Preview of Fearghal Kerin’s Seminar on The Assessment and Management of the Sporting Hamstring

Hamstring injuries have been a hot topic of debate over the past few years, with many debates on Twitter and Facebook between academics and clinicians alike on injury mechanisms, treatment strategies and reduction methods. Everyone has their own interpretation of the literature and arguments have ensued. Stretching vs Strengthening? Eccentric vs Isometric action? Nordics vs Functional? Its a complex topic and people get passionate, whatever side of the fence they sit on.
Some of the arguments however seem quiet reductionist. Putting together what we know works from clinical trials, and what has worked in clinical based practice seems a more sensible approach that more should base their treatment approaches on. Also, in my experience, the individual seems to get lost in the argument. The complex nature of human locomotion means that individual differences for hamstring strains need to be examined for every athlete/patient e.g. strength deficit vs over stride pattern.
Putting together the information that we know to optimise treatment strategies can be the complex part.
  • When do I begin loading the hamstrings?
  • How do I know when to progress loading?
  • What exercise selections target the area?
  • When do we begin running again?
  • How do I put a rehabilitation program together?
We at Sports Physio Education are delighted to welcome Fearghal Kerin of Leinster Rugby & Dundalk FC to help us answer those questions and give us the latest evidence and clinical based strategies to manage the sporting hamstring. Below is the agenda and link for the Seminar.


Sports Physio Education Seminar

– Friday 16th February, 6pm – 9pm.

– Fearghal Kerin of Leinster Rugby and Dundalk FC.

– Sports Physio Ireland, 29 Upper Fitzwilliam Street, Dublin 2.

We are delighted to welcome back Fearghal Kerin for his second seminar on the Assessment and Management of the Sporting Hamstring. Fearghal works as a Rehabilitation Physiotherapist in Leinster Rugby and the Head Physiotherapist with Dundalk FC. He brings a wealth of experience from the Elite level of sport on the management of hamstring injuries, and he is going to share with us his insights and the latest research around hamstring injuries. Fearghal’s last seminar with us in July was a sell out so we are looking forward to what’s in store for us this time round.

Seminar content:

  • Challenges of the Hamstring Strain
  • Prevention, Prediction and the Nordic Hamstring Exercises
  • Criteria based Assessment and Rehabilitation
  • Exercise Selection
  • Return to Running and Return to Performance

With most of the seminars we will be holding, there will be a large emphasis on practical assessment and interventions, so you can take away some ideas that you may integrate into your own practice. This seminar will be 1 hour of theory and 2 hours of practical assessment and treatment. Plenty of engagement and lots to learn. This seminar is open to physiotherapists, students, physical therapists, S&C coaches and healthcare professionals.

If you have any questions, don’t hestitate to contact us at


No refunds at any time.

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Fatigue Markers in Sport

Following on with some of our most recent posts on training load and injury/illness as we prepare to welcome Mark Roe for our August Seminar “Minimising Injury Risk and Maximising Performance in the GAA”, we will look at fatigue as a useful marker to monitor the athletes that we work in day to day, especially within the team setting.

Management of fatigue is important in mediating adaption to training and ensuring the athlete is prepared for competition. These training responses can be both positive and negative, and helps both the Strength and Conditioning and Medical staff see how the athlete is responding to the training load prescribed.

Different times of the year, different objectives will always make these slightly open to interpretation of the support staff e.g. during a period of planned overreaching,

the support staff will expect to have changes in fatigue markers that may be negative. Fatigue can also give us a better ability to reduce the athletes’ susceptibility to nonfunctional over-reaching, injury, and illness, by picking up signs and symptoms of difficulties to the training load early.

An excellent recent systematic review in Sports Medicine highlighted the role of fatigue on injury rates and illness in athletes. Below I have outlined some of the main findings from the review on fatigue markers and injury within that paper.

Fatigue Markers and Injury

The review showed that only 9 studies investigated fatigue–injury relationships, seven of which used perceptual wellness scales.

  • In soccer players 3 studies showed greater daily hassles to be associated with increased injury, using the Hassles and Uplifts Scale (HUS) (Ivarsson et al., 2010; Ivarsson et al., 2013; Ivarsson et al., 2015)
  • Laux et al. (2015) further support the positive perceptual fatigue– injury relationship in their findings, which reported that increased fatigue and disturbed breaks, as well as decreased sleep-quality ratings, were related to increased injury.

