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.”
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*
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.
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 (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.
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.
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.
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!