ASK A

SPORTS
PHYSIO

NEW ZEALAND PHYSIOS

ANSWER YOUR TOP 10 QUESTIONS
This advice is general in nature and is not intended as a substitute for care from a physio or
other health care professional. If you experience signs or symptoms of injury, illness or disease
you should seek the advice of a health care professional.

© Physiotherapy New Zealand 2014

 ASK A PHYSIO

YOU ASKED, WE ANSWERED!

In 2014 Physiotherapy New Zealand threw this question

out to the online community…

What one question would you like to ask a sports

physio?

The resulting questions were wide and varied; they

covered everything from performing the splits without
injuring yourself (might be tricky!) to preventing shin
splints.

In this ebook we highlight 10 of our favourite questions

and ask some expert physios from across New Zealand
to enlighten us with their answers.

www.physiotherapy.org.nz 3
 ASK A PHYSIO

CONTENTS | YOUR QUESTIONS ANSWERED

1 Shin Splints 6
What causes shin splints and how do I prevent them?

2 Hamstring Strain 8
I’ve pulled a hamstring muscle playing football, what’s the
best treatment advice and how do I prevent it happening
again?

3 Cramps 11
What causes cramps and how do I get rid of them?

4 Hot or Cold 12
With sore legs from running, is a hot bath or cold water
better for recovery and to help prevent injuries or niggles?

5 Sore Hips 14
I walk every week (around 6-7k per walk) and I get quite sore
hips/pelvis from this. I’ve been fitted for shoes but it’s still
quite sore. Is there anything I can do to help this?

4 www.physiotherapy.org.nz
 ASK A PHYSIO

6 Strapping vs Bracing 17
Is it better to use a brace or strapping tape when coming
back from an injury?

7 Massage 19
What’s the fastest way to relieve tension in the muscles
without seeing a masseuse or leaving the house?

8 Getting Treatment 20
What’s the best time to seek treatment on a sports injury?
Should I wait until the swelling has gone down a bit?

9 R.I.C.E 22
Is R.I.C.E still the best advice for immediate injury treatment?

10 Warming Up 23
I’m confused about warm up advice, should I be doing static
or dynamic stretches, or something else?

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 ASK A PHYSIO

What causes shin splints and how do I

prevent them?

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 ASK A PHYSIO

— Answered by Bharat Sukha

Shin splint pain is caused by repetitive What treatment and management
loading and can occur with running is required?
and sports that involve jumping or rapid There are a number of ways to treat, and in
acceleration or deceleration. It is classified as the long term, help prevent this injury. The
an overuse injury. best idea is to consult a sports physio who
can design a treatment and rehabilitation
When you do this type of exercise a lot of
plan that involves initial rest and local therapy
force is loaded on your shinbone (tibia) and
and then addresses ALL the factors that
the surrounding soft tissue. These structures
cause you pain.
eventually can’t cope with the extra load
and the result is the pain and swelling For example, you may need the correct
(inflammation) that you feel. shoes for your foot type and a programme
that initially reduces your activity level and
The worst that can happen with shin splints
then addresses cross training, stretching and
is a high pressure build up in the muscles
strengthening. Fixing just one factor won’t
called Compartment Syndrome or if bony
resolve your problem so you need to have
cracks (splints) appear which can result in a
them all covered!
stress fracture. These worst-case scenarios
are not overly common. Nevertheless, you It is important to see your sports physio as
don’t want to end up with severe pain EARLY as you can as this type of injury does
— which is why it’s a good idea to see a progress relatively quickly and just resting
sports physio. and medication alone will not help you in the
long term.
Shin splints are relatively common, but they
are not a simple injury and there are a
number of factors that can play a Bharat is the Principal
role. Physiotherapist at Physiosport
in Auckland and an Executive
Here are a few possibilities that Committee Member of Sports
a physio can look at: Physiotherapy New Zealand. He
has a Post Graduate Diploma
• poor or incorrect shoes in Sports Medicine and his past
• running on hard surfaces experience includes the Canadian
• muscle weaknesses Commonweath Games Team and 7
• muscle imbalance or inflexibility years with NZ Hockey. He is also a past
• poor body alignment lecturer in both Health Science and
• training too much or too quickly. Sport and Recreation.

www.physiotherapy.org.nz 7
 ASK A PHYSIO

I’ve pulled a hamstring muscle playing

football, what’s the best treatment advice
and how do I prevent it from happening
again?