However, In contrast rating of perceptual fatigue showed slightly different findings in other studies:

  • Killen et al. (2010) found increased perceptual fatigue (measured via worse ratings of perceptual sleep, food, energy, mood, and stress) was associated with decreased training injury during an elite rugby league preseason.
  • Similarly, King et al. (2010) showed increased perceptual fatigue (measured via various REST-Q factors) was associated with decreased sports performance training injuries and time-loss match injuries.

The authors theorise that these unexpected findings may be due to the fact that when players perceive themselves to be less fatigued they may train/play at higher intensities, increasing injury likelihood.

Most of the studies used wellness scales that take approximately 1–4 min to complete. These are extremely practical to administer to athletes and are quick and not too time consuming. The Rest-Q has been also well-validated within the literature.

The review also showed that current self-report measures fare better than their commonly used objective counterparts. In particular, subjective well-being typically worsened with an acute increase in training load and chronic training load, whereas subjective well-being demonstrated improvement when acute training load decreased. Using quick subjective questionnaires and “knowing” the athletes is vitally important. Earning the trust of the athlete and building a strong relationship over a period of time, is just as useful as any expensive monitoring system.

The authors also noted the poor investigation within the literature of the relationship between sleep and injury.

Sleep is a vital part of the body’s recovery process and has been well highlighted in recent times on it’s relationship to productivity, chronic pain and depression (Rosekind, (2010); Smith (2004); Tsuno (2005). The review showed that three studies assessed sleep–injury relationships via sleep quality ratings, with only Dennis et al. (2015) investigating objective measures of sleep quality and quantity in relation to injury. No significant differences in sleep duration and efficiency were reported between the week of injury and 2 weeks prior to injury.


While the number of studies is quiet limited in the review, evidence of the use in the team setting to monitor the role of fatigue on injuries is supported. However, anecdotally and from experience within the field the importance of speaking to people, building strong relationships and creating a supportive environment cannot be underestimated. An athlete who trusts your role and job in helping their performance and having their wellness as a priority will often speak to you sooner than any subjective or objective marker can pick up.

So while using these tools is of great importance, don’t forget the strength of building personal relationships with your athletes.

Thomas Divilly

  • Ivarsson A, Johnson U. Psychological factors as predictors of injuries among senior soccer players: a prospective study. J Sports Sci Med. 2010;9(2):347.
  • Ivarsson A, Johnson U, Podlog L. Psychological predictors of injury occurrence: a prospective investigation of professional Swedish soccer players. J Sport Rehabil. 2013;22(1):19–26. 93.
  • Ivarsson A, Johnson U, Lindwall M, et al. Psychosocial stress as a predictor of injury in elite junior soccer: a latent growth curve analysis. J Sci Med Sport. 2014;17(4):366–70
  • King D, Clark T, Kellmann M. Changes in stress and recovery as a result of participating in a premier rugby league representative competition. Int J Sports Sci Coach. 2010;5(2):223–37.
  • Kinchington M, Ball K, Naughton G. Reliability of an instrument to determine lower limb comfort in professional football. Open Access J Sports Med. 2010;1:77–85.
  • Kinchington M, Ball K, Naughton G. Monitoring of lower limb comfort and injury in elite football. J Sports Sci Med. 2010;9(4):652.
  • Killen NM, Gabbett TJ, Jenkins DG. Training loads and incidence of injury during the preseason in professional rugby league players. J Strength Cond Res. 2010;24(8):2079–84.
  • Laux P, Krumm B, Diers M, et al. Recovery-stress balance and injury risk in professional football players: a prospective study. J Sports Sci. 2015;33(20):2140–8.
  • Rosekind, Mark R., et al. “The cost of poor sleep: workplace productivity loss and associated costs.” Journal of Occupational and Environmental Medicine52.1 (2010): 91-98.
  • Smith, Michael T., and Jennifer A. Haythornthwaite. “How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature.” Sleep medicine reviews 8.2 (2004): 119-132.
  • Tsuno, Norifumi, Alain Besset, and Karen Ritchie. “Sleep and depression.” The Journal of clinical psychiatry (2005).
  • Dennis J, Dawson B, Heasman J, et al. Sleep patterns and injury occurrence in elite Australian footballers. J Sci Med Sport. 2015;19(2):113–6.

