CYCLING TOUR DOWN UNDER 2018

Angus lets you in on the hidden world of the World Tour Cycling, the Tour Down Under 2018!

 

I have now spent a few years working with teams at the Tour Down Under and it is always an absolutely fantastically organised and run event. The level of cycling talent that is put on display at this race is forever improving and year-by-year we are treated to spectacles of human performance.

 

Many wouldn’t know what happens behind the scenes at an event like the TDU and I thought I would take this opportunity to bring this hidden world of World Tour Cycling to the fore….

 

Teams arrive as early as two weeks before the event with some staff members spending the new-year in Adelaide in preparation, and by teams I mean not only riders but 2 soigneurs, a physio (myself), a director of sport, a media representative, a general manager and the team owner. Once teams arrive there is a flurry of training and acclimation to the climate of Adelaide. Most teams will embark on training rides and recon rides varying from 2-6 hours in length to get a feel for the conditions and to experience key points in of important stages. For EF Education First DRAPAC p/b Cannondale this involved a 5hr ride including multiple repeats of Willunga hill and other starts and finishes of various stages. As many riders are receiving new race bikes, which are built on site, and gear. This is the time for testing and tweaking equipment and checking and double-checking measurements transferred from training bikes.

 

Other staff are busy working to preparation for the race, media and social media releases and sponsor relations, trying to get ahead as far as possible before the first stage. Riders are seen daily by soigneurs and for soft tissue work and spend most of the rest of the time eating and resting and eating agai

n. Race tactics are formulated and rider lists are studied to determine opportunitiesand possible threats from other teams.

 

When racing starts things come together like a well oiled machine, soigneurs look after riders, mechanics look after bikes and the director of sport looks after tactics…

 

Meals are held in a central conference room with a table set for each team and a long buffet that runs the length of the room, some 20-25m in length. Riders are hungry…. While the riders are having their breakfast the mechanics are checking bikes and loading the cars while soigneurs are filling bottles and stocking race food, along with about 100 other odds and ends jobs. Riders come down and a 5-minute warning is issue from race organisers to signal convoy depart. Teams then travel in convoy to the race start, one team car and one team bus with race bikes and riders. Police escorts and roadblocks make for a smooth transition to the start line and teams begin their final preparation. Rides will stock food, check their race radio and lather themselves in sunscreen before signing on and then they are off.

 

On the road, given the condition this year, riders consumed about 12 600ml bottles each over the course of each stage, which equates to about 85 in total plus extras that they use as a road shower to cool down. They take these from the race car and from the feed zone where every riders receives a mousette containing 3 gels, 2 biddons, 1 ice stocking, 1 bar and 1 can of coke… that’s lunch.

 

Waiting at the finish line are the soigneurs who have travelled there in a police convoy from the feed zone. An area has been set up with rider’s bags, chairs, towels and extra drinks and sandwiches (usually subway). Riders come in and are immediately given extra water and protein recovery. One soigneur stays at the finish line with a bag containing fresh kit, caps and sponsor correct shoes in case any riders are required for the podium. The other stays with the bus awaiting the arrival of the riders, and team car.

Depending on the distance of the race finish line to the hotel, riders will either transfer back to the car in the bus or ride, and can clock up quite a few kilometres, for example the 145km stage finishing at Stirling plus the ride back clocked up 183km over the day…

After race transfer, riders drop their bikes to be washed, tuned and stored and head to the hotel to snack and see the soigneurs for a 1hr massage, during this time it is all about replenishing fluids and energy and promoting recovery. I will see riders for specific issues or niggles throughout the stage and deal with any injuries from crashes. Dinnertime is usually 7:30 at the buffet again with sometimes a race de-brief following. From there soigneurs head back to the team tent to prep bottles and race foot etc for the following day. Lights out by about 9-9:30 to get up and do it all again for the next day.

 

To read more about Angus click here.

PARTICIPATING IN THE OXFAM TRAILWALKER (OR ANY LONG WALK)?

Anna, our podiatrist’s top tips for preparing your feet for the event. 

Many people who embark on the challenge of a long distance charity event such as the Oxfam Trailwalker believe that because they can walk around the tan a couple of times that a 100km will be a bit hard, but easily doable. In fact walking for up to 48 hours is no easy feat and the need to train for this is imperative along with preparing your feet for the long long road ahead.

