Life style
Physiotherapy for optimal performance in sports
BY RANDIMA ATTYGALLE
Sports physiotherapy is a specialized field that focuses on the prevention, treatment, and rehabilitation of injuries related to sports and physical activity. Unlike general physiotherapy, which encompasses a broad range of medical conditions, sports physiotherapy addresses the unique needs of athletes and active individuals.
With their specialized knowledge, sports physiotherapists, manage sports injuries, enhance athletic performance, implement injury prevention strategies, and contribute to the overall health and well-being of players and athletes. The role of the sports physiotherapist in international sports competitions is significant today.
In an interview with Sunday Island, Dr. Subashini Jayawardana, senior physiotherapist, educator, and Head of the Department of Allied Health Sciences at the Faculty of Medicine, University of Colombo, sheds light on this specialized branch of physiotherapy which calls for better recognition here at home.
Following are the excerpts:
Q: Could you brief on the scope of physiotherapy in sports?
A: A sports physiotherapist plays a crucial role as part of a multidisciplinary team, working alongside coaches, trainers, massage therapists, sports physicians, counselors, and nutritionists. The primary responsibility of the sports physiotherapist is to help athletes and sports professionals perform at their optimal levels by preventing injuries and managing them through acute interventions and rehabilitation.
However, the role of sports physiotherapists extends far beyond injury treatment. They also assist uninjured athletes in maintaining musculoskeletal fitness and facilitate post-competition recovery, contributing significantly to the overall enhancement of athletic performance.
Sports physiotherapists rely on evidence-based practices to ensure the highest standards of clinical care. The International Federation of Sports Physical Therapy (IFSPT), a global body representing national sports physiotherapy organizations, has established competencies and protocols aimed at elevating the practice of sports physiotherapy worldwide. These guidelines not only provide a framework for the professional conduct of sports physiotherapists but also promote safe participation of athletes and foster the ongoing development of professionals within the field. By adhering to these standards, the IFSPT aims to improve the quality of sports physiotherapy and ensure the continued advancement of athlete care globally.
Q: What are the short-term and long-term objectives of physiotherapy?
A: The short-term goals of sports physiotherapy focus on effectively managing acute symptoms, such as pain and swelling, following a sports injury. Immediate physical intervention offers numerous benefits, including the prevention of further damage or recurrence of the injury, as well as promoting faster recovery.
Long-term objectives, on the other hand, are centered on ensuring the athlete’s safe return to sport, rebuilding confidence, and achieving enhanced performance levels.
Q: What is the preventive aspect of sports physiotherapy?
A: Physiotherapy plays a critical role in the prevention of sports injuries by employing a comprehensive approach that combines injury risk assessment, biomechanical evaluation, personalized exercise programmes and education on proper movement techniques.
Injury risk assessments allow physiotherapists to identify potential weaknesses and imbalances that may predispose athletes to injury. Meanwhile, biomechanical evaluations analyze sports-specific movement patterns and techniques, helping to ensure that the bones, muscles, and joints function optimally and healthily.
Based on these assessments, physiotherapists develop tailored exercise programmes that address the unique needs of each athlete. These programmes incorporate sport-specific considerations, including warm-up routines, stretching, and strengthening exercises. Additionally, physiotherapists provide athletes with guidance on proper techniques and practices to minimize the risk of musculoskeletal injuries, ensuring safer and more effective performance.
Q: What is the injury-related role played by physiotherapy?
A: When an athlete sustains an injury, physiotherapists intervene across three key stages: the acute phase, the sub-acute phase, and the rehabilitation phase.
During the acute phase, physiotherapists provide immediate on-site support at the time of injury. The sub-acute phase follows, typically lasting from several days to a few weeks after the injury. The rehabilitation process is a critical phase where careful management is essential to ensure a smooth, injury-free return to sport. The physiotherapist’s focus during this phase is on restoring movement control, regaining joint range of motion, and rebuilding muscle strength.
The rehabilitation phase is vital for minimizing the risk of re-injury when the athlete returns to sport. Physiotherapists conduct physical examinations and tailor interventions to meet the specific needs of the athlete. For athletes undergoing surgical interventions, such as ligament reconstruction, physiotherapists follow evidence-based treatment protocols to ensure optimal recovery and successful outcomes post-surgery.
