EDITORIAL: By SEPNZ President Blair Jarratt

March 2021, here we are - January has passed by with summer and holidays; February school is back and most people are back at work. Let's kick this year off with the intention of a "different" year to 2021. For SEPNZ, there are some significant events this year.

Late last year, we entered our memorandum of understanding with PNZ working on the unity plan's first steps. We will be taking this merger to the vote with our members later this year. This is a crucial vote for you as a member of SEPNZ as it signals either the inclusion to PNZ (such as the majority of branches and special interest groups (SIG) that have merged to date) or to go alone (as the Hands SIG has decided to do). This year is traditionally our symposium year, and the planning for this is well in the pipeline. This time around, we have changed up how we are going to do this. It is exciting to announce that we will be combining with the NZMPA SIG and running a joint symposium with a combination of live and online presentations and workshops - this will be the best CPD event of the year in NZ. It will be a one-day event and will be cram-packed with leading-edge content. We hope this goes some way to reducing the costs for both SIG's members so you can come along, and as a bonus, it may let you enjoy your night out more after the symposium catching up with old friends and colleagues.

Date: Saturday 25th Sept, Venue: AUT North shore - Watch our social media on Facebook and Instagram for updates in the coming days for presenters and line up.

Thanks to Brett Harrop from Otago Cricket for his feature article in this edition of the bulletin. The pathway that a sports physiotherapist takes always makes for an exciting story. There are usually stories of massive decisions/sacrifices on the personal, social, and vocation front. What doesn't kill us makes us stronger. Brett's story is clinically informative and an excellent read of his time in Bangladesh and then back to Dunedin's pace. In our last bulletin we featured the Aussie Instagram picks. We head back to the Gram for the app review in this bulletin to pick over the Best of the Brits. Emma Lattey puts forward her top 3 British Instagrammers so you can get snippets of CPD and opinions whenever you need them. In association with ASICS, podiatrist Anthony Ng provides insights into "Charcot foot" in diabetic populations with their footwear review on the GT4000. As the prevalence of diabetes increases (rising from 4.7% in 1980 to 8.5% in 2014 https:// www.who.int/news-room/fact-sheets/detail/diabetes), clinicians should be aware of possible pathologies, appropriate education and care. Rounding out our first bulletin of the year is another excellent clinical review from Pip Sail correlating to our feature article on Cricket. How can you not be engaged in the New Zealand Cricket scene with a plethora of national games between provinces at present and internationals on our doorstep in New Zealand? This summer on our shores, we have seen: West Indies- Men, Pakistan- Men, England - Women, Australia - Men. We are still to host Australia Women, Bangladesh- Men and later this year, the Black Caps are set to tour England.

The mornings are getting darker; there are a few more rainy days and the occasional crispness in the air, so winter sports are on their way. When writing this, Emirates Team NZ and Luna Rosa Prada Pirelli are locked in with one win each in America's cup. (Editor’s note: and have now taken the win!) What a fantastic place NZ is to be a sports and exercise physiotherapist. We will be back in another couple of months with the next bulletin but in the meantime, stay tuned to our social media for details and ticket sales to the 2021 Symposium - From Plinth to Podium.

Kind Regards Blair Jarratt SEPNZ President

Cricket Edition:

HOWZAT!! Brett Harrop

Brett Harrop is in his 5th season as physiotherapist for the Otago Volts cricket team in Dunedin. He is an APA Sports & Exercise Physiotherapist, an ASCA Level 2 Strength & Conditioning Coach and a Level 3 Cricket Coach. He has worked exclusively in cricket for the past 8 years, including internationally with Bangladesh and in T20 franchise cricket in the Indian Premier and Pakistan Super Leagues. Brett shares with us some of his experiences along his cricket physiotherapy journey!

How did you come to find yourself working as a physiotherapist in cricket?

I graduated from Melbourne University in 2001 and initially worked in a couple of multidisciplinary private practices in Melbourne. In 2006 and 2007 I travelled overseas and worked for the British Forces on army bases in London and Germany. This was an interesting time to be involved as there were two conflicts going on at the time in Iraq and Afghanistan and I was treating soldiers on pre- or postdeployment. Upon returning to Australia, I had decided that I really wanted a career in professional sport. Over the next 4 years I applied and/or interviewed for dozens of professional sports team jobs, but all of them were unsuccessful. Like many physios, I found it difficult to get a ‘foot in the door’. One of the consistent hurdles I received feedback for was that I didn’t have a masters degree. So, in 2011 and 2012, I completed a Master of Sports Physiotherapy at Melbourne University. I thoroughly enjoyed the course and it greatly helped improve my clinical skills and knowledge. (Obviously, there were a few other confounding variables), but it also helped my career prospects, with my next interview being successful. Some of our family and friends thought we were crazy, but my family and I packed our bags and for the next 3 and a half years we were based in Dhaka, Bangladesh – with me working for Bangladesh Cricket as Rehabilitation Manager. The work, lifestyle, and cultural experience in this vibrant and cricket passionate part of the world was eye-opening, challenging and highly rewarding.

