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Do you need a Belfast Physio?

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The Physio Group, located at 37 Kilmorey Street in Newry, is a physiotherapy and sports injury clinic that first opened its doors in 2005. And now operates out of three clinics; BelfastNewry and Newcastle

“The Newry Clinic for Physiotherapy and Sports Injuries” was the Clinic’s initial name. Soon after this, it immediately rose to prominence as one of the area’s premier musculoskeletal private clinics. Then, a second clinic was opened in the heart of Belfast City Centre (Alexander House, 17 Ormeau Avenue, Belfast, BT2 8HD) to service current Newry customers studying or working in Belfast City Centre. However, because it is easily accessible to local office employees, it has swiftly established itself in Belfast. Since then, a third clinic has opened in Newcastle (1 Shimna Road, Newcastle, Co. Down, BT33 0AS). This purpose-built Clinic is conveniently accessible to clients from the surrounding region. 

Who is behind The Physio Group?

Frank Quinn and Kieran Murray, both very accomplished Chartered Physiotherapists, are the two partners behind The Physio Group. They’ve worked in the English Premier League (Sunderland AFC), Rugby League ( Gateshead Thunder) and men’s and women’s inter-county Gaelic football with Down and Antrim GAA, as well as ladies’ MMA fighter Leah McCourt.

‘BEST MUSCULOSKELETAL EXPERIENCE AVAILABLE’

The Clinic’s mission is to set the standard by constantly providing the most excellent musculoskeletal experience possible.

Continued Professional Development is a priority for our Musculoskeletal Physiotherapy Specialists. This guarantees that our clients receive the best possible therapy, given in a professional and timely way.

The Physio Group is more than just a sports injury and physiotherapy clinic. As well as Sciatica, Frozen Shoulder, Tennis Elbow, Whiplash, and Low Back Pain treatments are available. Therefore, any muscle, joint, ligament, or nerve damage can be treated at the Clinic. MANIPULATIONMASSAGEACUPUNCTURE, or PILATES are some of the techniques used. For a complete list and description of the treatments we offer, visit our SERVICES section. Occupational health services, such as workplace and ergonomic examinations, are also available at the Clinic.

Looking for a Belfast physio? We can help.

Are you suffering some joint pain and are looking for a physio in the Belfast, Newcastle or Newry areas? Our physios are fully qualified and insured to help get you back on your feet. Book your appointment today.

THE PHYSIO GROUP – BELFAST

TEL: +44(0)28 908 97554 

The Physio Clinic Belfast: Appointments are Monday to Friday with some early morning and as well as some late evenings.

Best Exercises for Golfers

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Any force required by a golfer to generate a long-distance golf swing originates in the legs. As a result, if you aggressively activate your leg muscles during golf fitness routines, you’ll see an increase in clubhead speed. You’ll also notice that you’re able to better steady your swing, enhance flexibility, and reduce strain to avoid injury.

Because the bulk of the weight is transferred to the legs when you swing your club, you may overload without feeling the weight. You can achieve adequate load on the swing without slipping or swaying by encouraging stability with powerful legs. Leg exercises are beneficial to all levels of golfers, including beginners, the elderly, and those recovering from injury.

Top Golf Exercises for the Leg Muscles

Romanian Deadlifts

This exercise, also known as RDLs, works all of the muscles that generate power as well as those that stabilise the hip complex. To build powerful hips, you’ll need optimal stability as well as maximal muscle fibre activation.

How to do it:

  • Begin slowly, concentrating on form.
  • Perform 3 to 4 sets with a weight that seems somewhat heavier hanging from your arm.
  • Master the movement first, then go to power training.
  • Start with 8 to 12 repetitions and progressively lower the number as the resistance increases.

Lateral Band Walks

This exercise may appear simple, but it’s essential you strengthen the gluteus medius muscle. This allows your knees to take the lead on the downswing, promoting optimum stability.

How to do it:

  • To begin, choose the appropriate band.
  • Do 10 to 20 back-and-forth walks to the left of your starting location.
  • You’ll start to feel the burn in your muscles after two long walks.

Get in touch – we can help.

Are you suffering some joint pain and are looking for a physio in the Belfast, Newcastle or Newry areas? Our physios are fully qualified and insured to help get you back on your feet. Book your appointment today.

THE PHYSIO GROUP – BELFAST

TEL: +44(0)28 908 97554 

The Physio Clinic Belfast: Appointments are Monday to Friday with some early morning and as well as some late evenings.

THE PHYSIO GROUP – NEWRY

TEL: +44(0)28 3026 9733

The Physio Clinic Newry offers appointments from early in the morning until late evenings, Monday to Friday, as well as Saturday mornings.

THE PHYSIO GROUP – NEWCASTLE

TEL: +44(0)28 4321 8005 

Preventing Running Injuries

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It can be challenging to get your body’s kinetic chain to work as a single, well-functioning system. The payoff is enormous, especially for endurance athletes. Consider a body that is injury-free and capable of producing more power and speed for a more extended amount of time when running. It now becomes a little simpler to shave minutes off those racing timings. Muscle imbalances are the most significant obstacles to overcome. Runners acquire these imbalances through months and years of training and begin to adjust in various ways.

For example, if you’re a quad-dominant when running, you’re more likely to get hamstring strains since that area is weaker and less flexible. Because it lacks strength, you’ll have to rely more on your quads to get through runs.

This might eventually result in an injury. You’ll be stronger and less prone to injury if you train the quadriceps, hamstrings, and glute muscles simultaneously.

Single-leg workouts are one of the most effective strategies to treat muscular imbalances. Balance is used in these workouts to isolate muscles on each side and strengthen them equally and separately. Try a mix of the following leg exercises to see if you can enhance your performance and get rid of those persistent ailments.

Squat with One Leg

Squat down by standing with your feet shoulder-width apart and bending your knees. Maintain as much straightness in your back as possible. Try it on one foot, with your resting leg bent behind you. On each leg, do two sets of 15 repetitions.

Calf Raise with a Single Leg

Slowly lift to your toes on one foot, then descend back down, using a wall or chair for support. On each leg, do two sets of 15 repetitions.

Get in touch – we can help.

Are you suffering some joint pain and are looking for a physio in the Belfast, Newcastle or Newry areas? Our physios are fully qualified and insured to help get you back on your feet. Book your appointment today.

