Cowbells & Handball at the Copper Box that rocks

Not every sport played in the world is worshipped in the UK. Perhaps we should warm to handball-especially Olympic style at the impressive Copper Box in Olympic Park itself.

This is an acoustically stunning venue: the PA beats out Duck Soup & Maroon 5 repeatedly as the cameras pan the crowd for enthusiastic dancing: of which there are heaps decked out in national colours and flags of Montenegro, Brazil, Sweden & Norway.

Goalkeeping flexibility is extreme

These nations played out two cracking matches of an hour each with skill,wit,pace & no little respect. A thunderously physical sport, it is refreshing that despite enthusiastic coaches with frequently elongated arms outstretched at players & referees, decisions are immediately accepted & the fouling team immediately drop the ball for fear of a costly two minute 'sin-binning' styled penalty.

Pre match Scandinavian huddle

What of injury in this sport of strategic passing as well as fast breaking attacks?

With landing in the opposition circle only permitted in the act of shooting there is ample scope for landing injuries on every assault on goal there is huge risk if problems associated wit unstable ankles and lower limbs in the act of balancing, or of being pushed and falling or stumbling in the act of passing, running or shooting. It is most definitely a contact sport.

Keeper is vulnerable to fast breaks and on penalties

There are substantial risks to the shoulders for the extreme rotational powerful throws with subtle changes of direction whilst midair render ball and socket joints vulnerable to both trauma and overuse injury.

Absolutely cracking sport, played by both men & women, with the former taking more of their shots from longer range to goal. The goalkeeper is flexible and dances agitatedly in front of strikers & wingers whom arrow in on goal from all angles with power, precision or lobbed shots.


SPACE's Physio Emma-Jane Petherick is at the venue for the Games keeping her close eye on both the action and traumatic injuries.

The Copper Box will become a music venue
as well as entertainment site afterwards

Embrace it Britain. 

Give the Copper Box the rousing ovations it deserves as well!

#savethesurprise as the Games of the XXX Olympiad open in London

The Countdown Clock in London's iconic Trafalgar Square will shortly come to a halt for the second time. It stops for good at around 1930 irrespective of when the Games of the XXX Olympiad are actually declared open in the Olympic Stadium in Stratford.

#savethesurprise from BusinessReviewAustralia

Remarkably for the Opening Ceremony of the magnitude and spectacle romised by Director Danny Boyle, the use of the hashtag, one of the internet generation's key tools for information dissemination often virally for key events appears to have largely succeeded. The #savethesecret and #savethesurprise devices have even meant that social media outlets, rather than being awash with images and clips from mobile devices and cameras 

instead are full of scorn for the likes of the Daily Mirror for even having the audacity to print pics from the rehearsals! Danny Boyle, Boris Johnson & even Big Ben are trending in the UK (should it be GB for the next 6 weeks?)

The Host Broadcaster, the BBC, has shown a short 29 second clip yesterday (26th July): BBC Clip of Opening Ceremony: What to Expect.

Meantime there is a live build-up if you want to check what is happening in London in the hours leading up to the Opening: Build Up LIVE

This will be the second time the Omega Countdown Clock  has stopped. Obviously it has been sponsored as everything within the Olympic Games has been since the debacle of Montreal in 1976 which changed the face of the Games forever.  It took eight years, when the only bid in town was Los Angeles who were bidding and playing under new corporate funded rules for the IOC to really see profit from hosting: this forever altered cities' view of a potential Games Bid. 

It is a great time to be in London, so would have been churlish to open this blog with a piece on how the clock stops that would not appear out of place on the (OfficialHost Broadcaster) BBC satire, 'Twenty Twelve'. You can read about it here Countdown Clock stops.

Why this is interesting is that it seems SOOO long ago.

It was 500 days.

Now the clock stops, and this time for keeps.

The Olympic Games are here!

Tour de France? Tour de Force more like!

Incroyable!

King of Mod cycling LEGEND Bradley Wiggins has put his Tour de France disappointments of 2010 & 2011 behind him (Link: Bradley Wiggins Tour de France ).

Velodrome seen from Olympic Park

It seems highly appropriate the day after Sir Chris Hoy has been selected by the athletes to be Flag-Bearer for the British team for the Opening Ceremony (note it will be the first he has actually witnessed) and on the same day that some of the cycling team actually come into the Olympic Village that some reflection be called for.

How good is Wiggo then?

