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'You can't just stop': The science behind the decision to retire (or keep going)

One of the world’s leading experts in sports medicine explains the intricacies of what it really means to ‘call time’.

MORE THAN MANY recent years, the end of this rugby and football season has been dominated by sportsmen asking themselves serious questions.

To carry on and go against some perception that age has made the body no longer fit for purpose?

Or to retire, leave well enough alone and cease to be a sportsman?

Doug Howlett’s shoulder forced him out, Ronan O’Gara decided it was time for a new chapter and, tonight, Isa Nacewa will hope to end his career as gracefully as he ended so many attacking moves.

On the other side of the ledger Brian O’Driscoll opted to carry on. Having vowed all year to ‘listen to his body’, it evidently gave him good news.

In the end, that’s all any athlete can do, but they require someone like the Sports Surgery Clinic’s Dr. Andy Franklyn-Miller to translate.

Franklyn-Miller is a consultant physician specialising in sport and exercise with a CV that includes British Athletics, the RFU and on into rugby league with the Melbourne Storm and New Zealand Black Ferns. In both codes of rugby, the demands of the modern game mean it is more important than ever to heed Franklyn-Miller’s advice and input.

Higher, faster, stronger

“The game is clearly adapting and speeds are higher. Collisions are higher. Injuries really are divided into avoidable and non-avoidable.” Says Franklyn-Miller. And it is his job to make sure the avoidable category remain avoidable. Particularly as athletes age, become less explosive and heal much more slowly.

Speaking before the Six Nations, Jamie Roberts (a student doctor at the time) speculated that players breaking into the international game at a young age today would not manage to play far beyond their 30th birthday.

However, as rugby becomes more physically demanding, an increase in the integration between coaching and sports science and medicine can help to offset the casualty rate.

“It’s really careful monitoring of the load, monitoring the recovery and then really putting all those bits together so maybe by being smart with working more on speed, muscle strength rather than heavy lifting you maintain he availability on the playing list.

“Our job as sport physicians in a professional environment is really to try and maintain that playing list for the coach at 100%.”

Absolute recovery

As he says, doing that requires a team to be smart. More haste and less speed, in effect, with more timely work rather than simply more – a changeover which many may find counter-intuitive.

“Sleep becomes more important as an athlete ages.” Says the consultant as point number one in a simplified check-list.

“Maintaining quality sleep and recovery becomes a much bigger part of the day-to-day existent than necessarily hitting the same targets in volume.

“You want to try and reduce the training volume to a level which meant that the recovery was absolute.

“That doesn’t mean doing half a training session, it means being smart about which bits – and that involves the coach and the conditioner working with medical staff to maximise that availability.”

More sleep, reduced work-load: little wonder that Brian O’Driscoll felt driven to carry on.

Obviously, there is only so far even the best-oiled machine can be pushed. David Wallace last week told that his strength and conditioning scores had never been as impressive as they were in the lead-up to the 2011 World Cup. Wallace cites the wear and tear on his joints as the factor that eventually forced him to call it a day.

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“The longer anybody spends in professional sport or spends time as a full-time athlete they increase the chance of sustaining a joint injury.” Franklyn-Miller adds.

“The more joint injuries build up, the more the impact on the body is and therefore the harder it is to recover from them. The advantage of course is that a retiring athlete doesn’t have the same demand on the body.”

The good doctor is sure to issue a stern caution, however: “The real skill here with someone who has been training professionally for 10 years or more is an athlete can’t just stop.

Dr Andy Franklyn-Miller, left, with Leinster Rugby doctor, John Ryan, at the opening of their 3D Biomechanics Facility recently.

Cardiac risk

“It’s more difficult for an endurance athlete – a cross-country skier, a rower or swimmer – but it’s the same for anybody who has been training regularly.

“What we know is that if you stop suddenly there is increased risk of cardiac abnormality or hormonal imbalance developing a diabetic type or inflammatory bowel disease or cardiac failure because you’re used to a certain level of activity. And that’s without looking at the joints.

“The immediate risk means you have to go through a period of de-training almost and manage that de-training.”

“Whilst it might be hard to sustain the multi-directional movement [that simulates match-play] because of a cartilage injury or a previous bone injury on the hard cartilage, the benefits of de-training are that you’re not asking the body to deal with the regular load that it has.

“The flip side of that is you need a loaded joint for good bone health. So the risk is if you de-load it too quickly you don’t do that and you develop some de-mineralisation or loss of bone strength just by the very fact that you’ve stopped training.”

An athlete’s gift is rare. You either use it, or you lose it.

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