THE PHYSIO GROUP – BELFAST

TEL: +44(0)28 908 97554 

The Physio Clinic Belfast: Appointments are Monday to Friday with some early morning and as well as some late evenings.

THE PHYSIO GROUP – NEWRY

TEL: +44(0)28 3026 9733

The Physio Clinic Newry offers appointments from early in the morning until late evenings, Monday to Friday, as well as Saturday mornings.

THE PHYSIO GROUP – NEWCASTLE

TEL: +44(0)28 4321 8005 

The Importance of Single-Leg Exercises

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At The Physio Group, we want to give you the best advice possible regarding health and wellness. That’s why we’ve created this informative guide on the importance of single-leg exercises. Find out the benefits and why you should incorporate them into your wellness routine. 

Single leg training

In recent years, single-leg training has gotten a lot of attention in injury prevention, rehabilitation, and performance improvement training programmes. Physiotherapists often utilise it for anterior knee discomfort. This is because the gait cycle, which is effectively a succession of single-leg bounds, dominates athletic movement abilities in the field and court sports. As a result, single-leg training is ideal for return-to-play programmes and sports performance enhancement. Because of the higher muscle activation with single limb exercise, it promotes higher muscular growth and strength.

Single leg Vs Double leg exercises

We just strengthen the primary movers when we undertake double leg movements like a traditional double leg squat. Single-leg exercises target not only prime movers but also stabilisers and neutralisers. So, what exactly does this mean? Single leg exercises, in essence, allow us to strengthen our muscles in the same way that we utilise them in everyday actions like walking and running. 

Anterior Knee Pain

Anterior Knee Pain is a term used to describe a group of individuals of all ages and levels of activity. The various symptoms under this umbrella term frequently include discomfort, inflammation, muscular imbalance, and instability of the knee’s extensor mechanism. Extensor mechanism dysfunction is the most prevalent cause of anterior knee discomfort, affecting up to 60% of the athletic population.

Exercise

End-stage rehabilitation and sport-specific activity, such as single-leg squats and single-leg box drops with eccentric control, are safe and beneficial. And should be incorporated in the complete rehabilitation of anterior knee discomfort. The single-leg squat is a particular favourite workout at The Physio Group (see image below). Strength, stability, flexibility, and technique are all necessary, and as previously said, we’re targeting and developing more muscles in a functional movement pattern! 

It’s also a good idea to do this action in front of a mirror so that you can focus on the ideal knee position and avoid the flexed knee slipping medially or laterally.

Get in touch – we can help.

Are you suffering some joint pain and are looking for a physio in the Belfast, Newcastle or Newry areas? Our physios are fully qualified and insured to help get you back on your feet. Book your appointment today.

THE PHYSIO GROUP – BELFAST

TEL: +44(0)28 908 97554 

The Physio Clinic Belfast: Appointments are Monday to Friday with some early morning and as well as some late evenings.

THE PHYSIO GROUP – NEWRY

TEL: +44(0)28 3026 9733

The Physio Clinic Newry offers appointments from early in the morning until late evenings, Monday to Friday, as well as Saturday mornings.

THE PHYSIO GROUP – NEWCASTLE

TEL: +44(0)28 4321 8005 

Common sports injuries – and how to deal with them

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Anyone who has ever participated in sports has most certainly had an injury of some type. Sports are physically demanding, putting our bodies through a variety of stress and pain.

There are several typical sports injuries in the field of athletic exercise. No matter how excellent shape you keep yourself in, you’re bound to get some kind of injury at some point.

Preventing and Treating Common Sports Injuries

Summer is almost around the corner, which means it’s time to get outside and enjoy some outdoor activities. Read on to discover how to avoid common sports injuries and how to cure them so you can enjoy the summer pain-free.

1) Runner’s knee

If there was an injury orthopaedic surgeons see constantly, it’s knee injuries. Therefore, one of the most effective means of prevention is to replace your running shoes and insoles regularly. Take a few days off from activity after an injury and take some anti-inflammatory medication. 

2) Shoulder injury

Injuries to the shoulder are frequent in a variety of sports. The most effective technique of preventive is just stretching correctly before exercise. Taking a rest and using anti-inflammatories are both helpful treatments.

3) Achilles Tendinitis

Thirdly, overuse of the Achilles Tendon (the rear of the ankle) can result in severe inflammation and discomfort. Stretching and calf muscle-strengthening activities can help avoid this ailment. When it is damaged, use RICE (rest, ice, compression, and elevation) and anti-inflammatories.

It’s best to wait till it’s completely healed before getting back into shape.

4) Concussion 

In addition, a blow to the head is the most common cause of this injury, which produces confusion and dizziness, among other symptoms. Our best preventative advice is to avoid any contact sports. Recovery takes time, rest, and the use of acetaminophen.

5) Ankle Sprain

Sprains of the ankle are prevalent in sports that demand a lot of running and twisting rapidly. Moreover, prevention entails strengthening your ankles to the greatest extent feasible. Therefore, RICE, anti-inflammatories, and ankle movement can aid with blood circulation.

Get in touch – we can help.

Are you suffering some joint pain and are looking for a physio in the Belfast, Newcastle or Newry areas? Our physios are fully qualified and insured to help get you back on your feet. Book your appointment today.

THE PHYSIO GROUP – BELFAST

TEL: +44(0)28 908 97554 

The Physio Clinic Belfast: Appointments are offered Monday to Friday with some early morning and as well as some late evenings.

THE PHYSIO GROUP – NEWRY

TEL: +44(0)28 3026 9733

The Physio Clinic Newry offers appointments from early in the morning until late evenings, Monday to Friday, as well as Saturday mornings.

THE PHYSIO GROUP – NEWCASTLE

TEL: +44(0)28 4321 8005 

GAA Return To Play

GAA Injuries Comments Off on GAA Return To Play

Slow and steady wins the race


With the world of GAA returning to training in the North from this week, the desire to jump straight back into high-intensity work is going to be off the charts. 

Following months in the wilderness, so to speak, being unable to officially work together as teams and even in small groups, due to the Covid-19 pandemic, teams across the six counties have already been out in force as they make a long-awaited comeback top the pitch. 

While many have been doing their own training over the lockdown period, very little can replicate the intensity of a team training session. However, with that comes the hugely increased likelihood of injuries occurring, something we saw plenty of during the truncated season last year. 

