FMPA Conference & Networking Event 2024

We are delighted that England Men’s U21 Physiotherapist, Dave Galley will be heading up #fmpa2024 educational content.

As many of you will remember this is a fantastic venue which has hosted all but one of the FMPA Conferences over the last 10 years.

The FMPA Conference is THE medicine and performance event in the professional football calendar, combining excellence in educational content and superb networking opportunities for members and business partners alike.

The Conference this year is aimed at a wide variety of subjects to give practitioners an idea of the medical and performance aspects of our game. We will be looking at the high end performance strategies, through to how managerial changes affect us all on the Medicine and Performance side. We aim to encompass the world of the Men’s and Women’s game, Academies and also how external practitioners are currently working alongside medical departments to better serve our players. We will also cover how the world of nutrition works and how this has changed dramatically over the last few years.

We are lucky to have so many highly qualified, experienced and knowledgeable speakers and they will all come together at the end of the day as a round table to answer any of your questions

We are looking forward to, what we are sure, will be an excellent event. Join us!

THE SPEAKERS

CONFERENCE LEADS

DAVE GALLEY

England Mens U21s Physiotherapist & FMPA Conference Co-ordinator

Dave is a highly Skilled Physiotherapist with a wealth of knowledge and experience gained from working with a range of worldclass footballers and teams including a number of Premiership teams, The England National Squad and a range of International football clubs.

KEVIN PAXTON

High Performance Manager

Kevin has worked in professional sports for nearly 25 years and is a BASES High Performance Sport Accredited Practitioner, Supervisor and Reviewer with chartered scientist status and UKSCA Accredited Strength & Conditioning Coach.

Chair, Medical Advisory Group, Lord’s Ground

Simon Shepard has worked at Lord’s cricket ground for the past 30 years, firstly as a physiotherapist, then head of player health, wellbeing and sports science, before overseeing organisation development and culture.

Alongside this work he has used data (heart rate variability) to unlock a greater understanding of the way individuals are dealing with the demands of daily life.

More recently, he has turned his attention to the brain; and he has started to look at how data can lead practitioners to glean a better understanding in the event of a concussion. This has also lead to some frank personal reflection, and a commitment to what can be done to help players not just get better but return to the performance levels required for success.

Senior Physiotherapist, Women’s Super League

Ally is a senior physiotherapist currently working within the Women’s Super League. She has over 7 years experience working across men’s and women’s professional football. Her special interests are optimising female health for performance. She is currently an expert panel member with UEFA writing a consensus piece on menstrual cycle tracking in female footballers.

SIMON SHEPARD

ALLY BARLOW

CALLUM WALSH

Elite Performance Management Specialist

With over 15 years of experience in elite performance management, I have worked in several leagues and competitions across different cultures and continents, including the Premier League, Euro 2016 Championship, Championship, League 2, Turkish Super Lig, and Brazilian Serie A. I have collaborated with various coaches and stakeholders at multiple levels, from international senior and junior teams to world-leading performance institutes such as EXOS and Aspire Academy. My mission is to apply my scientific knowledge, practical skills, and cultural awareness to help athletes and teams of staff achieve their full potential.

PHIL HAYWARD

Head of High Performance, Wolverhampton Wanderers FC

Phil has vast experience as a leader in elite sport having spent 19 years in football, tennis and rugby. He started his career at Bradford Bulls before transitioning into football, initially at Bolton Wanderers before moving to Wolverhampton Wanderers in 2008. Phil progressed from Head of Academy Medical to become Head of Medical Services in 2012.

After 8 years as Head of Medical Services, Phil made the switch to the USA and Major League Soccer, becoming Director of High Performance at the most successful club in US soccer history, LA Galaxy. During this time he oversaw dramatic change across the performance and medical areas and sat on the MLS working group as the league became the first in professional sport to return to competition during the Covid pandemic, helping develop protocols for the MLS Is Back ‘bubble’ – a 6 week long residential tournament held in Orlando, FL.

