“From Treating to Monitoring Injuries”. Therese Leahy

As a physiotherapist, it is fair to say that I have an obsession with injuries. If you break it down, an injury is a form of physical insult to the body. What is so fascinating for me is that our bodies are so resilient and adapt at absorbing load, yet, when we get injured, a part of our body either reduces or ceases to operate to its maximum functional capacity. In a nutshell, a physiotherapist’s role is to facilitate an individual’s return to function. As a physiotherapist who focussed specifically on sports injuries over the last few years, I have witnessed some horrendous injuries and yet some remarkable recoveries. I have had the pleasure of working with a wide range of athletes from Professional Jockeys to GAA/Rugby players to Irish Dancers and yet, an athlete’s ability to push through mental and physical barriers to return to sport never ceases to amaze me.

It also got me thinking….

What if we could prevent some of these injuries? Injury prevention is a significant area of interest for physiotherapists/coaches/team managers as it increases an athlete’s availability and performance potential. When you work with athletes, a substantial aspect of treatment is in fact, “injury prevention”. In physiotherapy, injury prevention includes the implementation of evidence-based specific exercises/drills/warm-ups that have been associated with reduced injury risk. Injury prevention can be more challenging in some sports than others. For example, in horseracing, the sheer impact of hitting the ground whilst travelling at 40mph is somewhat unavoidable, or at least outside the realms of physiotherapy. In Rugby, a physically demanding, contact sport, the tackle has been associated with increased injury risk 1-3 ,yet is considered a key characteristic of the game.

This begs to question; how can we reduce injury risk in contact sports? Is it strength and conditioning? Is it more reliant methods of injury screening? Is the multidirectional aspect of the sport to blame? Is the contact element of the sport to blame? Is it just bad luck?

Over the past few years, I began to develop an increased interest in the mechanism of injuries instead of focussing solely on the rehabilitation. I carried out a small study with inter-county U21 GAA players on injury incidence, training load and stress and recovery states as part of my MSc in Sports Physiotherapy, but I was left with more questions.

I wanted to investigate further how the injuries occurred, what variables outside of physiotherapy influenced injury risk? Is there an association with age, physical fitness, body mass?

I have always had a special interest in working with young athletes as I feel that if injury risk can be modified at this level, it would significantly influence and positively impact their sporting careers and overall wellbeing. This is also where, perhaps it could be argued that player welfare is most important? Some may even refer to young athletes as a vulnerable athlete group.

These questions shaped my journey from the rehabilitation and treatment of injuries to injury surveillance and analysis. My PhD is focussed on injury surveillance in school Rugby where my objective is to implement the IRIS (Irish Rugby Injury Surveillance) system into Rugby schools across Ireland to determine injury trends and risk factors in this group. This data is crucial in understanding injury mechanisms in school players and will be used to inform and develop future injury prevention strategies with the overall goal of improving school player welfare.

References:

  1. Yeomans, C., Kenny, I. C., Cahalan, R. et al., The Incidence of Injury in Amateur Male Rugby Union: A Systematic Review and Meta-Analysis. Sports Med, 2018;48(4):837-848.
  2. Williams, S., Trewartha,G., Simon, K. et al., A Meta-Analysis of Injuries in Senior Men’s Professional Rugby Union. Sports Med, 2013;43(10):1043-1055.
  3. Freitag, A., Kirkwood, G., Scharer, S. et al., Systematic review of rugby injuries in children and adolescents under 21 years. Br J Sports Med, 2015;49(11):511-519.

Therese Leahy is a postgraduate researcher in the Department of Physical Education and Sport Sciences at the University of Limerick. A qualified physiotherapist Therese’s current research interests include injury surveillance, injury prevention, player welfare and injury rehabilitation.  You can contact Therese via email at Therese.Leahy@ul.ie or view her research profile on Researchgate