Throwing a discus involves an incredibly complex sequence of movements. The throw consists of turning the body through one and a half circles and requires a high level of technical skill. The aim is to generate the highest possible force and transfer this force optimally through each phase to the final discus release.
Due to the complexity of throwing a discus, for the purpose of this case study we will focus mainly on the dysfunctional movements (biomechanics) of our athlete. By correcting these specific components of her throw, we were able to alleviate the presenting symptoms, enhance overall throwing performance and reduce further injury risk.
Case study – Tereapii (Apii) Tapoki
Apii has been representing the beautiful country of the Cook Islands throwing the discus since the age of 12. After competing in her first Commonwealth Games in 2006, she had children and pursued a career as a sergeant in the police force. An absolute legend and she’s not done yet…
In preparation for the 2018 Commonwealth Games, Apii moved to Melbourne to work with a highly regarded discus coach. After an intense year of training and competing in 2017, Apii found her overuse injuries were becoming more of an issue and beginning to hinder her performance. This is when Apii approached us at Kinematics to assist with her injury management.
As previously stated, the aim when throwing a discus is to produce the highest force possible. However, even if a high amount of force can be produced, it is no good if this cannot be transferred correctly and efficiently throughout the throw.
In the case of Apii, dysfunctional biomechanics were preventing her from achieving both maximum force generation and efficient force distribution. As a result, she was placing increased stress on the soft tissues around her knee and elbow leading to pain.
Apii’s presenting complaints:
- Right elbow pain during release action
- Right knee pain during wind up and power phases
Findings from our assessment:
- Locking through the midfoot
- Poor right ankle mobility
- Poor right hip mobility
- Lack of strength through the groin and deep hip stabilisers
- Locking of the thoracic spine
- Forward shoulder posture
Examples of how the above issues affected technique and contributed to symptoms:
- Reduced mobility preventing force production. Poor hip/knee/ankle mobility → unable to achieve enough hip, knee and ankle flexion during wind up → a reduction in force generation → increase stress on the right knee resulting in pain.
- Reduced mobility preventing force transfer from the lower body to the upper body. Poor thoracic mobility and forward shoulder posture → locking through the thoracic spine → preventing wind up and transfer of force → force lost through wind up and flight stage → compensatory patterns adapted to try and reproduce the same force → tissue stress through the right shoulder and elbow.
- Reduced strength preventing appropriate control during ground contact. Weakness of the groin/deep hip stabilisers → reduced balance during wind up → inability to stabilise the pelvis and lower limbs as effectively → unable to control momentum when landing on single leg → increased tissue stress around the knee → knee pain → less force generated and transferred to the discus release → compensatory patterns adapted to try and generate force → increase stress on elbow → elbow pain.
Interventions addressing the findings
The initial focus was to improve mobility through the hips and lower limbs to enhance force generation. The next stage was to increase thoracic mobility and pelvic stability in order to improve the efficiency of force transfer throughout her body to the discus release.
Treatment techniques included:
- Dry needling, soft and deep tissue releasing through the hips, knees, feet and ankles → reduced tension on the knee and therefore reduced knee pain.
- Mobilisation techniques of the foot, ankle and hip → improved range of movement and increased ability to produce force.
- Releasing and mobilisation through the thoracic spine and shoulder → improved thoracic and shoulder mobility → improved trunk wind up and the ability for trunk rotators to store energy and transfer energy generated from the lower limbs → more powerful and efficient throw produced on release → less stress on joints (e.g elbow) → increase distance of discus throw.
- To increase proprioception (sensory feedback) for activation of groin and hip muscles → stabilise the pelvis and lower limbs → decreased load through the lateral hip and knee.
- Shoulder opening exercises and thoracic mobility exercises.
- Self-releasing techniques and stretches to maintain results achieved from our manual therapy work (foam roller, trigger point ball).
- Exercises to begin to challenge balance and strength of the pelvic/hip stabilisers.
After spending eight weeks working alongside Apii addressing her underlying mechanical issues, we were able to greatly improve her mobility and posture. As a result of this, she became completely pain-free in her elbow and reported significantly reduced knee pain. Not only was Apii able to compete more comfortably and perform well in the 2018 Commonwealth Games, she was able to reduce her risk of further compensatory injuries.
Having only recently joined Apii on her journey, we are excited with the progress made so far. Moving forward, we are looking to implement a progressive balance, strength and conditioning program. The aim of this being to continue improving her mechanics of throwing, eliminate her knee pain completely, and enhance performance to the best of her ability.
If we had only treated the localised areas of Apii’s symptoms without analysing her full body biomechanics, we would not have been able to achieve these outcomes. This unique approach to sports Physiotherapy is how Kinematics is different. At Kinematics we don’t just diagnose and treat at the site of pain, we go above and beyond to identify all the contributing factors of the issue. We also ensure that everything we do is patient-centered by incorporating core values and beliefs whilst working towards specific individualised goals.
By Jay Main
Kinematics Health + Performance
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