Physios at GC2018

We are really excited that a few of our physios that are heading along to the Commonwealth Games and thought we would have a quick chat to them about their involvement.

Shane Lemcke – Director and Sports Physiotherapist

What is your involvement in the games?

I am part of the Australian team as Team Manager and Sports Physio for the Squash program. I will be looking after the 10 squash athletes in the team for a weeks training leading into the Games, and then for the duration of the competition (singles and doubles competitions) which runs for the whole games period. 

Why are the Games important to you?

I’ve been lucky enough in my career to work at a number of major sporting events. It is a real privilege to be able to be part of these events and help the athletes achieve their goals. In a professional sense it is really fulfilling to see athletes and clients who have worked so hard to get to an event like the Commonwealth Games compete and do their best. Personally as a lover of sport it is great to be able to be able to experience the games so intimately, as I never had the talent to make it as an athlete!

What are you looking forward to the most?

I have worked with most of the squash team since they were juniors, and have known some of them for almost 15 years. I am really looking forward to seeing them compete at a home games with all of their family watching, and hopefully enjoying some success. 

Geoff de Jager – Musculoskeletal and Sports Physiotherapist

 What is your involvement in the games?

My involvement in the Games is as a volunteer Physiotherapist on the Medical Volunteers Team. I’ve been stationed at Oxenford Studios, which is the venue for Boxing, Table Tennis and Squash. My main role is going to be with boxing, and will combine “Field of Play” duties as well as working in the Athlete Medical Facility on-site.

Why are the Games important to you?

Working at the Commonwealth Games gives me an opportunity to work with elite athletes in sports I don’t often get the chance to work in. Being involved in a huge multi-sport competition on our doorstep is a once-in-a-lifetime chance to further develop my sports physiotherapy skills and experience a fantastic event from the inside, something spectators don’t get to do. I will also get the chance to help athletes from countries that don’t get much support due to lack of funding, which is always very satisfying. It’s also a great opportunity to meet other sports physios from around the country and around the world, sharing information and techniques.

What are you looking forward to the most?

I’m really looking forward to meeting people from all walks of life, who have come together for this great event. The athletes and other support staff are what makes the games special and creates a fantastic atmosphere for all involved. It will be interesting to pick up new skills too!

Josh McCabe – Physiotherapist

What is your involvement in the games?

My involvement in the Commonwealth Games is sports coverage and treatment with the Hockey and Lawn Bowls venues. I will be working as a venue based physiotherapist in a team of medical professionals including another physiotherapist, nurse and medical doctor. Our role is to provide coverage for every match and to make ourselves available to help any country that may not have access to physiotherapy or medical services while travelling and those teams that require an extra pair of hands for preparation and recovery.

Why are the Games important to you?

Volunteering at the games is an important part of my learning experience as a young physiotherapist and I see this as the first big step in the direction I want my career to head towards. Aside from learning how to work within a medical team at a major championship, also working closely with the teams and some of the worlds best athletes is going to be a very cool experience and one that I am very grateful for.

What are you looking forward to the most?

It’s exciting being part of something that’s so much bigger than an individual sport, it really is quite special to be involved in a home games. I’m looking forward to experiencing the sport from the sidelines, this in my opinion is surely the best way to see live sport.

Interview with Donna Urquhart

In the lead up to the Commonwealth Games and in the wake of her 11th PSA title, we chatted to squash champion and QSMC client Donna Urquhart on her squash career and the upcoming games!

How did you get involved in Squash?

I spent my childhood living next door to the squash centre in our little town (Yamba), and before I was old enough to go to school I would follow Mum over to the courts when she played socially. It wasn’t long before I was picking a racket up myself and running around. I just loved it and started playing in under 9s tournaments when I was 6 or 7 years old.

What do you wish someone had told you when you were starting out as an athlete?

I wish I understood the value in active recovery and pre-hab exercises as a young athlete (stretching, rolling, triggering etc). The thing is I’m sure I was told back then, but I used to place so much more importance on the ‘harder’ and more gruelling training sessions instead. I think I find a better balance now between working myself hard and time spent actively looking after myself.

What is going through your mind when you first step onto the court to compete in something like the Commonwealth Games?

