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Year: 2020

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By Justin Lopes August 20, 2020 Uncategorised

Educational videos from the FIFA Medical Network (@FIFAMedical): Rehabilitation exercises for common football injuries

Recently Justin (@backtoyourfeet) was asked to help make some short educational videos for the FIFA Football Medical Network with @DrMarkFulcher. Here is a collection of the videos that are available on FIFA Medical Networks Twitter page (@FIFAMedical).

The first collection of videos demonstrate how to do some rehabilitation exercises for common football injuries. It is a great idea to see your physiotherapist as soon as you have an injury. They can diagnose what has happened, refer you for investigations or to specialists if necessary and give you great advice on what to do in the acute phase of the injury to help you get back to what you love doing.

The Muncie Straight Leg Raise is an exercise that helps to strengthen the quadriceps muscle and can be done safely quite early after an injury.

Hamstring injuries are one of the most common injuries in football. Confirming the severity and location of the injury can help with prediction for return to sport.

Eccentric exercises targeting the hamstring muscles have been shown to significantly reduce the risk of sustaining a hamstring injury, but have also shown to reduce the risk of re-injuring you hamstring. Doing the exercises regularly increases the chance of them being effective.

Patallae tendinopathy can cause pain in the anterior aspect of the knee, and often affect players who are more dynamic and can jump higher than their peers. As with most tendinopathies it is caused when the tendon is exposed to more load than it has capacity to cope with. Using a decline board helps to load the patallae tendon.

Managing Achilles tendinopathies can be frustrating for players as it can be difficult to get the balance of how much loading activities like running and jumping the tendon can tolerate before it gets aggravated. Isometric exercises can be used as a way of loading the tendon early in the rehabilitation process or during the season when the player has a high playing load.

Groin injuries can be frustrating for players and therapists. You can prevent groin injuries by doing the Copenhagen Adductor Exercise regularly.

If you have had a long-standing groin injury, then the 10-week Holmich Protocol has been proven to be effective as a treatment. It was first described in 1999 by Per Holmich in The Lancet (Hölmich et al., 1999) but is still one of the most validated programmes for footballers who have chronic adductor-related groin pain. There are two phases to the protocol, and they include exercises to build strength in the hip adductors, abdominals, glute’s and lower back.

The first phase of the @PerHolmich protocol can be used to help manage a player with adductor-related groin pain. Do you know how to initiate this rehabilitation programme? #FootballNetwork #FIFADiploma pic.twitter.com/lVCDKYdGl1

— FIFA Medical Network (@FIFAMedical) December 16, 2019

The second phase of the Holmich protocol is used to progress a player’s strength and improve function. Do you know what it involves? Have a look at this clip to see. #FootballNetwork #FIFADiploma pic.twitter.com/S68h3p2lFJ

— FIFA Medical Network (@FIFAMedical) December 23, 2019

Recently the programme was validated by (Yousefzadeh, Shadmehr, Olyaei, Naseri, & Khazaeipour, 2018) who found that the Holmich programme may be an effective treatment for long-standing adductor-related groin pain (LSAGP). However, they suggested more emphasis should be paid to the hip adductor muscles’ eccentric strength and have modified the programme to make it more effective. One of the exercises they included in their programme is the Copenhagen adductor exercise. The Copenhagen adductor exercise can reduce the risk of getting adductor injuries and should be done regularly to maximise the effect. Our Premier Football teams use the Copenhagen adductor exercise as well as the FIFA 11+ warm-up exercises to help reduce the risk of injury during the season.

When done regularly the Copenhagen adductor exercise can reduce the risk of developing groin pain by 40%. This video shows how the three progressions are done. #FootballNetwork #FIFADiploma
See the original paper from the @BJSM_BMJ to learn more: https://t.co/v6SclZeEz4 pic.twitter.com/9Z6NCVExMY

— FIFA Medical Network (@FIFAMedical) January 20, 2020

Groin pain does not just affect footballers. If you have had an adductor injury, or have groin pain that is restricting your ability to play football or achieve your calls then we would love to hear from you. Make an appointment and we can hep prescribe the best way to help you return to your sport.

References:

Hölmich, P., Uhrskou, P., Ulnits, L., Kanstrup, I.-L., Nielsen, M. B., Bjerg, A. M., & Krogsgaard, K. (1999). Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. The Lancet, 353(9151), 439-443.
Yousefzadeh, A., Shadmehr, A., Olyaei, G. R., Naseri, N., & Khazaeipour, Z. (2018). Effect of Holmich protocol exercise therapy on long-standing adductor-related groin pain in athletes: an objective evaluation. BMJ Open Sport & Exercise Medicine, 4(1), e000343. https://doi.org/10.1136/bmjsem-2018-000343

Comprehensive rehabilitation after ankle sprains are important to reduce the risk of re-injury.

Adding in perturbation drills helps to reduce injury risk.

By Justin Lopes July 22, 2020 adductor injury, adductor strain, exercise prescription, Exercises, groin injury, groin pain, Physio, Sideline Physio, Sporting, Supervised rehabilitation, Taping, Therapy

Educational Videos from the FIFA Football Medical Network (@FIFAMedical): Techniques for football physiotherapists / trainers

Recently Justin (@backtoyourfeet) was asked to help make some short educational videos for the FIFA Football Medical Network with @DrMarkFulcher. Here is a collection of the videos that are available on FIFA Medical Networks Twitter page (@FIFAMedical).

This collection of videos demonstrate techniques physitherapists or medical staff use to manage footballers.

