Dazed and contused: Tackling concussion in women head on – Colm Fuller SSC

Sports Surgery Clinic’s head of Physiotherapy, Colm Fuller, contributed to this article by Sharon Ni Chonchuir which was published in the Irish Examiner in December 2022.

A growing number of women are togging out to participate in team sports. The Football Association of Ireland’s 2019 review found that there were more than 19,000 female youth and 4,800 adult soccer players in Ireland. The Ladies Gaelic Football Association has more than 1,000 clubs nationwide. And as of 2018, there were 2,500 girls and 1,341 women playing rugby union.

While this level of women’s involvement in sport is to be celebrated, it is concerning that their injury rates are increasing in tandem with their participation rates. A 2019 study [exa.mn/women-rugby-injuries] reported that St Vincent’s Hospital in Dublin had experienced a 243% surge in injured female rugby players presenting at the hospital in the previous ten-year period and its authors warned of an increasing number being treated for concussion.

It’s happening in ladies’ Gaelic football too. A recent DCU survey of 657 players found that 10% had been diagnosed with concussion in 2020 and a further 8% thought they had been concussed but hadn’t reported it.

Experts point out that delaying seeking medical attention for concussion can lead to persistent symptoms.

International research warns that women may be more vulnerable to concussion than men. A 2021 study [exa.mn/soccer-concussion] led by Abigail Bretzin, a research investigator at the University of Michigan’s Injury Prevention Centre, looked at data from 43,000 male soccer players and 39,000 female soccer players over three years. It concluded that girls’ chances of concussion were 1.88 times higher than boys’ and that they were more likely to require longer recovery times.

“It proves something we’ve suspected for a while,” says Bretzin. “When comparing sports that men and women participate in, women have a higher rate of concussion.”

Bretzin is one of many academics working to uncover the reasons for this gender bias.

“Some studies suggest there are differences in axonal structures in male and female brains,” she says. “Axons are tiny fibres that form a network within the brain, transporting information from neuron to neuron. A 2017 study [exa.mn/axonal-structure] found that female axons were predisposed to greater mechanical damage and physiological dysfunction compared to male axons receiving the same injury. However, this is limited to animal studies and more research is needed.”

Other research points towards the difference in neck strength, girth and circumference as a factor that may reduce females’ ability to resist a head impact compared to males. “Using neck strengthening and muscle activation is now being studied as a way to protect athletes, and military personnel, from concussions,” says Bretzin.

Dazed and contused

Colm Fuller is the head of physiotherapy at the Sports Surgery Clinic in Santry and has worked with the London Irish, Munster and Ireland Rugby teams. He explains that concussion is a “mild traumatic brain injury that results from a transfer of mechanical energy to the brain from external forces”.

This can happen in all sorts of ways. Players can sustain a direct knock to the head by bashing against another player or hitting a ball or a goalpost. Concussion can also be indirect, resulting from the brain absorbing some of the impact from a fall on another part of the body.

“Sports – particularly contact and collision sports – account for approximately 20% of concussion injuries, but concussion can happen in many other circumstances,” says Fuller.

It can also result in a wide range of symptoms. “Some people experience a change in mental status and become dazed and confused,” says Fuller. “Others have physical symptoms such as headache, dizziness or increased sensitivity to light and noise. There can be cognitive symptoms like difficulty concentrating. There can also be emotional symptoms with people experiencing emotions that are uncharacteristic or heightened for them.”

Losing consciousness only happens in about 10% of cases. “The brain has three main parts: the left and right hemispheres and the brain stem,” says Fuller. “A loss of consciousness may only occur when both hemispheres are disrupted at once. If only one side is disrupted, the other side can usually compensate and help it out.”

Because concussion is a mild form of brain injury, it affects how the brain works but doesn’t cause physical damage. Scans won’t show bruising or bleeding of the brain. This means it’s typically diagnosed by analysing the symptoms that follow a head injury.

“It could be a cognitive test such as asking the patient their name, where they are and what time of day it is,” says Fuller. “Or maybe a balance test or seeing how their eyes move and react to vision tasks.”