When working with sports teams, you meet a mixture of people working within the management and administration of the club/county. As it is still firmly an amateur organisation, the clubs and counties still rely heavily on the volunteerism that has built the foundation of the GAA, and please God may this never change! These people have a mixture of skills and experiences that make the GAA so unique to our country and culture. Everyone has different backgrounds that make trying to mesh an amateur ethos and drive with the professional demands needed to compete at inter-county and club levels easier. And yes, not only are inter-county setups extremely professional, a lot of clubs are following closely. Managers and coaches are extremely ambitious nowadays and want to create the most professional setups in the country.
And so often Physiotherapists, Strength and Conditioning Coaches and other related professionals are greeted with a mixed reaction within different setups, depending on people’s past experiences. Some are lauded as essential and necessary for continued success on the pitch, while some are greeted with a mixture of suspicion at our role within the team. We have all been in that situation, when you meet a coach or manager who doesn’t understand what your skillset involves, what you can do to help a team succeed. Physiotherapists are seen as giving out “rubs” and S & C professionals are seen as “doing the gym”. And while these may have been our role historically, we have moved on well from this! We have greater skillsets than this and we can heavily influence both the welfare and performance of the athletes we come in contact with.
And so like any profession I believe we should justify our roles within these groups:
  • Are we addressing intrinsic/extrinsic factors that may influence injury risk?
  • Are we putting in injury prevention programmes that have been proven to reduce rate of injuries?
  • Do we use the most up to date methods of preparing our players for their performance demands?
  • Are we continually up-skilling and increasing our knowledge?
  • Are we educating the people who make the important decisions on best practices?
These are all questions that we should be continually asking ourselves when working in these environments. So how do we justify our role first and foremost? What is the one thing every coach and manager puts the most weight on when making decisions? What can they not ignore. They are all striving for the same thing.
And while talent is important.
We know that team success is heavily influenced by player availability.
In this study by Hagglund et al. (2013) they looked at the injury incidence and injury burden on performance measures in soccer. What made this study unique is that the clubs that participated included the likes of Barcelona, Manchester Utd etc. So massive clubs at the elite level! And over an 11 year period they found that a team that had both decreased injury rates and injury severity compared with the preceding season had a statistically better chance of improved team performance, based on final league standing and league points per match. This is massively important!
The study concluded that the “association between injuries and performance is probably one of the most important messages to convey to management and coaching staff, as well as to other stakeholders in clubs, in order to continue to improve medical services for the players and to increase efforts to prevent injuries”.
Therefore, while we can’t prevent every injury, there is no magic bullet! We can use the best of our knowledge and our understanding of the science out there, how to put in programmes to help reduce the injury risk.
Read the data out there. Collect your own data. React to the data if needed.
Put into place some high quality injury reduction programmes.
Work as a team within the medical and performance department.
Help each other. Don’t let egos clash.
You should have a common goal. Work together to make it happen.
Thomas Divilly
Chartered Physiotherapist, MISCP, CSCS

Golf Fitness by Moss Landman

Golf has come a long way in the past few years, from a fitness point of view in particular. It doesn’t seem too along ago people joked that you could be a quality golfer but significantly over-weight and unfit. The reality is that these days, players along with the game itself, are developing quickly with guys hitting it further, maintaining concentration for longer in all sorts of weather conditions and they’re not breaking down with injuries as much.

At Sports Physio Ireland we train golfers of all playing levels – from beginner through to professional players and it’s paramount for club golfers and tour players alike to keep up with these developments whether you’re looking to win your weekly singles stableford or the next major.

At the top level, Gary Player was one of the first players to advocate fitness for golfers back in the 1950s.

People thought he was crazy lifting weights back then. But today he is one of the fittest 75 year old men you will meet out there. I have a lot of admiration for Gary as even though the concept of Strength and Conditioning was so new back then, he was smart enough to take recovery and specificity (more on this later) into account with his training regime. He really was ahead of his time.