As much as you try to treat it like any other competition and focus on your game plan, it’s hard not to feel the extra excitement of the big occasion, not much compares to how proud you feel to be in the green and gold and representing Australia.

You have travelled and competed all over the world and in two Commonwealth Games previously. What is different about the Commonwealth Games to other competition? Does playing the games on home soil change anything?

The biggest differences would be the fact that it’s a multi-sport event and you find yourself surrounded by all kinds of athletes in the one place living and eating together. Also that the Commonwealth Games is a much bigger deal at home in Australia than other squash tournaments usually are, so more media coverage, and even more interest in what I’m doing from friends at home! This time around being a home Games has intensified that even more, but it’s great for the sport – there are people that I have known my whole life coming to watch at the Games who have never actually watched me play before! Having a Games on home soil is just more exciting in that sense, there’s a real buzz around it at the moment, and for me personally it’s a dream come true.

If you had to choose between the two, single or doubles?

Singles, because that’s what I train for and compete in most of the year round, but I actually love playing doubles too. It’s so much fun and I love the team element of it.

What is your favourite Commonwealth Games event to watch?

I like watching the hockey because I grew up playing a lot, and the Australian men’s and women’s teams are both awesome.

How has physiotherapy played a part in your preparation for competition?

Unfortunately injuries are a part of sport and I’ve had my fair share! Physiotherapy has helped me recover fully every time, whether the injury is big or small. I have been looked after by QSMC since the start of my career and I have always had peace of mind knowing that I can trust the advice and help they’ve given me.

You turned pro in 2005, what is the key to 13 years in the sport? How has squash changed over that time?

Even though I currently don’t have any injury problems, I spend time every day doing preventative and maintenance exercises (most of which I have learned from QSMC and Aspire over the years), which I know plays a huge part in keeping my body feeling good and able to compete at the top of my game. In addition to that I am still playing because I absolutely love the sport and I am still driven to keep improving and pushing my limits.

Since the beginning of my career the scoring system has changed in professional squash and also the ‘tin’ height has been lowered. Both these changes have made the game shorter and more attacking, and while squash is still a physical game of endurance, it now has an extra need for speed. The lower tin means you have to cover more ground and get down lower to the ball at the front of the court, making it even tougher on the body, but professional athletes have trained harder and adapted to these changes making squash more exciting to watch than ever before.

Speaking of more exciting to watch, the other big change during my career has been the improvement of technology, making squash so much more TV friendly. It’s awesome to see it from all the different camera angles and in slow motion replays – check out the highlights of the PSA World Tour on YouTube! All the major tournaments can be watched live online at psaworldtour.com/tv.

Thanks so much to Donna for taking the time to talk to us, we cannot wait to watch you compete in the Commonwealth Games!

Welcome to the Team

We are really excited to welcome to our team a new Sports Physio!

Marguerite King

Marguerite joined our team on the 13th March and we are really excited to have her experience in the clinic. Marguerite has a dual Masters degree in Sports and Musculoskeletal Physiotherapy from the University of Queensland. In 2011, she was the recipient of the Vasyli Prize for the highest academic achievement in the Sports Physiotherapy program.

 

Marguerite is part of the preferred physiotherapy provider network of Rowing Australia and was personally a member of the Australian rowing team from 2002 until 2008, winning two world championships during that period!! She competed in the Beijing Olympics in the lightweight double scull. Read more about Marguerite.

Vionic Beach Thongs

Not your average plugger!

The Vionic Beach flip flops have arrived in the clinic and just in time for your christmas stocking fillers! With a biomechanical footbed, contoured heel cup and cushioned comfort these stylish thongs are the perfect addition to your summer wardrobe and the best part is they promote alignment making them much better for you than your average plugger!

In an effort to promote natural alignment and elevated support the team at Vionic have engineered their orthotic technology into on-trend styles you will love. Through innovation and modern, thoughtful design Vionic’s research has brought them here – the Beach Flip Flop.

With multiple colours and plenty of sizes available come into the clinic and grab your new summer footwear, supporting you from the ground up.

 

That Winning Feeling with Red Bull Holden Racing

CONGRATS JAMIE WHINCUP AND REDBULL HOLDEN RACING TEAM
For his seventh time Jamie Whincup won the V8 Supercars title in Newcastle on Sunday 26th November! Specialist Sports Physio and Director at QSMC and Aspire Chris Brady has been working with the team for over 13 years. We sat down with Chris and asked him;

What its like to be with the team when they win something like this?