While symptoms can be serious, Fuller reassures us that they are usually temporary. “Most of the time, they resolve and people recover,” he says. “Adults are typically symptom-free within four weeks of their injury.”

However, recovery is dependent on them receiving proper treatment. Delaying treatment can have significant consequences, leading to more serious injury, prolonged recovery and even death.

“Early intervention promotes better recovery,” says Fuller. “About 30% of concussions have persistent symptoms and, in most cases, this is because they delayed seeking medical attention.”

Governing bodies have introduced guidelines to protect their male and female players from concussion. These guidelines are similar across GAA, soccer and rugby.

As soon as someone sustains a suspected or confirmed concussion, they must immediately be removed from play and subjected to a medical examination before following a graduated return to play.

This phased return consists of five steps. The first is two days of complete physical and cognitive rest. The second involves building up to normal activities and light exercises. Then aerobic exercises are introduced, followed by sports-specific and non-contact exercises before players finally return to full contact practice. Players can only progress from one step to the next if they remain symptom-free during the various exercises and for 24 hours afterwards.

Different guidelines

The Irish Rugby Football Union and the Football Association of Ireland apply the same guidelines to male and female players but the GAA distinguishes between the sexes. In recognition of the evidence that females may require more time to recover, they are advised to take at least two weeks before returning to full contact training and matches, while men are advised to take at least one week.

Increasing medical personnel at women’s sports could help redress the concussion gender imbalance.

“We have seen that the quality of medical personnel available at the time of injury may not always be equal for women and men,” says Bretzin. “Equal access to trained medical providers could help in early concussion management.”

Fuller agrees. “Women’s sports tend to have less financial support than men’s, which means that they’re less likely to have medical personnel at games,” he says. “This has to be addressed and, in the meantime, players, referees and coaches should be educated about the risk of concussion.”

His advice to all players is never to ignore a head injury. “If in doubt, sit them out,” he says. “Take them off the pitch and seek medical attention.”

Regardless of the risk, Fuller doesn’t want to deter women from playing sports. “Sports participation is to be encouraged and promoted for all the benefits it brings from a physical, mental, emotional and social point of view,” he says.

“Concussion is a risk factor in the majority of sports, and this needs to be addressed with education. The better informed we are about it, the better decisions we can make.”

Concussion checklist

Concussion is defined as a mild traumatic injury to the brain and most people are symptom-free within four weeks. However, this depends on you and those around you recognising the signs and symptoms of concussion and getting the treatment you need in time.

The range of symptoms varies from person to person and case to case, and they may develop over minutes, hours or even days. If you think you might be concussed, the Ladies Gaelic Football Association has compiled a checklist of critical symptoms.

  • Are you displaying cognitive symptoms such as difficulty concentrating, difficulty remembering, fatigue or a feeling of brain fog? Are there any physical symptoms like headache and pressure in the head to neck pain, nausea, dizziness, vision problem or sensitivity to noise and light?
  • Concussion can have an emotional impact. Are you feeling more irritable, nervous or more intense emotions than usual?
  • Concussion can have a wide-ranging impact on sleep. Some people feel drowsy, while others have difficulty falling asleep. Some sleep more than usual, and others sleep far less.
  • If you suspect someone else of sustaining a concussion, they may be unable to tell you their symptoms. You will have to rely on the signs you can see. These include poor balance and loss of coordination, slurred speech, vomiting, constant clutching of the head, a vacant facial expression or a loss of consciousness.
  • If you’re in doubt, err on the side of caution and seek medical attention. Then rest for 48 hours, avoiding screens, alcohol, recreational and prescription drugs, and driving.
For further information on this topic or to make an appointment with Colm Fuller, please email sportsmedicine@sportssurgeryclinic.com

 

An Interview with Colin Griffin : Masters of Running Podcast

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Listen to this interview with Colin Griffin, Head of Running Services at Sports Surgery Clinic’s Sports & Exercise Medicine Department.

This was recorded as part of The Masters of Running Podcast in October 2022.

