How important is foot posture? Think about this question… what are your thoughts? I guarantee that the majority sports physiotherapists would be aware of the impact of foot posture on the lower limb kinetic chain. Thus, you sports physiotherapists would be aware of the predisposition to many overuse injuries that poor foot posture will give your athletes. This has lead to the practice in the sports medicine world of attempting to strengthen the musculature responsible for restricting and/or controlling foot (over)pronation. This article discusses the thinking behind these clinical decisions and research regarding the optimal exercise choice.
If you are a sports physiotherapist who works with endurance athletes, in particular runners, I am certain that you would have had the pleasure of treating lower limb overuse injuries (?sarcasm). As you would know, they can frequently be a challenging condition to rehabilitate due in no small part to the reluctance of the athlete to stop training. This makes the prevention of these injuries, and identification of ‘high-risk’ athletes essential.
How do you make a diagnosis? I assume that you perform a subjective examination and develop competing hypotheses, and then work to support or negate these via your objective examination. Can you, however, following your physical examination tell the patient the percentage chance of them having a particular diagnosis? Is that something you might be interested in? If your answer is a resounding yes, Bayes’ Theorem and a Fagan’s Nomogram can give you the ability to do so. This post will give you the easily implementable basics of using the Fagan’s Nomogram to improve your diagnostic accuracy!
How often do you treat ankles? I know that I treat them every day, and it is likely that you do to. Osteochondral lesions are very underdiagnosed causes of ankle pain and dysfunction. The astute sports physiotherapist should be aware of the hallmarks of this diagnosis. This article aims to present an overview of the evidence based assessment and management of osteochondral lesions of the ankle.
Osteitis Pubis is a condition that many consider rare, however, it is probably more common than you may think. The incidence of groin pain, in some sports, is as high as 13% (Ekstrand and Ringbord, 2001). Thus, it is highly likely that as a sports physiotherapist you will encounter may athletes with a diagnosis of osteitis pubis. Therefore, as is frequently stated on this site, you need to be aware of the current research and evidence based practice, even in a world with limited research.
Cuboid Syndrome is defined as minor disruption or subluxation of the structural congruity of the calcaneocuboid portion of the mid-tarsal joint (Blakeslee and Morris, 1987). Now, that is quite a wordy definition which essential means the subluxation of the cuboid from its natural position. Whilst you may feel that this condition is rare, it is probably more common than you think, particularly in certain athletic populations. Therefore, for the sports physiotherapist who routinely treats foot and ankle injuries, cuboid syndrome is a condition that you must be aware of. It is frequently misdiagnosed and therefore poorly treated. If you do not look for this it is likely you won’t find it, and your athletes will suffer.
We all know that hamstring injuries are an exceptionally common sporting injury. In some sports, such as Australian Football League (AFL), they have the highest incidence of any injury (Warren et al 2010). Therefore the sports physiotherapist will routinely assess and rehabilitate these injuries. During this process the athlete and coaching staff will frequently demand timeframes of return to training and play. Thus, if you are a sports physiotherapist who treats these athletes you should be acutely aware of the clinical predictors, or prognostic indicators, of return to play timeframes following hamstring injury.
The sports physiotherapist will commonly treat shoulder presentations. One of the most common presentations, particularly in an athletic population, is subacromial impingement syndrome (or external impingement). Therefore, it is essential that the sports physiotherapist be fully aware of the more common contributing factors and treatments for this condition. This article discusses the effect of posterior capsule tightness and the “Diablo Effect” on subacromial impingement syndrome.
The sports physiotherapist will frequently assess and diagnose acute knee injuries. In doing so, we will regularly rely on the results of special orthopaedic or clinical tests. However, if we are going to use these tests to make diagnoses and therefore guide our treatment decisions, it is vital that we are aware of the diagnostic accuracy of clinical tests. This article evaluates the research regarding the diagnostic accuracy of commonly used clinical tests for medial meniscus tears.
Femoroacetabular impingement (FAI) is, as the name suggests, an impingement or abutment of the chondro-labral structures between the femur and acetabulum. Whilst the diagnosis of femoroacetabular impingement has only recently gained attention, it is known that the presentation is more common in the athletic population. High activity athletes are at increased risk; particularly athletes who participate in sports which require them to frequently move into a position of internal rotation and flexion. This makes it an important diagnosis for the sports physiotherapist to be aware of current research and the best practice.