Justin is an APA titled sports & exercise physiotherapist. He has worked in the A-league as a physiotherapist for over 10 years and is passionate about all things in sports medicine and high performance.
Highlights of the episode:
- Advice to physios in making the most of their mentors and resources
- Difference between rehab role and clinic role that physios may be surprised about
- His philosophy in communicating with athletes in rehab
- How to boost confidence of players post rehab
- Robert Dingle
- Craig Purdum
- Jill Cook
- Damian Raper
- Rob Inness
- Shane Lehane
- John Longmire
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Jack: Welcome back to the ‘Prepare Like A Pro’ live chat show. My name is Jack McLean. I’m your host. And tonight my guest is Justin Dougherty. He’s the rehabilitation physiotherapist at the Sydney Swans football club. He’s a titled sports and exercise physiotherapist. Lifelong student, he has a passion for all things, sports medicine, and high performance.
Before we start tonight’s episode, our mission here at ‘Prepare Like A Pro’ is to empower aspiring athletes and staff with practical knowledge from some of the industry’s most inspiring individuals and to strengthen the AFL community. If you liked the show, please show support by finding us on Instagram and subscribing to the podcast. We are on iTunes, Spotify and YouTube.
Welcome, Justin. Thanks for jumping on, mate.
Justin: No worries. Good to be here.
Jack: Let’s dive in the beginning of your career. What age did you discover you had a passion for physiotherapy and working in sports?
Justin: I think, like most sports physios, I grew up being an active kid, playing a lot of sport myself. And I think it was, I was at year 10, actually, when I had my work experience. I wasn’t sure what I wanted to do. I knew that I loved sport and actually spent my youth going down to the local physio clinic. And I guess that was my first introduction to physio. And it sort of kicks out from there and putting the two interests together. And so, I’ve always made it my goal to pursue the sporting side of the physio in my career.
Jack: And were there any challenges early on, in terms of, like you mentioned, getting experience and almost opening up doors while you were doing your degree?
Justin: Yeah. I’d have to say that I’ve been very fortunate. I sort of sought out the sports physio pathway straight off graduation. I sought out the local physio clinic in Newcastle, where I was studying and graduated from, that had the connection with the Newcastle Jets. I had a contract with youth team at the time. So, my thinking was to partner with that clinic and start my career there. With the hopes of one day working my way into that.
And, as I said, I was really lucky. I spent a couple of years doing some work in the MTL-level as the physio and an opening came up with the Newcastle Jets youth team. And that sort of really kick-started my sports physio career.
Jack: Fantastic, mate. That’s great to get that experience. Was that something, when you started working in the field, that you realized that this is definitely something that you’re passionate in, and at that point did you have a particular sport that you were wanting to work in, now that you’re working in AFL? Was that always sort of the focus or are you taking one job at a time, one experience at a time, so to speak?
Justin: Yeah, I played soccer growing up, so that was probably my interest. And I think it’s funny. It’s supposed to be that you always have this dream, and my was to work in professional sport, in soccer. That’s sort of where I wanted to go, given that was my background and that’s what I played.
And, as I said, I was lucky enough to sort of work my way into that and working in A-League quite early on in my career. And I think spending a few years working in A-League, it opened my eyes a little bit to the challenges, I guess, of working in some special codes in Australia. The A-League is relatively under-resourced league compared to, say, AFL, and it obviously comes with the challenges as well.
So, to answer your question, definitely soccer was my initial thinking. And, it being the world game, made me thinking, maybe overseas opportunities can open up there. But, having landed where I am now, I really love where I am and then the structure AFL has played in sports medicine and high-performance department. So, I’m really happy where I am and it’s definitely something that I always wanted to get to.
Jack: And then, early on, who were some strong influences on your career as you were forging your way during studying, but also working at Newcastle?
Justin: So, as I said, I was lucky in that. I think I was out of uni for a couple of years when I first started working for the Newcastle Jets. And the person who gave me the opportunity, his name was Robert Dingwall, who was the head physio at the time, and he was someone who really did influence me in a big way early on. I would say, he gave me an opportunity, but also sort of mentored me through those first couple of years. It’s sink or swim mentality. But he really sort of nurtured me through those early years and taught me a lot.
Going forward, I think, through my post-grad studies I’ve been fortunate to come across a lot of great people and met a lot of people that were working in the professional sporting world. Influences have been made. I think people like Craig Purdam and Jill Cook, two of the Australian sports medicine royalty, definitely had a big impact on, especially now my rehab philosophies and how we go about managing injuries from soft tissue and attendant perspective.
And even now, I work in a great department at the Swans, and there’s a lot of people from a lot of different backgrounds, and we challenge each other every day. And over the last two years at the Swans, they really had a big influence on me.
Jack: You mentioned, in the A-League, it’s relative compared to the AFL, it’s not as resourced. Do you think early on, for the physios listening, it’s good to be in those environments where you may not have as much support as some of the other codes, so you do have to maybe go out of your area and assist potentially coach in a drill or an S&C in the gym and get experiences outside of your lane, so to speak, early on to develop understanding in different areas?
Justin: Yeah. I think the practices I had there, like, it’s the best thing I did in that I was always sort of forced to upskill. If I was just in a solid role where I was just a physio doing something in a really highly resourced team, it would’ve been really difficult for me now.
Back in the early days of the A-League, you’d be sort of upskilling in sports science, strength & conditioning, as you said, the football coaching side of things. You’re taking rehab drills and sessions, and you’ve really got to expand your knowledge more broadly, so to speak.