Colin Griffin has over 15 years experience in high-performance sports having represented Ireland at the 2008 and 2012 Olympic Games in the 50km walk which he holds the Irish record of 3.51.

He has also coached other Irish athletes to Olympic level

In 2013 he joined Sports Surgery Clinic in Santry, where he now manages Running Services at the Clinic. Colin is undertaking a PhD on the biomechanics of muscle-tendon interaction at the Achilles during exercise and gives great tips here on avoiding and helping such an injury.

He’s continuing to race as a masters athlete at 040, recently running a 1.11 half-marathon as a build-up to The Dublin Marathon.

For more information on Running Services at SSC or to make an appointment with Colin, please contact sportsmedicine@sportssurgeryclinic.com

Interview with Professor Brian M. Devitt: The FiftyFaces Podcast

Listen to this Podcast with Professor Brian Devitt,  Consultant Orthopaedic Surgeon at Sports Surgery Clinic and Professor of Orthopaedics and Surgical Biomechanics at Dublin City University.

This interview was recorded by Aoifinn Devitt for The FiftyFaces Podcast as part of their “Inspiring People in Medicine and Science” series, which is being released later this year.

For more information on how to make an appointment with Professor Brian Devitt, please contact devittadmin@sportssurgeryclinic.com

Limerick’s Mike Casey conquers ‘dark moments’ on long road to recovery from injury blows

This article was published on the Independent and written by Donnchadh Boyle.

Earlier this year, when Limerick were still searching for their first win in the National League, Mike Casey had his own little milestone success.

Limerick hadn’t managed a win in four attempts in the league at that point but after a most unfortunate series of events, Casey was about to start his first game for Limerick in two years.

Back in 2020, the All-Ireland-winning full-back was motoring well, playing four of the first five games in that year’s league. However, Covid hit and set in chain setback after setback that would see him out of action.

“In October 2020 we played a challenge against Galway and I did the cruciate then,” Casey explains, picking up the story.

“I had surgery in mid-November, and around July, after my nine months, I came back and played a club game and got through that okay – then the next training session I had a cartilage issue. I felt a pop in the knee and unfortunately my cartilage had given way.

“In July 2021, I got that surgery done by Ray Moran up in Santry; they were excellent.”

 

“Thankfully, I haven’t looked back since.”

Back in the thick of it, it’s easy to forget that the road back was a grind.

“There were definitely dark moments – my girlfriend, Jessica, I’ve been with her five or six years and she was excellent through it all. Any time I had a setback and needed someone to talk to she was there for me. And with the group, a lot of the lads have been through a lot of things, knee surgeries and things like that. And I never left the group.

“I was asked to come in and help with stats and that so I was part of everything that was going on, there was some small bit to contribute to the team.”

He missed plenty in his time out with Limerick sweeping the boards. And while he could help out with the analysis, he also found himself in the unwanted position of being able to advise his brother Peter on his own recovery. He damaged his ACL in last year’s All-Ireland final while in the midst of a tour de force and has just recently returned to full training.

“It was really unfortunate but he’s been able to bounce ideas off me and ask me questions. With an ACL they’re all different but Barry Murphy did his the week after in a club game but they’ve rehabbed unbelievably well under our medical team.”

In the wake of the Munster final win over Clare, a photo featuring Casey and a few of his team-mates celebrating shirtless emerged.

Their remarkable physiques served as a reminder that while they’ve led the way with their hurling, Limerick’s physical conditioning is top drawer too. “It (gym work) is such a fundamental to it. If you’re progressing there, it is definitely going to help you on the field.

“Yes, it’s not the be all and end all of it. You still have to put the ball over the bar. Your bicep curls aren’t going to do that for you.

“But we’re really, really competitive in there, and everyone takes massive pride in it.

“And it’s definitely something that if you are slacking, lads are going to let you know that you need to improve this aspect of where you’re coming at. A lot of lads have really bought in.”

Limerick face Galway this weekend, two wins from yet more silverware for this remarkable team. A third consecutive All-Ireland win would force them deeper into the ‘great teams’ conversation. But for Casey there’s no real secret to their success.