Q: What are the short-term and long-term repercussions of unaddressed sports-related injuries?
A: Secondary trauma is the immediate repercussion. When a player or an athlete is injured his/her common psyche is that regardless of the injury he/she can continue to play or compete. The mind-set is such, we often see them being reluctant to get out of the field. For example, if a badminton player suffers a partial meniscus tear in the knee and continues to play without seeking professional physiotherapy or medical advice, there is a high risk of causing further damage to the meniscus, potentially requiring surgical intervention. This could result in the athlete being sidelined for an extended period, significantly affecting their career.
Neglecting timely and appropriate medical treatment and physiotherapy can increase the risk of aggravating the condition, leading to frequent recurrences and a decline in performance. In many cases, this can ultimately force athletes to abandon their sports careers prematurely.
Furthermore, damage to soft tissues in weight-bearing joints, such as the knee, can lead to long-term complications, including degenerative arthritis in later years. Without proper rehabilitation in the early stages, athletes may eventually require joint replacement surgeries, further diminishing their quality of life and mobility as they age.
Q: What are the advancements found in sports physiotherapy in terms of diagnostics and treatment modalities?
1. Advancements in Diagnostics
High-Resolution Ultrasound: The resolution of ultrasound imaging has greatly improved, enabling physiotherapists to visualize soft tissue injuries, tendon damage, muscle strains, and joint abnormalities in real-time. This technology aids in monitoring tissue healing and guiding targeted therapeutic interventions.
Advanced Motion Capture Systems: Techniques like 3D kinematic analysis are now used to assess an athlete’s movement patterns, helping to identify abnormal motions or compensations that could lead to injury. Early intervention can thus be made to prevent further damage or enhance performance.
Wearable Devices: Devices such as accelerometers, gyroscopes, and pressure sensors provide real-time data on movement mechanics, load, and forces. This continuous monitoring allows physiotherapists to track athletes’ progress and adjust treatment plans accordingly.
2. Advancements in Treatment Modalities
Instrument-Assisted Soft Tissue Mobilization (IASTM): utilize specialized instruments to break down scar tissue and facial adhesions, improving mobility and alleviating pain.
Active Release Technique (ART): ART targets soft tissue restrictions caused by muscles, tendons, ligaments, and nerves. Commonly used for treating overuse injuries, this hands-on technique aids in restoring optimal tissue function.
Dry needling: involves inserting fine needles into trigger points to relieve muscle tension and improve blood flow. It is particularly effective for treating myofascial pain and chronic muscle tightness, common among athletes suffering from muscle strains.
Postural and Core Stability Training: These exercises focus on enhancing posture, balance, and core strength, preventing injury and improving performance.
Sport-Specific Rehabilitation: Treatment protocols are increasingly customized to address the unique movement patterns, agility drills, and strength requirements of the athlete’s sport.
Virtual Reality (VR): VR technology is being used to simulate real-life sports scenarios, aiding in functional movement recovery. This immersive environment enhances both cognitive and motor rehabilitation for athletes.
Telehealth & Remote Monitoring: Telehealth allows physiotherapists to conduct virtual consultations and monitor recovery remotely. Wearable devices integrated with apps enable physiotherapists to track progress and make adjustments to treatment plans in real-time.
Active Recovery & Compression Therapy
Devices like pneumatic compression sleeves and cryo-compression systems have been developed to accelerate recovery. These devices improve circulation, reduce swelling, and enhance tissue oxygenation, speeding up the healing process.
Hydrotherapy
Water-based therapies, including swimming and underwater treadmills, offer a low-impact environment for rehabilitation.
Q: What is the Sri Lankan situation in terms of awareness and adherence to physiotherapy in the sports arena, especially at school level?
A: In some of the leading schools in Colombo, as well as a few regional schools, physiotherapists are employed to support competitive sports such as rugby and cricket. However, for other sports, particularly athletics, the presence of a physiotherapist is virtually nonexistent. This gap may be attributed to a lack of awareness among relevant authorities about the crucial role of physiotherapy in sports.
Q: What is the level of accessibility to sports physiotherapist in the state sector?
A: The Ministry of Sports has a dedicated unit that focuses solely on national athletes, but there is a need to enhance its capacity. The Sri Lanka Cricket Board also operates its own physiotherapy unit.
