My name is Kevin Feely, and I am currently the owner and head therapist of the Kevin Feely Athletic Therapy Clinic. My background in this line of work came from having studied Athletic Therapy and Training in DCU for 4 years from 2010 to 2017 (with a 3-year sabbatical in between!) and followed by a Master’s degree in Strength and Conditioning which I completed in IT Carlow in 2018. Personally, working in sport has been something I have wanted to do from a very young age whether as a player or in capacity as a coach/therapist/performance specialist and I have been very lucky to have had the chance to do both of those things in my career to date. Athletic Therapy and Training in DCU is a brilliant course with a heavy focus on the diagnosis, treatment, and rehab of musculo-skeletal based injuries as well as some excellent modules on training and performance in sport. I completed the first 2 years of this course before moving to the UK to take up a career in professional soccer firstly with Charlton Athletic FC in London and then Newport County AFC in Wales. Those 3 and a half years were an absolutely brilliant experience for me as not only did I get a chance to live my childhood dream of playing professional sport, but I also got a very close insight in to the workings of the performance and medical teams in elite level sport. The insights I gained from the different physios and sports scientists I came across during my time in the UK have been invaluable in helping me with my career since! Since coming home, I have been a part of the Kildare senior gaelic football team as a player and in this way have been able to stay in touch with elite sport and continued to gain valuable experience on the injury and performance management of athletes at the highest level.
After completing my Master’s in IT Carlow, in July of 2018 I rented a space in a public gym in Tallaght called Fit4Less and I have been operating the Kevin Feely Athletic Therapy Clinic from here ever since! From a team perspective I have been working as the head physio for the Athy Gaelic Football Club since 2018, I worked as the varsity’s soccer physio for DCU for 2 years and also got some great full time physio experience working for 12 weeks with the PSC soccer group during their Irish tours. Since January 2019 I have been the head physio for the Kildare GAA u20, Minor and development squad teams and have also been working as a consultant strength and conditioning coach for Kildare GAA providing programmes and direct contact sessions for a number of secondary schools in the Kildare region. Within my private clinic I have been lucky enough to work with some great individual athletes across a variety of sports from GAA, to soccer to more individual sports like track running, golf, and tennis. To date the clinic and teams work has been going very well and I am thorough enjoying my work!
In this short piece I will discuss some of the more common injuries being seen since lockdown and ways to manage them, challenges involved in trying to safely return to training after the longest off season most of us have ever known, and some strategies on how best to minimise your injury risk and maximise your performance as soon as you start back into your playing season.
Regarding the more common injuries I have been dealing with lately, there has undoubtedly been a huge trend towards overuse and repetitive strain issues. This comes as no surprise given the sudden burst in physical exercise that the population seems to have undertaken since the beginning of the first lockdown. People who maybe did not have the most consistently active lifestyles while in full time work are using the time they have now to try and improve their fitness levels and for a lot of people the jump from nothing to 5km runs 3-4 times a week has been too much too soon for their bodies to handle. Similarly, athletes who were used to a regimented training schedule with their teams or coaches have now been forced to totally alter their training styles to fit with the lockdown protocols. This sudden shift in training emphasis and intensity has also resulted in areas of the body becoming heavily overloaded at intensities and volumes that they are not used to. The predominant tissues to get injured because of this sudden spike in training load are tendons. And for weight bearing exercise this has usually meant patellar (kneecap) and Achilles tendon issues with Achilles tendon pain being the most prevalent issue I have seen to date.
Managing tendinopathies can be a tricky business and tends to change from case to case. However, there are some nice tips that I can advise on which will help to kickstart the rehab process whether it is a hip, knee, or Achilles tendon issue someone has. In most assessments you get for a lower limb tendon injury you will have tests carried out to determine what potential deficiencies you may have in strength and mobility that may have contributed to the tendon becoming irritated (eg. Weak lateral hip muscles, poor lumbo-pelvic control, reduced ankle mobility or big toe mobility). Correcting these deficiencies is an important part of the rehab process but just as important is to gradually start loading the irritated and sensitive tendon once the initial pain has started to settle to a tolerable level. Early on this means performing ‘isometric contraction’ exercises designed to specifically load the affected tendon and my advice is to begin this process as soon as possible with any tendon injury if the pain intensity remains at or below a tolerable 4-5/10. Isometric contractions involve exercises that load the muscle or tendon without any change in length happening in that muscle. For example, for an Achilles tendon injury this might involve a single leg heel raise where you hold your heel off the ground in the same position for a sustained period (usually 45-60s in the early stages). As well as safely loading the affected tendon, these exercises can also have a pain-relieving effect to make simple activities like walking and running seem a bit easier! I have loads of examples of these types of exercises on my Instagram page if you want to see more (https://www.instagram.com/kevinfeelyat/).
