Does your child have persistent heel pain?

If you’re a young basketballer/netballer/footballer and have heel pain when playing sports involving running or jumping, you may have a particular growth pain disorder called Sever’s Disease.

What is Sever’s Disease?

It is a condition (not a disease) usually affecting 9-15 year olds that occurs at the back of the heel, where the Achilles tendon attaches to the foot. The Achilles tendon is the tendon connected to the calf muscles. Pulling of the calf muscles results in tension in the Achilles and in adolescents, repeated running/jumping can result in pain and inflammation at the heel – this is called Sever’s Disease.

Why does it happen?

Sever’s disease is often associated with a growth spurt, when the bones grow but the muscles do not. Therefore the muscles effectively become tighter which results in increased stress at the heel. It may also be related to unusual biomechanics, for instance poor foot posture, muscle tightness or muscle weakness. Overtraining or incorrect training can also play a part. Usually, the cause is a combination of factors.

What will the physiotherapist do?

The physiotherapist will thoroughly assess the affected areas and general mechanics to determine what factors may be contributing, also to rule out any other injuries or stress fractures, etc. Treatment focusing on the affected area will consist of modified rest, ice, massage, stretches and electrotherapy. A foam heel raise may also be given to help decrease pain.

The physiotherapist may also treat other areas if biomechanical problems are noted. This may include massage, mobilization and exercises to stretch and strengthen certain areas. They may also refer the patient to see a podiatrist if they believe the foot posture is a factor.

What about sport?

The term relative rest is often used. It is difficult to quantify an amount of activity because everybody is different and does different amounts and levels of sport. Pain-free activity is important for recovery. This usually means decreasing the number of sports played or the amount of training. Complete rest is rarely required.

Outcome

Sever’s Disease will settle, usually within six weeks to 12 months, but symptoms may persist for as long as two years, especially if you do not manage the condition properly.

If your child is complaining of heel pain whilst playing sport, make an appointment at your local clinic and have this assessed by a Physiotherapist.




We’ve got your back…common FAQ’s on back pain

Physiotherapist, Laura Fox, answers some common questions on back pain.

Back pain is extremely common, with 84% of people in the world experiencing it at some stage.

With all the conflicting advice on back pain from Uncle Jim and the next door neighbours’ cousins’ boyfriend, there is no wonder you are confused about the best way to manage your back.

If managed incorrectly, lower back pain can contribute to disability and create personal, social and economic burdens.

Should I rest? 

No. Arguably the most important piece of advice. DO NOT REST OR AVOID MOVEMENT! Evidence has come a long way since our great-grandparents were advised to rest their sore backs in bed.

Although you may initially experience some relief from rest, prolonged rest is detrimental and is correlated with higher levels of pain, disability and work absentee. An over-cautious approach can
make your pain linger and develop into a chronic condition, opening a whole new kettle of fish!

Evidence suggests that an active approach is important for recovery and gradual return to all activities is encouraged (work, hobbies, sports). Three important points to keep in mind through your active recovery:

  • Backs are strong, they are not weak and vulnerable;
  • Pain does not equal more damage;
  • Backs are designed for lifting/bending/twisting/rotating

 

Should I get an MRI?

Radiological investigations (ie xray, MRI) are often unwarranted. In the absence of serious pathology (cancer, broken bones, infection) they are not useful and may in fact be detrimental to your recovery due to the psychological implications of diagnoses.

It is important to note the prevalence of disc degeneration, bulges and protrusion on imagining increases with age despite pain/symptoms. In other words, a scan will often show you have something, however Jo Bloggs sitting next to you with no pain could have the exact same findings on a scan (the radiological results are often not linked to your pain).

You may as well save yourself the dollars and treat yourself at the local mall or favourite restaurant instead!

However, if you do get a scan, remember to take the report findings with a grain of salt – I reiterate many of the conditions described are common and normal findings in people without pain.

Will I ever be cured, or will I be coming to the physio forever?

The prognosis of low back pain is excellent, provided adequate education and reassurance is given. Treatment will focus on symptom modification, then restoration of movement and function.

‘Give a man a fish and you feed him for a day, teach a man to fish and you feed him for a lifetime’. We empower YOU to be able to actively self manage. We will help you understand your condition and the benefits associated with a healthy lifestyle (adequate sleep, exercise, healthy diet, smoking cessation).

Should I exercise?

