Mark Roe

Protection Against Spikes in Workload With Aerobic Fitness and Playing Experience: The Role of the Acute:Chronic Workload Ratio on Injury Risk in Elite Gaelic Football

PURPOSE To examine the association between combined session rating of perceived exertion (RPE) workload measures and injury risk in elite Gaelic footballers. METHODS Thirty-seven elite Gaelic footballers (mean ± SD age 24.2 ± 2.9 y) from 1 elite squad were involved in a single-season study. Weekly workload (session RPE multiplied by duration) and all time-loss injuries (including subsequent-wk injuries) were recorded during the period. Rolling weekly sums and wk-to-wk changes in workload were measured, enabling the calculation of the acute:chronic workload ratio by dividing acute workload (ie, 1-weekly workload) by chronic workload (ie, rolling-average 4-weekly workload). Workload measures were then modeled against data for all injuries sustained using a logistic-regression model. Odds ratios (ORs) were reported against a reference group. RESULTS High 1-weekly workloads (≥2770 arbitrary units [AU], OR = 1.63-6.75) were associated with significantly higher risk of injury than in a low-training-load reference group (<1250 AU). When exposed to spikes in workload (acute:chronic workload ratio >1.5), players with 1 y experience had a higher risk of injury (OR = 2.22) and players with 2-3 (OR = 0.20) and 4-6 y (OR = 0.24) of experience had a lower risk of injury. Players with poorer aerobic fitness (estimated from a 1-km time trial) had a higher injury risk than those with higher aerobic fitness (OR = 1.50-2.50). An acute:chronic workload ratio of (≥2.0) demonstrated the greatest risk of injury. CONCLUSIONS These findings highlight an increased risk of injury for elite Gaelic football players with high (>2.0) acute:chronic workload ratios and high weekly workloads. A high aerobic capacity and playing experience appears to offer injury protection against rapid changes in workload and high acute:chronic workload ratios. Moderate workloads, coupled with moderate to high changes in the acute:chronic workload ratio, appear to be protective for Gaelic football players.

High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football.

OBJECTIVES To examine the relationship between chronic training loads, number of exposures to maximal velocity, the distance covered at maximal velocity, percentage of maximal velocity in training and match-play and subsequent injury risk in elite Gaelic footballers. DESIGN Prospective cohort design. METHODS Thirty-seven elite Gaelic footballers from one elite squad were involved in a one-season study. Training and game loads (session-RPE multiplied by duration in min) were recorded in conjunction with external match and training loads (using global positioning system technology) to measure the distance covered at maximal velocity, relative maximal velocity and the number of player exposures to maximal velocity across weekly periods during the season. Lower limb injuries were also recorded. Training load and GPS data were modelled against injury data using logistic regression. Odds ratios (OR) were calculated based on chronic training load status, relative maximal velocity and number of exposures to maximal velocity with these reported against the lowest reference group for these variables. RESULTS Players who produced over 95% maximal velocity on at least one occasion within training environments had lower risk of injury compared to the reference group of 85% maximal velocity on at least one occasion (OR: 0.12, p=0.001). Higher chronic training loads (≥4750AU) allowed players to tolerate increased distances (between 90 to 120m) and exposures to maximal velocity (between 10 to 15 exposures), with these exposures having a protective effect compared to lower exposures (OR: 0.22 p=0.026) and distance (OR=0.23, p=0.055). CONCLUSIONS Players who had higher chronic training loads (≥4750AU) tolerated increased distances and exposures to maximal velocity when compared to players exposed to low chronic training loads (≤4750AU). Under- and over-exposure of players to maximal velocity events (represented by a U-shaped curve) increased the risk of injury.

Hamstring injuries in elite Gaelic football: an 8-year investigation to identify injury rates, time-loss patterns and players at increased risk