After 2 years stateside, Phil returned to the UK and took up a role on the ATP Tour as performance physio for Sir Andy Murray, the greatest British tennis player of all time.

In January 2023, Phil returned to Wolves as Head of High Performance where he currently oversees all aspects of performance across Men’s, Women’s and Academy programmes.

MATT KONOPINSKI

Director of Physiotherapy & Performance

Matt has extensive experience at the highest level of Mens’ Professional Football. Previous roles include Head of Physiotherapy at Liverpool, Rangers and Barnsley FC and Mens’ Team Physiotherapist at the FA. Specialising in lower limb rehabilitation Matt is passionate about human movement and it’s impact on injury and performance. His vision is to create an optimal team culture at R4P for staff and clients alike.

Sponsored by

THE SPEAKERS

PROFESSOR DON MACLAREN

Emeritus Professor of Sports Nutrition, Liverpool John Moores University

Don is an emeritus Professor of Sports Nutrition at Liverpool John Moores University (the first professor of sports nutrition in the UK), which is a testimony to his many publications on the subject in journals and books as well as his presentations at scientific and coaching conferences. He has been research active since 1980 in the fields of carbohydrate and fat metabolism, nutritional ergogenic aids, and applied aspects of sports nutrition. A consequence of the work undertaken has resulted in two prestigious fellowships being awarded i.e. FBASES and FECSS. Don has been responsible for the development of the NutritionX range of sports nutrition products. Although retired from full time duties at LJMU in 2010, Don has kept his links by lecturing to final year students and on the MSc programmes as well as helping with research ideas and projects.

JOHN LUCAS

Head of Physical Performance, Preston North End FC

John Lucas joined Preston North End in May 2022 as Head of Physical Performance.. John has previously worked at Bury FC and Plymouth Argyle enjoying promotion with both clubs. Early in his career, John spent time at Rochdale and Salford City. He also has a background of lecturing at the University of Bolton, and he has also worked with the Rugby Football Union.

DI RYDING

Former Head of Foundation and Youth Development, Manchester United FC

Diane Ryding joins us following 18 years at Manchester United FC where she was Head Physio for the Foundation and Youth Development phases.

She also worked within the NHS for 10 years specialising in Musculoskeletal physiotherapy at the Royal Bolton Hospital and is therefore experienced in managing both adult and paediatric musculoskeletal conditions.

23 RD MAY

Sponsored by

FMPA CONFERENCE PROGRAMME 2024

8.30 – 10.00 REGISTRATION OPEN

9.00 MEET & GREET BREAKFAST

Network with colleagues and exhibitors. Tea/Coffee & breakfast served.

10.15 Concussion: The Role of Rehabilitation and The Importance of Responsibility

The role of rehabilitation in the management of concussion is gathering pace. No longer simply a matter of counting to ‘x’ many days and adding in some exercise, this session will look at how multimodal assessment, clinical reasoning and a targeted approach to rehabilitation may be key for both the short term and longterm health of a player and their performance. It will be frank and challenge people to consider how proactive they are in dealing with the condition.

10:50 Lessons learned from The ATP Tour

Lessons learned from the ATP Tour: A talk providing insight into life as a physio on the ATP tour with some detailed reflections and learnings from my time working with Andy Murray. How my 16 years of previous work in football helped me give a different perspective to Andy and how now, on returning to football, my work and approach has evolved as a result of experiences at the cutting edge of elite Tennis.

11.35 The applied recovery day

• The demands of a championship season

• Periodising the weekly schedule

• Incorporating recovery into what we do and how we do it.

