Review the past to focus for the future

It has been great to read and reflect on the great memories and events which have occurred within the New Zealand Triathlon and Multisport community over the years.

This makes it a good time to stop and consider our own personal successes (and failures) over the years.

Evaluating the effectiveness of our training programmes and our competitive results with our coaches and our fellow athletes is a frequent occurrence throughout the year. This same process applies with an athlete and their physiotherapist; Or at least it should. In particular we should often stop and reconsider what physiotherapy means to us. Physiotherapy offers a lot more than a “quick fix” to sort out injuries and little niggles so that we can continue to train and compete until the next problem occurs. Physiotherapists can offer preseason screening assessments (including the Functional Movement Screen) to help identify potential risk factors for injuries. As well as injury management and prevention experts, our role can be performance enhancing. The key to unlocking this added potential lies within our expert analysis and exercise prescription skills. However, many athletes view their exercise programme as  a mere adjunct to the “hands on” therapy they receive. At best many will complete exercises until the problem they have is resolved, not realising the many benefits that come with successful rehabilitation and conditioning programmes.

This problem can be identified across many fields of sports medicine research. Following reconstructive surgery to the anterior cruciate ligament (ACL) a very extensive period of rehabilitation is required. Studies have shown that even after two years when athletes have fully returned to their sport, asymmetries between the injured and normal leg continue to exist. Some athletes may be more than 20% weaker on their previously injured leg and it is suggested asymmetries of more than 10% are highly significant in relation to injury risk.


Photo © Delly Carr / ITU

Furthermore “previous injury” continues to be the most significant risk factor in relation to predicting the likelihood of further injury. The upshot of this would be to suggest that athletes are not persisting with their rehabilitation until the underlying problems identified have been fully resolved. Instead, resolution of symptoms and the ability to train are the outcomes which curtail any further physiotherapy input. As a result they develop imbalances in their physical make up, risking further injury but perhaps more importantly limiting their full potential.

Compliance with rehabilitation programmes is an ongoing challenge for physiotherapists and their clients. This often depends on a person’s perception of their injury, the effectiveness of the treatment they receive and their ability to incorporate this into their everyday life. We frequently see athletes focusing on the importance of massage for their sore calf and Achilles problems while developing strength in this area is often the key to a good recovery. With busy lives, daily activities are often prioritised and training sessions are rarely skipped for the sake of doing a series of tedious stretches while “down time” in front of the TV may take precedence over completing Pilates type exercises.

The key to resolving this age old problem is to establish collaborative goals between the athlete, coach and physiotherapist. Information is power, and a good therapist will be able to clearly describe the diagnosis in easy to grasp terms as well as identifying all the weak links and contributing factors which need to be addressed. The aim and importance of each exercise needs to be adequately explained and a plan to regularly review progress is required. A written record of their treatment plan to facilitate their understanding of the rehabilitation journey is best practice. Access to an online exercise programme (Physiotec) can provide written and visual reminders on how to perform exercises correctly. Through a range of screening and assessment tools including video analysis (Silicon Coach and Kinesiocapture), a physiotherapist is able to delve deeper to discover the weak links which you should prioritise as part of your exercise programme. So if you are a typical triathlete who only does the minimum in relation to looking after your body, why not try another approach to assist with maximising your enjoyment and improve you results. Ask your physiotherapist how they can help you achieve more.


Originally published in New Zealand Triathlon and Multisport Issue 100, January 2015