8 www.physiotherapy.org.nz
 ASK A PHYSIO

— Answered by Grant Plumbley

Surprisingly, considering that this is a very What you can do to help your
common injury and the financial impact recovery:
involved in having a multi-million dollar • If you do sustain a hamstring injury
football player side-lined for weeks, the then you should really stop the activity
research to support the best prevention immediately or you risk making the injury
strategies for this type of injury is worse.
inconclusive.
• Follow the RICE regime (Rest, Ice,
The only risk factor that has been identified Compression, Elevation).
conclusively for a hamstring injury is previous
hamstring injury which doesn’t really help! • Ice immediately on the side-line,
for 20 mins.
So given you have ‘pulled’ your hamstring
muscle it is important to visit a physio to • Shower and re-ice again.
determine exactly how bad your injury is; it • Apply a compression bandage or tubigrip
can range from tightening or spasm of the to the injured area.
muscle, to a few fibres of the muscle being
• Limit the amount of walking you do for at
torn, to many of the muscle fibres being
least the next 24 hours, and if you have
torn, to a complete and total rupture of one
to walk then allow any limp that the body
(there are three back there) of the hamstring
may cause as this helps protect the injury.
muscles. From taking a detailed history and
examining your injury, the physio will be able • Then every 2-3 hours remove the bandage,
to ascertain how severe your injury is, how re-ice for 20 mins, then re-apply the
long it is likely to take to repair and, along bandage again and continue the RICE
with yourself, determine the best treatment regime for 2 -3 days.
options and set out some goals for you to
• You should see a physio for assessment,
reach. A complete rupture would likely be
advice, treatment and rehabilitation of
best managed by surgical repair but this
the injury. This will help ensure that all
would depend on a few factors including the
the contributing factors are identified and
level of football you play.
a rehabilitation plan organised so as to
rectify these problems.

If you do sustain a hamstring injury then you should really

stop the activity immediately or you risk making the injury worse.

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 ASK A PHYSIO

What can be done to encourage the injury to heal well and reduce your
chance of injury?

Your physio will comprehensively assess your • There is evidence in support of treatment
injury and set out a rehabilitation programme and exercises directed at improving the
which may include the following; mobility AND stability of the spine, and
also the positioning sense and stability of
• Encourage adequate flexibility of the
the pelvis, hip, knee and foot.
hamstring groups and ensure that the
neural supply to the muscle is functioning • Review your footwear dependent on your
well. specific foot type, e.g. pronator (flat),
neutral or supinator (high arch) foot.
• Improve the strength, endurance and
performance of the hamstring group by • Suggest a warm-up routine, including
giving appropriate exercises during your dynamic stretching and plyometric
recovery (including Nordic curls which exercises.
the research has shown to be effective in
• Teach you a gentle warm-down with
rehabilitation and prevention of hamstring
stretching after activity to restore resting
injury).
muscle length and help reduce the waste
• Improve the function of the hamstring by by-products formed with exercise.
encouraging you to run when appropriate,
• Discuss with you the need to keep
advancing to include sprinting,
hydrated.
accelerating/decelerating, incorporating
changes of direction, jumping, kicking and • In the case of tournaments or many games
lunging as your injury heals. in a row, consider the use of ice baths
to help reduce muscle injury and assist
recovery – are you tough enough!

Grant is a Co-Director and physiotherapist at Willis Street Physiotherapy in

Wellington. Before his return to New Zealand he spent 13 years working in the UK.

