A cropped low-angle shot of a young couple running along the esplanade at sunset

What causes tendon pain?

Research suggests that many tendon troubles are associated with tendons that are given a load that is more than they can cope with. This leads to tissue breakdown without the traditional inflammatory response that other injuries get. This ‘degenerative’ process happens in athletes of all ages who go through a period of stressing their tendons more than they can cope with.

A common (and surprising) example of this is the sedentary office worker who plays the ‘one-off’ game of touch football at a family barbecue. Another example may be an athlete who experiences a sudden increase in their training load such as the start of preseason. The prolonged ‘inactivity’, or reduced activities of the individual has the tendon feeling good but susceptible to damage with the sudden change in workload which may tip the tendon into a degenerative state.

Get and Stay Active – Follow these guidelines to maximise the chance of a successful recovery:

Activity
Be Active. Low load endurance activity that is relatively symptom free has enormous benefits to your physical, psychological and recuperative health. Avoid exhaustive and high heart rate exercise as it promotes free radical production that fosters further troubles with your tendons. Further, avoid a sudden increase or decrease in your activity loads. A well-balanced general activity program is of paramount importance to a good recovery strategy for tendinopathies.

Unload
Tape, brace, or the use of an orthotic may be required to unload the injured tendon. Your Physiotherapist will advise you if these interventions are appropriate for your condition.

Lose weight around your belly
Tendon injuries have been shown to be much more common in men with a waist girth of greater than 108cm and women with a waist of more than 88cm.  Get on that ‘pushie’ to shed some kilos.  You don’t even have to be exercising the injured part to help its recovery.

Tendon Loading Program
Your physiotherapist or Exercise Physiologist can design a specific exercise program that research shows is the ‘key’ to a successful rehabilitation program. Your clinician can also show you how to perform these activities at home with appropriate technique.

Action Plan
With activity being the key to successful rehabilitation, being armed with an injury management plan from your physiotherapist, sports physician or accredited exercise physiologist will have you on the road to recovery faster.

To make an appointment with one of our Physiotherapy team to discuss your tendon pain book online, email reception@qsmc.net.au or call 07 3891 2000.

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Out of the Lions den and into the Centre

Over the last 12 years one of QSMC’s Directors and Sports Physiotherapist Shane Lemcke has been at the Centre in a reduced capacity to enable him to work full-time with the Brisbane Lions. Particularly in the last 7 years as Medical Coordinator, Shane has had the opportunity to work with players and other practitioners on a multi-disciplinary approach to treatment of players at an elite level. At the end of the season Shane decided it was time to move on from the Lions to allow him more time to devote to his young family and share his experience with the staff here at QSMC. We are very excited to be getting his experience back on the treatment floor full-time as of November.

Shane is looking forward to getting back to the Centre to work with our exciting range of practitioners and reconnect with his clients. Shane will also have capacity to take on new clients and with his experience in working with athletes in a pressured environment to minimise the impact of injury.

We asked Shane to give some insight into working with the football team and how it differs from the QSMC treatment floor.

Firstly, welcome back! What made you decide to move on from the Brisbane Lions?
After 12 years working with the club I decided that it was time to step away from football and head back to the Centre. I have a young family now and it’s important that I devote some time to them, which is difficult to do when travelling with a football team. It was time for a change and I’m really looking forward to getting back to the Centre environment.

What is the best thing about working with a football team such as the Brisbane Lions?
For me it’s about the relationships that have been built over a long period of time. Even though we didn’t always achieve the win, it doesn’t take away from being part of a team and working together for a common goal. Watching players develop and improve is really exciting to be able to contribute to their growth and development as an individual and an athlete is extremely fulfilling.

What are the main differences when treating athletes?
You get to have access to them, essentially full-time. The treatment that you are providing to them can be as often as required and the approach is a collaborative multi-disciplinary treatment plan to get the best outcome for the player. You find yourself working with a strong team of experts daily, coordinating treatment in the gym and taking them right through to running onto the field for a game.