Here are my tips for preparing your feet;

  1. Shoes– Ensure you have shoes fitted for your foot type and the type of terrain you will be walking on. Every persons biomechanics are different and therefore so are your feetwear needs. Having your feet analysed by a professional is a great way to ensure you have the right shoes from the beginning. You will no doubt need at least 2 pairs of shoes for any trail type event, especially if its wet and off road. I would suggest looking at a running shoe that you can do the majority of your training in and then a trail shoe for the wet, uphill, trail conditions (for people that are running the event then one pair of trail running shoes will suffice)
  2. Socks–are one of the best investments (after your shoes) that you can make. Ensure they are made with Coolmax or a similar moisture wicking technology to ensure water is drawn away from your skin. Have these come up above your ankle and have multiple pairs (best changed at regular intervals). Carry multiple pairs and change at every checkpoint for comfort and protection.
  3. Skin– You must prepare and care for your skin in the lead up to the event. Any area of your skin that gets large buildups of callous (hard skin) is an area prone to friction and will most likely blister with large volumes of training.

***  IT IS NOT RECOMMENDED FOR LONG DISTANCE WALKING THAT YOU ‘TOUGHEN UP YOUR FEET” BY LEAVING AREAS OF CALLOUS/HARD SKIN. YOU WILL GET BLISTERS IN THESE AREAS.

We recommend having this professionally removed by a podiatrist and to MOISTURISE  your entire feet DAILY to increase the elasticity of your skin.

Learn to tape your feet for blister prevention ….you can view my U-tube videos on how to tape your here;

 

These are techniques that I created and have used over the many years of Oxfam Trailwalker.

These have been tried, tested and are an amazing tool to have to reduce blisters (one of the major reasons people have to pull out of large events)

The tape used is Fixomull Stretch 5 cm.

  1. Training– you will need to walk at least 75% of the distance of the event you are partaking in. You will need to start at least 6months out from the event and plan your training well. This allows your body to adapt to the change in loading and will ensure you enjoy the event so much more with less chance of injuries. It is not enough to walk just 50% of the event …just like you wouldn’t only run 21 km in the lead up to a marathon. Plan your training well to build up slowing and include a few bigger walks.
  2. Injury prevention– be it foot, leg, knee, hip or back pain …..any strength inefficiency in your body will raise it’s ugly head as you increase your training. Having a strength and stability program that is tailored to your event will be of great benefit and help reduce over use injuries.

Having your biomechanics, gait and walking assessed by a podiatrist can be very effective in identifying any issues that may cause problems along the way.

Happy Walking !!

 

By Anna Beetham

Podiatrist

 

THONGS

As the weather warms up many of us will reach for a trusty pair of thongs, but do you know what effect that have on your feet? Health professionals have been warning patients to limit their use for decades and now there is evidence to reinforce the message.
Research completed at Auburn University has found that thongs significantly change how you walk. When compared to bare feet, walking in thongs decreased stride length, decreased stance time, increased muscle activity in the lower leg, increased ankle dorsiflexion during swing and decreased hallux dorsiflexion. Furthermore when walking in thongs, plantar foot pressure is increased when compared to walking in runners (1)
What does this research mean? It is generally accepted that thongs don’t support or protect the foot. But what we now know is that thongs actually make more work for the foot. The research highlights how the wearer grips thongs by changing the angle of the foot and increasing muscle activity. These same muscles fatigue earlier and are less able to perform their primary role of supporting the foot.
Thongs have their place in any shoe closet as a ‘sometimes’ shoe. But what the research now confirms is they are not suited for long periods or for people with certain foot pathologies.
We do know that in the Australian summer it’s difficult not to reach for a pair of thongs or sandals when it gets hot however there are more supportive options available, something our podiatrists are trained to advise based on your foot type and footwear needs. If you have any questions about your footwear please make an appointment to see one of our podiatrists.

TEMPERO-MANDIBULAR DYSFUNCTION (TMD) OR JAW DYSFUNCTION

Tempero-mandibular dysfunction (TMD) or jaw dysfunction is a common issue that effects between 10-15% of the population. Symptoms of TMD include headaches, pain in the region of the jaw, face and neck, as well as, ear blockage and pain.

There are many causes of TMD including clenching and grinding your teeth or direct trauma to the face or jaw from impact during sport and activity. TMD can also arise following extensive dental work and surgery.

The pain associated with TMD may be due to spasm in the muscles surrounding the jaw or from dysfunction inside the joint. The pain may also be referred from the muscles in your neck and head.

Common signs of TMD to watch for include:

  • Clicking or cracking sensations inside your mouth
  • Locking or seizing of the jaw in either the closed or open position. Pain and discomfort with chewing or yawning
  • Persistent facial pain and headaches.

