Blog
Adolescent girls participation in sport
Over four days the Australian Institute of Sport hosted the annual Women in Sport conference (WISC) in Sydney. Speakers from all over Australia featured, covering all aspects of the female athlete from adolescence through their elite years, postpartum and life after sport. At Woollahra Physiotherapy we were able to watch and gained some valuable takeaways from the conference.
One of the key takeaways from the conference was how sport participation changes in adolescent girls. By 14 years old, 50% of adolescent girls participating in sport have walked away. Research has explored adolescent girls' perspectives around their participation in sport and what environment would support long term involvement. Researchers are currently trying to reduce the 71-79% dropout among 10-19 year old girls in team sports, which is at a much higher rate than boys their age.
Some barriers to involvement or walking away from sport for adolescent girls can include:
Lack of friends in the team
Poor parent/coach behaviours
Competitive nature of sport as age progresses, not as much ‘for fun’
Perceived lower skill level than peers
Internal pressure to perform
Anxiety and pressure
Clashes between sports
Time/distance to get to training and games
Early and late practices
School balance especially going into Year 11 and 12
Research is currently exploring strategies to maintain adolescent girls in sport throughout their teenage years. Several key areas have been identified for action in the future, with the aim of keeping the next superstar in the Australian sport system.
Recognising the ‘why’ adolescent girls do sport isn't just because of winning. Sport for adolescent girls is not just linked to success but also being in a team/community, with an ‘in it together’ mentality, learning and improving their skills and increasing fitness. Sport can give adolescent girls a space to grow, have standards and build on values giving them identity and a safe environment to do this in.
Catering for an environment for girls to grow, can look like a relationship style of coaching. Adolescent girls value input, collaboration and communication within a team and individual sports, compared to adolescent boys who value a more direct style of communication. Building relationships and having open communication can determine if adolescent girls feel supported in sporting environments. This can look like being asked questions during training around directions or areas they think they need to improve. The research is emphasising the need for supportive language alongside still giving these girls the challenge and competitiveness they enjoy within the sporting environment.
Research also uncovered the benefits and positive effects of having female role models. These role models or coaches give adolescent girls someone to look up to, and can be an easy source to go to for help navigating through puberty and menstrual cycle changes, which occur alongside their sport commitments.
Less than 20% of Australian girls aged 10-17 years old meet the Australian physical activity guidelines. These guidelines recommend a minimum of 60 minutes every day of moderate to vigorous activity. By giving adolescent girls a supportive, collaborative, and challenging environment, it is hoped that more Australian girls will stay in sport over the years to come.
By Ella Waite
Precision-Led Rehabilitation at Woollahra Physiotherapy
At Woollahra Physiotherapy, rehabilitation is not left to assumption - it is measured, analysed, and strategically progressed.
Through advanced testing using VALD force plates and dynamometry, we gain a detailed understanding of how your body is truly performing beneath the surface.
Force plate technology allows us to assess how you produce and absorb force during movements such as squatting, jumping, and landing - highlighting asymmetries and inefficiencies that may not be visible to the eye. Dynamometry provides precise muscle strength data, enabling us to detect and address even subtle deficits that can delay recovery or increase reinjury risk.
This level of insight allows us to:
● Establish a clear, objective baseline
● Design rehabilitation programs tailored to your exact needs
● Monitor measurable progress over time
● Make informed, confident return-to-sport decisions
Recovery should not simply be about feeling better - it should be about restoring strength, symmetry, and performance capacity with confidence.
At Woollahra Physiotherapy, we combine clinical expertise with world-class technology to deliver rehabilitation defined by precision.
If you are ready for a more measured, strategic approach to your recovery, speak with our team to incorporate advanced performance testing into your physiotherapy journey.
Excellence in rehabilitation starts with precision, and we are committed to delivering both.
Concussion in Sport
February 2025
Kristin Haigh
Concussion Consensus
The science of concussion continues to evolve. The Amsterdam Consensus that was developed by 5 international statements in 2022 developed through the Concussion Sports group is discussed below .....
Sport related concussion[SRC] at any level, i.e. recreational or elite, is a condition Physiotherapists and often Sports Doctors are asked to assess on -field and in the clinic following a concussion There are guidelines for the management on field and assessing at follow -up visits. The consensus developed is to ensure consistent and reasonable practice of the Health Care Provider.
Assessment involves Vestibular -Occular Motor screening
Symptoms, signs, balance, gait ,neurological and cognitive changes. This is optimally done within the first 72 hours and up to a week after the injury.
The 11 R’s of Sport Related Concussion, clinical concussion management and considerations:
Recognise
Reduce
Remove
Refer
Re-evaluate
Rest
Rehabilitate
Recover
Return to learn / Return to Sport
Reconsider
Residual Effects - (Retire?)
Sport - related concussion is a traumatic brain injury cause by a direct blow to the head, neck or body, where the force being transmitted to the brain that occurs in sports and exercise related activities.
If you have suffered a concussion book in to get a thorough assessment and examination from your Physiotherapist or Sports Medicine Doctor.
Should you use an ice pack or a hot wheat bag for your back pain?
By Adrian Davies
16/12/2024
Back pain is a common musculoskeletal issue in Australia, with around 15% of Australians experiencing it at any given time. When faced with pain, many people instinctively turn to medications as the first line of treatment. However, as a physiotherapist, I believe that heat and cold therapy are often underutilized alternatives. These methods are effective, safe, and come with minimal side effects, making them an easily accessible option for pain management. Research, including studies published by Cochrane, supports their benefits, and the Royal Australian College of General Practitioners also recommends them too.