• Are recovery protocols transferable across different clubs

• Lessons learned over a period of time and what are the key fundamentals

12.00 Why Gender Matters - Disparity Between ACL Injuries in Males and Females

Are ACL injuries an epidemic in the women’s game or are we just taking note of them now. Professionalisation and media attention surrounding women’s football is rapidly growing. The burden of injury is more important than ever to clubs and national teams. This talk will discuss the sex and gender differences between males and females particularly relating to injury and ACL injury. Specific focus will be given to the menstrual cycle and its impact on female footballers performance

12.35 LUNCH BREAK / EXHIBITOR DEMOS

Simon Shepard Chair, Medical Advisory Group, Lord’s Ground Session sponsored by:

Phil Hayward Head of High Performance

Wolverhampton Wanderers

Session sponsored by:

John Lucas Head of Physical Performance

Preston North End FC

Session sponsored by:

Ally Barlow

Women’s Team Physiotherapist

Chelsea FC

Session sponsored by:

• Ballistic Quasi

Figure 1.3 Quasi Isometrics

• Ballistic Quasi

THURSDAY 23 RD MAY

RADISSON BLU HOTEL

DERBY DE74 2TZ

Sponsored by

13.45

These contractions are undertaken for approximately 1 -2 seconds, voluntary isometric contraction repetitions (Figure 1.4). It macroscopic level where contractions (Griffiths 1991; Ballistic Quasi isometric

FMPA CONFERENCE PROGRAMME 2024

Tackling Academy Physiotherapy

We all know the old adage that ‘children are not mini adults’, but what does this really mean to the medical and performance team working with the youth academy player? Practical aspects of growth and maturation will be discussed along with a child-centred approach and paediatric pathology. We will consider how we optimise Academy physiotherapy over and above the standard rehab pathway, considering how we create ownership and engagement in our youth athletes. Finally, we will discuss how we can also develop our Academy therapy staff as well as our players.

These contractions are undertaken where maximal 1-2 seconds, the contraction released to approximately (0.5 secs), this process is then repeated for isometric contractions exist at all, as at macroscopic 28% in “isometric muscle contractions (Griffiths This HRIG Ballistic Quasi isometric function

Di Ryding

Former Head Foundation & Youth Development Physiotherapist

Manchester United FC Session sponsored by:

14.40

Impacts of managerial change on performance support staff

– The New Manager Cycle (NMC)

– The Managers Position

– Our Position – Impact of External and Internal threat on High Performance.

– How do training and game models impact support staff and their service provision and requirements?

– Do injuries follow managers?

– How can we learn from I’m a Celebrity Get Me Out of Here?

– Why would a manager trust you

– Strategies around increasing trust and supporting transition day to day.

1.4

14.55

15.25 My Guy

There is a changing landscape in professional football. Players are seeking external service providers on a more regular basis. What are the challenges for club Medical and Performance staff? How can these be overcome? This presentation will discuss and contrast perspectives of ‘in-house’ staff versus ‘externals’. Case examples will be used to outline processes utilised at R4P to address the challenges for club staff.

16.00 Football and Nutrition: reflections on 25 years working with professional clubs

The last 25 years or so have seen some significant changes in the professional football scene within the UK.Mirroring some of these changes has been the revolution in nutrition advice to football players based on developing science. This presentation explores the adaptations that have taken place in the role of the nutrition advisor (not least the relationships between nutrition and the managerial, fitness and medical staff), significant enhancements in the so-called canteen facilities and meals presented to players, as well as the explosion of sports nutrition companies and supplements available. Some key aspects of the developing science related to football performance and recovery is also examined.

16.35 CHALLENGE THE PANEL!

All the speakers will come together to discuss points raised during the day.

17:00 CLOSING ADDRESS

Thank you to all our trade exhibitors and sponsors.

How does these fundamentals

Matt Konopinski Director of physiotherapy & Performance, Rehab 4 Performance

Dr Mc Intyre has studied This testing position is biased hamstrings (76-81%) when selected isometric body hamstring activity is similar

Professor Don Maclaren

Professor of Sports Nutrition

Liverpool John Moores University

Session sponsored by:

All Speakers

Eamonn Salmon CEO, FMPA

Callum Walsh Elite Performance Management Specialist Session sponsored by:

