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View Full Version : Micahael O'Loughlin - Conservative Approach



Bob
01-05-2004, 07:03 AM
Can you plead read this article from The Australian and tell me what the "conservative approach" would entail?

Body of evidence mounts for O'Loughlin
By Jenny McAsey
May 01, 2004
IT has become a familiar sight at Swans games. Brilliant forward Michael O'Loughlin gathers the football, swivels and shoots for goal but then he grimaces, his hand going straight to a niggle in one of his troublesome legs.

In 2003 he battled knee and calf injuries before the final blow on the eve of the finals when he ripped a hamstring.

This season the trouble began early, in round two against Fremantle at the SCG. Before half-time he had hobbled from the ground clutching his hamstring.

A scan showed the hamstring hadn't torn and O'Loughlin - a vital cog in Sydney's potent forward structure and one of the most gifted players in the AFL - was given a strong chance to play the following week.

However, a month later O'Loughlin is still curiously absent from the team to play Essendon at the MCG today.

Each week he has been listed as a near certainty to play, only to miss because of what club doctor Nathan Gibbs describes as nerve pain in the suspect hamstring.

Even though he is only 27, after almost 10 years in the game O'Loughlin's body appears to be failing him and he is beginning to despair.

"One of Mick's concerns is 'why is this happening to me'?" Gibbs said yesterday.

"That is the question he has often posed to us based on the fact that most of the first part of his career he hardly ever got hurt. And now he has had calf muscle strains and hamstring strains and knee tendonitis."

Gibbs said there was a simple explanation for the run of injuries that has seen O'Loughlin miss eight games in 2003 and four this season.

"Unfortunately the body clock is ticking over and everything starts to degenerate a bit," Gibbs said. "He's got a few years left but now he is starting to get hurt more.

"It is not to do with his make-up, it is more to do with his birth certificate and there is nothing I can do to help him there.

"Unfortunately the most common reason why someone in the second half of their career starts to get more injuries is the fact they are getting older and their body tissue is more at risk of injury."

O'Loughlin resumed training and running this week and the nerve pain, which the medical staff believe may be caused by lower back problems, has almost disappeared.

The length of O'Loughlin's lay-off has surprised Gibbs, but the club has opted for a conservative approach with their star player.

"The problem with Michael is that some players, when they have low-grade nerve pain, can play and get through a game," Gibbs said.

"But the pain predisposes to the hamstring muscle, actually developing a tear, and this is the same leg where he had that bad tear at the end of last year.

"So we are all very careful not to push him at this point to play through the pain because it might lead to a genuine hamstring tear."

Gibbs has stopped saying O'Loughlin is a certainty next week but estimated he had an 80 per cent chance of resuming in round seven when Sydney play Richmond.

Today against Essendon it will be fellow Swans forward Barry Hall who bears the load in attack.

In Melbourne yesterday, Hall was fired up for the important match but said he no longer judged his own performance on his personal goals tally.

"When I first came to Sydney I hung my hat on how many goals I was going to kick," Hall said.

"That was probably, for me, the wrong thing - it was a little bit selfish.

"I've more tailored my goals around team-oriented things - getting to contests, helping others, and goals come with that."

Essendon's forward linchpin, Matthew Lloyd, said Sydney were a top-four side and the MCG game would be a real test of the Bombers' ability.

injuryupdate
01-05-2004, 12:54 PM
Conservative basically means (in this scenario) giving the player extra time to recover and avoiding the risk of playing games. If the team doctor estimates that a player has a 75% chance of successfully getting through a game without re-injury, then the coach may choose to play him in a must-win game, but rest him early in the season to try to prevent the injury becoming long-term. Conservative is the risk averse approach, with the opposite strategy of taking risk being termed 'aggressive'. The general strategies used by teams are conservative in the pre-season, aggressive in the finals, and trying to hold out with conservative (safe) management as long as possible during the season if the team is winning enough games!

More on this issue with muscle strains at:
http://www.injuryupdate.com.au/images/research/CJSMeditstrains.pdf

Bob
01-05-2004, 01:11 PM
So it is just rest? What treatment methods or modalities would you use in such an example to accelerate healing?

injuryupdate
01-05-2004, 05:08 PM
So it is just rest? What treatment methods or modalities would you use in such an example to accelerate healing?

It is pretty hard to accelerate healing, with most experts thinking the body does as good a job as possible at healing at the fastest possible rate. Probably anabolic steroids would increase rate of healing, but they are illegal and players who take them continuously tend to have higher injury rates for ligaments and tendons (which don't strengthen as much as the muscles).

The jury is still out on modalities, with many of them probably working but proof hard to gather.

The skill in managing a hamstring strain is in making decisions on how much load to add at each stage of the rehab program without increasing the risk of recurrence. The other major skill is to monitor anything secondary which might be contributing (such as a low back problem).

A further controversy is the role of anti-inflammatories. These drugs are catabolic (opposite of anabolic - lead to decreased new tissue, delay healing) but many practitioners use them. They decrease pain and scar tissue and some players maybe lay down too much scar when they are healing a muscle strain. Anti-inflammatories (including cortisone injections) probably increase the risk of re-tear at the site of the original injury but perhaps in certain cases can decreased the dysfunction of the hamstring unit and reduce the risk of re-tear at a different location (which is not uncommon).