Category: Blog

As a young teenager I was an aspiring athlete but unfortunately skill and injury both got in the way, so instead I decided that I if I wasn’t on the pitch, I’d like to be on the pitch side and that really drew me to sports medicine.

I’ve worked in a number of different sporting roles in the past with international soccer teams, intercounty GAA, European Tour golf, as well as rowing and rugby. Currently I work in the Sports Ireland Institute as well, which basically involves working with track and field Irish athletic team, so I’m part of the Olympic Federation of Ireland traveling team, with Team Ireland for Paris.

I have a specific interest in bone stress injuries, factors that can increase bone stress injuries include strength and biomechanics changes, endocrine and hormonal deficiencies, bone health issues so it’s important to take a quite a large, broad investigative net really to try and find out exactly why it’s happened.

We’re lucky here at UPMC to have a full team of people and that can help with management options regardless of the injury. We have access to orthopaedic surgeons to neurosurgeons to Radiologists to specialist physios to Sport Science as well as strength and conditioning coaches, that can help with the issue once we identify it accurately.

Sports Science has exploded in the recent years and I think it’s important really to not get lost in the numbers and to really focus on the patient or the athlete. I use fitness wearables quite a lot, for tracking illness and injury recovery. Technology as well in terms of Imaging, we’re really lucky here at UPMC Sports Surgery Clinic to have such a phenomenal team of musculoskeletal radiologists that have been a great help to both the Team Ireland Olympic athletes as well as the patients here at UPMC.

Quite unique here in that we have such a wide ranging team with so many unique skill sets, we do see that in in elite sporting settings but we rarely see it in settings that are available to the public so it’s energizing to be able to work in such setting. We have a number of elite athletes that will come when they’re injured, to our clinic and attend on a daily basis at times for more specialist rehab. Wouldn’t be uncommon in the waiting room to see a number of athletes, recognizable athletes,  there has been professional rugby players from France attend here, professional Australian football league players, professional golfers, as well as professional Premier League soccer players.

With a lot of elite athletes, they have huge muscle mass in their hamstrings so MRI can be really helpful to identify the exact structure that’s injured, that helps us to guide rehab and helps us to give the athlete a little bit better prognosis about the return to play times. Two of the physios here are currently carrying out PhDs in hamstring rehab and it’s really important for us to be able to guide rehab with the best evidence. The athletes that I have been working with very closely over the last number of years a few in particular, that have had a number of illnesses and injuries, that I would hope to think that I’ve helped them with seeing them perform to their best on the world stage would be the most satisfying moment for me.

As a sports and exercise medicine physicians we not only care for elite athletes we care for everyone. For a recreational runner, for general advice I suppose in terms of if you’re new to training don’t try to increase your training load or training intensity too quickly take things quite gradually, I suppose important as well to not just focus on your running but also work on your strength. Listen to the niggles don’t run through injuries and seek help early when you do have injuries and issues, there are people there to help with that. Physical inactivity is a really big issue worldwide so I suppose sports and exercise medicine has a larger role to play not just for elite sport but also for everyone out there.

The most common sports injuries I would see usually relate to instability of the shoulder especially in collision sports, we have so many rugby players in this country and obviously rugby sevens is up and coming and, in the Olympics, we have Gaelic football and hurling, so there is a range of shoulder injuries that can happen in sports and we take care of all of them. For more recreational athletes, if you’re out there on your own a good place to start is with your GP because they will be able to assess whether this is something that can be sent to a physiotherapist or is it something that needs to come directly to us here.

We are always happy to take direct queries as well so patients can contact us here at UPMC Sports Surgery Clinic and we have the sports medicine department and we have orthopaedic specialists in each joint. A man who had a shoulder replacement came last week and said it’s a whole new way of life because I can sleep at night and I can lift my grandkids so that’s not a high performing athlete but that’s somebody’s life is much better because of what we could do. Its also very rewarding when you have the elite athletes and you see them get back to the same level they were at before their shoulder surgery.