Physiosports Brighton Physiotherapist Angus McDowell has completed professional training in regards to management and treatment of TMD and headaches. If you’re suffering any of these symptoms or have any questions feel free to give us a call on 03 9596 9110.

3 REASONS TO STRENGTH TRAIN AFTER INJURY

Strength or resistance training involves much more than simply going to the gym a couple times a week. To gain the most from strength training it’s crucial to understand the science behind exercise choice, dosage and planning. This is the foundation of designing a strength training program.

 

In fact, strength training is more about the design of the program than the exercises themselves. Recent evidence highlighting the significance of concepts such as load management and periodization emphasize this point. These concepts include progressively building your training volume and intensity, providing appropriate variety in the program and accounting for the physical profile and injury history of the patient.

 

The idea of strength training can make some people who’ve been previously or currently injured apprehensive. However, the risk of aggravating an injury must be balanced with the risk of staying in a deconditioned state and maintaining a higher re-injury risk. Which brings me to one of the most common questions I get asked by patients, ‘what can I do to prevent this happening again?’ Thankfully these days my answer is both simple and based on sound scientific evidence – improve your strength.

 

It would be wonderful if improving strength were an easy process. Though physical and mental effort is required to complete the actual strength program, it’s structure need not be complicated. With the guidance from an appropriately qualified Physiotherapist, a simple yet highly effective strength training program can be designed to progress your injury rehabilitation and reduce your injury risk.

 

In summary there are three main reasons you should strength train following an injury:

 

1. Resistance Training is a valid treatment option for musculoskeletal rehabilitation.

A recent systematic review using data from 1545 rehabilitation patients demonstrated that strength training improved outcomes in chronic low back pain, knee osteoarthritis, chronic tendinopathy and post hip replacement patients (Kristensen and Franklin-Miller, 2012. Other studies have shown that a structured resistance training program can reduce pain and improve function in neck pain (Gross, 2015), groin pain (Jensen, 2012), shoulder pain (Andersen, 2014) and also osteoporosis (Gomez-Cabello, 2012).

 

2. Strength training reduces sports injury risk
A recent systematic review using data from over 26000 patients showed that ‘strength training reduced sports injuries to less than a third’ and suggested that strength training may also halve overuse injuries (Lauersen et al, 2014).

 

3. Strength Training is easy to start
As most patients following injury are starting from a low base of fitness, strength training doesn’t need to involve large weights, squat racks, benches or sweaty mats in a gym with blaring music. In most cases to achieve an appropriate training stimulus simple bodyweight training is ideal.

 

IN SUMMARY, RESISTANCE TRAINING:

  • is effective in treating a range of common musculoskeletal conditions
  • is effective in reducing sports injury risk
  • is easy to perform.

 

By John Contreras

APA Sports Physiotherapist, S&C Coach, Pilates Instructor

 

Find out more about John’s Strength & Conditioning Essentials for Physiotherapists Course

KIDS – HOW MUCH SPORT IS TOO MUCH?

As sports injury managers, we are often asked this question, and especially regarding children and adolescents, with the expectation that ‘kids shouldn’t get injured’.

In a general sense ‘too much’ sports or activity is related to the individual CAPACITY (red line below).  Each body has a capacity to endure a certain LOAD, with many variables playing a role.  If the individual is active above this capacity, then the body is more at risk of injury. Importantly the body can increase its capacity.

This is called the training effect.

Capacity

 

By working just in the right range, we get a training effect that increases the capacity of the body, tissues, bones and joints, to handle sport and activity as per diagram 2 below.

Capacity2

The calculation is not as simple as shown, as day-day and month-month other factors can affect capacity including fatigue, lack of sleep, diet, poor immune function, stress and hormone changes.  During the growth phase of children many of these ‘other factors’ come into play, as well as the mechanics of the body and the unique nature of the way muscles attach to bone during puberty.

How much sport is too much is difficult to quantify.  In adults and children pain and soreness can be a good guide, as well as fatigue and wellness.

For a TRAINING LOAD INJURY (ie not a specific acute injury but soreness or pain due to overload) one can pain monitor – soreness which is a maximum of 1-2/10 is tolerable and maybe normal during and for 24 hours after activity, but any higher ratings OR pain that limits training/playing is too much.  Activity needs to be modified or decreased.  Extreme fatigue or being unwell related to activity is another indicator that activity should be modified or reduced.

 

In children growth and development phases are from 8-16years with girls slightly earlier, and the capacity of the individual will vary greatly with spurts of growth and hormonal change.

