Cathal Ellis: Players need to have the right work done

By Frank Craig

Donegal physio Cathal Ellis says that GAA players, especially club ones, need to be training smart and make sure they’ve the specific and required work done before games resume.

Club players the length and breadth of the country are hitting the roads and gyms with the hope of a green light coming soon from Croke Park that they can once again meet up and train collectively.


But in a fascinating sit down with the Donegal News this week, Ellis outlines the difficulties that players are currently facing, whether they’re actually aware of it or not.

But with some improvisation, he says they can get the requisite work in that will better guard against injury whenever the action eventually does get back under way.

Q: We’re seeing so many lads on the roads and a lot of them have kitted out gyms at home; what gap would still need to be bridged in regards to playing games?

A: “These are unique times. Sport has been in lockdown. Players have been in isolation for months. I think there is going to be massive learning to take from all of this.

Really, we don’t have anything similar or some kind of precedent to go by. For club players, this is probably the longest pre-season they’ll ever have to endure.

The one challenging thing, the one frustrating thing, for gaelic players at this moment, is that there is no end date set. There is no goal to aim or target.

There are guidelines coming on June 8 and July 20. We’ll have to see what they bring. But I guarantee we’ll be encountering a lot of injuries when sports resumes. There will be a hell of a spike in injuries.

We’ll be looking at ACL, groin and hamstring issue increases. And that’s every sport across the board. The only thing we really can look at for some direction is the NFL lockdown in 2011.

There was a players disagreement in terms of salary caps and TV contracts. What happened then was the owners restricted all training camps and team training for players. So no one could enter the team facilities.

It’s very similar to the situation we now find ourselves in. The worrying thing from that time was the average yearly incidents of Achilles ruptures had been five.

When the NFL got back down to business, that spiked to 12 in just one month. 10 of those occurred over the first 12 days. It was four times the increase on the yearly average.

What happened was the players were put back into play right away. They’d usually have between five and seven weeks of a pre-season. But they were only afforded a period of 17 days that year.

This isn’t intended to scare club or even county players. But there is a valuable lesson for team sports in all of that. That includes backroom teams and management.

Obviously, the physios, the S&Cs and the coaches relied heavily on the players to get the work done by themselves in the NFL. And look what happened.

On the first weekend of the return of the Bundesliga, injuries went from .27 average per game to .88. and have continued the same trend. Those are all soft tissue injuries due to players playing catch up.

For me, load management is king. You’re looking at the relationship between injury and training. That relationship is very fickle. The balance between short term and long term training load is crucial.

If you rapidly increase or surge that short term load, that leaves the player very vulnerable to injury. The injury risk is then amplified under fatigue and injuries then tend to happen later in games or later in the season.

If you limit your pre-season prep, the frequency of injuries rocket. The fundamental problem will be if that teams are given too little time to prepare, collectively, they will all feel they have to make up for lost time. And that’s when the problems will occur.”

Q: Hypothetically, if we were told we could all get back to training following Phase 2 or 3 of the easing of the COVID-19 restrictions; what would physios and trainers need to be guarding against or making provisions for?

We’re looking at this without the benefit of hindsight, we really don’t know what is going to happen over the next few months. I think, and I’d advise, that players need to be prepared to go.

Imagine the scenario – like you say – where things continue to improve and we get a green light. And we’re looking at playing games in a few weeks. I’d encourage players to prepare for Game Day 1.

As a coach, or someone that sets out training, you need to be looking at what would that first session look like and how are you going to get there? You really have to start with the end in mind.

In terms of conditioning, players are still getting that work in. But training needs to be mapped out like how you’re going to play.

If clubs were allowed to get back on July 20, and you’re expecting to be playing games within four to six weeks; training needs to be geared towards that.

A club player, you’re looking at covering 8 to 10km in a game. Of that, close to 1.5km will be high-speed running. Those bodies need to be able to tolerate the game’s demands and the style you want to play.

For clubs players especially, in the interim, they want to limit the risk of injury. And there is a huge link that exists there between Championship winning teams and injury free teams. You look at what Liverpool are now doing under Jurgen Klopp.

I’m a Liverpool fan so I’ve paid close attention to that. When he first came in he wanted this gagen-style press. When he first came the players were completing 9 to 10km.

He demanded those same players get to 12/13km. Bridging that gap, players picked up a lot of injuries. Now you look at Liverpool and they’re top of the league and flying with very few soft tissue injuries.

Again, that’s what I mean by mapping training to the style you want to play. Leicester City, when they won the league, they used the fewest number of players and had the fewest number of injuries. They also had the fastest team in the division.

Why that was, was because their game plan involved very pacey counter attacking football. You have to train to meet the demands of that and they reaped the rewards by doing so.

The non-negotiable in team sports… you have to sprint. You also have to accelerate, decelerate and be very good at changing direction.

Consulting with different players over the last few weeks, clubs’ running sessions are consisting of 400 to 600m runs. They might do a couple of weekly 5 and 10km runs. To me, as a physio, you have to call a spade a spade. It isn’t worth much at all.

What happens when those players get back into their first training session? If players are asked to sprint flat out, the likelihood is that hamstrings will go.

Again, it’s good to have a base of conditioning but there needs to be a right transition. Football requires high speed running. That work, flat out sprinting, can’t be replicated in the gym or on the road.

Players in the lead up, if things do change, they have to expose themselves to sprinting every four to five days. You have to be accelerating, decelerating. And you have to be changing direction.

From a GAA perspective – are they going to permit challenge games this year? Probably not. So if clubs don’t get back and county sides do, boys will be playing catch up.

There will be no exposure to the chaotic elements of Championship and hitting top speed in what are hugely competitive and important games. That’s a big concern.”

