Sports Therapy for the Footballer!

1. Sports Therapy for the Footballer! A guide for Sports care By David Murphy

2. Nutrition • There are 6 basic Nutrients all humans need to consume in a normal day to function correctly. • Carbohydrates • Fats • Proteins • Water • Minerals • Water

3. Footballers Have Extra Needs! • As Footballers yourequire • more nutrients than most . • Increase in Protein. • Increase in Fluids. • Increase in Carbohydrates • Increase in Vitamins and Minerals

4. Sport-specific nutrition Daily Total Caloric Ratio Need • 60% Carbohydrate • 15% Protein • 25% Fat

5. Carbohydrates: 55-60% 2 main types Complex and Simple Primary source of energy. Primary glucose source in the muscle & liver. Body stores glucose in the form of glycogen. Glucose is primary fuel for brain & the CNS. CHO are involved in maintaining blood glucose levels which are vital to performance & appetite control.

6. Types of Carbohydrates Examples of Simple Carbohydrates Fruit. Sucrose. (table sugar, cane sugar, beet sugar) Maltose. (malt sugar) Lactose. (milk sugar) Because simple carbohydrates are already simple sugars they can rapidly be converted into glucose and enter the bloodstream very soon after consumption. This where the term "sugar fix" comes from. After drinking a sugary cup of tea, for example, you may notice a sudden release of energy and an accompanying lift in your mood. However, have too much and your body will produce insulin to counteract the effect and, depending on how much sugar you've ingested, this will likely result in a rapid drop in blood sugar level and leave you feeling more tired than before!

7. Examples of Complex Carbohydrates Raw fibrous vegetables like broccoli, spinach, carrots, baked/green beans, cucumbers, tomatoes. Grains like oats, breads, bran cereals, pasta, rice. Starchy vegetables like potatoes, corn, peas, beans Unlike simple carbohydrates, complex carbs are digested at a much slower rate. As a result of this, the conversion to glucose also happens at a slower rate and your blood sugar levels will not fluctuate as rapidly as they do when digesting simple carbohydrates. Highly processed foods should be avoided. This is because they normally contain a higher proportion of simple carbohydrates. For example, whole grain bread (complex carbs) should be eaten instead of white bread which uses refined white flour (simple carbs). Complex carbohydrates are often also lower in fat and provide higher amounts of other essential nutrients like dietary fibre. It is for the above reasons that a diet of complex carbohydrates is preferable.

8. Simple vs. Complex CHO Simple Carbohydrates Are absorbed by the body quickly. Can cause fluctuations/spikes in you blood sugar level (BSL) triggering an insulin reaction. Quick increases in BSL cause: • Increased appetite. • Prevents fatty acid metabolism. • Suppresses growth hormone release. • Conversion of sugar to fatty acid.

9. Simple vs. Complex CHO Complex Carbohydrates Digest & release glucose into bloodstream at slow & steady rate. Are absorbed by the body slowly. Slow release of CHO into the bloodstream: • Regulates appetite. • Provides prolonged supply of CHO to the blood stream. • Provides a nutritional energy substrate which will further spare & replenish muscle & liver glycogen.

10. 2.Proteins: 15% Proteins are the building block of muscle. Proteins spare muscle breakdown during exercise. Protein is essential for maintenance, growth & recovery of muscle tissue.

11. Protein: Energy & Digestion Ignore bodybuilding trends---more is NOT better! Excess protein is counter-productive,because it can be broken down into glucose & fatty acids. Only 20-30 grams of protein can be digested every 3-4 hours (excluding post-workouts). Avoid eating high protein meals 2-3 hours prior to an exercise or Match but can eat after match

12. 3. Fat ( 30%) Fat is the third nutrient essential for the proper functioning of the body. Fats provide the "essential" fatty acids, which are not made by the body and must be obtained from food. When the body has used up the calories from carbohydrate, which occurs after the first 20 minutes of exercise, it begins to depend on the calories stored in fat. Myth: Reduced-fat foods are always low in fat.Fact: These foods are lower in fat than their full-fat counterparts, but that doesn't necessarily mean they are "low fat." To know the facts, read the nutrition label and compare the fat content of two similar products with the same serving size. Use the nutrition label to check the calories.