Figure

Ballistic Quasi Isometrics

BREAKING BOUNDARIES IN TRAINING: OBJECTIVE MUSCLE FATIGUE MEASUREMENT FOR ATHLETE

ADVERTORIAL / MYOCENE

All physical activities lead to more or less fatigue depending on the intensity of the physical effort and its duration. This fatigue reduces the subject’s physical performance, especially when the degree of fatigue is important. Since physical fatigue is secondary to muscular exertion, it is generally called muscle fatigue.This muscle fatigue can be reflected in a decrease in physical performance. Any reduction in maximal muscle force or power output due to exercise is defined as fatigue. In research, measurement of the maximal force of a muscle is used to investigate the physiology of muscle fatigue, what leads to define muscle fatigue as a loss of maximal force generating capacity (1-2)

Central and peripheral fatigue

Physiologists describe nowadays two main kinds of fatigue (Figure 1): the central (or nervous) fatigue and the peripheral (or muscle fibre) fatigue.

The central fatigue is a diminution in the nerve impulses firing on motor-units, leading to the recruitment of less motor-units and/or at a lower frequency and consequently less muscle force generation (3)

The peripheral fatigue is a diminution of force of the muscle fibres in response to nerve impulses i.e., for a same nervous system impulses firing, the muscle produces less force output. The peripheral fatigue has two components: a short-lasting component and a long-lasting component. Short lasting fatigue is related to metabolic factors and is thus named as well metabolic fatigue. The metabolic changes during muscle exertion are

indeed important: depletion of adenosine triphosphate, phosphocreatine, or glucose/ glycogen and accumulation of metabolic products in the fibres cytoplasm can affect the function of the contractile elements.

Long-lasting fatigue

To understand the long-lasting peripheral muscle fatigue, we need to consider the force-frequency relationship, that is, the force generated by a muscle in terms of the frequency of nerve impulses. The muscle force-frequency relationship draws a sigmoid curve. At very low frequency (roughly less than 10 impulses per second) the strength developed by a muscle does not increase.

Then, at low frequency (above 10 Hz) there is a tetanus and the strength rises sharply with the frequency to reach its maximum force and a fused tetanus at high frequency (roughly above 80 Hz).

The long-lasting fatigue affects the muscle force-frequency relationship (Figure 2). The sigmoid curve moves to the right and the slope at the low frequency (roughly between 10 and 50 Hz) is significantly less sharp while at high frequencies (above 80 Hz) the force is just a little affected (4)

Therefore, the long-lasting fatigue is markedly measurable at low frequency and less at high frequency firing of nerve impulses. This is the reason why long-lasting fatigue is as well called “low frequency fatigue”.

The origin of the long-lasting fatigue or low frequency fatigue has been investigated in details. It is now well established that it is due to a reduction of Ca2+ ions released by the reticulum sarcoplasmic (RS). When an action potential is transmitted from motoneuron to muscle fibres, it propagates along the fibres membrane and the t-tubule, inducing the release from the RS of Ca2+ ions that trigger the actine-myosin cross-bridges mechanical response. As the amount of Ca2+ released from the SR into the cytosol decreases, this attenuates the binding of Ca2+ to troponin C. Fewer cross-bridges are formed between actin and myosin and consequently less force is produced by the contraction (5-6). As a matter of fact, the long-lasting fatigue is of primary importance for sport exercises.

Figure 1: The different types of muscle fatigue

Figure 2: The long-lasting fatigue is more pronounced at low frequency that at high frequency

Firstly, because it lasts for several hours or days after the muscle exertion. But as well because it moves the steep part of the force-frequency curve to the right causing a significant reduction in the force of contraction and needing the central nervous system to compensate partly by increasing the firing frequency of the motoneurons. Therefore, it is a fundamental parameter closely linked to sports performance and it needs to be precisely monitored.

Monitoring of muscle fatigue in athletes

Up until this point, conditioning teams have had to assess the internal load, i.e. how the athlete body reacts physiologically to the workload of competitions and trainings, either based on subjective perception of fatigue expressed by the athlete on an analog scale, or based on performance tests which depend on the commitment and voluntary movements of the athlete.

