Commonwealth Day #10 – Refection #5

Well the end is in sight for Glasgow 2014 Commonwealth Games and I’ve had a blast so much so I might go to Rio.

Working in the poly clinic as a physio to the athletes has been a once in a lifetime experience and taught me so much about the world of elite multi-sport events.

I have had the opportunity to work under a great physiotherapy in Lynne Booth and a fantastic team of physio’s from across the UK.

The next goal for me is to get My Physio in sport bronze award and then continue multi-sport event physiotherapy through UK Athletics and BUCS pathways.

Thanks for reading my previous blogs.

20140803-104137-38497049.jpg

Commonwealth Day #3 – Refelection 3

XX Commonwealth Games
XX Commonwealth Games

Commonwealth Reflection #3;

The Glasgow 2014 commonwealth games are now well and truly underway with Saturday 26th July promising to be a busy schedule of competition across various sports including netball, Judo, and tracking cycling. The athletes are in full swing and the medals are coming thick and fast with this in mind I undertook my third shift at the Games Village Polyclinic.

 

The What?

The poly clinic environment, as I’ve previously mentioned, is a fast paced and exciting environment but requires a cool and collected approach to ensure the athlete gets 1005 the elite care they deserve.  But sometimes the system can be slowed down with bureaucracy  with a classic example of this coming when SEM doctors require ultrasound scans for soft tissue damage. SEM had to refer to radiography for U/S and were unable to perform U/S sans themselves. So SEM referred to radiography but radiography would only do MRI scans due to higher sensitivity rates (1) (2).

 

 

Courtesy of Shoulderdoc.co.uk
Courtesy of Shoulderdoc.co.uk

So What?

The systems clearly works within the polyclinic with this clinic seeing upwards of 400 contacts in a day, but the system can be slowed down. Ideally, the SEM doctor would like to use U/S as part of the assessment process but this may not be time efficient. HCP’s need to carry out a full and thorough assessment of the presenting condition and provide appropriate care, which in this case involved using U/S scans for soft tissue injury. However the radiography preferred MRI scans for diagnostics which cost a lot more money to provide. The resolution came when SEM were finally able to use the diagnostic U/S scans for the athletes. This is by no way a criticism of the current system but goes to show with the best laid systems they need to be flexible to provide a high level of care within a high-octane environment.

 

Now What?

  1. Multi-disciplinary healthcare provision is idealistic and can work with clear and concise communication as well as team work to overcome problems.
  2. Systems and approaches to care provision need to flexible to ensure correct diagnosis and treatment are provided
  3. The athletes are the main priority and excellent care needs to be provided to ensure the best outcome for the athlete

 

Thanks for reading.

 

Tom

 

 

Reference:

1) B Hamilton, R Whiteley, E Almusa, B Roger, C Geertsema1, Johannes L Tol (2013); Excellent reliability for MRI grading and prognostic parameters in acute hamstring injuries; Br J Sports Med.

2) K M Khan, B B Forster, J Robinson, Y Cheong, L Louis, L Maclean, J E Taunton (2003); Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study; Br J Sports Med

 

 

'prehab not rehab'
‘prehab not rehab’

 

Has a Hamstring Injury Shown Jozy the Alti-door To The World Cup?

Image

Jozy Altidore – World Cup Injury

By Gemma Tomkinson  posted Jun 18, 2014

Jozy Altidore, a 24-year-old USA striker, who plays for Sunderland in the Premier League, suffered a hamstring injury after 22 minutes of the first half of the 2-1 victory over Ghana. He had been running down a ball with Ghana’s John Boye when he grabbed the back of his left leg.

So what is a hamstring injury? The hamstrings are a group of 3 muscles located at the back of the thigh. These muscles are responsible for bending the knee and straightening the hip during activity and are particularly active during running, jumping and kicking.

During contraction of the hamstrings, tension is placed through the hamstring muscles. When this tension is excessive due to too much repetition or high force, one or more of the hamstring muscles can tear. This is known as a hamstring strain. This sometimes occurs with rapid acceleration whilst running or when a footballer performs a long kick. In Altidore’s case it was during sprinting.

Jozy Altidore told reporters after the game “I was sprinting and I felt something … I was crushed. I knew right away I couldn’t continue. It was the worst feeling.”

It appears that Jozy Altidore’s symptoms were more severe than a minor strain as he was unable to continue play and obviously in severe discomfort.

Hamstring injuries can range from a small partial strain to a complete rupture which may require surgical reconstruction. Hamstring strains are graded from grade 1 to a grade 3 tear and are classified as follows:

Grade 1: A small number of fibres are torn resulting in some pain, but allowing full function.
Grade 2: A significant number of fibres are torn with moderate loss of function.
Grade 3: All muscle fibres are ruptured resulting in major loss of function

As with all injuries, a thorough examination is undertaken by the medical team. Further investigations such as an MRI scan or Ultrasound may be required to confirm diagnosis. In Altidore’s case, he’s awaiting MRI results to determine his chances of playing again this tournament.

In terms of rehabilitation from an injury as Altidore’s it is vitally important that treatment starts immediately following injury with the principles of PRICE (protection, rest, ice, compression and elevation).

The initial acute stage of all hamstring injuries will last 24 to 48 hours. After this a full rehabilitation programme should be followed which looks to reduce pain and inflammation, improve flexibility and muscle control and gradually increase the load through the hamstring to a level where you are able to return to full training and match play. The rehabilitation will be designed by a highly trained physiotherapist to include stretching, strengthening, aerobic fitness and sports specific drills. It will be progressed appropriately related to the stages of healing.

Is Altidore out of the World Cup? Many would assume yes but Manager Jurgen Klinsmann remains optimistic and the medical team are working hard with Altidore to give him the best possible opportunity.

Follow us on Twitter @AposTherapy for more World Cup injury updates!