• Newsletter Spring 2017

    Sports Doctors Australia Newsletter No 12

    Spring 2017

    Summer is almost upon us, with Christmas trees appearing everywhere, so it’s a rushed job to get the spring newsletter written. Multiple sporting stories, with men’s and women’s Ashes series over the next few weeks. A horse apparently won the Melbourne Cup (I am told this may be considered a sport). Australia has qualified for the football World Cup. There is also a Rugby League World Cup being played, with countries not known by me to play the sport being involved. Locally the water skiers are out, with an early season start to ACL and hamstring ruptures (I saw 3 hammy avulsions in 1 week).

    Tim Lowe’s Excellent USA Adventure

    Orange based sports doctor, Tim Lowe, recently toured the USA with a local rugby team, playing several games against a number of sides, largely packed with Islanders. He sent a report of the trip:

    Orange Emus USA Rugby Tour 2017

    I’ve just returned from my first tour as a Team Doctor for a sporting team and thought I’d share my experience with you. The team I looked after was the Orange Emus Rugby Club, an amateur club from the Central West in NSW. My experience may be quite different to looking after a professional team, or quite similar in some regards.

    All the players were amateur with everyone paying their own way including myself. The tour lasted 2 weeks with 3 games being played against teams from New Orleans, University of Alabama and Las Vegas.

    The rugby

    Results of the games included 2 wins and a draw, beating New Orleans 38-12, University of Alabama 54-17 and a draw against Las Vegas 19-19. The other teams were HUGE!!! Lots of ex-american football players, with a couple of guys from Las Vegas having played in the NFL. However their skills and game awareness weren’t as good as our guys so its good to see that rugby is not all about brute force and power. Interestingly the team from Las Vegas had a dozen American Samoans playing for them – they all moved to Las Vegas for work from American Samoa. On their island they grow up playing American football on Saturdays and rugby on Sundays. Also as Las Vegas is a 24 hour city the team would get 30 guys to training on Tuesdays, then a different 30 guys to training on Thursdays and then it was a lottery as to who turned up on Saturdays. And to put things into perspective the closest away game for Las Vegas is 4 hours – their longest is 12 hours!! That’s a long bus trip home.

    The medical side of things

    There was more GP problems to deal with than sports medicine issues. Fortunately we had no serious injuries from the rugby, just a few lacerations, sprains, brachial plexus injury and one concussion. Off the field, GP problems included dehydration, a couple of viral gastroenteritis, otitis media and STIs. Only one player went to hospital for some IV fluids for his viral gastroenteritis.

    The off-field side of things

    As an amateur team recovery and looking after yourself wasn’t high on the guys priority list. The term “rugby” tour was a good disguise for “drinking” tour, with the guys hitting the town most nights. The only major incident was one player being arrested for being drunk and disorderly. However this was dealt with rather swiftly with the coach for the Las Vegas team being a lawyer. He represented the player in court and the case was dismissed after 5 minutes! Other off-field activities included helicopter tours over the Grand canyon, visiting Gracelands which is the home of Elvis Presley and going to a David Copperfield magician show. We actually arrived in Las Vegas 2 days after the shootings which I was a bit nervous about. However once there it was business as usual as far as I could see, with all the casinos operating as usual. There was no extra security in the hotels with no one checking your luggage on arrival.

    Overall it was a great trip for myself. It was a great insight into what travelling with a team is like. I’m sure travelling to more exotic destinations would have its different challenges. Now it’s time for me to earn some brownie points with my wife who looked after our 2 toddlers on her own while I was away!!

    NSWIS Conference:

    I recently attended the 2017 NSW Institute of Sport Conference at Olympic Park, Sydney. The conference dealt with load management in athletes, mainly with respect to cricket (fast bowlers), gymnasts, as well as runners and netballers.

    The salient points were:

    • -Pars stress fractures are related to total balls bowled, though are very much related to spikes in bowling. Changing from T20 to ODI’s to Shield and Test Cricket seem to enshrine these spikes in loading. Less time between tests, no rest days, and a frantic schedule make load management difficult. Injuries occur in general a few weeks after the spike.
    • -Fast bowlers do better in the long run (no pun intended) if return to cricket is delayed until MRI – confirmed bony union occurs.
    • -Selectors selections often take little heed of injury prevention concerns.
    • -Gymnasts are frequently injured, with prevalence rates in the Australian squads being ~50% at any time. Injuries affect virtually any part of the body and involve bone and soft tissue.
    • -Gymnastic coaches are in general very wary of reducing athletes’ load. Spikes again are related to injury, though even a brief rest of 1 week, followed by a spike is related to injury.
    • -It is possible that BMD may drop over even a few days of rest. Continuing some daily loading over rest periods (usually only Christmas) may help mitigate this.
    • -“Stiffness” in runners, helps improve efficiency and speed, though excessive stiffness leads to bone injury, and reduced stiffness causes more soft tissue injuries.
    • -Training in more cushioned shoes and on softer surfaces, such as grass, may help improve the runner’s “stiffness”.

    SMA NSW Conference:

    I also attended the NSW SMA conference on running at University of Western Sydney. The conference was largely practical, and looked at skills in returning from injury, tendons, as well as optimising gait. An interesting point was that most elite runners, whatever the distance, run at a cadence of ~180 strides per minute. Many sub elite runners run at a slower cadence.Changing gait in a runner may be fraught with risk, as many champion runners have “atypical” gaits, and adopting a more orthodox style may lead to injury. Rehabilitation and drills/ training need to be individualised.


    I have not yet received any reports of the recent 2017 SMA Conference. If anyone has a report on the conference, please email me and I will include it in the next newsletter. I am informed that next year’s national conference will be held in Perth, though as yet I am uncertain of the dates.

    ACT State Symposium: ‘Exercise as therapeutic intervention. Saturday, 3 Feb 2018 Strikers Room, National Hockey Centre



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