FEATURE: LEAN ON ME

LIFE is finally calming thrilling time for Falvey and With his aim to serve the Irish picked from so you have your down for and Lions here he shares the experience team first and foremost, Falvey information ready,” says Falvey. team doctor Eanna Falvey including the work involved kept the news to himself until “With the Lions, until the squad is after the carnage in the to keep the players fit during a after the championship, but picked you don’t really know so hectic tour, how the surgeon, he explains the difficulty in then it’s a mad scramble to get Irish medical bay in the Six medics and physios got Tommy preparing for the tour when you onto the teams and home unions Nations and the 60 days Bowe and back don’t know what players you’re and get player injury profiles spent as part of the mobile on the pitch after injury and why going to be dealing with. and training loads and as much juggernaut that was the is a genetic ‘lottery information as you can about 2013 Lions tour. winner’. “It was quite interesting because players. in a national squad if you’re “From the day we met up on By contrast, the last few weeks The path to getting the job to going on tour, even if you May 10 it was non-stop. It’s an have been quite tranquil. Falvey work alongside Dr James Robson, don’t know the 30 selected unbelievable juggernaut of an has his own practice to keep who has been a part of six Lions you know the operation it’s the only way I can ticking over as well as his other tours, began with an initial 40 players describe it. It’s on a bigger scale role with the Sports Surgery meeting in November, before from again than the World Cup, with Clinic in . As part of his getting the nod prior to the Six which the Lions it’s a bigger squad, a remit with the IRFU, however, Nations. the massive management squad business is picking up again as he squad around it too and eventually and the medical team, along with will the squad expanded out into 45 strength and conditioning staff, be players.” sat down to brief new Ireland coach Joe Schmidt on the In fact, while the players were status of the playing panel. left to celebrate their historic series win in , However, his most recent job as part of ’s backroom team was a

18 EMERALD RUGBY AUGUST 2013 FEATURE

By Adam Redmond

the medical team still had plenty everybody up to speed.” percenters” that when added the golden ticket because of work to do. Officially, the tour up make a big difference to his he’s incredibly durable as an didn’t break up until Tuesday July It was a hectic time period on performance. athlete. In his career he’s had 9 and although the players were tour and Falvey admits that the very little injuries,” Favley says. allowed to let their hair down on treatment board was full “all day, Although it certainly helps when “He’s genetically very lucky but the Sunday after their 41-16 win every day”. The schedule was you’re as robust as Heaslip, who being a talented rugby player over Australia, medical reports relentless and half the work goes is rarely injured, and Falvey is needs more than that and from had to be taken on the Monday into preventing injuries rather happy to pass on a tale about the Jamie’s point of view he’s brilliant to make sure that the players than just treating them, so the Naas man’s first encounters with at looking after his flexibility, he were returned to their clubs in doctors, physios, masseuses and the Lions medics on the 2009 stretches more than he should. the same condition they reached even the players themselves tour. “He goes out there and is always the Lions. were all singing from the same looking for the extra equipment hymn sheet in order to the Usually when the players arrive to keep him on top so there’s a “It’s part of your job not to get bodies fresh. lot of muscle stimulation when carried away that the series has he needs it, I can’t go into the been won,” he continued. “So details of what he does because you had to go through the full “Jamie’s a lottery it’s his own business, but he list of what injuries people had, very much uses cutting edge what the treatments were and winner, he’s the technology to give himself an that was all collated and emailed advantage. across back to their clubs so that nobody went guy that got the “It’s all about small angles home without the and it mightn’t always be people who were golden ticket... ” physiologically helpful but it’s going to be treating psychologically helpful. On top them knowing “Some guys who aren’t injured in Lions camp the doctors will of that he’s a very clean living what was going on. still require a lot of work to keep ask what their injury history is guy, he doesn’t abuse his body Unfortunately, for them off the injured list, they’re to which the normal response he looks after himself very well the guys who had getting treatment once or twice is along the lines of ‘I’ve had and then he’s a big brute on top injuries you had to set a day,” adds Falvey, who could a shoulder reconstruction, of it all so that doesn’t hurt either. out the plan for what not speak more highly of the knee surgery, etc, etc’. Heaslip’s Jamie is a fantastic example of way they were going attitude and dedication among conversation in 2009 was a little that and while there were other to be managed the playing squad. “Players who bit different according to Falvey. guys in the squad similar to him, to keep will come in for treatment, but “Jamie rocked up and said: ‘Ah, Jamie would definitely be the they come in 40 minutes early, yeah I had a hamstring injury pack leader on that score.” 20 minutes spent stretching, there one time.’ 10 on the EMS (extra muscle “Lions medics: ‘Right, and…?’ Rapid Recovery stimulation), then they’re doing “Jamie: ‘That was about six years However, some players are not so other movement exercises for 10 ago.’ lucky, even if they do have good minutes and then the treatment. ‘Right…?’ genes. is certainly “Jamie: ‘No, that’s about it’.” one of the more superior athletes “The players are well tuned into in Ireland while Jamie Roberts what it takes for them to perform It was a story that was still has been labelled a “physiological and they do it. It’s a pleasure getting rave reviews this time freak” by Falvey. But it was their being available 24-7 in a situation around on the tour because returns from a broken hand and like that because you want to hardly anything has happened torn hamstring, respectively, that add to the players’ success.” to Heaslip from an injury point were highlighted as the success of view in the proceeding four stories from the medical bay as One player who excels in looking years. A feat that has certainly both returned play a vital part in after the god-given gifts he impressed Falvey. the Test series. has received is Jamie Heaslip. The Leinster and Ireland No “There’s a couple of factors to After breaking a metacarpal 8 is always searching for new it. Genetically Jamie’s a lottery in his right hand against the ways to find those crucial “one winner, he’s the guy that got , Ulster star AUGUST 2013 EMERALD RUGBY 19 FEATURE: LEAN ON ME