“It’s about getting down to the brass tacks and working and winning that ball. We love doing that.

“It doesn’t matter if we win the game by 20 points or by one point to no score – we love the battle and the intensity and working hard. I think we’ve put that stamp on our play – when people come and play us they know they have to match that.”

From Cavan to Qatar: The physio helping the world’s best athletes recover and improve

This article was written by Maurice Brosnan and published by The 42.

In the summer of 2018, Tipperary and Sydney Swans flyer Colin O’Riordan came crashing to a halt. He suffered from osteitis pubis as a teenager and in his third year of professional sport it started to flare up again.

O’Riordan persevered until one agonising day at the SCG against the Gold Coast. As he turned to race up the field, the pain became unbearable. At that moment he was convinced his hip was about to explode.

“I couldn’t play the last four games of the season at all,” O’Riordan explained last year.

“I went home and saw Enda King. He had me back running in two weeks. He just sees things differently. Not that he doesn’t believe in surgery but fix the problem before you do that. It was about running mechanics and technique.

“He is honestly incredible. His knowledge of the body. I don’t think he did any work on my groins. It was all hips and glutes. We were doing calf work. I was wondering how this influenced my ability to run. But it does. We’d do a squeeze test and there would be less pain. It is all related.

“He views your body as one. Your upper back is as important as your hips in running. It is all linked. It opened my mind to how the body works. It was like going to college for five weeks.”

This endorsement came to mind recently when reading Chloe Mustaki describe her remarkable recovery from Hodgkin’s lymphoma and an ACL injury. The physical and emotional toll was considerable. During her first visit with King, Mustaki broke down in tears of frustration. It was seven months since her surgery and the pain had not subsided. Fears about never recovering had started to creep in.

Last month she made her Ireland debut.

“This is one of the best parts of my job. It is nice to help good people,” says King.

He has been working as the Head of Performance Rehabilitation at the Sports Surgery Clinic in Santry, Dublin for the past decade. There he has worked with the likes of Johnny Sexton, Ruby Walsh and Dan Carter as well as a host of professional clubs across sports from the Premier League, NBA and the AFL.

“Going back to my own career and injuries, it can feel like a crater. When you are in it and you’re not sure if anyone can help you get out of it, you cling to any light at the end of the tunnel.

“My goal is to help them understand why they are where they are, but it is also to give them some direction and that they feel empowered to stick to it rather than wait for it to get better. I am not at the level of Chloe or Colin and never was, but any footballer knows what it is like to sit in that chair and wonder will I ever be right.

“Most chronic or recurrent injuries do not go away. You have to get rid of them. People are waiting for it to go away and naturally you become despondent. Whereas a broken bone has a defined recovery and timeline and it gets better. Having been through those experiences, from a research and biomechanics point of view, really opened my eyes.

“Moving attention away from where you are sore and focusing on why you are injured. Then trying to get that across to an athlete. Ultimately, they are doing all the work. I am just trying to show them the direction.”

King’s own playing days influenced his approach now. He still draws on it. He was moulded by it. After success with his club Cavan Gaels, the midfielder went into an intercounty squad with dreams of Ulster glory. Meanwhile, his hip and groins gave him nightmares.

The same thing that hindered him on the field allowed him to prosper professionally.

“At the time, you want it to be fixed rather than standing back and wondering why it is happening. Training load is naturally a massive factor in most overuse injuries. You want to contribute to every team, all the time, rather than focusing attention and saying, developmentally I want to play at this level.

“What can I do this year to achieve that? You try to be a servant to everyone and end up pleasing no one.

“When I look back, rather than looking for a fix or anti-inflammatories or surgery, the first question is why am I sore in this area? How can I optimise my training load and how I move on the field of play to give me the best chance of staying injury-free and optimise my athletic performance.

“Then it is about how do I do it as an athlete? For example, the idea of being in a gym is to make you a better athlete on the field. Not to be only better in the gym.”

Knowing what you want and the best way to attain it. That is his creed and the bedrock of his work. When athletes present with pain, the first step is not targeting the painful area alone but understanding why it is there.

