Nathan Carloss Interview

Former Head Physio, Queensland Reds, Nathan Carloss reflects on some topical issues.

Nathan CarlossNathan Carloss is a physiotherapist from Brisbane with nearly 10 years of clinical experience in elite Australian sport. Many years were spent as Head of Physiotherapy at two AFL clubs (Gold Coast Suns FC and Brisbane Lions FC) and more recently the Queensland Reds Rugby Club. Nathan also performed the role of medical coordinator for the Super 15 Rugby competition, and provided services at an international level for the Australian Wallabies team. During this extensive career operating within elite teams, Nathan has gained advanced experience in soft tissue management, rehabilitation and load monitoring. Such techniques have led to Nathan being an industry leader in sports rehabilitation, evidenced through his high profile career and industry reputation.

How has the response been to the Reds’ losses over the past couple of months?

Obviously in the current environment they are finding it pretty difficult and challenging. Sport, and in particular Rugby, evolves very quickly. Year on year you have to develop and change how you play to keep up with new trends, and there are no warning signs as to what is the next way to play to help you win the games.

The Reds had great success in 2011, and with the quality of people they have there at the moment, I have no doubt that very soon they will turn it around and get back to the top of Australian Rugby.

Elite sport is ‘bloody’ hard. People can sit there and point the finger and say look at these guys. Elite sport is really tough. These guys absolutely smash themselves; they bust themselves; they get injured and they try to get back as quickly as possible onto the field. It really takes a fair bit of mental strength and fortitude to be able to do that. These guys train very hard and get injured almost as a result, because that’s what happens when you have big South African’s or New Zealander’s running at you. They can’t drop the ball as soon as they get injured, because if they don’t try to get back as soon as possible someone potentially can take their spot and they are left in the wilderness.
There are a lot of aspects behind the scenes too. The Reds are really progressive in developing the game. They do lots of appearances and promotions. They get around to the schools, see the kids and the clubs, etc. They want to communicate to the younger generation that there is a pathway there for them. They want to encourage them to keep playing and developing the game from grass roots.

What would you say has been the Red’s player’s biggest injury problem?

Big joint stuff is massive. Shoulders and knees. If you start hurting your joints too many times, you start getting arthritic change in your joint and then that will start shortening the life of your career.

Every time you get significant injury to a joint you significantly increase the chance of getting arthritis by 80%. This is where rehab is crucial.

Where do you draw a line of when someone is 80 – 90% fit to play?

It comes down to Doc/phsyio. There is no hard or fast number for return to play for any injury. For example, with someone returning to play with hamstring injury there is no ‘gold standard’ that you can get through literature or a test that will give you an answer whether to play or not. Isokinetic testing helps in measuring the capacity of the muscles. You can’t put someone who is harbouring too much injury out on the field. If you put someone 80% fit out there, they’ll get found out. They’ll perform poorly and other teams will steamroll through that position. There is lots of pressure. Being at least 90% fit won’t always see someone fulfil their role for the team. In particular, AFL stats show that if you get two injuries to two different players in the one team you have 60 to 80 % chance of losing the match regardless of opposition.

Is there much physical and/or physiological difference between the different codes?

Within the last two years, AFL body shapes have changed. They have lost more of their body bulk and look more like middle distance runners. This is due to the demands of the game. They are running harder and faster than they were 10 years ago.

For Rugby, you need to be big and powerful now, particularly with the way the game is played in the Northern Hemisphere. With the Rugby World Cup happening later this year, they want big guys who are powerful.

What does your role involve with the players?

To provide medical services for the team. That means, most of the time. Even when they are not at training they could hurt themselves at home. You need to be able to manage that, communicate that back to the coach. We have had situations where players have hurt themselves just digging a hole at home, have had a back spasm and haven’t been able to play. Essentially you are on call 24/7. When touring with them you are pretty much working in-house. Touring is different; you travel with the team, and you really do get plugged into the fabric of the playing group and their lives. You treat them; you pick them up when they get injured; and you support them, physically and emotionally. You do get the injury stuff but you are also there to help them perform the best they can. You have a role and responsibility to take leadership.

Why did you choose a career in sports medicine?

I have always loved sport. I’m a sporting type of tragic I suppose. I played sport very early on and liked the idea of helping people and their performance. Physio was the logical course for that. That’s why I gravitated towards sport. It’s hard to get into that arena. Everyone wants to do it. In Australia you are most limited as there are not many professional sporting teams here. In America and UK there is a lot more opportunity to get exposure to sports.

There was an article in the Australian Financial Review recently about MAMILs, Middle-Aged Men In Lycra. Cycling has become a pretty big sport for people of all ages. What type of injuries do you see the most from cyclists?

MAMILs is the new in vogue thing for the corporate world. Triathlons are still popular but more road cycling. Another thing that is popular is Tough Mudder. People like pushing themselves. People get excited and get really stuck into it.
To play a season of Rugby, you have got to do a Pre-season. Essentially to play Rugby we do three to four months of training to get ready to play. So if you want to do road riding and ride 500 km per week, you need to condition your body to get ready for that. This will minimize injury risk.

That’s what sport has taught me, how to prepare your body physically for the stresses you are going to place on it. If you don’t give it the appropriate time to do a pre-season you will get injured and it will be frustrating.