And as I said, I wouldn’t do it any other way. It was a challenge, but it’s really what laid the foundation for me to learn and develop my techniques and also allowed me to realize what I liked doing the most and what my strengths were, which, I would say, is the rehab-side of things, which is where I ended up now.
So yes, I’m resourced now and my advice to those listening, who are starting out their careers, is to get your hands dirty early on. Get out and volunteer or go down to your local footy club and try to get your hands dirty, because yes, it will be difficult and the money might not be there, but it’s really where you’re going to learn the majority of the craft, which can set you up for your career.
Jack: And then with Robin Dingo, like that sort of relationship of him being in the senior team, you working with the youth team, was there a lot of overlap or did you have to sort of call him and contact him outside of hours for him to act like a bit of a soundboard and for you to ask questions? How was that set up? Was it a formal sort of mentorship or was it more something that grew as you guys worked together?
Justin: Rob got a lot of his time for me. As you said, after our phone calls, standing board, whenever I needed him, he was always there. But the other thing was that he offered me the first-time training quite a bit just to observe and to help him out.
So, that’s sort of where I really learned. I just got to operate with him and see how he liked to do things and learn from him that way. As I said, that was invaluable to me at the time. I really didn’t know what I was doing as a young physio and to have someone like that who was willing to give me the time and who’d really cared to develop me. As I said, it really did set me up and it’s something that I’m very grateful for.
Jack: And for those listening, I can imagine starting at that level would be quite daunting, obviously, habits, massive for rewards as well, like a steep learning curve and the best way to learn, like you said, it’s getting experienced early in your career. But there would’ve been some challenging moments where you’re looking after athletes in rehab or you’re diagnosing an injury. There’s pressure in elite sport, of course. So, how would you recommend for developing physios working in that environment to make the most of mentors, like Rob in your instance? How did you make the most of those resources?
Justin: Best advice I can probably give you, is just to know your limitations. I definitely didn’t know everything and I knew that, and I was willing to admit that from an early age. You know that old saying: who know everything to go out of the door? And for me it was more like, if I didn’t know the answer, I wasn’t afraid to call someone and be like, ‘Hey, look, I’ve just seen this injury, not quite sure what’s going on. Do you mind having a second opinion for me?’ And I still do that to this day.
I think that, as a physio, you shouldn’t be ashamed to be asking for help. As I said, I’m still doing that to this day. They were experts like Craig Purdum and Jill Cook for tricky cases. And you can surround yourself with a good network of people that are willing to give you the time. They sort of have been there and have done it and sort of got the answers themselves and experience that’s really, really valuable. And I don’t think that you have to do all on your own. There’s always somebody who can help you.
Jack: That’s great advice, mate. Thanks for sharing. And in terms of building your network base, you mentioned Jill Сook and Craig Purdam. How did you go about developing those relationships as your career progressed?
Justin: I think early on everyone knows who they are just through their status, the sportsmen. And the research that I published was first introduced to both of them through a master’s program. That’s sort of when I first met them and knew who they where. And it’s actually not really until I started at the Swans. You know Damian Raper, the head physio there? Damian came from the IRS himself and had a good working relationship with both Jill and Craig. And I think that’s where the relationship strengthened, we were not afraid to give them a call and ask for advice on some things and as I said, that’s probably where that relationship blossomed, for a want of a better word.
Jack: And in terms of going from a code that you were familiar with, that you played yourself, to a different code in footy. You played football growing up or soccer you played, but did you play Australian rules football or was that a sport that you had to learn on the job?
Justin: Born and bred in New South Wales. So, AFL or footy isn’t on the list, no sports. So, that was a challenge for sure. And it’s probably something that I thought was going to be a limiting factor in me working in the code, having not played it and didn’t have a great grasp of the game myself.
I think I approached it from different aspect in that the body is the body, injuries are injuries and there’s a lot of similarities there. And I sort of brought my experiences with keeping groin and hamstring injuries from soccer backgrounds to the AFL code. And the first thing I did when I was lucky enough to get there, I always upskilled myself in the game, speaking to coaches, speaking to players, really diving into the game myself.
What are the physical demands of the game? What are the different positions? What do they have to do? For my role in the rehab space, that’s really important to know, what the player does and what they need to do and what you need to get them back to. So, I leant on the coaches and the players and stuff around that had that experience in AFL, to bridge that gap.
Jack: That’s an interesting point. It’s something that I’ve noticed in all football codes or team-based athletes, or maybe even practitioners that have come from track and field and different areas. Some people would have that same sort of belief, that I know I would have as well, if I was going for a sport that I didn’t play, ‘Geez, how am I going to go about applying my craft to that area?’ But you broke that down nicely. An injury is an injury, the body is the human body. So, the physiology doesn’t change. You just gotta learn the sport. And coaches sometimes can find that quite refreshing and same with athletes, that you work with practitioners that have got different backgrounds.
So, it almost can be a strength in some sense when you’re actually in the environment, because you’ve got some different things that you can add and contribute to the environment. If you found that like with having a soccer background, maybe it might be connecting with a coach who is interested in soccer, for example, when you get that connection, or a player that also has a passion or feels that they learn a little bit from soccer and apply that to their football.
Justin: Yeah, exactly. In physio department we’ve got, the four of us, we’ve got Lany Enslie, who’ve come from an apple background, myself come from soccer background, Justin Merlino – track and field, and then obviously Damian, who’s had the experiences of medicine and working in AFL. So, you know, that was a deliberate strategy for Damie to sort of get people with different backgrounds, different experiences that can bring a different perspective to things. It’s always good to have that in a team.