Top physiotherapist Frank Quinn, who has worked with the Down Senior Footballers over the years and has also been a part of the backroom team at Sunderland under the management of both Howard Wilkinson and Mick McCarthy, delved into the details of why some injuries on return to play are inevitable, how they can be avoided as much as possible and what players should be doing to minimise the risk of their seasons ending before they’ve even begun. 

“For me, the key thing is appreciating the full array of physical demands that Gaelic Games are made up of, and training for all those. A lot of people have been running 5ks and 10ks in parks and various places but they need to be getting back into agility and twisting and turning. If you’re trying to prevent injuries, you’re trying to prevent them from the full repertoire of anatomical aspects to the body,” explains Frank, who runs the Physio Group, with practices in Newry, Newcastle and Belfast.  

“So, it’s not just muscles, it’s ligaments and tendons as well. Tendons are a part of accelerating and decelerating, ligaments are a part of twisting and turning and what give the brain the signals to be aware of joint position etc. If you’ve been fairly linear and one-dimensional up to now, yes, you’ll have brought in a wee bit of endurance to the muscles. But it will be a bit one-dimensional in terms of speed. 

“It should be a case of beginning with plenty of agility work and then look at building up the pace of what you’re doing. For example, work at half-pace for a week and get the players operating with multi-directional activities that they haven’t been doing up to now. Controlled and uncontrolled turning, reaction work, is another progression. 

“You can set the cones out and ask players to move in a certain direction around them and utilise controlled turning, which is what we would use a lot of in rehab work. The progression to uncontrolled turning is a different dynamic and a different demand of the joints of the body to react to that.” 


INJURY INEVITABILITY 

While all the precautions in the world can be taken in order to avoid unnecessary knocks and niggles, if you want to get to the level required to perform to the best of your ability, intensity of training and pushing your body to certain limits are a given. 

With that comes the increased likelihood of your body giving in to some degree throughout the training process. 

“I think it is inevitable, because the longer you’ve been away from high-intensity exercise, the harder it is to get back to that level. So, there will be a degree of deconditioning so to speak,” admits Frank.  

“Even though the majority of injuries in Gaelic Games are still non-contact related, game scenarios still provide most of the statistics for injuries. If it’s the case where they’re going to cram more games into a shorter period of times than they would in comparison to any other year, by that definition alone, there are going to be more injuries.  

“What we learnt last year from the compacted season was that, if you are unfortunate enough to pick up an injury, then the likelihood is that you’re going to miss the main part of the competition you’re playing in. 

“Injuries will be inevitable, but they don’t have to be. The demands on the fixture makers are big. They might have to go with some things they don’t want to do, but have to. But, if a team is patient and has a manager or a coach confident enough to map out the season, it is possible to do well. A lot of the teams last year at the start of the Senior Football Leagues in Down weren’t overly competitive in it and were using it for the purpose of getting back up to speed in preparation for the Championship.   

“The key is for a manager to really know when he wants his players fit and peaking, to approach the season up to that point in a structured manner that will minimise the risk of injury,”.

“It all depends how those players have utilised their time. Rest alone will allow healing time for injuries, but it doesn’t necessarily prepare people of the particular demands of what the sport are,” he explains.  

“If you’ve been out for a long period of time, your body adapts or responds to overload. You have to challenge the body to do a wee bit more than it has previously done. That allows the body to adapt to the demands you’ve placed on it. It will lay down a thicker framework of muscle, stronger tendons and ligaments etc and that has to be an accumulation. As long as you’re on a rising plane of that over time, then that time will have been of benefit to those players. 

“At that stage, they will become injury free, they’ll be robust enough and they know that they’ve pushed their bodies to the normal demands of what games situations might be. Even though we haven’t had games in a long time, you can still get to a high level of simulating the demands of a game in a rehab situation.”  


If this is something that is giving you trouble and would like to book an appointment with Frank, you can do so by contacting us through the information below:


    *Article credit: Gareth McCullough – Newry Reporter Sports Editor*

    Hard Ground Injuries

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    Hard Ground Injuries

    Given the recent spell of dry weather the rise we see in ‘hard ground’ related injuries is inevitable. This is on top of rising training and playing levels during the summer months where we see the accumulative affect of overuse related injuries also. The areas that are mainly affected by the impact on hard ground are;

    1. Plantar fascia – sole of the foot
    2. Metatarsals – stress fractures more common
    3. Calcaneus – inflammation of the fat pad around heel and underlying bony bruising
    4. Achilles tendinitis
    5. Patella tendinitis
    6. Lower back – muscle spasm and stress fractures

    The main reason for the development of these type of injuries is due to how the body deals with the impact of when we hit the ground through our feet every time we take a stride. The intensity of the impact increases with the increase of speed we are moving at. The simple law of physics applies where action=reaction so if we hit the ground with a certain force then an equal and opposite force is reverberated up through the body. This force has to be somehow absorbed by the body and is done so using internal shock absorbing structures in areas like muscle, tendon and cartilage.

    When we run the ground reaction force to be absorbed by the body can be over 200% of our body weight. Therefore if we take an average sized male Gaelic footballer or Hurler weighing 80kg or around 12 stone the impact he would be absorbing is the equivalent of 160kg when running, the equivalent of 2 men. Maybe ‘piggy-back’ racing is not a bad exercise after all in terms of preparation for this absorption.

    The body is naturally able to cope with this impact but certain things dictate an inability for the body to cope eg.

    1. Tired or weak muscles not effective at their job
    2. Tendons that have to cope with an excessive amount of ‘spring’ due to muscles not doing their job
    3. Poor muscle function not protecting surrounding bones and joints therefore an over reliance on joint cartilage
    4. Consequent weakness appearing in bone and causing a small internal breakup of bone structure-stress fracture. This then cascades into a ‘crack in the windscreen’ effect which gradually worsens with repeated aggravation.

    Muscles are therefore vitally important in protecting the body from these type of injuries. They must be initially strong enough to do the job they are being asked. Muscles must have plenty of fuel supply to keep going. They must be given ample recovery time to repair in between training and games.

    Tips for avoiding injuries during the ‘hard ground’ season include

    1. Maintain your base level of muscle strength in the lower limbs with low intensity, maximum resistance exercises.
    2. Include gentle, static and dynamic stretching in the warm-up to prepare for the ‘springiness’ needed.
    3. Check your boots. All players should be wearing moulded studs and if the insole is not very comfortable you should source a pair that you can slot in to your boots.
    4. Avoid spikes in training load. Make any changes gradual over 2-3 sessions. Allow muscles time to recover.
    5. Refuel using proper hydration and food intake before, during and after sessions. ‘Dried out’ tendons, muscles and cartilage will give problems

    Get any of the above type of injuries addressed early. They may not be overly debilitating initially but their accumulative affect as the season goes on will ultimately leave you sitting on the sidelines for a long time!

