risk of skin issues. According to the cosmetic surgery professionals, it is better not to cool down for a long period of time, but to actually go straight to the shower to start on your post-workout skin care routine so that the sweat and bacteria don’t settle. “Sweating creates a warm and wet environment for bacteria to grow.” Facts you may not know: Use a clean towel if you need to blot your sweat, definitely don’t use your dirty hands or your sweaty t-shirt K eep your hair off your face. If you have longer hair, it’s best to keep it pulled back and away from your face during a workout. This helps prevent oils (not to mention any hair products you used that day) from also clogging your pores, which can contribute to breakouts. It’s also helpful to cool off skin to prevent breaking of blood vessels and return skin temperature to a normal level quicker, even a quick splash of cool water post-workout is good practice. Exercise not only benefits your muscles; it also improves your skin's health. Studies show that activities like endurance and high-intensity aerobic training can help reduce signs of aging and enhance your overall complexion. Whether you work out at a gym or exercise outdoors, always remember to moisturize your skin, protect your skin with sunscreen, and refresh your skin afterward with cool water. References: 1. https://premierdermde.com/the-importance-of-a-pre-workout-skincare-routine/ 2. https://southerncosmetics.com.au/news/home-workout-skincare-dos-and-donts-when-working-out/ 3. https://www.everydayhealth.com/skin-beauty/skin-care-musts-before-after-your-workout/
October 29, 2024
Fatigue is a significant concern throughout many work environments, affecting workers across various industries. Fatigue can be a by-product of long hours, demanding tasks, inadequate rest, and stress. While fatigue is often overlooked, its implications for injury risk are often profound. Understanding Fatigue in the Workplace Fatigue in the workplace can manifest as physical exhaustion, mental tiredness, or a combination of both. Physical fatigue results from prolonged exertion, while mental fatigue arises from extended periods of concentration and decision-making. Both forms can impair a worker's ability to perform tasks safely and efficiently, which can lead to a higher risk of accidents and injuries. Other factors such as sleep loss, and environmental conditions can significantly impact a workers’ fatigue levels. Individual factors such as age, hydration, fitness level, diet, smoking and alcohol intake are also just as important to consider. Mechanisms Linking Fatigue to Injury Risk Decreased Coordination and Balance Altered Perception and Reaction Time Increased Muscle Strain Compromised Judgment Neglect of Safety Protocols It is important to highlight that industries requiring workers to complete extended periods of manual labour are more likely to be involved in workplace incidents. The risks become elevated as fatigue is mixed into already high-risk environments. Mitigating the Risks of Fatigue There are several ways to help mitigate the risks of fatigue. These can be but are not limited to: Implementing Fatigue Management Programs Adequate Rest and Recovery Monitoring Workloads Providing Ergonomic Support Encouraging Healthy Lifestyle Choices Creating a Supportive Work Environment Fatigue is a critical factor influencing injury risk in the workplace. Understanding the mechanisms linking fatigue to injuries can help organisations implement effective strategies to mitigate these risks. By prioritising rest, monitoring workloads, and fostering a culture of safety and support, employers can enhance worker well-being and significantly reduce the likelihood of accidents. Addressing fatigue is not just a matter of improving productivity; it is essential for ensuring the health and safety of all workers.  Daine Richards Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services – WA
October 25, 2024
Meet Rowan 50% of our new QLD AB squad. Hello everybody, I’m Rowan, Accredited Exercise Physiologist at Absolute Balance. I studied in sunny Townsville at James Cook University, graduating in 2014. Shortly after, I landed a position at a local chiropractic clinic as the sole Exercise Physiologist among chiropractors, physiotherapists, and massage therapists. After a year, I transitioned to Max Employment as a Health Services Officer, covering Townsville, Ingham, Ayr, and Charters Towers. In this role, I helped job seekers secure suitable employment, an unexpected shift from my previous experience but one that ignited my passion for the role of exercise in mental health. After a few years, I decided to move to Brisbane, where I ventured into the occupational rehabilitation field. However, I soon realized that vocational rehabilitation wasn’t the right fit for me. This realisation led me to focus on pre-employment medical assessments, including functional capacity evaluations, drug testing, and lifting capacity assessments. Fun fact: I encountered every drug in the tests except cocaine—it's puzzling why people would use methamphetamines the weekend before their employment screenings! Eventually, I traded in corporate attire for shorts and joggers as I embraced a role in the gym environment. I enjoyed working directly with Medicare, DVA, NDIS, and private patients, so much so that I decided to start my own business (2021) with Meagan, the other 50% of the new Queensland team. As we launched our company, I found myself asking, "What the hell do I do now?" That's when I reached out to ol’ Derek Knox to be our business mentor. My experiences with Derek likely echoed those of many others: he was constantly emphasising my "why" and the "red brain-green brain" concept, all while sharing his extensive industry knowledge, and taking time out of his busy schedule just to hear me say things like, ‘nothings really going on this month’, and ‘red brain is bad right?’. Now, I find myself back in the WorkCover space—though this time, I'm not involved in vocational work—and I'm thoroughly enjoying it. If you’ve made it this far, thank you very much for your time, but let’s finish up with 2 truths and a lie, feel free to email me your answers: I hid on a plane, causing a lot of problems, when I was 5yrs and travelling alone from Sydney to Hobart. I was shipped off to military boarding school in Sydney for 9 years. I caused $40,000 worth of damage to a hotel because I left the kitchen sink tap on. Rowan Dicks Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services ‑ QLD
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