Bowe was back for selection unbelievable amount of work. work on a muscle that size is responder in chief Dr Eanna exactly three weeks later thanks Tommy had treatment three of little benefit. For a muscle Falvey needs all the tools he can to a myriad of factors that Falvey times a day and when he wasn’t to function properly you need get when it comes to diagnosing runs us through. having treatment he was up strength, endurance and then a concussion, yet despite the icing his hand, he needed to get you actually have to keep fitness outcry over the topic he not only “He had a fracture of the a glove off me every time he work up. welcomes the debate but is keen metacarpal in his hand. Had three needed to do it so it felt like I was to share his view from field. screws put in and I physically just carrying gloves around for “So at the start Jamie did bike It’s well known that the players went into the surgery and Tommy!” work when he could, pool work will find ways to avoid being watched and it was no different so he kept his fitness up quite caught with a concussion which to how it would be repaired As for Roberts his recovery was well and that’s the one upside would force them out of the here,” says the man. “The different because a hamstring to a short injury recovery, you game. A common trick is to difference was the surgeon. tear, and a reasonably bad at don’t lose as much fitness. The inform the doctor or physio that The night of the game we had that, requires to be built back up idea is to get him working as you have a “stinger” injury to an x-ray, an MRI and a CAT scan through hard work and treatment early as you can. So he’s walking deflect attention from a head done and those images were sent rather than waiting for bone briskly in the first few days, he’s knock or even deliberately get to the surgeon who was in his tissue to heal. The Racing Metro jogging as early as he can, for a poor mark on a pre-cognitive sitting room at 12.30am. I spoke man had begin to hit targets for two weeks before Jamie was test so that in the event of a to him and he said ‘yeah, I’ve the medics and physios to be declared fit he was running at concussion there will be less treated many of these in rugby confident that he would return in every training session at the end chance of detection. league and if all goes well there’s time for the third Test. of the pitch. With these injuries a possibility he’ll be fit to play in there’s a limited amount of magic On top of this Falvey may three weeks’ time’.” Initially Roberts needed to be involved, if the muscle is ready have pressure from a referee able to walk briskly in the days it allows you to do the stuff you combined with a capacity crowed From this point a number of after the injury, then begin to jog, need to do, if it doesn’t then you urging the game to be restarted. decisions have to be made. First, the perform hamstring curls at can’t.” In such an instance the doctor the medics need to be confident 30kg weight before running at 50 needs all the time he can get to of Bowe’s recovery timetable per cent, 75 per cent and then, Concussion make the right diagnosis and while the coaches need to be four days before the Test, run at As the Irish rugby team’s first although he admits the current prepared to hold on to a player 100 per cent. Pitchside Suspected Concussion who can’t participate for three “The physiotherapy was fantastic Assessment is not perfect, it’s a weeks. In Bowe’s case Gatland and Jamie was exceptionally step in the right direction. wanted him for the Test series professional about it. He “There’s been a lot of criticism so it was all stations go once an probably had the dullest tour of about the pitch side assessment additional player () any one there because he was in process – and I’d be the first to was called out. bed early every night resting up say it’s not perfect – but his hamstring,” says Falvey. “We were lucky the surgeon had “Physiologically a lot of experience with that

