Injury Prevention in Gaelic Games
/With Sydney’s Irish contingent returning to preseason training and games over the last couple of weeks I thought it might be a good time to touch on some sport specific injury prevention advice for the season ahead.
Injuries are unfortunately something that anyone who plays sport will likely have to deal with at some time or another. This is particularly true of contact sports like Gaelic Games. It would be great to say that there was a strategy that we could put in place that would be effective in preventing injuries from happening but given the wonderfully unpredictable nature of sport this is never going to be the case. While we can’t prevent injuries outright, there are things that we can do to reduce our risk of becoming injured. To look at some of these in more detail we’ll break down the injuries that are particularly common in Gaelic Football.
A comprehensive study following 17 Gaelic Football teams over an 8-year period found that lower limb injuries account for 76% of all injuries sustained in the sport. The graph below shows the incidence of each specific injury. Unsurprisingly hamstring injuries are the most frequent issue, accounting for almost a quarter of all injuries seen. This data is comparable with similar sports such as AFL and is largely related to the sport specific demands of these sports, requiring a substantial volume of high-speed running and ground ball pick-ups while on the move, which place the hamstring in a more vulnerable position. These specific requirements mean that much of our focus in terms of injury reduction needs to be directed at the hip and knee – the two joints that the hamstring works around. Although the data below is from Gaelic Football, the similar movement patterns seen in hurling mean that the results can be extrapolated across codes to an extent.
Data from Murphy et al 2012
Injuries can be broadly categorised as either acute (sudden onset type injuries) or chronic injuries. The majority of the injuries in the graph such as the muscle strains and joint/ligament sprains would come under the acute umbrella whereas chronic type injuries would include more of the overuse type issues such as tendinopathies (previously referred to as tendinitis).
For acute injuries there are a number of exercise interventions that have been proven to be effective in reducing injury incidence. At the top of the list in terms of effectiveness is strengthening exercise. Proprioception work (balance, movement practice, landing mechanics etc) tends to have a positive impact, particularly when it comes to ankle sprains. Although this will come as a surprise to many, stretching programmes have not been shown to have any meaningful impact on injury prevention. Does this mean that you shouldn’t stretch? Well, if stretching is something that you already do and you enjoy it or feel better after it then there is no harm in continuing but if you are sacrificing strength training because you are spending your limited time stretching then you might want to re-evaluate. Strengthening exercises (particularly eccentric biased exercises) give you the best bang for your buck in terms of increasing both muscle strength and length (flexibility) and reducing injury risk.
A lot of the evidence for eccentric strengthening has come from research around the hamstrings – making it highly applicable for a sport where hamstring strains are such a massive issue. One exercise which has gained a lot of notoriety in recent years is the Nordic hamstring curl, and for good reason – it’s exercise requiring little equipment that is really effective in reducing the risk of hamstring strains. If there was just one new exercise you started to implement for injury prevention this season it should be the Nordic curl. While it’s not the easiest exercise to master there are a number of simple progressions we can use. Some examples are shown in the videos below.
While overuse injuries also benefit from strength training to promote resilience in the relevant muscle groups, these types of injuries are largely attributable to training errors and thus largely preventable through maintenance of appropriate training loads. Often the training error is a simple case of too much too soon in relation to increasing volume, intensity or frequency. Other factors such as lack of recovery +/- external fatigue factors, nutrition, change in training type, terrain, footwear etc can also have an impact. In team situations training load is not something that is directly in your control but given that a sharp spike in running load at the start of the season (or following an in season break in training) is the primary cause of these overuse type injuries you can prepare your body (prevent the spike) by gradually introducing similar patterns of running within your training in the lead up to your return to play.
GPS data gives us a good insight into the type of running that we need to do to prepare for the loading we undergo during games. One study involving intercounty players identified the following:
Average distance covered: Male: 11.7km, Female: 9.6km
1731m covered at high speed >20kmph
Distributed across 44 sprint actions. >50% multidirectional
Players completed 184 accelerations
It’s important to remember that these figures are based on elite athletes in 70-minute games so at least 15-20% could be taken off each when applying the numbers to club players. Even so, what should be clear from this data is that just running steady state 5kms in the off season isn’t going to condition your body for what you will be asking it to do in games. Yes, these types of runs are certainly worthwhile but prior to returning to training your individual running ideally should include drills which will mimic the types of runs made in games. Some simple additions to the longer runs would be:
Sprinting up to 20m
Higher speed runs of between 40-100m
Change of direction and fast deceleration elements in 50% of the above runs
Ball interaction within high-speed running drills e.g. pick-ups, solos etc
Finally, just a note on warm ups. The GAA have developed a really nice standardised warm-up programme called GAA 15 which encompasses a lot of the principles covered in this blog. It’s available for free online and it’s a very handy resource for coaches and players as a means of putting the latest research into practice prior to training and games. If you are looking for advice or programming related specifically to you and your injury history, we can complete a thorough physical assessment along with a detailed discussion of your previous history to allow us to create an injury prevention programme that is tailored to the areas where you may be a little bit weaker or at greater risk of injury.
By Paul Keating, APA Physiotherapist