    It would have been better to break my ankle rather than damage the ligaments

    Uncategorized Comments Off on It would have been better to break my ankle rather than damage the ligaments

     

    ankle

    Very often we hear a frustrated client claim they wish they had broken a bone rather than the sometimes slow recovery of a significant ankle sprain.

    In part they may be right as:
    Firstly bone has a better blood supply than ligament therefore it has potential to heal quicker.

    Secondly with a fracture you are immobilised to allow healing. This pretty much negates pain as you aren’t encouraged to weight-bear on it quickly.

    Thirdly progress once out of cast can seem a lot quicker as once mobilisation starts usually there is rapid progress in the following 6 weeks. However there has still been the 4-6 weeks immobilised healing time to factor in!

    The interesting factor is perception of recovery time. As I’ve said above, a broken bone will take up to 6 weeks to heal and up to another 6 to rehab (overall up to 12 weeks) A significant ankle ligament injury will take anything from 8-12 weeks recovery but because they are often weight bearing in less than a week and usually very sore and swollen for the following weeks the recovery process often seems never ending.

    The other factor which affects the perception of ligament injuries is the high re injury rate. We find there are several factors here. Poor rehab adherence, rushing to return to play with heavy strapping and often varying degrees of residual ligament laxity.
    When recovering from a fracture firstly the cast prevents early return to play then there seems to be greater diligence with the rehab due perhaps to the rapid progress being made. There is also less expectation for rapid return to play from coaches etc because a fracture is seen as more serious.

    So in summary timescales for a broken ankle or badly sprained ankle will usually be similar but the perception of recovery is definitely different.

    We highly recommend seeking professional advice though for any ligament injury to help ensure it doesn’t become a chronic issue!!

    Tips to Aid Recovery post Marathon

    post marathon recovery
    With race day fast approaching hopefully the stars are aligned and all your pre race preparation will allow you to produce a PB on the day.

    Your marathon training will have taken you towards the 21-22 mile mark. So coming Monday you will be adding about 15% more distance to your longest run.

    Your legs will be pushed to the limit so how can you best recover following your big run??

     

    1- Be like Andy Murray!!

    It’s widely known that Andy Murray soaks in a chilled bath after competing. Research shows that immersing the body in freezing cold water speeds up recovery after exercise. By reducing temperature, blood flow and inflammation in tissues of the muscles. 8-10 degrees Celsius is the temperature to achieve this. The soak needs to last around 8 minutes.

    2- Avoid running in the early stages but do get up and move.

    In the next 24-48 hours a brisk walk, light cycle or swim / aqua jog will increase blood flow to the recovering muscles. Providing oxygen and protein to boost muscle recovery.

    3- Recovery massage.

    If there are therapists about straight after the marathon then jump on their table and get a gentle effleurage massage to help drain the lactic acid from those tired muscles.
    After that it might be 48-72 hours before you could bear someone touching those aching legs. Be sure to inform your physio of how you are feeling, previous response to massage and most importantly if you feel the massage is relieving the pain.

    4- Listen to your body.

    After the run you won’t know if the many aches and pains are an injury or just the result of the stress from the marathon. So let it settle early stages and if a pain isn’t reducing after 2-3 days consult a physio before starting to run again.

    5- Get your nutrition right.

    The endurance run you have completed will deplete your glycogen stores, so ensure plenty of carbs over the first few days post race. Increased protein consumption is also very beneficial to aid muscle recovery and rebuilding. Obviously hydration is essential although you might just deserve a pint of “ The Black Stuff” after the run, sure it’s full of iron apparently!!!!

    When and Why should I get a pre marathon sports massage?

    Running Comments Off on When and Why should I get a pre marathon sports massage?

    Race day is fast approaching and the taper is in full swing so the legs are beginning to get a well earned rest.

    The next big decision is

    1- Would a sports massage help me?
    2- With 10 days left till the marathon, when should i get it?

    Firstly you must consider, is this your first massage? If so there is an unknown as to how you will react to a sports massage. Some people are very tender and mildly bruised following It, although our therapists try to grade depth appropriately to each individual especially on their first visit.

    We would always recommend a pre marathon massage at least 5-10 days pre race ( if it’s a first massage the longer pre event the better) so that our physio’s can work at an appropriate depth to have an effect mobilising your muscles and fascia whilst allowing you ample time to complete a couple of short easy runs to help flush the toxins produced following the massage from the affected muscles.

    The principle thing to consider is:

    Why would you need a sports massage ?

    The answer is simple.

    Deep tissue massages improve blood flow to your muscles by stimulating the circulatory system. You’ll get an influx of oxygen-rich blood, which helps flush out the byproducts of hard exercise, and delivers fresh nutrients.

    The other aims of deep massage are to:
    Improve flexibility
    Reduce muscle tension
    Break up scar tissue and adhesions ( the micro trauma to the muscle caused by the stress of loading the muscles during marathon training)

    Our physio’s whilst massaging are able to detect tight knots within the muscle and can apply different techniques to mobilise them. The longer pre marathon they do the treatment the greater depth they can go to. This allows them to achieve the best effect. While still allowing plenty of time for any soreness to disappears.

    Everyone has different pain levels and pain tolerance so not only do our physio’s take feedback from the quality of the soft tissue they are working on but also the feedback from the client regarding it. As an area is worked on progressively it should relax, loosen and become less painful.

    What should you expect post massage?

    Depending on the depth our physio’s work at it is normal to have:
    Some tenderness to touch but feeling looser.
    Occasional mild bruising
    Improved range of motion
    Your legs feeling a little lethargic.

    This is why we never recommend a deep massage in the final few days pre event as it takes a day or two to recover.
    Always increase your hydration post massage to help flush out the toxins.

    So our take home message is:

    • Pre marathon massage is very beneficial
    • Best done 5-10 days pre marathon
    • Allow a few easy runs in the days after it
    • Provide plenty of feedback to to your physio to ensure the maximum depth of treatment with the minimum pain

    Please call our main office on 02830269733 if your wish to book your pre marathon sports massage

    Tips for Tapering for a Marathon

    The big day is approaching to Deep river rock Belfast marathon and for many runners the big question is when do you taper?