His PhD research focused on the use of 3D biomechanical analysis to better understand how an athlete moves, how that is driving their injury and how to individualise their rehab based on their specific deficits.

Soreness is not just to be dismissed or suppressed with a short-term fix. King rarely uses injections or anti-inflammatory during groin rehab. Pain is a useful marker. A signal providing valuable information. It is about understanding the source rather than temporarily quelling it.

He recently published a research study on hip and groin pain prevalence and prediction in Elite Gaelic Games. It monitored 2703 male athletes across two seasons, the largest study in elite athletes relating to hip and groin pain internationally. The findings were presented at the IOC conference in Monaco last year.

Such research has led to a seismic shift in rehab strategies. Yet the injuries keep happening. How are we improving one crucial aspect while stagnating in the other?

“That paper shows at least 40% of every intercounty team male squad will have athletic hip and groin pain every season, which is a substantial amount,” he explains.

“When you look at why people develop groin pain, it is also about how they move, and the amount of load placed on the body.

“Our understanding of how it manifests in terms of how we move has greatly improved. It has certainly been a game-changer from a rehabilitation point of view.

“But the one thing that has remained constant is the high training loads. The body is meant to train hard. That is not the problem. It is the fact that some things changed tremendously, and some haven’t changed at all. Look at the window from December to March and the demands on young players across several different squads. It is a recipe for groin pain.

“Our ability to rehab these athletes is improving all the time, our understanding and focus on their anatomy, not sending everyone for surgery but fundamentally it is still underpinned by a need to have sufficient periods of recovery within the week and to have sufficient periods of recovery within the season.

“You can’t be a servant to multiple teams at one time.”

Much done, more to do. After 15 years in Santry, the Cavan native is about to bid farewell and take a new role as Head of Performance and Development for the Orthopaedic and Sports Medicine Hospital in Aspetar, Qatar.

The plan is to swap Dublin for Doha while continuing to work with visiting athletes and travel internationally to assist teams. The chance to work at a FIFA-accredited world-renowned centre of excellence was too good to pass up.

“My role is assisting in the rehabilitation of elite athletes. Both in Qatar and with international athletes visiting. Whether that is players from teams they are affiliated with, such as PSG, or injured athletes I work with, or teams coming for warm-weather training and preparation for the World Cup.

“Obviously, they are connected to PSG, so you have Neymar, Messi, Mbappé etc. I am looking forward to working with that type of athlete and bringing my experience from the SSC with me to contribute to clinical practice and research.

“I will also be assisting the development of their multidisciplinary team. As an international centre of excellence, they highly prioritise that clinical consistency. Trying to put structures and ongoing research pathways in place with a continuity of care at the highest level.

“My attraction to working with elite athletes has always been that it is a fantastic environment to develop yourself clinically. To work with one athlete for five or six hours a day, you can really get into a depth of analysis. Get them from A to B as quick as possible.

“It allows you to take that expertise and share it with colleagues. One of the fantastic things about the SSC was providing elite athlete care for all.

“Take the principles you are applying to a high-level athlete and use that to apply a precise but modified version to the general population. You develop clinically and can have the most impact in terms of pushing understanding.”

Mining the smallest details generates the greatest lessons. That is at the heart of everything King does. Small brushstrokes without ever losing sight of the big picture. The goal is to rehab athletes. If implemented correctly that should ensure they improve as athletes.

“That is the starting point. The day one conversation is where are you sore, why are you sore, what are we going to do about it?

“If you run this way and do this, your performance will also improve. Everyone is great at rehab when they are injured and terrible when they are not injured. How can you get the buy-in that athletes are constantly developing?

“Great athletes like Colin keep in touch not just when injured but because they want to get even better. That is the whole point. Giving you what you need to rehabilitate your injury but also make you a better athlete.”

Paul Mannion talks knee injury, life outside Dublin bubble and pain of missing All-Ireland final

This article was written by Kevin O’Brien and published by The 42 on friday 1st April.

