Tag Archives: oakville sports medicine

Happy Earth Day: Recycling an old blog on Achilles Tendon Rehab

Happy Earth Day!! While this is a difficult time, and we are all staying home to help stop the spread of COVID 19, the earth is also getting a chance to heal itself. The skies are cleaner and the waters are clearer. When COVID-19 is behind us, we will need to be mindful of the environment and to take individual action, so that we can continue to see the blue skies. During this difficult time, remember to take care of yourself, go for walks, take stock in your life and take the time to get some fresh air and appreciate Earth Day.

The most effective way to reduce waste is to reuse and recycle. So today, we are going to recycle a great, old article on Achilles Tendon Rehab.

Injuries to the Achilles tendon is one of the most common injuries experienced among athletes, especially runners and soccer players. Statistics show that roughly 24% of athletes develop pain in the Achilles. It’s also an injury that can linger for long periods of time, if left untreated. One recent study found that 63% of athletes with Achilles tendinopathy still had symptoms two years after onset.

Causes of Injury to the Achilles:

  • Poor footwear;
  • Repetitive overstretching;
  • Training errors;
  • Abnormal Biomechanics;
  • And the most important:  Repetitive overuse and lack of proper training that causes the building blocks (tenocytes) to be poorly produced.

What does Treatment entail:

Initially one of the main focuses of treatment is decreasing the pain, which can be achieved through rest, manual therapy, taping and heel lifts. After this brief period of rest, a proper graduated exercise program is  one of the best ways to promote tissue repair.

Here are examples:

  • Start with some isometric holds in a slightly lengthened position;
  • Progress onto isometric holds in a lengthened position, but with a focus on one leg at a time;
  • Next, do some concentric heel raises, still in a slightly lengthened position, one leg at a time, lowering yourself down with the support of your opposite foot;
  • Finally, add in some running backwards and stopping in that same lengthened position, in good control. This adds an abrupt stoppage;
  • Progress the last exercise from an abrupt stop to a change of direction.

Watch the video below for examples:

And finally:

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What are the top risk factors for Hamstring Injury?

The Most Effective Hamstring Injury Prevention Program

Hamstring injuries have been reported as one of the most common injuries across a variety of sports that involve repetitive kicking and/or high speed running, such as soccer, track and field, football, and rugby. Re-injury rates are also an issue affecting many athletes long term, with roughly 30% of athletes suffering a re-injury to the hamstring within the first year. In order to prevent hamstring injuries it is important to understand WHY they occur, and to develop a prevention program which targets these risk factors.

The hamstrings are a group of 3 muscles, the biceps femoris, the semitendinosus, and the semimembranosus. Their main purpose is to bring the hip back and bend the knee. The majority of injuries to the hamstrings are strains to the biceps femoris long head muscle. Injury occurs mainly during sprinting, as the muscles contract eccentrically to decelerate the leg.

What are the Risk Factors?

Age
Unfortunately, the older you get, the higher your chance for hamstring injury. The age when the risk starts to significantly increase is 25 years old, with research suggesting a 30% increase in risk annually thereafter.

Decreased flexibility
Tight hamstrings aren’t the only problem; tight hip flexors and/or quads are also problematic.

Muscle Imbalance/weakness
Muscle imbalance within the lumbopelvic region and/or weakness in the hamstrings;

Previous injury
Previous injury to the hamstring, groin and/or knee.

The Most Effective Hamstring Prevention Program

Eccentric Strengthening Program
The majority of hamstring injuries occur during sprinting when the muscle is working eccentrically. As such, eccentric strengthening programs have been shown to decrease the risk of hamstring injury by 65-70%. The most popular and widely studied exercise for hamstring injury prevention is The Nordic Hamstring Exercise. We strongly encourage all athletes to add this exercise to their strengthening regime. However, it shouldn’t be the only hamstring exercise you do. While it has been shown to decrease the risk of hamstring injury significantly, it only activates part of the hamstring muscles (specifically the semitendinosus and short head of the biceps femoris). 80% of hamstring injuries occur to the long head of the biceps femoris, which is better activated with a hip extension exercise such as deadlifts. The most effective hamstring injury prevention program should focus on targeting all the hamstring muscles with both knee and hip dominant movements. Below you will find 2 different exercises: the nordic hamstring exercise and straight leg weighted deadlifts. We recommend doing both for the greatest benefit. See a progressive 12 week schedule below:

Frequency 2x/week x 12 weeks.
Week 1-3: 3 sets of 5-6 reps
Week 4-6: 4 sets of 6-7 reps
Week 7-9: 4 sets of 8-9 reps
Week 10-12: 4 sets of 10-12 reps

Nordic Hamstring Exercise: Can be completed with a partner holding your legs or hooking feet under something heavy. Lower yourself forward, keeping your back and hips straight. Once you cannot go any further push yourself back into start position.