type of injury and had similar he’s a freak. wins in the past. Then we From the start, even early employed everything we could on he was clinically quite to help. We used a low frequency good, his strength was ultrasound called Engine to quite good so we were improve bone healing, we able to push on. If he had manipulated his diet to increase been very sore for the his calcium intake, we hit it from first week we probably every angle we could including wouldn’t have made it. We getting a hurling company in caught a break. In terms Ireland called Micro to send us of treatment there is very out two sets of gloves to protect little hands on work on him in training. an injury like that. On a guy like Jamie Roberts his “It’s a combination of many small hamstring muscle is bigger things that add up. Tommy also than your arm so soft decided he was going tissue to make it back, he was incredibly compliant in himself and Prav Mathema, the Welsh physio, did an

20 EMERALD RUGBY AUGUST 2013 FEATURE

I think it’s a lot better than having winded, they may be lying on 20 seconds on the pitch to decide the ground and it’s difficult to if someone’s concussed or not, a immediately tell if they’ve been thousand people shouting and concussed, whereas if you’ve got the referee standing over your five minutes to examine them shoulder asking if everything’s on the sideline it becomes quite ok. That’s not a good approach, obvious that they’re perfect.” the more time that we have to look at the players the better it is Falvey will not put pride of for everybody involved,” he told opinion at the forefront of the Emerald Rugby. argument because he is happy that once a solution can be “Concussion is such a proven to benefits the players complicated and difficult then that’s the right answer, situation to deal with that I don’t regardless of anyone’s stance on think there’s one right answer. the matter. There are probably a couple of approaches to this, the way One school of thought is to things work prior to the pitchside introduce an independent concussion assessment was that doctor, who would be free you had to make an assessment to assess players free of any on the pitch. They looked at perceived pressure that team 50 cases where they had video doctors could be put under by analysis of these situations their coaches. However, Falvey and they said that you have 38 certainly isn’t in the business of seconds on average to make a knowingly putting players’ well- call on what was happening. beings at risk and he also points out that a doctor who knows the “That starts from the player player is better placed to make a knows him.” going down to you making the diagnosis than one who has just call; it takes 12 or 13 seconds to been introduced to him. As for the debate, which actually run out to the player so is also being voiced you’ve very little time to assess “There’s no such thing as too by Dr Barry O’Driscoll the player, so I fully support the far, what we should do is the within these pages, idea of the being able best thing,” he continues. “So I Falvey sees it as an to examine players think the primary goal here isn’t opportunity to educate and take a look at for teams to win games, it’s to the rugby community them properly. look after players’ health and about the serious nature “I think the time could ensure that 10 years down the of head injuries. be slightly longer and I think line they’re not dealing with the “I think the fact that probably how it’s being consequences of the injuries. there is a debate about done could potentially be it is brilliant, I think the tightened up as well. To “If the best solution was to have fact that people are make a diagnosis of a an external doctor on hand then worried and talking concussion is quite that’s what we should do, but about George Smith’s hard, it’s quite the evidence out there today case [against the Lions] difficult and in doesn’t necessarily support that. and the other cases that situations The evidence there shows that are out there is brilliant. where guys the person best placed to decide I think the more the get hit if a guy is concussed is the team public knowledge there to the doctor. is the better, because chest at the end of the day and “The reason for that is that team professional players are maybe doctors know their players. We actually looked after is did pre-assessment with all the quite well,” he said. players before we went on the Lions tour and some players “The real area where were exceptionally good at it and concussion needs to some players were exceptionally be managed well is in bad at it,” Falvey explained. “If I schools rugby, in youths met some of those players and I rugby and underage rugby Left: Eanna signals for a stretcher as Eoin didn’t know what their baseline so the more the kids and the Reddan’s game comes to an end. was and I did tests with them parents watching the TV know I might be making a call on about concussion and are aware Top: Eanna helps Jamie Roberts off the them that would be completely about concussion the better, so field during the Lions test

incorrect. So the work that’s out you’re not getting a guy playing Above: Gordon D’Arcy winces in pain as there at the moment shows that a schools game who gets a knock he get’s examined by Eanna the best person to make the call and a Tuesday and is playing is the team doctor because he again seven days later.”

AUGUST 2013 EMERALD RUGBY 21