PAUL MANNION IS content with life outside the inter-county bubble as he rehabs the knee injury that forced him to miss Kilmacud Crokes’ run to the All-Ireland club final.

Mannion suffered a torn lateral ligament in his left knee during the Leinster semi-final against Portarlington. It forced him to miss the provincial decider win against Naas and subsequent clashes against Padraig Pearses and Kilcoo in the All-Ireland series.

“I thought I might have gotten away with it without it being too serious but in the days that followed it was very painful and I wasn’t recovering at all and once I got a scan it confirmed the ligament had fully detached from the bone. And the only fix was surgery.

“I looked at the options, but once I had the surgery there was definitely no chance [of playing]. Without the surgery I’d left it about three weeks and it wasn’t recovering at all I couldn’t walk so there was no chance,” he adds.

“All kind of things go through your head, what if this happened or what if that happened but I have learned to park those thoughts because you drive yourself mad thinking about those what ifs, and not just what if I was around or what if something else happened.

“I spent the first week two weeks going through all that in my head and eventually you just need to move on and accept these kind of things happen in sport and that I have also been on the other side of those kind of results many times myself. So just accept it move on and hope for better days really.”

The 28-year-old says he’s nearing full fitness and if the All-Ireland had taken place in it’s traditional slot on St Patrick’s Day, he’d probably have made it back in time.

“The physio that’s working with me had said that if the final was on Paddy’s Day as it used to be…I was asking him would I be going for that and he said definitely.

“It mightn’t have been 100% but certainly by that time I felt like I could have done something on the pitch. It was unfortunate timing but now I’ve got plenty of time to recover and make sure I’m in full health for the championship this year.

“It’s flying, much better now, back running, squatting and doing everything in the gym. It’s been like that for the last few weeks and I’m close to 100pc I’ve been really, really lucky with the recovery and the surgeon Ray Moran is probably the best around, he did it out in Santry so I was fortunate to have him do that.

“There’s not a bit rush on it now because we’ve got league games coming up of course but I just want to make sure that the knee is more than 100% right before I go back training on it at all. I’ve been out running, kicking and it feels great from that point of view. The step into full competitive match play is a big one as well so I’ll take my time with that.”

He believes Kilmacud will react the right way to the heartbreaking extra-time defeat to Kilcoo.

“I don’t think it will have any kind of negative impact. In fact, I think it’s only made lads more hungry for an All-Ireland win. I know it’s definitely made me more hungry as well.

“Obviously the Dublin championship is the first big step on that road and that’s got all of our attention now. We had a meeting to regroup after that loss and discuss plans for the year and things we can improve on.

“Everyone was vocal about taking it to the next level and really, really pushing to get back to that stage again. I think it’s reinvigorated a lot of us.

“Management are all still fully bought in and there will be new younger lads that are coming into the team this year that will be pushing for places and adding to the team as well. I think everyone is really optimistic and excited for the year ahead.”

Mannion opted out of the Dublin panel at the end of the 2020 season and declined to answer any questions relating to Dessie Farrell’s squad.

The three-time All-Star picked up six All-Ireland medals during his inter-county career before stepping away due to the commitment levels involved.

Earlier this year Mannion confirmed he has no plan to return to the Sky Blues fold and he says he’s enjoying the freedom that came with his decision.

“It’s well-documented the commitment and time that goes into playing intercounty football and sometimes when you are in that it can be a bubble and I have enjoyed being outside that a bit and being able to spend more time and focus with the club and other things so it’s been a nice time.”

Mannion’s friend and former team-mate Jack McCaffrey is another high-profile absentee from the Dublin set-up.

“I think he’s off to Africa this summer for another few months there,” says Mannion. “He’s a bit of a free spirit, he just goes where the wind takes him.

“He seems to be doing well. I met him in Manchester a couple of weeks ago for the United-City game, it didn’t go too well. He’s in great form, loving life. ”

Legend of the club: Síle Nic Coitir is a prized jewel in the capital’s crown

This article was published in the Independent.IE on Monday, 21st March and written by Niall Scully.

