Kicking Goals! Praxis looks at AFL kicking mechanics

KICKING

As per usual the Praxis team delved into an area of clinical interest to better understand the demands of our athletes. Last session we discussed throwing technique which you can read about here.

SUMMARY

  • There are differences in kicking techniques when accuracy or distance is the focus.
  • More accurate kickers had tended to be more “head over the ball” with significantly:
  • greater hip flexion in both limbs
  • greater knee flexion in the support limb throughout the kicking movement and greater anterior pelvic tilt at heel contact
  • Longer kick distances were associated with:
  • greater foot speeds and shank angular velocities at ball contact,
  • larger last step lengths, and
  • greater distances from the ground when ball contact occurred.
  • To increase kicking distance:
  • increasing foot speed and shank angular velocity at ball contact, increasing the last step length, and
  • optimising ball position relative to the ground and support foot are recommended.
  • Injuries to the quadriceps are often associated with kicking

Given our longstanding association with AFL clubs around Brisbane, this week we looked at kicking kinematics (joint angles and relationships) with respect to both accurate and long kicks. Further, we discussed how to best rehab someone with a kicking based injury and helping them return to their chosen kicking sport (AFL, Rugby, Soccer, Gridiron etc).

ACCURACY:

The first paper we looked at was from Dichiera and colleagues (2006). Their study involved kicking an AFL football 15m at a target. They found that accurate kickers focussed more on larger hip flexion, anterior tilt and stance leg knee flexion. This best can be described as a “head over the football” approach.

They hypothesise that knee flexion is an important limb length adjustment mechanism which lowers the centre of gravity. During kicking, an increased stance leg knee bend would lower the centre of gravity somewhat throughout the movement. Lowering the centre of gravity is one way of increasing the stability of the body, a principle which is emphasised in many other areas in sports biomechanics.

DISTANCE:

Kicking for distance was associated with greater foot speeds and shank angular velocities at ball contact, larger last step lengths, and greater distances from the ground when ball contact occurred in a study performed by Ball (2008). This was more of a “lean back” strategy utilised by the kickers. Knee angular velocity at ball contact was measured at almost 1400 degrees per second! That kind of speed understandably places the knee extensors (i.e the quadriceps) at greatest risk for kicking injuries.

Ball (2008) outlined some basic coaching instructions to guide those seeking larger distances in their kicks. He suggested:

  • increasing foot speed and shank angular velocity at ball contact by increasing approach speed such that the hip of the kick leg is moving faster towards the target during the last step.
  • increasing the last step length but this step should be proportional to approach speed as over-striding is likely to be detrimental to the kick
  • Optimising ball position relative to the ground and support foot was also recommended though contact too high may result in a high kick, not a long kick.

From a physiotherapy perspective, we discussed:

  • Players have adequate hip extension range as to not to not overload lumbar spine and hip extensors (e.g hamstrings) especially in the presence of larger running and sprinting volumes typical in AFL and soccer
  • Hip flexor strengthening to improve the drive of swing leg through the kick and running
  • How to best reintegrate an athlete who sustained an injury whilst kicking back to full training and competition
  • Preventative exercise such as jump lunges and reverse nordics for quadriceps tissue resilience
  • How lumbopelvic control can help a kicker with both accuracy and distance

In summary, another Brisbane winter’s morning was successfully utilised by the Praxis team. We hope you enjoyed the read! For any injuries that you or your teammates need assessed and sorted fast, contact us.

Until next time, continue to Praxis What You Preach

– Team Praxis

​Prevent. Prepare. Perform.

References:

  1. Dichiera, A., Webster, K. E., Kuilboer, L., Morris, M. E., Bach, T. M., & Feller, J. A. (2006). Kinematic patterns associated with accuracy of the drop punt kick in Australian Football. Journal of Science and Medicine in Sport, 9(4), 292-298.
  2. Ball, K. (2008). Biomechanical considerations of distance kicking in Australian Rules football. Sports Biomechanics, 7(1), 10-23.

