Nature of knee injuries in Gaelic football explained sport is unwelcome, but knee injuries are particularly complicated to heal. In the not-so-distant past, a torn anterior cruciate ligament commonly killed the careers of amateur and professional athletes alike. Louth forward Ciarán Byrne is to miss the rest of the season after suffering an anterior cruciate ligament injury. This is the second time he has suffered a serious knee injury, the first of which occurred in 2016 when Byrne was playing AFL.

Conor Sweeney will miss Tipperary’s season after suffering a cruciate ligament rupture. The All-Star attacker and Premier County captain suffered the injury when knocked to the ground. Kerry are already without their former captain Joe O’Connor after the Austin Stacks midfielder suffered an ACL injury last September. While it is probable O’Connor will be back playing club football by the end of the summer, the nature of the injury means the midfielder is not expected to play any inter-county football in 2023.

The treatment and rehabilitation of these players back to playing will be the responsibility of the physio, doctor and strength and conditioning coach. The S&C coach will use current training methods that include strength training, balance training, and individualised instruction about proper positioning and movement.

Such programmes are especially useful for reducing ACL injuries in female GAA players. Due to the bio-mechanical make-up of the female body, females are more prone to ACL injury. The LGFA has embarked on an initiative that will tackle this problem in women’s football by educating LGFA members as to how to reduce the risk of ACL injury.

Why do these type of knee injuries occur in Gaelic football? Why does it take such a relatively longer time to return to playing football again in comparison to other parts of the body that pick up injuries? What can be done to try and prevent this horrendous and painful injury?

There are four major ligaments in the knee:

  • Anterior cruciate ligament (ACL) – This ligament is in the centre of the knee
  • Posterior cruciate ligament (PCL) – This ligament is in the back of the knee
  • Medial collateral ligament (MCL) – This ligament gives stability to the inner knee
  • Lateral collateral ligament (LCL) – This ligament gives stability to the outer knee

All four ligaments can be stretche, twiste, straine or torn. If you compare the four ligaments in the knee to the four legs on a table, and you remove a leg of table, it will be very unstable and will eventually fall over if you apply any force to it. The same happens to a Gaelic footballer if they tear a knee ligament.

If the ligament is not torn, then hopefully surgery will not be require to fix the damage. If surgery is require, it’s fair to say the ACL ligament is the most complexed ligament to repair and heal.

During  ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon – tissue like a ligament that connects muscle to bone. This replacement tissue is calle a graft. The surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor, hence the long time before the GAA player can resume playing again.

You normally tear an ACL in your knee by:

  • Bad luck. The player can slip, fall or twist awkwardly on the pitch, putting the knee in unnatural position. ACL injuries commonly occur during “twisting and turning” during training or a match that involve sudden stops or changes in direction, jumping and landing.
  • Contact-related ACL injuries usually occur when a direct blow forces an athlete’s knee inwards toward the other leg. In Gaelic, this often happens when a player’s foot is plante, and an opponent runs into the outside or front of his thigh.

In addition to all the twisting and turning in Gaelic Football other factors associated with an increased risk of ACL include:

  • Poor physical condition. If you train the thigh and calf muscles in the upper and lower leg to get stronger they will act like a seat belt or airbag to protect the knee area, so regular gym sessions will help prevent ACL injuries.
  • Poor movement patterns in gym, for example squatting incorrectly. GAA athletes of any age need to learn correct movement technique in the gym. I always advise learning to move your bodyweight correctly first before you load the body with bars and dumbbells.
  • Playing on artificial turf. If GAA teams do train on 4G pitches, the fact that there is very little give in a 4G pitch puts a great amount of strain on the joints and muscles, especially if your body isn’t use to it in comparison to training on natural grass.

There’s no set timeframe for athletes to return to play. The usual parameters are 9-12 months if the player involved is very diligent with their rehab. During this time the physio and strength and conditioning coach work together to perform tests to gauge the knee’s stability, strength, function, and readiness to return to playing at various intervals during the rehabilitation process.

During my time with the Ireland rugby team, I worked with a player who picked up a serious ACL injury. I was able to do 2-3 sessions a day with the player and they managed, through aggressive rehab and strength and conditioning, to return in six months with no ill-effects. These sessions were brutal and some of the conditioning work they had to endure included:

  • Hard weights sessions, which involved squatting, deadlifting, farmers walk with heavy chains. Flipping over massive digger tyres for over one minute.
  • Running in a diving pool for over an hour. In that hour the player had to sprint for 60 seconds, rest for 15 seconds, and do those 20 times.
  • On the rowing machine they would row for one minute and try and reach 300 metres in that time. They would rest for 30 seconds and repeat that 15-20 times. This was follow by then rowing for 30 seconds and trying to reach 155 metres. In that time and taking only 15 seconds recovery, we would do this 30 times, brutal stuff!

It’s been said that the injure GAA player often trains harder than the players who are training for matches. With this type of high intensity lung-bursting training, research shows that around 83% of GAA players. Will return to playing their sport within 12 months and about 65% will return to playing competitive sports.

It will be a long, hard, tough and painful journey for both Ciarán Byrne and Conor Sweeney to return  playing. For their respective counties, but with some of the excellent backroom teams now associated. With inter-county sides, they will have the best of treatment. Care and conditioning to get them back out on the playing field again.