Sport Archives - Praxis Physiotherapy

From Pitch to Pressing: Leading the Way in Shoulder Pain Recovery

by Stephen Timms | May 10, 2025 | Return to Sport, Shoulder, Sport, Sports Injury

Understanding Rotator Cuff Pain in Active Populations

Shoulder pain, particularly rotator cuff (RC) injuries, is one of the most common complaints among athletes and active individuals. The rotator cuff, comprising the supraspinatus, infraspinatus, teres minor, and subscapularis, stabilises the shoulder and enables dynamic overhead movement. Athletes in cricket, tennis, AFL, and CrossFit are especially prone to strain this system through repetitive, high-load movements (Desmeules et al., 2025).

At Praxis Physiotherapy, we specialise in managing rotator cuff injuries with precision. Our expertise spans throwing athletes, tennis players at our Coops Club location, contact sports like AFL, and recreational CrossFit athletes — ensuring tailored care across sporting domains.

Tailored Treatment Backed by Clinical Evidence

Current guidelines recommend avoiding over-reliance on imaging and emphasize active rehabilitation. Many rotator cuff cases can be effectively managed without surgery, using structured, progressive rehab programs including resistance training, neuromuscular re-education, and load management (Desmeules et al., 2025).

Key strategies include:

Individualised education about the condition and recovery timeline
Isometric and isotonic strengthening of shoulder stabilizers
Use of validated outcome tools (e.g., handheld dynamometry, ROM apps) to track progress
Selective adjuncts, such as manual therapy or taping, when needed for short-term symptom relief

In persistent or complex cases, our close collaboration with shoulder and knee surgeon Dr. Kelly Macgroarty ensures a seamless escalation pathway and expert review.

The Athletic Shoulder: Why Sport-Specific Rehab Matters

The demands placed on a shoulder in throwing or overhead sports are extreme. During a cricket bowl or tennis serve, angular velocities can reach 7000–7500°/s, and forces on the shoulder joint can exceed bodyweight (Wilk et al., 2009). These actions demand both mobility and stability—a balance referred to as the “thrower’s paradox.”

Our assessments go beyond the shoulder joint, considering the entire kinetic chain — from trunk control to hip mobility — to ensure optimal movement integration and minimize overload (Cools et al., 2021).

The Evidence on Rehabilitation & Prognosis

Recent guidelines emphasize exercise-based rehab as the most effective first-line intervention. Strength gains and symptom reduction are typically seen within 12 weeks if appropriately dosed (Desmeules et al., 2025). Furthermore, the longer pain persists, the lower the likelihood of full recovery from physiotherapy alone (Chester et al., 2013).

In terms of injury prevention, shoulder-focused warm-up programs — such as FIFA 11+, the Oslo Shoulder Program, and sport-specific throwing drills — have shown a moderate to large effect size in reducing injury risk (Liaghat et al., 2023).

Return to Sport: Measured, Not Rushed

Our return-to-sport protocols are designed to ensure both readiness and resilience. We use objective criteria:

Strength benchmarks (e.g. ER/IR ratio)
Symmetry comparisons
Fatigue tolerance testing
Sport-specific drills and reactive control

Whether you’re pressing overhead in a CrossFit WOD, tackling in AFL, or ramping up bowling loads in cricket, our protocols ensure a safe and confident return.

Prevention: Not an Afterthought

Our clinic philosophy incorporates injury prevention from the first session (PREVENT | PREPARE | PERFORM). For athletes at our Coops tennis facility, we screen for scapular dyskinesis and GIRD (glenohumeral internal rotation deficit). For CrossFitters, we optimise loading strategies and lifting technique.

Prevention is an ongoing cycle: screen, intervene, reassess. It’s not just about avoiding injury—it’s about building capacity and sustaining high performance (Cools et al., 2021).

Conclusion

Rotator cuff pain doesn’t have to be a long-term setback. With expert diagnosis, individualised rehab, and a sport-specific return plan, most athletes recover without surgery. At Praxis, we combine cutting-edge evidence with clinical experience — and our collaboration with orthopaedic surgeon’s and sports medicine practitioners means you’re in expert hands every step of the way. For more on throwing specifically, check out our blog where we put the Praxis team to the test!

Ready to take control of your shoulder pain? Book an appointment today and let our team guide you back to strength, confidence, and performance.

📍 Clinics in Teneriffe, Buranda, and Carseldine

💪 Trusted by athletes. Backed by evidence. Here for everyone.

References

Desmeules, F. et al. (2025). Rotator Cuff Tendinopathy: Diagnosis, Nonsurgical Medical Care, and Rehabilitation: A Clinical Practice Guideline. Journal of Orthopaedic & Sports Physical Therapy, 55(4), 235–274.
Wilk, K.E. et al. (2009). Shoulder Injuries in the Overhead Athlete. Journal of Orthopaedic & Sports Physical Therapy, 39(2), 38–54.
Cools, A.M. et al. (2021). The Challenge of the Sporting Shoulder: From Injury Prevention Through Sport-Specific Rehabilitation Toward Return to Play. Annals of Physical and Rehabilitation Medicine, 64, 101384.
Chester, R. et al. (2013). Predicting Response to Physiotherapy for Musculoskeletal Shoulder Pain: A Systematic Review. BMC Musculoskeletal Disorders, 14, 203.
Liaghat, B. et al. (2023). Diagnosis, Prevention, and Treatment of Common Shoulder Injuries in Sport: Grading the Evidence. British Journal of Sports Medicine, 57, 408–416.

Kicking Goals! Praxis looks at AFL kicking mechanics

by Stephen Timms | May 24, 2019 | Return to Sport, Sport, Team Praxis

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.

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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.

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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:

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.
Ball, K. (2008). Biomechanical considerations of distance kicking in Australian Rules football. Sports Biomechanics, 7(1), 10-23.