If you want to do a marathon and do it well, it’s almost a two-year lead in time. Maybe you could do it in a year, but any shorter time, you’d break down. People don’t like hearing that. You can cheat it and get injured or do the appropriate build up and give yourself a chance to do it healthily. It’s important to reduce the risk of overuse injuries and soft tissue injuries by preparing yourself well.

Have you done much with Altitude Training?

We have done heaps of Altitude Training. You have to do it a lot to get any type of physiological benefits. It’s going by that old adage, ‘Live high, train low’. You would be more effective putting an altitude tent over your bed eight hours per day and getting longer exposure to altitude, rather than just putting a mask on for half an hour four to five days per week. Elite sportspeople do it four to five days per week. Some AFL clubs have Altitude Lounges where the players would hang out.

What is your perception about Drugs in sport?

The representation of Drugs in sport is the same that it is in society. If anything, Rugby seems to have come out in the media as the cleaner code. To be a professional sportsperson, you need to be driven and determined and that can sometimes work against you in a drug setting, as what comes with determination can sometimes be addictive personalities. If anything, recreational use is worse with players as when they get their time off they want to relax. There are more stringent controls around performance enhancing drugs. That’s a bit of a minefield, that one. Put it this way, Australian sport plays by the rules a lot harder than the other countries, particularly South Africa. Generally, Australia follows the rules pretty well.

Outside the world of drugs, when we travelled to South Africa, we had a team that got filmed while they were training and when they went to run their plays in the main game, they knew everything that we were going to do. You could tell they had learnt all our back and frontline moves. When you would do a Captain’s run the day before the game, they would turn the sprinklers on just as the players were about to run out, so the field was soaking wet. Other countries make it very hard, but here in Australia they seem to do it fittingly. That’s why it’s hard for teams to win in South Africa as they make it so difficult. We once trained on a field of broken glass everywhere in Bloemfontain. We couldn’t do any contact, tackling or anything. They film all your sessions and just make it difficult.

What are some of the funniest comments you get from players across the codes?

You become like ‘hairdresser’ to the players essentially. They confide in you with pretty much everything. If you ask me some of the funny comments I’ve heard, most are unrepeatable. I’ve heard anything and everything. LOL crazy stuff. Some of the stories that come out of people’s mouths about what happens when they’re having a bit of fun, I could write a book. The book of my memoirs would be a very interesting read, that’s all I can say.

Education of sports players?

Educating the players is a challenge in sport – across all sports really. It is widely known that NFL players are broke within two years of finishing their career. In basketball 60% are broke within 10 years of finishing playing. These guys are talented and good at a skill. They play, they develop and train but they just don’t have the life skills. It’s hard to get exposure when they are in that environment as they just get everything done for them and they know no other way. Sport can be a bubble. They get plucked out of a normal world at 18 and put in an environment where they are very heavily supported. They don’t get exposed to life skills. Some of them can’t even pay their own bills or even read their gym programs.

What is the culture like in these sporting clubs where you have worked?

That’s a good question. I’d say the culture is very different with teams within the different codes. I’d say the Reds have a really united culture. They are quite respectful and appreciative of what you do for them. Just recently when I left, the players said some nice words and really made me feel good. Culture is a funny one, because there is a lot in it. Culture is the glue that can hold a team together or split it a part. Some teams get it right and some teams are still finding it.

In AFL, if you look at teams that have sustained success, you would say that they are doing some really good things in those areas. They gel the group together and that drives them forward. Culture can’t be told by a staff member to the players. It needs to get driven within the group. A specific example. I spoke to a former All Black. He was telling me that everything is driven by the senior players and you know pretty much straight away how to perform if you are an All Black. That can only come from the senior players and not from the staff. If you do something outside what they would perceive to be good behaviours, a senior player will step in subtly and respectfully. This in turns fosters the right behaviours.

What are you trying to accomplish with your new venture?

I had a long-term desire to start my own business. It gives you more flexibility, where I can still consult to teams and bits and pieces in sport. It’s an arduous job when doing sports physio. It’s tough. 24/7, travelling with the team all the time, now that I have a young family.
I really want to provide my clients all the services that you would give to elite athletes.

Integrated Physio Centre provides physiotherapy and has a gym attached for general and surgical rehabilitation. An end to end facility like we are returning you to sport.

Working in sport has given me great experiences in the realm of what it takes to get elite athletes to perform at the best level with the lowest risk of injury.

I think I can offer a point of difference. Not a lot of Physios have that knowledge. You don’t get taught it. I know I learnt it through sport. Ultimately I want to try and have a one stop shop: dietetics, nutrition science, strength and conditioning, psychology motivation and podiatry.

Who do you think will win the Super 12 Rugby this year?

Gosh, who’s on the top of ladder at the moment? LOL I think the Hurricanes as they can be very damaging with
a lot of their attacking options.

Finally, who do you think will win the Rugby World Cup this year?

I’d say, it’s in England, it would be hard to go past the home team. But then again you have the All Blacks. Actually, I’m going to go with an ageing All Blacks to finish the dynasty of Richie McCaw and to send off Ritchie McCaw for being such a champion of the game.

If you would like to have a consultation or a general chat with Nathan, he can be contacted at:

Integrated Physio Centre, Ground floor, 12 Prospect Street
Fortitude Valley 4006
Mobile: 0413 565 679

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