And there’s obviously quite a few of the boys who follow the English Premier League and the A-League as well. And so, being able to discuss that with them and give them a bit of an insight on the differences between the two sports. I remember speaking to one of the players once about knives and chimneys, how they can play and what that entails, having a career on a Saturday, playing on Tuesday, flying back, playing on the Estrada in Melbourne, three-day turnaround and all this sort of thing.
Yeah, it’s just really interesting just to see the differences in the athletes and what they’re capable of doing. So, yeah, I’d say it’s definitely been helpful coming from that background, for sure.
Jack: And on that note, soccer is known for quick turnarounds and AFL had to experience that with COVID for the last couple of years.
So, leaning on that experience and knowing what athletes can handle, obviously, they are different sports from a contact point of view, but the demand on the legs and the main physical stressor, you could say, in terms of speed and acceleration change direction, those sorts of loads from groins and hammy point of view. Do you feel like you could lean on that a little bit and have a bit of a better understanding of what’s been going on with the calendar year the last couple of years?
Justin: Yeah, definitely. I think the biggest thing that I realized through soccer, you realize what the boys are capable of doing. As I said, the A-League squads aren’t big, you’ve probably got 15 to 16 high-quality players who play every week or could play every week. And so, often it’s the same players playing back-to-back. And, as I said, here in Champions, they are playing mid-week and weekend for a six to eight week period.
And it’s the same players playing all the time. And so, you’ve got these 34-, 35-year-old players, that are just backing out every three days, running 12, 13 K. And the long haul slots from Asia back to Australia and they manage and they get through. And so, I think that’s something that may be a model to what’s capable and bring that to the AFL. As I said, obviously the big difference is the contact piece. In AFL it really does take the body longer to recover from, but it also does make you… And the COVID period, the changes in schedule just show that you can do it, and if you have to do it, the body will find a way to do it.
I think it’s just probably comes back to what you’re used to doing and how you train. And if you’re used to training three days a week for 10 years, then you enter the week and that’s what you’re going to be comfortable doing and trying a full pitch session in that might be difficult. But if you build it up slowly and expose the players to a little bit more training load, that ultimately might be a protective thing.
And that’s probably something that I could, again, lean on from my experiences in soccer, is that just because you’ve got not the right joints or something like that, it doesn’t mean you can’t train. That’s probably something that we are quite big on at the Swans is what can you do and not what can’t you do.
Jack: Yeah. A hundred percent. And what about from an application point of view and being a successful candidate. So, you’ve got that with the Newcastle gig and then Sydney Swans. For physiotherapists that are going out there and wanting to put their best foot forward, how do you prepare yourself for either an interview or maybe the first call with someone who you’re applying to, whether it be the head physio or a coach that you’re speaking to? What are some of your ways that you try and work on your philosophy and going with to clear your mind?
Justin: I think the first time that happened for me, the Newcastle job was a little bit organic. I went from the youth team into the first team after Rob left. And so that was a bit of a smooth transition, but when the Melbourne victory position became available and I was contacted about that, it was obviously nerve-wracking to start with.
But I think the first thing you can do is get your philosophy in place and get your ideas together. You want to go there and present something to them and sort of show them: this is how I operate, and this is what I can bring to the table or the department. You’re not selling yourself, but you’re just showing: this is what I believe in, this is how I can help and how I can fit in.
And I think the other big thing is showing that you want to be part of a team, you want to work with people. That’s another really big thing. You’re working with other people, you want to be able to lean on them and engage with them, rather than just, as I said, do things on your own and have a bit of a solid view on things. So, these are probably the two main things, I’d say, are important if you try going for an interview.
And then the first thing is just understanding what role you’re applying for. Just as an example, like for me applying for a rehab physio role. I wasn’t really going to go into the interview and talk about my experiences so much as the head physio and push that bond so much, because I’m applying for the role because rehab is something I’m interested in. So, that’s something that I pushed. And I leant on my experiences in the rehab space at my previous jobs, rather than just, ‘I’ve been the head physio here for this amount of years. And I’ve seen this and this.’ It was more in terms of: these are the tricky injuries I’ve had and this is how I managed them and these are my strengths and limitations from a rehab sense. So, that’s another thing. Just understanding the job you’re applying for and tailoring your responses to that.
Jack: I love that, mate. That’s great advice for anyone applying as a strength & conditioning coach or physio. Showcasing how you’re a team player and you can work in environment, like you said, fit into the environment. And understanding the role. I think we can all get caught up in all the experiences that you may have done before that point, but if it doesn’t apply to what they are looking for, like you said, you’ve got to contribute to the club. That’s ultimately what they’re looking for, the best candidate to help through the club and be able to serve the athletes. Focus your energy on that. Then you’re almost helping them make the decision.
Justin: Yeah, exactly. One of the things I’ve learned in Swans over the years I’ve been there, it’s play your role. And I think that’s something that is vitally important in all performance and sports medicine, that A – we know our role, and B – play that role. It doesn’t mean that we can’t work with the S&Cs and maybe give them a bit of feedback or advice in the program, but it’s just knowing what your role is and what you’re going to bring to the team. And, as I said, playing that role.
Jack: And what about self-development? What are some of your favorite ways to sharpen your craft as a practitioner?