Congratulations Nancy!

GRADUATION

A massive congratulations to our resident remedial massage guru Nancy! She recently “doffed the cap” during her graduation ceremony. Nancy successfully completed a Bachelor of Health Science (Myotherapy) at the Endeavour College of Natural Health.

Myotherapy involves an extensive physical evaluation and an integrated therapeutic approach in the treatment of affected muscles, joints and nerves. Nancy gains an in depth understanding of human biology, musculoskeletal anatomy and function. Through extensive practical classes and clinical experience, graduates such as Nancy learn to conduct testing and physical assessments and apply a variety of practical skills such as myofascial release, dry needling, joint mobilisation and trigger point therapy.

Nancy continues to service her loyal massage followers on Tuesdays and Fridays at our Teneriffe location (91 Commercial Rd). You can book online here.

Well deserved Nancy – we are all proud of you!

– Team Praxis

Prevent. Prepare. Perform

Throwing Injuries

Throwing Injuries

THROWING

This week in professional development session, our physio team delved into throwing techniques and links to injury. Proper throwing mechanics are important to understand as they may enable an athlete to achieve maximum performance with minimum chance of injury (Fleisig et al 2012).

Throwing, tennis serving, cricket fast bowling and golf swings are all excellent examples are how the summation of the bodies forces can result in massive outputs of power. Although force to a ball or other projectile is applied directly by the hand, a ‘kinetic chain’ of the entire body is used.

Mid Potion Achilles Tendinopathy Location

One essential and shared property of these activities is they utilise the kinetic chain to generate and transfer energy from the larger body parts to the smaller, more injury-prone upper extremities. These activities are all also notorious for high rates of injury. The kinetic chain principle asserts that in a coordinated human motion, energy and momentum are transferred through sequential body segments, achieving maximum magnitude in the terminal segment.

This kinetic chain in throwing includes the following sequence of motions: stride, pelvis rotation, upper torso rotation, elbow extension, shoulder internal rotation and wrist flexion (Fleisig et al 2012).

According to Agresta and colleagues (2019), Risk factors for shoulder pain are:

  • Workload (spikes or high volume)
  • Age (younger athletes are more prone to injury)
  • Throwing technique (e.g lack of follow through, elbow varus and shoulder external rotation torque)
  • Reduction in shoulder range of motion (particularly shoulder internal rotation in preseason)
  • Reduced preseason strength (supraspinatus and prone external rotation strength)
  • Reduction in thoracic rotation
  • Previous injury

Whilst we love a nerdy discussion on intrinsic vs extrinsic risk factors and specific rehab options as much as the next person, sometimes you just need to get outside in the sun and FEEL the task you are poring over!!

The key phases of throwing are loosely depicted in the below photos by our Praxis Principal and former 1st Grade Cricketer, Stephen (adapted from Escamilla et al 2007):

Click on the photo to slow the sequence

One of the final key questions from the day was: Who out of our physiotherapists has a “custard arm” and who has a “bullet”?? So if you or someone you know is in a throwing sport, have a chat to us today on (07) 3102 3337 or book online to ensure you have an injury free season ahead!

Until next time, Praxis what you preach

Team Praxis

Prevent. Prepare. Perform

Praxis in the Alice

Praxis in the Alice

ALICE SPRINGS

Cam and Steve finish their week at the National Indigenous Cricket Carnival (NICC) as the central Physiotherapists representing Cricket Australia and Praxis. The NICC has been created to further advance and develop Indigenous cricket. The competition provides greater playing opportunities in Alice Springs, but also forms a deeper connection with Australian cricket’s high performance pathway.

They were busy providing their expertise to over 10 male and female cricket teams who didn’t have a travelling physio accompanying them to Alice Springs. With over 150 consults in a week and 12 hour days as a minimum, our principal physio’s leave the tournament a little weary but proud of the standard they maintained during their stint in the Red Centre.