We have colleagues in lots of different orthopaedic sub specialties so I will often consult with a spine specialist as well if I think someone may have a neck problem or the pain specialist, the physiotherapy department has a really advanced shoulder team as well, so sometimes we put our heads together to come up with the best plans and usually that involves discussing the whole thing with the patient or if it’s a younger athlete for example it might be with their parents also or their coach or physiotherapist.

One of the big challenges is when an athlete can safely return to play particularly in contact and collision sports the traditional ways of knowing that were just arbitrary timelines, depending on the type of surgical reconstruction but there is a lot more and our physiotherapy department has been doing a lot of work on that, Edel Fanning our lead shoulder physiotherapist has actually done a PhD in this area in collision athletes specifically after shoulder stabilization surgery, biomechanics testing along with isokinetic testing using things like force plates and that’s helping us to understand how to fine tune the rehab to a much more detailed level and individualized to each athlete and to their sport as well and we are lucky to have a really comprehensive biomechanics lab here at UPMC SSC that helps us with that.

I think its really that we measure the outcomes of our surgeries, not good enough, the surgery seems to go well on the day or your happy with it, the patient has to be happy with it ultimately, so we track these outcomes so this helps us to plot their progress. Ideally 1 year, 2 year, 5 years that we are delivering measurable outcomes and we can then advise future patients what they can expect as well. I would tell people who have shoulder problems there is often more that can be done than you think, so I would encourage us to engage with us and let us try and help them if they have a shoulder problem that’s not going away.

We are not just for elite athletes although we do take a lot of satisfaction and a lot of pride in taking care of elite athletes right from professional rugby players, Olympic athletes, we are equally as proud of the people who are in their 80s or 90s and need joint replacements. Seeing somebody just having a better life after what I have been able to do for them is the most satisfying thing.

At UPMC Sports Surgery Clinic I work as a rehabilitation specialist, I have a particular interest in calf and Achilles tendon injuries, Foot and Ankle injuries, and general lower limb running injuries. I’ve had the opportunity to do a PhD in Achilles tendon injury rehab and lower limb biomechanics which I completed last year.

My background was a Race Walker, I competed over 20 kilometres and 50 kilometres and competed at the Beijing Olympic Games in 2008 and the London Olympic Games in 2012 and that led me down the road of biomechanics working on and developing any weaknesses or deficits in strength or athletic qualities. My career in Olympic sports gave me that inspiration to pursue that side of things further once I retired from elite sport. I understand what it’s like being an athlete so I can understand the stresses involved, I can understand what it’s like to be injured and you know, so I feel I can use my own experiences to connect with the athlete better and hopefully find the right solution for them.

Everybody’s treated the same regardless of their physical activity background and age profile, no two athletes are the same no two injuries, are the same. So, we would do a good thorough assessment, asses their muscle strength, their power and plyometric ability. Look at the running mechanics and what quality they’re lacking that might be relevant to either how they might have developed the injury or how they may be struggling to progress back to full training and try to individualize their plan based on their individual needs, what the gym access is like, what equipment they have and what time they can dedicate to their rehabilitation or strength program.

Taking into account their individual circumstances, their work demands, family demands and social demands and not trying to squeeze too much in. There’s going to be extra stress around exam time and that might heighten the risk of injury and getting the basics right getting 7 to 8 hours of sleep a night and good quality sleep, having a good diet and making sure they’re meeting their nutritional needs and stress management. We do try to make it fit to the person rather than trying to have a one size fits all model.

It’s hard to prevent every injury but we can certainly manage the risk of developing an injury or a repeat injury, so particularly during marathon season we see a lot of running injuries, that present in the last say two or three months before the marathon and depends on the injury but we try to get the athlete to the start line as best we can.