During this time he gained extensive experience in performance, sports and corporate health sectors –
including working as physiotherapist with Riverdance - The Show from 1997 to 1999, as they toured
Europe, Australia and New Zealand and as a physiotherapist at Tottenham Hotspur Football Club
in 2005 to 2007. Grant also looked after the 2000 Olympic Heavyweight boxing champion Audley
Harrison, from 2000 until 2007.

10 www.physiotherapy.org.nz
 ASK A PHYSIO

What causes cramps and how do I get rid

of them?

— Answered by Greg Lynch The stretch needs to be sustained

for 20–30 seconds and symptoms
A ‘cramp’ is defined as a painful involuntary
should improve within this time.
muscle contraction that occurs suddenly and
can be quite debilitating.
Exercise induced cramps may also be caused
Cramps most commonly occur in the leg by a loss of ‘electrolytes’ (resulting in a
muscles, particularly the calf muscle or the chemical imbalance) which happens when
muscles in the feet. The onset can be quite we sweat a lot. Ensuring that you take plenty
sudden, but they usually resolve themselves of fluid when exercising may help prevent
in a few seconds. The muscle can be quite cramps, if this is the cause.
sore for several minutes or even a number of
If you suffer from cramps during or after
hours.
exercise, then a physio can assist you with an
The cause of cramps is often unclear, appropriate stretching programme, assessing
however there are some theories. Cramps and correcting any muscle imbalances and
can occur during or after exercise and may ensuring that your muscles are conditioned
be caused by the continued repetitive muscle for the activity that you are wanting to
contraction during exercise - which is why participate in.
stretching the affected muscle often offers
Cramps may also be caused by various
relief. The stretch needs to be sustained
medications or disease, if this is the case then
for 20–30 seconds and symptoms should
I would suggest you seek advice from your
improve within this time.
GP for management of cramps.

Greg graduated from the Otago School of Physiotherapy in 1991. He is an

accredited provider for High performance Sport NZ, a Senior and International
lecturer with the McKenzie Institute International and is an Advanced Practitioner
with the NZ College of Physiotherapy. He is a co-director of Inform Physiotherapy in
the Hutt Valley and Wellington Sports Medicine in Kilbirnie, Wellington.

www.physiotherapy.org.nz 11
 ASK A PHYSIO

With sore legs from running, is a hot bath

or cold water better for recovery and to
help prevent injuries or niggles?

— Answered by Andy Schmidt The ice therapy should be applied for 15 to a

maximum of 20 minutes, and should ideally
Judging by the number of times I get asked
be done every three or four hours over the
this, there seems there is a lot of confusion
first three days (although you don’t have to
and possible misinformation out there about
wake yourself during the night to do this!)
this very question!
Ice itself should never be applied directly to
To answer this question, some more the skin, as it can cause an ice burn, so a wet
information about the injury needs to be tea-towel is recommended if an ice pack or a
known, initially about the type of pain that it pack of frozen vegetables are not available. It
is present. is also very helpful during this time period to
elevate and compress the area if possible.
‘Acute’ pain comes from a sudden injury e.g.
spraining your ankle. Common symptoms of The other type of pain commonly seen is
an acute injury are pain, swelling, redness or ‘chronic’ pain. This type of pain develops
heat, which generally come on after the first over time, and may come and go. Chronic
few days following an injury, and are all signs pain is often a result of overuse of the body
of acute inflammation. part. Sometimes it may follow on from
an acute injury that hasn’t been treated
In this case, cold or ice therapy is the best
properly, or that hasn’t healed within the
modality to use. Studies show that icing an
usual timeframes.
area causes vasoconstriction, or narrowing
of the blood vessels that supply circulation to
the area. This is thought to therefore limit the
inflammation occurring at the injury site.

