When spring comes, it's not only plants that leap into life.
People pull on their sports gear and get moving, often with too much enthusiasm. Then they come unstuck.
New Plymouth Physiotherapy owner Anita Walsh says her practice sees more preventable injuries in spring than in any other season.
"The injuries people get at this time of year are from moving too fast, too soon."
People may have deconditioned over the winter, so their bodies aren't strong enough to cope with a burst of full-on exercise. "They need to build up again."
Someone with a previous injury may have rested over winter and then started exercising again after three or four months. "But the consequences of that injury are still there," she says.
Walsh explains that if someone has a sore ankle, they may have unknowingly developed a limp. "If something hurts, we move in a different way and that's not the right way."
The brain becomes used to that pattern of moving and further injuries can occur.
"The brain has to be retrained - it's not automatic."
Walsh says a patient of hers had knee surgery and two months later she saw him in the street still limping.
"I tapped him on the shoulder and said, 'why are you doing that?'. He didn't know he was limping."
She reminded him of the exercises he had been shown.
A big role of physiotherapy is helping people to move correctly so they don't get those secondary consequences. "That's at all ages. The elderly need the same support as the young and our athletes," says Walsh, who has been working with the Taranaki rugby team since 1993.
"We just have to find out what your weaknesses are and manage them - we are not trying to make people into super humans."
When a person is under the care of a physiotherapist, he or she should expect to have an exercise or stretching programme as part of the treatment. If a patient hasn't been doing that programme or has forgotten what to do, he should book in for a biomechanical assessment.
"We will look at how they are moving, the strength and flexibility of their muscles and give them simple exercises they can do at home or in the gym," Walsh says.
"We need constant reminders and reinforcement.
"Become a friend to your physio."
Walsh says people can visit a physiotherapist to get a checkup before springing into exercise - they don't need to be injured to make an appointment.
"We get warrants of fitness on our cars, but we don't on our bodies until they break down," she says. "So get a warrant of fitness on your body - they are much more precious than our cars."
Osteopath Mick McBeth believes the best way to avoid injury is to be well conditioned for the exercise or sport a person is planning to do.
The core components of conditioning are flexibility and strength.
"People need to make good choices in what they plan to do," says McBeth, who owns Body Logic in New Plymouth.
"They need to make sensible progression.
"What we often see is spring comes around and people make the choice that 'I'm going to do a half-marathon or half-ironman'. They have the energy, so they go like a bull at a gate, but the body is not up for it."
These new-season athletes will last at that pace for one to two weeks. "Then we see them start to come in."
Achilles tendon, hamstring, knee and ankle injuries are the most common.
To avoid the pain, people need to make a plan and have someone who knows what they are doing go over it with them.
That's something an osteopath can do.
"I can give advice in many different areas - what goals they've got and break it down. If I feel it's something in their muscular skeletal system that's predisposing them to an injury, I will address that."
Mick, who was the osteopath for the New Zealand triathlon team at this year's London Olympics, says he gives massages, exercises to correct problems and treatments for injuries.
"We get people in for 30 minutes a week, but what they do in the rest of the week that's the most important."
For people who are bigger, he will recommend lower impact activities, like swimming and cycling, to lessen the chance of injury.
"If someone is wanting to do a half-marathon and they are a big person, cross-training is a great way to get fit without the impact."
Unless people are used to running, it's one of the worst sports to do.
"If you've been running from a young age and keep running throughout your life, then you can run as much as you want."
But then there are the people who used to run when they were younger and haven't been out pounding the pavement for 10, 20 and sometimes 30 years. "That can lead to an undesirable outcome in terms of injury," he says.
"If running is the desired outcome or goal then make slow progression back into running by using soft trails, doing low mileage and wearing the correct footwear."
An osteopath is trained to consider the person as a whole, mechanically, emotionally and even their environment.
"When someone starts a goal and then becomes unable to train or have an injury, they are frustrated - that's like an indirect stress from the training."
Then there are those on the other side. "You can have too much drive. Sometimes an osteopath has to rein in their passion."
To prevent injury, people have to ensure the exercise is appropriate for their fitness and size.
Sports and soft tissue therapist Roger Gooch is on the same track.
"What I think people need to understand is that if you have been inactive for five years, you can't get straight back into things."
Having ongoing massage sessions with a quality soft-tissue therapist can definitely help people in training keep injuries at bay.
"Fortnightly is ideal and weekly is gold seal," he says.
Massage frees up restrictive tissue that people get from heavy training and enables the therapist to prevent that stiffness turning into more serious injuries.
"It puts out little fires and decreases the amount of muscle spasms," Gooch says.
"The skill of the practitioner is to find where those restrictive areas are within the soft tissue, unbind them and then also treat the other parts of the body to help condition the client for ongoing training."
Gooch says he likes working with triathletes because running is generally the most injury-prone activity. "They can swim and cycle. But if you tell a runner to go swimming they will look at you oddly."
There is also a new breed of cyclists coming through - the over-40s who would still like to run, but they can't because they have chronic injuries.
"It's the baby boomer age - they are slowly wearing themselves out."
Massage is great for prevention and maintenance, says Gooch, who was massage therapist to the New Zealand team for the 2000 Paralympics and sports massage therapist to the New Zealand team at the 2004 Athens Olympics, where he worked closely with K-1 1000-metre silver medallist Ben Fouhy. For the past 10 years he has worked with ironwoman Joanna Lawn. "She has not missed a race in the last 10 years through a soft tissue injury."
While this treatment is much needed by elite athletes, Gooch says the "weekend warrior" would also benefit from regular sessions with a sports massage therapist.
These may include a corrective exercise programme to get them functioning properly. He does gait analysis, muscle length testing and looks at muscle firing patterns. "Do your gluts work? Most people have very average glut function."
People need to have good mobility, stability and strength, but the first two are the most important. One of the most overlooked areas of dysfunction is the hip, Gooch says.
"The key to good sports therapy is if someone appears with a symptom you treat that and then treat the underlying cause."
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