Physical activity and sport is an integral part of numerous people’s lives and many have suffered an injury which has set them back in their function and/or their ability to play and participate in daily activities. So how do we best equip ourselves to minimise our chance of injury? Ideally we would look at why the injuries are occurring, however to spare you reading an essay we will define injuries in one of two ways: Contact injury Non-contact injury Contact injury: A direct injury which is caused by an external force e.g. tackling or being struck by an object. Indirect injury: this can be due to a physical mechanism such as falling. Or can be due to internal factors which can lead to strains or sprains for example. Here we will focus on strategies to implement to prevent indirect injuries. Rehabilitation from past injuries A large indicator of risk of injury is if you have had a particular injury previously. This is highly attributed to the incomplete recovery due to early cessation of rehabilitation exercises. This could be due to pain levels decreasing, however we also need to look at function! We love seeing pain levels reduce, but rehabilitation exercises also have a large role to play in enabling your levels of function and activity return to pre-injury levels. If you stick to them and check in with your physiotherapist your rehabilitation exercises can also be progressed to potentially get you functioning to levels even better than your pre-injury levels. This all depends on your dedication and appropriateness of your exercises. Seeking input from a physiotherapist will allow you to have many aspects assessed such as, range, strength, control, balance, functional activities and/or more to allow exercises or manual therapy to be tailored to your ability with room to progress along the rehabilitation journey that will also be adapted to your ability with re-assessments of the above mentioned aspects. Adequate warm up Preparing your body prior to your activity increases blood flow and oxygen, increases your range of motion and flexibility, and can improve your performance. Having trouble as to what you should include in your warm-up? Head over to our static vs dynamic stretching’ blog post, instagram reels, or book in with one of our physiotherapists who can assist you. Managing load Sometimes we get excited and increase either the intensity, frequency, and/or weight too quickly when our body, in particular our tendons, are not ready to take that much load. Our bodies take time to adjust to the stresses we put it through. This is where we want to implement the principle of progressive overload. This gives your body the chance to gradually adjust to the stress and slowly build up as necessary. In your sport you may see this through your pre-season training into your season training to ensure that your body is able to withstand the higher weight or intensity in training/games. Load management will be a key strategy used by our physiotherapists to reduce pain levels and increase your participation levels. Strength and functional training Increasing your strength and your ability to protect your joints is imperative to decrease your risk of injury. This can be training specific muscles that you may have found to have strength deficits or can be overall strength levels to optimise your performance levels. Functional training can incorporate similar movement patterns that you may complete in your training or sport. Similarly, it can include balance, proprioception, stability, and agility exercises. Many researchers have found a correlation between balance and proprioception levels and ankle sprains. If you would like some guidance on what this may look like for you feel free to book in with one of our physiotherapists or exercise physiologist who would love to help. Additionally, you can book in for a VALD assessment to get real data on your strength levels and compare it to normative data. Adequate recovery Recovery strategies such as sufficient sleep, hydration, and nutrition are imperative. To aid your recovery efforts post training/games and between sessions compression garments such as NormaTec boots or infrared saunas can also be of benefit, with their ability to increase circulation of blood, possibly reducing the onset of muscle soreness Our recovery room has 2x infrared saunas and 3x NormaTec boots ready for you and your friends! Call us or book online for a casual session or $20 weekly subscription for unlimited access!

Blood Flow Restriction (BFR) Training BFR has been used in bodybuilding circles for many years for muscle hypertrophy, however, recently we’ve seen it makes its way into the rehab & general strength & conditioning arena. It involves the use of an inflatable tourniquet, such as an elastic band or cuff, around the top of the arm and/or leg to restrict blood flow during exercise. The goal of BFR training is to increase strength gains while lifting lighter loads which reduces the overall stress on the limb and avoids muscle breakdown.

Both squats require ankle knee and hip mobility, but front squat demands more ankle mobility and less hip mobility due to the upright torso positioning.