13. 3. Fat ( 30%) Essential Fatty Acids (EFA) are required for growth, recovery, & overall health. Aid in absorption of fat soluble vitamins. Fatty acids (FA) are an important source of energy. Protective padding for organs

14. Good and Bad Fats • 1. Saturated fats(butter, cheese, whole milk, ice cream, cream, and fatty meats) • 2. Unsaturated fats (Fats that help to lower blood cholesterol if used in place of saturated fats. there are 2 types • 1.Mono-unsaturated fats 2.Poly-unsaturated fats • olive and canola oils safflower, sunflower, corn, and soybean oils. 3. Trans fatty acids:(These fats form when vegetable oil hardensand can raise LDL levels. They can also lower HDL levels ("good cholesterol) Found in fried foods, commercial baked goods (donuts, cookies, crackers), processed foods, and margarines 4. Hydrogenated(oils that have become hardened)should be avoided because they contain high levels of trans fatty acids, which are linked to heart disease

15. Water & Athletic Performance Hydration is one of the most important factors in performance for all sports! Glycogen is stored in the muscle and liver together with water. One gram of glycogen is stored with three grams of water. This means when glycogen is used, water weight is lost in the process.

16. Water & Athletic Performance Water replenishment is the most important factor during exercise. Outside the narrow range of 98-100°F, your body will always sacrifice muscle function for temperature regulation. Drink a minimum of 1 to 1.5 litres a day! • Flushes out metabolic waste products • Maintains the bodies cooling system • Prevents muscle cramps, strains and pulls On Match days drink more!

17. Water & Athletic Performance Dehydration equals: • Reduced endurance levels • Fatigue • Poor stamina • Reduced maximum recovery between workouts • Muscle cramps and joint pain Rememberthirst lags behind need!!! You are already dehydrated when you sweat Drink before you reach this stage!

18. Water & Athletic Performance If you drink 12oz. of plain water, 8 oz. of it will empty from your stomach within 15 minutes. Avoid High Carb Drinks that are over 10% simple sugars. If you drink 12 oz. of a >10% sugar solution, (Powerade)less than 1% will empty in the same period. Simple glucose at 1-5% hardly inhibits stomachemptying at all, and does provide a boost to blood glucose. (Gatorade)

19. Timing • Stay well-hydrated throughout the day, everyday: urine should be clear and pale, and you should need to urinate at least 4-5 times per day. • Two hours before practice or match: At least 2 cups of water or sports drink • During warm-up: ¼ to ½ cup fluids as tolerated. • During practice or match: ½ - 1 cup water or sports drink every 15 minutes(where possible). • After practice or match: 2½ cups water/sports drink for every pound lost in sweat

20. Alcohol Contrary to popular belief, Alcohol is not counted as fluid intake :0) The human digestive system cannot Tolerate or break down alcohol so it has to flush it out of your system very rapidly. Your liver has to work overtime to do this and so does your kidneys/bladder to expel it! (opening the flood gates…) If you eat while you drink alcohol, your digestive system has to cope with the alcohol as a priority, therefore it pushes the food straight to fat cells to be able to do this. (Hips on women and abdomen on men)

21. Alcohol Alcohol and Exercise Alcohol affects the body's ability to turn food into energy, it slows down reaction times, increases body heat loss and reduces endurance. If you have alcohol 24 hours before exercising you are more likely to develop muscle cramps. Remember - if you were drinking the night before, when the time comes to really dig deep, there mightn't be anything there. It is also important to remember that drinking before or during exercise can lead to injuries. Alcohol in the body can slow down the healing process leading to an increased recovery time from an injury.

22. Alcohol Alcohol and Sports InjuriesDrinking after the game or heavy exercise will have a major effect on soft tissue injuries. Alcohol:• dilates and relaxes blood vessels, which leads to more bleeding and swelling.• increases the time the body will need for recovery and repair.The sensible approach to alcohol and sport is:• give your body a chance to metabolise any alcohol in your system by avoiding alcohol 24 hours before playing or training.• put First Aid first, and if you’ve been injured, don’t drink alcohol until you’ve had treatment.