Justin: I think for me the first thing was study. As I said, your undergraduate degree only gets you so far. So, the first thing I wanted to do as early as I could was get a load of experience and as much experience as I could fresh out of uni, but also I was pretty keen to get into the master’s program. So, I did Sports Physio Master’s through La Trobe University. And that’s something that progressed me clinically, but the main way I develop my skills is just purely through communicating with other people that are working in the field.
As I said, I’m not afraid to reach out to other people and ask them for advice, ask them how they do things. I’m learning every day from the people I’m working around. I’ve got Jody, who’s Health Performance major and Jody’s background’s at Richmond. And I constantly ask him, ‘How you do things at Richmond? And how would you approach this?’ He’s been in the rehab role as well. Shaun Maynor, a strength coach with background in rugby union. Again, just asking him, ‘When you were in rugby union, how did you approach this?’
So, that’s probably where I actually pick up the most, it’s purely through conversations and discussing things with our network. I think a lot of people find that there’s a lot of people out there that are willing to help and offer advice. So, that’s definitely something that I’d say is the main way I sharpen my focus or develop my skills.
Jack: What about from a highlights point of view, mate? Like over your career to this point, what do you look back most fondly?
Justin: I think a couple stand out. The 2018 early season for me was a highlight. I was in Newcastle Jets at the time and we’d been through a bit of a rough patch. We’ve been through two owners and a handful of coaches. And we’d gone from being sort of a wooden spoon ended up at the bottom of the table to then Ernie Merrick came in and really turned the club around.
And we sort of went on this runway. We were winning more often, we ended up sitting at the table and made it all the way to the Grand Final. It’s still something that I look back on as one of the best years of my career. Not just because of the success that we had. But because of the way the success was manufactured, I guess. It wasn’t through luck, it was through design. He really brought this philosophy to the club. That was new and it really changed the way that we did things.
I think the other ones that stand out are the Championship campaign when I was with no victory. It’s that experience when you are playing games in front of sold-out stadiums in Guangzhou, in China, and in Korea, in Seul. And as I said, visiting these places and being fortunate enough to work over there is something that I’ll never forget.
I think that in more recent years in AFL there is probably one that really stands out to me. And that was last year, I remember in the Hub we had the game against GWS. And it was about half an hour before kickoff, and we had four players rolled out through being close contacts, especially halfway through the warmup. And yeah, just that whole chaos was something that I’ll never forget.
And just the way that John Lowman and the coaching staff just turned it into a positive straightaway and said, ‘Heck with this, we’ve got four other players who can come in and do the job.’ And we ended up going on after sliced up and we went on to win the game. And it’s something that still it’s probably the highlight of the whole season for me. It’s just this game that will probably never happen again, the circumstances and how everybody reacted to that adversity and sort of shrugged it off and took it as a positive and got the results.
Jack: That’s awesome. Testament to good leadership there. And culture for those players stepping up.
You mentioned the turnover of owners at Newcastle at the time and instability of staff, including coaches. For those that haven’t worked in A-League, how does it work? You hear stories of English Premier League, where a new manager means new staff. Are you contracted to the club or are you contracted to the coach? Did you have insecurities during those phases of your job security or, if you were doing a good job, that was taken care of, so to speak?
Justin: No, you definitely don’t feel safe. I think, soccer or football is a lot more cutthroat than AFL or Rugby League and clubs are obviously a little bit quicker to pull the trigger on firing a manager, if they are not getting the success they want.
As medical staff we are a little bit more independent of the coach and we do work for the club, so we have contract to the club. But in saying that, I have seen it happen before where new coach comes in and just brings his own staff in, and there’s nothing you can do about it, whether you’re doing a good job or not.
So, I think for me they were very challenging times where you’re not quite sure if you’re going to have a job and for how long. And you do second guess yourself a little bit, but also start having backups in place just in case that tap on the shoulder does come.
It’s not something that’s fun. It’s not something that I hope many people need to go through. But at least that means that again, I think it highlights, if you are doing a good job and you’re giving your best, then you would hope that in more circumstances than not that you will keep your job and the club sort of can see the value you add and the benefit you can bring.
Jack: On that it’s a good segue for challenges made in you career so far. What are some major challenges that you’ve faced and what have you learned from it? If any?
Justin: I guess it started from that. From the changes of coaches and sitting there, not knowing if you’ve got a job or not. That’s probably one big challenge.
But I think the other thing for me was when I moved from Newcastle down to Melbourne with my partner and then wife at that time to basically take up a job with Melbourne Victory. And so, for me, I was comfortable in Newcastle. I was settled, loved where I lived, family just up the road. And we decided to pack up and move down to Melbourne, which was a bit of a step that I’d always wanted to take, it’s something that always challenges you.
Going to a new city where we didn’t really know anyone was difficult and moving to a club of the status of Melbourne Victory with the success they’ve had at that time had its own pressures and expectations. But I guess, the learnings from that was just to embrace it. How lucky I am to do what I do and be able to do that, to pack up and move and experience a new city through my job. So, that was a great experience. And we were really glad that we did that.
Other challenges that I’ve faced along the way, there’s always a tricky injury that you run into. And, as I said, early on in my career I was always thinking I’d rather find a solution, rather than dwell on the problem. Just try and find the solution. And you might have a tricky injury or you have a recurrent injury, and for that 24-hour period it’s the worst experience of your life, doom and gloom.
But I very quickly shifted my focus towards finding a solution and reaching out to other people who may have seen it before, or, again, ask for advice. I think that’s something that I can’t really emphasize that enough, and I’ve mentioned it a few times, but just don’t be afraid to reach out to other people and ask for help. You’re gonna be held in a high regard for doing that rather than not and continually making the same mistakes.
