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Preventing Skiing and Snowboarding Injuries: Essential Tips from Acland Street Physiotherapy

8/24/2024

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During the Victorian winter season, many of us look forward to hitting the slopes for some alpine skiing or snowboarding at popular resorts such as Mt Buller, Mt Hotham and Falls Creek. These exhilarating sports not only offer a great way to stay active but also a chance to connect with nature and enjoy snowy landscapes. However, with the thrill of these activities comes the risk of injury, in particular ACL injuries. At Acland Street Physiotherapy, we're dedicated to helping you stay safe and injury-free while enjoying your time on the slopes.

The Risks Involved
Skiing and snowboarding are among the top contributors to sports-related injuries each year. The high velocities, varying terrains, and unpredictable conditions inherent to these sports increase the likelihood of injuries, particularly to the lower extremities. Common injuries include knee sprains, fractures, and muscle strains. However, with proper preparation, many of these injuries can be prevented.

The Importance of Physical Fitness
The role of physical fitness in preventing injuries cannot be overstated. A systematic review by Hébert-Losier and Holmberg (2013) found that while much of the focus on injury prevention has historically been on equipment and third-party involvement, there is a significant need for targeted physical fitness to meet the technical demands of skiing and snowboarding. Strength, endurance, agility, and balance are crucial components that help manage the intense physical demands these sports place on your body .

A more recent study by Wang et al. (2022) emphasises the importance of lower extremity fitness, specifically agility and balance, in reducing injury risk among recreational skiers. The study found that skiers with inferior agility or balance are at a higher risk of injury, highlighting the necessity of neuromuscular training that targets these areas .

Recommendations for Injury Prevention
Based on these findings, here are some evidence-based recommendations to help you prepare for a safe and enjoyable skiing or snowboarding season:

1. Focus on Lower Extremity Agility and Balance
  • Agility: Incorporate exercises that improve your ability to quickly change direction, such as lateral jumps, agility ladder drills, and cone drills. These exercises mimic the quick, multidirectional movements required in skiing and snowboarding. According to Wang et al. (2022), better agility was associated with a lower risk of injury .
  • Balance: Training on unstable surfaces, such as balance boards or Bosu balls, can enhance your ability to maintain control in challenging conditions. The same study by Wang et al. highlighted the importance of balance in preventing injuries, noting that lower composite YBT scores were associated with higher injury risk .
2. Build Endurance
  • Alpine skiing and snowboarding can be physically demanding, requiring sustained effort over extended periods. To prepare, engage in endurance exercises such as cycling, running, or circuit training that target the lower body. Incorporating squats or box jumps into your routine can build the muscular endurance necessary for the repetitive movements of skiing and snowboarding. Although endurance was not found to be a significant factor in injury occurrence in the multivariate analysis, its role in overall fitness and injury prevention remains important .
3. Strengthen Key Muscle Groups
  • Focus on strengthening the quadriceps, hamstrings, glutes, and core muscles. Strong muscles not only improve performance but also provide stability and support to your joints, reducing the risk of injury. Hébert-Losier and Holmberg (2013) emphasised the importance of physical fitness, including strength, in meeting the demands of alpine sports and preventing injuries .
4. Proper Warm-Up
  • Before hitting the slopes, make sure to warm up properly. Dynamic stretching and mobility exercises can increase blood flow to your muscles and prepare your body for the intense activity ahead. A well-prepared body is less likely to suffer from strains and sprains during skiing or snowboarding.
5. Invest in Quality Equipment
  • While physical fitness is crucial, don't forget the importance of well-fitted, quality equipment. Ensure that your bindings, boots, and skis or snowboard are properly adjusted to your specifications. According to Hébert-Losier and Holmberg (2013), equipment-related recommendations are among the most common in injury prevention, reflecting the importance of gear in reducing injury risk .

Conclusion
At Acland Street Physiotherapy, we believe that with the right preparation, you can significantly reduce your risk of injury and make the most of your skiing or snowboarding experience. By focusing on agility, balance, endurance, and strength, and using well-maintained equipment, you'll be well-equipped to enjoy the slopes safely. If you're preparing for the winter season and want personalised advice or training, don't hesitate to reach out to our team. We're here to help you stay fit, healthy, and ready for the challenges of the mountain.