23. Meal Frequency Meal frequency is the most important factor in any Sports program! • Keeps metabolic rate elevated. • Maintains blood sugar levels. • Maintains energy throughout the day. • Provides small “packets” of macro/micro nutrients throughout the day.

24. Meal Frequency:Optimum Digestion Limit carbohydrate (complex and simple) intake in the later evening when activity level is low. Evening meals should consist of a high source of lean proteins and fibrous vegetables & a low source of starchy/grain CHO to prevent excess calories and fat storage (excluding evening practices). Eating the right combination of foods during your pre & post training workouts will be effectively replenished your bodies energy systems

25. Championship Football requires energy for: Defenders: Agility, Precision, Endurance. Midfielders: Endurance, Agility, Quickness, Precision.Forwards: Explosive power, Precision, Agility. Endurance Goalie: Explosive power/Quickness, Precision, Agility, Strength. Most positions in GAA rely 98% on aerobic energy, which is provided largely by carbohydrate and fat

26. What do I eat on Match Day? 4 Hours Before Pasta Stir-Fry Sandwiches Fajitas Eggs and Toast Chicken,potato, veggie Veggie burger 2 HoursBefore Crackers Biscuits Cereal with milk Waffles or pancakes Pasta salad 1 HourBefore Cereal bar Toast Instant breakfast Nutrition shake

27. What do I eat on Match Day? Bake or broil food instead of frying it. Steam or microwave vegetables rather than fry them. Examples and the best carbohydrates to eat are the Complex Carbohydrates - as found in foods such as Pasta, Rice, Noodles,Baked Beans, Pulses (beans,peas,lentils), Brown Bread, unsweetened Breakfast Cereals, Potatoes and sweetcorn. Peaches apricots and bananas are excellent choices in fruit. On match days fat and protein intake should be restricted and an easily digested pre-match meal eaten about three hours before kick-off - with a 'top-up' high protein snack consumed 90 minutes later. The stomach should then be practically empty during the game A baked potato, pasta or rice with a low fat sauce or breakfast cereal with low fat milk or banana sandwiches are all foods that are not too bulky and are easily digested. For a high carbohydrate snack try toast (or muffins) with jam or honey, jelly sweets or sweetened cereal. Drink orange juice with the meal and the snack. After the game, a sweet snack should be consumed and fluids replaced. Fluid replacement is probably the most important nutritional concern for a soccer player

28. Effects of Bad Nutrition • Fatigue is often caused by bad nutrition. • Colon Cancer has been known since the seventies to be diet related. Eating high saturated fat (red meat, etc.) is a main cause. • Five of the top 10 causes of death are all lifestyle related. • The five biggest reasons people are under a doctors care are low quality of life, cancer, stroke, hypertension, and heart disease. • Good nutrition can help you bounce back from the effects of stress.

29. Food Pyramid

30. Smoking Smoking has obvious health risks. It fills your body with Carbon Monoxide amongst other carcinogenics (cancer causing agents) etc.. The main danger with smoking in relation to Nutrition is the damage smoke does to the arteries throughout the body. It filters through, making abrasions in the walls of the arteries. When Cholesterol is passing through the walls, these abrasions catch lumps of it and it stays there building up. Eventually with Blood pressure rising, it will flush through the arteries breaking this lump off. This will in turn either travel to the heart casuing a blockage and heart attack or to the brain causing a stroke

31. Stretching & Injuries The Truth …and nothing but the Truth so help me God!

32. Stretching – An Intro • Stretching is the process of placing particular parts of the body in a position which will lengthen the tendons and muscles. It enhances athletic performance, reduces the possibilities of injury and minimizes muscle soreness. • The benefits of Stretching is extended range of movement, this gives increased comfort, a greater ability to move more freely and…. reducing our risk of injury.