YES YES YES! Did I say yes? Exercise is key to your recovery! More than 30 minutes per day is recommended but any amount that can be managed will reap benefits. When exercising, it is important to do so in a confident and relaxed manner – no bracing or breath holding. Exercise may consist of relaxation exercises, mobility exercises, strength and conditioning and/or aerobic exercises.

Make an appointment with your Physiotherapist at your local PSM Clinic who can implement a program to suit you. Over time, we will monitor and gradually progress your exercise and activity levels.

Don’t worry, be happy!

Remember, just like thoughts, pain is processed through the brain.. so the more you worry and think about your pain the worse it gets. Furthermore, factors such as poor sleep, stress, depression and anxiety have been shown to be strong predictors for low back pain. So make sure you’re taking some time to rest, relax and destress!




The role of physiotherapy in AFLW injuries

To say that women’s football has exploded in the last six months is an understatement. The exposure brought by the AFLW has filtered down to the local level and women everywhere are showing interest in the game.

The Southern Districts Football League has already begun their first ever women’s competition and The Victorian Amateur Football Association kicked off their inaugural women’s competition this year. From what was initially an expression of interest in a premier league competition has had over a thousand women register and now three divisions have been created.

So, with this increase in activity, have we seen an increase in injuries? Absolutely! Four players in the AFLW sustained an ACL injury in the first four weeks of competition. As compared with the one per year average at AFL clubs.

But why?….

There are numerous factors:

1.The Nature of the sport: Football is unique from many other sports that have previously dominated the female sporting landscape such as netball, tennis, running, basketball and general gym fitness (Source: ABS ) in that it requires full contact tackling.

2.Risk Factors: Given that football is a relatively new option for women, there has been an influx of women either commencing or returning to the sport after a long absence, at many different age groups. As seen in the AFLW, there was a higher proportion of athletes in their thirties than is usually seen in the AFL. Increasing age statistically correlates with an increased injury risk across both genders. There is also a reasonable body of evidence to support the theory that females are more likely to rupture their ACL due to specific anatomical and hormonal differences.

3. Reduced Exposure to Traditional Injury Prevention: There is mounting research to support the concept that strength training reduces injury risk for various injuries and not just ACL’s. Given that many women’s football clubs are in their infancy, facilities and funding are often scarce and exposure to strength and conditioning programs vary greatly from club to club.

Considering all these factors, you can already see how the recreational female footballer can become part of this high risk group!

So what can we do about it?

Strength Training- Major sporting bodies such as FIFA and Netball Australia have utilised current research to create injury prevention preparation programs. The programs are designed develop the way players absorb load and tolerate training and incorporate elements of strength training and effective warm up drills. Prevention programs can be helpful to introduce an athlete to strength training with a view to developing a more complex strength program.

Recovery and load management- Although it can be tempting for coaches at the recreational level to ‘go hard’ to get their athletes into shape, research has shown that even small increases in unaccustomed load can lead to the development of a tendinopathy (tendon injuries). Recent research suggested a ‘safe zone’ for increasing training loads at around 5-10% (reference) and above 20% as increasing the risk of injury.

If you are a female footballer, a physiotherapist can assist you in developing an effective strengthening program that incorporates the right amount of load.

Contact your local clinic today and make sure you are in the right condition to minimise injury.

 

IMAGE SOURCE: AFLW, Western Bulldogs’ Ellie Blackburn, www.aflplayers.com.au




PSM Physiotherapist, Daniel Browne, represents Australia at the International Brazilian Jiu Jitsu Federation World Championships

The pinnacle event for most sports is the world championships – for an individual a position to represent your country against the best in the world, for a team – the opportunity to cement yourself as the number one organisation. At the start of June I was afforded this opportunity at the International Brazilian Jiu Jitsu Federation (IBJJF) World Championships held in Long Beach, California. This was my first time on the world stage, and although I had competed internationally before, it was a totally different experience. The atmosphere was truly electric. Athletes from all corners of the world had flocked to test their metal and strive to become the 2017 world champion.

I competed in the brown belt middle heavy weight division (194.5lbs/88.3kg) weighing in at a respectable 185lbs/84kg . I had decided not to cut weight to the division below because I knew that way at least I would sleep better and could enjoy all the American cuisine my stomach could handle (M & M world deserves a blog post on its own!) . Generally I get quite anxious before competing but this time I wasn’t feeling the pressure as much – I figured what is there to loose. My primary goal was to make the event a positive experience irrespective of the result. It wasn’t until the morning of the competition that the butterflies kicked in. Fortunately I was able to compose myself and remember the goal of the experience – to enjoy it, the results will look after themselves.

