Download MAXIMISING CLUB PERFORMANCE

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PATHWAYS
TO
SUCCESS
Aif '01
Aifric Morrissey, MISCP
Chartered Physiotherapist
MAXIMISING CLUB
PERFORMANCE
INJURY PREVENTION AND
MANAGEMENT
INJURY PREVENTION AND
MANAGEMENT
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Injury Prevention
Simple Injury Management
Rehabilitation
Special Groups
Maximising the use of your Club
Physiotherapist
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INJURY PREVENTION
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Principles of Injury Prevention
Pre-participation Assessment
Flexibility
Equipment Selection
Massage
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1. Principles of Injury Prevention
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Correct biomechanics
Warm up
Stretching
Taping/bracing
Suitable equipment
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Appropriate surfaces
Appropriate training
Adequate recovery
Psychology
Nutrition
2. Pre-participation Assessment
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Medical
Nutrition
Psychological
Physical
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PAR
NB:
• Plan
• Act
• Review
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Why Screen?
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Identify weaknesses
Injury prevention
Baseline for review
Introduction to medical team/backup
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Physical Screen
• Past history
• Equipment used
• Training
schedule/content
• Posture
• Lower limb
biomechanics
• Peripheral joint
assessment
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Spinal assessment
Flexibility
Neurological
Proprioception/Coordination
• Specific Tests
• Functional Assessment
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3. Flexibility
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Principles of stretching
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Warm up prior to stretching
Stretch before and after exercise
Stretch gently and slowly
Stretch to point of tension, NEVER PAIN
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Benefits
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Reduce muscle/tendon injuries
Minimise muscle soreness
Improves range of motion
Reduces tension
Earlier return to function
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Methods of stretching
• Static flexibility
– Injury prevention
• Dynamic flexibility
– Athletic performance
• PNF
– Care not to overstretch
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4. Equipment Selection
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Footwear
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• >300 miles shoes lose 50% of shock
absorbency
• Studies show appropriate footwear can
reduce shock by 2/3
• Impact:
– Running sports – 2-5 times bodyweight
– Jumping sports – 4-7 times bodyweight
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• NB select shoes suited to sport, surface,
foot type/biomechanics
• Prior to purchase, examine soles of shoes,
inner lining, wear from behind
• Features:
– Rigid heel counter – added stability
– Flexible forefoot – easy motion
– Midsole – not too firm or soft – shock absorber
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Sports Shoes
• Running spikes
– overuse of calf muscle, AT, Shin pain
• Football boots
– Rigid heel counter, adequate foot depth, wide
sole, curved, flexible forefoot
• Court based sport e.g. basketball
– Good grip, ankle support, shock absorbency
• Dancing shoes -?
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Protective Equipment
1. Shield against injury without interfering
with sport
2. Allow early return to sport, while adding
protection
3. ? Psychological benefit
NB. Fits correctly
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5. Massage
• Pre-performance massage
– ? Performance enhancement
• Post event massage
– ? Better to do good warm down
– Positive psychological effect
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• Research – varied results
• Bruising should not occur
• Never in acute inflammatory stage
• Injury – refer for treatment
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INJURY PREVENTION AND
MANAGEMENT
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Methods of Injury Prevention
Simple Injury Management
Rehabilitation
Special Groups
Maximising the use of your Club
Physiotherapist
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SIMPLE INJURY
MANAGEMENT
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P.R.I.C.E.
Blister Care
The First Aid Kit
Taping and Bracing
1. P.R.I.C.E
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Protect
Rest
Ice
Compression
Elevation
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Protect
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Crutches, sling, taping, P.O.P.
Up to day 3
Avoid complete immobilisation
Accommodate swelling
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Rest
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Immediately
1-5 days
Isometric work
Reduce overall general activity
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Ice
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Immediate
Avoid ice burn
20-30 minutes, every 2 hours
Complete area
Care with thin skin, nerve damage, certain
conditions
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Compression
• Distal to proximal
• Apply min. 15cm below injury site
• Accommodate swelling overlap by 2/3
spiral turns
protect vulnerable
areas
• Continue for first 72 hours
• Check Circulation
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Elevation
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First 72 Hours
Support area
If in elevation, reduce compression
Avoid dependent position immediately on
removal
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Avoid in first 24 hours!