Information from several sources suggest he is clearly one of our great cyclists but the convetsations about his being one of the truly Great Britons alongside multiple medallists and true greats from across the sporting landscape should make us sit up and take time to take note of what he has achieved this past three weeks. After all, the tradition for cycling in the UK has been rooted in time trails & the track rather than endurance and hill climbs on the road.

'Inspire a Generation' on the side of the velodrome

However it may all be about to change the face for cycling in this country. Has Bradley Wiggins & Team Sky instead stolen a march on the 'Inspire a generation' theme of the London Olympics? Can't just have been London's balmy 27 degrees that had public parks such as Victoria Park whirring to the sounds of spinning pedals?

 Here's hoping that Cav can tame the 7 laps at Boxhill and the rest of Saturday's Road Race and be 1st to bring home gold for #TeamGB furthering the cementing of cycling as a contemporary British sport (and if not then PLEASE could it be Aberdeen's Hannah Miley for swimming?)?

Next stop UCI event dominance, more TdF success and then the challenges of the Sir Chris Hoy Velodrome at Glasgow 2014!

Kitting out the Volunteers

This is the final week of preparation for the 2012 Olympic Games.
For the athletes, this week will see the entry to the Village at last if they are not already esconced there.

Up to 70,000 volunteers are due to be processed through the brick building housing the uniform & accreditation centre and it is these good people that will represent a public plum and strawberry uniformed face to the 2012 Olympic Games, whether visitors, 'Olympic Family' or even the athletes themselves!

UDAC accreditation & uniform venue

This accreditation 'experience' has taken around 60-90 minutes per volunteer so hats (& purple caps) suitably tipped + doffed to those assisting the process.

Amongst the Volunteer force 

will be some physiotherapists from 

Edinburgh's premier West End clinic, SPACE!

Watch out for tweets, blogs & facebook updates!

Is Contact Sport Bad for Your Brain in the Long Term?

Of course sport is good for you!

Even contact sport offers up the benefits of exercise.

Caution only with the recent spate of evidence regarding brain injuries and concussions. 

Take the latest edition of the journal Cerebral Cortex (May 2010). Tremblay et al have a paper discussing a neuro-imaging investigation of brains of those whom had experienced concussions during their sporting lives, and those whom had never experienced any head-related injury Cerebral Cortex May 2010 Tremblay et al abstract.

The study concludes that otherwise healthy former athletes whom had concussive events and other associated manifestations demonstrated brain anomalies and patterns of decline. These areas included memory areas such as the hippocampus, but also cognitive regions too.

This follows up the study in 2009 in the Brain Journal (Brain. 2009 Mar;132(Pt 3):695-708. Epub 2009 Jan 28) that demonstrated that neuropsychological and motor alterations more than three decades after concussions occured providing some more evidence to the chronicity of cognitive and motor system changes.

Dry Needling Treatments: SPACE staff experience 'the needles' for themselves! Could they help you?

Getting headaches, achilles/calf pains,

 a 'frozen' shoulder or backache?

Perhaps your arm is not moving as freely since an accident? 

Runner's knee possibly affecting your training? 

Dry needling is a physio technique that can treat these conditions and many more! Tiny needles inserted briefly into tender regions called trigger points in muscles and fascia form the main thrust of dry needling, with effects on the nervous system and overall on the body as well as locally at the site of insertion.

SPACE physiostaff Jon Twynham
 & Kenny Watt inserting needles for calf pain

The needles are a little like these used in acupuncture, and up to 80% of the points are the same as in traditional Eastern Acupuncture but the brief insertion is different, as are the positions the muscles and soft tissues are placed in for application. The needles are very thin, but can measure up to 100mm in length depending on where the need is for treatment.

Dry needling as a technique for managing musculo-skeletal and fascial pains that may be causing problems is a relatively new treatment, but it is widely and safely practised by physiotherapists in South Africa, Australia, New Zealand, North America as well as the UK. It is a clean technique, as the single-use needles are sterile and the body part cleaned prior to insertion.

SPACE staffers Kenny Watt & new recruit Jon Twynham (see JT new physio at SPACE) have just attended the updated and exciting course from the Dry Needling Institute from South Africa, along with SPACE Clinical Director Stephen Mutch. This follows on from fellow Director Stuart Barton attending last year, which fits well with the needling approaches of Ross Mayberry & Emma-Jane Petherick meaning that if you attend SPACE with a request for needles (yes it sometimes does happen!) or if that is indicated as a reatment then any of our SIX physio staff are able to administer a safe and competent treatment technique!