Being a full time physiotherapist, it was always going to be a tough tournament against full time athletes. I get to train 3-4 times per week, for a couple of hours at a time at Absolute MMA St Kilda under Lachlan Giles. Along with this I lift weights 4-5x per week, and do Pilates twice per week. So in total my training consists of around 8 hours of technical training and 6 hours of strength and conditioning per week. My opponents are full time athletes generally clocking 20+ hours of technical training and around 10 of strength and conditioning, so essentially double. In saying that, leading up to the tournament I was able to train at some high level clubs whilst in LA and Vegas and performed well against comparable level athletes- this gave me confidence leading into the event.

Now for the all-important result; the result is that I achieved my goal – I had a great time. I wasn’t too nervous, I was able to execute my strategy and I left with a positive experience. I won my first two bouts via submission and lost my third which placed me into the final round of 16 resulting in an equal 9th placing at the world championship.  A result that had I have known before going in I would be infinitely happy with. Upon reflection, I feel as though had I have made a couple of different tactical decisions I may have been able to go even deeper into the bracket – but alas, hindsight in 20/20 and I am very proud of the result.

I believe it is most definitely possible to become a world champion AND work full time. It comes down to a matter of prioritising time, and optimising your training. I would like to thank the PSM staff for their ongoing support to my endeavours and would encourage anyone who too is looking to take their training to the next level, or is being held back by an injury due to martial arts or otherwise to drop in and have a chat. Who knows what you too may be able to accomplish with the right team around you.

Daniel Browne
Physiotherapist
Langwarrin Sports Medicine Centre




Spotlight on Simon Johnson – Physiotherapist for Frankston YCW

Physiotherapist, Simon Johnson, from our Langwarrin Clinic, is currently the Physiotherapist for local Football Netball Club, Frankston YCW. We recently sat down with Simon to find out a bit more about what makes him tick…

What inspired you to become a Physiotherapist?

I have always been a massive sport fan, whether that’s playing, spectating or being part of the medical team. At school, I was most interested in science subjects, especially human anatomy. So I guess I paired my passion for sport with a genuine interest in the human body and chose to peruse physiotherapy as a career!

What does being part of community sport and specifically, Frankston YCW mean to you?

One of the best things about being involved in community sport is making new friends, whether that is with players, coaches or supporters. It’s a great feeling belonging to a network of people who enjoy footy but also interact in the community in which I enjoy being a part of.

What is your philosophy around injury management?

Hard work equals goals. As a physio we may spend 40 minutes total with a patient per week. In that small amount of time I do as much as I can with my hands to help but it is the tools I give that patient to self manage through stretches, exercises, activity modification and behavioural changes that is really valuable. The patient has to put in some hard work to successfully rehabilitate and injury, being proactive and following the advice provided usually leads to great outcomes and speedy return to sport.

What is your proudest sporting moment as a player?

Winner of the 2014 Gentlemen’s Cup. An annual competition held amongst friends in which we compete in four events; table tennis, darts, lawn bowls and golf. The winners name is engraved into the trophy each year so I’m pretty proud of that.

What is your worst injury and how did you overcome it?

I’ve been pretty lucky with sporting injuries in the past. Worst injury was probably when I fractured my leg in footy. I was playing in the centre and was carrying the ball out of the stoppage and was chased down and tackled. Heard the crack and knew it was fractured. Worst part about it I was due to fly out that afternoon with friends on a surf trip to Gold coast, so I had to sit on the beach for two weeks watching the boys surf. A trick I learnt from that day was when you apply ice to an injury and the pain worsens, its often a telling sign that there is a fracture and an X-ray is a good idea!

Who is your sporting hero and what do you admire most about them?

Mick Fanning.

I thought it was pretty inspiring when he returned to Jeffrey’s Bay in South Africa one year after being attacked by a great white and not only entered the water where he was attacked, but won the event against the world’s best. That takes some serious bravery, courage and also skill! I don’t throw around the term hero much, but that to me was heroic!

If you could have a superpower, what would it be?

It would be nice to have a magic wand with healing powers, save my hands from the pain of a long day of treatment!




