Implementation of Recovery Strategies for International Rugby Union Tournaments

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Earlier this year saw the release of this textbook and if you read it carefully you will find our very own Campbell Hanson’s name in the contributors list. 

Campbell was asked to write on his experience as the Physiotherapist for the U/20 Wallabies and his case study is titled the "Implementation of Recovery Strategies for International Rugby Union Tournaments"
Rugby Union is a sport that requires intense physical contact and repeated sub maximal efforts over an eighty minute period. When attending the annual IRB Junior Rugby World Championships, the premier junior rugby tournament in the world that showcases the new generation of talent, teams are faced with the task of playing five competition games in the space of seventeen days. This is a large fixture load for any team sport let alone a code that requires a high degree of physical contact and the increase in soft tissue trauma associated with this. At tournaments like these it is often the teams that recover the quickest, or manage their decrement to fatigue the best that have a better chance of being successful as the tournament progresses. This presents some unique situations to the medical staff when trying to optimise recovery and performance. There are some key factors that we use to try and combat the levels of fatigue and muscle soreness that go with this and to prevent a drop off in performance. Interestingly it is not always implementing the most highly technical or having a complicated system but often it is a case of consistently doing the basics right and developing good habits in aspiring young professional athletes.
With only three full days between matches our program will generally look like:
Day 1: Recovery Protocols: pool session, stretching, ice baths, injury assessment and treatment, time off feet. Training will involve off field match analysis, individual player reviews etc. Players who played less than 20 minutes will do a gym session.
Day 2: Field session usually with no contact, running through set pieces etc. Massage in afternoon.
Day 3: Team run in morning, visit match venue in afternoon, more time off feet. 
From a recovery viewpoint there are three factors that we deem most important. Sleep, nutrition and an effective athlete monitoring program.
1. Sleep
Sleep is the most important recovery factor so planning ahead for optimal sleep during travel and on arrival is crucial especially when flying East to West and crossing multiple time zones which is what occurs when flying long haul from Australia to the Northern hemisphere. Effective strategies that we have found useful include issuing all players with an eye mask to help facilitate sleeping on the plane. We will advise players of when they should attempt to sleep when flying so that they are integrated into the local time zone as quickly as possible on arrival. Avoiding caffeinated or sugary drinks and staying hydrated while flying will help with hydration levels and avoid negative impacts on sleeping patterns. During transit or stopovers we will run a team “flex and stretch” session which will incorporate a team stretching session in a vacant space in an airport lounge.  On arrival at our hotel we will have a team walk and an outdoor “stretch and flex” session to help adjust the player’s circadian rhythm through exposure to natural light sources. Sleeping on arrival before the local bedtime is discouraged unless some individuals are struggling to stay awake. Prior planning with hotels to ensure that all rooms have reliable working air conditioning is essential in providing the best sleep environment for our athletes. “Time off feet” between training sessions is an effective recovery strategy and when travelling with younger squads in a different environment is something that should be enforced. 
2. Nutrition
Daily hydration testing is carried out before breakfast and players who are identified as being at risk of dehydration are advised how much fluid they should consume. Snacks are available immediately post training and player education prior to travel is carried out so individuals have a clear idea of how many grams of carbohydrate and protein they should be consuming. Scales are available so fluid consumption post training can be calculated. Establishing basic nutrition protocols in a young player group is an important part of an athlete education program.
3. Athlete Monitoring Programs
Rugby Union is unique in that there are fifteen players on the field who all have different roles and individual skill sets to carry out and this is reflected in the wide array of physiques and physiological make ups of the players. We run a daily athlete wellness monitoring program that records players VAS scores on factors such as muscle soreness, general fatigue, sleep, emotional stress and lethargy and find that this is an effective way of gathering information that will help coaching staff make decisions on training load or to identify individuals that we feel are at risk of impaired performance or injury. The significant amount of physical contact and positional differences in Rugby Union requires an effective monitoring program that allows individuals who are fatigued or suffering from significant muscle soreness to be identified and their training load adjusted accordingly to allow them to perform at their best during a tournament with short turn around periods between games. It is not uncommon for some players in the latter stages of a tournament to have a significantly limited training load due to the effects of fatigue and soft tissue trauma. Effective athlete monitoring will also allow better implementation of active recovery strategies. Ice baths post training and matches are compulsory due to their added role in controlling local tissue inflammation from the exposure to physical contact in Rugby Union.
It is important not to forget the mental side of recovery- having a small team outing that doesn’t require players to be on their feet for too long, gets them out of the hotel environment and their minds away from rugby for a few hours can be as valuable as the above techniques.
Pre travel planning to ensure that sleep and nutrition strategies are in place as well as having an effective athlete monitoring program within a structure that has the flexibility to change individuals training loads is essential to allow Rugby Union players to perform at their optimum during a tournament with short turn around periods. 
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