12 www.physiotherapy.org.nz
 ASK A PHYSIO

For acute pain, cold or ice therapy

is the best modality to use

In this situation, the evidence is mixed. One

For this type of pain, generally heat therapy school of thought says that because muscle
is better to be used, as chronic injuries more damage has taken place and probably
often than not have no inflammation or inflammation, cold therapy should be used,
swelling present. Stiff joints and nagging pain however the results of studies into this have
respond well to heat therapy. been mixed. Equally heat has also been
trialled, and in some cases was found to
Heat will increase the circulation to the area
effective, and other times not.
making stiff joints and tight muscles more
flexible. Apply the heat using a wheatbag In high level sports therapy, immersion cold
or hot water bottle for 15 to 20 minutes. or ice baths are often used following a period
Again, keep the skin protected with a towel. of intense exercise, and a lot of athletes
Sometimes in the presence of chronic pain, will testify to their effectiveness. Again the
you may have an acute inflammation at evidence behind the effectiveness of using
the site after over-activity. In this case, you these is also limited.
could use ice on the site for a few days, as It is always important to take care of the skin
described above. when using both hot and cold, particularly
Often over a period of exercise, you can also for the elderly or those with skin conditions.
have symptoms of muscle soreness, and As always, try to get your injuries assessed
often for 24-72 hours after exercise. This type as early possible, so the best advice and
of pain is often called ‘delayed onset muscle treatment can be given and the correct
soreness’, or DOMS for short, and is thought therapy commenced.
to be due to micro-trauma to muscle fibres.

Andy has a Masters in Health Practice with Distinction in Musculoskeletal Physiotherapy,

and a Bachelor of Physiotherapy. He has been practicing in the musculoskeletal field
for 18 years, and has worked with all levels of sport in the UK and New Zealand.
Andy is the co-owner and head physiotherapist of Active+ branches in Albany and Orewa, and is also
currently the physiotherapist for the New Zealand Davis Cup tennis team. www.activeplus.co.nz
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 ASK A PHYSIO

I walk every week (around 6-7k per walk)

and I get quite sore hips/pelvis from
doing this. I’ve been fitted for shoes but
it’s still quite sore. Is there anything I can
do to help this?

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 ASK A PHYSIO

— Answered by Greg Bell Frequency

I would like to know if this set of legs is
As a physio looking at the body as a
walking once a week or daily. What if
machine, and then as a creative feeling
this person is walking twice a day at this
individual, you come up with a few possible
distance? There’s nothing wrong with doing
questions to bounce back to the individual,
a lot of walking but were you accustomed
which will hopefully provide some answers,
to walking, have you been walking like this
or some actions to take to go the step
for years or have you just started? How fast
further. Information is key.
are you walking? What are you walking on?
Location Location Location Sand, concrete, paddock, bog, up hills?
Where is the pain? Hip pain can be felt All these surfaces change how the hip
elsewhere; such as buttock, groin and thigh. interacts with the pelvis, so these must be
Conversely low back pain can be referred questions that have answers.
into the hip, as can other structures — so a
Are you walking alone or with someone else?
quick investigation of other joints should be
If you are a slow walker trying to keep up
done.
with a rocket powered buddy there could
General Health be some problems. Interestingly, Alison
This is an essential part of questioning the Grimaldi, a physio from Sydney and expert in
walker. Were there any hip problems in hips, detailed a common hip pain possibility
the childhood of the walker? Is there any in the stature differences of walking buddies.
symptom that might suggest arthritis either Say there’s a husband and wife who love
osteoarthritis (creaking, weakness, stiffness walking briskly. He is 6’5”, she is 5’0”. If they
progressing) or rheumatoid (joint pain, many are to walk abreast then the Mrs is going to
joints involved, fatigue, stiffness of joints)? have to walk harder, over stretching her hips
The physio needs to be aware that many to keep up with Michael Jordan.
conditions can look perfectly like a muscular
or joint problem, but if we ask the right
questions, we could avoid missing
the rare severe condition.

