Ankle Injuries – 14 Day Balance Challenge

What to do about that ‘dodgy’ ankle?

Try this quick test without shoes on – stand on one foot and close your eyes.
Have a friend time how long you can keep your balance.
If you can’t stay balanced for at least 30 seconds you need to read on.

Ankle Sprains – The Facts!

Ankle sprains are the most common team sport injury and account for up to 60-90% of all injuries. Unfortunately after the first time sprained, and without any rehabilitation, you have around a 70% chance of rolling the same ankle again.
Balance is very important to ankle stability. Balance is made up by a combination of three different senses:

  1. Vision
  2. Vestibular (Ears)
  3. Joints

Unfortunately, once we sprain our ankle the message of ‘Position’ to our brain gets a little confused and in effect makes our balance worse. The good news is balance can be improved with practice. This can then decrease your chances of re-injuring the ankle again.

Give this 14-day balance challenge a go to improve balance and prevent re-injuring the ankle.

14-Day Balance Challenge

Exercises should be completed twice daily and should take approximately 10mins with no footwear or tape.

Day 1 – 3
1) Single leg balance, eyes open, standing on the floor – 30secs x 10reps
2) Single leg balance, eyes closed, standing on the floor – 30secs x 10reps

Day 4 – 6
**Note – unstable surface = either a pillow, foam mat/mattress, mini-tramp or a wobbleboard/durodisc at your gym
1) Single leg balance on unstable surface eyes open – 30secs x 10reps
2) Line walking – heel toe walking over 10 metres – 10m x 5reps
3) Standing on injured leg, kicks whilst maintaining balance – 4 x 10 kicks forward, backward & sideways whilst maintaining balance

Day 7 – 9
1) Single leg balance on unstable surface eyes closed – 30secs x 10reps
2) Forward hop-soft landing, hold landing 3secs – 2 x 10reps

Day 10 – 12
1) Single leg 1/4 squat on unstable surface, eyes open – 4 x 10reps
2) Sideways hop on ground, hold landing 3secs – 2 x 10 each way
3) Forward hop off step, land softly, hold landing 3secs – 2 x 10reps

Day 13 – 14
1) Single leg 1/4 squat on foam, eyes closed – 4 x 10reps
2) single leg hop with 1/4 turn on ground – 2 x 10 clockwise & anticlockwise
3) Sideway hop off step, land softly, hold landing 3secs – 2 x 10reps to each side

Final tip to a quicker recovery – Sport specific retraining is the key!

To make an appointment with one of our Physiotherapy team to discuss your ankle injury, sports specific retraining and when to return to sport book online, email reception@qsmc.net.au or call 07 3891 2000.

The ‘Need-to-Know’ on Knee Injuries

The ‘Need-to-Know’ on Knee Injuries.  What injuries cause the most prolonged absence from sport and how to know when to return?

The knee joint is formed by the thigh bone (femur) and shin bone (tibia). Your kneecap, or patella, sits in a groove on your femur and this joint is know as you patellofemoral joint. The main movements that your knee performs is bending (knee flexion) or straightening (extension). There are four main ligaments that help restrict unwanted movements at your knee: the anterior and posterior cruciate ligaments, the medial ligament which is on the inside, and lateral ligament which is on the outside.

The major structure that when injured causes the most prolonged absence from sport is the ACL, which stops the tibia moving forward on the femur as well as rotation. Commonly it is injured when pivoting or landing and it is accompanied by a loud ‘pop.’ Typically you are unable to continue the activity due to the knee giving way and pain. This is usually followed by swelling. If the ACL has ruptured, you will more than likely require a knee reconstruction. Diagnosis of such an injury is able to be made by your physiotherapist but may also require an orthopaedic surgeon to assess the knee and possibly investigations such as a magnetic resonance imaging (MRI) scan to confirm the diagnosis and to assess for other coexisting pathologies..

The most common type of reconstruction performed uses your hamstring tendon as the graft for the new ligament. The surgeon may elect to use another method such as your patella tendon, or even a synthetic graft.  In the reconstruction, the surgeon will take a portion of your hamstring tendon and insert it to take the place of your ACL. This is all done by arthroscope and physiotherapy will generally start within the first week. Over the course of the next nine to twelve months, a rehabilitation program will be followed which is set out by the orthopaedic surgeon in consultation with your physiotherapist. After such surgery and a comprehensive rehab program, you can reduce the risk of injury to almost the same risk of injury as you had before your initial injury.

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But at the end of your rehabilitation, how do you know when you right to return to sport? Below are a series of hop tests which can help you and your physiotherapist decide when you are right to return.

Studies have shown that 3 simple tests: vertical jump, hop for distance and a side hop can accurately show when your knee is right for action. Your injured side must be at least 90% of your un-injured leg in all tests to pass. The tests look at the strength of the muscles surrounding your knee, the ability to control your knee under high load as well as its resistance to fatigue. It is important that these tests are done under appropriate supervision of your physiotherapist.

Vertical Jump
Start by standing upright on your un-injured leg with your arm up as high as possible with chalk bend your knee and jump as high as possible while striking the wall with your hand at the highest point. Repeat with your injured side.

Hop for Distance
Stand on your uninjured leg with hands behind your back, bend your knee and hop as far as possible. You must be able to hold the landing for 3 seconds. Measure from your toe at push off and the heel where you landed. Repeat with your injured leg and compare the two scores.

Side Hop
Get two strips of tape 40cm apart on the floor. Stand on your un-injured leg and hop from side to side without touching the tape as many times as you can in 30 seconds. Repeat the test with your injured side and compare the two results.

The results of these tests will let you know what elements you need to work on: strength, stability or fatigue. These tests should be completed under appropriate supervision and it is also important that if you have had a reconstruction, before you return to sport, you are cleared by your orthopaedic surgeon.

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

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.

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.

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.