The sports physiotherapy unit at the National Hospital can only cater to a limited number of athletes due to constraints in infrastructure and human resources. On a positive note, the Department of Allied Health Sciences at the Faculty of Medicine, University of Colombo, runs a sports physiotherapy clinic that is currently undergoing expansion. We strongly encourage athletes and sports enthusiasts to take advantage of this clinic, as the services provided are completely free of charge.
Q: What are the local state institutions which offer qualifications in physiotherapy?
A: The Faculty of Medicine at the University of Colombo, the Faculty of Allied Health Sciences at the University of Peradeniya and the Kotelawala Defence University (KDU) are the key state institutions in Sri Lanka offering four-year degree programmes in physiotherapy. Each year, approximately 120 students graduate from these institutions.
Q: Finally, what needs to be done to recognize the role of physiotherapy in local sports?
A: Beyond the innate talent of an athlete, achieving success on the global stage requires the professional expertise of physiotherapists from the outset of their training. Unfortunately, outside of cricket, physiotherapists are seldom seen accompanying Sri Lanka’s national teams on international tours. While athletes may have access to local professionals in the host country in the event of an injury, it is crucial that they have the support of a local physiotherapist who is familiar with their medical history, pre-existing conditions and previous injuries to provide more effective emergency care.
Modern rehabilitation approaches have far surpassed traditional methods, now focusing on active rehabilitation that requires the full engagement of both the athlete and the entire rehabilitation team. In a multidisciplinary sports team, which includes coaches, sports physicians, massage therapists, and other professionals, each member plays a vital role. The success of the team depends on the understanding and mutual respect for each professional’s expertise, with the athlete at the center of the process.
In Sri Lanka’s sports landscape, there is a growing need for greater recognition of the physiotherapist’s role in helping athletes and players reach their full potential. A more prominent position for physiotherapists within the sports community is essential to ensure that athletes receive the comprehensive support they need for optimal performance and recovery.
Life style
From colour to contour: Ramani Fernando on what next in 2026
Every year style and beauty evolve in exciting new directions. We met Ramani Fernando, one of Sri Lanka’s most celebrated hair and makeup artists, to get an insider’s news on the trends shaping 2026. From daring hair colours to refined makeup palettes, Ramani shares her expert insights on how brides and fashion forward women can carry the season’s looks with confidence and elegance.
As the beauty industry moves into 2026, one thing is clear, excess is giving way to elegance, and individuality is the new luxury. Ramani believes 2026 is all about refinement, health and personal expression, rather than rigid trends. Over styled hair is fading away she explains soft layers, lived in waves and gentle volume will dominate, replacing heavy curls and stiff finishes. Bridal hair, the emphasis is on romantic simplicity – loose chignons, modern buns and softly structured hairdos. When it comes to colour, natural tones are evolving, expect warm browns, soft caramels, muted coppers and delicate face framing highlights.
Beauty Trends 2026 — Ramani Fernando
When you look ahead to 2026, how would you describe the overall beauty mood?
The beauty mood for 2026 is refined, confident, and very intentional. It’s about individuality rather than excess — effortless luxury, where everything looks polished but never overdone.
What hairstyles will define 2026, especially for brides and formal occasions?
We’ll see soft structure — modern chignons, low textured buns, sleek ponytails with a twist, and relaxed waves that move naturally. Hair looks styled but touchable, with a strong emphasis on shape and finish.
Are brides moving away from traditional styles?
Yes, absolutely. Brides still respect tradition, but they want it reinterpreted. They’re choosing styles that reflect who they are rather than following a set bridal “rulebook.’
- Soft colours and pastels
What role do accessories play in 2026 trends?
Accessories are statement pieces. From sculptural hairpins to fresh flowers and couture headpieces, they’re used thoughtfully to elevate a look rather than overwhelm it.
. How is hair colour evolving in 2026?
Hair colour is becoming softer, richer, and more dimensional. The focus is on healthy shine and colours that enhance skin tone rather than dramatic contrasts.
Which shades will dominate this year?
Warm brunettes, soft mocha, honey blondes, champagne tones, and muted coppers will be very popular. Natural-looking luxury shades are key.