When Tiger Woods first broke onto the scene it seemed he put on a lot of muscle during his first few years on tour. He hit the ball hard and swung it as fast as anyone. He developed himself into an incredible athlete and although he had a huge amount of success early on, the idea of ‘golf-fitness’ still took a few years to take hold on tour. 

Nowadays a huge chunk of tour players are in the gym. At the time of writing, 8 of the 10 top ranked players are established gym-goers.

Rory works out twice a day, Adam Scott works out 5 times a week while Dustin Johnson’s preferred training choice is Olympic Weight Lifting.

Here are some videos which give an insight into some of the World’s best player’s routines and thoughts on fitness


Golf fitness doesn’t just apply to tour players. Ask yourself if you’d like to hit the ball a little further?

If you hit it 250 off the tee now maybe adding 10-20 yards to your drives, which by the way is without doubt possible, could mean hitting one of your club’s par 5s in two? If you it it shorter than than that maybe it is the difference between hitting an iron on some of your par 3s rather than a wood. 

What about the longevity of your playing career? The beautiful thing about golf is that we can play until we’re more or less knocking on death’s door. However, how often have you heard of people in your club complaining of neck, back, elbow or wrist pain preventing them from playing regularly or playing pain free?

Getting fit helps keep injuries at bay which will allow you to enjoy your golf for many years to come. Not many sports can offer that. Aside from the benefits on the golf course, getting fitter and stronger will help you live longer, stay healthier and feel better about yourself every single day. It will make you a happier person. 


How can you benefit from golf-specific fitness training?

When I think of golf-fitness there are a few things that spring to mind. We must ask ourselves what it is we are looking to achieve from the development of a golf-specific training programme. For example, golf is a sport that does not require the highest levels of human strength at the expense of function or mobility compared with contact based field sports such as GAA, soccer or rugby. Equally, we walk when we play golf, we don’t run. Golf is a slow endurance sport with intermittent complex swings that require sound technique, speed and power, all in a controlled and consistent manner. For correct technique we not only require the knowledge to swing it right, but also the correct balance of flexibility, control and strength in combination to execute consistent golf shots. 

In my view, functional training is the best way to train golfers in the gym. (Functional Training is summed up well by Dr. Steve McGregor here

Functional training is a process.

Before a golfer should be concerned with lifting weights, we must ascertain whether he can move well enough to get into the correct positions in order to lift efficiently, without risk of injury. We must also ensure the golfer has the capacity to move into the correct positions to swing the club efficiently in order to hit the ball as consistently as he/she can. At SPI we focus on developing a golfers functional ability, which includes working on coordination and the correction of aberrant movement patters in order to make them more athletic, reduce their risk of injury and help them swing the club better.

Once the movements patterns are on-song we load our clients up using weights, challenging the golfer’s function at a higher level. 

There are many sub-categories of and compliments to functional golf training. Things such as foam rolling, stretching, core work, swing speed work, plyometric & power development, cardio vascular fitness and on-course nutrition are all components of functional training on one level or another and can add to your performance as a golfer. I like to think of these aspects of a golfer’s fitness as ‘boxes to tick’ along the journey to becoming a better golfing athlete. It is important to remember that not one size fits all and some individuals need specific focus on some components of functional training more so than others.

My view is that an individual should train based on what they need to improve (relative to their sport) and to get better at what they’re already good at. Generally, I want golfers to have strong, stable lower bodies and quick, powerful upper bodies. I always aim to keep my programming simple and relevant working towards short medium and long term goals.

At SPI, our initial golf-screening process will establish where your weaknesses lie and we will develop a programme for you to right these wrongs.

We also arrange nutritional consultations to help you make the necessary changes to your body along your journey, particularly helping you manage your energy levels on-course to get the best out of yourself during those 4+ hours of play.

Our goal is to make you a better athlete. No matter what your level of fitness is, we can help improve your performance on and off the golf course. For more information on pricing, our packages and to book in click the button below. 

Moss Landman MISCP

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Tips to Avoid Muscle Fatigue during Fitness Workouts


Most people who have just begun their fitness training at the gym have experienced this sensation: a sudden inability to go further, to take one more step on the treadmill or to do one more push-up or crunch. It is called muscle fatigue and it can occur even among professional athletes. Therefore, since it is such a common problem for people training intensively, it is worth our attention.