Stay safe, stay active, and enjoy your winter adventures!
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References:
  1. Hébert-Losier, K., & Holmberg, H. C. (2013). Exercise-based injury prevention recommendations for recreational alpine skiing and snowboarding: A systematic review. Sports Med, 43(5), 355-66. doi: 10.1007/s40279-013-0032-2.
  2. Wang, Z., Cai, Y., Wu, J., Xie, S., & Jiao, W. (2022). Relationship between Lower Extremity Fitness Levels and Injury Risk among Recreational Alpine Skiers: A Prospective Cohort Study. Int J Environ Res Public Health, 19(16), 10430. doi: 10.3390/ijerph191610430.
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Our principal physiotherapist Barry and his son at Mt Buller
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Sleep: The Unsung Hero of Injury Recovery and Athletic Performance

3/9/2024

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In the competitive world of sports and the meticulous field of physiotherapy, discussions frequently orbit training methodologies, nutritional strategies, and the forefront of recovery technologies. However, a crucial element in athletes' well-being and recuperation that is often overlooked is the role of sleep. Emerging research unequivocally emphasises the profound impact of sleep on injury recovery and athletic performance, spotlighting its indispensable role in an athlete's regimen.

The Foundation of Recovery
Sleep stands as a fundamental pillar in the body's recovery mechanism, providing not only rest but also facilitating cellular repair and hormonal equilibrium. A systematic review in the British Journal of Sports Medicine delineates the significant role of sleep in the convalescence of sports injuries, pointing out that inadequate sleep quality and duration are common among athletes and considerably amplify injury risks . This body of work stresses the importance of incorporating sleep management into training and competition schedules to curtail injury rates and expedite rehabilitation.


Enhancing Muscle Recovery
The intricate nexus between sleep and muscle recuperation is especially noteworthy. According to a narrative review in the Journal of Science and Medicine in Sport, extending sleep duration not only bolsters performance but also enhances pain sensitivity and anabolic responses, such as elevated levels of GH/IGF-I, pivotal for muscle repair and recuperation from exercise-induced injuries. This evidence suggests that sleep interventions could serve as a critical tool in hastening recovery processes, presenting a topic of keen interest for medical professionals and coaches alike.

Sleep’s Role in Injury Risk Management
Further research detailed in the Journal of Sports Rehabilitation elucidates the association between sleep and injury risk, demonstrating that chronic insufficient sleep is correlated with an increased risk of musculoskeletal pain and sports injuries. Specifically, consistently sleeping less than seven hours is linked with a higher injury risk, underscoring the necessity of adequate sleep for injury prevention .

The Impact on University Athletes
The challenge of managing sleep extends beyond professional athletes to include university athletes as well. A study published in Frontiers in Sports and Active Living reveals how academic and social stresses can exacerbate sleep disruption, leading to adverse effects such as performance decline, mood alterations, and an increased vulnerability to injuries and illnesses. This highlights the widespread applicability of sleep management strategies across different levels of athletic engagement.

Practical Implications for Your Recovery Journey
For athletes embarking on the recovery path, or anyone aspiring to elevate their physical performance, the directive is clear: sleep must be prioritizsed. Here are actionable steps to integrate into your routine:
  • Establish a Consistent Sleep Schedule: Strive for at least 8 hours of sleep each night, maintaining consistent bedtimes and wake-up times.
  • Create a Restful Sleeping Environment: Diminish noise and light exposure and ensure your sleep area is comfortable and conducive to rest.
  • Incorporate Relaxation Techniques: Engaging in activities like reading, meditation, or gentle yoga before bedtime can prime your body and mind for sleep.
  • Limit Screen Time: Minimise evening exposure to screens and electronic devices to reduce the impact of blue light on your sleep cycle.
Conclusion
The expanding corpus of research on sleep's effects on injury recovery and athletic performance furnishes invaluable insights for athletes, coaches, and healthcare practitioners. As we delve deeper into the myriad benefits of sleep, it becomes increasingly clear that sleep is not merely a passive rest period but a dynamic process integral to athletes' health, well-being, and achievement. By prioritising sleep, we can optimise our recovery processes, mitigate injury risks, and unlock our utmost potential in sports and beyond

