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Rehab and the road to recovery


ON THE COMEBACK TRAIL Ger Commins played his first club match for Claremorris in two years recently.

Rehabilitating from knee surgery is a slow and difficult process

Ger Commins

SUNDAY, October 15, 2017. It’s county semi-final day for Claremorris versus Ballintubber and, after 20 minutes, I see the side-line official putting the board up. I make my way over and take a seat in the stand of MacHale Park. Things aren’t going well on the pitch, but my mind is already thinking about the future. For years I have had constant problems with chronic patellar tendonitis in both knees.
Getting through games was becoming a major struggle in early 2017. Half-time in the dressing room would result in stiffening up of the knees and the feeling of being an 80-year old man such was the discomfort of trying to straighten my legs when static for a few minutes. This was more than just being able to return to play football ‘pain free’, it was an issue that was affecting my lifestyle.
My journeys travelling from Dublin to Mayo would result in having to pull in two or three times so that I could get out of the car to stretch my legs. Squatting down a few inches, going up and down a set of stairs, or kneeling would be severely uncomfortable. Even jumping off one leg in a warm-up prior to a training session or a game would be a non-runner. Taking anti-inflammatory tablets just to get through matches and pitch sessions was the norm at the time.
A few days after the semi-final I made contact with a local physio who knew my injury background. Earlier in the summer I had already been to Dr Seán Moffatt in Ballina, where I was sent for MRIs on both knees and the results came back as atypical.
I undertook a series of shockwave sessions which helped for a short time. The next step was Santry [Sports Clinic] where I met the consultant in June and he used PRP injections to try and heal the injury, along with specific rehab. Again, I still didn’t feel 100%.
I was given the name of Professor Hakan Alfredson who is dubbed the ‘Godfather of Tendons’. He is a world-renowned Tendon Specialist and Orthopaedic Consultant, specialising in the Achilles, patella and elbow tendons. He has a clinic in London so I booked an appointment with him in late October.
On arrival, it was apparent straight away that Dr Alfredson was a gentleman who took genuine interest in my wellbeing. We talked through my injury history and next he began a few tests. I knew straight away by his facial expressions that things weren’t great.
In his report he said: “This is a complicated case of bilateral patellar tendinopathy in a patient who has patella alta and major bone changes, together with minor partial ruptures in the tendon. It is very difficult to say whether he could be improved by surgery or not”.
He also said if he showed the images to a group of consultants at a forum they wouldn’t believe that I had still been playing football through this, which took me by surprise. 
This was ‘the last chance saloon’ so I booked into his tendon clinic in Northern Sweden for operations on both knees two weeks later. I am very lucky to have supportive parents, and a principal in the school where I teach, who gave me the time off to go ahead with it.
In total I spent five nights in a small town called Umea. Sub-zero temperatures greeted me on arrival. It was a rather surreal experience. The town itself fell almost silent after 7pm.

Undergoing surgery
AS I walked into reception of the Alfredson Tendon Clinic, signed jerseys of Zlatan Ibrahimovic and Carlos Puyol took centre stage as he had operated on them as well as a host of different sporting stars. One regret I had was not bringing a Claremorris GAA jersey with me to display proudly on the wall at reception!!
The operations lasted for 90 minutes each and were three days apart. Being fully conscious for them was strange as he would talk about what he was doing, step-by-step, while I looked at the screen. After each operation, we had a meeting the next day to discuss the results.  It showed up massive partial ruptures in both knees, particularly the right. ‘A combination of genetic make-up and sport were the contributing factors to these injuries’ he concluded.
Overall, he was happy with how they went but warned that due to the complex nature of the injuries it would take a lot of time, and reiterated the need to be patient with it. The chance of playing football again was not the main goal for him, it was about being able to do daily activities that most people take for granted ‘pain free’.
I made two further visits to Dr Alfredson in London 10 weeks and six months post-op. In between, I continued my rehab work diligently. Some parts of the rehab were tedious and mentally it was really challenging.
Both follow-up meetings were very positive, particularly the last one as he said returning to sport was now a real possibility. I had responded very well to the rehab up until that point. This was a big boost. I had been working hard and now it seemed it was paying dividends.
Nearly 18 months post-surgery, and countless physio sessions with Tommy Brennan of Pain and Performance Clinic in Dublin, and I am definitely in a much better place.
Last week I played my first full game in over two years with our Junior team against Charlestown. I was delighted to get through it, albeit I was a bit stiff for a few days after, but that was to be expected I guess! A hamstring strain and a fractured finger have hindered my progress since I returned this year, but thankfully no knee-related injuries which is a good sign.
I decided to write this because I know a lot of people are dealing with long-term injuries and some feel stuck in a rut. I read Philly McMahon’s book over Christmas where he talks about the frustration and how lonely a process rehab can be. Even though you’re still amongst the squad it’s not the same.
When this happens, it’s human nature to feel sorry for yourself and ask questions like, ‘Why me?’ in your head. In essence, this is counterproductive and benefits no one. The mind is a strange thing.
I’m 27, but if I could give people advice it would be to ‘listen to your own body’. You only realise when you get older that playing through injury when younger will come back to haunt you in the long run. Sport plays a major role in my life and it’s a huge void when you can’t train with your friends and team-mates and help them on the pitch.
Throughout the past year, I’d be lying if I said I didn’t feel like packing in the rehab. In many instances it was a case of one step forward, two steps back. Mentally it’s very difficult when you are following all the professional advice and you feel like you’re making little or no progress.
Then other days you might be able to leg press an extra 10kg pain free or go further down in a squat with zero pain, it’s those small things that have kept me going.
I don’t know what 2019 has in store for me on the football field, but I can rest in the knowledge that I did everything that was asked of me throughout the rehabilitation process.

Ger Commins plays football with Claremorris GAA club.

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