Tips to Avoid Muscle Fatigue During Fitness Workout

Muscle fatigue is an insidious condition, in the sense that it does not give you any warning signs. In other words, your body does not give you specific hints to slow down your training. It just stops obeying your commands at a certain moment. There are several causes which favour muscle fatigue, and they are all simple and easy to correct. Thus, we decided to have a talk with professional trainers and find out their best tips for preventing muscle fatigue.


What we found out was rather encouraging – it is in everyone’s power to take the necessary steps to fuel and strengthen their bodies adequately, and to increase their endurance for intense training. Therefore, without further delay, these are the top recommendations from professional trainers to avoid muscle fatigue:


  1. Fuel Your Body Properly

Adequate nutrition is the key to everything you do – from the ability to focus on complicated tasks at work to your body’s endurance during fitness training. A well-balanced diet includes lots of fruit, vegetables, proteins and carbohydrates. Carbohydrates are of a particular importance. They help your muscles store glycogel, which is depleted during training, leaving you with the sense of fatigue.


If you are planning to start fitness training, you should change your nutrition habits 10 days to a week before you hit the gym for the first time.


  1. Hydration

Yes, once again we touch on this subject because it is as critical as proper nutrition. We will never tire of reminding amateur and professional athletes that the human body is made of 70% water and it loses lots of it through sweating during intense physical training, along with essential minerals and electrolytes.


Staying hydrated involves drinking water and sport drinks before, during and after training and avoiding at all costs the sensation of thirst. The moment you feel thirsty, your body already experiences dehydration, your muscles are prone to cramps and fatigue and you will not be able to complete your training schedule.


  1. Use the Correct Posture

One of the reasons why people feel muscle fatigue, especially at the beginning of training, is the fact that they do not maintain an adequate posture on the treadmill, on the elliptical bike and during weight training. The first consequence of a wrong posture is the fact that one group of muscles takes the brunt of all your efforts, while others are not properly exercised. It also means that you will develop an unnatural posture, unless you correct it, with long terms effects such as a predisposition for injuries and chronic pain.


  1. Build up Lung Capacity

In most cases, muscle fatigue is accompanied by shortness of breath. This means that your lungs are not working efficiently to deliver oxygen to all the cells in your body during training. The best way to correct this is to start your fitness training with a series of exercises which are meant to improve your aerobic capacity – that is, the quantity of air you intake with each breath. In many sports, learning how to breathe in and out and synchronise your breathing with the movements of the body are the main keys to pushing your endurance and performance further.


  1. Do Not Skip the Rest Day

For beginner athletes it is very tempting to push themselves to the maximum capacity. They will go to the gym every day of the week, ignoring the trainer’s recommendation for a rest and recovery day after each two days of training. The result of pushing yourself too hard is suffering from dead leg, muscle cramps and losing your enthusiasm in the training, due to the soreness you will have to endure at the end of your first week of fitness.


Rest days are important, even for professional athletes who win Olympic medals. The human body is a fine tuned machine, which needs time to recoup and regain strength. If you keep the machine working for too long without a break, something will snap sooner or later.


Now that you know what you need to do to keep your body working properly, you can certainly avoid any further muscle fatigues by sticking to a healthy and balanced diet and training regime.


How to Prevent the Most Common Inline Skating Injuries

Inline skating is very popular among people of all ages, but especially among children and teenagers. It offers more freedom in movement than riding a bicycle and also a considerable speed. For this reason, a lot of people use it as a means of doing sports, having fun, and getting quickly from one point to another without the hassle of taking the car or the bike.

How to Prevent the Most Common Inline Skating Injuries

However, many people who practice inline skating are prone to accidents – these accidents being quite prevalent among novices. Statistics say that out of the most serious inline skating injuries which ended in the ER, 14% are suffered by beginners who do not yet master the art of swerving or stopping their inline skates properly.


What Kind of Injuries Are Involved in Inline Skating?

By far, the wrists are the most exposed body parts to injury while inline skating. This is generally due to the fact that the natural instinct when you trip while skating is to put your hands forward to break the fall. A research study conducted by the Medical Clinic and Polyclinic, Department of Sports Medicine, University of Tubingen, Germany showed that the overall percentage of injuries in inline skating is:


  • 38% to the shoulders, arms and torso;
  • 31% to the legs;
  • 21% to the pelvis and hips, and
  • 10% to the head.