Are bold colours still relevant?
Yes, but in a more curated way. Bold colours appear as accents or in editorial looks, not as everyday statements. It’s about confidence, not shock value.
What’s the biggest makeup shift you’re noticing for 2026?
Skin is everything. Makeup is moving toward enhancing rather- masking — luminous, healthy skin with strategic definition.
Is natural makeup replacing glamour?
Not replacing, but redefining it. Glamour in 2026 is sophisticated and subtle. Even a bold look is rooted in flawless skin and balance.
What colours and finishes are trending?
Soft neutrals, warm browns, rose tones, muted peaches, and bronzed finishes. Creams and satins are preferred over heavy mattes.
What advice would you give brides planning their 2026 look?
Stay true to yourself. Choose a look that feels timeless, comfortable, and confident. Trends should enhance your personality, not overpower it.
What defines beauty in 2026 for you?
Authenticity. Beauty is about confidence, self-care, and feeling like the best version of yourself — not trying to look like someone else.
Why has skin become the focus point of beauty in 2026?
Because healthy skin is the foundation of everything. When skin looks good, makeup becomes effortless. Clients are investing more in skincare, and it shows — beauty now starts long before the makeup chair.
Life style
Chekhov Sandhyava: A Sri Lankan Evening with a Russian Master
More than three decades after it first illuminated a Colombo stage, Chekhov Sandhyava returns—not as a relic revived for nostalgia, but as a living theatrical conversation between Sri Lanka and one of world drama’s most perceptive minds.
Its revival on January 29, 2026, is quietly momentous, coinciding with the 166th birth anniversary of Anton Chekhov and the 88th birth anniversary of Professor Sunanda Mahendra, the scholar, translator, and theatre-maker who first imagined this encounter for Sinhala audiences.
Unlike conventional productions that centre on a single canonical text, Chekhov Sandhyava is conceived as an evening—a carefully composed sequence of short works that together reveal Chekhov’s range, irony, and emotional restraint.
The programme brings together adaptations of The Proposal, Swan Song, A Summer in the Country, Nincompoop, and a brief satirical piece addressing the destructive effects of tobacco. Individually modest, collectively they form a mosaic of human behaviour that is unmistakably Chekhovian.
What distinguishes Chekhov Sandhyava is not merely its selection of texts, but its method of approach. Chekhov is not treated as a distant European classic preserved behind a glass case of reverence. Instead, his characters are allowed to breathe within a Sri Lankan theatrical sensibility—shaped by spoken Sinhala, local performance traditions, and an instinctive understanding of social awkwardness, suppressed desire, and quiet disappointment. The laughter, pauses, and silences feel familiar, suggesting that Chekhov’s insights into human nature travel effortlessly across geography and time.
The origins of Chekhov Sandhyava can be traced to the late 1980s and early 1990s, a period when Professor Sunanda Mahendra was deeply engaged in theatre education and practice in Sri Lanka. Although Chekhov was widely read and discussed, his plays were rarely staged in Sinhala with sustained seriousness. Mahendra’s objective was both pedagogical and artistic: to introduce Chekhov not through academic theory, but through the immediacy of performance.
The first staging took place in 1991 at the Soviet Cultural Centre in Colombo. Emerging from the work of theatre students and practitioners, it was conceived as a collective exploration rather than a conventional repertory production. Over time, it came to be recognised as a milestone in Sinhala theatre, opening pathways for further translations, adaptations, and deeper engagement with Chekhov’s dramatic method.
Central to this achievement was Mahendra’s work as translator and adaptor. Drawing from English translations of Chekhov’s Russian originals, he reshaped the texts with careful attention to linguistic rhythm and theatrical economy. The current revival extends that legacy.
New adaptations of The Proposal and Swan Song by Ravindu Mahendra draw on multiple English translations while remaining faithful to the emotional texture of the originals. The emphasis is on restraint rather than exaggeration—on allowing Chekhov’s humour and melancholy to surface naturally.
The 2026 production is directed by Ravindu Mahendra, who also performs alongside a seasoned ensemble that includes Prasannajith Abeysuriya, Wasantha Moragoda, Seneviratne Rudrigo, Jayani Sarathchandra, Indika Jasinghe, and Ajith Sirimanna. Music by Gayan Ganadhari and costumes and visual elements are designed to support the understated tone of the plays, avoiding spectacle in favour of atmosphere.