So, they’re probably the challanges I’ve faced and the learnings from them.
Jack: Thanks for sharing. And on the different roles that you’ve had from physiotherapist in the youth academies, from head physio Mevitrio Karen Rehab Physio. So, you’ve experienced many different roles that a physiotherapist can do in elite sport. From the rehab point of view, where you’re sort of bridging that gap between acute management all the way to taking them back to return to performance, what are some areas that you feel physiotherapists may be surprised about, when you’re taking on a rehab role compared to being a physiotherapist in a clinic?
Justin: I’d say the first thing is just the amount of strength & conditioning and sports science knowledge that you need to have, or that helps you in those roles. As I said, I think in a clinic, you may get caught in this manual therapy model mindset. Whereas in the rehab space, that’s still a big tool to use, but it’s very much exercise therapy and exercise progression.
So, I guess, expanding your knowledge in that, was something that I had to do from the start. You really have to upskill your prescription and fine-tune your rehab philosophies and focuses. Probably the biggest difference between a rehab role and your non-default clinical role.
Jack: And what are some of the best ways to do that? If let’s say someone has gone from working in the clinic for a number of years and they’re really sound physio-therapist and then working for themselves and running their own practice, client base, and then working in a team and you are involved in, like you mentioned, sports science, so analyzing GPS, maybe working out the worst case scenario, knowing their average game output, but also being able to take them through the gym progressions. And then also, like you mentioned, it’s still treating and so you are across everything. And then in some circumstances involving the coaches as well. So, what are some of your favorite ways to try and develop those areas that you may not get experience in the clinic?
Justin: Again, I think, there’s obviously the academic group. You can do things like actual accreditation or keep going and do a post-graduate in strength & conditioning course, if that’s the way you want it to go.
I didn’t do that, I actually learnt on the job, so to speak. So, for me, it was more about, as I said, making a network of people in those areas and leaning on experts in those fields. Following them on Twitter, reading their research and staying up to date with literature. That’s definitely something that I did a lot of early on. I read a lot, upskilled. There’re plenty of textbooks out there that you can look for. And that will give you some pointers in that direction as well.
But for me, from strength & conditioning side of things, I’ve been really lucky to work with a number of great S&C coaches, and it’s just asking them questions and picking up things as you go. In my Master’s course, obviously we got quite a bit of that as well, which helped with that skill set. But from S&C side again, it’s just literature. There’s plenty of literature out there on AFL and Mesh domain and the worst case scenarios, and sprint volumes and all that sort of stuff.
But even speaking to a sports scientist and saying, ‘Hey, look, this isn’t my area of expertise, but can you help me understand what these metrics mean?’ Or ‘What does high speed running mean for this person?’ And ‘What’s an accel, what’s a decel, change direction?’ All those sort of metrics that you’re looking at throughout the rehab process.
So, as I said, it’s either an academic way or upskilling and reading or just reaching out to people that are working in those fields and asking them for their opinion or their help on it.
Jack: You mentioned earlier, the challenges that the athlete goes through when they’ve had an injury and particularly those first 24 hours. What’s part of your philosophy in terms of communicating with an athlete once they’re injured and you’re looking after them, so they’re in the rehab group? What do you find are some successful ways to support that athlete, but also maybe respect their space? Take us through the art of the coaching side of things.
Justin: Everyone goes through a grieving process and the severity of the injury might determine how long those processes are. I’ve seen athletes that might have a season-long injury and you always need to let them go through that anger phase and denial and all those phases that they’re going to go through, it’s normal. And you almost just have to be there and support them through that.
And then when the time is right, it’s trying to redirect their focus towards the rehab and saying, ‘Hey, look, this is great opportunity for you to work on things you weren’t good at before.’ I always say to the athletes that rehab’s an opportunity to develop. Maybe they might’ve had a leg injury and they’re going to be off for a little bit. But you can work on upper body strengths, if that’s something that the coaches want to work on with them, or if that’s something they want to develop. So again, just sort of redirecting their focus a little bit towards things that they can do and what they are capable of doing.
And probably in case of longer-term injury, this is also just making sure that they do have something else to focus on. A lot of younger players especially, their life is almost defined by their sport. And so, when that’s taken away from them, they really struggle. So, we’re really lucky in the AFL, where there’s a great support network around the player in that sort of wellbeing and wellness space.
But maybe you can say, ‘Have you thought about taking up some study?’ Or someone might be already studying and you can say, ‘This is a great opportunity for you to focus on that.’ So, it helps them get away from their life being defined by the injury and by not playing their sport, and get out of their head a little bit and focus on things that they can do and redirecting their focus, as I said.
Jack: And what about recurrence and a situation where it might not be a significant setback, but it hasn’t been linear, which is, I imagine, quite common in rehabilitation? How do you go about supporting that athlete and knowing that they’re still on the same timeline, or maybe only set back by a week, reassuring them and, like you mentioned, that refocus? Is that showing some video or is it a reporting? What are some ways that you can get an athlete back on track and give them that positive mindset?
Justin: I guess it depends on the context around that. But if they’re coming back from a hammy strain and they do have a recurrence in rehab early on, when they are getting back into training, I guess the one thing that the athlete wants to know is why. And I think the earlier you can answer that question for them, the better it’s gonna be. One thing that you always want to make sure is that you keep that trust with the athlete and they trust what you’re doing.
