Sports Injury Prevention
On recommendation from the Medical, Scientific and Player Welfare Committee of the GAA, a National Injury Database was set up in 2006. Detailing injury rates for 5 inter-county football and 4 inter-county hurling teams in the 2007 season, the first report was published recently. Funded by the GAA and written for the GAA by two Chartered Physiotherapists, John C. Murphy and Catherine Blake, this comprehensive annual report on all injuries sustained by top GAA players last season.
Exercise and sport is recognised as a major contributor to wellness at every age. Injury often stops sports participation for a short period, sometimes permanently. Many factors contribute to sports injury, but it is important that records specific to each sport are kept and analysed so that causes can be addressed and risks reduced or prevented. In the sporting arena, it is the evidence that emerges from high level athletes that in the main informs how doctors and chartered physiotherapists treat the leisure sports person.
GAA is played in every parish in the country. The findings of such reports percolate right down to local level and have implications for team selectors, coaches and the medical and paramedical professionals who have each a role to play in player welfare.
This ground breaking report, the first ever to give a clear picture of all injuries sustained by these elite GAA players over a full season produced some key findings including:
- The most common injury in this elite group of GAA players in 2007 was hamstring strain, accounting for 24% of all injuries in hurling and 23% in football.
- Recurrent hamstring injuries were also frequent occurrences during the season, hurling producing 26% and football 38%.
- Between 2-2.4 new injuries were recorded each week in these elite teams, defined as injuries that had been present for more than 24hours and prevented an inter-county player from taking full part in training or match activities.
- On average 1 in 7 players were missing through injury each week in hurling, and 1 in 6 in football.
Though a range of muscle, ligament, joint injuries and bone fractures (broken bones) were reported, the prominence of hamstring injuries means that doctors and chartered physiotherapists are now developing a protocol to reduce frequency of occurrence, including guidance for coaches, evidence based advice for early treatment of this injury, a comprehensive rehabilitation programme and steps for return to training and match fitness.
Further analysis is due to look at exactly when the first or recurrent strain occurs, whether in training or in a match situation, early in the season or towards the end of the Championship, and even the time within each session when the injury actually came on. The more detailed the evidence, the more education can be provided to players, coaches and also all health professionals involved on a local level in the care of GAA players.
Hamstring injuries range from a slight strain or tightening sensation in the back of the thigh to the more serious partial tear, where the muscle can take a long time to heal. To the leisure club member, a hamstring strain used to be considered a straightforward injury. However from research across many sports we now know that full assessment of the whole lower limb right up to and including the lumbar spine is necessary for all hamstring injuries. Often there may be several reasons that contributed to this injury and unless each is spotted and addressed the chance of break-down on return to training is very high, as shown in the GAA report.
One reason for hamstring strain is the scientific evidence that regional muscle imbalances create a likelihood that injury may occur. In this case poor ‘core stability’ (a weaker lumbar region with very strong thigh muscles) is a significant precursor to some hamstring injuries. Again within the lumbo-pelvic area, either a stiff lumbar region or tight hamstring muscles can contribute to mechanical dysfunction. The role of poor foot biomechanics, mostly in terms of what is known as ‘functional flat feet’ also needs to be included.
Thus, even in an apparently simple, first-ever hamstring injury, there are several different strategies to assess and treat to ensure full recovery. In a recurrent situation, locating and fully rehabilitating each factor is even more critical. Less than complete rehabilitation or return to training too soon can be predictive factors for recurrence.
On a different tack, statistics about the number of new injuries recorded at intercounty level in 2007 are raising challenges for GAA Central Council. The fact that between 1 in 6 or 1 in 7 players of each 32 person intercounty squad was unavailable for selection each week due to injury confirms the pressure on selectors in the presence of a reduced squad. In the light of this finding, the high rate of player layoff due to injury may ultimately suggest that a larger squad size may be necessary at this level.
Player welfare is at the core of this 2007 GAA Report detailing sport specific research on the number and type of injuries being sustained in our national sports. It is envisaged that it collecting this data will continue over coming years, including more counties each year. The findings will improve the game for all involved. Watch this space!