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Dr David Opar discusses the Hamstring Injury

Posted on | by Mark Brady | Leave a Comment on Dr David Opar discusses the Hamstring Injury
It is the most common injury in the Premier League and accounts for 49.3% of all muscular injuries reported in soccer yet risk management rather than prevention is the key when it comes to hamstring injuries.
Compared to most other muscular injuries, Athlete’s that suffer hamstring injuries have a very high chance of re-injury, in some cases up to a 63% likelihood.
Age and history are the two most common factors that affect the hamstrings, and while these attributes are constant according to Dr. David Opar from the Hamstring Research Group at the Australian Catholic Institute, the key to managing the hamstring injuries is modifiable factors.
Understanding the factors and looking at the Athlete as a whole is a large part of understanding and managing hamstring injuries.
Strength is a key factor that can help researchers understand more about the hamstring process. The older and weaker you are then there is an increased chance of suffering a hamstring injury. Older athletes that are stronger have the same risk however as younger athlete meaning that the ageing process plays an intrinsic role in hamstring injuries.
The most commonly researched, and used exercise for building strength in the hamstring is the Nordic hamstring exercise.
Traditionally this involves a partner holding down the ankles with you slowly fall forward however this has been modified over time with the partner replaced by a rig with force measuring devices meaning that you now have feedback as to how much force each leg is producing.
This feedback, or high-level data, has already helped the few athletes using the device to be monitored so that fluctuations in strength can be seen in the weeks leading up to injury, providing a detailed insight into a highly-common injury.
If a deficit in eccentric strength does indeed suggest a risk of hamstring injury, an easy to use monitor of that strength could be a huge asset in the risk management of athletes
The Nordic hamstring exercise is a valuable tool that is objective-driven, easy to implement and provides data for clubs that is measurable.

‘The benefits of Cryotherapy’ with Dr Chris Bleakley

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“Cryotherapy” has emerged as something of a buzz word in the sports medicine industry in recent years.  Often we have seen sports star pictured in cold chambers, a bath of ice or indeed submerged in extremely cold water.
At its most basic, Cryotherapy is described as using extremely cold temperatures, often at minus 110 degree Celsius, to aid in the treatment of a wide range of injuries.
However, as Dr Chris Bleakley, lecturer at the University of Ulster explains, Cryotherapy offers much more.
When a top sports person or athlete is injured, the focus, naturally, is on the area affected. Using Cryotherapy allows a Sports Medicine professional to not only control the pain, reducing inflammation and the swelling for the athlete but also to slow down his metabolism.
As Dr Bleakley points out slowing down the metabolism is very important, especially in the management of secondary cell injury.  When an injury occurs, the healthy cells around the injury are deprived of blood, oxygen and nutrients and as a result, they die too.
So by cooling the body tissue thus reducing the metabolism, you give the cells a “mechanism to cope with that ischemic environment”
However before you all run off and jump into a bath of extremely cold ice, you need to be warned that cryotherapy is not suitable for all injuries and body types.
In fact, according to Dr Bleakley, Cryotherapy is really just suited for injury close to the surface of the skin in those with low body fat. The field according to the lecturer is one that requires more study and is perhaps, given the lack of medical technology, one of the rare situations where the medical theory lags behind the practical use.
But for those that are suited to this type of treatment and for the club’s medical staff charged with managing their well-being cryotherapy is an inexpensive and effective pain management tool”.
For further information on this please email [email protected] or call +353 1 5262030

