March a curse for cruciate injuries

If the adage “beware the ides of March” can be applied to Gaelic games, it must surely reflect the susceptibility of damaging an anterior cruciate ligament (ACL) during the month.

Ciarán Kilkenny, who describes it as “March madness”, picked up his season-ending tear this coming weekend 12 months ago. The same month, Cork’s Ruairi Deane and Mayo’s Cathal Carolan also experienced it.

Two of Colm O’Neill’s three cruciate injuries have come in March, as have one of John Galvin’s two setbacks. Four years ago this month, former Dublin hurler Stephen Hiney ruptured his.

In 2010, it was ex-Dublin footballer Paul Griffin and Meath’s David Bray. In 2009, there was Wexford hurler Eoin Quigley.

David Moran’s two tears came at the end of February and the beginning of April. The likes of Colm Cooper, Paddy Bradley, Gearóid McKiernan, Mark Davoren, Paul Brogan and Emlyn Mulligan have all broken down either side of March.

So why are they most common around this time of year and what exactly are the reasons for cruciate problems?

 

1 THE GROUND

The recent cold snap wouldn’t suggest it nor the underfoot conditions last weekend but March is usually when the sod dries up. Where one week there may be give on a field, there may be none the following week or thereafter. There’s an inconsistency issue between pitches too.

For example, the Croke Park surface for the Dublin-Tyrone game this Saturday will be nothing like the turf Jim Gavin’s side encountered in Fitzgerald Stadium last Sunday.

2 ARTIFICIAL SURFACES

A major concern of medics going back years, it has been suggested in several pieces of academic work that synthetic pitches raise the chances of cruciate injuries.

But there is also the issue of exchanging training on synthetic during the week for a regular grass pitch come the weekend. Sand-based pitches are also blamed.

 

3 TECHNIQUE

Tony McEntee of this parish gave a stirring address at last month’s Ulster GAA Coaching Conference in Tyrone. He warned the basics were being taken for granted.

“Kicking technique, jumping technique, landing technique... in the GAA we just accept that people can do this things. It’s wrong to make that assumption. A lot of injuries stem from landing mechanics and running mechanics. In the GAA we have tended to ignored these things.”

4 CONDITIONING

In his seven years with Tipperary, their former physio John Casey encountered just one cruciate injury.

His methods were thorough and also included taking players from training if he detected warning signs. On the escalation of ACL injuries, he said: “The focus appears to be on strengthening and powering up quads but neglecting the hamstrings, which participate in reverse running, moving side to side and speeding up and slowing down. That causes an imbalance around the knee.”

 

5 FOOTWEAR

In 2011, Fermanagh club St Patrick’s banned blade boots after four of their players suffered cruciate injuries. There had been studies done which concluded blades created more traction than studs. That being said, the grip provided by studs is that good these days the difference can be marginal.

 

6 FATE

No, not a matter of luck but the chances of damaging an ACL are high considering how weak the ligament is. As knee expert Dr Ray Moran says, it’s “puny”.

He continued: “The simplest movement could damage it. You’re talking about snapping a chicken’s neck and if it rotates beyond the control of the brace, there lies the difficulty.” The GAA have developed a prehab routine — GAA15 — aimed at reducing such injuries but Moran doesn’t believe any prehab workout can increase the stability of the cruciate.

 

7 INTENSITY

With four games over five weekends in the Allianz Football League and four in as many weeks in the hurling equivalent, the risk of picking up the injury are increased, especially when the top flight in each code is ultra-competitive. Although a lot of cruciate ruptures are non-contact, the more times players are involved in full-blown action, the more chance of bother.

 

8 DISTRACTION

Another knee expert Tadhg O’Sullivan has spoken of how Cooper and Henry Shefflin picked up their injuries when they had their minds on something else.

“How many times has a fella given him (Cooper) a push in the back like that and he’s got up?

Thousands and thousands of times. But on this occasion he just did it at the wrong angle with his toe and foot getting caught. Your brain automatically sets your muscles and everything to protect your knee, but if you get distracted by something else then that’s the moment that something happens.

The last time Henry did it, it was catching a ball against Cork. He had put up his hand and the ball just popped out of it. As he was landing, he tried to catch it a second time.”

 

9 BETTER MEDICINE

It sounds simplistic but ACL injuries are no new phenomenon. That we’ve only been hearing about them so much over the last 10 years is because they are diagnosed and treated. As Dublin defender and physio Mick Fitzsimons states: “They were always there but the surgery and rehab probably wasn’t there to fix them so a lot of players would’ve just retired or just got on with them.”

10. OCCUPATIONALHAZARD

The conclusion UK physio Paul McCormack, came to when he studied ACL injuries. As Kilkenny shrugged after his disappointment last year: “I’ve another 10 years ahead of me playing GAA, so I suppose you’re bound to get one bad injury at one stage.”


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