Síle Nic Coitir (extreme left) at Ballyboden St Enda&rsquo;s Sports Surgery Clinic Sponsorship launch along with (l-r) Fiachra O&rsquo;Connor, Fiona Roche (both from Sports Surgery Clinic), Ciarán Maguire (Chairman) , Paschal Taggart (Chairman of the Board), Dr Ray Moran, Brian Keane (CEO SSC) and Shane Durkin

Síle Nic Coitir (extreme left) at Ballyboden St Enda’s Sports Surgery Clinic Sponsorship launch along with (l-r) Fiachra O’Connor, Fiona Roche (both from Sports Surgery Clinic), Ciarán Maguire (Chairman) , Paschal Taggart (Chairman of the Board), Dr Ray Moran, Brian Keane (CEO SSC) and Shane Durkin.

“It’s wonderful to see female athletes at the centre of things” says Ballyboden and county legend

A Big night at Boden. Billy Joel’s ‘Piano Man’ comes on the music system.

If the great man had been in Páirc Uí Mhurchú himself, he would have sung: ‘It’s 9 o’clock on a Tuesday. The regular crowd shuffles in.’

Soon, it’s standing room only. For the big sponsorship announcement. From the Sports Surgery Clinic, Santry, the club’s new sponsors.

Earlier in the day, Rachael Blackmore and Honeysuckle won the hearts at Cheltenham. This club has known Gold Cup days too.

In the corner of the Boden clubhouse, the Manchester United-Atletico Madrid match is on the tele. Stephanie Roche is on the RTÉ panel.

Síle Nic Coitir finds a quieter spot and reflects on her own role models .

She was a big fan of Paul Curran. And the Antrim hurling goalkeeper, Niall Patterson. Then there was Dublin’s hurling All-Star, Brian McMahon.

“All men,” she smiles now. “Thankfully, that has changed.

“There’s so many outstanding women in sport that young people can now look up to. That has been a brilliant development,” she notes.

“The 20×20 campaign was a big success. As it says, if you can’t see it, you can’t be it.

“It’s wonderful to see female athletes at the centre of things. At launches and on TV, and in the media in general. You have the likes of Katie Taylor and Kellie Harrington. It’s incredible what they have done.

“When I was growing up, it was different. Thankfully, the achievements of women in sport are being recognised, and that young people can see that, and can relate to it. Women in sport work just as hard as the fellas. So it’s only fair that they get the profile.”

She’s a pundit herself now. “I really enjoy that. You see the game from a totally different perspective. You are up on a height and you are focusing on things like tactics and all the rest of it.”

In the clubhouse, there are pictures the tell the Boden story. This is where Síle calls home.

She’s been coming here for over a quarter of a century. And she has a bagful of medals that stretch the length of the Firhouse Road.

She was born into the games. Her Dad, Don, was the Chairman of the Dublin County Board.

Síle recalls happy days at school in Scoil Naithí and Coláiste Íosagáin. And with Ballinteer St John’s and St Olaf’s. And then arriving down to Boden. Playing for the U14’s. “I felt so welcome from the first day.”

She became an acclaimed dual player, with club and county. With Boden, she won ten Dublin Senior Camogie Championships, plus one Leinster. “That Leinster win was one of my proudest days.”

In Ladies’ Football, she collected four Dublin Senior Championship crowns, three Leinster and one All-Ireland. Bill Daly lighting a spark that became a bonfire.

Then for the Dubs, there was a Leinster Senior Championship Ladies’ Football victory, and an All-Ireland Camogie Junior Championship success.

She has learned so much along the way. And one of the most important lessons of all – keep playing as long as you can.

She’s a coach herself now. Mentoring the Maynooth camogie team. “I’m really enjoying it. Coaching is such a completely different ball game. Just because you played, doesn’t mean you can coach.

“You have to listen and learn from other people. There’s so much emphasis on tactics and formations, etc. It’s fascinating. I feel fortunate that I have got the chance.”

She delights in how ladies football is prospering. Mick Bohan’s Dubs. “It’s so quick now. The play is constantly up and down. It’s a very attractive game to watch.”