References Used 
  1. Vermeir, P., De Leye, M., Grymonprez, R., Goethals, A., Vermeir, R., Vanden Bossche, L., & Mariman, A. (2021). The impact of sleep on the recovery of sport injuries. British Journal of Sports Medicine, 55(Suppl 1), A173.3. https://bjsm.bmj.com/content/55/Suppl_1/A173.3Chennaoui, M., Vanneau, T., Trignol, A., Arnal, P.,
  2. Gomez-Merino, D., Baudot, C., Perez, J., Pochettino, S., & Eirale, C. (2021). How does sleep help recovery from exercise-induced muscle injuries? Journal of Science and Medicine in Sport. https://pubmed.ncbi.nlm.nih.gov/34074604/
  3. Huang, K., & Ihm, J. (2021). Sleep and Injury Risk. Journal of Sports Rehabilitation. https://pubmed.ncbi.nlm.nih.gov/34099605/
  4. Hamlin, M.J., Deuchrass, R.W., Olsen, P.D., Choukri, M.A., Marshall, H.C., Lizamore, C.A., Leong, C., & Elliot, C.A. (2021). The Effect of Sleep Quality and Quantity on Athlete's Health and Perceived Training Quality. Frontiers in Sports and Active Living. https://www.frontiersin.org/articles/10.3389/fspor.2021.705650/full​
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Don't be afraid of seeing a physio for your muscle strain as soon as possible!

8/23/2020

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Early rehabilitation after an acute muscle injury can get you back to your favourite activities faster!

When you strain a lower limb muscle like a calf or a thigh, it is often possible to exercise or load these muscles up in the first couple of days right after the injury. 

Surprisingly, muscles can handle significantly more than you think in the first few days of a muscle strain. This recent study published in the New England Journal of Medicine supports this view.


In conclusion, early physiotherapy rehabilitation after an acute muscle injury (even if it is severe), can help accelerate the healing process - allowing you to get back to your favourite activities much early than delaying professional intervention.
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PHYSIO OPINION: What is good running form?

7/24/2020

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During the COVID-19 pandemic, running observably has become an extremely popular exercise activity locally obviously, for its health benefits and simplicity as no equipment is required. I am avid runner myself recreationally often clocking up 50kms per week. Over the past 10 years as a physiotherapist, I have coached hundreds of my patients who have never ran before to shed a few pounds or improve their overall fitness. Many of my patients have misconceptions about running in particular, that running is bad for your knees and that you are at major risk of arthritis. This common concern has been debunked by science by multiple studies. Based on large population studies, the chances of developing arthritis from regular running are very slim. In fact, regular running has shown to strengthen joints and plays a protective role in the development of osteoarthritis later in life. Commonly reported knee pain by runners at Acland Street Physiotherapy that is generally treatable with a moderate amount of physiotherapy and strength training are Iliotibial Band Syndrome or Patellofemoral Pain Syndrome.

The following is a concise infographic on how what good running form generally looks like. If you would prefer to further explore this, please do not hesitate to make a booking with us for a comprehensive physiotherapy and biomechanical running assessment. 


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What you need to know about ankle sprains

7/19/2020

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Lateral ankle sprains are very common among the active population and with proper professional guidance, can have serious long-term complications. Complications include fractures, recurrent sprains and ligamentous instability, resulting in surgery. 

As a first point of call, it is important to get assessed by an experienced physiotherapist to get thoroughly assessed and diagnosed. Through history taking and physical examination, the physiotherapist will determine what ligaments have specifically been injured, the severity and whether an x-ray may be needed.

Studies have shown that early mobilisation of a sprained ankle has significant benefits for improvements in pain, function and its long term stability. 

Physiotherapy treatment may include strategies to reduce swelling and inflammation, ankle taping/bracing, manual therapy to break up the scar tissue and an exercise rehabilitation program to help improve range of motion, strength, neuromuscular control and proprioception/balance. A high quality exercise rehabilitation program can get you back to what you were doing previously quickly and prevent injury recurrence. 