The Challenges of working as a Sports Physician in professional football

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Success on the field of play is often attributed to the work that goes on behind the scenes. The manager, coaching staff, club administrators and medical staff all play a huge role in ensuring that the stars on the pitch have all the tools necessary to succeed.
The challenges facing clubs, at all levels, are the same. Clubs need to generate revenue to run, they need to ensure that the players are prepared for games and they need to manage injuries as and when they occur. However the bigger the club, the bigger the challenge and the bigger the pressure.
Dr Luis Serratosa knows all about the challenges and pressures of working with a big football club. The physician was a team doctor with Real Madrid from 2001 to 2013. During that time he worked with the biggest footballers in world football including legends of the game such as Raul, Luis Figo, Zinedine Zidane, Roberto Carlos, Kaka and Ronaldo. For him, working with the players was the easy part. The challenges came from instability elsewhere.
During his 12 years at Madrid, Dr Serratosa worked with 11 different managers, each of whom had their own ideas on how a club should be run. Each one was employed to do one thing, win. When the results were going good, everyone was happy however all the good work that went on behind the scenes to prepare players for games was soon forgotten when results went against the team. For Dr Serratosa, the pressure became part and parcel of his job and something he learned to live with. The flip side of working at very of his profession was the instant access to facilities, advice and experts. Fans used to instant access with social media can understand the excitement at having information at hand quickly and easily and with everyone wanting to work alongside Real Madrid the same access was available to team doctors.
The top-class club facilities were, and still are, located near a state of the art hospital while expert opinion on any subject was just a phone call away. Unrivalled access to the best brains, advice and technology in the game. Now out of the limelight and away from the club, Dr Serratosa opens up on the challenges that come with being a sports physician with one of the biggest clubs in the world.

Dr Alan Byrne on the relationship between Manager and team Doctor in Football.

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The relationship between manager and team doctor is often one of the least talked about, but perhaps one of the most important interactions in football.  The manager’s job is to ensure that he picks a side that is fully fit, prepared and wins. To do that he needs the team Doctor to ensure the players fitness and health is managed during the time they are with the team. The sight of a doctor marching down the corridor to a manager’s office can fill even the most hardened boss with dread. The “messenger” more than likely delivering bad news that will affect team plans. Respect and trust are two key elements to any relationship and according to Dr Alan Byrne, team Doctor with the Republic of Ireland international football team, these are crucial to building a strong relationship with the medical team and the manager.
The role of the team doctor is determining, in the build-up to a big game, who can train, who can’t and who is available. The flow of information is important, as is communication.  The manager needs to trust the doctor and work with the information he is receiving. Ultimately the player’s well-being is the main aim of the doctor, as much as the desire to see a team or indeed country win. Unlike most patient and doctor relationships, the connection between a team doctor and a player can is often stronger. Training camps can often be an intense period in a team’s calendar and build up to a game and those get-together’s offer opportunities for staff and players to spend time together. From eating together to time spent monitoring the players, the bond between the two grows especially during the longer period spent together. If a doctor was to treat a player differently from a “normal” patient then it would unethical and that is something more important that success. Watch Dr. Alan Byrne, team doctor with the Republic of Ireland national team, talk about his role with the FAI.

What is Patellar Tendinopathy?

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Imagine a pack of dry spaghetti – these are the collagen fibres that make up a tendon (you have a mix of type 2 and 3). Tendinopathy is a continuous process where a few fibres initially fail – imagine wet spaghetti amongst the dry. These then snap and packets of fluid collect in the structure – eventually, the tendon swells and is painful to take the load – some tear or snap, but this is rare. It is difficult to manage, Shock Wave, Platelet Rich Plasma and heavy weight lifting are used along with surgery. We still do not understand fully the genetic process.

What is the best treatment for tendonitis of the knee?

  • Establishing hip strength early is important.
  • Good eccentric quadriceps strength should be developed through exercises such as box squatting.
  • Put an emphasis on excellent single leg control throughout rehabilitation.
  • Do not underestimate the role the trunk has on lower limb biomechanics and on loading the knee.
  • Ensure to include dynamic tasks such as running and jumping mechanics during all rehabilitation management strategies.

Rehabilitation focusing on addressing lower limb biomechanics is important in preventing overload of the patellar tendon issues.

Can you fully recover from patellar tendinitis? High recurrence rates 20% are often associated with patellar tendinopathies.

What are the typical causes of patellar tendinitis?  It comprises 1.5% of all injuries in soccer

How long does patellar tendinopathy take to heal? 38% of patellar (knee) tendinopathies result in absence between 8-28 days.

Owen Hargreaves was limited to 9 first-team appearances from 2008-2012 mainly due to patellar tendon issues.

 

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