 

Weighted Deadlifts:

Work on your core
While strengthening the hamstrings is important, you can’t forget about everything else that helps support, align and coordinate the hips. If there is an imbalance around the hip such as tight hip flexors, weak glutes, etc., the hamstrings will be more susceptible to injury. In addition, exercise programs that focus on trunk stabilization and agility vs. a traditional program of ONLY hamstring stretching and strengthening post injury results in a quicker return to sport and significantly much lower reoccurrence rate (7% vs. 70%).

Running Program
Most hamstring injuries occur during sprinting, especially later in the game when fatigue sets in. Therefore, strengthening and isolating the hamstrings in the gym is essential, but you must also include interval speed training to improve coordination, large hip/knee joint torques, and explosive strength. Weekly sprint workouts have been shown to prevent hamstring injuries. Like all training loads, ensure the sprinting load (distance, reps and speed) is progressed gradually.

Where to go from here?

If you currently are suffering from a hamstring injury it is best to book an appointment with a therapist and get on an individualized rehab plan. If you are currently injury free and would like to stay that way, then add the above hamstring exercises to your current strengthening program following the 12-week plan. If you want more bang for your buck, then add some core and hip stability exercises as well. If you still have questions or want more guidance on injury prevention book an appointment with one of the Sheddon Physiotherapy and Sports Medicine therapists at 905-849-4576.

Heiderscheit et al., (2010). Hamstring strain injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention. Journal of Sports Physical Therapy. 67-81.
Liu et al., (2012). Injury rate, mechanism, and risk factors of hamstring strain injuriesin sports. A review of the literature. Journal of Sport and Health Science. 92-101.
Prior et al., (2009). An evidence based approach to hamstring strain injury. A systematic review of the literature. Sports Health. 154-164.

For more info, contact Sheddon Physiotherapy and Sports Clinic at 905-849-4576.

We are located only 6 min East of Oakville Place and 4 min East of Whole Foods Market on Cornwall Rd.

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Prevention and Treatment of Groin Injuries in Athletes Sheddon Physio Mississauga

Prevention & Treatment of Groin Injuries in Athletes

Groin injuries affect roughly 20% of soccer players due to the nature of the sport, which involves lots of kicking, inside passing and changes of direction. These movements put a large eccentric force on the adductor muscles, which puts them at risk for injury. As such, roughly 70% of soccer related groin injuries involve the adductor muscles, with the adductor longus being the most frequently injured. Injury to these muscles is usually due to overuse and muscle imbalance, two factors that can be modified with a good prevention program.

The adductor muscles consist of a group of muscles in the inner thigh that work together to move one leg in towards the other. They also assist with other hip movements, as well as balancing the pelvis. They are injured during soccer from kicking, changing direction, reaching and sprinting. Risk factors for injury include:

  • Athletes with muscle imbalances around the hip/pelvis/core;
  • Adductor muscle tightness or weakness;
  • Higher level of play;
  • Previous groin injury;
  • Hip adductor to abductor muscle imbalance.

Treatment will initially be focused on controlling pain and maintaining range of motion. Depending on the severity of the injury, your therapist may also teach you how to wrap the groin in order to relieve pain. As the pain subsides other treatment strategies will be implemented such as soft tissue techniques, modalities to encourage healing, as well as a strong emphasis on exercise. Exercise will focus on the adductors, as well as the core and pelvic musculature. Reintegration into sport specific training will focus on cutting, sprinting, passing and progressive kicking exercises to improve stance leg loading and kicking leg impact. At Sheddon we use the SKLZ Star Kick Elite, a solo soccer trainer,  that returns the ball with true rolls and bounces to help players build passing, receiving and shooting skills.groin injuries in soccer players sheddon sports clinic mississauga

No athlete wants to be sidelined with an injury. Be proactive and follow the injury prevention recommendations below to ensure you stay injury free:

  • Work your CORE: core and pelvic stability can prevent groin and many other injuries;
  • Make sure your hip/pelvis muscles are well balanced in terms of flexibility, coordination and strength.
  • Following the FIFA 11+ warm up program can prevent many injuries, including to the groin.
  • Slowly integrate large amounts of isolated inside passing and kicking into training, as too much has been shown to increase the risk of groin injuries.
  • Specific exercises to strengthen the adductor muscles pre-season have been shown to reduce groin injuries. One of the exercises researchers have focused on is the Copenhagen Adduction exercise (see photo below). Completing this exercise 2-3x/wk, 3 sets, with 6-15 reps per side can significantly increase eccentric adductor strength, thereby reducing the likelihood of groin injuries.Copenhagen Adduction exercise Sheddon Physio Oakville
  • If the Copenhagen Adduction exercise is a little too advanced for you, other researchers showed benefits from strengthening with a theraband. See photo below. This exercise should be completed 3x/wk, 3 sets, 15 reps.injury prevention strengthening with a theraband

If you have been suffering from groin pain or want to prevent groin injuries, contact one of our therapists at Sheddon Physiotherapy and Sports Clinic, who will assess and treat your injury and get you back on the field pain-free.