I’m really fortunate to work alongside a wide and multidisciplinary team of physiotherapists, fellow strength conditioning coaches, biomechanics, staff research assistants and our Sports Medicine consultants and then within the wider hospital you know radiology staff and consultant and orthopaedic surgeons. It really broadened my horizons allows me to see the bigger picture when someone has an injury and if there’s a problem to be solved be able to look far and wide to try and find that solution. We have regular in-service workshops and you know we learn from each other.

What gives me the most satisfaction?

Yeah, getting patient better, whatever that takes and even if I can’t do it all myself, sometimes it might be involving one of our Sports Medicine Consultants or maybe a colleague, particularly on some of those difficult, complex cases and doing whatever it takes to find the right solution for them and when they get to a point where they’re back doing the things they want to be able to do and have overcome their injuries. That gives me a lot of satisfaction, whether that’s an elite athlete, or whether that’s someone who just wants to be go back playing golf or walk their dog for half an hour every day, the principles are still the same and yes seeing someone achieve a satisfactory outcome gives me a lot of satisfaction in my job.

Trying to get your child into regular physical activity, from an early age and encouraging them to do that consistently is a really important life skill from a social perspective, from a mental health perspective and from a broad physical health perspective, and then more broadly for society as you have a healthier population overall.

The sports that are beneficial for children are the ones they will do, so everyone has their own preferences, those preferences will sometimes come from their siblings, their parents but the most important thing is they enjoy it, so if they ever get to a stage where they are feeling like they want to move away from a certain sport or start trying other things then I think encouraging them to do that is important and giving them a bit of time away from sport periodically as well and particularly through adolescence when we get growth spurts and changes in body shape and body composition, it takes a little while before the athlete gets used to using that body. We don’t want to be doing too much, you want to be able to facilitate a couple of rest days every single week.

Essentially, we have two ends of the spectrum, we have a group of children who don’t participate in sport and we need to nudge towards it, on the other end of the spectrum you have athletes who are playing maybe multiple sports for multiple teams. Making sure there are a couple of days where they are not playing sport each week is important, that allows recovery for the individual to make sure the risk of injury is lowered.

When you have young athletes, who are very good they are asked to play a lot by a series of different coaches so actually beginning to prioritize and ultimately learning to say no to coaches sometimes is an important for the child and the parent to support them in.

Training tips from anybody anywhere in the world might look cool on Instagram but it might not be applicable to that individual, so I think guarding against poor information or controversial information maybe is probably one of the more challenging areas and that’s where like seeking out a strength and conditioning professional is probably a better approach than purchasing a program from an online practitioner somewhere in the world.

The big thing I would say when you go along to watch sport as a parent is to just let them play, you are not there to coach and the way they play isn’t a reflection on you as a parent, so brining them there and leaving them alone I think would be a recommendation.

Being able to find a balance between fostering competition and social participation is challenging for coaches when you have a larger team, maybe a squad of players that is a lot bigger then the amount you can get on to the pitch and particular with younger age groups then rotation is important giving everyone a chance to shine and not just putting the best players on the pitch. If 90% of your players are still playing in their 20s that’s a far more important statistic than winning more games when you are 14.

In terms of guidelines when trying to ensure safety for children that would apply to any field sports, so ensuring the right level of coaching experience and ensuring good warm-ups prior to training probably two big pieces of safeguarding children.

I think we have had a change in our environments where free play and physical development has been curtailed and because of that children don’t get the same exposure to jumping, landing, running, falling that maybe previous generations might have and then we parachute them into organized field sports at a later age and they don’t have the physical literacy to be able to do that and that increases the risk of injury, last year we saw a 50% increase in ACL surgeries here at UPMC Sports Surgery Clinic and that’s not just because of the market share I think there has to be some changes in the athletic preparation prior to playing field sport.

We have professional players coming in to visit us for testing and rehabilitation, if you are 50 years old and have a sore knee you will under go the same testing processes, if you are a young athlete same thing. Our thought process here is we should be applying the same principles that we do for the elite athletes to everyone.