 

TAKE HOME MESSAGE:

  • Capacity of the body is key.
  • Rest and over-activity is bad = need to do just enough to maintain and improve capability and fitness.
  • PAIN MONITOR – over-load injury >2/10 pain or not resolving or affecting performance needs activity modification or advice.
  • FATIGUE and BEING UNWELL will decrease capacity – pull back if this is occurring.
  • Control what you can control – can’t control growth but can control CAPACITY (ie conditioning training) and ACITIVITY – if your child is continually sore and breaking down take advice regarding these 2 options.

 

For more information about athlete load management go to physiosports.com.au/blogs or email paul@physiosports.com.au

ARE THERE SPECIFIC GUIDELINES FOR KID’S PARTICIPATION IN SPORT AND ACTIVITY?

As parents, coaches and injury managers we look for the magic number regarding the amount of sport our kids should undertake. What is clear is that children and adolescents need to exercise. The question is do we know how much exercise and what type of training and play will optimise their athletic development rather than compromise it resulting in injury.

The recent study ‘The Youth Physical Development Model: A New Approach to Long-Term Athletic Development’ by Lloyd and Oliver (2016) gives a nice description of many different types of activity in strength and conditioning training and relates the type of training to the BIOLOGICAL or MATURATION age of the child.

In SUMMARY, before the ‘growth spurt’ that occurs in adolescence (the early teenage years), one should focus on basic strength, movement skills, speed and agility. It is important in this phase to jump, land and do strength activities to optimise bone development.

Once the ‘growth spurt’ begins one can take advantage of growth hormones and optimise muscle bulk with hypertrophy work (i.e. weights), power and sports specific skills BUT only if the athlete is competent.

YPD for females

The YPD model for females. Font size refers to importance; light pink boxes refer to preadolescent periods of adaptation, dark pink boxes refer to adolescent periods of adaptation. FMS = fundamental movement skills; MC = metabolic conditioning; PHV = peak height velocity; SSS = sport-specific skills; YPD = youth physical development.

 

While specific sporting load guidelines are limited across all sports, governing bodies of Cricket and Baseball have published articles which outline age appropriate fast bowling and pitching loads respectively to help minimise risk of injury in children. Furthermore, consensus statements exist to help guide how much time kids should be engaged in organised sport and training per week. These recommendations are outlined below.

 

CRICKET:

Recently Cricket Australia published a number of guidelines surrounding fast bowling loads for adolescents. These have been designed to minimize the risk of injury.

AGE GROUP SPECIFIC GUIDELINES

AGE GROUP  
Under 11 2 over limit each spell & 4 over limit per match
Under 13 4 over limit each spell & 8 over limit per match Target* of 100-120 balls per week
Under 15 4-6 weeks bowling preparation before the season 5 over limit each spell & 12 over limit per match Target 100-120 balls per week
Under 17 6-8 weeks bowling preparation before the season 6 over maximum each spell & 16 over limit per match Target 120-150 balls per week
Under 19 8-10 weeks bowling preparation before the season 7 over limit each spell & 20 over limit per match Target 150-180 balls per week

*weekly targets are a combination of training and match bowling

 

BASEBALL:

Elbow and shoulder injuries are common in adolescent baseball pitchers.  These injuries are often the result of overuse, poor conditioning or suboptimal pitching technique.

Recommendations to avoid these injuries were outlined by the American Sports Medicine Institute in 2013:

  1. Monitor levels of fatigue, often associated with deteriorating technique as well as with decreased accuracy or pitching speed. If these signs are beginning to surface, allow a break from pitching/throwing.
  2. Furthermore, if a child reports pain in the elbow or shoulder, cease throwing activities and seek an expert’s opinion.
  3. Allow a period of 2-3 months with no competitive overhead throwing per year.
  4. Prevent pitching duties on multiple teams with seasons that overlap.
  5. A child should not have both pitching and catching duties. This places too great a load on the upper limb with the throwing requirements.
  6. Ensure spikes in pitch counts are offset with increased rest in the days following.
  7. Pitching more than 100 competitive innings in a calendar year in considered an injury risk.
  8. Emphasise the importance of correct technique prior to a velocity focus.

 

A consensus statement from the American Orthopaedic Society for Sports Medicine recommends several measures to prevent burnout and injury in children including ‘avoiding over-scheduling and excessive time commitments’. (LaPrade, et al. 2016)

As a rule of thumb kids should limit the number of hours they participate in organised sports each week to the number of years they’ve been alive — or less. ‘So a 10-year-old should not play or practice more than 10 hours a week,’ (McGuine, et al. 2017)

IN SUMMARY:

  • Strict activity guidelines are scarce.
  • ‘Hours for age’ has no evidence but can be a guide.
  • No need to specialise early – a broad range of sports may be beneficial.
  • Be aware of stages of maturation – wait until late puberty and spurt before commencing ‘super heavy’ strength and plyometrics work.
  • Monitor pain, fatigue and wellness, and rest, sleep and eat well.
  • Avoid excessive spikes in load.