CHRIS: To be honest, while at a personal level, having success in the championship makes me feel really good, mostly I feel good that I’ve been able to help the team achieve the outcome that we were aiming to do. Having said that, being with that team when we win is exactly the same as it is when we lose. We support each other, and we encourage each other to be the best we can. With this, we share in our victories and our defeats. We have a Sunday night beer either way. Winning just makes it taste a little better.

What do you think sets the team apart?

CHRIS: Red Bull Holden Racing Team is set apart by three factors:

1. Leadership. We have really clear consistent leadership from Mark Dutton and Roland Dane so that every person knows their role and knows what is required of them at all times.

2. Grit. In 2005, 2006, and 2007 we came second in the championship by small margins. This taught us the ability to keep our mind on our own job, and keep a clear head under pressure.  Being calm when everyone else isn’t, is one of this team’s strengths.

3. Passion. Every single member of RBHRT is a racer. From the cooks, to the commercial team, from the Directors to the drivers, everyone loves racing and loves helping get our cars to the pointy end. It takes a team to win a championship.

Some great insight into such a well oiled machine! Well done to the Red Bull Holden Racing Team for a tremendous effort.

Hamstrings and the Nordboard

Hamstring injuries are among the most common injuries sustained in sports. They are prevalent in all sports that include running and kicking, such as AFL, soccer rugby codes and track and field.

The average amount of time an AFL player misses if they injure their hamstring, is about 3 weeks. Whilst that isn’t a large amount of time, one of the main issues is that hamstring injuries are prone to recurrence. What can start as a short-term injury can ruin an athletes season if they have recurrent problems.

This is where the Nordboard can help. The Nordboard is a device that has been developed to accurately measure the strength of your hamstring muscles. One of the reasons why hamstring injuries can occur and indeed why they can reoccur is because of a lack of strength in the muscle group. We are lucky enough to have a Nordboard here at the clinic at QSMC.

The team at Vald Performance developed the Nordboard with a large amount of research and now have some strong evidence that if the strength of your hamstring muscles are below a certain level for particular sports you increase your risk of injury, or if there is a difference in strength between each of the hamstrings. This makes the Nordboard a very powerful tool to evaluate your strength, help make the decision if you need to do more strength work and help determined if you are ready to return to training after an injury. That’s the reason why so many of the professional sports teams such as our friends at the Brisbane Lions now utilise the device to screen their players and to monitor their progress following an injury. It will also be one of the reasons that the recurrence rate of hamstring injuries has started to decrease in recent years.

If you have had a hamstring injury or are part of a sporting team then getting QSMC to accurately assess your strength on the Nordboard can help to minimise the effect your hamstring injury has on your chosen sport.

Contact our friendly reception team on (07) 3891 2000 to book in for a hamstring test on the Nordboard today. To watch a video of the Nordboard in action. Click here. 

 

 

Rowing Flexibility

– with Sports Physiotherapist Ivan Hooper

Over the next few months, rowers both young and old will be increasing their early morning training. Schoolboy rowing will be in full swing in Term 4 while Masters rowers prepare for the classic Head races.

Rowing is a sport that requires a unique mix of fitness, strength and skill. It requires the athlete to get into challenging positions that demand flexibility. The catch position where the athlete places the blade into the water requires a compression of the hip, thigh to chest. To achieve this position the athlete needs flexibility of the hamstrings, hip flexors and gluteals amongst other muscles.

The catch pictured above – shins at 90 degrees

Whether young or old, it is very common to see rowers with deficits in flexibility in these key muscle groups. This will have the effect of limiting hip compression. A consequence of this can be the athlete reaching further through the spine to get their stroke length. This places the spine into a weaker position and could lead to overload of spinal structures.

As rowers start to build their training volume, it is important to incorporate regular stretching into the weekly routine. A routine of 10-15 minutes repeated 2-3 times a week should produce gains. Stretches are best done when warm after activity. Hold the stretches for 20-30 seconds and repeat three times on each side. Improving the flexibility of the hamstrings, gluteals and hip flexors will assist in achieving better positions during rowing, helping with both injury prevention and performance.