Background Hamstring injuries occur frequently in field sports, yet longitudinal information to guide prevention programmes is missing. Aim Investigate longitudinal hamstring injury rates and associated time loss in elite Gaelic football, while identifying subgroups of players at increased risk. Methods 38 data sets from 15 elite male Gaelic football teams were received by the National Gaelic Athletic Association (GAA) Injury Surveillance Database between 2008 and 2015. Injury and exposure data were provided by the teams medical staff via an online platform. Results 391 hamstring injuries were sustained accounting for 21% (95% CI 20.0% to 21.7%) of all injuries. Prevalence was 21% (95% CI 19.2% to 23.4%). Incidences were 2.2 (95% CI 1.9 to 2.4) per 1000 exposure hours, and 7.0 (95% CI 6.5 to 7.1) times greater in match play than in training. Typically each team sustained 9.0 (95% CI 7.0 to 11.0) hamstring injuries per season affecting the: bicep femoris belly (44%; 95% CI 39.4% to 48.7%); proximal musculotendinous junction (13%; 95% CI 9.8% to 16.3%); distal musculotendinous junction (12%; 95% CI 8.6% to 14.9%) and semimembranosis/semitendinosis belly (9%; 95% CI 6.3% to 11.7%). ∼36% (95% CI 31.5% to 41.0%) were recurrent injuries. Mean time loss was 26.0 (95% CI 21.1 to 33.0) days, which varied with age, injury type and seasonal cycle. Hamstring injuries accounted for 31% (95% CI 25.8% to 38.2%) of injury-related time loss. Previously injured players (rate ratio (RR)=3.3), players aged 18–20 years (IRR=2.3) or >30 years (RR=2.3), as well as defensive (IRR=2.0) and midfield players (RR=1.5), were most at risk of sustaining a hamstring injury. Comparisons of 2008–2011 with 2012–2015 seasons revealed a 2-fold increase in hamstring injury incidences. Between 2008 and 2015 training incidence increased 2.3-fold and match-play incidences increased 1.3-fold. Conclusions Hamstring injuries are the most frequent injury in elite Gaelic football, with incidences increasing from 2008–2011 to 2012–2015. Tailoring risk management strategies to injury history, age and playing position may reduce the burden of hamstring injuries.

A six stage operational framework for individualising injury risk management in sport

Managing injury risk is important for maximising athlete availability and performance. Although athletes are inherently predisposed to musculoskeletal injuries by participating in sports, etiology models have illustrated how susceptibility is influenced by repeat interactions between the athlete (i.e. intrinsic factors) and environmental stimuli (i.e. extrinsic factors). Such models also reveal that the likelihood of an injury emerging across time is related to the interconnectedness of multiple factors cumulating in a pattern of either positive (i.e. increased fitness) or negative adaptation (i.e. injury).The process of repeatedly exposing athletes to workloads in order to promote positive adaptations whilst minimising injury risk can be difficult to manage. Etiology models have highlighted that preventing injuries in sport, as opposed to reducing injury risk, is likely impossible given our inability to appreciate the interactions of the factors at play. Given these uncertainties, practitioners need to be able to design, deliver, and monitor risk management strategies that ensure a low susceptibility to injury is maintained during pursuits to enhance performance. The current article discusses previous etiology and injury prevention models before proposing a new operational framework.

Yo-Yo Intermittent Recovery Test Performance in Subelite Gaelic Football Players From Under Thirteen to Senior Age Groups.

Abstract Roe, M and Malone, S. Yo-Yo intermittent recovery test performance in subelite Gaelic football players from under thirteen to senior age groups. J Strength Cond Res 30 (11): 3187–3193, 2016—Gaelic football is indigenous to Ireland and has similar locomotion profiles to soccer and Australian Football. Given the increasing attention on long-term player development, investigations on age-related variation in Yo-Yo intermittent recovery test level 1 (Yo-YoIR1) performance may provide useful information in talent identification, program design, and player monitoring. Therefore, the aim of this study was to evaluate Yo-YoIR1 performance across Gaelic football age groups. Male participants (n = 355) were recruited from division one, Gaelic football teams. Participants were allocated to one of the 7 groups according to respective age groups from under 13 (U13), under 14, under 15 (U15), under 16 (U16), minor, under 21 (U21), to senior age groups. Total Yo-YoIR1 distance (m) increased progressively from U13 (885 ± 347 m) to U16 (1,595 ± 380 m) equating to a rate of change of 180.2%. In comparison to U13, total distance at minor (1,206 ± 327 m) increased by 136.4%. Subsequent increases were observed in U21 (1,585 ± 445 m) and senior players (2,365 ± 489). Minimum (800–880 m) and maximum (2,240–2,280 m) total distances were comparable for U15, U16, and U21 players. Differences in total distance (m) for all age groups were statistically significant when compared to U13 players (p < 0.002). In comparison to U13 players, the magnitude of differences between age groups for total distance was deemed to be large (effect size > 0.8). Similar trends were observed for maximum velocity and estimated V[Combining Dot Above]O2max. The evolution of Yo-YoIR1 performance in Gaelic football players from adolescents to adulthood highlights how maturation may influence sport-related running ability. Changes in Yo-YoIR1 performance should be closely monitored to optimize interventions for individuals transitioning across age groups.