Haroy et al., (2017). Including the Copenhagen Adduction Exercise in the FIFA 11+ Provides Missing Eccentric Hip Adduction Strength Effect in Male Soccer Players. A Randomized Control Trial. The American Journal of Sports Medicine, 45;13;3052-3059.

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Concussion-Baseline-Testing Concussion management Sheddon sports clinic Oakville

SPECIAL EVENT: Concussion Baseline Testing

We are currently offering athletes of all levels and sports who have not completed their Concussion Baseline Testing a special rate of 70$, when completed during our group sessions on Saturday Dec. 2nd, 2017 from 8am-11am. For more information or to make an appointment, please contact admin@sheddonphysio.com for available times. Please note, we require a minimum of 10 athletes to sign up to run this special event.

Frequently Asked Questions:

  • The season has already started, are we too late for concussion baseline tests?
    • NO! Preseason is the ideal time for testing, but anytime during the year prior to a concussion is better than no baseline.
  • WIll the cost be covered through my insurance?
    • The cost of the baseline is covered under most Extended Health Plans since it is administered by a physiotherapist.
  • My child had a baseline done over a year ago, why should we do it again?
    • As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season.
  • My hockey team did the impact test preseason, isn’t that good enough?
    • No! Computerized neuropsychological tests, such as the ImPACT test are only assessing one aspect of concussions, neurocognitive function. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity AND neurocognitive function). In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed prior to and after a concussion.
  •  It’s not mandatory for my childs team.
    • Concussion baseline tests are becoming widely used in many sports at all levels. Although not mandatory (yet) in all high-risk sports, it is one of the most important and effective tools for concussion management. Without a baseline test there is no way to accurately know when an athlete has fully recovered from a concussion. Research has shown that concussion symptoms improve much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms.
  •  Those dates don’t work for my child or team?
    • If you are part of a team or an individual who would like to participate in Concussion Baseline Testing but you cannot fit these dates into your schedule, please contact us and we will try to arrange for another date and time.

Please click here to learn about Concussion Baseline Testing and why it’s so important.

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Baseline test concussion Sheddon Physioyherapy Sports Clinic Oakville Mississauga

Baseline Testing: The Key to Effective Concussion Management

Concussion management programs have become a major focus in sports medicine clinics due to the increased public awareness and recognition of concussions. One of the biggest concerns following a concussion is the possibility that an athlete returns to sport before the brain has fully healed and sustains a second concussion, which has the potential to cause irreversible brain damage. Unfortunately, there is no single clinical test that can be done to know when an athlete has fully recovered from a concussion. Furthermore, research has shown that symptom resolution occurs much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms. How are health practitioners, coaches and parents supposed to know when an athlete is ready to return to sport? In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed, including:

  • Balance;
  • Strength;
  • Reaction time;
  • Neurocognitive performance;
  • and visual processing.

These different test results need be compared to pre-injury values in order to know when an athlete has returned to their normal pre-concussion baseline values. As such, the best way to ensure that you return to sport safely following a concussion is to get baseline tested before a concussion even occurs. At Sheddon Physiotherapy and Sports Clinic we offer the most comprehensive concussion baseline testing of any sports medicine clinic in the Mississauga and Oakville area.

Why choose us for baseline testing?

Most clinics will tell you that they provide concussion baseline testing, but that doesn’t mean they do it properly. Traditional baseline programs focus solely on computerized neuropsychological tests, such as the ImPACT test. Although vital for assessing neurocognitive function, research has shown that neuropsychological tests should not be used in isolation, since they only address one aspect of concussion. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity). All of the therapists at Sheddon Physiotherapy and Sports Clinic have undergone extensive training with the Complete Concussion Management program in order to be educated with the most recent research-proven concussion management strategies.

How often should an athlete undergo baseline testing?

As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season. Also, if an athlete sustains a concussion during the season, a new baseline will be done following full recovery from the concussion, in case a second concussion occurs during the year.

We are one of the top private clinics in Canada in volume of concussion baseline testing through Complete Concussion Management. In addition, we have successfully treated hundreds of sports-related concussions and have an extensive network of specialists, including a sports medicine physician, vestibular physiotherapists, chiropractors and athletic therapists. We offer the highest quality of concussion testing and management in the Mississauga and Oakville area. If you are interested in learning more about our baseline testing for individual athletes or teams, please contact us at 905-849-4576

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