Return to Play after Covid19

It has been just over 12 weeks since Ireland shut for business and there seems to be a definite move in the right direction towards our new normal over the past few weeks. Since June 8th, we have moved into Phase 2 of the Governments national reopening plan and as part of this phase, outdoor group exercise can now take place with up to 15 people following social distancing and infection control guidelines.
It is fantastic to see some gyms reopening with outdoor boot camps and classes and lots of GAA clubs have returned to training in some form. Meath County board have also released their proposed timetable for club fixtures resuming in August giving us all a wonderful sense of hope that all is not lost for sport in 2020.
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Since the lock-down period began back in March, lots of gyms have been providing online classes for their clients to follow at home, sports teams have supplied their players with strength and conditioning programmes to work on at home and many people have been maintaining and improving their cardiovascular fitness with walking, running and cycling. This will have given many GAA players in particular an excellent foundation for restarting training however, there are some other factors for players and coaching staff to consider when returning to the pitch that should not be overlooked.
GAA players returning to the pitch for the first time from now on more than likely will not have had enough exposure to the sports specific, multi-directional movements that make up the games of football and hurling including sprinting, twisting/turning, hopping, jumping and landing, cutting, rapid acceleration and deceleration etc over the last couple of months.
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As the tissues/joints used in these movements have not been loaded enough in this way in over 12 weeks, there is a risk that injury may occur due to sudden overload if training resumes at a high intensity. The terrain may also have changed since these players last set foot on a pitch and it is clear to see that the ground is pretty hard at moment from the continuous dry spell in weather. Players following strength programmes at home may not have had adequate weights to work with and compliance may not have been the best either resulting in some deficits in strength and power compared to before. All of the above may increase the likelihood of injury now that training has resumed.
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We have never seen an off season period like this in GAA before but we can look to the NFL who experienced a similar period of “lock out” in 2011 when players did not train together or compete between March 11th and July 25th of that year. Those professional players also didn’t have access to their strength and conditioning coaches, team physios, doctors etc for that period between March and July. Studies done during that time and afterward showed that there was a substantial increase in injury rates when the players returned to training and in particular the incidence of Achilles Tendon ruptures increased 4 fold. There were more Achilles tendon ruptures in the first 2 weeks back at training than in a normal entire NFL season. There were also sharp increases in re-injury rates of previous injuries when players returned to training camp, (Myer et al, 2011).
NFL achilles data
More recently we can look to the Germans who were some of the first to return to competitive play since the pandemic started with the Bundesliga returning a few weeks ago. Early data analysed by Sports Scientist Joel Mason has found that injuries shot up from 0.27 per game to 0.88 per game in the first weekend back after the recent rest period.
If professional sports teams are starting to see this pattern and have done in the past with the NFL statistics from 2011, then teams at amateur level will also need to be aware of the risks and prepare and plan ahead for the weeks ahead before games begin.
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We can never fully prevent injury from happening but we can certainly decrease the risk or likelihood. The most important way for GAA coaches and teams to do that right now is to plan. Plan ahead for the next 6-8 weeks, starting off with a clear path from the first session back all the way up to competitive match play in a few weeks time. Begin by building up load gradually and progressing strength, speed, agility etc along the way.
There may be a temptation to jump back in at a high level and intensity to make up for lost time but it will only lead to overload of the tissues = injury = more lost time.
In addition to progressive and gradual loading on return to play, ensuring players warm up properly can also have a positive affect on reducing injury risk. There are some fantastic readily available resources specifically for hurling and football that have been used successfully over the past number of years to help with decreasing injury risk for these sports. The GAA 15 and the Activate warm up programmes are highly recommended, easy to follow, free to download and can be started straight away. Aim to add these warm ups and cool downs to every training session and game for the best results.
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To all club coaches, mentors, players – don’t hesitate to contact your local Physio/Athletic Therapist for advice on safe return to play and how to decrease the likelihood of injury. We can advise on a team and individual basis, provide strength and return to play programmes, warm ups and cool downs and help with any current injuries/rehabilitation.
S.D. @ Athboy Physio & Sports Clinic June 2020 
Resources and References: 
GAA 15 Warm up link – https://learning.gaa.ie/gaa15
Bundesliga Injury Report by Dr Joel Mason – https://www.trackademicblog.com/blog/bundesligablueprint

NFL Lockout paper – Did the NFL Lockout Expose the Achilles Heel of Competitive Sports? Journal of Orthopaedic & Sports Physical Therapy

Published Online:Volume41Issue10Pages702-70 https://www.jospt.org/doi/10.2519/jospt.2011.0107

Images from GAA.ie

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