Having being qualified for over twenty three years and having looked after Wharfedale Rugby team for over twenty, sports injuries consist obviously of direct effects of trauma and also secondary effects key to the compensations for traumas sometimes in other areas quite a distance from those where the pain is actually being felt. Injuries can obviously occur from anywhere in the body in the feet through to the neck. Quite often one sees Achilles problems and these can be part of muscle imbalance from above e.g. the glutei being weak causing an internal rotation of the leg so causing instability of the heel area of the foot and therefore Achilles problems or indeed it may even be from the pronating foot causing an instability of the rear foot and so problem occur at this juncture.
Hip injuries can again be from local or different areas in origin, but one increase in the area of awareness is in a young person’s hip where even adolescence finds hip problems occurring. We have a good relationship with surgeons such as Professor Ernest Schilders or Mr John Conroy who do operations directly on young people’s hips to repair minor damage so it does not progress onto major damage and therefore arthritis at an early stage. Around the pelvis there is an awful lot of muscle imbalance which does occur and this can be tied in with occupational or habitual overuse/underuse scenarios. It is crucial via examination and good case history to reach an understanding where the initial origin of the problem is coming from and then whether conservative (hands-on) treatment is appropriate or a referral elsewhere.
Runners who try to do too much too soon often develop problems of levels within the leg, hip, low back or even upper body. We do see an awful lot of rugby injuries and contact sports where cruciate ligament damage has occurred. We have a very quick direct referral system or via the GP to knee specialists and then we can do rehabilitatory treatment after operations if appropriate. Liaisons and communication with GPs and Specialists are to the extent where one can chat on the phone and therefore get quick information, advice and referrals.
Obviously being Osteopaths we do see an awful lot of athletes who have back problems from the lower back through to the neck and it is the understanding of the impact that the torso has from the lower limb or indeed the upper limb dependent on the sport and the actual origin of the problem which is key to the diagnosis and treatment. We follow recent work done by Professor Stuart McGill of Canada, who has raised the awareness of the impact that the spine has either directly or indirectly from the limbs and therefore the treatment that is appropriate to undo these lines of trouble and then rehabilitation exercises which actually do work on these appropriate areas. There are an awful lot of myths to do with core stability and we feel that at Farfield House we have an understanding of what actually does and does not occur in both injury and also rehabilitation. On our website we have some of the core stability exercises we use as part of this rehabilitation.
The shoulder too is an area of great acute and chronic pain and limitation. As this joint is so dependent on the muscular stability it is crucial to examine this whilst being aware of tears and damage of the shoulder structure. Once a careful case history and examination reveals the diagnosis, a treatment strategy can be developed. This area can be both acute and long term in history. The more long term due to the complexity of the shoulder mechanism, the more layered the strategy of treatment is till we find the cause. As with the hip, microsurgery has revolutionised the options available to correct shoulder injury and not just leave it as a “weak shoulder”.
A sports person can present with upper limb injury which affects not only the local joint but also into the soft tissue around. It is important to consider the soft tissue anatomy which has an effect on or can be affected by dysfunction of a joint, eg tennis or golfer’s elbow.
Racket or rowing athletes often present with tendon or “tenosynovitis” injuries again in their chronic and acute forms. Here a clear case history to set out chronographically the impacts on the area is important so a regime of treatment, but mostly self-treatment can be prescribed.
Finally the design of feet is so good that even when injury has plagued an athlete for a long period, they can respond quickly when a correct diagnosis is made and treatment strategy developed. This may purely be hands on or involve other areas. We inter-refer with Podiatrists in this area regularly and this combination commands considerable treatment potential.
Effects of Sport on the Musculo-Skeletal System
We also have very affordable and high quality imagery at Dewsbury Hospital for their MRI scanner and we can do direct referrals for MRI with a twenty-four hour requirement and quick turn around for results at the same time.
Nutrition in Sport
Recently there has been quite a change in nutritional understanding and use of the percentages of carbohydrates, fats and proteins and the big realisation that it is far better to change the use from a 60% carbohydrate intake to that of about 30% with an increase in fats and proteins. This then allows the body to use the food of propensity as a much more efficient fuel and so achieve much more relevant aims in sport. Due to the higher intake of proteins and fats the body is then able to utilise not only the foods taken on board but then any storage of fats around the body and this breakdown of much more efficient fuels means that it does not compete with fuels which the brain uses (glucose) and therefore the musculoskeletal system is able to perform far greater levels of intensity and endurance.
The very brief background of this is that one decreases the use of insulin to pack carbohydrates into cells when there is a massive influx of sugars from foods of a refined type. Therefore due to the lack of insulin one finds those hormones such as DHEA, human growth hormone are increased to maintain the body and even the production of cholesterol is far more appropriate. By using this different approach it not only helps the immediate sport but also the wellbeing of the body as a whole. It is therefore appropriate to say that this use of not only a weight loss diet but also a way of improving sport dynamism is very pertinent here. More is written about this approach under “Metabolic Balance”.
Breathing is obviously a very important part in sport and yet one finds that regularly people from stressful environments have a poor breathing level where they normally breathe too fast and to greater volume of air. This means biochemically they blow off too much carbon dioxide which then leads on to an imbalance within the body’s biochemistry which can in turn affect performance. By using a Capno trainer we can develop a better base breathing style and therefore greater ability in sport. Very quickly there is potential to increase the breathing capacity certainly by 15% in a short term.
In the long term as the breathing system becomes more robust there will be more capability in the higher reaches of respiratory ability for much longer periods. After diagnostic procedures by Spiromatory (to check the anatomical capacity of the lungs) and Capnometry (to check the functional capacity of the lungs) “homework” can be given to improve ability with now even an “App” on smart phones is always present for easy rehabilitation.