3 weekends into 2019 Six Nations Rugby and a quick look at the injury list shows currently 63 players either injured or unavailable in the home nations teams.
Most common injuries in that list:
This shows the broad spectrum of injuries teams have to deal with and prepare for. These player have incredible resources available: large medical teams caring for them as well as great sport science with research being applied and continually updated to put them in the best physical and mental state possible.
So what about our amateur players? Those who have full time jobs, family commitments who are lucky to make 1 practice a week, maybe some gym time…?
Here is a little insight in to what what goes on when managing players:
Strength and conditioning
Recovery
Skills
Nutrition
Mental state
Activity tracking
We have to prepare players to cope with the various challenges of the sport. Look at all the probabilities and then ensure they have sufficient S&C to deal with the worst case scenario - heavy pitch, close match, 2 players in the sin bin, opposite number bigger and faster.
S&C helps develop the muscles and other tissue structures to deal with the loads applied to the body in various situations during practices and matches. We also develop improved control of movement and function to better support the body and minimise the risk of injury.
2. Recovery
Post match fatigue can have a large impact on ability to produce force in training and next match. Understanding recovery process and dedicating time to it is very important. Sleep together with suitable training at the right time is key in optimising recovery. Post match training needs to be at a level which allows for recovery of injured tissue rather than increasing demand which may lead to increase risk of injury. Sleep is also very important when recovering form injury.
3. Skills
Having the necessary skills helps protect joint and muscle function - eg. playing out of position will mean the body is not accustomed to the forces and loads applied to the body and the body won’t have the ability to manage changes as it has little to no previous experience to help it cope.
There has been much focus on tackle positions to help reduce the number of concussions. This is a skill that can learned, practised and developed into automatic behaviour to help during match time. Cutting / change of direction requires skill and control and can be worked on to improve ability and reduce risk of injury.
4. Nutrition
Recovery and strength and conditioning are affected by what we eat. Beer and a curry post match might sound good but are not what it takes to get your body back on track for training. Higher protein intake less carbohydrates (easy on the beers) - imagine the Kiwis and Boks with their big slabs of steak on the barbie / braai
5. Mental state
Fatigue, stress, anxiety can all have effect on neuromuscular function, recovery and decision making. These affect all parts of your life from training, to practices, match situations, work and home life.
There has been far more focus on these areas in the last number of years. The media has revealed a lot lately about the world that professional athletes live in and the issues they have to deal with. This is true for the amateur as well. What is great is that we are finally seeing people talk about these issues which can have a tremendously positive effect on recovery and injury prevention as well as quality of life.
6. Activity tracking
Our digital world is now filled with devices which can track athletic function and performance. This helps manage player loads. Too much activity and a player becomes susceptible to injury but not enough load and the conditioning is less than optimal to protect and have necessary ability on the pitch. Understanding load vs recovery relationship is vital whether it be gym training, marathon training or professional or amateur rugby player.
So what do we do?
Player gets an injury - what happens next? Off to the Physio!
Assessment
Medical management
Return to play
Maintenance
1. Injury Assessment:
A good assessment is vital in order to create a working plan towards recovery. We look not only at the local injury site but also at the effect this will have on the player both physically and mentally all the while maintaining the unaffected parts. Together we create a treatment plan which can be adjusted and is manageable for the player.
2. Medical management:
Following an assessment the Physio might feel it necessary to involve further medical opinion and imaging to ascertain the level of injury and if further intervention is required. We use a number of sports physicians and orthopaedic consultants to assist in such cases. They will carry out their assessments and provide guidance and recommendations and where necessary provide medical assistance. We believe in building a multi-disciplinary team around the player to enhance recovery.
3. Rehab: Where the fun takes place.
Phase 1 protecting and calming of the injury.
Here all the necessary recovery interventions are put in place: treatment, sleep, nutrition, psycho-social guidance, suitable training for the rest of the body. Just because 1 area is injured does not mean the rest can have the time off. Treatment can involve a number of different tools from hands on skills to taping and strapping as well as low load work and mobilisation / movement of the body. We involve other members of our care team to assist in the recovery: sports massage, chiropractor, Biokineticist
Phase 2 - building.
The body recovers better with activity rather than complete rest. A suitable amount of loading will be applied to the recovering tissues to allow for adaptation to forces as they recover. Progressive strength and conditioning will assist recovery and adaptation. Your Physio will work with you in the gym / clinic but you are also expected to continue with the homework program.
It is also here that skills are re-introduced and challenged - balance, control, change of direction, acceleration, deceleration, impact. Decisions are made about return to practice and how much loading to allow for adaptation rather than overload.
4. Return to play:
Working with your physio - testing in gym / rehab and at practices will provide information which will guide the return to play phase. Too often amateurs return far too early making themselves prone to re-injury. Being realistic and working with players to facilitate their return is vital.
5. Maintenance:
We work with players regularly throughout the season to monitor function and help keep them at optimal state. This is also a good time to keep track of strength and function and alter training programs accordingly.
So much more goes on behind the scenes in sport than what is seen on TV. For some injury is easy to deal with for others it can be very hard. Each players injury is individual and it is the combined effort of the player and the care team which will ensure a good recovery and safe return to the sport / profession they enjoy.
We look forward to the rest of the Six Nations and the excitement of the upcoming Rugby World Cup.
References:
1) RUCK online article
Call us today on 0203 893 5100 or book your appointment online.
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