Can I see a physio if I’m not injured or in pain? Definitely! There’s actually some great reasons to see a physio when you’re feeling ok and even have a regular check in schedule. 1. Injury prevention: We can assess range of movement, strength, balance and coordination to assess injury risk and put a plan in place to help prevent issues from arising. 2. Sports performance optimisation: Regular check ins and treatments with your physio can help keep problem areas under control and avoid getting as sore and tight. By having someone who knows your baseline measures and your body, we can help keep you on track and be able to notice if changes are needed in terms of training schedule, rehab exercises and treatment plan. 3. Advice and education: we can help guide your training loads, work place set up, rehab/prehab exercises and activities to avoid when needed. 4. Improved healing and recovery if injuries do occur: As much as we’d like to, we can’t 100% prevent injury. Things happen in the sporting arena and in everyday life that are sometime unavoidable, and can cause pain, inflammation and dysfunction. The good news is that if you do regularly check in with your physio and get regular treatments, it can lead to improved injury recovery and reduced time on the side-lines. 5. Reduced falls and related injuries: One of the most common reasons that older adults are admitted to hospital is due to injuries sustained in a fall. We can help older adults who may be at risk of falling by working on strength, balance and general fitness, as well as managing any pain that may be causing in increased risk of falling. Regular sessions with guidance from our physios can help reduce the likelihood of falling in the first place, and if falls do occur, can help reduce the likelihood of serious injury. In summary Physiotherapy isn’t just for athletes or injured people. By regularly checking in with your physio, you can reduced the likelihood of injury, improve your healing when injuries do occur, optimise sports performance, and just feel better in general! At Active Balance, we want to get your feeling great not just now, but in the long term. What that means for you will be different to the next person, as will the frequency and type of treatments that are recommended. Your physio will work with you and take into account your lifestyle, current functional abilities and goals to work out the best treatment plan for you.

The plantar fascia is designed to absorb the stress and strain we place on our feet when walking/running and doing other activities such as playing sports.

The anterior cruciate ligament (ACL) is one of the many structures in the knee joint that aids in the stability of the knee joint throughout movement. Mainly preventing excessive anterior (forward) translation of the tibia (lower leg bone) on the femur (thigh bone), as well as rotational forces. The ACL is commonly torn in athletes with the mechanism of injury occurring being non-contact with your foot planted and a sudden change in direction or rapid stopping, or contact with a direct below to the side of your knee. You may experience hearing or feeling a “pop” in addition to the sensation of lack of stability or “giving way.” It is of popular opinion that if an ACL is ruptured the only option is surgery, due to the belief that the ACL cannot heal naturally. However, there has been a big shift with new evidence surfacing concluding that ACL full thickness tears can in fact heal with conservative management, with no adverse effect on return to play*, and improved patient outcomes. Filbay and colleagues (2022) analysed the data from The Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) randomised control trial where participants either had rehabilitation alone or an optional delayed ACL reconstruction (ACLR). All measures were taken at baseline, three and six months, and one, two, and five years. At the 2-year follow-up, 16 out of 54 (30%) of rehabilitation plus optional delayed ACLR participants displayed evidence of ACL healing on MRI. Compared to MRI showing evidence of ACL healing of 53% of rehabilitation alone participants at the 2 year follow-up and 58% at the 5-year follow-up for the same group. Better sport/recreational function and knee-related quality of life was reported 2 years after injury by participants with evidence of ACL healing compared with the non-healed, delayed ACLR, and early ACLR groups. Another reason for the pathway of surgery was due to the theory that an ACLR prevented the development of osteoarthritis (OA), however it is now being suggested that ACLR could increase the risk of OA. A 20 year follow-up study found that there was no difference in knee OA between operative versus nonoperative groups. This study found that the operative group demonstrated greater knee stability however subjective and objective functional outcomes were poorer despite this (Yperen et al. 2018). It is important to note that in this post we are talking strictly on ACL ruptures alone. Everyone’s experiences and circumstances differ in what additional structures may or may not be implicated and a holistic approach is necessary for you and your allied health team to collectively choose what option may be best for you. If you would like more information feel free to get in contact with one of our physiotherapists or exercise physiologists. Alternatively, book in for your rehab journey that we would be delighted to be a part of! *It is important to know that electing to have surgery is not a necessity for return to sport and does not necessarily prevent further knee damage when returning to sport. References: Filbay, S, Roemer, F-W, Lohmander, S, Turkiewicz, A, Roos, E-M, Frobell, R & Englund, M, 2022, ‘Evidence of ACL healing on MRI following ACL rupture treated with rehabilitation alone may be associated with better patient-reported outcomes: a secondary analysis from the KANON trial,’ BMJ Journals, vol. 57, no. 2, pp 91-99. Yperen, D, Reijman, M, Es, E, Bierma-Zeinstra, S & Meuffels, D-E, 2018, ‘Twenty-year follow up study comparing operative versus nonoperative treatment of anterior cruciate ligament ruptures in high-level athletes’, The American Journal of Sports Medicine, vol. 46, no. 5, pp. 1129-1136.