What were some of the challenges you faced working in Bangladesh?

Bangladesh is an amazing country with extremely friendly people. The interest in the Bangladesh cricket team in Bangladesh is akin to the All Blacks in New Zealand, but with a fan base of 160 million people as opposed to 5 million. So, there were the obvious pressures and challenges working with high-profile athletes. I was fortunate to work with some world class cricketers, but also alongside a variety of high-quality coaches and support staff, learning lots away the way. It was also a rewarding time with Bangladesh having one of their most successful periods, including making the quarter finals of the 2015 World Cup.

In terms of lifestyle and culture, Bangladesh never ceased to surprise me on a daily basis. Taking my son to a ‘typical’ Bangladeshi 2-year-old birthday party (which was more like a Bollywood wedding), the confronting, uninhibited slaughtering of animals in the streets (and the subsequent rivers of blood) during the religious festival of Eid or enduring the daily exasperating traffic jams. The cricket stadium where I worked was only 6km from my apartment, but it would consistently take between 1-2 hours to get there by car. Running or bike riding to and from work (dodging pedalled and 3-wheeled-auto rickshaws, water buffalo carts and buses overladen with people) became my regular go-to, as it was guaranteed to always be quicker.

My first assignment when I arrived in Bangladesh was a warm-up match in Khulna in the south-west of the country. I checked into the hotel and upon entering my room on the 5th floor, something did not feel quite right. Something was askew in the room. I picked up the round ashtray from the coffee table and placed it upright on the floor. I let it go and it started rolling, accelerating faster and faster across the floor, crashing into the far wall. The building was leaning! Being on the 5th floor of a ‘moderately’ tilted building with metal bars blocking any window exits, my first night’s stay in a Bangladesh hotel was a little uneasy! In terms of professional development, there were few opportunities in Bangladesh, so I made the most of things by completing a predominantly online masters degree in Exercise Science (Strength & Conditioning) through Edith Cowan University in Perth. I was able to slowly work my way through the course, one paper per semester. It certainly helped with improving my end-stage rehabilitation and physical performance management of elite athletes.

How did you end up in Dunedin with the Otago Volts and what is your current role?

Unfortunately, in 2015 and 2016 there were a couple of terrorist events in Dhaka and subsequent security changes meant it was time for my family and I to move on. Luckily for me, the Otago Volts were going through a restructuring phase and the team physiotherapist role opened up. The change was one of extreme contrast – coming from Dhaka with its high population density, congested traffic, hot tropical climate, and high levels of pollution/smog to ‘remote’ Dunedin with its relatively low population, ease of traffic, refreshing ‘temperate’ climate and clean environs! It was the perfect location for bringing up two little kiwi kids! Ironically, we joked at the time that Dunedin would be the perfect place to be if there was ever an unprecedented global crisis, catastrophe or pandemic! My current role with Otago Volts is team physiotherapist which is full time during the summer months. We have had a great group of coaches and support staff over the 5 seasons I have been involved, and the players are extremely professional – working the hardest and most purposefully of any in the country (some potential bias here). It has been great to see a number of them progress into the New Zealand A and Blackcaps setup this season (Duffy, Rae, Smith, Rippon).

What are the types of injuries you commonly see?