And, as I said, it might be just ‘Look, we’ve done everything by the book and we’ve followed what evidence says is the best way to rehabilitate this injury. You’ve got back and, unfortunately, there’s been a recurrence. So, we’re going to wait and look at alternative ways. We’re going to, as I said, reach out to these experts in these fields and try and see if there’s another way we can approach it.’ Sometimes just that is enough to help them mentally get through it. Knowing that you are doing everything for them. And you’re giving them every chance they had at getting better.
And I think the other piece on it is just, if you set expectations early that rehab isn’t linear, because I haven’t seen many rehabs where it’s a smooth, gradual progression and everything goes the way you want it to. There’s always going to be up days, down days, small setbacks and also some winds on the way where things are moving quicker. And if we set that expectation from the start and communicate that to the player that that’s probably what the process is gonna look like, that can definitely help them.
And then the third thing I was gonna say, sometimes it’s just a conversation with a fellow athlete, who’s been through it. Knowing that you’re still going to get there, things are going to be okay and you’re going to get through this. And sometimes it’s just reaching out to a fellow teammate, who’s been through that same experience and had a recurrent hamstring or had a second ACL injury or something like that, and got back successfully. And even that is enough to get them to refocus.
Jack: That’s amazing advice, mate. And what about, from the rehab practitioners point of view, how do you go about managing that pressure and that stress of it might be a recurrence or something hasn’t quite gone to plan and and you’re reviewing things and naturally there’s going to be just stresses within that? How do you go about managing those stress levels?
Justin: Do you mean with the athlete or with the staff?
Jack: With yourself and then, I guess, within your own team as well, high-performance medical team?
Justin: So again, for me, if something like that did happen, the first thing I’d do is reflect. You can pick up the rehab and go through it with a fine tooth comb and think: have we done everything correctly, have we followed our philosophies and have we stuck to the structure that we have in place? And then, as I said, if the answer to that question is no, we didn’t follow our philosophy, then there’s the first problem. If the answer is yes, we did follow our philosophy, then, as I said, that’s where we need to be thinking a bit more laterally and thinking outside the box.
When you’re working in a department, it’s always important to involve the high performance team, doctors, physios, transitioning sport scientists, dietetics, psychologist, just everyone around them needs to be involved in the rehab process. And what we would do is, if there was something that didn’t go the way I wanted it to, or there was a setback, we would sit down with the team and discuss it and go ‘Well, what’s happened here?’
And again, sometimes for me to actually sit back and get external feedback on ‘Have you thought of doing this?’, or ‘Maybe you should look at this?’, or ‘That can actually be really helpful as well.’ Because sometimes when you’re in a rehab for a period of time, you can get a little bit narrow focus, for want of a better word. And sometimes when someone with the fresh set of eyes is running their eye over the program, they begin to say things that you probably haven’t picked up in the first place, or again, they’re gonna be looking at you a bit more laterally anyway. So, that’s something that I find really helpful.
Jack: Yeah, that makes a lot of sense, mate. And it’s good to get that, no matter what your role, I imagine, by leaning on others and team members that might have a different perspective and different experiences to shed light on an area. So, thanks for sharing that.
And then what about getting the information from the athlete? Let’s say they’ve either just got injured for the first time and, like you mentioned, you want to know the why, the athlete’s gonna want to know the why. So, you’ve got your detective hat on. What are some of the key questions from the athlete’s perspective, knowing what state they were going into from a mental point of view or what’s going on with their life or sleep and these other contributing factors to breakdown? What are some key questions, do you think, are important for physios to ask?
Justin: We’re a little bit lucky in that we collect the data, so we can look at it that way. Your wellness values, your sleep, your stress, your muscle soreness and all that. That’s definitely something that you look at.
You can communicate with the player. It is important to know what else might’ve been happening in their lives. Say, through a recurring hamstring and then after the fact they tell you ‘Oh, yeah, I moved weights for those.’ But that might be something that comes into it. It might be someone who their wife has just given birth and their sleep patterns are all over the place. So, I think it is really important to have that conversation with the athlete about ‘Is there anything else going on that side of here that may be contributing to that?’
Again, you’ve got to be a little bit careful, when you ask that question. You’ve obviously got to have a good relationship with the player, and not do it from an interrogation perspective. But throughout that process of rehab you’re spending a lot of time with the player. I would hope that I’d know all that stuff just through general chit-chat and conversation about what’s going on in their life. And you hope that just through general discussions that they’re gonna open up about those sorts of things and you can be aware of it.
But if not, then, as I said, it might be asking somebody else who’s close to them. ‘Hey, how has so-and-so been at home?’ You know, they might live together. ‘How are they at home? Do they seem themselves?’ Speaking to other people that are around them a lot can also give you a bit of insight as to how they’re actually doing.
Again, I mentioned the stress and then the mental and psychological state that players might be in. And you might not see that. And as I said, it might be just speaking to their housemates, speaking to their partner. ‘Is there anything else going on? How are they doing at home? Are they struggling?’ You might have a player who says everything’s fun and rays, when they see you, but behind the scene, they’re really struggling with it all. And you might need to take that into consideration in terms of referring on, speaking to the doctors and team around them. And sort of helping them holistically.
Jack: With that, like you mentioned, you spend a lot of time with them and you’re picking up a lot of information from the athlete. Plus, you’ve got the objective-subjective data to lean on as well. When you’re going about your weekly planning, and let’s say there’s a little bit of pressure with bringing that athlete back, maybe it’s September, from the coaches to bring them back earlier, than what you would like. Maybe they want a full week and it needs to be a three week.