Below are some stretches for rowers recommended to incorporate into your weekly training routine. If you would like a more thorough assessment of your flexibility and how it relates to rowing our physiotherapy team at QSMC can assist with a musculoskeletal screening.

Hamstrings 

Hold your leg tight in vertical position with both hands. Keep your ankle and foot relaxed. Straighten your knee until you feel a stretch in the back of the thigh. If you can fully straighten the knee with the thigh vertical, repeat the stretch while the thigh is closer to your chest.

Alternate Hamstrings – Long 

Lie in a doorway with one leg through the door and the other straight against the edge of the door. Position your hips a distance away from the door so that you feel a mild hamstring stretch. Hold this for up to 5 mins per leg. If your leg gets sore or goes numb, break up the time into smaller blocks.

Gluteals  

Positioned on the ground with one leg behind you and one bent out in front with the knee in line with your trunk, lean forward while keeping your pelvis square to the ground. 

Hip Flexor & Quad – Hip Flexor and Lateral Trunk Extension 

Kneeling with your front shin vertical, tighten your stomach to keep your lower back flat. Tuck your bottom under to tilt your pelvis backwards. Lunge forward so that you feel a stretch in the front of the hip. A variation that an help stretch the outside of the hip and side of your trunk is to add a side bend, with arm over head. The stretch should move to being a bit higher and lateral to the previous stretch.

Quadratus Lumborum

Sitting with the left leg straight and right heel tucked into your groin, place your left hand on your right knee and use this to pull your trunk into rotation. Your shoulders should align with your straight leg. Place your right arm over your head and bend towards your left knee. The stretch should be felt in your lower back.  

Swimmer’s Shoulder

– with Sports Physiotherapist Ivan Hooper

Spring has hit and with it warmer weather is on its way. As the temperatures rise our exercise thoughts often turn to swimming as a way of keeping fit and keeping cool.

Shoulder pain is a common complaint for swimmers, and is especially prevalent as people are ramping up their kilometres in the pool after a long winters hibernation. Here are a few tips from our Sports Physiotherapist Ivan Hooper, who has spent the last 2 years working with the Australian Swim Team as their Clinical Services Manager – Physiotherapy. His role is to coordinate and manage the physiotherapy services being provided to elite swimmers around Australia. With Ivan’s extensive experience, he has shared with us some tips on what to be considering, that might help prevent shoulder pain from happening to you as you hit the water this spring.

Make your shoulder strong – Making sure that the muscles of your shoulder are strong will decrease your risk of injury when you get back in the water. Whilst everyone is a bit different, the common muscles that need strengthening to avoid injury are the muscles that control the position of your shoulder blades, and the rotator cuff muscles. Try these exercises to get a head start. Remember that everyone is a bit different, and you may need a strengthening program that is more specific for you. In that case it would be a good idea to drop in a see your physiotherapist at QSMC for an individualised program.

Prone T Raises

Starting with arms on ground straight out from the body just below shoulder height. Engage between shoulder blades and lift arms off the ground keeping thumb pointing to ceiling. Hold squeeze at top for 1-3 secs and slowly release back to the ground. Repeat for 10-20 reps. Ensure not to engage neck or upper trap muscles.

Prone Y Raises

 Starting with arms in Y position above shoulder height with thumbs point up. Engage shoulder blades to lift arms off ground, hold squeeze for 1-3 seconds and slowly release back to the ground. Repeat for 10-20 reps. Ensure not too engage neck or arch up through lower back

Build up slowly  – One of the big mistakes lots of people make is to get back into things too quickly and do more than their body is ready for. There is lots of evidence now that how much you do, and how quickly you increase that amount has a big impact on the risk of developing an injury. If you have been out of the pool for a while make sure you take it easy at first and slowly build up the amount that you are doing. Early on it is advisable to only swim every second to third day to allow time for your muscles and joint tissues to recover and adapt.

Keep an eye on the frequency of your sessions (how many sessions you are doing a week) the volume of the sessions (how much you do each session) and the intensity within the sessions (how hard you are going). Try to build all of these areas up slowly and you are a good chance of avoiding an injury.