It fits well into our paradigm that the human body effectively develops adaptation strategies in times of pain or dysfunction. Do not be surprised if 'the needles' may well play a significant part of rehabilitation possibly added to myofascial release, stretches, exercises & taping.

Neck Treatments have multiple points for needle insertion

Why not ask your physio about this next time you are in? Perhaps your physio will recommend you undergo the treatment, so don't be afraid to question where and how the needles be inserted: we are all happy to discuss our ideas and theories as to how they may help.

Remember you are part of the decision-making process, and can happily discuss any part of your treatment: whether that also involves coloured taping in addition to the needling or not!

Australian Rugby League Head Injury: State of Origin III 2012 Part 2

So the dust has settled on the State of Origin in Australia.
Here is a link to the 2nd episode during this epic rugby league match when a player is clearly concussed. In this instance, he is only removed from the field of play due to what is described by the commentators as 'a touch of claret', namely blood from the head.

Again it is worth considering what takes place.
remember you are far from the venue, away from the heat if battle, and you are limited in your knowledge of the player, and the current playing and medical status.


But do consider what happens. 

State of Origin III 2012 - Head Injury Video Part I

In Brisbane this week, a huge tv audience for a sporting event witnessed a classic rugby league match for the deciding state of Origin match between Queensland & New South Wales. 

That audience would have seen this episode just before the quarter hour mark that raised a few eyebrows as well as issues regarding player welfare. This would be even more particular to Australia currently, where head injury and concussion has been in the news recently with claims that medical management has to be respected and medics lead the debate on appropriate patient/player care. Australia seeks to tackle concussion (blog link)

Here is the first of two videos worth examining whilst only being able to speculate from television footage what has occured, and without the benefit of the onfield medic's opinion which should always be respected.

Australian Football Codes seek to tackle Concussion

Been a while since we blogged on concussion?
Seems to have been something of a big deal recently in Australia.


The Medical Journal of Australia has just published an article suggesting that the current neuroscience evidence should be driving the debate rather than media interest, particularly in light of recent high profile cases in the USA: check SPACE articles-
Concussion litigation 
Flights & Games post concussion 
Derek Boogard 'Brain going bad'.


Andrew Kaye & Paul McCrory discuss the medical management of sporting concussion in their piece "Does football cause brain damage?"Medical Journal of Australia 2012; 196 (9): 547-549
However elsewhere within the same journal there is a piece by Gilbert & Partridge Medical Journal of Australia 2012; 196 (9) 561-563 on the need to tackle concussion in Australian football codes. 


The much cited article of Omalu et al ( J Forensic Nurs. 2010 Spring;6(1):40-6. Omalu et al) raised the spectre of Chronic traumatic encephalopathy (CTE) being linked in the death of a 44 year-old American Footballer to premortem history of cognitive and neuropsychiatric imariment, including depression, suicide attempts, insomnia, paranoia and impaired memory prior to the fatal gunshot wound.  


Gilbert & Partridge state that although CTE is usually linked to a history of 'concussion', tauopathies found at post-mortem examinations of young footballers' brains did not report any such history.

Shaun Valentine being assisted from the field of play

Yet rugby league players in Australia have been asked if they would consider donating their brains to the 'Boston Brain Bank' as a result of the headaches, nausea and vomiting following their carers in the sport with concussive episodes (Herald Sun: Shaun Valentine & NRL players sought for study).


How is rugby league managing their population that is injured on the field of play in 2012? Watch this SPACE for a couple of intriguing examples whilst we should pay attention to the comments of Kay & McCrory say: "Everyone involved in athlete care, including referees, administrators, parents and coaches, as well as the athletes themselves, must be educated about the importance and principles of safe return to play after injury."

Reflections on the Summer Tours by the North to the South

Rugby news: in case you missed it! One Northern Hemisphere team wins 3 from 3 on tour!

Scotland Captain Ross Ford
after receiving this trophy after beating Australia
pictured with SPACE's Stephen Mutch

Blink you may have missed it! 
Even online newspaper reading of UK papers & media has shown that Scotland's tour to Australia,Fiji & Samoa has been under-reported & scarcely rated alongside heavyweight Irish defeats in NZ, three close run losses by Wales in Australia and England losing 2 matches comfortably in South Africa before a draw on the weekend.