What would you be most concerned about, things like lifestyle stress or clinical assessment, maybe strengthened numbers in the gym? What would be some big markers that you’d feel if they’re not hitting, it’s going to be pretty hard to convince the coach they’re going to be ready to be able to play a full game in three weeks?
Justin: First and foremost, that’d probably be clinical markers. So, I’ll be thinking of things like strengths, lengths, triangular motion. That’d probably be the first things I’ll hang my hat on. If someone’s only got 50% strength on their hamstring after the injury and they’re expected to play in a week, chances are that’s going to be unlikely. That’s probably the first thing I’d go through is to see, clinically what do they look like? How are they progressing?
If all of the clinical tests are okay, I’d probably then start leaning on the loading data a little bit, and I’d be speaking about GPS. And if you don’t have access to GPS, it’s just probably having an understanding of how fast do they run? How often have they run fast? We’ve talked about a hamstring as an example. What distances have they hit? How many times do they keep their footy? How that looks at speed? All those sorts of things that you take into consideration that might limit your decision as to whether or not they should or shouldn’t play.
And then, if all of that looks good, then you start thinking about ‘Is there any other reason why this person shouldn’t play?’ If their loading data sets up and they train fully, and the clinical markers look good, you might then look at the wellness data and start saying, ‘Well, is there any trend here? Is stress through the roof? Are they really sleeping poorly? Or are they starting to develop an illness? Is there some other reason as to why they might come unstuck if they do return to play?’
So, I’d probably say clinical markers first, loading data is obviously important. And then probably the wellness data comes after that.
Jack: Awesome. Thanks for sharing that. And then on the flip side, and the last one before we go into the larger part of the podcast, the get-to-know-you section.
If you’ve got an athlete that is hitting all your markers and all your clinical assessments, and they’re going really well from a physical point of view, however, they’re not confident within themselves, what are some methods that you’ve leant on in those circumstances to try and boost confidence and boost their self-esteem to return to play?
Justin: That’s a really important point. And just sort of reflecting on the question you asked earlier, one thing I didn’t say is that athlete’s readiness is a huge indicator of readiness to return. And there’s obviously quite a bit of literature around that coming out now.
So, I would actually say that even if you have ticked all your boxes, and the athlete’s saying, ‘I don’t quite feel ready’, that is something that probably would ring alarm bells. And it would just make you think why. Knowing athlete would help. If they are an athlete who is typically an overreporter and an anxious person generally, and maybe they’ve got a bit of performance anxiety, and that may be the reason they don’t want to go back to play, then that’s something that you might target and tell them, ‘You look really good at the moment.’ Get the coaches involved. ‘You’re looking great. I’m really happy with how you’re playing and training.’
That’s probably one angle I’d go at. Get coaches involved and then get them to help build confidence. It’s all good for your physio or an S&C to say, ‘Mate, you look great,’ but to hear it from the head coach or line coach, that support goes a long way.
The other thing is, again, just asking why they don’t feel like they’re ready. And that might help you as well. They might say, ‘Look, I know that I’m strong, but I’ve still got some symptoms when I do exercises.’ And that might perk up your ears a little bit to something that maybe you’ve missed through your clinical assessments or something that you might want to investigate a little bit further.
But if you’re pretty confident as a medical practitioner, that the injurie’s healed or it’s as healed as it’s going to be, then it’s all about relaying that confidence to the player and saying, ‘Hey, look, we’re really happy with it. You’ve done all the things.’ You might want to show them their GPS data. ‘Look, mate, you’ve sprinted, you had a hundred percent of the max velocity, you’ve changed direction maximally, you’ve done a match load in one-on-one skill sessions and controlled rehab. You’ve done three training sessions. You’re ready to go.’ So, giving them the data models to help them realize that they’re ready or at least boost their confidence a little bit.
But, as I said, it’s definitely something that I personally take into consideration quite a bit in that return to play discussion.
Jack: Thanks, mate. You can see how much is involved in your current role. And you mentioned how important it is to be a team player and be across all the different cohorts within the footy club. Not only for your sake, but also for the athlete’s sake. So you can lean on all those different roles in helping with return to performance. So, yes, dropping gems all the way through for physiotherapists listening in.
But looking back at your career now, going back to being a head physio, do you feel like the rehab role is a great development role for physiotherapists to then come into a leadership position? Because you’ve done the head physio role and then now you’re going to rehab, do you feel like it helps being in those sort of leadership positions, once you’ve been a rehab physiotherapist?
Justin: Yeah, definitely. I think, probably the more natural evolution would be going to, say, a rehab role and then into a head physio. For me it was more getting the exposure in a different sport and being able to focus on something that I really love and the rehab space was my reason for going into this role.
I think any experience, whether it’s as a massage therapist, volunteering with the first team, or being a sports science intern with the first team, it doesn’t really matter what you’re doing. If you’re in that environment or around it, you’re still going to learn, you’re still going to develop your skill set.
So, yeah, as I said, I think it matters what that pathway looks like, but getting any exposure to it definitely helps. If you’re going into rehab role first, the benefit of that is you can really just focus on rehab and start to fine tune your philosophies and intrinsic skill set with different injuries.
So, that’s something that can help you for then, if you do make that step up to be a head physio, that you already got that understanding, and you’ve had that experience of fine tuning the rehab space. And then the other side of it comes in, obviously, the diagnostics and the management side of things and communication with coaches and managing up, so to speak, that sort of comes into it.