Spotlight on Emma Iacovou – Physiotherapist for Peninsula Waves

Physiotherapist, Emma Iacovou, from our Langwarrin Clinic, is currently the Physiotherapist for VNL (Victorian Netball League) Club, Peninsula Waves. We recently had a chat with Emma to find out a bit more about what makes her tick…

What inspired you to become a Physiotherapist?

I wish I had this big story of why I became a physio – but unfortunately I feel like I just got lucky. I have always had an interest in the sport, however I was unsure on what particular area. I completed my Bachelor of Exercise and Science in 2012 and was fortunate enough to get a position in post grad physiotherapy. Started the course and LOVED it.

What does being part of community sport and specifically, Peninsula Waves mean to you?

Peninsula waves is my family :). I have been a player, coach, sports trainer and now physio for the club. I always believe in “giving back”, and being involved with Waves and their affiliated association Frankston District, allows me to do just that.

What is your philosophy around injury management?

I wouldn’t say I go by a philosophy as such, I more focus on injury prevention. I think netball specific conditioning and managing load are KEY to keeping players on court.

What is your proudest sporting moment as a player?

2015 I went to assist the physiotherapist for Two Bays Netball in their State Title Championship tournament, and due to injuries and sickness in the senior team I had to step on court. We ending up winning the grand final by 1 goal close to the siren. That would definitely be a highlight of mine !

What is your worst injury and how did you overcome it?

I have been pretty lucky, no real injuries in my playing career at all. Fingers crossed it stays that way.

Who is your sporting hero and what do you admire most about them?

This is easy – Jessica Jean Cox. This is a current player, and good friend in Waves, who has overcome 2 x ACL reconstructions. She has been told she should “never play netball again”, and yet she finds every way to prove them wrong. When you see a player strive so hard for something they love, that is inspiring to see as a physiotherapist.

If you could have a superpower, what would it be?

Obviously – heal injuries !




Spotlight on Andrew Lee – Physiotherapist for the Karingal Bulls

Physiotherapist, Andrew Lee, from our Langwarrin Clinic, is currently the Physiotherapist for local football netball club, Karingal Bulls. We recently caught up with Andrew to find out a bit more about what makes him tick…

What inspired you to become a Physiotherapist?

I’ve always had a fascination with the workings of the human body. I initial completed a biomedical science degree, and my strongest subjects and greatest interests were anatomy and exercise physiology. Going on to complete a Physiotherapy degree seemed a natural progression from there.

What does being part of community sport and specifically, the Karingal Bulls mean to you?

I love all sport, and what better than being involved at grass roots. It’s a really exciting time to be involved with Karingal too with the current infrastructure improvements taking place. The plans I saw for the new club rooms look fantastic and I can’t wait to see it all when it’s complete.

What is your philosophy around injury management?

Knowledge is power, so I try to help patients understand their injury. It’s no good simply telling someone to do something if they have no idea why they are doing it. I think it’s also really important to look at the bigger picture. One of the best pieces of advice I was given as a student was “don’t treat pain, treat dysfunction”. Often the deep rooted cause of someone’s pain can be located well away from the pain itself. Lastly, whenever possible, try to avoid complete rest. It’s rarely good for the body, and if you’re an active person, completely stopping what you love is never good for the mind.

What is your proudest sporting moment as a player?

Early in my twenties, a surgeon directed me away from playing football and running due to a hip issue. I took up cycling on his guidance, and committed myself to completing the ‘round the bay in a day ride’ with three mates as part of my surgery preparation. Despite the surgery being brought forward by a couple of months, I somewhat stupidly decided to follow through with my pledge and ride 240km in a day, only six weeks post hip surgery. It wasn’t a good thing for my recovery, and I spent most of the ride in pain, but it was an amazing sense of achievement and something at the time I needed to feel like the injury wasn’t defeating me.

What is your worst injury and how did you overcome it?

If not for the cartilage tear in my hip listed above, then probably breaking my hand coming off a mountain bike a few years ago. It was mostly numb at the time so I kept riding and didn’t think much of it, but a CT scan picked it up after about 5 weeks of continued pain. The worst thing I remember about it was when tradies would come in with a gorilla grip and want to shake my hand. Eventually with some protection in the form of a brace or taping, some activity modification, and some re-strengthening, it settled and has been fine since.

Who is your sporting hero and what do you admire most about them?

Rodger Federer. He has incredible technique, a great court side manner, and his career achievements pretty much speak for themselves.

If you could have a superpower, what would it be?

I would love to be able to fly.