    Start to early and you will lose the fitness levels you have worked so hard to achieve.

    Start to late and a long run won’t give your body time to recover prior to the big day. ( it takes about 7-10 days after your last long run for your muscles to recover!)

    One of the biggest things to remember in marathon training is that there is no way to bluff it or cram at the last minute like you would for an exam. If the hard work isn’t done by 2-3 weeks out it won’t be!!! The taper is purely about refining your training.

    Firstly, what is a taper?

    It is a runner cutting their mileage of training significantly in the days/ weeks preceding the big event. It doesn’t necessarily mean slowing the pace down when running but shortening the length of runs to allow body recovery prior to the marathon.

    Why taper?

    When we train hard and consistently we push our muscles to the limit causing micro trauma of the muscle fibers. (please note, this is due to overloading the muscles in training not an acute muscle tear like feeling a sharp pain in your hamstring). When your muscles are damaged, your body will recruit amino acids. (the building blocks of proteins) to come and repair your muscle. However, as a coastal city might build a mightier dam after a flood, the body recognizes that this muscle will be subject to this type of damage and rebuilds the muscle bigger and stronger to adapt to this new stimulus.
    In the last 6 weeks leading up to a marathon the stress on the muscles is increased weekly with less recovery time for the body to repair these micro-tears. This is were the taper is essential in the last few weeks to reduce the load and allow the muscle to repair stronger.

    Aims of your taper:

    1- Allow muscles time to heal and rebuild stronger
    2- Let your body restock its glycogen stores
    3- Minimise accumulated fatigue and allow your immune system to recover.

    When to taper?

    The majority of runners aim to complete their last big run 3 weeks prior to the marathon. So anyone running Belfast should hopefully have that complete. Although for more experienced marathon runners sometimes 2 week is sufficient but that would be the absolute minimum.

    How to taper effectively:
    From 3 weeks out cut the mileage to around 80% of maximum week but keep intensity of runs aiming a lot for marathon pace runs to get used to the speed. Plenty of rest days and stretching to aid muscle recovery. If you are planning on changing trainers for race day this must be done now to allow adequate break in time.

    From 2 weeks out cutting miles to around 50% maximum but again keep running at marathon pace or slightly above it. At this stage beginning to carb load steadily to boost the now depleted glycogen stores. Steady carb loading is recommended rather than eating 14 bowls of pasta in the last 48hours

    The week of the race, a steady run 6 days out is excellent to avoid staleness over the 3 week taper. A 12-18min easy run the day before can get you ready for the off on race day. Plenty of sleep, hydration and carb loading are essential. Whilst forming your plan for refueling on race day.
    Most importantly on the day of the race don’t do something you have never done before. ( like eating 500 jelly babies) and repeat as close as possible the routine and plan you followed on the days of your long runs!

    Now the only thing to do is try not to hit the wall!!!

    Improve Player Robustness

    How to Improve Player Robustness?

    The World Conference on Sports Physical Therapy was held at the magnificent Titanic Centre in Belfast recently. The 2 day conference was based around the topic of Optimal Loading. This basically translates as the optimum amount of training required to reach specific performance levels while minimising negative outcomes. Negative outcomes can manifest in the form of injury, physical fatigue, mental fatigue or under-performing. Managing Optimal Load is approached from several angles. Including managing the injured athlete, rehabilitation and sport-specific conditioning for recovery, injury prevention and achieving performance.

    Speakers at the event:

    • Tony Strudwick ( Head of Athletic Development at Manchester United FC)
    • Dr Andrew Massey (Head of Medical Services at Liverpool FC)
    • Robin Sadler (Head Physiotherapist at Derby County FC)

    All 3 speakers talked about their role in managing players at their respective clubs. With a view to avoiding negative outcomes of training by what they referred to as ‘improving player robustness.’ They explained that in order for players to be able to play at the top level. They had to show that they can cope with the various demands of training at the top level. In order to achieve the desired outcomes of that level of a sport. They talked about the need for resilience and resistance to injury as opposed to players who are both physically and mentally weak and prone to injury.

    I can think of several words some use to describe the ‘unrobust’ player – soft, milky, flaky. Pampered being some examples I’ve heard over the years. I recall a Sports Psychologist once noting that in his experience, one of the traits of top athletes was their ability to tolerate pain. This is not confined to the pain of straining a muscle. More so across the spectrum of demands of the sport. The pain of hard training, the pain of pushing yourself to the limit, the pain of losing, the pain of suffering any setback.

    Tony Strudwick from Manchester United even went as far as saying that:

    “robustness is now something they consider as part of their recruitment of young players”

    Robustness (or lack of) is something for us to be wary of in the GAA. Some people will be of the opinion that robustness is ‘just in ye’. However, the experts from Man United, Liverpool and Derby all stated that they were aiming to improve player robustness. Almost like saying they were toughening players up to the demands of the sport. One of the easiest ways of judging robustness is to look at the number of games a player plays either consecutively or over the course of a season. This is one of the main factors when professional clubs are considering signing a new player.

    As inter-county managers head into the new season (never mind the training ban in place for a phenomenon once known as burn-out). They need to be aware of Optimal Loading and realise that they CAN develop player robustness. Trials will be the normal procedure in various counties. To see who will join the already established players of previous county squads. These established players will have built up a robustness to the demands of county training over many years. So new players striving to train at the optimum level required to play inter-county football need time to develop their robustness. They need time to reach the optimum level. This requires managers not picking players so far off the mark in terms of their present fitness that they will require too much time and 1:1 attention to catch up with others.

    ‘sensibly designed, progressive training programme’

    It requires a sensibly designed, progressive training programme that allows players time for their body to adapt physically to the demands of a new level of exercise. It requires an experienced Medical back room team who are able to spot the early signs of injury risk, underperformance, under-fit, overtrained situations. A good medical team will know that Muscles like to be strong to cope with these demands. Tendons don’t like a sudden change in demand. As for older players (30+), joints suffer from the accumulative trauma of long-term high level, high impact exercise.

    I’d like to know how many counties take into consideration player robustness in their underage Development squads. How many managers are training young people with a view to improving robustness so they are more resilient and resistant to injury, underperformance, physical and mental demands of sport at higher levels further down the line.