During the week of the championships, a special screening of Walkabout Wickets, a documentary commissioned by Cricket Australia commemorating the 150th anniversary of Australia’s first cricket team to go on an international tour. There was a preview screening aired in the Alice Springs’ Todd Street Mall as well as on Channel 7. The documentary will be free to stream for the next few weeks on 7Plus. Stephen was fortunate enough to be on that tour providing physiotherapy services for both the national men’s and women’s indigenous sides .

Both Cam and Steve are back in clinic on Wednesday looking forward to living the Prevent Prepare Perform mantra at our HQ in Teneriffe.

Until Next time

Prevent. Prepare. Perform.

Team Praxis

Private Health and Pilates – Changes for April 1st 2019

SUMMARY:

  • Private Health Rebates don’t apply for Pilates after the 1st of April
  • After April 1, Members can still claim private health for Pilates when classes are lead by a physio
  • The term “Clinical Pilates” will be replaced with “Physiotherapy Exercise Sessions”
  • To understand the difference between Reformer Pilates and Physiotherapy Exercise Sessions (formerly Clinical Pilates) 
  • Physiotherapy and Remedial Massage reman as is

From April 2019, private health insurance will no longer cover a number of natural therapies, including pilates. These changes were announced by Health Minister Greg Hunt late last year. This move comes after a recent review by the Commonwealth Chief Medical Officer found there was no clear evidence of the efficacy of several therapies including homeopathy, iridology, kinesiology, naturopathy, reflexology, shiatsu, tai chi, and yoga.

However, the Australia Physiotherapy Association (APA) has won a hard fought battle ensuring Pilates exercises prescribed by physiotherapists as part of an individualised program will continue to receive rebates in one-on-one, group and class settings. Great news for all of you who are already using our Pilates at Praxis!

The Department of Health has just released its final clarification on the Rules governing its Private Health Insurance (PHI) reforms and agreed with our position that the use of exercises drawn from Pilates are acceptable and within the scope of physiotherapy practice.

Pilates-only sessions will no longer be funded as of 1 April 2019. The reform of natural therapies was designed to eliminate rebates for non evidence-based therapies, and not intended to impact physiotherapy.

However, there are some things that will change! These include:

Advertising and Promotion

Advertising and promotion of sessions must reflect the fact that they are physiotherapy exercise sessions, not Pilates.

Scheduled physiotherapy exercise classes advertised or promoted as Pilates—in material such as timetables, pamphlets and online—cannot lawfully receive rebates.

This Rule does not affect other types of marketing material such as our business name, practice signage and branding. It’s perfectly acceptable for us to incorporate the word Pilates in our branding, and in fact to offer Pilates-only classes that do not attract rebates.

However, sessions eligible for rebates by private insurers cannot consist solely of Pilates and therefore cannot be called Pilates in any timetables, promotion or advertising. We must therefore use the term “Physiotherapy Exercise Sessions” when referring to what once was coined, Clinical Pilates.

Private Health Insurance (PHI) compliance

The key to PHI compliance is the basic foundations of individualised assessment, follow up and record keeping that should already underpin our clinical pilates practice. To comply with current PHI requirements, physiotherapists must create:

  1. Individualised assessment of patients in one-on-one, group sessions and classes.
  2. A program of exercised-based interventions specific to the patient. In group sessions this includes adjusting the group program for individuals as required. In both groups and classes, the exercises should address a current health problem.
  3. High quality clinical notes that reflect physiotherapy practice.

So, there you have it. There are some sweeping changes coming to this space which we think are a good thing. Changing coverage for the excluded natural therapies will ensure taxpayer funds are spent appropriately and are not directed to therapies that do not demonstrate evidence of clinical efficacy. Changing coverage for the excluded natural therapies will remove costs from the system and contribute to reducing private health insurance premium growth.

If you have any questions, please don’t hesitate to contact us or your Private Health insurer or alternatively the governments own website.

Until next time… Prevent. Prepare. Perform.

Team Praxis.