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ATTENTION GYM-GOERS AND ATHLETES: GRADUALLY EASE INTO EXERCISE POST-CORONAVIRUS AS ADVISED BY PHYSIOS

6/17/2020

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A week ago, there was an interesting news article via ABC News regarding physiotherapists warning gym-goers to gradually ease into exercise post-coronavirus. Experts are also predicting a rise in soft tissue injuries as Australians return to sport post coronavirus lockdown. This is relevant information as recently, I am seeing a significant increase in patient presentations associated with return to sport and return to gym/exercise injuries. Popular clinical diagnoses at my clinic have included sciatica, lower back pain, nerve impingement, lateral ankle sprains, shin splints, patella tendinitis, subacromial burisitis, rotator cuff tendinitis, tennis and golfer's elbow. This has not been a surprise as individuals who have been very active during social restrictions and lock down would experiencing muscular de-conditioning, reduced neuromuscular control and a loss in mobility. Soft tissues such as ligaments and tendons generally get weaker when there is inconsistent physical loading on them too. 

Here are 6 key tips on how to get back into sport or gym workouts reducing the risk of injury
These include:
1. Slowly and gradually return to pre-coronavirus levels of exercise
2. Spend more time warming up by rehearsing exercise routines with significant less resistance or intensity (30% is the general guidelines for this)
3. It will likely take about 4-6 weeks before your body will get back to pre-coronavirus levels of performance if you consistently train
4. Watch your posture and technique more carefully using a mirror, physiotherapist or coach for feedback before you progress with higher levels of difficulty 
5. Spend time time in between exercise sessions or workouts recovering or resting than you would usually 
6. Do not feel like you need to urgently make up for lost time and leave the pride at the door
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TRAINING SMARTER, NOT HARDER

6/9/2020

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There is emerging scientific research that training loads are directly correlated to injury risk.
Training load injuries are generally caused by:
  1. A spike training load from a period of inactivity or the training history of the individual 
  2. A high training load sustained for a long period (> 8 weeks) of time without recovery weeks or deloading 
  3. Sustaining a monotonous, consistent daily training load across the week without recovery days 

External vs Internal Training Loads
Specifically, there are 2 types of training loads: External Loads and Internal Loads. External loads measure the amount of external workload eg. (running on the treadmill, weight lifting) to the individual while internal load measures the individual’s post exercise heart rate or rate of perceived exertion (RPE) as a response to the external workload.
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Rate of Perceived Exertion Guides for Aerobic and Resistance Training

It is important to understand that to optimise performance, there needs to be a fine balance between training hard and overloading resulting in injuries and comprising performance. This sounds like common sense however to accurately monitor training loads is a challenging task given that it is associated with frequency, duration and intensity. Duration and frequency are relatively easy to measure however intensity could be measured by for example, how fast you are running, your heart rate, how much weight you are lifting with the barbell or the complexity or speed of the movements you are performing. Tracking your training loads is not just about managing the specific exercise you are doing but can help you determine when it may be appropriate for you to do some cross-training or vary your load. 

Acute on Chronic Workload Ratio (ACWR)

For those who are a serious about injury prevention,a great way to find your training ‘sweet spot’ while minimising the risk of injury if you are serious about optimising performance is using the Acute on Chronic Workload Ratio calculator. Scientific research indicates a 0.8-1.3 ratio range is ideal. Injury risk increases at a 1.5 ratio or higher.

To calculate your ratio, multiply your rate of perceived exertion (RPE) after each exercise with the duration, intensity or frequency of the exercise session (external load). The Acute Workload is over a 7 day period. The Chronic Workload is over a 28 day period. The ratio is the result of dividing the Acute Workload by the Chronic Workload. 
Tips:
  1. Use an activity tracker to monitor your training loads, noting the frequency, intensity and duration of your activities. Free GPS activity tracking apps recommended include Strava for cycling and running and RunKeeper for running. 
  2. Consider calculating and tracking your Acute on Chronic Workload Ratio (ACWR) 
  3. Consider varying the load (high, moderate and low) or cross-training on consecutive days for example, running on day one, lifting weights on day two and swimming on day three.
  4. Avoid sudden increases in load after a period of inactivity such as a break after a marathon event, post-injury or a relaxing holiday. 
  5. A rule of thumb is to increasing the exercise 5-10% per week (either frequency, duration or intensity) however it is important to be aware that a 5-10% increase in intensity is a significant change compared to a 5-10% increase in duration or frequency. 



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    Author


    ​Barry Nguyen
    ​Founder & Head Physio

    Barry is an Australian qualified physiotherapist with over 19 years clinical experience in sports and musculoskeletal injuries.
    ​
    Many of my patients and GPs whom I work with use this resource! 

    Got a question for Barry?

    Feel free to join his "Ask Barry The Physio" 
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