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22/01/2016

The Chamber of Confession: Poland’s Physio Room

EHF EURO blogger Magda Pluszewska invites us behind the scenes with the Poland national team to explore the work of the home side's medical trio

Photo: Grzegorz Trzpil

They leave their hearts and gallons of sweat on the floor. They twist their joints, break bones, overload muscles and rupture ligaments. Handball players do not have an easy life, especially at major tournaments, when there is often only one day for regeneration between games.

How do they get back on their back on their feet in such extreme conditions?

Three people – one doctor and two physiotherapists – take on the challenge. Rafał Markowski, Krzysztof Rudomina and Jerzy Buczak carry out the secret recovery operations for the Polish national team in the physio room, otherwise known as the Chamber of Confession.

Dr Rafal Markowski agreed to open the door to the secret room and show us how it all works. Usually that nice gentleman works in five (!) hospitals scattered throughout Poland, as well as in the first league football club and the Polish Olympic Committee Medical Commission.

Markowski began working with the national team in 2012, and admits that this is a unique job.

"The boys are able to be a burden. They have their moods. We – the medical staff – of course, too," he laughs.

Markowski spends at least half a day in the physio room. He doesn’t go to bed before three o'clock, and must be back on his feet at eight. "But I like to sleep. Yesterday, when we needed to finish our breakfast before eleven, I went down at 10:45."

Working with the team Markowski comes across interesting medical cases, straight from the scripts of ‘House’.

"The strangest injury I had to deal with was the one of Krzysztof Lijewski in Qatar," he says. "He tore the adductor halicus of the big toe, a common site of bunions. The injury caused the toe to bend outward. All the doctors who later saw Lijek said that they never saw anything like this before."

Cold therapy

When the team is together they use about 50-80 kg of ice on a daily basis. A large part of that is for the use of the device Game Ready – a machine for cold treatment. The team has two such objects that constantly circulate around the players’ rooms.

The device compresses and transmits icy water through trousers worn by the players while reclined, cooling muscles at a temperature of 3 to 15 degrees. The boys choose a programme depending on their sensitivity.

The remainder of the ice is used at trainings and then in the evenings for drinks ;)

A private pool in the locker room

It is important to cool the tired muscles right after exertion, so, after the game. The Poles therefore installed a special pool, iCoolSport, in the locker room, which is able to fit in up to three players in a sitting position.

"It is not a mobile device like Game Ready, so we don’t carry it with us everywhere. We take it only when we install it somewhere for a long time,” explains Markowski.

A continuous circulation of cold water moves around the pool, with the pump drawing it on one side, cooling it and returning it to the pool on the other. Players have a bath in water with a temperature of 7 Celsius degrees for approximately three to five minutes. Brrr it’s cold!

Portable ultrasound

It looks like an ordinary, innocent case, but do not be fooled! This is a mobile ultrasound machine with internet access, which enables archiving of documentation. Thanks to this, Markowski can make an examination at any time of day or night without having to go to the hospital.

High-energy laser

"[It has] such high-energy that it sometimes starts a fire alarm in the hotel,” laughs Dr Markowski. "We had such a problem at a training camp in Chicago. The alarm went off, it thundered and all people were brought out of the hotel."

The laser is used only by physiotherapists. You need to know exactly how to do this, because the device can be dangerous. The head, which releases laser beams, keeps a constant distance from the skin of the player so that it does not burn.

Business tablet

Markowski and his colleagues from the clinic Rehasport in Poznan are the authors of a pioneering app for injury evidence called SIOMS, which is used by the Polish staff. Apart from the most ordinary characteristics of the player, such as height, weight, age, etc., you can find information about their injuries. For example, the place where the injury appeared, the mechanism (whether it happened in touch with a player or not), the type (whether it is an acute trauma or a chronic one).

"At every championship you have to report injuries, there are appropriate forms for this,” says Markowski.

“Our goal is to get away from paperwork. We want to have it all archived on tablets, so that this application is the official app of the championships. The idea is that doctors could benefit from the collected data in the future. At the moment we all report it and then it disappears somewhere.”

Boxes full of equipment

For each gathering of the team there must be a large supply of protective equipment. The Polish team have several chests full of it. One is even padlocked, because the boys tend to pilfer something from time to time.

What can we find in the boxes? Protectors for various parts of the body (you will see them, for example, on Kamil Syprzak), socks, stabilisers (some athletes, such as Krzysztof Lijewski, have used them almost from the beginning of their career), tape (professional, not the ones you can get on the internet) and a collection of other interesting inventions. My attention was particularly caught by boned underwear shorts, worn by the guys under regular sports shorts. In some places, they have a special sponge absorbing feature in anticipation of potential impact.

"Some boys do not like to play in them, but I recommend them to all. If the boys don’t put them on, they must be aware of the fact that after possible injury they will be recovering much longer," says Markowski.

Why? Because thanks to the shorts, a hit in the thigh is distributed through the sponge on a larger surface and potential hematoma is simply smaller.

The colours of the equipment are very important. Poland players use white or red equipment so that they become indistinguishable from the colours of their playing kits. Everything must be uniform in line with the playing regulations.

Supplements, medicines and ointments

There are also separate boxes with dietary supplements. Among them are energy drinks, amino acids, protein bars and vitamins. Each player gets three to five servings of different kinds daily. In the morning they all take amino acids, and in the evening magnesium.

Before the matches everyone takes something different. Some drink aspirin, others Red Kick, others Power Bomb (tiny vials of energy drink based on caffeine and guarana). Karol Bielecki takes only vitamin B12.

The doctor must also have a supply of medication for any occasion. Antibiotics, stronger painkillers, injections with hyaluronic acid – applied into the knee to protect the cartilage of players with worn joints, for example Sławomir Szmal or Adam Wiśniewski – as well as the usual ointments, antipyretic medicaments, bandages, cotton swabs and other basic equipment.

written by Magda Pluszewska