    So here are some simple tips for building player robustness:

    1. Design the level of training to suit the current level of fitness and conditioning of your players.
    2. Know the required level of conditioning for the level of competition you are playing at and aiming for i.e. There is no point pinching county training programmes and using them for a division 3 club team (and vice versa).
    3. Make progression gradual towards higher levels of training. Fitter players recover and adapt quicker. They can progress quicker to higher levels.
    4. Communicate with your players what you are trying to achieve at each stage of the training program so they know what to expect regarding effort and fatigue from specific training sessions.
    5. Be consistent in the intensity levels. Don’t let one or 2 nights drop off in intensity of don’t make sudden spikes in intensity.
    6. Use an experienced Physiotherapist who can detect the early stages of overuse injuries. A good Physiotherapist will also be able to detect what is a natural response to training or what needs rest. This will be crucial in building robustness as in order to become fitter. The player needs overload and the physiotherapist needs to know when the player is ready for overload. An experienced Physiotherapist with a knowledge of player and manager psychology will know when is the right time to ease off and when is the right time to push on. Know when the player needs to be pushed on or when the manager needs to be pushed away. A player who has confidence in the physiotherapist will trust the therapist’s judgement and avoid fear factors on return to play following injury. The old-fashioned methods of a manager trying to toughen up an individual or sometimes a whole squad by attempting to ‘break’ them have failed time and time again.

    ‘an experienced Physiotherapist is crucial’

    Hence an experienced Physiotherapist is crucial to building player robustness from both the physical and mental aspects of the sport for the benefits of the player and manager. At higher levels of sport, this robustness can be monitored and developed using a team of experts who monitor their respective interests including Strength and Conditioning experts, psychologists, physiologists, and doctors.
    So robustness is not ‘just in ye’ from previous life experiences. In can be harnessed when dealt with by the right people.

    Pitch-side Physio Rules for GAA

    Recently I had the pleasure of covering an Irish League match between local team Newry City and Dergview. It was the first soccer match I had provided pitch-side physio at since leaving Sunderland in 2005. All my experiences since then have been with Gaelic football and Hurling teams. So I enjoyed the opportunity for something different again. Newry have had consecutive promotion to what is the second tier of soccer in the Irish League under the guidance of Local Manager Darren Mullan.
    Thankfully before the game Darren had the foresight to remind me of the rules regarding physios coming onto the pitch in soccer matches.
    ‘Don’t be running onto the field like a blue-arse fly’ he said, ‘the referee will ask the player if he wants you on and if so then he (the referee) will call for you.’

    I appreciated the reminder from Darren thinking that in theory this all sounded well and good but, knowing mainly from my Gaelic experiences that I was still in for a busy night. How wrong I was! In the whole 90 minutes ( I was gathering my things up at 70 minutes to head home but I don’t think anyone noticed!) on a very wet and windy night, in a tough, no-holes-barred Irish League battle between 2 competitive teams, NOT ONCE had I to enter the field to attend to a player. There were several occasions when I thought I might be needed having watched players ship heavy tackles.

    The referee would make his way over to the player on the ground and simply ask him ‘do you need the physio on?’ Had he said ‘yes’ the referee would have waved me on. However as soon as I enter the field, the player who requests my input must leave the field of play even if the intention is to play on. He must go to the side-line and wait for the referees signal to re-enter the field. Knowing this, every player who went down or had taken a knock informed the referee that they did not need physio, took a few seconds to recover then got on with the game. Thanks to the rigid application of the rules the players know and understand that they are playing a contact sport where they will pick up knocks, which as per this Irish League game, all subsided sufficiently within a few seconds to allow the player to continue in the game.
    This ruling in soccer is a far cry from what goes on in the Gaelic field at present. Like many other rules within the GAA, the directives around when the physio can or cannot come onto the field seem to change year-on-year.
    There is no consistency on whether the physio can enter the field when an injury happens or will the referee call you on. Will the game be stopped or will play continue? Referees seem to vary in their approach to this. As a result, both managers and players vary in their understanding as to the role of the pitch-side physio. Our main job is to assess whether a player is able to play on or not. Apart from some minor running repairs such as taping a thumb/ wrist or dressing wounds and dealing with blood, the focus of the physio is decision making- Return to play or removal from play.
    For most other injuries such as muscle strains, there is nothing the physio can do to enable the player to continue. The catastrophic long-term affects of numbing an area with freeze spray so as to play on are well known.

    Over the years I’ve dealt with a wide range of scenarios on the Gaelic pitch as a physio. I recall once in a bruising encounter between Down and Armagh in a National League game in Crossmaglen, one Down player received a head injury. While initially satisfied the player passed my basic Head Injury Assessment I allowed him to play on but I continually monitored him. He strangely took up position out on the far wing away from the play and away from any Armagh player. Concerned about this I quickly made my way around to the far side of the field where he was. ‘What are you doing out here?’ I shouted to him. Not taking his eye off the play he responded ‘I’m picking up this man here,’ he replied. ‘Where?’ I asked. Again not taking his eye off the play, he said ‘there,’ as he was pointing to the linesman! Myself and the linesman looked at each other, caught the referees attention to stop the game and removed the player from the game with obvious concussion.

    Permission to enter the field for urgent incidences such as a concussion could easily be facilited through the officials but the trivial things could be handled similarly to soccer. This would facilitate a change in the culture and psychology as to how injuries are dealt with during a game. One team I was involved with had me hooked up through radio to one of the selectors on the side line so as to feedback the decision on a player from my own pitch assessment. However every time I had reached a decision I realised the man I was to be communicating with had made his way onto the field as well and was standing beside me.
    So I believe the GAA need to follow the lead of soccer on this one, make clear guidelines that officials, managers, players and physios are all aware of and then follow these guidelines consistently rather than change them every year.

    This will help speed up the game by avoiding time wasting and encourage a greater mental toughness in players towards minor injuries and knocks without putting players who are seriously injured at any greater risk of further damage.

    To finish, one of the most obscure incidents I was called onto the field for was by a player who was having a ‘wardrobe malfunction.’ In the middle of an important National League game he wanted to know if I had a safety pin for the front of his boxer shorts as a certain piece of his anatomy kept popping out for fresh air. I wish he hadn’t shown me what he meant!

    Headaches? How Do The Physio Group Clinic’s Treat Headaches

    chronic headaches, sports injury, physiotherapy

     

    At The Physio Group Clinic we are seeing an increased number of clients suffering from chronic headaches.