Anatomy On the side of your wrist underneath your thumb is two tendons called the abductor pollicis longus (APL) and the extensor pollicis brevis (EBP). They help the thumb to abduct (move away from the wrist/other fingers) and extend (bring the thumb back or up). These tendons are cord like structures which attach the muscles to the bone. Signs & Symptoms Pain near the base of the thumb that develops suddenly or over time and gradually gets worse. Swelling near the base of the thumb Difficulty moving the thumb and wrist when doing something that involves grasping or pinching/gripping Pain with turning the wrist Pain with lifting something with thumbs pointed upwards (i.e. lifting a child) A “sticking” sensation in the thumb when moving it Pain that can occasionally radiate up the forearm. Feeling of weakness in the thumb Occasionally tingling or pins and needles in the hand Causes Dequervian’s Tenosynovitis refers to inflammation to these two tendons. While a direct cause can be unclear, it is strongly associated with overuse of these two muscles. Any activities that lead to chronic overuse of the thumb can lead to the development of this issue There are several instances where It can often occur, particularly: In new mum’s or child care workers, picking up babies is common and frequent. Typing or scrolling phone hammering /sawing Gardening Repetitive grasping Treatment of Dequervian’s Tenosynovitis During your physio consult after accurately diagnosing the condition, some treatments we can provide include: Soft tissue massage through the thumb and forearm. We may occasionally treat from the neck down the arm Mobilisation of the joints – again working from the neck all the way down Stretching/strengthening exercises – any weakness or tightness may be addressed by stretching and strengthening exercises Give activity modification advice – educate you to complete the activities that cause the main concern with simple modifications Taping/splinting of the forearm, wrist and thumb to decrease pain and improve function of the hand. At Home treatments Some things you can do at home to be proactive include: Ice or heat packs to increase blood flow through the region to aid with recovery and decrease pain Exercise to help strengthen and stretch weak and tight muscles Other treatment practices can include splinting, NSAIDs, steroid injection and surgery. We believe that physiotherapy is a less invasive or disabling treatment style than the aforementioned and should be given a try first, and to try these treatments if there is little response to physiotherapy guided treatments. Conclusion If you think that you’re suffering from De Quervain’s Tenosynovitis or are suffering from wrist or thumb pain and still aren’t quite sure, give us a call on 0450 877 731 or book online so we can get you in the right direction and move without pain.