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Heat
Alcohol
Moderate/intense activity
Vigorous massage
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2. Blisters
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Causes
• Friction:
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Stones/debris
Loose/ ill fitting shoes
Incorrect shoes
Biomechanical
New shoes
• Fungal infections
• Medical cauases
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Prevention
• Dry feet well
• Moist skin- surgical
spirit
• Natural fibre socks
• Seamless socks
• Check shoes for debris
• Inner soles smooth
• Break in new shoes
• Correct footwear
• Avoid man-made
materials
• Protect areas prone to
blisters
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Treatment
REMOVE CAUSE
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Cover blister – Bandage, pad-protector
Do not burst
If bursts – clean in salty water and dress
Infection/pain – seek medical advice
Black toenails – leave or see chiropodist
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3. The First Aid Kit
• Club bag
• Touchline bag
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Contents of Club Bag
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Taping and Strapping
Cold therapy
First Aid goods
Miscellaneous goods
Over the counter medication
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4. Taping and Bracing
Is Objective:
1. Practical?
2. Logical?
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Taping
Joints suited to taping:
Ankle, wrist, AC joint, finger, thumb
No proven benefit in injury prevention:
Knee, shoulder, elbow, spinal
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Guidelines for taping
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Skilled
Assess prior to taping
Plan
Prepare the skin
Protect friction areas, pressure areas
Check positioning
Apply tape
Check the finished product
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Bracing
Considerations:
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Initial cost
Easy application by athlete
Custom made braces – hand, wrist
Brace may be cumbersome
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INJURY PREVENTION AND
MANAGEMENT
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Methods of Injury Prevention
Simple Injury Management
Rehabilitation
Special Groups
Maximising the use of your Club
Physiotherapist
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REHABILITATION
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Essential Components of Good
Rehabilitation
EARLY REFERRAL to appropriately trained
sports physiotherapist and/or doctor!
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Physiotherapist’s Role
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Accurate diagnosis
Clear explanation
Precise, individual prescription
Make the most of facilities available
Knowledge of sport
Communication with coach/team etc.
Liaison with other professionals
Understanding of psychological impact
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Rehabilitation
NB.
FUNCTIONAL AND
SPORT SPECIFIC
ACTIVITIES
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Return to Sport
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Soft tissue healed
Pain-free full range of movement
No persistent swelling
Adequate strength, endurance
Good flexibility
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Good proprioception
Adequate cardiovascular fitness
Skills regained
No persistent biomechanical abnormality
Psychologically ready
Coach satisfied with training
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Adjuncts to Rehabilitation
1. Hydrotherapy
2. Muscle Balance
3. Gymnastic Ball
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Hydrotherapy
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Why treat in water?
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Early rehabilitation
Protect from further stress/injury
Maintain/improve cardiovascular fitness
Test in water prior to progressing to land
Psychological benefit
Part of training, including injured athlete
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Deep Water Running
Uses:
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Rehab of lower limb stress injuries
Rehab of injury where weightbearing restricted
Recovery activity after hard workout
Substitute for land exercise
More specific than cycling, swimming to maintain
cardiovascular fitness
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2. Muscle Balance
• Aims to address differences in muscle power and
flexibility in order to prevent overuse and
recurrent injuries.
• Scapular/shoulder injuries
• Back injuries
• Knee pain
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Assessment tools
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Physical examination
Biofeedback
Video
Isokinetic testing
Ultrasound
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Back problems
Important muscles:
Multifidus
Transversus abdominus
Pelvic floor muscles
Core stability:
Body system which gives spinal stability
while at same time providing a base of
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support for other activities
to be carried out
3. The Gymnastic Ball
• Adjunct to
rehabilitation
• Unstable base
• Proprioceptive
training
• Co-ordination
• Strength
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INJURY PREVENTION AND
MANAGEMENT
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Methods of Injury Prevention
Simple Injury Management
Rehabilitation
Special Groups
Maximising the use of your Club
Physiotherapist
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SPECIAL GROUPS
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The younger athlete
The female athlete
The disabled athlete
The older patient
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1. The Younger Athlete
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• Variety of activities
• Responsibility
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Suitable equipment
Vary training surfaces
Avoid sunburn, dehydration etc.
Monitor frequency, duration, intensity of
training
– Introduce to flexibility
• Pain? – refer on
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How much is too much?
Take into account all other activities carried
out by child
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2. The Female Athlete
Musculoskeletal Problems:
• Stress fractures
• Patellofemoral joint problems
– Overuse injuries in the lower limb
• Anterior cruciate ligament rupture
• Osteoporosis
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3. Disabled Athletes
• Blind athletes
• Amputee athletes
• Wheelchair athletes
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4. The Older Athlete
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NB – accurate exercise prescription
Previous level of activity
Past medical history
Current health status
Drug therapy and its response to medication
– Diuretics – dehydration
– Beta blockers – adrenalin surge
– NSAID – peptic ulcer
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INJURY PREVENTION AND
MANAGEMENT
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Methods of Injury Prevention
Special Groups
Simple Injury Management
Rehabilitation
Maximising the use of your Club
Physiotherapist
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Incorrect diagnosis and/or
treatment can aggravate the
injury !
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• Establish good rapport with local Chartered
Physiotherapist
• Ensure fully qualified
• Refer early
• Maintain communication
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