I could just fancy some cheese Gromit. What do you say?

I’m partial to some, now let’s be honest most cheeses yet I’ve never thought about using gorgonzola or perhaps a nice ripe brie to heal an injury. You haven’t either I hear you say? Well it seems some people have. Lindsey Vonn is the most successful American Alpine woman skier in history and was due to excel at the recent Winter Olympics in Canada following her successes at three consecutive overall World Cup Championships (2008, 2009, and 2010).

However just prior to the Winter Olympics, Vonn revealed that she was suffering from periosteal bruising (bruised bone) to her tibia. The solution was not horse’s placenta which is a favourite amongst Premiership football players of late, but Topfen, a soft, tangy Austrian cheese that has a similar consistency to cottage cheese. I was never partial to cottage cheese. So in addition to more conventional treatments like Laser, painkillers, and stretching   apparently Vonn had her shin regularly covered in Topfen to help reduce the inflammation.

Whilst many in the sports medicine community have been quick to distance themselves from cheesegate (although they were strangely quiet over the horse placenta issue), and dairy scientists have held forth over the healing properties of cheese, it is easy to see why Vonn opted for the fromage. Athletes will try anything to get fit again – especially in the build up to a major tournament. Vonn was in training in Austria when she sustained the injury and it is not uncommon to treat injuries with a poultice in Austria.

Did it work? Almost certainly not but you can’t underestimate the power of placebo. Vonn was helped by the unseasonable warm weather that delayed the alpine events in Canada, but out of the five medals that she was chasing she managed a gold, a bronze and a fractured finger. For Vonn it was a disappointment and inevitably it was the cheese that made the headlines.

So is David Beckham sitting at home with his Achilles tendon covered in dairylea triangles? No, but don’t bet that he’s not trying something. 

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A Millimetre from Death?

The six nations provided the usual mix of dazzling highs and disappointing lows and, unsurprisingly, a pretty high injury rate. I didn’t manage to catch all of the games between having to gain clinic experience and exams/coursework, but I did watch the awesome Wales vs Scotland game at the Millennium Stadium that unfortunately saw Scotland’s Thom Evans suffer a spondylolisthesis to his cervical spine. 

A spondylolisthesis refers to the slippage of part or all of one vertebra on another which can lead to compression of the spinal cord or spinal nerves. It is rare for this to occur as a traumatic injury and it normally occurs to the lumbar spine, however it is possible for it affect any area of the spine. Initially Thom was unable to move his legs but he hasn't suffered any lasting paralysis and is now back in light training. Former Lions team doctor, and current team doctor for Scotland, James Robson suggested that any further movement of his spine could have resulted in paralysis or even death. He went on to say it was the worst injury he had ever seen – which says a lot for someone in his position. Thom himself believes that he owes his life to the treatment he received from the medical staff - to read an account of the injury from Thom's perspective check out this article very interesting reading... Also have a look at this excellent article from the Scotsman which gives information about the two operations Thom has had and also the rehabilitation necessary from this injury.

Whilst injuries to the likes of David Beckham and Ashley Cole make the headlines because of the profile of the players, this injury highlights the inherent risks involved with rugby but also the excellent quality of care provided by the medical staff. Because of the lack of first aid courses that address the specific nature of the injuries experienced in rugby the RFU developed the Rugby Pitch Side Immediate Trauma Care Course that meets the needs of both doctors and Sport Therapists/Physiotherapists working within rugby. The bottom line is you cannot work at the top level in Rugby without this qualification and the game is better for it. 

On the plus side at least Thom had company in hospital after the game as Chris Patterson (hospitalised with bruising to his kidney) and Rory Lamont (MCL Tear) joined him in Cardiff University Hospital that evening... Plus he gets to listen to the support from his more famous cousin on his radio show over the course of his rehabilitation. We wish Thom all the best in his recovery and look forward to seeing him on the pitch again next season. 

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Time Flies....

It has only been a couple of months but what a difference it makes. Gone are the days of three matches a week instead it is 0 games (well it should be 1 but as my Sports First Aid Certificate has run out….) statistical analysis and dissertation time. Oh for the happy days of January. A lot has happened in the intervening period; David Beckham has torn his Achilles tendon, the Six Nations has been and gone, Glebe FC are top of the league and I’ve seen some really interesting injuries. Most recently I’ve observed a stress fracture of the pars interarticularis in a young cricket player who presented with classic symptoms: unilateral low back pain, pain aggravated by lumbar extension, pain on extension whilst standing on the affected leg and pain/tenderness on palpation. Doesn't get much more textbook than that. 


What is more interesting with this case and some of the others I have seen recently (hamstring avulsion, grade 3 ACL tear and a meniscus tear) is the issue of referral for diagnostic imaging to confirm the diagnosis. Almost without fail each case has been knocked back by their GP and their local A&E department despite the referral from their physiotherapist. This shows the dichotomy in the treatment of elite performers who are rushed off to see the clubs preferred specialist within days of injury and the weekend warriors who have to wait weeks or months for referrals to be acknowledged and acted upon…By next week we are hoping for some better news.

Good to see some high profile publicity for Sports Therapy of late with London Metropolitan Alumna Jo Denby on show on BBC Three looking after Eddie Izzard on his epic Sport Relief journey around the British Isles and sports therapist Ellie Steele discussing David Beckham's tendon reconstruction on the BBC.  We're taking over!

Oh and good luck to everyone at uni in their last semester - almost there!

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