What do you feel you have gained as a Sports Physiotherapist?
Definitely the experience of managing injury. For an athlete you want to minimise the impact that injury has on their ability to play and maximise the outcome to get them back to playing as quickly and safely as possible. It’s a pressured environment and makes you a better practitioner for it. I’m looking forward to working with clients and developing strong injury management plans from my experience with the Lions to get them back to their sport or activity of choice.

Lastly, what are you most looking forward to coming back to at QSMC?
I think at QSMC we have such an exciting range of practitioners which such vast experience. I have been at the Centre in a somewhat part-time capacity for the last few years, focusing more on the management side of things and have seen the Centre go from strength to strength within our team. I’m looking forward to getting back to the floor full-time and working with all of that great experience as well as getting to contribute. Mostly I’m looking forward to reconnecting with previous clients and building relationships with new clients to work on the most effective treatment plan for them.

Everyone at QSMC is really looking forward to having Shane back full-time and treating as of November. If you are looking for a high quality injury management plan, book an appointment with Shane by contacting the Centre reception on 07 3891 2000.

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Return from Rio Olympics

Want to be treated like an Olympic medalist? Fresh from his stint at Medical Headquarters for newsletter-pic_ivanthe Australian team at the Olympics, Ivan Hooper is back treating clients at QSMC.

Those who know Ivan will recognise that he is no stranger to Olympic teams having made Rio his fifth berth.  Previously with Kayaking and Rowing, Ivan has been a fixture in every Australian Olympic team since Sydney 2000.  This makes Ivan among the most experienced Olympic physiotherapists in the country.

Ivan has just reopened his schedule on return to QSMC and while he is still juggling commitments to Australia’s Olympic sport program, he is available for consultations Monday, Tuesday, Wednesday and Friday.  Call our reception on 3891 2000 and book an appointment.

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Running Assessments with Dolph Francis

With summer well on the way many of us will dust off the running shoes and start hitting the pavement to try and get fit after the winter hibernation. At QSMC we know that in the eagerness to get stuck into it, you can often run into injury trouble by going too hard too early. Injuries such as shin splints, Achilles tendinopathy, anterior knee pain and plantar fascia are all common running injuries that we see as people get back into the swing of things.

In addition to how quickly the volume of running is increased, your running technique can also play a role in the development of injuries. How your foot interacts with the ground, how good your muscle control is around your hip as well as other factors can be critical in making your running technique more efficient, and decreasing your risk of injury. QSMC is fortunate to have a number of physiotherapists with experience in treating runners over a long period. Dolph Francis, an ex-elite runner in his own right, has a specific interest in running mechanics and has helped many runners around Brisbane with his running analysis and technique correction work.

Do you feel that your running technique might be a playing a role in your injury? Is your technique limiting the amount of running you can achieve? If yes, then a running assessment with Dolph may be the answer for you. Don’t let injury get in the way of your running goals this summer, book your running assessment with Dolph. Contact reception on 07 3891 2000.

Winter is coming:  Go Skiing

Winter is Coming700Love skiing and addicted to Game of Thrones?

Trying to decide whether to hang up the skis and just binge on life in Westeros?  Let’s face it.  Game of Thrones is a lot like skiing.  Lots of bumps that offers some exhilarating moments but is, all in all, pretty downhill.  We all love the Snow: Jon Snow.  

So while we’re waiting for him to be re-incarnated, here’s some good news to cheer you up.  In the largest study of it’s type of all time, a March 2016 review of the careers of elite skiers found some surprising news:

Elite Skiers who injured their Anterior Cruciate Ligament (ACL):

  • All returned to skiing
  • Had longer careers than their injury free competitors and
  • Performed better than uninjured skiers over the remainder of their career.

You heard it correctly.   This article from the March 2016 American Journal of Sports Medicine studied professional skiers from 1980 – 2013 and split them into two groups; those that ruptured their ACL and those that did not.

Not only did the ACL damaged group all return to professional skiing, they ended up having longer careers.  They also made the podium at World Cup, World Championships, and Olympic Games more often (12.8% or  61 / 477) than their ACL intact colleagues (8.3% or 27 / 329).