Injury Scheme Claims in Gaelic Games: A Review of 2007-2014.

CONTEXT Gaelic games (Gaelic football and hurling) are indigenous Irish sports with increasing global participation in recent years. Limited information is available on longitudinal injury trends. Reviews of insurance claims can reveal the economic burden of injury and guide cost-effective injury-prevention programs. OBJECTIVE To review Gaelic games injury claims from 2007-2014 for male players to identify the costs and frequencies of claims. Particular attention was devoted to lower limb injuries due to findings from previous epidemiologic investigations of Gaelic games. DESIGN Descriptive epidemiology study. SETTING Open-access Gaelic Athletic Association Annual Reports from 2007-2014 were reviewed to obtain annual injury-claim data. PATIENTS OR OTHER PARTICIPANTS Gaelic Athletic Association players. MAIN OUTCOME MEASURE(S) Player age (youth or adult) and relationships between lower limb injury-claim rates and claim values, Gaelic football claims, hurling claims, youth claims, and adult claims. RESULTS Between 2007 and 2014, €64 733 597.00 was allocated to 58 038 claims. Registered teams had annual claim frequencies of 0.36 with average claim values of €1158.4 ± 192.81. Between 2007 and 2014, average adult claims were always greater than youth claims (6217.88 versus 1036.88), while Gaelic football claims were always greater than hurling claims (5395.38 versus 1859.38). Lower limb injuries represented 60% of all claims. The number of lower limb injury claims was significantly correlated with annual injury-claim expenses (r = 0.85, P = .01) and adult claims (r = 0.96, P = .01) but not with youth claims (r = 0.69, P = .06). CONCLUSIONS Reducing lower limb injuries will likely reduce injury-claim expenses. Effective injury interventions have been validated in soccer, but whether such changes can be replicated in Gaelic games remains to be investigated. Injury-claim data should be integrated into current elite injury-surveillance databases to monitor the cost effectiveness of current programs.

Monitoring player fitness, fatigue status and running performance during an in-season training camp in elite Gaelic football

ABSTRACT Objectives: To examine selected perceptual and physiological measures to monitor fitness, fatigue and running performance during an in-season training camp in elite Gaelic football. Methods: Twenty-two elite Gaelic football players were monitored for training load, perceived ratings of wellness, heart rate variability (HRV; LnSD1), heart rate recovery (HRR), exercise heart rate (HRex), lower limb muscular power (CMJ) and global positioning system (GPS) variables. The Yo-Yo intermittent recovery test level 1 (Yo-YoIR1) was assessed pre and post the training camp. With specific small-sided games (SSG) used as a measure of running performance. Results: During the camp, HRex decreased (−12.2%), HRR increased (+10.3%), CMJ decreased (−8.1%) and pretraining LnSD1 (+14.1%) increased during the camp period. Yo-YoIR1 performance (+19.7%), total distance (TD) (+9.4%), high-speed distance (HSD) (+12.1%) and sprint distance (SPD) (+5.8%) within SSG improved as the camp progressed. Δ HRex and Δ HRR were correlated with Δ Yo-YoIR1 (r = 0.64; – 0.55), ΔHSD (r = 0.44; −0.58) and Δ SPD (r = 0.58; −0.52).There were large correlations between Δ wellness and Δ Yo-YoIR1 (r = 0.71), Δ TD (r = 0.68) and Δ SPD (r = 0.68). Conclusions: Daily variations in training load measures across the camp period were shown to systematically impact player’s physiological, performance and wellness measures.

Eccentric knee flexor strength profiles of 341 elite male academy and senior Gaelic football players: Do body mass and previous hamstring injury impact performance?

