About the AAMM

From the 1940's onwards James Cyriax was a major author in the field of "orthopaedic medicine" and had a profound influence on the profession in English-speaking countries. The 1950's and 1960's saw an increase of interest in physical modalities of treatment.

A body known as the Australian Association of Physical and Rehabilitation Medicine was formed in the 1960's and a sub-group of its members formed the Australian Association of Manipulative Medicine (A.A.M.M.) in 1971. Dr. Frank May convened the first meeting in Melbourne on 6th November 1971 and became the first president. Dr. Brian Corrigan (a Rheumatologist) was vice president, Gordon Byth was secretary and John Livingston treasurer. There were 10 other foundation members including a neurosurgeon. Thus the Association gathered doctors from different disciplines who were interested in manipulative treatment.

The first sizable conference was in 1974 with Dr. Bordillon speaking and opened by the health minister at the time. The theme of the conference was “Meeting the Challenge - is there a scientific basis for manipulation.” ... NOTHING MUCH HAS CHANGED!!

This association grew steadily over the next ten years providing hands on training in manual medicine in the form of weekend workshops and annual conferences. By 1982 its membership had reached 200. A change of name to the Australian Association of Musculoskeletal Medicine, was made that year to reflect the widening interests in various aspects of musculoskeletal function and dysfunction.

Since then the A.A.M.M. has emphasized the importance of the basic sciences (especially anatomy and biomechanics), theoretical development and research, patient assessment and diagnosis, and a wide range of therapeutic modalities. In 1987 it published a comprehensive syllabus of musculoskeletal medicine setting out the body of knowledge and the clinical skills associated with the discipline.

In 1989, under the guidance of Dr. Barrie Tait of the Christchurch School of Medicine, the University of Otago, New Zealand offered its Diploma in Musculoskeletal Medicine. This was the first course of its kind in the world, and to date there are more than 80 graduates. Not to be left behind, in 1991 the first Australian University based Diploma course in Musculoskeletal Medicine was established at the Flinders University of South Australia by Dr. Norman Broadhurst. A second Australian course began at the University of Newcastle under Professor Nikolai Bogduk in 1995.

The A.A.M.M. continues to pursue its objectives of promoting research into, and knowledge of the causes, mechanisms, diagnoses, treatment and other aspects of disorders of the musculoskeletal system. In addition to the diploma courses a yearly annual scientific meeting is convened, regular workshops are conducted and a publication is produced 2 to 3 times a year. Previously known as “The Bulletin of the A.A.M.M.”, a name change to “Australasian Musculoskeletal Medicine” occured recently to include our neighbors New Zealand. This journal style publication includes original scientific articles as well as case commentaries, scientific abstracts of interest, book reviews and news and information about local and overseas courses.

THE AUSTRALIAN COLLEGE OF PHYSICAL MEDICINE (ACPM)

In 1988 a sub-group of the AAMM. under Dr Clive Kenna established a new organisation called the Australian College of Physical Medicine, whose main aim was to focus more on hands on skills of doctors practicing manual medicine and to establish a special interest college in Physical Medicine/Manual Medicine.

Training was initially under Professor Maigne of France and Prof. Greenman of North America. Dr. Kenna and Dr Creswick established a University-based 2 year Diploma course in Physical Medicine at the University of Sydney commencing in 1996 and has moved to a 3 year Masters of Medicine course in 2000. To date this college has 29 Fellows around Australia.

Most Fellows of the College have moved from primary care to full time Physical Medicine practice, such is the demand for this type of service in the community. Most members also belong to the AAMM and are actively involved in running hands on workshops for doctors. There has been a move to once again affiliate this group with the AAMM particularly on education of musculoskeletal medicine skills to GPs.

The ACPM is about to run its own Diploma course in Physical Medicine to foster "hands on" and other Physical Medicine treatments for interested doctors and will be actively running workshops in the coming year (2007).

More information on the ACPM can be found at www.physicalmedicineaustralia.com.au

THE AUSTRALASIAN FACULTY OF MUSCULOSKELETAL MEDICINE

The Australasian Faculty of Musculoskeletal Medicine was constituted in 1993 and formally incorporated in 1994 as a result of negotiations between the Australian Association of Musculoskeletal Medicine and the New Zealand Association of Musculoskeletal Medicine. The inception of formal postgraduate courses in musculoskeletal medicine in three Australasian universities (Otago, Flinders and Newcastle) led the two national associations to believe that a separate and independent body was required to develop and promulgate standards of practice in the discipline based on a responsible, academic analysis of the scientific literature.

Prior to the Faculty's incorporation, various groups, including musculoskeletal physicians, rheumatologists, neurologists, rehabilitation physicians, interventional radiologists, anaesthetists and pain management specialists, had moved towards those ends but each from a relatively narrow perspective.

The main intention of the Faculty was to co-ordinate development of the scientific, academic and educational aspects of musculoskeletal medicine. The Faculty was not formed in the first instance to serve as a credentialling organisation, but to develop and publicise a cogent distillation of valid knowledge and best practice in the field and to make this available to the public.

Membership of the Faculty is restricted to medical practitioners with university postgraduate qualifications in musculoskeletal medicine and those with Fellowship of relevant learned Colleges and appropriate interests. The current membership includes the teaching staffs of all three university departments offering postgraduate courses in the discipline (The University of Otago, Flinders University of South Australia and The University of Newcastle) and members of the Australian and New Zealand Associations of Musculoskeletal Medicine, the Royal Australasian College of Physicians, the Australasian Faculty of Rehabilitation Medicine, The Australasian Faculty of Occupational Medicine, The Royal Australian College of Surgeons, The Australasian Faculty of Anaesthetists and the Royal Australasian College of Radiologists. Rheumatologists constitute the largest single craft group represented in the Faculty.

The inaugural examinations were held in November 1998. And now there are around 40 fellows in Australia and New Zealand. The Current President is Dr Jay Govind.

THE NATIONAL MUSCULOSKELETAL MEDICINE INITIATIVE

The National Musculoskeletal Medicine Initiative was established by the Minister for Health, the Hon Dr Michael Wooldridge, soon after the Australian Government came to power in March, 1996, with a grant of 7.2 million dollars over 3 years to commence in 1997. The Initiative was developed to address the need for more effective services for patients with musculoskeletal health problems, and in particular the common conditions associated with low back pain, neck pain and other regional pain syndromes.

He commissioned the Australasian Faculty of Musculoskeletal Medicine to undertake the project, combining a practical program for the establishment of dedicated clinical services with a formal academic study of utility and outcomes. The evidence base has been distilled from the scientific literature and clinical practice guidelines developed from it. Musculoskeletal Medicine clinics were established in 13 teaching hospitals around Australia and in 4 selected community-based settings. Within the clinics, conduct of audits and controlled trials of evidence-based practice were carried out for the management of musculoskeletal health problems.

The location of clinics in teaching hospitals encouraged knowledge of their existence, and information about their function, amongst patients, established medical practitioners and doctors in training. It also ensured controlled settings in which the clinical and financial conduct of the clinics were superintended by responsible, academic and administrative authorities. Information was sought about the various types of service provided to similar patients in other settings, for comparative purposes.

Professor Nik Bogduk was appointed Director of the Initiative. The Directorate is located at the Bone and Joint Institute of the University of Newcastle. This is also the centre for the gathering of all scientific material to be synthesized into working guideline documents covering all aspects of management of musculoskeletal disorders. The National Musculoskeletal Medicine Initiative has made Australia the first country in the world to apply the principles of evidence-based medicine.

The clinics were in operation for over two years and data has been forwarded to the department of health in 2001. The results are yet to be released to the public.