France lost in Cordoba to Argentina prior to a huge win in Tucuman,albeit with 20 changes made to the Pumas.
Italy lost to Argentina this summer but rallied to win in both Canada & USA.
Is this a new dawn for Scottish rugby, or an isolated 'blip' in an otherwise virtual Southern hemisphere whitewash.


What does this mean for Northern Hemisphere rugby?

Sonny Bill Williams escaping Ireland's clutches

The North is still playing catch up according to Sky Sports' commentator and Rugby World Magazine writer Stuart Barnes. Online subscription would allow  read of his thoughts here: Rugby World Magazine August 2012.

But then the Scots' success was on a tour with very little precendent in the modern era, and merited something more than grudging praise. This piece had some nuggets of positivity contained within it: Rugby World review of Scotland Summer 2012 Tour.

Welsh disappointment in Australia

England's Head Coach took some positives from the England Tour of South Africa (Lancaster's Coaching Report) whilst rugby legend Brian O'Driscoll was simply embarrassed by Ireland's 60 point thrashing by New Zealand (NZ defeat 'embarrassing'). Wales only lost to Australia by an aggregate of eleven points but three test defeats, and Caretaker Coach Rob Howley was left frustrated but proud of his Grand Slam team (Howley proud of his team).


Overall the IRB standings have changed from 4-12 after these tour results, and with the 2015 World Cup Rankings being determined by the standing of the countries at the end of 2012 (yes really!) then there will be some excitement and nervousness come the reverse tours in the Autumn of 2012.

IRB Rankings in full at end of Summer Tours 2012

Getting it Taped - and why we need to view even BBC blogs with open eyes & minds

Coloured tape everywhere you look. Switching on to watch coverage of the tennis at Wimbledon or the recent European Championships in Eastern Europe it is clear that stretchy brightly coloured tape will be a feature of this 'Summer of Sport'.


The Olympics will undoubtedly see athletes bedecked in national team colours (see Dwain Chambers with an apparent tib post/peroneal 'hammock' strapping in Helsinki at the weekend).


The BBC has highlighted the use of tape in an article following the exposure of Mario Balotelli's back strapping BBC article -Why are athletes wearing coloured tape? and this piece includes discussion with the undisputed 'father of kinesio tape, Dr Kenzo Kase.


However Dr Kase persists with the line that kinesio tape works by lifting the skin to assist lymphatic flow which in turn reduces pain and swelling.


This is despite there being very little by way of evidence, a point taken up by physio Phil Newton, 26 years a physio practitioner at Lilleshall & 3 times-Commonwealth Games staffer.

Dwain Chambers in Helsinki

At least he has some credence within sports' medicine and rehab, and therefore we can read his pronouncements with some degree of interest.


However we should have some contention with the BBC piece rather than blindly accepting its wisdom just as we should not blindly accept the tape itself. Newton is quoted by the BBC along with Professor John Brewer from the University of Bedfordshire. Clearly an expert in sport science and administration-his experience with handball, as a Director of Glaxo-Smithkline and the British Olympic Association makes for impressive reading...in sports' nutrition and administration certainly. 


However he represents an odd choice for a commentator in this arena as his expertise is clearly in applied sport science and sports nutrition thus demeaning the status of the article, and also opening Michelle Roberts, BBC Health Online Editor up for questioning as to her choice of 'experts' for such an article steeped in contemporary controversy. It also demonstrates that articles from even trustworthy and august bodies such as the BBC should be viewed with caution as there is undoubtedly issues in credibility of these assumed 'experts'.


Newton suggests that the kinesio tape (and it's many producers and imitators) has suggested that there is an element of fascial unloading, and that this may be a mechanism for improvements seen with the tape, along with an undoubted placebo effect.


We at SPACE Clinics are happy enough to be using the tape when indicated, but as an adjunct rather than alternative to therapy and rehab. It has been seen recently with the Scottish volleyball and rugby teams with good effects, but the tape has had its critics among medics whom are well known & respected within sport. 


The effects are not well understood: the neural and mechanosensitive structures lying within the extracellular matrix may well be a critical component part of how the kinesio tape affects the skin (body's largest organ remember fact fans) but there is certainly an affect that lies well beyond the influence of the medic applying the tape. 


So we don't understand how the tape works. So perhaps we shouldn't just judge materials on the currently available evidence when we have so many athletes and patients happy with their results?