    There are many different types of headache such as : tension, migraine, cluster, vascular and hormone induced; these will be managed from a medical perspective.

    Within our scope of practice it is the CERVICOGENIC headache that we can assess and treat effectively.

    A cervicogenic headache is one that starts in the neck and refers up to the head. The upper neck contains joints, muscles, ligaments and nerves which if irritated can cause the headache.

    The cause varies from poor posture to repetitive activities such as lifting and carrying. Significant use of phones, laptops and computers in poor positions also increases the load on your upper neck. Whiplash injuries are also common aggravating factors.

    A true cervicogenic headache will always originate from the neck either during or after an activity And presents as a dull ache which spreads up the back of the head towards the temple, usually affecting one side rather than both.

    headachesOn our physical examination we expect to find:

    – reduction of normal cervical movement

    – tenderness and or headache referral on pressing the upper neck joints

    – muscular trigger points around the upper neck which refer to the head

    – poor posture often with a rounded back and a poking chin.

     

    Once  we at The Physio Group Clinic feel the headache is of cervical origin our treatment consists of:

    -soft tissue massage to release the muscles

    -joint mobilisation or manipulation to improve joint mobility

    -postural and mobility exercises

    -advice on computer set up etc

    -acupuncture

    -postural taping if needed

     

    A course of treatment yields high success rates for the true CERVICOGENIC headache so feel free to enquire whether Physiotherapy at The Physio Group Clinic can help you!!

     

    WHAT EVER HAPPENED TO A BAG OF PEAS

    sports injury, physiotherapy

    Welsh rugby captain Sam Warburton faces a race against time to recover from injury to face Ireland in the Six Nations on Saturday.

    In a bid to speed up the healing process he has been on an intensive ice machine to get rid of inflammation. This new High Tech bit of kit ” The Game Ready”  has also been endorsed by Rory McIlroy.

     

    But what is the difference  between this and a bag of frozen peas from your freezer?

    And what ultimately are we trying to achieve?

     

    What these athletes are following is the PRICE regime for an acute injury:

    Protection – Aim to prevent further injury e.g. using crutches

    Rest – Allow healing by preventing further aggravating activities

    Ice – Reduces pain, swelling and inflammation

    Compression – A pressure strap such as tubi-grip to limit the swelling

    Elevation – By raising the injured area above the level of the heart excessive swelling can allow swelling to drain away.

     

    When we look at the outcome of an injury  we need inflammation to occur to facilitate the body healing itself, it is the excessive inflammation which as therapists we aim to minimise as this ultimately slows the recovery process.

    This has led to an extensive array of treatment options using ice/cryo therapy all claiming to speed up the reduction of swelling and ultimately the recovery of injury.

    So what are the options available????

    Hyperbarbic Gaseous Cryotherapy

    This technique consists in applying for a short time on the skin up to the painful area, carbon dioxide at −78 °C with a pressure of 50 bars and a frequency of 400 Hz. Sessions can be repeated at will. Unlike ice packs, the usage of carbon dioxide does not produce pain. Even if not as dangerous as liquid nitrogen used in cryosurgery, the low temperature could cause burns.

    The Ice Bath

    The theory behind ice baths is related the fact that intense exercise actually causes microtrauma, or tiny tears in muscle fibers. This muscle damage not only stimulates muscle cell activity and helps repair the damage and strengthen the muscles ( muscle hypertrophy ), but it is also linked with delayed onset muscle pain and soreness (DOMS) , which occurs between 24 and 72 hours after exercise.

    The ice bath is thought to:

    • Constrict blood vessels and flush waste products, like lactic acid, out of the affected tissues
    • Decrease metabolic activity and slow down physiological processes
    • Reduce swelling and tissue breakdown

    Then, with rewarming, the increased blood flow speeds circulation, and in turn, improves the healing process. Although there is no current protocol regarding the ideal time and temperature for cold immersion routines, most athletes or trainers who use them recommend a water temperature between 12 to 15 degrees Celsius and immersion times of 5 to 10 and sometimes up to 20 minutes.

    The Game Ready

    As modelled by Rory McIlroy below the Game Ready System continuously circulates cold water from the control unit’s ice reservoir, via a connector hose, through an inner chamber of the anatomical wrap  (this chamber is located closest to the body) before returning to the ice reservoir.

    As a complete loop, the cold water is refreshed through the ice before returning through the anatomical wrap, thus delivering continuous cold therapy to the body part, allowing heat to be removed from the treatment site.

    Simultaneously, the control unit pumps air into the separate, outer chamber of the anatomical wrap, intermittently inflating and deflating according to the pressure setting that is selected.

    The compression not only assists in preventing/ limiting swelling, but also conforms the Anatomical Wrap to the contours of the body.  This increases the surface contact and aids the delivery of the circumferential cold therapy.

    rory game ready

    The Ice Pack 

    Ice packs can be made from ice cubes in a plastic bag or wet tea towel. A packet of frozen peas may also be used as they mould nicely and can go in and out of the freezer. Purpose-made cold packs can also be bought which are reusable.  They can be applied for 15-20minutes and repeated every 2 hours. However care should be taken to protect the skin to prevent an ice burn.

     

    Within our clinic we see trends towards a new type of ice therapy on a regular basis, with half a football team heading to cold baths in County Meath, or to an ice chamber in Portadown. Ultimately if the time spent travelling to these places was spent focusing on the PRICE regime with rest and ice packing maintained religiously, the same outcome would be achieved almost all of the time. So hold onto those peas for a little longer !!

     

    PILATES – AT THE PHYSIO GROUP CLINIC

     PILATES

    Pilates is an exercise based therapy which is designed to strengthen, elongate and restore the body’s muscular Skelton system into balance.

    The origins of pilates stem from early part of 1900 from its inventor ‘Joseph Pilates’ who as a child had been very frail but developed a technique of physical fitness using experiences from classical Roman to body building to martial arts.

    He developed his own approach to exercise and body conditioning which gained popularity as athletes found it the best way to recover from injuries and prevent recurrence.

    Over the years it has been developed and from the 1970’s on has become increasingly popular with the public.

    WHAT IS PILATES?

    It is a gentle, non-aerobic exercise method designed to strengthen weak muscles, lengthen tight muscles and improve general posture. The aim is for a properly balanced body which results in improved joint mobility, firm musculature and a good natural posture. It is a very specific form of exercise which is safe and controlled as well as low impact and works on the principle of ‘gain with no pain’.