What it is SLAP Lesions Superior labral anterior posterior (SLAP) tears/lesions are injuries that occur in the shoulder. It generally occurs as a result of overuse injury to the shoulder in overhead athletes or traumatic falls in older population and can result in deep shoulder pain and biceps tendonitis. Anatomy The shoulder consists of the glenohumeral joint (a.k.a the ball in a socket joint) because the humeral head (ball) articulates with the glenoid cavity (socket). The humeral head is larger than the socket/ glenoid cavity and therefore a capsule called the glenoid labrum attaches to the fossa and provides better stability to the shoulder/glenohumeral joint. Signs & Symptoms Sensations of painful clicking and/or popping with shoulder movement Pain can be intermittent / deep shoulder pain Loss of range of motion at the shoulder, especially internal rotation Pain with overhead movements Loss of rotator cuff muscle strength and endurance Loss of scapular stabilisers muscle strength and endurance Inability to lie on the affected side. In throwing athletes it can result in pain with throwing and no longer being able to throw with the same velocity. Causes Common causes of SLAP tears involve repetitive overhead activities (often in throwing athletes) Fall on outstretched arm with tensed biceps Traction on the arm (i.e. pullups or having your arm pulled) Heavy lifting Direct trauma Treatment of SLAP Lesions After an assessment and diagnosis of your shoulder, the majority of SLAP injuries initial management involve non-operative. This involves some physiotherapy-related treatment which can include Soft tissue massage – through the shoulder and arm/ neck. Occasionally muscles will become quite tight and grumpy if they are required to overwork and releasing these can reduce some pain. Activity modification – finding out what activities aggravate your pain and modify/avoid these activities until pain and inflammation reduces and strength is restored to be able to return to the activities. Stretching and strengthening – strength exercises focusing on shoulder stability and rotator cuff strength are key components of SLAP tear management, and exercises can also address trunk, core and scapular musculature, restoring range of motion and training to improve dynamic joint stability. Stretches which address the posterior cuff of the shoulder also help improve the range of motion. Other treatments can involve NSAID’s and corticosteroid injections to reduce inflammation initially and work best when done in conjunction with physiotherapy. Occasionally in certain instances, depending on the injury severity, SLAP tears have difficulty improving with non-operative management and may need to look at operative/surgery. Things you can try at home Short term pain relief can include heat or ice packs after activity, or gentle stretching. For most effective treatment, a professional consultation should be conducted so that we can give a tailored approach. Conclusion If you are an overhead athlete or suffering from shoulder pain that sounds similar to the above, please don’t hesitate to contact us on 0450 877 731 so that we can provide you with a proper assessment and plan of action in order to get you back on track and pain free.

What is Whiplash? Whiplash is a neck injury that is caused by a sudden high velocity backwards and forwards movement to the neck. It is typically caused by rear-end car accidents, but can also be from sports accidents, physical abuse or a fall. Anatomy Whiplash is typically poorly understood, but usually involves and affects the muscles, discs, nerves and tendons in your neck. The severity and intensity of the affected muscles depends on the type of trauma incident. Signs & Symptoms Traumatic onset Neck pain and stiffness Worsening of pain with neck movement Loss of range of motion in the neck Headaches – most often starting at the base of the skull Tenderness or pain in the shoulder, upper back or arms Fatigue Dizziness Occasionally: Blurred vision Ringing in the ears Sleep disturbance Irritability Difficulty concentrating Memory problems Causes Typically high velocity movements. Treatment of Whiplash Most people who have whiplash feel better within a few weeks, and seem to not have lasting effects from the injury, however some people continue to have pain for several months or years after the injury occurred. Early intervention usually involves some soft tissue massage and gentle stretching to relax any affected muscles, and then some neck strengthening exercises to restore normal functioning. What you can do at home Early recommendations are rest, pain relief, and some basic neck stretching and strengthening exercises. Should your symptoms get progressively worse, or are associated with any of the occasional symptoms listed above, it is best to see your local GP for further investigation. Conclusion Overall, whiplash is an injury where a wide range of factors come into play regarding symptom intensity and recovery time. It is best to consult your healthcare provider who will take a full assessment in order to give you an educated estimated prognosis.