Medical Policy

The information on this Medical Policy page is for information purpose only and should not be used as a definitive guide . Always check with a medical professional at all times if you have any questions relating to Medical needs.

The player is central to the GAA and all its activities. The skill and dedication of our players at all levels have captured the imagination of the public since the founding of the GAA and have been fundamental to the on-going success of the Association. The welfare of players is therefore of paramount importance to the GAA and its future success. During the development of the GAA’s Strategic Plan and Vision 2009-15, a key objective was the enhancement of the experience of all our players within the Association.

The Association’s Medical, Scientific and Welfare Committee is comprised of medical professionals, players and administrators, they work to ensure that player welfare matters are kept to the forefront of priorities within the GAA. The primary responsibility of the Medical, Scientific and Welfare committee is to advise the Association on medical and general welfare matters relevant to our games and to drive Association policy in these areas.

Click on the various topics for more information.

Download the GAA Player Welfare Booklet. This document has information on a wide range of topics including injury prevention, nutrition, hydration and more.

 

What Are Sports Injuries?

The term sports injury, in the broadest sense, refers to the kinds of injuries that most commonly occur during sports or exercise. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warm-up and stretching.

Although virtually any part of your body can be injured during sports or exercise, the term is usually reserved for injuries that involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage.

Common Types of Sports Injuries

  • Muscle sprains and strains
  • Tears of the ligaments that hold joints together
  • Tears of the tendons that support joints and allow them to move
  • Dislocated joints
  • Fractured bones, including vertebrae

Sprains and Strains
A sprain is a stretch or tear of a ligament, the band of connective tissues that joins the end of one bone with another. Sprains are caused by trauma such as a fall or blow to the body that knocks a joint out of position and, in the worst case, ruptures the supporting ligaments. Sprains can range from first degree (minimally stretched ligament) to third degree (a complete tear). Areas of the body most vulnerable to sprains are ankles, knees and wrists. Signs of a sprain include varying degrees of tenderness or pain, bruising; inflammation; swelling, inability to move a limb or joint; or joint looseness, laxity, or instability.

A strain is a twist, pull or tear of a muscle or tendon, a cord of tissue connecting muscle to bone. It is an acute, non-contact injury that results from overstretching or over-contraction. Symptoms of a strain include pain, muscle spasm and loss of strength. While it’s hard to tell the difference between mild and moderate strains, severe strains not treated professionally can cause damage and loss of function.

GAA 15 Warm-Up

The Medical, Scientific & Welfare Committee in conjunction with John C. Murphy, Catherine Blake and Edwenia O’Malley in UCD have developed a new injury prevention intervention which aims to reduce the number of injuries sustained by GAA players. A standardised warm-up comparable to the FIFA 11+ and other injury prevention interventions has been tailored to meet the needs of GAA players based on data collected through the National Injury Database since 2007 and a randomised controlled trial of Gaelic players in UCD was undertaken to pilot the effectiveness of the GAA 15.

“Did you know that 70% of ACL injuries are non-contact and can be reduced significantly (not always) with prehab and correct warm-up.”

Instructions – How to do the GAA 15

For instructions on how to carry out the GAA 15 with your team, click on this document.

Videos

To view the videos provided by SportsClinicPlus, please log in to the GAA’s e-Learning portal by clicking here.

Recovery from Exercise

The importance of adequate recovery from training and games cannot be over emphasised. Building periods for recovery into a training programme is as important as incorporating proper progression.

Recovery involves a number of different factors:

  • Replacing fluids and energy
  • Reducing muscle damage
  • Reducing psychological symptoms of fatigue, such as anxiousness and irritability

When should recovery begin?
Adequate recovery begins long before the players leave the playing area or gym — it starts during the session. By trying to maintain proper hydration during training or games, players can reduce the amount of dehydration they will experience. Sipping 125 — 250ml of water or a sports drink every 15 — 20 minutes can keep fluid levels topped up during activity. All training and games should finish with a proper cool down taking place over 10 — 20 minutes.

The Warm Up and Cool Down
Progressively lower intensity to help speed the removal of lactic acid from the muscles and blood. Stretching exercises are an important aspect of all cool downs.