 

 

References:

McGuine, T. A., Post, E. G., Hetzel, S. J., Brooks, M. A., Trigsted, S., & Bell, D. R. (2017). A Prospective Study on the Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes. The American Journal of Sports Medicine, 0363546517710213.

LaPrade, R. F., Agel, J., Baker, J., Brenner, J. S., Cordasco, F. A., Côté, J., … & Hewett, T. E. (2016). AOSSM early sport specialization consensus statement. Orthopaedic journal of sports medicine, 4(4), 2325967116644241

 

SHOULD MY CHILD FOCUS ON THEIR BEST SPORT, OR DO MANY SPORTS?

With the remarkable amount of resources being invested into the sporting world, the popularity of youth talent identification programs has increased sevenfold. In Australia, these elite youth programs are popular in the AFL, tennis and basketball settings. These programs have the long-term aim of developing elite athletes from an early age, thus guiding them along a specific sporting journey. Because of this, many parents are unsure whether their child should focus on a specific sport, or continue to diversify.

Cote (et al. 2009) has previously outlined key concepts of athletic development, concluding:
1) Playing different sports in the younger age groups does not effect one’s potential for elite sport participation after puberty.

2) Variety in sporting involvement at a younger age is linked to a longer sporting career and a decreased likelihood of drop out.

3) Exposure to a range of sports positively influences youth development in the areas of relationship formation, behavioural tendencies and an understanding of healthy habits.

4) Injuries may be more likely if a high-school student specialises in one particular sport (McGuine, et al. 2017), or this increase in injury rate could be related to an increased volume and intensity (Di Fiori, et al. 2014).
With the evidence considered, your child will benefit from participating across a range of sports at an early age, which prevents injury and improves participation and well-being, without impacting their chances of reaching an elite level once they mature.

 

 

References:

Côté, J., Lidor, R., & Hackfort, D. (2009). ISSP position stand: To sample or to specialize? Seven postulates about youth sport activities that lead to continued participation and elite performance. International Journal of Sport and Exercise Psychology, 7(1), 7-17.

DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A. (2014). Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med, 48(4), 287-288.

McGuine, T. A., Post, E. G., Hetzel, S. J., Brooks, M. A., Trigsted, S., & Bell, D. R. (2017). A Prospective Study on the Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes. The American Journal of Sports Medicine, 0363546517710213.

Do you play basketball?

Ankle Injury

Ankle injuries are common in basketball players. A sprained ankle may seem like nothing at first, but it can cause significant problems. In Basketball, players over half the time missed due to injury is because of ankle injuries.

What is it?

Your ankle joint is made up of bones; tibia, fibula and talus, and ligaments; lateral and medial, Inversion injuries or ‘rolling your ankle’,

(where you fall onto the outside (lateral) of our foot) are far more common than eversion injuries, where you fall on inside (medial) of your foot. Inversion injuries may result in the lateral ligaments of your ankle becoming damaged or torn.

What can we do?

Ankle injuries often swell and bruise. Therefore the immediate treatment of RICE (Rest, Ice, Compression and Elevation). It is also important to apply the principles of no HARM (which is no Heat, Alcohol, Running or Massage) in the first 24-48 hours.

Depending on severity of the injury there may be a period of time on crutches. But hopefully not! The aim is then encourage the joints to move properly and to strengthen the muscles around the joint as soon as the pain allows.

Prevention

It is important to prevent ankle injuries because recreation basketball players with a history of ankle injury are 5 times more likely to hurt their ankle again. To help prevent ankle injury you can wear correct shoes, ensure stretch and warm up appropriately before training or playing, tape or a brace.

Stiff ankles are poor landing technique also increase your risk for ankle injury. This can be picked up by your physiotherapist in a screening review.

Ankle braces and taping

Not everyone need to wear ankle braces or tape there ankles. There is an indication that ankle taping or bracing can decrease the risk of re-injuring in those of you that have a history of ankle injuries. We can help teach you the best techniques to safely tape your ankle or provide you the ankle braces required.

Conclusion

Ankle injuries are painful and frustrating because they cause you to miss games, not only for McKinnon but at school too. Prevention is just as important as treatment and the team at Physiosports Brighton are available for screenings and treatment to help manage your ankle injuries.