Typically, the most common injuries seen in cricket are hamstring strains, side strains, traumatic hand and finger injuries and lumbar stress fractures (with these resulting in the longest periods out of the game). The types of injuries I have encountered though, have varied across the different demographic groups, geographical locations, and cricket formats I have worked in. One constant, however, is that the fast bowlers are consistently the most injured. Interestingly, in Bangladesh there are fewer fast bowlers overall than we see in New Zealand or Australia. This is due to various reasons but includes (1) the conditions/ wickets are generally more conducive to spin bowling, (2) the shorter average height of the athletes (3) the youngsters role modelling themselves on successful Bangladesh international spinners. As a result, the overall number of lumbar stress injuries was less than what we tend to see here. The cricket program in Bangladesh was centralised in Dhaka. A lot of the players would return to their village when a series/tour finished where they may not have access to training facilities. Upon their return to Dhaka, there would be a spike in training volume and intensity, and we would often see intensity-related soft tissue injuries (hamstring strains, side strains etc). Furthermore, the domestic schedule in Bangladesh could suddenly change at short notice (often due to the international fixture suddenly changing). There were a couple of instances where the first-class competition (long format / 4 -day cricket) was announced with only a couple of weeks’ notice. This made it impossible to appropriately load the fast bowlers for competition. The players were therefore more often exposed to sudden spikes in volume and intensity than what we tend to see here (where the preparation for Plunket Shield, Ford Trophy and Super Smash can be planned well in advance). The Otago Volts injury profile over the past 5 seasons has been a little atypical for cricketers – with no hamstring injuries and no lumbar stress injuries to our fast bowlers. We are fortunate to have a core group of fast bowlers who are relatively resilient, have good training ages and have exposed their bodies to consistent and uninterrupted bowling workloads over several seasons (Duffy, Rae, Smith, Bacon, and previously Wagner). What we have tended to see the most in our squad are traumatic hand and finger injuries. However, a particular recent focus on high volume, foundational catching technique drills and protective handwear for training has helped reduce these injuries.

What is it like working in T20 cricket leagues such as the IPL and PSL? What are the common injuries you see there?

Working in T20 competitions in the subcontinent is a fullon experience. The electric atmosphere at the grounds, the elaborate hotels and extravagant team functions, the CONTINUED ON NEXT PAGE >>

high demands of your time and high quality/quantity work output expected of you, along with the pressures of dealing with big name players and owners, is both an awesome challenge as well as complete sensory overload.

In terms of injuries, in most of the T20 competitions I have been involved in (regardless of country), fielding coaches and new coaches (despite their best intentions) tend to get overly zealous about “being the best fielding team in the competition”. In the days leading up to the first match of the tournament, there is a big focus on fielding training. The number and intensity of throws ‘spike’ and as a result, there tends to be an increase in the presentation of shoulder and elbow pain in the physio room. Often several of the players may not have thrown at such high intensities, distances, volumes, or frequencies for a number of weeks prior to the team assembling. To help reduce this issue, I now prescribe the players a throwing program 6-8 weeks prior to the start of a tournament to progressively load their shoulder/elbow. What do you think are key aspects in successfully managing or preventing injury in cricketers?

Load management would be a big one. Cricket is a unique sport in that it has 3 different formats (multi-day, one-day, T20). Each format has unique workload demands related to intensity and duration. Successfully transitioning players

between formats is one of the great challenges and balancing acts for physiotherapists, coaches and performance staff working in cricket. Load management for both injury prevention and performance is an important aspect of these transitions. Fast bowlers may need to bowl more (↑volume) at trainings during short format competitions (T20) to prepare themselves appropriately for upcoming long format matches. Conversely, during long format competitions, some players may not be adequately exposed to high intensity activities (e.g. sprinting) and may need additional speed exposure training (for both an injury prevention and performance perspective) to prepare themselves appropriately for upcoming short format matches. Cricket also involves multiple disciplines (‘positions’) that are vastly different in physical requirements. Physiotherapists working for cricket teams should be aware that the fast bowlers are the group that is the most injury prone. An emphasis should therefore be made towards this group regarding preparation and recovery strategies and injury prevention and management.

What are some tips for physiotherapists treating cricketers in their clinic?

In the subjective assessment it is important we identify certain physical information regarding the athlete such as limb dominance, primary and secondary skills, and the level and format of cricket being played. This information will influence the treatment and management.

It is important to identify limb dominance for batting, bowling (if applicable), and throwing. There is a lot of ambidexterity in cricket. Sometimes a left-arm spin bowler may actually throw right-handed. By identifying limb dominance for each skill, you can more accurately prescribe activity restrictions, allow unprovocative activities to be continued, and apply appropriate progressions throughout the rehabilitation process. Most cricketers will have a primary and secondary skill (e.g. wicketkeeper and middle-order batter, or, opening batter and pace bowler etc.). They may be able to continue training or playing with one or the other of their skills during the rehabilitation process. It is important we are focused on what they can do, as opposed to simply what they cannot do – to minimise the deleterious effects of detraining. It is also crucial to understand which teams (frequency), level (intensity) and format (volume and intensity) of cricket they are playing – including previously, currently, and upcoming. This information is important for differential diagnosis (e.g. identifying likelihood of stress related injury), guiding treatment progressions and for devising appropriate return to play plans (team, level, format). .