This flies in the face of the historical wisdom that injuring your  ACL is a performance killing and ultimately career ending event.

Bring back Jon Snow?  Who needs him?  We’re going to the gym to get ready for the slopes.  For more information on this study and how it can affect your return to the slopes, contact our resident shredder and GoT addict James Rees.

Remember.  Winter is Coming

 

Race Fitness: Red Bull Style

T3aWant to get race fit?  Whether your race is running, cycling, or a quick lap around the office, the fitness secrets of Red Bull Racing Australia can help you.

This article shows the inner workings of Red Bull Racing Australia’s pre-season crew preparation for champion drivers Craig Lowndes, Jamie Whincup and new kid on the block Shane Van Gisbergen.

Chris Brady and Dolph Francis support the team with traveling sports physiotherapy services while Adam Garred writes the team’s training programs and Claire Trembath delivers them with a punch.

With the season now under way, the proof is in the pudding, with a solid start from the team at the Clipsal 500 and a clean sweep of the podium at the Australian Grand Prix.

For your racing fix, come and see the team at QSMC | AFR.

Add Pilates springs this Spring

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With winter definitely on the way out and the warmer weather upon us, it’s time to get that Queensland body back in shape again.   For those that don’t trust your bodies with an unforgiving gym program, Clinical Pilates is just right for you.

Clinical Pilates at QSMC is a tailored exercise program targeting core muscles and postural control.  In most cases, it can be commenced without a note from your Doctor, and our physiotherapy driven Pilates program allows you to feel confident to exercise without the risk of injury.

Physiotherapists Emma Polinelli, Mardi Watson, James Rees, and the latest addition to our team, Emma Trumble will assess your injury profile, start you on an individualised program, and assess your suitability to join one of our Pilates exercise classes.
To enquire about your Pilates program, go here, or call us on 3891 2000 for your first session.

5 tips for happy shoulders

Lots of people get sore shoulders. Some of them are swimmers, some are throwers, some do ironman, and some just iron. Shoulder problems happen to teenagers, twenty year olds, and those in their 40s, and they happen for a variety of reasons. The good news is that there are things people can do to help get their shoulders better, and most of those things involve exercises which people can do themselves.

At the Queensland Sports Medicine Centre, we’ve collated our favourite exercises for people who have sore shoulders. Each exercise takes 30 seconds to perform. We recommend completing each exercise twice for a total exercise time of 5 minutes.

1. Sleeper Stretch (added by Sarah Grimstone)

One of the classic reasons for sore shoulders is a lack of shoulder turn in or ‘internal rotation’. This can be simply check by standing in ‘Scarecrow Position’. Standing upright with your arms out to the sides, elbows bent to 90 degrees, turn your palms as far down to the floor as you can and measure the angle of your forearms to the floor (and to each other). This measurement of internal rotation has been observed for 30 years as a key predictor of risk for shoulder troubles.

If you notice that your turn in is different on one side, the sleeper stretch is a proven way to help improve this:

  • Lie on your side with your lower arm out in front of you and your elbow bent
  • Use your upper arm to push down and internally rotate the lower forearm
  • When you get to the limit, roll your body forward onto your lower arm to add to the stretch. [A trigger ball can be applied under the lower arm to increase the stretch further]
  • Hold for 30 seconds

 

2. Happy Clavicles (added by Laura Schwab)

Happy Clavicles is a Postural Cue to promote good shoulder and shoulder blade positioning. It involves:

  • Sitting or standing upright
  • Chin Tucked
  • Imagine the space between your two collarbones at the front of your sternum.
  • Try to create a ‘smile’ using the ends of your collarbones by raising your sternum skywards.
  • Hold for 30 seconds

 

3. Supraspinatus Activators (added by Tammie Dare)

Supraspinatus is one of the most commonly injured muscles in the rotator cuff. Almost everyone who gets a sore shoulder has some kind of involvement of the supraspinatus whether primary or secondary. Here is a great exercise to get it going at an early stage:

  • Standing with ‘Happy Clavicles’
  • Lift the arms out to the side a small way (15 degrees) as your start point
  • Side raise from 15 to 45 degrees while holding ‘happy clavicles’
  • Repeat for 30 seconds to activate and relearn the correct motion

 

4. Turn Outs (added by Dolph Francis)

Turn Out exercises involve retraining the Infraspinatus muscle. This muscle is also commonly injured in shoulder problems.