Replacing Fluids and Energy
Replacing the energy used during exercise and the fluids and electrolytes lost through sweating is important within the first 2 hours after completing training or a game. During the cool down and stretching, water, sports drinks and fruit should be available to players to begin this process.

Drinking 500ml of a sports drink immediately after training or a game will help replace lost fluids and also replenish used energy stores. A sports drink containing a source of vitamin C, vitamin E or protein is useful to repair muscle damage. If the sports drink does not contain protein eating a small snack, such as a chicken or turkey sandwich at this time will also be useful.

Knowing how much fluid is lost will provide a good indication of the level of fluid intake required by each player. There are a number of different ways of assessing a player’s hydration status, however a simple method is to weigh a player before and after training and games. The weight difference is the amount of fluid lost from the body through sweating. Ensure that the player is wearing as little clothing as possible each time you weigh him. Remember for each 1Kg of weight lost, 1.5 litres of fluids must be consumed. Water is fine for most people after exercise, as long as it is accompanied by a meal or snacks to provide for carbohydrate and electrolytes used during exercise. However, if a player does not feel like eating solid foods in the hours after exercise, it is important to drink fluids containing other nutrients such as a sports drink, milk drink or smoothies. Protein and carbohydrate are essential nutrients for recovery. The meal or snacks consumed after training or games should contain a source of each. A snack such as a chicken and salad roll (white bread) is a good option.

Fruit, dried fruit/almonds and museli bars are other alternative snacks after training or a game. The meal eaten in the hours after exercise can make a big difference to recovery, and should contain a source of protein (such as chicken, turkey, tuna or lean beef) and carbohydrate (such as potatoes, pasta, rice or noodles), but not too much fat.

Good examples include:
• Beef and vegetable stir-fry with rice or noodles
• Pasta with chicken or lean meat tomato sauce, add vegetables or serve with salad
• Chicken and vegetable risotto
• Grilled chicken with vegetables (including potato/pumpkin)
• Home-made pizza (low-fat cheese and lean ham)
• Soup with pasta/noodles/rice and meat/chicken/legumes
• Dont forget to have a large drink with this meal, and sip fluids regularly during the hours after training and games. Fruit should always be available to players to snack on.

Complete recovery is not achieved in just a few hours after the game; it can often take more than 24 hours. Adequate fluid and food intake is important over the next couple of days to ensure optimal recovery and preparation for the next game ahead!

Reducing Muscle Damage
Muscle damage occurs naturally in each training session and game. Often the damage is microscopic, with the effects not being felt for up to 48 hours (often called Delayed Onset Muscle Soreness, or DOMS). Cooling the muscles after exercise is a good way to reduce muscular damage and soreness, with there being a number of different options for coaches to consider:

Contrast Recovery (Hot/Cold)
This involves submersion or covering the body in hot (must be bearable to the individual) water, followed by the same with cold water (with a temperatute of approximately 15°C if possible). The guidelines for this are two minutes hot, followed by 30 seconds cold. This is repeated two-four times (as necessary).

Cold Immersion
This is similar to above except it is just cold immersion. The guidelines for this form of training are 30 seconds – 1 minute immersion, followed by 1 minute out of water (towel dry). Repeat this three times.

Ice Massage
This form involves ‘rubbing’ the muscle groups which have been trained, with ice. This can either be done with ice in a plastic bag, or a cooling bag. The guidelines for this are one minute on one minute off, for a total of four minutes on each area/limb. Make sure that you keep the ice moving over your skin, do not keep the ice stationary for any period of time as ice can burn! If you have any circulatory or sensory (e.g. paraesthesia) problems please check with your doctor.

Extreme care must be taken when using these, as some players may be very sensitive to extreme changes in temperature and may find the experience of going from a warm environment in the training area or dressing room into a cold shower or ice bath painful, or may go into shock. Always check how a player responds to cold before use. Careful monitoring of players at this time is advised. It is always advisable to consult a doctor before introducing such regimes into the post training or game practice.

Reducing psychological symptoms of fatigue
Many players complain of being mentally fatigued after training or games, or show symptoms of anxiety or irritability in the hours and days after a particularly tough training session or game. It should be noted that getting adequate sleep is a major part of ensuring recovery. Some players require more than others, but players should be encouraged to report if they have difficulty sleeping. Ensuring that players are properly recovered before undertaking the next training session or taking part in the next game requires careful monitoring. Providing players with a training log and incorporating adequate hydration monitoring, will help to ensure that players are properly recovered. The training log will also help to identify early warning signs of under recovery.

