Will there be any injuries??

What can you do to help yourself??

Folk that tend to attend our Ashbourne Clinic will know exactly what we’re talking about when we discuss the Shrovetide football match – those at Hilton may not be so aware… there is more information and a quick glimpse here….(link)  Why not come and have a look one year – it really is a spectacle to behold but is not for the faint hearted.

The Shrovetide football match has been a huge part of life in Ashbourne for many, many years and running a physiotherapy and sports injuries clinic in a town so committed to it’s crazy football tradition has it’s challenges and delights.

Having provided physiotherapy in Ashbourne for more than 30 years, here are some of the delights and challenges of the game from our perspective:

• First there are those appointments in the run up to Shrovetide as the players ramp up their training in the weeks after Christmas. Any niggles and aches that threaten to impact of training need to be problem solved in a similar way to the build up to any endurance event such as a marathon. Managing the increase in training load is key and often requires advice on building up training more slowly to allow tissues to adapt to a more strenuous role.

Next come the challenging last-minute appointments as the date approaches where pains of perhaps 6 months duration are required to be ‘cured’ or at the very least ‘patched up’ before the ball is turned up. Lots of advice is given by our physios in the run up to the big day and it’s not only the players, spectators will find themselves on their feet for much longer periods of time and often in the cold and wet. Slippery conditions underfoot can also be a challenge or the need to be able to suddenly move away from trouble when the hug swerves to a different direction.

For us as a clinic there is the small matter of altered half-terms – as the Shrovetide dates relate to Easter, the date can be really variable from one year to another and may even affect half-term as local schools get special dispensation to change their holiday dates. We close our Ashbourne Centre from 2pm on the Tuesday and Wednesdays of Shrovetide week to limit the risk of damage to vehicles and in case the ball comes down to Waterside business park. This arrangement still allows us to treat people in the morning. Hilton of course is unaffected.

The amount of injury treatment required in the Shrovetide aftermath is really variable depending a lot on how tight the play is, weather conditions, and how long the play continues – the longer the play, the darker it becomes and more hazardous it becomes over fields, hedges etc, as well as taking into account how tired both players and spectators become. Of course, the amount of drink consumed would have nothing to do with any of this!!!!

So, whatever the cause, the symptoms of injuries to muscles, joint, tendons and ligaments are likely to be:

• Pain
• Swelling
• Tenderness to touch
• Bruising/bleeding
• Deformity
• Loss of function either struggling to move or to use the part injured or noting instability
• Occasionally numbness or tingling

There may also be skin lacerations, grazes etc which will require cleaning and dressing carefully to prevent infection.  Injuries will tend to fall into 3 categories:

• Those requiring immediate/emergency attention like breaks and dislocations which should of course go straight to A&E
• Those that require an assessment and advice from a physiotherapist to ensure there is nothing seriously wrong and to suggest what further management might be required
• Those that can be safely managed at home

Traditional advice for treatment of recent injuries has been:

R I C E

Rest

Ice

Compression

Elevation

And a slightly more complete acronym used in the past has been P R I C E where ‘protection’ to prevent more injury is the first step to take.

More recent thoughts on this have taken on board the findings of research and would suggest the acronym:

POLICE

Protection

Optimal Loading

Ice

Compression

Elevation

This replaces ‘Rest’ with ‘Optimal Loading’ as it has been proven that too much rest can be detrimental to healing hence why we no longer advise bed rest for back pain and when recovering from operations. Optimal loading means still getting up and about where possible without causing increased pain or inflammation e.g. trapping the injured part or using crutches.  As physios much of our work is around finding ways to optimise healing by optimising how much an injured tissue is loaded.

And the most up-to-date thoughts use PEACE and LOVE

Protect unload or restrict movement for 1-3 days and start to move as soon as is possible

Elevate elevate the limb higher than the heart

Avoid Anti-inflammatories – this might come as a surprise to many, but inflammation is actually the process by which our tissues heal and it’s thought not always to be a good idea to limit/hinder this. Although anti-inflammatories may bring short term alleviation of some of the symptoms of inflammation, it’s unsure what long-term effects on healing this might have.  When you consider that there are some definite side-effects from taking the medication, apply caution and perhaps speak to a healthcare professional if unsure.

Compress taping or bandages

Educate this is so important that people know what is likely to help and when they should be starting to do more.  The right education at the right time can prevent an injury becoming ‘chronic’ ie lasting longer than we might expect for optimal recovery.

Then after a few days move on to L O V ELoad – normal activities should continue as soon as symptoms allow.  Optimal loading promotes repair.

Optimism – this is to address the very real psychological side to injuries and pain that current research is exploring at a fantastic rate. Especially at a time when access to medical advice can feel restricted, knowing what you are dealing with and how you should expect it to progress can really make symptoms easier to cope. So often we hear patients at the clinic say

“I feel so much better for having had it properly looked at and I now know what it is and what I can do to help myself”

Vascularisation – cardiovascular physical activity promotes blood flow and healing

Exercise – there is evidence that exercise restores mobility and strength and function after an injury

Our top tips for preventing a Shrovetide injury

Know your own limits and have a break if you are becoming tired

Wrap up warm and wear appropriate clothing

Warm up each time you go to back into the game

Wear appropriate footwear for the terrain – usually wellies

Prepare in advance – raise your fitness prior to the game if you are going to play

Keep an eye on the game if you are spectating so that you can move quickly if the ball comes your way

Listen to the Marshalls who are they to help to keep everyone safe.