    WHO CAN BENEFIT FROM PILATES?

    Anyone can benefit from Pilates as it is a very gentle form of exercise. Traditionally the classes tend to be female dominated and there is still a tendency for Pilates to be avoided by men, however top premiership footballer Steven Gerrard is joining the growing list of sportsmen who are extending their career through incorporating it into their regime  so we encourage everyone to the class.

     

    Although if attending for a specific ailment or injury it is best to inform the teacher prior to starting the class to ensure they can tailor certain exercises to specific needs.

    WHAT EXERCISES DO I DO?

    Pilates is a complete exercise method developed by its founder Joseph Pilates over the course of a lifetime dedicated to improving physical and mental health. Pilates focuses on building your body’s core strength and improving your posture through a series of low repetition low impact stretching and conditioning exercises.

    By core strength, we are talking about your back, abdominal and pelvic muscles. Through pilates, you will be able to develop these muscles without adding bulk, increasing your flexibility and agility and at the same time toning your stomach and thigh muscles.

    Pilates goes far beyond your core muscles however and not only provides a complete body workout (you will be working muscles you didn’t even know you had!), but also helps you develop an awareness of how your body works, helping your mind and body to work in harmony.

    THE EIGHT PRINCIPLES OF PILATES

    Pilates is based on eight principles:

    1. Relaxation
    2. Alignment
    3. Control
    4. Precision
    5. Routine
    6. Breathing
    7. Centring
    8. Flowing movement

    Should you wish to find out anymore about the benefits of pilates do not hesitate to contact our main office on 02830269733

    ACHILLES HEEL

    achilles tendon, achilles heel, sports injuryAchilles Heel!

    The term Achilles heel derives from Greek mythology when a great warrior Achilles was dipped in water as a baby which was supposed to make him invincible, unfortunately as his mother dipped him in, she held him by the heel Which wasn’t washed over. This became his weak spot and ultimately led to his downfall.

    Unfortunately for most runners and triathletes who suffer from Achilles pain the duration can also be EPIC!

    It is one of the most common weak spots in the body for overuse injuries and will usually be classified as one of 3 diagnosis’s

    – Achilles tendonosis : this involves degeneration and some inflammation of the tendon itself. Its shape changes from that of a thin pencil like shape to an overall thickening along the tendon.

    – Achilles paratendonitis : the paratendon is a sheath that encloses the tendon and should provide protection and allow fluid movement of the tendon. Unfortunately symptoms of inflammation and swelling can develop between the tendon and the sheath this can cause scar tissue and reduces the tendon mobility.

    – A combination of the 2 above.

    Very often with this the key to recovery is not just physiotherapy assessment and treatment but also evaluating the causes of it. These may include:

    Biomechanical faults ( usually over-pronation)
    Overtraining
    Poor footwear ( digging into heel)
    Direct injury or previous unresolved injury
    Changes of running surface
    Tight and or weak calf muscles

    Commonly when athletes self diagnose and treat they get stuck into copious amounts of eccentric exercises ( heel drops with a gorilla on their back) and can often aggravate the complaint.

    That is not to say eccentrics are not appropriate, just they need to be added to a rehabilitation program when appropriate i.e. when the basic calf mobility and strength is returning and the tight calf muscles have been released. Along with specific soft tissue treatment to the tendon.

    Occasionally these injuries require a full podiatry assessment and orthotic prescription and if they fail to recover an ultrasound scan via a radiologist who may administer high volume saline injections to break up scar tissue between the para-tendon and the tendon.

    THE CONCUSSION DEBATE

    The Physio Group Clinic – Physiotherapy

    Concussion debates seem to be played out nearly on a weekly basis at the moment.

    The 2 most notable recently are George North( below) who played on despite 2 head injuries and a momentary loss of consciousness. The other being the Tyrone County Board issuing a statement that star player Sean Cavanagh had not been concussed during a national league game and the medical team where satisfied that he could safely continue.

    As you can see these 2 incidents have taken place under the watchful eye of full medical teams and yet the assessment / diagnosis is still extremely unclear.

    So for coaches, managers and sports first aiders in charge of underage or amateur teams with no immediate medical back up what should you do if concussion is suspected?

    I think firstly the question must be asked – What is concussion??

    Concussion is the sudden but short-lived loss of mental function that occurs after a blow or other injury to the head. Concussion is the most common but least serious type of brain injury.

    Symptoms of concussion include:
    brief loss of consciousness
    memory loss
    disturbances in vision, such as ‘seeing stars’
    confusion

    If a neck injury is also suspected the player should not be moved until medical professionals have assessed them.

    If concussion is suspected with no neck injury the player should be immediately removed from the field of play and not be left on their own.

    They should then be advised to seek medical opinion.

    The danger you have when dealing with a concussed player is that usually they are oblivious to being concussed thus they can’t reliably make a decision about playing on.

    You must always make the decision for them and substitute them immediately as you are dealing with a BRAIN injury and a second blow in quick succession is extremely dangerous!

    THE CONCUSSION DEBATE
    Concussion debates seem to be played out nearly on a weekly basis at the moment.

    The 2 most notable recently are George North( below) who played on despite 2 head injuries and a momentary loss of consciousness. The other being the Tyrone County Board issuing a statement that star player Sean Cavanagh had not been concussed during a national league game and the medical team where satisfied that he could safely continue.

    As you can see these 2 incidents have taken place under the watchful eye of full medical teams and yet the assessment / diagnosis is still extremely unclear.

    So for coaches, managers and sports first aiders in charge of underage or amateur teams with no immediate medical back up what should you do if concussion is suspected?

    I think firstly the question must be asked – What is concussion??

    Concussion is the sudden but short-lived loss of mental function that occurs after a blow or other injury to the head. Concussion is the most common but least serious type of brain injury.

    Symptoms of concussion include:
    brief loss of consciousness
    memory loss
    disturbances in vision, such as ‘seeing stars’
    confusion

    If a neck injury is also suspected the player should not be moved until medical professionals have assessed them.

    If concussion is suspected with no neck injury the player should be immediately removed from the field of play and not be left on their own.

    They should then be advised to seek medical opinion.

    The danger you have when dealing with a concussed player is that usually they are oblivious to being concussed thus they can’t reliably make a decision about playing on.

    You must always make the decision for them and substitute them immediately as you are dealing with a BRAIN injury and a second blow in quick succession is extremely dangerous!”