Lisfranc Injuries

LISFRANC JPG.001.jpeg

What does a French surgeon and gynaecologist have to do with this week's Flow Knows?

Well you would have heard his name thrown around a fair bit since Collingwood's Daniel Wells, sustained a left Lisfranc injury that required surgery in round 12.

The Lisfranc joint refers to the joints at the base of the five metatarsals and the articulations with the tarsal bones in the foot.

Injuries can range from ligament sprains to complete tears with differing degrees of separation and displacement. 

The 2 main mechanisms of injury are a direct crush force to the midfoot, or an indirect force.

The indirect mechanisms usually occurs from a fall backward with the foot trapped, a longitudinal compression or a fall on the point of the toes. 

Clients typically present with difficulty weight-bearing, running and walking on toes after an acute mechanism or injury.

It's important to note, that while Lisfranc injuries are uncommon in the general population, they are the second most common foot injury in athletes and require a high amount of clinical suspiscion in presentations where midfoot pain lasts greater than 5 days. This is due to the disastrous consequences if left untreated. 

Treatment will depend on the severity and amount of instability present. In lower grade injuries, with no separation, conservative management with a period of non-weightbearing in a CAM boot can be recommended. For higher grade injuries with instability and separation, a surgical approach is usually favoured.

 

SUTHERLAND SHIRE NDIS PHYSIO AND EXERCISE PHYSIOLOGY SERVICES - FLOW PHYSIO CO SUTHERLAND

IMG_5930.PNG

FLOW PHYSIO CO SUTHERLAND IS A REGISTERED NDIS PROVIDER FOR PHYSIOTHERAPY AND EXERCISE PHYSIOLOGY SERVICES

Flow Physio Co is an approved and registered provider of Physiotherapy and Exercise Physiology Services under the NDIS.

We have been servicing the Sutherland Shire's NDIS clients since the roll out of the National Disability Insurance Scheme.

We have both male and female providers who are passionate about helping people return to the activities they love. 

Our boutique studio provides a comfortable setting to help clients achieve their goals, whatever they may be.

We have wheelchair access, plenty of parking and are very close to Sutherland Station. 

We are currently working with a number of NDIS clients and have space for new bookings.

For more information, please contact our friendly staff in the clinic on (02) 9545 0361 or book online below 👇🏽

 
 
 

Post Natal / Mums and Bubs Pilates Sutherland

IMG_5835.JPG

MUMS & BUBS PILATES | Monday & Thursday, 11:15am at Flow Physio Co Sutherland

Postnatal Pilates usually begins 6 weeks after the birth of your child.

Prior to commencing classes, we offer a 6 week postpartum check where we thoroughly examine the integrity of your pelvic floor and transverse abdominus (deep core muscle). We will also check for a Diastasis Recti (abdominal separation), wound check if you have had a Caesarean and a general assessment to ensure you are safe to return to exercise.

Following the 6 week check we recommend joining the Mums and Bubs Pilates class. This class has a maximum capacity of 2 people which allows room for you to bring your baby and allows the Physiotherapist to monitor you more closely. 

This session will be 50 minutes.



FLOW KNOWS - Hamstring Injuries

This week we have seen Newcastle Knights rookie sensation, Kalyn Ponga ruled out of State of Origin 3 with a reported grade 1 lateral hamstring strain suffered against Canterbury over the weekend.

Backing up from a huge performance in Origin 2, Ponga sustained a somewhat innocuous injury early in the first half against the Bulldogs. 

When do hamstring injuries occur?

Hamstring muscle injuries are a common injury in sports that involve high-speed running and kicking. 

Lateral Hamstring Injuries.001.jpeg

The biomechanics of hamstring injury

During maximal sprinting, the hamstrings work to decelerate the swinging shin bone and control the straightening of the knee. They then work as the foot hits the ground to help extend the hip.

Most hamstring injuries occur at the end of the swing phase when sprinting.

As was reported this week with Kalyn Ponga's injury - we usually see these injuries occur at the muscle-tendon junction of the outside hamstring muscle (biceps femoris).

Kalyn Ponga made 10x his season average for tackles per game in State of Origin 2

Some interesting stats out of Ponga's Origin performance came in his tackles made. Playing in the front-line, Ponga made a total of 29 tackles, approximately 43% of his total tackles made in 24 appearances for the Knights this year (68 tackles). 

How much has this spike in workload contributed to Ponga's hamstring injury? I would love more data, however what we have seen from his Origin performance is a spike in acute workloads comparative to his chronic workloads at fullback.

Acute workload increases >1.5x = increased injury risk

We know from the work done by Tim Gabbett that acute workload spikes that exceed 1.5x chronic workloads (preceding 3-6 weeks) leads to an increased soft tissue injury risk in the following weeks. 

Unfortunately, in Kalyn Ponga’s case, we have seen him sustain a grade 1 lateral hamstring strain and will likely miss 3-4 weeks of football, including State of Origin 3