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Physiotherapy at the Olympics

Sarah worked with the National Alpine Ski team for five years through her affiliation with the Canadian Sport Institute (CSI). During her time as lead physiotherapist at CSI Calgary, Sarah gained extensive experience rehabilitating complex injuries in elite snow sport athlete populations. Her highlights include working as a medical team member at the 2018 PyeongChang Winter Olympic Games and two FIS World Ski Championships. Sarah is a Pelvic Health Physiotherapist at our Evidence Sport and Spine South location.  We caught up with her to find out some of her best experiences in the Olympics. We also got a great lesson on how the complexities of an athlete’s needs correlate to other individuals as well. 

How prevalent was pelvic floor dysfunction in the populations you worked with?

Anecdotally, I’ve found pelvic floor dysfunction to be much more prevalent than I would have expected, both in both elite athletic and “general” populations. Within the sport world, I encountered many athletes with pelvic floor dysfunction, primarily in the form of pelvic floor muscle overactivity. Some cases stemmed from pelvic organ pathology, such as the athlete who sustained a pelvic organ prolapse from repetitive heavy weight lifting. However, a large number of cases involved athletes with chronic orthopedic injuries - ranging from low back pain to lower limb overuse injuries. Upon further questioning, the presence of subjective pelvic health complaints (i.e. incontinence, pelvic pain) in addition to injury chronicity prompted me to view these cases through a pelvic floor lens.

What’s the biggest mechanical difference between high-performance athletes and those of us who are not Olympic level?

Elite athletes push the envelope, always seeking higher, stronger or further.  Most of their kinematics and techniques are highly practised, but at times, they are masters at cheating! I often find otherwise well-trained athletes lack pelvic girdle movement literacy. Examples include breath holding, over-bracing, and suboptimal trunk-pelvis movement strategies as ways to cope with high loads, fatigue, and complex movement tasks.

Conversely, athletes absorb loads so great that typical movement patterns are neither realistic nor ideal in the most strenuous of situations. Skiers absorb approximately three times their weight in ground reaction forces during a single giant slalom turn while travelling 90 km/hr. In the instance of an alpine ski athlete with chronic low back pain (and a history of pelvic floor dysfunction), I was compelled to better examine breathing and core canister patterning in response to high intra-abdominal pressures but acknowledged that perfection was perhaps not realistic nor ideal in the most strenuous of situations.

If we’re more likely to be in the stands than on the field, what is the biggest takeaway we can learn from your experiences?

The biggest takeaway is that whether you are a weekend warrior or an olympic gold medalist, progress towards a fitness or rehabilitation goal is never perfectly linear. Elite athletes experience good days and bad days as well. The most resilient athletes are (most days) able to maintain a positive outlook and persevere regardless of the state of their health or performance. 

What’s your best funny story from 2018?

Haha all of my favourite stories probably shouldn’t be shared!

Is there a moment you were blown away or so proud of being Canadian while you were at the 2018 games?

While there were many moments during the games where I felt proud to be Canadian, the lead up to the closing ceremonies was an understated but special moment. The entire Canadian team was corralled into a waiting area. Standing to shoulder with 200+ friends and strangers from around the country, all dressed head to toe in the exact same outfit. Everyone is hugging, laughing, reminiscing.  It was one of the most intimate and unique atmospheres.

What’s the best advice you learned from a mentor or colleague?

Physiotherapists are constantly learning and applying new skills to their practice, and it’s easy to get tunnel vision and focus on one or two aspects of therapy. The best advice I ever got was to not lose sight of the big picture, and to never underestimate the importance of health and wellness basics. If an athlete isn’t getting proper sleep, nutrition, or dealing with stress in a productive manner, our manual therapy and therapeutic exercise treatments are not enough address the whole picture. 

Sarah graduated from the University of Calgary with a Bachelor of Kinesiology in 2008, followed by a Masters of Physiotherapy from the University of Alberta in 2011. Sarah is a pelvic health physiotherapist who treats a wide range of conditions including incontinence, pelvic organ prolapse and pelvic pain. She has additional training in pregnancy and post-partum pelvic pain management and exercise prescription. She strives to educate and empower each client so that they can make informed decisions throughout their rehab journey.
Prior to becoming a pelvic health physio, Sarah spent numerous years working in orthopedic and sports therapy settings. She has received additional training in orthopedic manual therapy, functional movement, acupuncture and functional dry needling. Sarah acted as the lead physiotherapist for the National Alpine Ski Team for three years, and was a medical team member at the 2018 PyeongChang Winter Olympic Games. Sarah enjoys skiing, hiking and spending time outdoors with her young family.