She commends camogie’s journey. “The physicality has greatly added to the game. The rule changes have helped so much.”

She’d be thrilled to see the Dublin camogie team return to the big-time. “I hope things can keep progressing. It’s all about getting the grassroots and structures right. And building from there.”

Having the GAA family under one roof would be an initiative she’d welcome. A family that have been such an important part of her life.

There’s a growing hum coming from the Boden Bar now. Proceedings are about to begin. She tips her hat to the generosity of the new sponsors.

She has known the long, injury-filled days herself. A catalogue of cruciate and cartilage operations.

She overcame them all. A sharp, darting forward with big ball and small. And when the knees began to act up, she put on the goalkeeper’s cap.

It’s her composure, under pressure, that most stands out. The ability to think on those quick feet.

An attribute that will serve her well in the coaching department. And in the commentary box.

Chloe Mustaki thrilled to finally make Ireland debut after overcoming cancer and serious injury

This article was published on the 21st February 2022 on Extra. IE Sport. This article was written by Mark Gallagher.

The smile on Chloe Mustaki’s face said it all. On Saturday evening in La Manga, the Dubliner finally made her senior international debut, almost two years after tearing her ACL in an Ireland training camp.

As she spoke to journalists over zoom yesterday, there were times when she got a little emotional as she reflected on the path that led to Saturday night, and her Playerof-the Match performance in the 1-0 defeat to a fine Russian side.

Mustaki spoke of the support from her family, her boyfriend — Dundalk player Greg Sloggett — the staff at Shelbourne and the likes of Enda King at the Santry Sports Clinic. When the anthem started playing ahead of the Pinatar Cup semi-final is a moment Mustaki will never forget.

‘It was a day and night to remember for myself,’ she said.

‘The award could have went to a number of different players, the two other debutantes [Megan Walsh and Abbie Larkin] had a fantastic game as well, so I am probably sharing it with those two. It was a long time coming over the last two years. It was hard but I am very happy.’

The ACL tear hasn’t been the only setback which the former Irish under-age captain has had to overcome. At just 19, as her senior career was starting, she was diagnosed with lymphoma.

‘Something my auntie told me early in my diagnosis when I was going through the lymphoma is that everyone experiences setbacks in life. Unfortunately I had been hit with quite a bad one quite early. I had just turned 19 when I was diagnosed. But you need to keep perspective, everyone has road bumps along the way. I had two bad ones early on, but there are more to come and it is just about realising everyone has them at different stages. As long as you have the right people around you to keep going during the bad days, that’s all that matters,’ she said.

The journey back for Mustaki from the ACL was extra lonely as it was during lockdown.

For the first few months of her recovery, she had no face-to-face contact with physios and no gyms were open. So, she ended up doing too much and that significantly delayed her rehabilitation. She missed certain milestones, and seven months in, she still wasn’t able to run.

‘That did freak me out. That is when I went to Enda King in Santry. My first day with him, I just cried in front of him and he was probably wondering what he got himself into. But he set me right and now here I am.’

Mustaki was one of Ireland’s more impressive players on a windy night in La Manga, where Brighton keeper Walsh was an assured presence behind her.

Vera Pauw selected a fairly inexperienced side against a fine Russians – it was the first time in 46 Ireland matches that Katie McCabe didn’t start although both herself and Denise O’Sullivan came on in the second-half.

And Mustaki wants to become an established part of the squad. She accepts that will probably mean a move abroad at some point if she wants to become a mainstay in the international team.

‘When I came back last season, my body was trying to catch up, but now I was able to last 90 minutes in an international game. I was delighted to do that, and it is down to all the effort I put in over the last year and a half. I am committed to Shels but to keep my place in the Ireland team, I do think I need to move abroad.’

Mustaki’s senior debut made her the 11th player from the Ireland under-19 side – that reached the 2014 European Championships semi-final – to win a full senior cap.

‘Obviously that was a super team at the time, with a lot of talented players. And I think the more success you have at a younger age, the more ambition that breeds. I think part of it must be having so much success at a young age, we all wanted to continue to have it.’