As I said, any experience in a higher position is integral. And it doesn’t matter what it is. Like, as I said, we used to get physio students from the university of Newcastle to come in and help with a massage in the A-League. And even that was good experience for them, because then we ran PD research and sort of educate them a little bit on how we go about doing things. So, even though they are here to be a massage therapist and to help out there, they’re still gonna see how we operate on a day-to-day basis. So, yeah. Any experience is valuable.
Jack: All right. We’ll move into the get-to-know-you section now, mate. So, we can have a bit of fun with this. But which movie or TV series has impacted you the most and why? You can throw in books as well.
Justin: Difficult one to answer. I was thinking about it. More recently I watched the Michael Jordan documentary. ‘The Last Dance’ was a phenomenal docuseries. And just seeing the insight into an elite mentality of almost how neurotic someone of that level is, and how obsessed they are with sort of getting to the peak of their sport.
And I guess too much of that is actually the Rinaldo documentary. If anyone hasn’t seen that, again, it’s just sort of gives you a bit of an insight into his elite mentality and how he goes about being the best in his sport.
They are probably two that I can think of that really stand out to me and are influential just in the way that you see an insight into their daily operations, but just the mentality that these people at the top of their game have.
Jack: I didn’t even know there was a Rinaldo one. I’ll have to check that out.
Justin: On Netflix.
Jack: Your favorite inspirational quote or life motto?
Justin: I’m not really a quote guy, to be honest. I think life motto is probably ‘don’t take anything for granted’. I would say, I’m probably very lucky to be doing what I do. I love what I do, and I’m very lucky to work in sport every day and work with professional athletes.
And it’s not something that I do lightly. I’m really proud of what I do, but also very lucky to be doing what I do. And then I don’t take it for granted. I think that’s something that, whether it’s an athlete or a physio, or S&C, it doesn’t matter. I think it’s just never take anything for granted, because life is short and you never know what can happen.
Just don’t take anything for granted and make the most of it.
Jack: Well said, mate. And what about pet peeves in your work life? What makes you angry?
Justin: I’m going to say whinge. I probably saw it a little bit. I just said about not taking things for granted, and probably one of my biggest pet peeves is when I hear a professional athlete who gets to come in every day and kick a footy around whinge at what they have to do. ‘Oh no, I’ll go to bed around two o’clock today.’ And it’s like, ‘Mate, you don’t really realize how good you’ve got it and how many people would kill to have this position.’ So, probably my biggest pet peeve at work is just whinge and people that don’t appreciate what they’ve got.
Jack: And in COVID free world, which we’re pretty close to being in now, what’s your favorite way of spending your day off?
Justin: Other than catching up on work? It’s probably, I like to get out on a bike, get for a ride where I can. Also, just staying at home with my wife and family and just making the most of the time together. You know, working in sport days off are few and far between at times. So, it’s probably staying with your loved ones and family as much as you can, when you can.
Jack: And what about your favourite holiday destination?
Justin: Probably, that’s Italy. Only been there once. But I absolutely loved it. And the architecture, the food, everything about it I loved. And it’s probably first on my list to head back to when we’re able to.
Jack: Absolutely. It’s definitely on my list. I haven’t been there yet and I’ve heard it’s fantastic. So, I have to get there at some point.
Well, thank you so much for jumping on and sharing with us your experiences in elite sport and how you’ve got the opportunities that you’ve worked hard for. And also some things that have worked for you in your field and in the experiences that you’ve got and also some learnings as well.
So, no doubt for physios, S&Cs, anyone that wants to be in sport, it has been massively beneficial and I’ve learnt a lot from it, mate. So, thanks so much for jumping on. And, hopefully, some developing athletes as well will have a bit more awareness of when they next whinge, how good they’ve actually got it. Couldn’t agree with you more, mate. That’s definitely a pet peeve of mine.
But talk us through what are you excited about for 2022? What’s on the horizon for you?
Justin: I think, obviously, work-wise, it’s seeing just how far this young Bloods can go, seeing how far this team can take it this year. That’s something that I’m definitely excited about. And outside of that, it’s probably international travel again, which has just been off the radar for a while. So, looking forward to, hopefully, getting away.
Jack: And for those that want to reach out and maybe ask any questions or get in touch, what’s the best way to connect with you? Is it socials, email?
Justin: Shoot me a message on LinkedIn. It’s probably the easiest way to contact me. I check it semi-regularly. It goes without saying, but it might take me a couple of days to get back to you. Just given travel, et cetera. So, LinkedIn’s probably the easiest way, mate. But I can flick through my email after this and people are more than welcome to contact me via email as well.
Jack: Easy. I’ll add the LinkedIn in the show notes for anyone listening while driving.
Thanks again, mate, for jumping on. For those that are tuned into the live show later on the podcast, make sure to listen to the very start. You can watch this, it’s on our YouTube channel and then we’ll be releasing it on our podcast on Tuesday next week. So, stay tuned. We’ll release the podcast on Tuesday and you’ll have access to that and any of your favorite podcast directories.
But thanks again, Justin, for jumping on. Looking forward to seeing what the Bloods can do and, hopefully, have some success and Hayden can get involved with as well. Thank you so much for jumping on and looking forward to seeing what you can do for the rest of your career as well, mate. No doubt, it’s only the very beginning of a great career in elite sport.
Justin: Awesome, mate. Thanks for having me. And take care.
Jack: For those that want to watch our next live chat, we’re actually going to do a monthly collaborated event with AFL high performance managers next Friday. So, it will be the 29th of April. We’ll be at the same time, at 8:30 Australian Eastern Standard Time. So, we’ll post a link on our social. See you, guys, then.