On the other hand, wearable technologies like GPS in collective sport or power meters in cycling allow to accurately measure the external load, i.e. the amount of work performed, which can be evaluated with the total distance run, number of meters at max speed, number of accelerations and decelerations of the player during the game or the watts developed by the cyclist. However, Strength and Conditioning coaches miss objective data to monitor the internal load.

On-field measurement of long-lasting fatigue

The Myocene has been developed and designed to be an on-field device to objectively measure the long-lasting fatigue of the quadriceps. The device combines a neurostimulator that allows to produce perfectly quantified muscle contractions on the quads of both legs of the athlete and a sensor specifically developed to register very accurately the force variations of the quadriceps in response to these contractions. The fatigue index is then calculated by a specific algorithm using the forces values recorded by the sensor. The Myocene device has been scientifically validated by renowned universities to confirm reproducibility, repeatability and sensitivity of the measurement, as well as correlation

medicine & performance football

CASE STUDY: MATCHDAY + 1 RECOVERY ASSESSMENT

Post-game fatigue measurement to individually adapt the recovery period and related recovery modalities allows to ensure full recovery before resuming the training. This image shows matchday + 1 fatigue index values (right leg in orange and left leg in blue). For the first two matches, the player fully recovered. After the third match, the fatigue index is decreased: the player did not fully recover from the game. The recovery modalities were enhanced and the player did not train on the pitch with the team on that day.

with traditional laboratory techniques used to evaluate the muscle fatigue (7)

The game changer aspect of Myocene is the objectivity of the measurements it creates. The portability of the technology and how quickly data is generated are great assets for performance team. It is a unique technology which allows to realistically check and monitor muscle fatigue without having to use physical movement of the athlete.

The fatigue index is instantly available, allowing the performance team to see the true individual picture of how that athlete is recovering from muscle fatigue. In football for instance, by comparing the fatigue index taken in a post training or game condition to a rest condition index, the fatigue can be quantified and monitored till the player has fully recovered. In congested period for instance, several consecutive decreased fatigue indexes are a sign of an accumulated fatigue and incomplete recovery, which can lead to overtraining syndrome and increased risk of injuries.

In conclusion, the Myocene is a portable datagenerating device which allows conditioning coaches to be able to very quickly assess the muscle readiness. This unique technology removes the subjective perception or voluntary action element of the measurement of the internal load.

With manageable test times and instant access to performance data, coaches can make quick decisions based on accurate and objective data to reduce muscle fatigue as a factor in future games and trainings.

References

1. Merton, P.A. (1954) Voluntary strength and fatigue, J. Physiol. Lond., 123: 553–564.

2. Ciba Foundation symposium 82, Human muscle fatigue: physiological mechanisms, Pitman Medical Ltd 1981 ISBN 0 272-79618-2

3. WNLöscher,AGCresswell,AThorstensson(1996) Central fatigue during a long-lasting submaximal contraction of the triceps surae. Exp Brain Res(1996) Mar;108(2):305-14

4. S A Binder-Macleod, L R McDermond (1992) Changes in the force-frequency relationship of the human quadriceps femoris muscle following electrically and voluntarily induced fatigue. Phys Ther 1992 Feb;72(2):95-104.

5. Simeon P Cairns, Luke A G Inman, Caroline P MacManus (2017) Central activation, metabolites, and calcium handling during fatigue with repeated maximal isometric contractions in human muscle. Eur J Appl Physiol 2017 Aug;117(8):1557-1571.

6. ChristopherA.Hill,MartinW.Thompson,PatriciaA. Ruell, Jeanette M. Thom, Michael J. White (2001) Sarcoplasmic reticulum function and muscle contractile character following fatiguing exercise in humans. Journal of Physiol (2001), 531.3, pp.871–878

7. Ridard J, Rozand V, Millet GY and Lapole T (2022), On-field low- frequency fatigue measurement after repeated drop jumps. Front. Physiol. 13:1039616. doi: 10.3389/fphys.2022.1039616