  • Lie on your unaffected side with a rolled up towel under the arm to be exercised.
  • Hold Happy Clavicles
  • Use a light weight in your hand and ‘turn out’
  • Repeat for 30 seconds

5. Seated Row (added by Adam Russell)

Seated Row is the first of the basic gym exercises to be done in shoulder rehabilitation therapy and is the signalling point that you can return to strength and conditioning. This exercise can be done at home using tubing as resistance.

  • Sit at the equipment, or stand if using tubing. Choose a load that your body can do easily at first to ensure you learn the correct activation sequence.
  • Hold happy clavicles.
  • Holding your resistance, activate your shoulder blades to ensure you have control at the back.
  • Draw your elbows back until your elbows come in line with your body.
  • Repeat this for 30 seconds.

Sleeping Position

What Sleeping Position is Best?

Sleep is the best form of recovery for active people. Without sleep our mental and physical capacity slowly gets worse and training and performance can suffer. For some people the positions they sleep make their body sore enough that sleep is disturbed or even stopped. This article reviews the current views on sleep position and bedding to enable ever athlete to make night time the right time for recovery.

Back Sleeping

Back sleeping is ideal for those who don’t have a risk of snoring and have flexible enough hips to allow them to lie flat without their backs over-arching. Most people find that the can only last a limited time in this position, and many like to have a small pillow tucked under their knees, or cross their legs in order to bend one knee.

When sleeping on the back, a small to medium pillow is recommended. Many people feel like they a larger pillow, and while they may get to sleep more peacefully, they often wake with a sore neck.

Trying to train your body to cope with a smaller pillow when on your back teaches your body to get better at holding a straight position. Try just resting on your back in bed at first – without trying to go to sleep. You may find you learn how to cope better and better in this position.

For people with extension related back pain (spondylolysis and stress fractures), this position usually provides an increased risk of discomfort.

Side Sleeping

Side sleeping is usually described as the most common sleeping position. Pillow selection is critical here. The aim of a pillow with a side sleeper is to fill the gap between the bed and the side of your head. This is probably the thickest a pillow should be, and is therefore not much use in other positions of rest. A good idea is to use two thinned pillows in place of one large one. This allows you to use the two pillows under the neck when side sleeping, but switch to one when you are on your back.

Side sleeping is usually the least injurious position for neck and back pain, but can place undue stress on the shoulder you are sleeping on if you don’t take the opportunity to roll over in the night. Your body is designed to move, even in your sleep.

Stomach Sleeping

Stomach sleeping gets a bad rap from sleep experts, but is the most comfortable sleeping position for many flexible people. In truth there are not many who truly sleep on their stomach’s where many will sleep on their belly’s with one leg hooked up. A well placed pillow under the hips here will make for a comfortable and sustainable position especially when combined with a small pillow tucked under the chest to allow the head to comfortably be turned to one side.

A pillow is not recommended under the head at all in this position, however if one must be used – a very thin one is the main option. Stomach sleepers also generally like to have a firm bed.

Bed Selection

Bed selection based on sleeping posture has been found to correlate with sleep quality in a 2010 study of beds. 27 patients were given beds to use for 12 weeks based on their sleep position, and asked to rate their risk of pain and quality of sleep over the trial period. The results showed that choosing your bed firmness based on your sleeping posture decreases pain and increases sleep quality.

Using this simple guide, you can sleep to the fullest of your potential. Remember to move in your sleep, and as you move, shift your pillows accordingly. All positions are good positions if you are suited to them. Sleep well, and stay active.

References

Jacobson B, Boolani A, Dunklee G, Shepardson A, Acharya H. Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied Ergonomics [serial online]. December 2010;42(1):91-97.

Fong T, Choice Magazine Mattress Survey, Choice Australia, May 2010