Q: But if sides, club or county, were to get back, and they were to get something like a six-week pre-season window; It is possible to get up to speed and guard against all of that?

Of course it is. Definitely. From the perspective of the intercounty set up, it was a frustrating thing at the time. We were going well, our injuries were coming on well. They were hitting their goals and timelines. Certainly, within a six-week block, we’d feel we could (get up to the required level).

The big thing for inter county lads is maintaining the physical qualities we’ve built up since pre-season. That’s speed, power, strength, body composition and conditioning. And then they’re looking at their sports specific skills.

From our point of view, if we can maintain all that, we minimise the risk of injury when we do return. The saying is “if you don’t use it, you lose it” and that’s true. Again, one of the non-negotiable is your speed and power training.

This is a great opportunity to train speed. Along with your strength sessions and injury prevention work in the gym. Your nervous system needs that stimulus. Your soft tissue needs a stimulus. The research on that suggests you hit your top speed once a week. And you need a regular exposure to high speed running.

We liken it to a ‘weekly vaccine’ to protect against soft tissue injury. With all this planning and prep, if you think long term, then after that six-week period, if you do put the burners on in a game there is much greater protection from soft tissue injury. Sprinting plays a key role in all of that.

My main concern would be for lads coming back from serious injury. With social distancing measures in place, physios aren’t able to replicate that hard Championship feel or replicate true match demands with players. That will make returning from injury that bit more difficult and challenging.”

Q: For you and Donegal, the squad’s long term injuries like Paddy McGrath and Oisin Gallen were all in the final stages of their respective rehabs. How much more difficult would it have been now, working remotely, had the side suffered a fresh and serious knock?

Funnily enough, it still would have been fine, the treatment I mean. If someone had picked up a serious injury not much would have changed. Obviously, I wouldn’t be permitted to meet them face to face. What I’ve been doing since all this started is holding regular zoom calls and I’ve been communicating regular with the lads across a variety of platforms. It’s been really interesting. All the lads are kitted out, as best as they can be under the circumstances, in terms of the home equipment they need.

That allows me to set up a time and we go through the rehab, through Zoom. It’s not the way you’d like to do it but we’ve all had to improvise and find different ways.

One of the lads had a little knock, nothing serious, and what we did was very simple. Your evaluation, it’s then based around subjective assessment and getting as much information as possible from the player. You base a hypothesis around that and then you target your rehab from that information.

There definitely are areas, and I’m sure everyone working remotely will find this; but some of it definitely can be retained in the future as it is more practical and less time consuming than having to meet face to face. As a physio, I much prefer the one to one engagement. It’s a hands on role.

When lads are doing gym sessions and rehab you want to be there and looking at technique and form. You can’t substitute for that. But I do see avenues there for the future with how we’re currently having to work. Donegal is a huge county. If there is the opportunity to save lads travelling up to two or maybe three hours of a round trip, to see me, then we’ll look at it through the methods we’re maybe using at this moment.

As a management group even, some of this can definitely be retained. I’ve a friend as a physio working at Wasps Rugby Club. He said this will definitely change the way they go about some of their business. And that’s a professional team. So much of the regular face to face stuff can be done this new way. It’s all really interesting as to where it’ll lead on to.”

Q: The job of an intercounty physio appears high pressure. On any given Championship Sunday, there are some big on-the-spot decisions to be made. Physically and mentally, it must be draining?

A: I enjoy it. It can be hectic. I came on board at the end of the 2016 season. I joined the group in October of that year. I’d graduated in August and Rory Gallagher, the then manager got in touch. I’ve been there since. You learn as you go. And you get better at dealing with what it can throw at you. Game days take on a life of their own. I remember my first year, after most games, I was getting these headaches. I think it was just… not stress but just the comedown from the tension you were probably putting yourself under. I think you learn to deal with that all as you get more comfortable in the role.

You’re constantly watching, you’re in a state of concentration. When you do go out, you’re already processing what you think might be the problem. You’ve usually seen how the injury happened, how the player went down. Are they holding their head?

If someone is sprinting or turning and they pull up right away, that’s a huge red flag. You’re nearly sure they’re not going to be able to continue. With most injuries, the subjective and objective assessment, checking the range of movement, in a lot of cases a quick strength assessment to see does that reproduce their pain and the severity of same. The skills test, you’re getting them up on their feet and seeing can they weight bearing.

Something that’s more prevalent in the last year, as soon as you go out referees, who are under their own pressure, are on you. They’ve really cracked down on time. And you might only have 15 to 20 seconds to make a high pressure call. So you might have the ref in one ear, Dr Kevin Moran on one side and then the player in front of you. So a good and safe call has to be made in the middle of all of that! But like I said, I’m much more comfortable now and, like anything, that has come with experience.”

Q: ‘Tales from the Treatment Table’, that would make a great title for a very interesting book! Could you write your own book yet?!

Funny, I remember listening to Dan McFarland, Ulster Rugby Head Coach, and he was saying when he went there at the start he hated the idea of how the physios were portrayed. His annoyance was that physios were seen as individuals that just fixed people and got them back onto the pitch.

What he said was that physios actually spent so much time with the players when they’re injured. He said there is a massive role to be played there. Personally, when you spend so much time with someone, particularly through a rehab programme, a bond is created. There is a real trust there. That’s special. Through any rehab journey there are ups and but there also can be setbacks. So you do learn so much about the individual in those times. To me, the player is the be all and end all. Players tell you so much about their lives, be it on the treatment table or in the one-to-one sessions in the gym. They’re on their own journeys back to fitness and you are on it with them. It’s rewarding on a good few levels.”


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