Guidelines for Safe Exercise

Exercising safely is important for avoiding injury. When exercising, it is important to focus on what you are trying to do. For example, is exercise part of the warm-up, a conditioning activity or part of the recovery? In essence, what you are trying to do should be dependent on why you are trying to do it.

Player Burnout

Burnout occurs where people who have previously been highly committed to a sport lose interest and motivation. Typically it will occur in hard working, hard training, hard driven people, who become emotionally, psychologically or physically exhausted.

 

Tips for Preventing Injury

Whether you’ve never had a sports injury and you’re trying to keep it that way or you’ve had an injury and don’t want another, the following tips can help:

  • Avoid bending knees past 90 degrees when doing half knee bends.
  • Avoid twisting knees by keeping feet as flat as possible during stretches.
  • When jumping, land with your knees bent.
  • Do warm-up exercises not just before vigorous activities like running, but also before less vigorous ones such as golf.
  • Don’t overdo.
  • Do warm-up stretches before activity. Stretch the Achilles tendon, hamstring, and quadriceps areas and hold the positions. Don’t bounce.
  • Cool down following vigorous sports. For example, after a race, walk or walk/jog for five minutes so your pulse comes down gradually.
  • Wear properly fitting shoes that provide shock absorption and stability.
  • Use the softest exercise surface available and avoid running on hard surfaces like asphalt and concrete. Run on flat surfaces. Running uphill may increase the stress on the Achilles tendon and the leg itself.

Concussion Management

The Medical, Scientific and Welfare Committee of the GAA in conjunction with Ms. Ruth Whelan (Physiotherapy Manager, UPMC Beacon Hospital) have devised new concussion management guidelines based on the findings from the 4th International Conference in Concussion in Sport.

For the GAA specific e-Learning course on Concussion Awareness, please visit our Learning and Development Portal.
Summary principles of GAA concussion management guidelines:
– Concussion is a brain injury that needs to be taken seriously to protect the long term welfare of all players.
– Any player suspected of having sustained a concussion, should be removed immediately from the field and should not return to play on the same day.
– Where a Team Doctor is present, he must advise the person in charge of the team (i.e. Team Manager) in this regard and the player must not be allowed to continue his participation in the game.
– Concussion is an evolving injury. It is important to monitor the player after the injury for progressive deterioration.
– Concussion diagnosis is a clinical judgement – Use of the SCAT 3 can aid the doctor in his /her diagnosis.
– Players suspected of having a concussion, must have adequate rest of at least 24 hours and then must follow a gradual return to play protocol.
– Players must receive medical clearance (by a doctor) before returning to play.

 

Signs and Symptoms
Contrary to popular belief, most concussion injuries occur without a loss of consciousness and so it is important to recognise the other signs and symptoms of concussion. Symptoms include:
– Headache
– Confusion
– Nausea
– Balance problems or dizziness
– Double/blurry vision
– Sensitivity to light
– Feeling sluggish, hazy or groggy
– Just not ‘feeling right’
– Concentration/memory problems
– Pressure in hand

 

Return to Play
– A player with a diagnosed concussion should never be allowed to return to play on the day of injury.
– Return to play must follow a medically supervised stepwise approach and a player should never return to play while symptomatic.

Action Plan
Recognise the signs and symptoms

Report if suspicious, don’t hide it

Rehab with rest and medical guidance

Return after following Return To Play Protocol and getting medical clearance

 

*E-learning*

Want to know more about Concussion? If you are a player, parent, coach, referee or even medic who wants to know more about concussion, please try our e-learning course on concussion awareness!

The course takes 15 minutes to complete and there is a quiz at the end to test your knowledge. You will learn about:
1) Concussion Injuries
2) Signs and Symptoms
3) Action Plan
4) Coping with the Injury
5) Return to Play Protocol
6) Management in Children

For information on how to register and access the course, click here.

 

For a full range of resources including a GAA specific e-Learning course on Concussion Awareness, please visit our Learning and Development Portal.