Should you reach for a cold pack or a hot wheat bag?
Your body may have already given you some clues about which treatment you prefer. For example, you may feel relief after a hot shower. If you’re unsure, I recommend trying both heat and cold to see which one offers the most comfort and pain relief. You should be able to determine which works best for you fairly quickly.
Key Tips before for using heat or cold therapy:
Always place the heat or cold pack over a towel or a t-shirt to avoid direct contact with the skin and prevent burns
Check the sensation of your skin before applying a pack. If you have reduced sensation, speak to your therapist as you will need to be extra cautious to avoid burns
Aim for 20-minute sessions, 3-4 times a day.
Heat Therapy Options:
Hot water bottles
Wheat bags (soft packs filled with grain)
Hot towels
Hot baths
Saunas
Heat wraps
Cold Therapy Options:
Ice packs
Cold towels
Cold gel packs
eferences:
https://www.cochrane.org/CD004750/BACK_superficial-heat-or-cold-for-low-back-pain
https://www1.racgp.org.au/ajgp/2024/september/best-practice-care-for-acute-low-back-pain
BONE STRESS INJURIES AND THE EFFECTS ON BONE MINERAL DENSITY
By Kristin Haigh
25/06/2024
Bone Stress Injuries (BSIs) are injuries that occur when bones are subjected to repetitive stress or overuse, leading to small cracks or fractures. These injuries typically result from activities that involve repeated impact, such as running or jumping. Examples of these injuries are Shin Splints (Tibial bone stress or Medial Tibial Stress Syndrome) and metatarsal (foot bones) stress fractures.
People with BSIs generally have pain that develops gradually and worsens with weight-bearing activities, and sometimes have swelling and tenderness at the injury site.
BSIs in runners commonly are in the tibia. These injuries often require a prolonged recovery period, and there is a high rate of reinjury. Popp et al. (2021) investigated the effects of a tibial BSI on the Bone Mineral Density (BMD) of female athletes. They evaluated 30 female athletes aged 18-35 years, all diagnosed with a tibial BSI. The athletes all underwent an initial period of reduced weightbearing, such as walking with crutches or a pneumatic walking boot.
From time of BSI diagnosis to 12-weeks post diagnosis, all measures of BMD declined by between 60%-95% in both the injured and uninjured legs, indicating that reduced weightbearing associated with the initial management of a BSI affects the BMD in all weightbearing bones. Weightbearing physical activity was at its lowest during the first 8 weeks of the study then steadily increased, while BMD continued to decrease until 12 weeks before beginning to increase again. This finding indicates that reintroducing higher level weightbearing and impact loading of bones takes some time to begin to produce noticeable changes in BMD. Therefore, the critical time to ensure safe and cautious progression of weightbearing is at least the first month, as re-loading in this period involves increasing the impact load on bones that may be briefly continuing to decline in BMD.
By 24 weeks, bone measurements returned to near-baseline values, and had surpassed baseline values by 1 year post-injury. 10 of the 30 participants (1/3) experienced a subsequent BSI during the re-loading period of the study. Participants of a younger age, who’d had a later age of menarche, and who’d had previous BSIs were more likely to sustain a second BSI.
To summarise, bone density declines in both legs post-BSI and does not return to baseline for 3-6 months. It’s vital to cautiously re-load impact and weightbearing to avoid overloading bones that may continue to have reduced BMD for 4 weeks. Please see your physiotherapist if you have any running-related pain or injuries.
ROTATOR CUFF TEARS AND TENDINOPATHY
By Ali McGill
29/02/2024
Managing the painful shoulder
The shoulder joint (also known as the glenohumeral joint or GHJ) is surrounded and supported by a powerful band of muscle tendons called the rotator cuff. The rotator cuff muscles of the shoulder work as a dynamic structure to centralise the head of the humerus (upper arm bone) in the socket (made by the shoulder blade or scapula) and aid movement, acting to keep the GHJ functioning and stable.
Structural changes in muscle tendons:
Type 1 collagen is the most abundant connective tissue in tendons, but these can degenerate over time, in response to injury or due to metabolic conditions (such as diabetes). This phenomenon is termed “tendinopathy, and this process can affect a tendon’s:
tensile strength ie. the ability to transmit force from muscle to joint
shock absorption
innervation and blood supply, leading to a potential increase in sensitivity and increased risk of tears
MRI and ultrasound are the preferred imaging modalities for imaging and evaluating tendon tears. Important to note however, is that tendon abnormality seen on imaging does not always diagnose the cause of your pain, as many people with asymptomatic pain-free shoulders demonstrate rotator cuff tears or tendon abnormality on imaging. In adults over the age of 60, 66% of rotator cuff tears found on imaging are asymptomatic. The use of routine scanning for cuff tears therefore remains debated in terms of efficiency. Your physiotherapist can refer you for necessary imaging as they see fit to assist in the diagnosis and management plan for your painful shoulder condition.
Management of rotator cuff tendinopathy
The two treatment pathways for rotator cuff tendinopathy are; Non operative management such as lifestyle changes, physiotherapy and injections or shockwave therapy; and operative management, which consists of a subacromial decompression surgery to increase the available anatomical space for the tendons to pass through.
Management of rotator cuff tears
In the case of an acute rotator cuff tear, urgent referral to a specialist surgeon is advised to discuss the potential for surgical management and repair. Indications that support surgical tendon repair are:
High energy traumatic injuries
People in high performing roles that require shoulder use for their sport or hobby
People under 50
In the case of non-traumatic tears: where non-operative management including physiotherapy for >3 months has failed and patient has persistent pain and dysfunction