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 ASK A PHYSIO

It is possible that the wrong shoe for a walker could alter the mechanics
of the lower limb enough to create gradual onset hip pain

“I’ve been fitted for shoes...” Is there anything I can do to help

Many people still choose to shop in the this?
popular discount chains and end up choosing Once the diagnosis is arrived at, then this
a shoe based on look and price, yet I have question can be answered. If you had
sent many a patient back to these stores persistent troubling pain causing something
when a pronating flat foot buys a shoe for a as fundamental as walking to malfunction,
high arched foot. It is possible that the wrong you would want to get it seen to by a living
shoe for a walker could alter the mechanics breathing clinical reasoning physio wouldn’t
of the lower limb enough to create gradual you? If all the red flags are put away, then
onset hip pain. Road camber can also there is a phenomenally good chance for
contribute to foot strike mechanics. physiotherapy to help.
I remember a runner I treated who had
To discuss every possibility would require
bought the wrong type of shoes for his foot
a few thousand more words, but what’s
type. He ran on cambered roads at high
discussed here covers the thinking process
volume. He developed a case of bilateral
required by physios to effectively treat or
shin splints which went away with the right
manage such conditions.
shoes and flatter running surfaces. Many
physios have undergone foot biomechanical I hope I have described to you how seriously
training and can tell you with the chair side we take that quest to answer your question.
assessment technique what shoes will suit
you. Sure, it’s not a fancy technology-laced
approach, but it’s an expert opinion which
can take in the whole picture of the person,
rather than just the foot.

Greg practices physiotherapy in Wanganui and is part of a line of physiotherapists

dating back to the polio epidemics where grandfather Bill Bell worked in USA and later New Zealand.
He has developed some expertise in management of Jaw and Headache problems, but happily works
with the rest of the human body as well. He is married to Vanessa, and proud father to four sons.

16 www.physiotherapy.org.nz
 ASK A PHYSIO

Is it better to use brace or strapping tape

when coming back from an injury?

— Answered by Hamish Ashton

Following an injury controlled movement is The aim of strapping and bracing is to

important. Initially this is to prevent stiffness provide some external support to the healing
and regain mobility, but in the later stages it tissues while you increase your activity and
is import to help improve the strength of the loading of the injured area. It should not be
healing tissue. As you do more there is the used to try and allow you to do activities that
risk that you may do too much and reinjure you (or your injury) are not ready for.
yourself. This is where strapping and bracing
can help over the short term.

www.physiotherapy.org.nz 17
 Braces come in many shapes and styles and
if you are looking at a brace it is best to
seek advice, as a good and appropriate fit
is important for the best effect. Though the
initial cost may be higher if you are going to
Strapping, though initially feeling tight,
need support over a longer time it can be
stretches and starts to give after 15-20
cost effective. Braces don’t usually need help
minutes – a way shorter timeframe than most
to apply, which makes life easier if you need
trainings or games. The benefit therefore is
to put it on regularly. Some people find them
largely sensory – the pulling of the tape on
a bit bulky, and some sports won’t allow
your skin helps keeps your body aware of
certain materials when involved in play.
the area and more responsive to movement.
Strapping can cause skin irritation in some So which is better? The simple answer is that
people, especially after being worn over a either can be used, but in some body areas
period of time and often needs someone else or situations, one may be more practical than
to apply it. If only used for a short period of the other. Discuss the best option for your
time it is quite cost effective. injury with your physio.

Bracing and strapping should not be used to try and allow you to do
activities that you (or your injury) are not ready for.

Hamish is a sports and general physiotherapist who works in a gym-based clinic

in Tauranga. He has 20 years of experience working with teams in a multitude
of sports, from club through to international level. He is a strong believer in
prevention, so gets out and talks to groups on regular occasions. He also has sports
science training, so he can help you take your performance to the next level.
www.p2pphysio.com

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 ASK A PHYSIO

What’s the fastest way to relieve tension

in the muscles without seeing a masseuse
or leaving the house?

