Enhancing recovery and performance in sport

Article Outline

• Copyright

The first Physical Therapy in Sport International conference was held on 7–8 July 2006 in Birmingham, UK. The event was sponsored and organised by Elsevier and hosted by the Association of Chartered Physiotherapists in Sports Medicine (ACPSM) and the International Federation of Sports Physiotherapy (IFSP), and incorporated their Annual General Meetings.

Three of the competencies of a sports physiotherapist formed the theme for the conference:

(http://www.sportsphysiotherapyforall.org/publications/competencies.html).

Keynotes, guest lecturers and workshops were delivered on each of the themes from internationally renowned clinicians and researchers and provided an extremely stimulating programme. Additionally, a free paper session saw the best eight submissions presented, and these as well as the posters prompted some lively discussion. For readers who were not able to attend the conference the oral and poster abstracts are included in this issue of PTiS.

The feedback from those attending was extremely positive for the content of the 2 days, the quality of the speakers, and the structure of the programme enabled many networking opportunities and a chance for more informal debates with speakers. The evening reception at the National Sea Life Centre provided the perfect opportunity to catch up with old friends and make some new ones whilst watching the Sting Rays swim by—a truly surreal experience.

We are about to embark on a new season of winter sports and there have been previous reports in the literature of an increased incidence of LBP in young cross-country skiers. The first article in this issue, by Alriccson and Werner, reports on a 5-year follow up of low back pain in a group of 15 young, elite, cross-country skiers. Seven of this cohort reported LBP during the period of the study, and these skiers demonstrated a significantly higher relationship between thoracic kyphosis and lumbar lordosis than those who did not. Additionally, the majority of those skiers who were asymptomatic also participated in other physical activities. These findings suggest that cross-training in sports that do not include repetitive flexion, as cross-country skiing does, may help prevent the incidence of LBP in this group of young athletes.

Clinicians continue to search for outcome measures that are easy to use in the field, require little equipment and are valid and reliable. An additional, potentially confounding issue lies in the fact that there may be a learning effect having conducted a particular test. The reality of this situation is that any improvement recorded could be as a result of using the test rather than any other intervention employed. Controversy exists in the assessment of proprioception in the clinical setting. Whilst many clinicians employ some form of the single leg stance test (SLST) to evaluate proprioception comparing both legs, what is this judged against? The length of time? the amount the subject wobbles? Warren and Colleagues report on a variation of a theme whereby the SLST is conducted for 20s and the postural stability is measured via a balance error scoring system (BESS). The authors subjected healthy subjects to repeated measures of this test over a 2-week period and found a decrease in the scores over this time. This represents an ‘improvement’ in the test in the absence of any intervention. These results remind us to question the potential effects of using functional type tests for evaluation in a rehabilitation setting to monitor improvement.

Continuing with the theme of evaluation and outcome measures, software analysis packages are becoming increasingly popular to analyse video footage of dynamic movement. In a technical note, Cronin and colleagues report on the reliability of siliconCOACH, a sports analysis software package, to determine both static and dynamic range of measures of knee flexion. Results from this study show a high degree of stability of both these measures on different days of testing and acknowledge that further research is required to evaluate the reliability in situations where less controlled and more dynamic movement is to be evaluated.

The type and role of stretching in clinical practice, rehabilitation and prevention of injury continues to be a controversial topic. Clinicians are interested in other parameters, as well as range of movement, that may be influenced by whatever type of stretching is undertaken. Whatman and colleagues reported a small and short lived increase in ROM and decrease in stiffness following static stretching of the hamstrings. The reduced stiffness may increase the compliance of the musculo-tendinous unit in preparation for activity, and the authors’ discus potential implications of these results.

Various modalities have been suggested in the management of muscle haematomas. In the final article, Smith and colleagues present a literature review on the management of this common sporting injury. The evidence base is placed strongly in the field of animal studies and, unsurprisingly, there are very few clinical trials on which to base your practice. The modalities and strategies used reflect the clinical reasoning of how therapists try to influence the physiological process that occur having sustained this type of injury.

Finally, I would like to take this opportunity to thank all the reviewers (listed in this issue) who have been involved with PTiS over the last year. Reviewing really is a labour of love, and we really appreciate your input.