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David Spurrier at SA Symposium

Emma Breheny
29 July 2016

APA Sports and Musculoskeletal Physiotherapist David Spurrier’s interest in bone injuries in sport, particularly among adolescents, will be the focus of a presentation at the upcoming SA Symposium.

David’s postdoctoral study and clinical interest in tendon growth in children have led him towards the recent science on bones that has significantly updated 25 years of wisdom on managing stress fractures and related injuries.

Bone stress injuries predominantly affect athletes with few rest periods throughout the year, such as runners, tennis players and those in team sports. There is also high incidence among those with low body weight participating in high intensity exercise, such as ballet dancers.

‘As I researched further on where the tendon joins onto the bone, I realised that at the tendon insertion, an area of symptoms in a lot of athletic kids, there’s a continuum of other problems where the bone gets affected as well as the tendon and surrounding structures.

‘There’s a range of physiological and biomechanical changes around that tendon insertion, and if that’s irritated by load from athletic endeavour, you get bone reabsorption and, potentially, that can lead to bone stress as well,’ David says.

In bone that’s stressed or overloaded, treatment such as vibration and ultrasound (recommended in the past by the literature) aren’t effective due to the bone being exhausted, according to David.

A group of interested minds that includes David; sports physician Dr Greg Lovell; Craig Purdam, FACP; APA Sports Physiotherapist Professor Jill Cook; APA Sports Physiotherapist Mick Drew; BenRaysmith, APAM; and APA Sports Physiotherapist Ivan Hooper is exploring whether tendonipathy exercise management plans can be adapted for bones.

‘It’s slightly different in some of the peculiarities that bone cells show that tendons don’t, but we’ve been trialling some of these regimes and getting good results,’ David explains

Examples include a femoral fracture in a race walker, tibial fractures and foot fractures across sports as diverse as rowing, AFL and athletics.

A significant knowledge gap for Australian sports physiotherapists is the actual incidence and degree of injury occurring in children playing sports.

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Understanding these injuries better may provide insights into later bone stress problems in adults. David sees adolescence as a window of opportunity for bone health.

‘This is a time where you can develop not just bone but also quick muscular development. Yet we know that 50 per cent of girls stop all physical exercise at the age of 13. With boys, this 50 per cent dropoff occurs at about age 15.’

‘Bone health is a continuum from day dot to the end of your life and it’s so reliant on exercise and the activity rate. It’s very pertinent for physios to understand that.’

The SA Symposium is happening Saturday 22 October 2016. Registrations are open now.


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