The choice of venue—the Namel Malini Punchi Theatre in Borella—feels particularly apt.
Chekhov’s drama thrives on intimacy: on timing, gesture, and what remains unsaid between characters. Afternoon and evening performances allow audiences to experience the plays as they were intended—not as grand statements, but as close observations of human behaviour.
Chekhov Sandhyava
is also inseparable from the wider legacy of Professor Sunanda Mahendra, one of Sri Lanka’s most influential figures in theatre, literature, and media studies. Academic, broadcaster, playwright, translator, critic, and mentor, Mahendra helped shape modern Sinhala theatre through both practice and pedagogy.
His receipt of the State Drama Lifetime Achievement Award in 2023 acknowledged a career that consistently bridged scholarship and creativity.
In this sense, Chekhov Sandhyava is more than a revival. It is the continuation of an ongoing dialogue between Sri Lankan theatre and a playwright who resisted neat conclusions. Chekhov’s characters do not resolve their dilemmas; they talk, hesitate, joke, and fail. That quiet refusal of certainty—radical in its time—remains deeply resonant today.
By bringing these works back to the stage, Chekhov Sandhyava invites contemporary audiences to listen again: to silences, to half-finished thoughts, and to the small contradictions that define ordinary lives.
It is an evening that honours both a Russian master and a Sri Lankan tradition of thoughtful, serious theatre—one that understands that sometimes, the most profound truths are spoken softly.
By Ifham Nizam ✍️
Life style
he silent killer: why we ignore Osteoporosis
Silent yet destructive, Osteoporosis often advances without warning until a simple fall results in a life altering fracture. In this interview Dr. Anura Caldera, Consultant Rheumatologist sheds light on a condition long misunderstood as an inevitable part of ageing. He explains why Osteoporosis is preventable, detectable, and treatable when addressed early and awareness especially among women and the elderly can mean the difference between independence and disability. Drawing from years of frontline experience, Dr. Caldera unpacks the myths, risks and lifesaving interventions surrounding one of the world’s most under diagnosed bone diseases.
Dr. Caldera is a product of Royal College with advanced foreign training that has shaped his professional expertise. This blend of strong local education and global training has been central to the perspective and standards he brings to his work today.
All of us may have seen the elderly woman in the neighbourhood who broke her hip, disappeared from the community, and passed away a few months later. We may also have seen another woman who gradually stoops forward and ends up needing a walking stick in no time. But many of us may never have realized that these are complications of a disease that could have been prevented.
What is Osteoporosis?
Osteoporosis is a systemic bone disease that reduces bone mineral density, making bones extremely weak and fragile. This reduction in bone density makes bones highly prone to fractures, often involving the hip, spine, forearm just above the wrist and upper arm, even following minor falls.
What happens in Osteoporosis?
Bones are dynamic structures, meaning they are constantly being built up and broken down within the body. Two main cell types are responsible for this process: osteoblasts, which form bone, and osteoclasts, which break down bone.
When we are young and healthy, these cells work in perfect harmony, maintaining strong and healthy bones. Ideally, we should not fracture a bone even if we fall from our own height.
In Osteoporosis, this balance is tipped towards bone breakdown. Over time, bone mineral density gradually decreases to dangerous levels. At this stage, even minor trauma—such as slipping while trying to sit on a chair and falling to the ground—can result in a fracture, particularly of the hip.
Why aren’t patients aware of it?
The major problem with Osteoporosis is that it has no symptoms until it causes a fracture. When you have diabetes, you may urinate frequently, feel excessive thirst, and lose weight. When your heart arteries are blocked, you may feel breathless climbing a few stairs. When your kidneys are failing, your feet may swell. But with Osteoporosis, you feel nothing.
By the time symptoms appear, the disease has already manifested its complications—fractures. Most patients in Sri Lanka discover they have Osteoporosis only after breaking a bone.
Some patients gradually lose height over time due to silent fractures of the spine, known as vertebral wedge fractures. Sometimes the pain is so minimal that the patient is unaware a fracture has occurred. Degeneration of spinal discs can also contribute to height loss. A stooped posture may develop for the same reasons. Lower back pain usually appears only once fractures have occurred.
