Injury is an all too often event in sport at all levels of participation. This may be the consequence of trauma such as falling off a bike or attrition associated with the repetitive nature of training for improved sports performance. These injuries will invariable result in time away from training and racing, and reduced performance. Injury is normally associated with a negative impact on the triathlete and a time of frustration. However, it should be viewed as a window of opportunity to review, refine, recondition and to improved athleticism and mental toughness.
What does a physiotherapst do?
Physiotherapists are traditionally associated with the rehabilitation of the injured and disabled. However before rehabilitation can begin it must start with the correct clinical diagnosis. Physiotherapists are skilled in the diagnosis of musculoskeletal conditions and undergo specialist training at undergraduate and postgraduate level. At a philosophical level physiotherapists first screen patients for signs and symptoms of serious medical conditions that need referral to a hospital for urgent care such as a fracture, tumour or neurological disorder. Once they are satisfied that the athletes condition is not mimicking a serious illness the search for the cause of the symptoms can begin.
Physiotherapists use an analytical process to establish the cause of the athlete’s symptoms in addition to prescribing treatment to reduce the severity of the symptoms. However, the cornerstone of good quality physiotherapy is to establish the cause of the athlete’s symptoms which is especially true in a sport such as triathlon because of its repetitive nature. The physiotherapist will take a full history of all the factors that led up to the injury and also examine other areas of the athlete’s lifestyle that may be delaying recovery. A physical examination is conducted:
* To make a clinical diagnosis
* To identify the consequences of the injury
* To identify the biomechanical or movement errors that may have contributed to the injury or continued delay in its recovery
Why see a physiotherapist?
Physiotherapists are human movement specialists and use their education of the human movement system to diagnose and treat pain which is related to movement. To understand the development of musculoskeletal pain one must accept that movement which is excessive, imprecise or insufficient can contribute and be the cause of injury and pathology.
The identification of these factors in an athlete’s injury history is the real difference between a skilled physiotherapists and other healthcare practitioners. While many healthcare professionals will focus on identifying and treating the injured soft tissues, the often ignored and more important question is “What caused them to become painful in the first place”. This can only occur through an analytical process using a structured interview with the athlete and conducting a detailed physical examination
What happens during the physiotherapist's physical examination?
The examination is a most important step in the physiotherapist’s management of persistent injuries and must never be rushed or curtailed in the sprint to begin treatment.
This is often the case for many healthcare professionals that have not undergone specialized training and for patients that don’t understand the importance of establishing a diagnosis for the injury and its biomechanical and movement consequences. This is a problem in the National Health System where time is rationed because of limited resources. However, it is also a problem in the private sector where patients often expect treatment on their first visit because they are paying for it!
So to be CLEAR!
* The physical examination is to clarify the extent and nature of your injury.
* To identify the biomechanical or movement errors that may contributed to the injury or continue to delay its recovery.
* It is to record numerical data about the athletes problems in order to establish a basis to judge their progress against.
Then and only then can a diagnosis be established to successfully treat the “Entire” problem.
Once the diagnosis has been made physiotherapists can offer the following:
* Sports Massage
* Dry needling (AKA Acupuncture)
* Exercise therapy and rehabilitation
* Two dimensional video analysis
* Strength and conditioning
* Lifestyle advice
* Behavioural modification
However, treatment without an in-depth understanding of the patient and their condition is like a house built of straw, its foundations are always flimsy and likely to collapse in unpredictable conditions.
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Uzo Ehiogu is Clinical Director of Inside Edge Physiotherapy a specialist clinic in the UK specialising in extreme outdoor sports, climbing and triathlon. He is a specialist musculoskeletal physiotherapist and strength and conditioning coach.
Uzo is a former Commando and British Army Officer and is himself a passionate climber and outdoor fitness athlete. For more information visit www.insideedgephysio.com or email at him firstname.lastname@example.org, or connect on Instagram and Facebook.