What situation do you most dread during game day coverage? I know what my most dreaded situation is – seeing one of my guys stay down after a tackle, laying motionless on the ground. I think at that point you know, as the sports physio, it is GAME TIME! The decisions that you make over the next few moments have the potential to impact the rest of that player’s life. Pretty heavy huh! So you would want to make sure that what you do when you get out there is evidence based wouldn’t you? This article gives you that knowledge…
Hamstring injuries are an extremely common sporting injury. Hawkins et al. (2001) showed that hamstring injuries accounted for approximately 12% of football injuries. In certain sports, such as Australian Football, hamstring injuries have the highest incidence of any injury (Warren et al., 2010). This means that many teams, and their sports physiotherapists, invest massive amounts of time and energy in hamstring injury prevention. This is clearly based on the adage that ‘prevention is better than cure’. So what can we do to prevent hamstring injuries??
Plantar heel pain, or commonly plantar fasciitis, is a very common clinical presentation. In an athletic population of runners, plantar heel pain has been shown to account for as much as 8% of injuries (Taunton et al 2002). Thus, sports physiotherapists should be aware of the most appropriate management techniques for this condition. Recently support for the effectiveness of myofascial trigger point therapy has come from a randomised controlled trial. The results and techniques utilised in the trial are discussed in this post.
Neck pain is a common clinical presentation, affecting up to two-thirds of the population at some time in their life. Therefore, as sports physiotherapists we will regularly assess and treat athletes with recent onset neck pain. As a component of rehabilitation many physiotherapists will include some form of evidence based manual therapy, commonly either mobilisation or manipulation. However, a clinical question I am often asked (by both myself and patients) is what additional benefits does manipulation provide, given the additional risks? This clinical question is answered by a recent RCT that compares the use of mobilisation and manipulation in patients with recent onset neck pain.
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.
In the retail and customer service world, we are told, the customer is always right. Whilst you may think that this has no relevance to the world of sports physiotherapy, where the athletes or patient are frequently wrong, it is surprising how frequently the athletes beliefs can affect your (yes, you!) clinical reasoning or practice. In this article I discuss how patients may dictate your treatments, and identify some of the issues with allowing this to happen.
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.