— Answered by Gill Stotter the muscle fibres with an oil or cream. You
can also use a tennis or spikey ball or a foam
There are a number of reasons for people
roller to ease out the tension.
to feel tightness or tension in their muscles.
It can be due to over-training, lack of Following the massage gently stretch the
preparation and conditioning or due to muscle using effective breathing techniques
muscle imbalances. Muscles work together to increase relaxation and promote the
to perform functional movements; some can length in the muscle. Gently work into the
be weak and not activating correctly whereas stretch, breathing in through your nose and
others become tight due to over-activity. It out through your mouth, hold for 30 seconds
is a fine balance for the body to function and repeat 3-4 times, increasing the range
optimally, similar to keeping your car tyres of active movement. You may feel slight
balanced. discomfort as the muscle is lengthening.
Always maintain good alignment as you
Tension in the muscles can be relieved by
stretch; it is important that the stretch is
heat, self-massage and stretching. You
not painful and it should never feel worse
may find a tight trigger point in the muscle
afterwards.
or a tight band of tissue. Firstly warm the
muscle with a heat pack for a few minutes Education, injury prevention and teaching
to promote relaxation and increase blood self-management strategies are all important
flow, then gently massage along and across roles of a physio – so if the tension doesn’t
disappear then make sure you seek
professional advice.

Gill is an Advanced Practitioner with the New Zealand College of Physiotherapy

and has over 30 years experience. She has expertise in musculoskeletal, sports and
orthopaedic physiotherapy with a particular interest in education, prevention and
management of problems by looking at the bigger picture. Gill is a physiotherapist
and director at Wellington Sports Med. www.wellingtonsportsmed.co.nz
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 ASK A PHYSIO

What’s the best time to seek treatment

on a sports injury? Should I wait until the
swelling has gone down a bit?
— Answered by Dr. Angela Cadogan

The best time to seek treatment for a sports information and the necessary compression
injury is ‘as soon as possible’. This is especially bandages and techniques to help with
true for significant injuries that affect your the RICE protocol (Rest, Ice, Compression,
ability to walk or weight-bear or to carry out Elevation) and advise you how to avoid
your normal activities. Physios can assess “HARM-ful” activities (Heat, Alcohol,
your injury and provide you with a diagnosis Running and Massage) that may slow down
and a specific management plan for your your recovery.
injury. They can also refer you for further
investigations such as x-rays or ultrasound To answer the question regarding whether
scans to help with making a diagnosis or to you should wait until the swelling has gone
rule-out a more serious injury. down before you seek treatment, the answer
is ‘no’, you don’t have to wait. Swelling is
The first 48 hours after an injury is the most usually a sign of tissue damage. As well as
critical time for the management of acute assessing the significance of the swelling
sporting injuries to avoid further damage and providing a diagnosis, your physio can
that could later lead to impaired healing. We show you how to manage and minimise
know that proper management in the early the swelling in the early stages to optimise
stages of injury can significantly reduce the your recovery. As the swelling goes down,
time it takes for you to return to your sports it is important that you begin to move the
or recreational activity. Your physio can injured part slowly and progressively to avoid
advise you how to care for your injury in the excessive stiffness that may develop later on.
early stages by providing you with specific Your physio can provide advice about when

20 www.physiotherapy.org.nz
 ASK A PHYSIO

to begin moving, how much and how often, shape for your return to sport while you
and provide valuable advice about what recover from your injury. There is nothing
other activities you should and shouldn’t worse than getting your sprained ankle ready
be doing at various stages of your recovery. to play again, only to find your lungs are
So even if there is some swelling, there are letting you down!
many things you can be doing to help your
recovery with the guidance of your physio. So, in summary, see your physio early for
a diagnosis and advice on the best way to
After the swelling has reduced, your manage and rehabilitate your injury, and
physio can provide you with appropriate how to keep the rest of your body in the best
strengthening and rehabilitation exercises possible shape to get you back to sport as
specific to your sporting activities to help soon as possible.
minimise the risk of future injury to the same
area, or to other areas that may compensate
for any residual weaknesses.
A physio can also advise you on ways to
maintain your general fitness if you are
unable to run or carry out your usual fitness
or sporting activities because of your injury.
Physios can prescribe exercises and cross-
training/fitness activities that will help to keep
the rest of your body in the best possible

Dr Angela Cadogan
Physiotherapy Specialist (Musculoskeletal)
PhD, NZRPS, MNZCP (Advanced Practitioner – Sports & Orthopaedic)