Recover between sessions  – When you haven’t been swimming for a while it can be a bit of a shock to the system. Often you feel pretty good in the first session, but your muscles pull up sore and tight, and the next session can seem a lot harder. Making sure you give your muscles some care and attention between your swimming sessions will help you hit each session feeling good. Doing some self massage and stretching to the muscles that work hard might do the trick.

Self massage 

Back of Shoulder – Position a tennis ball against a wall and lean the back of your shoulder blade onto the ball. Roll across the back of the shoulder blade to find tight / sore areas within the muscles. Hold the pressure on the tight areas for 20-30 secs before moving onto the next tight spot. Do this for a total of 3-4 mins.

Front of shoulder – put your shoulder in a pec stretch position, pictured. Using the fingers of the other hand massage across the pec muscles from the point of the shoulder towards your sternum. The pec muscle is a fan shape – so make sure you cover all areas for a total of 3-4 mins.

Stretching

Lat Stretch – put the arm that you are stretching on the floor in front of you with your palm facing up. Lean your body away to extend your shoulder to feel a stretch in your lat. Hold the position for 20-30 secs and repeat 3 times each side.

 

By sticking to these tips, chances are you can build up your swimming and enjoy all the benefits of this great sport. If you do sustain an injury or feel you need a more detailed assessment before hitting the water, make sure you get in touch with your physiotherapist at QSMC. Don’t let an injury get in the way of your exercise goals this spring.

Calf Strains

Calf Strains in runners

We are now well into the running season, with some having just completed the Gold Coast marathon or Half Marathon, and the Brisbane marathon festival happening this Sunday. Others are preparing for the Bridge to Brisbane, the Noosa Triathlon and a host of other running events in the coming months.

As a preparation for an event picks up, runners will increase the length of their runs and the weekly mileage starts to  creep up. One very common running complaint suffered by nearly all runners at some time is calf soreness or calf strains.

Usually runners complain of a dull aching pain, but in severe cases a sharp intense pain is felt and the person will find it difficult to walk. A runner’s worst nightmare is to pull a calf muscle during a race or during the last few weeks of preparation. The calf muscle is a group of 3 muscles at the back of the lower leg. The gastrocnemius muscle (which has 2 parts, an inside and outside portion) is at the top of the lower leg and is stretched with the knee straight. The lower, deeper soleus muscle is stretched when the knee is bent. Both these muscles attach onto the heel via the Achilles tendon.

Common causes of calf strain:

  • Overload and fatigue
  • Speed or hill training
  • Ineffective warm up and warm down routines
  • A sudden increase in mileage
  • Dehydration and cramping
  • Calf tightness from back and sciatic pain
  • Inappropriate footwear

Assessment

There are 2 quick measures Physiotherapists use as part of an overall assessment of a clients calf. You can use these as a guide to see how your calf stacks up.

  1. Knee to wall measure – To assess the flexibility of the calf and ankle we get the patient to place a ruler perpendicular to the wall. The patient stands with their big toe on the ruler and keeping their heel down, bends the knee to touch it to the wall. You continue to move the foot back until you are no longer are able to touch the wall with your knee while maintaining your heel on the ground. The last point you can manage this is the measurement. For most people we would like have a measurement over 10cm.
  2. Single leg calf raises – The patient stands on one leg and rises up and down onto their toes as many times as they can. The magic number we are looking for to indicate adequate strength in the muscle is the ability to do 30 calf raises on each leg.

Treatment

If you have injured your calf, the early treatment aims at reducing inflammation and strain on the muscle. This may include:

  • Ice massage over the muscle several times during the day.
  • Compression to limit bleeding and swelling in the muscle.
  • Elevating the leg whenever possible.
  • Stopping running and limit all activities that aggravate the condition.
  • Using a heel raise/shoe insert that helps take the pressure off the muscle as it heals
  • Potentially using anti-inflammatory medication (if advised by your doctor or treating therapist).
  • Early mobilisation and pain free strength work as advised by your physiotherapist.