33. Injuries and stretching • There is irrefutable evidence if you stretch you avoid injury and if you don’t , you will either cause a new injury or exacerbate an old one or weak structure that will give way. • You should never ignore injury and its very important you do the basics to prevent serious injury or shorten the rehab on a new injury. • Basic injury care is R.I.C.E • Rest • Ice • Compression • Elevate

34. Injuries and stretching • Rest – You need to rest immediately and get off the injury ASAP. The longer you stay on it, the more damage you do or risk making it a lot worse. • Ice – Always use Ice in the first 24 hrs of an injury in 2 hour stints using 10 mins on the are and 5 mins off. NEVER USE HEAT OR DEEP HEAT!!!! • Compression – Keep the area compressed to stop inflammation and provide blood flow if an open wound • Elevate – Keep the limb or area raised above the heart area so the flow of blood and fluids is constant

35. Stretching Static Vs Dynamic • Stretching offers many benefits, but there is an issue about the type of stretching and the timing of stretching before training and athletic competitions • There are many types of stretching but we will look at two main types here! • Static (holding a stretching exercise in one position without movement) • Dynamic stretching, which means moving while stretching (arm swings, knee rotations, neck circles).

36. Stretching Static Vs Dynamic • Using Static stretching is it a wise pre-training strategy? • Researchers show that athletes should not perform prolonged static stretching before the big game or a key practice session because this slows muscle activation for around an hour afterwards. • Static stretching builds flexibility and should be performed regularly, just not immediately before a big game or a key practice session but maybe after or to return your muscles to normal length as part of rehab. • Static stretching can be used as part of a warm-up for training. However, static stretching will slightly slow down athletes for an hour afterwards so examine your training goals

37. Stretching Static Vs Dynamic • Using dynamic stretching is it a wise pre-competition strategy? • Dynamic stretching (arm swings, hip rotations, knee rotations) will aid in the pre-competition, pre-practice warm-up process by increasing flexion in the joints and increasing body temperature. This method is preferred before athletic competition. • The best way to improve overall flexibility is static stretching with 30 second stretch-holds performed away from events requiring peak performance and as much dynamic stretching pre-competition!

38. Stretching Time spent • Do static stretching with 30-second stretch-holds in practice • Gains in flexibility are dependent on the "duration" of stretch-hold position, and researchers show the best "stretch-hold position" (for time-spent) to increase flexibility is 30 seconds. • Best" means optimal results for time-spent. You can get positive results with 2 minute stretch-holds, but 30 seconds yields equal results. • The long-term effects of stretching on range of motion show that after six weeks, those who stretch for 30 seconds per muscle each day increased their range of motion much more than those who stretched 15 seconds per muscle each day. • However no additional increase was seen in the group that stretched for 60 seconds. Another 6 week study conducted found that one hamstring stretch of 30 seconds each day produced the same results as three stretches of 30 seconds. • Therefore do 1 x 30 second stretch and move on!

39. Standard Stretches Shoulder Stretches Hip Stretches Back Stretches Glutes Stretches Neck Stretches Leg Stretches

40. Eccentric Stretching • One other type of stretch to consider is Eccentric Stretching which can be invaluable in rehab of any injury. Eccentric means stretching a muscle to its full safe length and then strengthening once its there. • This has added benefits over static and dynamic stretching. • You would stretch the leg statically for 30 seconds in the position as shown and then once done, you would perform the eccentric stretch by pushing the foot into the table in 5 seconds bursts with 5 second gaps between pushes. • 2 sets of 5 is good to start with and work up to 4 sets of 5 if needed in rehab.

41. PNF Stretching • Pnf or (Proprioceptive Neuromuscular Facilitation) iswhen you contract a muscle and your body automatically relaxes the opposing muscle (the antagonist). • For example, when you tighten your biceps, your body automatically relaxes the triceps. The full PNF pattern is done with the assistance of the therapist telling you to "contract for about 6 seconds, relax. They will then stretch the muscle to safe length! • Example here is the Hamstring on own and with partner or Therapist • PNF stretching was originally developed as a form of rehabilitation, and to that effect it is very effective. It is also excellent for targeting specific muscle groups, and as well as increasing flexibility, (and range of movement) it also improves muscular strength

42. Thank You!By David Murphy NMTNeuromuscular/Physical TherapistPhone : 087 97 86 814Dave@allsportinjuries.iewww.allsportinjuries.ie