I get asked every week by a patient in the clinic whether the best course of action with their current injury is to stop all activity until it recovers. And so when I saw a recent discussion with Darren Burgess discussing this very topic I felt it was a good time to discuss it here.
If you know any Demons supporters in the AFL you will have not stopped hearing about how good they were, how they were the best prepared and the most physically capable etc etc. And some of the more astute supporters even pay attention to the performance staff and what effect they have had on the landscape at Melbourne Football Club. The most well known performance staff professional in Australia is probably Darren Burgess. With a multitude of international experience and success, he is often the most highly sought after high performance manager in the AFL and Australian sport. And at the end of 2019 he moved to Melbourne Football Club assisting the coaches and other performance staff to winning the 2021 premiership.
Unfortunately for demons fans he has already accepted a ob in Adelaide for the upcoming season. However in a recent podcast he spoke about some of the changes that he and the performance and coaching team implemented that they feel had an effect on the preparation of the team. The most striking part of the discussion was where he explained that the philosophy around injuries, niggles and training gaps has changed enormously and the he felt it was a key reason that they had very high player availability across the season. For those who don’t work in sport, player availability is probably the least spoken about, most important factor in success of teams. It is becoming a much more broadly discussed factor in the 24/7 news reporting of sport, but injuries that reduce the availability of players ruins your chances of success. Not only do you not have your best players to influence the game, the disruption to the team structure often leads to issues that sees teams lose cohesion under pressure.
So what was the philosophical change?
The change that he described was that he shifted from completely resting players or reducing their training loads when they were carrying soreness or minor niggles. It is very common especially during a long season for players to be sore and tired, so when players presented with reports of these ailments, performance, medical and coaching staff have a few choices.
Do you push through minor complaints? Do you cut back the training completely? Do you modify the training to a small extent?
The answer is one of the most annoying answers to hear. It depends!
But what is clear is that very rarely is a minor complaint a reason to cut the training completely. In fact if you are to do this too often you set up the players to become more fragile over time and may actually increase the chances of them getting injured further in the future. Burgess went on to explain that the mindset of the entire playing and coaching staff changed. It became an environment in which the intensity of training was high and the expectation was that you were there to perform at a high level at all times. Now this does not mean that you train when you are clearly injured, but he mentioned that there was no stopping for a minor ankle tweak or a tight back. If you are a Melbourne player you know that training will be hard and at a high intensity and that was the attitude they brought to training and playing.
This also extended to when players were injured and unable to participate, in fact I often suggest to athletes that when they are injured they are likely going to train harder than when they were not injured. It will likely be modified (bike instead of running for instance) but you will be working as hard as you can.
So what is the mindset behind this?
We have spoken about sports performance researcher Tim Gabbett previously in a number of articles and his research has highlighted multiple times that the aim of training and of preparation is to extend the athletes capabilities to levels as high or higher than that they would experience in competition. What this does is it lifts their performance potential but also creates a buffer to reduce the likelihood of injury. The reason this is the case is that the forces, speeds, movements in training environment have created the opportunity of the athletes to adapt to the requirements of the sport and placed them in a position that what they experience during their sport is less than what they have in training. Effectively it makes the athlete robust to the stress they experience in their sports activity.
With all of this in mind the answer is not to push everyone through injuries. But in many cases there is a need to seek out opportunities to extend patients and athletes capabilities when the opportunity arises, so that they have more tolerance for the stresses of competition when they encounter them once again. The effect of dropping training loads down each time the environment, body, or mind is not perfect leads to athletes and patients with the inability to deal with future physical stress, leaving them more susceptible to injuries in the future.
Take Aways.
- If a patient of athlete presents with an issue look to identify what the major features are that are needed to improve their capability in the future. These may include strength, speed, jump and land capability, endurance factors.
- If there is opportunity to maintain relatively pain free activity whilst managing an issue, keep the training or workloads as close to the desired prescription as possible.
- If the person is unable to complete the tasks due to the injury, ask the questions what else and where else? This will allow you to formulate a plan that addresses other features or the required features by looking at what else you can do to extend their capability to make them more robust going forward.