Angela is a registered Physiotherapy Specialist (Musculoskeletal) working in clinical practice in

Christchurch where she specialises in the assessment and management of sports injuries and
musculoskeletal conditions. Angela has a special interest in shoulder pain and sees a large number of
patients of all ages with a variety of shoulder conditions including sports-related shoulder pain and
chronic joint and tendon disorders. Angela has a PhD in Musculoskeletal Diagnostics, specialising in
the shoulder. Angela also has a Masters Degree in Sports Physiotherapy (Curtin University, Western
Australia), and has worked with a number of sports teams, including working as the physiotherapist for
the NZ White Ferns women’s cricket team, and NZ Cricket men’s “A” teams for eight years.
www.drangelacadogan.co.nz
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 ASK A PHYSIO

Is R.I.C.E still the best advice for

immediate injury treatment?

— Answered by Blair Jarratt Optimal load means replacing rest with a

balanced and incremental rehabilitation
Yes, you can go a long way to promoting
programme where early activity encourages
appropriate healing with the simple
early recovery, as rest is not always
RICE concept which stands for Rest, Ice,
appropriate and can sometimes slow
Compression and Elevation.
recovery. An example of this type of situation
However, the most up-to-date research tells is with a simple ankle sprain that we see in
us that if you go a couple of steps further the clinic has simply become a stiff ankle as
to this and add in Protecting the injured the ankle has been “rested” for too long.
area and also introducing in the concept of
So now the best acronym for acute injuries
Optimal Load.
should be P.O.L.I.C.E (Protection, Optimal
Load, Ice, Compression, Elevation).
So now the best acronym for Physios are excellent at knowing what and
acute injuries should be P.O.L.I.C.E when to apply the ‘Optimal Load’ that I am
(protection, optimal load, ice, describing and will accelerate your return to
compression, elevation) function following an injury.

Blair is a Director of Bureta Physiotherapy Tauranga. 2013-current Physiotherapist

to NZ U19 Cricket, 2010-2013 Physiotherapist to the Canterbury Wizards Cricket,
2011-2013 Physiotherapist Canterbury Metro and Canterbury B ITM Rugby.
www.buretaphysio.co.nz

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 ASK A PHYSIO

10

I’m confused about warm up advice,

should I be doing static or dynamic
stretches, or something else?

— Answered by Justin Lopes

Warming up is as much about injury Current research suggests it is best to keep
prevention as it is about preparing your body warm ups to dynamic stretches, or short
and mind to perform at its best. By doing static stretches. Progressively building up
movements that are designed to prepare the tempo of the warm up is a good idea,
you for the activity you are about to do, you making sure you are doing movements that
are preparing both physically and mentally. are specific for your sport i.e., all footballers
By gradually increasing the intensity of the need to warm up the large muscles of their
exercise you are increasing the blood flow legs, but tennis players should spend time
to muscles and also your core temperature, warming up their arms too.
which can lead to reduced muscle and joint
Generally speaking, a warm up should start
stiffness.
with some slow general movements (jogging
for football, slow lengths for swimming
etc.) then progressively increase in tempo.
After a couple of minutes stop and do
some dynamic stretches or core activation
exercises (such as a plank). Once you are
feeling warm, you can start to increase the
tempo further by doing more sport-specific
drills (using a ball for football, or hitting the
ball for tennis). Finally, position-specific high
intensity exercises should be left for just
before you are ready to compete.

www.physiotherapy.org.nz 23
 ASK A PHYSIO

Current research suggests it is

Having a routine that includes all the major best to keep warm ups to dynamic
muscles that you will be using in your sport is stretches, or short static stretches.
important. Warm ups can vary depending on
what you are warming up for - for training
• Progressively build up the intensity of your
you may include more strength drills, whereas
warm up.
pre-competition you would stick to the
activities that warm up the muscles but which • Progress from general movements, to sport
don’t put extra load through them so you are specific, to position specific, and finally
not fatigued. ballistic movements.