As the rehabilitation progresses your Physiotherapist will guide you through the necessary steps to get you back to running. These may include,

  • A graduated calf strength program
  • Calf flexibility and mobility
  • Plyometric exercises such as jumping, skipping and hopping.
  • Addressing other predisposing factors such as lower limb and foot biomechanics, decreased ankle range, and weakness in other muscle groups
  • Advice on safe activities to keep your fitness going whilst you work through your rehabilitation
  • Technical advice on running technique, and running drills
  • A detailed return to running program
  • An ongoing home exercise program to minimise the chances of recurrence

When treating runners one of the most difficult things is to convince them of, is the need to take time out from their running schedule to let their injuries heal. We as a runners know how mentally hard it can be, feeling like you are going to loose all your fitness and undo all your hard training. The good news is that research points to the fact that endurance training doesn’t disappear overnight. In fact, the benefits of those long runs last upwards of 6 months! Also cross training, and particularly water running have been shown to maintain your fitness while you are out of action. The key is to get better so you don’t re-injure yourself or change your running style and suffer continued injuries and problems.

As always prevention is the key! Ask your Physiotherapist for the specifics that relate to you, but some strategies that may help include,

  •       A good warmup and cool down routine.
  •       Avoid dramatic increases or changes to training.
  •       Address small injuries quickly – don’t make them big injuries!
  •       Modify your training when fatigued.
  •       Wear good quality, supportive shoes appropriate for your feet.
  •       Keep well hydrated

Hopefully this keeps you on track for your running goals this year and aids your preparation for this running season. If you have any questions about your personal running technique, niggling injuries or are in need of a strength and conditioning program, contact our friendly reception team on (07) 3891 2000 or email reception@qsmc.net.au for booking your next appointment with a Physiotherapist or Accredited Exercise Physiologist.

Hydration Matters

 

Our body is made up of 60% water (can be up to 78% depending on age) water.

It is crucial for survival so it is important to be aware of our body’s need for hydration. Our body needs water for the following functions:

  •    It transports materials throughout the body
  •    It eliminates toxins and waste products
  •    It acts as solvents for nutrients
  •    It regulates body temperature
  •    It is used for energy product in
  •    It aids in digestion and absorption

Every system in the entire body depends on water and requires hydration!

It is recommended that the average individual take in at least 3L of water a day…that figure is raised to 4L during hot days or in hot climates.

Sports and Hydration

Caffeinated beverages, such as soft drinks, coffee and tea act as diuretics and can increase urination that can lead to dehydration. It’s important therefore to consult your Sports Dietician if using caffeine pre-event to ensure to ensure you are getting the stimulant vs hydration balance right.

What happens during exercise?

Heat is generated as a by-product of your working muscles. As body heat rises, body temperature and heart rate also rise. As the exercise continues, the body is limited in transferring heat from the muscles to the skin surface. The body will require hydration.

Exercising in hot, dry climates presents additional risks to dehydration. Body fluids will evaporate rapidly so that you may not notice any symptoms. In humid climates, when moisture increases, sweat decreases. When your sweating rate decreases, your body temperature rises and you will fatigue more easily and your risk of heat injury is greater.

What is heat injury?

Heat injuries include heat cramps, heat exhaustion, and heat stroke.

  •    Heat cramps are severe muscle spasms resulting from heavy sweating.
  •    Heat exhaustion is severe fatigue resulting from excessive exposure to heat that can lead to collapse.
  •    Heat stroke is a life threatening condition that develops rapidly and may not have any warning signs. It is the third leading cause of death among athletes.

There are three factors that contribute to heat injuries. They are –

  •    Increased body temperature
  •    Loss of body fluids
  •    Loss of electrolytes

Symptoms to look for include –

  •    Weakness
  •    Chills
  •    Goose pimples on your chest and upper arms
  •    Nausea
  •    Headache faintness
  •    Disorientation
  •    Muscle cramping
  •    Cessation of sweating

To reduce the risk of heat injuries, adequate fluid replacement is essential before, during and after exercise.

What fluid is best for rehydration?

Water is the appropriate drink before, during and after exercise. However, for exercise lasting longer than one hour and after exercise, it is important to replace electrolytes lost. Sodium replacement not only maintains blood concentration but also increases palatability, and therefore the desire to drink.

The addition of carbohydrates will delay the onset of fatigue and help to maintain blood glucose concentration. A sport drink with 4%-8% carbohydrate is recommended for replacement during exercise, especially with exercise bouts lasting longer than one hour.

So the next time you exercise, remember the importance of hydration. It is a simple step that can save your life!