These isometric exercises are a great starting point for tendon overuse injuries and require little to no equipment which is even more ideal for our current pandemic situation. However, it is important to note that this is only the beginning of the rehab journey as far as tendon pain is concerned. Gradually progressing and increasing the load while constantly monitoring pain levels is compulsory for tendon injuries and the best way to do this is with the advice of a therapist or trainer who can help you put together an appropriate plan to get you to whatever your goal is.
When sport returned last Autumn after the first lockdown, there was a predictable amount of soft tissue injuries occurring with the teams I worked with as players’ bodies tried to re-adjust to unpredictable, intermittent, high intensity, change of direction-based training. I was expecting the high number of hamstring injuries that occurred as players returned to repeat sprint training, however, the most common soft tissue injury I came across last season was undoubtedly quad strains. Most likely this was because of the increased kicking demands in sports like soccer, Gaelic Football, and rugby. These injuries can result in time losses from training of anywhere from 2-8 weeks and in a time where seasons are being squeezed in to short, very match heavy schedules, this can mean an entire playing season wiped out for a player. With this in mind, it is so important that every player takes some measures to prepare their body for return to group and contact training in the weeks leading up to that date!
For me, this return to play prep can be divided in to 3 sections: gym work (or home based strength work), pitch/field work, and recovery work. From a gym perspective, some graded strength training of the most commonly injured tissues is incredibly important. For hamstrings this might mean incorporating exercises like the Nordic hamstring exercise, or weighted Single Leg Romanian Deadlifts into your programme. For reducing groin injury risk this would mean Copenhagen Adductor Plank and Lateral Lunges. For quads, exercises like Rear Foot Elevated Split Squats and Reverse Nordics are great. Even those 6 exercises performed as a lower body strength session twice a week (3-4 sets of 6-10 of each) would be highly beneficial in a 4 week block leading back to training. Plyometric exercises are another great way pf prepping the body for high speed and change of direction work, but they are a topic for another day I think! A quick YouTube or Google search of any of those exercises will bring up some nice video demos for you.
From a running perspective, if you have been a slave to the long distance runs for the last few months, now is the time to change that! Yes it’s important to set an aerobic or endurance foundation of fitness early on in pre-season but that time has most definitely been and gone and it’s time to start sprinting again. Start with low volumes and distance and gradually increase from week to week. In field sports it is unlikely that you will ever be sprinting flat out for longer than 40-60 metres (barring an intercept try in rugby!) so there is no need to do that in training. Work off distances ranging from 5-40 metres at top speed, with rest times of around 60 seconds for every 10 metres covered. Total distance at top speed covered for the whole session should be around 300-350 metres. Change of direction drills also need to be incorporated at this stage as well. There is a wide variety of drills that can be used but the ones I like best are curved or ‘S’ runs at top speed, shuttle runs at varying distances, figure of 8 runs, and T test runs. These bring most of the change of direction type movements you will use in training. Again, long recovery times are necessary for this type of work as you are performing each rep maximally. Save your high intensity fitness work for runs that do not have as many direction changes in them. Your last job on the pitch now is to get back doing the fun stuff! Skills drills, kicking, passing, shooting all need to be gradually brought back into your routine now to have your body ready for doing all these things at higher intensities once training starts back. Use your imagination and experience to design drills and skills work for yourself in this regard and don’t be afraid to add a conditioning element to them as well by carrying out the drills with a time constraint and a recovery time limit.
The last section I mentioned was recovery work. By this I don’t mean investing in compression boots, massage guns, or foam rollers, I mean including days during the week of total rest. If your normal training schedule involves 3 pitch sessions and 2 strength sessions in a week then do not be tempted to do more than this before training starts back. The last thing you need is to be injured before you even start back into it! Focus on the basics of recovery like getting 7-9 hours’ sleep a night, eating adequate amounts to meet your calorie expenditure from training, and staying on top of hydration levels. Aim to eat a meal containing carbohydrates and protein in the hour window after you have trained and look to rehydrate with 1.5 litres of fluid for every kilogram of fluid lost during the session over the next couple of hours (weighing yourself before and after a session will tell you how much fluid has been lost to sweat during training). The main thing is to listen to what your body is telling you and manage your load according to how you are feeling both physically and mentally.
It might seem like a lot to be thinking about for a simple training session but these are the small things that if done well will go a long way towards keeping you fit and healthy and allowing you to be performing at your best for your team week in week out. Best of luck with the season ahead to all the sports men and women out there and if you have any questions on any of the topics brought up here don’t hesitate to get in touch! (kfathletictherapy@gmail.com, www.kevinfeelyathletictherapy.ie)
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