What treatment options are available?
The mainstay of treatment is anti-resorptive therapy, which is available in tablet, injection, and infusion forms. The most commonly used medication is alendronate 70 mg, taken once weekly on an empty stomach with 200 ml of water. Patients must remain upright and avoid eating for at least 30 minutes after taking the tablet.
There are also monthly tablet formulations. If oral medications are poorly tolerated, treatment can be switched to an annual infusion such as zoledronic acid or six-monthly denosumab subcutaneous injections. Other treatment options are also available.
In addition, patients require calcium and vitamin D supplementation. The minimum recommended intake is 700 mg of calcium and 800 IU of vitamin D, obtained through a combination of diet and supplements. Combination tablets containing calcium and vitamin D in these ranges are generally safe.
How long should patients be treated?
The duration of treatment depends on the individual patient. A common misconception is that five years of treatment is sufficient for everyone. This is incorrect.
Decisions regarding treatment duration and drug holidays must be made carefully, based on multiple factors. Patients require regular DXA and FRAX assessments to monitor treatment response and identify new risk factors. If the response is inadequate, the physician may need to change the antiresorptive medication—for example, from oral therapy to infusion. Osteoporosis cannot be effectively managed by prescribing a single medication and assuming five years of treatment will resolve the condition.
Why is Osteoporosis called a “silent killer”?
Osteoporosis-related hip fractures significantly increase the risk of death within the following year, with up to 30% of patients dying within 12 months of a hip fracture. Death often results from complications such as pneumonia or blood clots due to prolonged immobility.
A significant number of survivors also lose their independent mobility after a hip fracture. Therefore, it is far better to be safe than sorry—get tested and treated when necessary. One of the greatest assets in old age is independent mobility, which allows a person to remain self-sufficient and maintain quality of life.
As a result, patients tend to attribute their pain to this condition. However, the real cause may be that one of the weakened vertebrae has already fractured and collapsed, and the next bone at risk of fracture could be the hip.
Which patients are most affected?
Peak bone mass is achieved in the early 30s, after which bone mineral density gradually declines. This loss is usually minimal and does not significantly increase fracture risk.
However, once women reach menopause, the lack of estrogen accelerates bone loss to a level where bone mineral density may reach Osteoporotic levels.
A study conducted in Sri Lanka in 2004 by Prof. Sisira Siribaddana and Prof. Sarath Lekamwasam revealed that 42.3% of women aged 50-59, 67.5% of women aged 6069, and 81.6% of women over 70 had Osteoporosis. According to similar studies, 94% of Sri Lankan patients with Osteoporosis are female. These figures are notably higher than those seen in many developed countries, where the prevalence is lower.
How can we diagnose this condition?
Any woman over the age of 50 should undergo a “fracture risk assessment”. Those with an intermediate or higher risk should then have a bone mineral density assessment using a DXA scan. This scan measures bone density in the spine, hip, and, in selected cases, the wrist.
The T-score is used to guide treatment decisions in most patients. However, a FRAX score—calculated using an online tool—is particularly useful for patients with borderline bone density (Osteopenia), as the DXA scan alone cannot reliably predict hip or major Osteoporotic fracture risk in all individuals.
There is one situation where treatment is initiated even without a DXA scan: when a patient has already suffered a fracture believed to be due to Osteoporosis. In such cases, treatment is started even if the DXA scan (Dual Energy Xray Absorptiometry scan) does not show established Osteoporosis.
Additional blood tests may be required, though not all are necessary for every patient. These commonly include serum calcium, vitamin D levels, parathyroid hormone levels (in selected patients), and routine kidney and liver function tests. Further investigations may be arranged on a patient-by-patient basis.
Are there other high-risk groups apart from post-menopausal women?
Yes. Other risk factors include advancing age, low Body Mass Index (BMI), previous fragility fractures, a parental history of hip fractures, long-term steroid therapy (more than three months), smoking, alcohol consumption exceeding three units per day, rheumatoid arthritis, type 1 diabetes, chronic liver disease, chronic kidney disease, sex hormone deficiency, and concurrent malignancy.
FRAX score is a fracture risk assessment tool that is particularly valuable for patients who do not meet treatment thresholds based on DXA results alone.
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