Player Welfare & Injury Prevention: What now? Marty Loughran Physiotherapist

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1 Player Welfare & Injury Prevention: What now? Marty Loughran Physiotherapist

2 GAA Injuries: The tipping point Conor McCarthy, Irish Examiner January 28th 2012 'Rugby players don't know how they do it' Making Headlines Marie Crowe, Sunday Independent January 29th 2012 GAA players pushed beyond breaking point." Dr Tadhg MacIntyre, Belfast Telegraph February 9th 2012 Rebel rages that Cork GAA left him with 7000 medical bill Fintan O Toole, Irish Examiner February 20th 2012 Cruciate curse crippling GAA Irish Examiner February 16th 2012

3 Still making headlines Knee Injuries top list as GAA shell out 8m in insurance claims Irish Independent Feb 2014 Please stop this abuse Sunday World Jan 2014 Are hip injuries just the price we pay for a stronger, faster, more powerful game Irish Times Jan 2014 Moyna warns of training health risks Irish independent Jan 2014

4 Groundhog Day. What s the point? Joe Brolly, Gaelic Life, 11 th January 2015 Saving the GAA Joe Brolly, Gaelic Life, 19 th January 2015 Enough words, now its time for action Joe Brolly, Gaelic Life, 26 th January 2015 Treat the lifeblood with respect Joe Brolly, Gaelic Life, 8 th February 2015 Paraic Duffy says GAA to tackle fixtures and welfare issues Irish Times 28 th January 2015 Its not dark yet, but it s getting there Eamon Sweeney, Sunday Independent 18 th January 2015 Earley pays price for playing through pain Irish News, 19 th February 2015

5 How big is the problem really? What is the reality? How has this come about? What can we do about it?

6 What Percentage of players in a senior inter county squad will get injured each year? 67%

8 Some players get injured more than others 34 players = 40 injuries 1.2 injuries per player per season

9 More likely to get injured during matches or training? Matches 15 times more likely to get injured in matches Bigger the match the more likely you are to get injured

10 25% of all injuries are recurrent injuries Previous injury is the No. 1 risk factor for future injury

11 What are the most common Hamstrings 20% Knee 11% Ankle 10% Pelvis/hip/groin 13% injuries in GAA?

12 average 18% 2014 season 26% Why the surge? Hamstrings

13 1% of total Large time loss 1/squad/biannually Knee OA unavoidable ACL Significant changes in yrs Financial Loss QOL

14 How do GAA injuries happen?

15 Contact v Non contact 32% v 68% Sprinting 27% Turning 12% Landing 7% Kicking 5%

16 Why do injuries happen?

17 Oslo Sports Trauma Research Group

18 Unfortunately its not as simple as that

19 Oslo Sports Trauma Research Group

20 Summary High injury rate in GAA (2/3 of squad) 68% of all injuries are non-contact injuries (?preventable) 25% of all injuries will reoccur Previous injury, decreased flexibility, strength and control can cause future injury Big 4 - Hamstring, groin, knee, ankle Potentially large number of undocumented overuse injuries Some Injuries are catastrophic and having wider ranging effect beyond sporting life

21 Why are we so injury prone? Previous injury, decreased flexibility, strength and control can cause future injury Fixture calendar Decreased recovery / Overtraining / Nonapplication of sports science Early specialisation Developing S&C culture

22 What can we do about it?

24 Individual Intervention or Group Intervention

25 Group Intervention

26 Contact v Non contact 32% v 68% Sprinting 27% Turning 12% Landing 7% Kicking 5%

32 The Sequence of injury prevention Determine the extent of the injury problem Determine aetiology & mechanisms Assess effectiveness of strategy Introduce prevention strategy

33 Implementation Stage Launched at 2014 conference by Mario Bizzini (FIFA) to 400 Delegates SINI launch to sports medicine community (100+) 50 Workshops Rolled out to over 1000 coaches 4/5 workshops in each of the 9 counties

34 Website 54,000 hits Over 8000 unique users Viewed from 11 countries GB, USA, Canada, Australia, Scandinavia & Spain

35 Individual Intervention

37 Predicting who is at risk

38 Screening

39 The Big 4

40 Screening for Hamstring Injury 1. Previous Injury 2. Hamstring Strength (Single leg hamstring bridge test)

41 Screening for Hip/Groin Injuries 1. Previous Injury 2. Hip ROM tests (FADIR, IR ROM) 3. Provocation Tests (squeeze test)

42 Knee Screening Tests 1. Previous Injury 2. Landing/cutting technique Tuck Jumps LESS

43 Ankle Screening Test 1. Previous Injury 2. Balance Deficit Star Excursion Balance Test (SEBT)

44 ONGOING PROCESS SCREEN INTERVENE INTERVENE RESCREEN

45 Why are we so injury prone? Previous injury, decreased flexibility, strength and control can cause future injury Fixture calendar Decreased recovery / Overtraining / Dearth of sports science Early specialisation Developing S&C culture

46 Cam Deformity Link to hip pathology, loss of ROM & Hip/Groin pain Form pre PHV Unlikely to form after 14 Dose related Early Specialisation

47 Early Specialisation Playing 4 times a week at 12/13 increases likelihood of hip pathology Relevance to elite u-14 squad Overlapping seasons of school, club and county

48 Why are we so injury prone? Previous injury, decreased flexibility, strength and control can cause future injury Fixture calendar Decreased recovery / Overtraining / Dearth of sports science Early specialisation Developing S&C culture

49 Training Response

50 Insufficient RECOVERY Body adapts to the exercise load during the RECOVERY process.

51 Overtraining Symptoms Decreased focus Fatigue Lacking motivation Frequent illness Loss of strength, speed, or power Elevated resting/mo rning heart rate Decreased performance Loss of appetite Aches/pain s in muscles & joints Increased injury Heavy legs

52 Oslo Sports Trauma Research Group

53 Overuse Pain (nonacute injury), & often increases with activity. Swelling. Changes in form or technique. Decreased interest in training.

54 Gaelic Groin

55 Report - Gaelic Groin

56 FIFA >2 d Recovery Days

57 Why are we so injury prone? Previous injury, decreased flexibility, strength and control can cause future injury Fixture calendar Decreased recovery / Overtraining / Dearth of sports science Early specialisation Developing S&C culture

58 KISS Train movements not muscles Strength & Conditioning

59 Qualifications UKSCA, CSCS, BSc, MSc, EXOS

60 High Injury Rate High Re-Injury Rate Many of these preventable Summary Good evidence for group and individual injury prevention strategies Fixture calendar as it stands makes it difficult to prevent overuse injuries and overtraining

61 Key Recommendations Activate ( Group mobility, stability and prehab sessions Individual interventions for identified at risk players Train smarter, optimal recovery Adoption of Gaelic Groin Recommendations Major overhaul of fixture calendar required

62 Being against GAA player burnout is like being against racism or for free speech. It offers us all the chance to deliver a few pious platitudes while doing absolutely nothing to mitigate the actual problems involved. Eamonn Sweeney, Sunday Independent 18/1/15

64 Responsibilities

65 What are we going to do?

66 Joe is right, Enough words, now it s time for action

Addressing the physical challenges of the young elite GAA player. Marty Loughran Antrim Coaching Conference March 2014

Addressing the physical challenges of the young elite GAA player Marty Loughran Antrim Coaching Conference March 2014 Making Headlines GAA Injuries: The tipping point Conor McCarthy, Irish Examiner January