Static stretches are used to increase the • It takes 3-5 minutes to raise muscle
length of the muscle, and short duration temperature and if you warm up for too
static stretches can be used in the warm long it can affect performance (keep it
up, but be aware that repeating static shorter than 20 minutes and below 80%
stretches for 30 seconds or more can affect intensity).
performance as this reduces the force output
• Once you have increased your muscle
of the muscle.
temperature, do a couple of repetitions of
Environmental factors can influence your dynamic stretches or short static stretches
warm up; you may need to warm up longer (8-12 seconds) for each of the major
in colder conditions, or for shorter periods muscle groups you will be using.
when it is really hot. The intensity of or level
• Use a couple of activation exercises such as
of competition can also have an influence on
plank or single leg supine bridge to activate
how intense your warm is.
stabilizing muscles.
To summarize:
• Static stretches of greater than 30 seconds
• Warming up prepares your body and mind can be used at the end of training to
for performance and helps reduce the risk increase muscle length but may have a
of injury. short term negative effect on performance.

Justin is the director and principal physiotherapist of Back to Your Feet Physiotherapy Ltd. He
has over fourteen years sports physiotherapy experience and holds a Masters of Health
Science (Hons), a Post Graduate Diploma in Musculoskeletal Physiotherapy and a Post
Graduate Certificate in Western Acupuncture. He has worked with New Zealand Football
since 2004. Justin also worked full time at the NZ Knights FC for two years and with
Waitakere United for three seasons, and is currently the physiotherapist for New Zealand
Football’s elite referee group, the New Zealand Roller Derby Team, Western Springs AFC, Pirate City
Rollers, and the Auckland Roller Derby League. www.backtoyourfeet.health.nz
 ASK A PHYSIO

GOT YOUR OWN

PHYSIOTHERAPY QUESTION?
A sports physio can help you with all the
questions listed in this book and many,
many more. They are experts in injury
prevention, injury rehabilitation and HOW TO
improving your sporting performance. FIND A PHYSIO

How can physio help? Go to www.physiotherapy.org.nz

Injury management and rehabilitation and click on “Find a Physio”

• Pain management to see who’s available in your area.
• Postural education Check that your physio is a member of
• Joint mobilisation and manipulation Physiotherapy New Zealand. This shows
• Specific rehabilitation exercises they’re committed to high standards of
• Strapping and taping professional practice. And remember
• Developing a programme for a safe return that you don’t need a GP referral
to training, or modifying training to suit to see a physio.
• Referring you to a specialist if your injury
needs further investigation.
Sports performance
Injury prevention • Sport specific conditioning to meet your
• Identifying any previous unhealed injuries goals
• Teaching correct techniques for warming • Home and gym-based strength and
up and stretching flexibility training
• Prescribing an injury prevention • Exercises to improve your efficiency of
programme specifically tailored to you and movement patterns
your sport • Core stability programmes (such as pilates)
• Giving you a biomechanical screening • Improving your breathing control
assessment • Biomechanical screening assessment to
• Prescribing an individual exercise identify any faulty movement patterns that
programme to correct any muscle may be impacting on your performance
imbalances and improve your movement • Many physios also offer video analysis of
patterns. your activity and movements.

www.physiotherapy.org.nz 25
 ASK A PHYSIO

USEFUL RESOURCES

1 ACC – Common Sports Injuries

http://www.acc.co.nz/preventing-injuries/playing-sport/common-sports-
injuries/index.htm

2 ACC - SportSmart - 10-point plan

http://www.acc.co.nz/preventing-injuries/playing-sport/sportsmart-10-point-
plan/PI00111

3 Physiotherapy New Zealand – online find a physiotherapist tool

www.physiotherapy.org.nz/findaphysio

4 PRICE needs updating, should we call the POLICE?

http://bjsm.bmj.com/content/46/4/220.extract

5 Sports Physiotherapy New Zealand

http://sportsphysiotherapy.org.nz

6 STOP Sports Injuries – Sports Injury Prevention

http://www.stopsportsinjuries.org/

26 www.physiotherapy.org.nz
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