OBJECTIVE Report eccentric knee flexor strength values of elite Gaelic football players from underage to adult level whilst examining the influence of body mass and previous hamstring injury. DESIGN Cross-sectional study. SETTING Teams training facility. PARTICIPANTS Elite Gaelic football players (n = 341) from under 14 years to senior age-grades were recruited from twelve teams. MAIN OUTCOME MEASURES Absolute (N) and relative (N·kg-1) eccentric hamstring strength as well as corresponding between-limb imbalances (%) were calculated for all players. RESULTS Mean maximum force was 329.4N (95% CI 319.5-340.2) per limb. No statistically significant differences were observed in relative force values (4.4 N ·kg-1, 95% CI 4.2-4.5) between age-groups. Body mass had moderate-to-large and weak associations with maximum force in youth (r = 0.597) and adult (r =0 .159) players, respectively. Overall 40% (95 CI 31.4-48.7) presented with a maximum strength between-limb imbalance >10%. Players with a hamstring injury had greater relative maximum force (9.3%, 95% CI 7.0-11.8; p > 0.05) and a 28% (95% CI 10.0-38.0) higher prevalence of between-limb imbalances ≥15% compared to their uninjured counterparts. CONCLUSIONS Overlapping strength profiles across age-groups, combined with greater strength in previously injured players, suggests difficulties for establishing cut-off thresholds associated with hamstring injury risk.

Lower limb injuries in men’s elite Gaelic football: A prospective investigation among division one teams from 2008 to 2015

OBJECTIVES To prospectively investigate incidence and associated time-loss of lower limb injuries in elite Gaelic football. Additionally, to identify sub-groups of elite players at increased risk of sustaining a lower limb injury. DESIGN Prospective, epidemiological study. METHODS Team physiotherapists provided exposure and injury on a weekly basis to the National Gaelic Athletic Association (GAA) Injury Surveillance Database. Injury was defined using a time-loss criterion. Fifteen different teams participated throughout the 8-year study providing 36 team datasets from 2008 to 2015. RESULTS Lower limb injuries (n=1239) accounted for 83.5% (95% CI 82.0-85.0) and 77.6% (95% CI 75.8-79.4) of training and match-play injuries, respectively. Injury incidence was 4.5 (95% CI 3.7-5.2) and 38.4 (95% CI 34.3-42.60) per 1000 training and match-play hours, respectively. One-in-four (25.0%, 95% CI 22.4-27.0) lower limb injuries were recurrent. Non-contact injuries accounted for 80.9% (95% CI 79.2-82.6) of cases. The median team rate was 30 (IQR 24-43) lower limb injuries per season resulting in 840.8 (95% CI 773.3-908.2) time-loss days. Previously injured players had a 2.5-times (OR 95% CI 2.2-2.8) greater risk of sustaining a lower limb injury. Overall, 56.8% of players with a previous lower limb injury sustained another. Incidence was higher for forward players and those aged >25years. CONCLUSIONS Lower limb injuries are the most common injury among elite division one Gaelic football teams. Injury risk management should become an ongoing component of a players development programme and consider injury history, age, and playing position.

Time to get our four priorities right: an 8-year prospective investigation of 1326 player-seasons to identify the frequency, nature, and burden of time-loss injuries in elite Gaelic football

Managing injury risk requires an understanding of how and when athletes sustain certain injuries. Such information guides organisations in establishing evidence-based priorities and expectations for managing injury risk. In order to minimise the impact of sports injuries, attention should be directed towards injuries that occur frequently, induce substantial time-loss, and elevate future risk. Thus, the current study aimed to investigate the rate at which elite Gaelic football players sustain different time-loss injuries during match-play and training activities. Datasets (n = 38) from elite Gaelic football teams (n = 17) were received by the National Gaelic Athletic Association Injury Surveillance Database from 2008 to 2016. A total of 1,614 time-loss injuries were analysed. Each season teams sustained 24.0 (interquartile ranges) (IQR 16.0–32.0) and 15.0 (IQR 10.0–19.0) match-play and training injuries, respectively. When exposure was standardised to 1,000 h, greater rates of injury (12.9, 95% CI [11.7–14.3]) and time-loss days (13.4, 95% CI [12.3–14.9]) were sustained in match-play than in training. Acute injury rates were 3.1-times (95% CI [2.7–3.4]) greater than chronic/overuse injuries. Similarly, non-contact injury rates were 2.8-times (95% CI [2.5–3.2]) greater than contact injuries. A total of 71% of injuries in elite Gaelic football affected five lower limb sites. Four lower limb-related clinical entities accounted for 40% of all time-loss injuries (hamstring, 23%; ankle sprain, 7%; adductor-related, 6%; quadriceps strain, 5%). Thus, most risk management and rehabilitation strategies need to be centred around five lower limb sites—and just four clinical entities. Beyond these, it may be highly unlikely that reductions in injury susceptibility can be attributed to specific team interventions. Thus, compliance with national databases is necessary to monitor injury-related metrics and future endeavours to minimise injury risk.