Taping, or strapping, can help reduce the risk of re-injury when returning to football, however the ankle still needs to be strong enough to withstand the forces that changing direction, tackling (or being tackled) or kicking produce. Therefore it is important to progress the return to sport appropriately, and only return to play when it is safe to do so. There are a number of different techniques that can be done depending on what has been injured around the ankle. Syndesmosis injuries are also known as ‘high ankle sprains’ and they tend to take longer to return to football than lateral ligament injuries. Be aware you can also get adverse reactions to taping such as skin reactions and some players may take more risks because they feel the tape will protect them.

The “Low Dye’ technique is used to support the arch of the foot and can be used to see if orthotics may be appropriate for players to reduce pain and improve their function. It can help players with midfoot pain or posterior heel pain. You can vary the technique to support different areas of the foot. Sometimes I use Fixumull or Dynafix to lock the tape off as it is more flexible than rigid tape.

Taping can also be used around the knee to help reduce pain associated with patallaefemoral pain (pain around the kneecap). You need to make sure the skin is clean and dry if you want the tape to stick. We use adhesive spray to help the tape stay attached during football, and have found that using elastic adhesive bandages can also help the tape stay on during training and games.

Thumb sprains are most often sustained by goalkeepers when making a save, but can be caused by falls, or when caught on opponents jerseys in outfield players but contact from the ball.

Players can injure themselves in many ways on the field. It is common for players to break their skin and bleed while on the pitch. In football, if blood is visible on a player or his apparel, he will be asked to leave the pitch until it has been cleaned, the bleeding stopped, and the dirty apparel changed. It is important to always be prepared to deal with blood on the pitch. I always wear gloves on both hands to protect myself and my players.

Although rare, it is important that serious medical conditions are managed well on the sideline. Recognising the signs and symptoms of serious medical conditions and knowing what to do in an emergency is important for all medical personnel involved in covering football teams.

It is important to understand how to do good quality CPR. At WSAFC, where Back To Your Feet Physiotherapy is based, we have 4 AED’s, and trained staff who know how to do good quality CPR.

Good quality CPR saves lives.

The following set of videos show tests that football physio’s and medical professionals use to help diagnose conditions or objectively measure changes and progress in conditions.

The Y-balance test can be used in the clinic to monitor athletes progress after they have had an injury, and can be used as a screening tool to highlight imbalances between limbs.

New Zealand has one of the highest incidences of asthmatics and so it is important to understand how to monitor their asthma.

If someone does have an asthma attack and they are struggling to use their inhaler then understanding how to help them using a spacer is important. At WSAFC we have spacers upstairs at the physio clinic.

With so many young players playing football, it is common for them to develop pain at their growth plates due to the combined load of growth and activities such as running, jumping and kicking on their skeletal system. Here are some common sites they develop pain.

Although most injuries happen in the lower limbs, payers can sustain upper limb injuries too. Shoulder relocations are best left to trained medical personnel. Here are a couple of techniques for relocating a dislocated shoulder.

Recovery strategies are important after trainings or games to ensure players can continue to perform. Nutrition is an important component as it helps to replace energy lost during exercise.

Justin was also involved as part of the World Wide Delphi Study into the design of the FIFA 11+ Goalkeeper Injury Prevention Warm-Up.

By Justin Lopes May 19, 2020 Uncategorised

Tests for concussion that are commonly used in football

As part of our series of posts highlighting the informative video’s Justin Lopes from Back To Your Feet Physiotherapy did with Dr Mark Fulcher from Axis Sports Medicine for the FIFA Medical Network, this group of tweets are aimed at physiotherapists or medical professionals working with teams. These video’s show the process for the concussion assessment and demonstrate some tests for the vestibular occulomotor reflex.

By Justin Lopes April 9, 2020 adductor injury, adductor strain, exercise prescription, Exercises, groin injury, groin pain, Physio, Sideline Physio, Sporting, Supervised rehabilitation, Therapy, Uncategorised , , , , , , , , , , ,

The Holmich protocol for long standing adductor related groin pain

If you have had a long-standing groin injury, then the 10-week Holmich Protocol has been proven to be effective as a treatment. It was first described in 1999 by Per Holmich in The Lancet (Hölmich et al., 1999) but is still one of the most validated programmes for footballers who have chronic adductor-related groin pain. There are two phases to the protocol, and they include exercises to build strength in the hip adductors, abdominals, glute's and lower back.

Recently the programme was validated by (Yousefzadeh, Shadmehr, Olyaei, Naseri, & Khazaeipour, 2018) who found that the Holmich programme may be an effective treatment for long-standing adductor-related groin pain (LSAGP). However, they suggested more emphasis should be paid to the hip adductor muscles' eccentric strength and have modified the programme to make it more effective. One of the exercises they included in their programme is the Copenhagen adductor exercise. The Copenhagen adductor exercise can reduce the risk of getting adductor injuries and should be done regularly to maximise the effect. Our Premier Football teams use the Copenhagen adductor exercise as well as the FIFA 11+ warm-up exercises to help reduce the risk of injury during the season.


Groin pain does not just affect footballers. If you have had an adductor injury, or have groin pain that is restricting your ability to play football or achieve your calls then we would love to hear from you. Make an appointment and we can hep prescribe the best way to help you return to your sport.

Schedule an appointment

 

References:

Hölmich, P., Uhrskou, P., Ulnits, L., Kanstrup, I.-L., Nielsen, M. B., Bjerg, A. M., & Krogsgaard, K. (1999). Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. The Lancet, 353(9151), 439-443.
Yousefzadeh, A., Shadmehr, A., Olyaei, G. R., Naseri, N., & Khazaeipour, Z. (2018). Effect of Holmich protocol exercise therapy on long-standing adductor-related groin pain in athletes: an objective evaluation. BMJ Open Sport & Exercise Medicine, 4(1), e000343. https://doi.org/10.1136/bmjsem-2018-000343