Understanding these statistics is important, because it shows the mechanics of injuries and helps us become more aware of the dangers. For example, although the head injuries have the smallest proportion in the above percentages, they also tend to be the most severe. For this reason, you should always wear a protective helmet, even if the statistics say you are the least likely to injure your head.


What Are the Best Ways of Preventing Inline Skating Injuries?

There are no specific injuries or conditions related to this sport – injuries are strictly related to accidents. For this reason, our list of tips will refer to the prevention of such accidents, rather than the prevention of specific injuries.


  1. Beginners Should Practice on Special Lanes

There are special lanes for inline skating in parks and sports facilities. These are the ideal places to practice until you master your skating technique. The lanes are smooth, in a straight line and with very wide curves, helping you learn how to advance forward, swerve and stop. There is no pedestrian or bike traffic on these lanes, so you will be able to concentrate on skating itself without fear of accidents.


  1. Wear Protective Gear All the Time

Accidents can happen even to seasoned inline skaters. A sudden bump in the road, a person unexpectedly appearing in front of you are enough to cause you to fall down. The most common items of protective gear are the helmet and the knee, elbow and palm pads. If you take part in a high speed skating race, you should also wear a mouthpiece to protect your teeth in case of a violent impact with another competitor.


Apart from these protective items, inline skaters are recommended to wear long sleeve shirts and full length trousers in order to minimise the amount of cuts and bruises in case of an accident.


  1. Learn How to Fall

This is one of the first lessons an inline skate trainer would give to all beginners. Learning how to fall safely is a must if you want to reduce the extent of your injuries. The best way to fall, when it is inevitable, is on your sides – right or left. Falling backwards should be avoided at all costs because you could injure your spine or neck. When you fall forward, do not lock your elbows, but let the shock travel up your arms and along the muscles. This will avoid a serious wrist sprain, or even a fracture of the metacarpal bones.


  1. Warm up Before Skating

Warming up should be done in two sessions: the first before you put on your inline skates, and the second with your skates on, before you start gaining speed and swerving. For the first part of the warm-up, you should focus on flexibility by doing a series of stretches. For the second part, assess your range of movements, practice various stops (in a curve, all of a sudden, at various speeds) and build up momentum gradually.


  1. Keep a Close Eye on Your Surroundings

Once you leave the sanctuary of specially designed lanes for skating, anything could happen. For this reason, you must be very careful at what is ahead of you and around you, navigate carefully in traffic, never skate behind a car or a bike, and pay special attention to the potential bumps and irregularities in the road.

Speed For GAA Players

Speed is defined as the rate at which someone moves.  We can divide speed into an explosive phase and a knee drive phase. A lot of GAA players spend far too much time developing muscles to move slowler, simply because this is an easier way to train during a gym session. We have to look at the relationship between gym sessions and the game played. GAA involves a lot of acceleration and deceleration, but many gym programs don’t reflect the two patterns.

There is a huge role for both strength and hypertrophy in athletic development but speed is often ignored. Reasons for this include;

It’s Time Consuming

In order to train absolute speed it can take up to 40 minutes to properly warm up and activate the muscles and patterns required. This can be slow and tedious. Quite often this part is skipped or sped up in order to get to ‘the good stuff,’ such as sprinting. Athletes can be resting for up to 4 minutes between exercises which can result in sessions lasting up to 2 hours . These sessions are regularly omitted from training plans because of an already busy schedule.

It Is Perceived As A Light Session

There is a ‘if its not hard its not worth doing’ mentality in GAA. Quite often coaches would rather see teams out of breath rather than doing a pure speed session. Athletes don’t get their heart rates up too high or break a sweat. For coaches and some athletes the temptation to work hard can be too much. Working smarter is better for athletic development.

Too Tired After Heavy Training Loads

Heavy weights, long training sessions and matches make it hard to fit speed work into a training regime. You need to prioritise it in your training week for when you are at your freshest. Typically GAA matches are on a Sunday so a speed session would be optimum on a Wednesday. Pitch sessions and gym sessions are regularly prioritised ahead of this, with pitch sessions regularly on a Tuesday and Thusday and gym sessions on Mondays and Wednesdays.

Joey Boland,

Head Physiotherpaist

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