The enormous impacts of COVID-19 on the country, the economy and the physiotherapy profession have been sudden, devastating and a game changer.

In many ways we are still in the epicenter of what is sure to be reflected in history as a catastrophic event that changed forever the way we function.

No doubt we will feel the reverberations of what has gone before, and what is happening now, as this coronavirus crisis continues to unfold throughout the remainder of 2020 and, perhaps, beyond that.

On the Thursday in March that the Melbourne Grand Prix was cancelled, I knew that this was going to be the start of a huge upheaval in sport, and in particular the Australian rugby union community of which I’m a part.

As the newly appointed head physio for the Melbourne Rebels rugby union team, myself and the team were packed and ready to embark on a two-week tour of South Africa and Argentina when our plans suddenly changed on the back of COVID-19 developments.

Having global sporting fixtures cancelled was the catalyst for the big changes we continue to navigate today.

We were into round eight of our international competition when all this happened.

Given the competition structure of 15 teams made up from Australia, New Zealand, South Africa, and a team each from Japan and Argentina, global travel was a hallmark of the demands of the Super Rugby concept. It required teams to be on the road in some form, for most of the season. This, however, all came to a grinding halt in March.

Like every other physio out there, the implementing of COVID-19 restrictions in Melbourne meant introducing new safety measures in the workplace such as social distancing, the use of personal protective equipment (PPE) and new levels of sanitisation of ourselves and our work space.

For the physiotherapy team I lead, this meant our usual practice was disrupted in many ways as we grappled with the practicalities around things like time limits on treating the athletes, only having only a certain number of people in a treating room at once, and the difficulties and delays in sourcing gym equipment as we were moved outside of our normal HQ, a shared facility at AAMI Park, Melbourne.

The initial restrictions were very challenging in our environment given that there were still athetles to service from an injury management point of view, be that either the acute or the long- term players.

With minimal staff being allowed into our HQ, seeing five players would end up requiring a five-hour window, whereas normally the job is pretty fast and furious. Everything took much longer and the delays affected everyone.

As the lockdown wore on, the decision was made that our competition needed to go on—this was welcomed by both the franchise and the supporters.

The tricky question, however, was that given we were an international competition, how best would this work?

The powers that be made the call to loop out of Melbourne prior to the harsher lockdown laws and just like that, we relocated to Canberra prior to round one of our newly established domestic-type competition, which would give us our focus across the next three months. Just how next season will operate will be decided at a later date.

Initially we were told that we would be relocating from Melbourne to Canberra for two weeks to undertake a required short tour so that the competiton could push ahead despite the harsher state lockdown laws in place in Victoria.

But during those two weeks away, Melbourne went into Stage 4 restrictions for another six weeks. Our short tour was to grow, and so we are here now, two months in.

I’m currently with the team in Terrigal on the central coast in New South Wales, and thoughts are, or there is an expectation of, being away from Melbourne for rest of the competiton.

Personally, this has now meant being away from my fiancé, Lisa— we had been planning to marry in November and have some of my relatives from the United Kingdom fly out for the wedding, but that has all changed.

When we initially went through the lockdown period, it was an interesting time for Lisa and myself because we ended up actually spending so much more time together. Usually our working hours never marry up; I’m always either away with the team, working late or the team’s playing across weekends.

During that first lockdown, Lisa and I were working from home, exercising together and we actually got to see lots of each other. While we may have our challenges being in this current situation, its great to be away in a team environment that is supportive of each other.

Many of us here are experiencing similar issues, something we are all aware of.

To drive comradery, there remains a lot of structure in our diary. Outside of training commitments, we maintain formal times to eat together and hold weekly quizzes and activities, which allow us to just chat and spend time. I think different characters in our group are dealing with the situation quite differently; you’ve got to adjust mentally, emotionally and physically.

Now, in our little bubble outside of Melbourne, there is no limitation on the amount of time we can spend working with the players. This is a huge advantage in the scope of team performance.

We’ve all had multiple coronavirus tests and we’re permitted to eat at the hotel we’re staying at and use the facilities there. We’ve got a bit more freedom of movement although we are having to be mindful of social distancing and the like.

I’m supported by a full-time doctor on tour—not many teams have that luxury. In terms of the practicalities around temperature checks and daily check-ins and wellness of the players, the doctor takes the lead and I play a supportive role.

One of the biggest challenges we face is that we don’t have an end date for when we can return home to Melbourne. The coaches and players have got rugby games to win, sure, but they’ve also got partners at home who are struggling alone with the kids so it does take a bit of an emotional toll.

For us, as a group, we’ve tried to remain very connected and not just let everyone do their own thing every single day, which can lead to feelings of isolation and frustration.

Another challenge has been maintaining the progress of the rehabilitation of injured players or those who have undergone surgery in this shifting landscape.

Many of our rehabilitation timeframes have blown out, particularly with those players with injuries from the previous season.

These players, as well as the ones with injuries from this season, still need to be serviced and we had limited access to gym equipment at times. That made it very difficult for those injured players to get up to speed with where they needed to be, particularly the acute players who are post-surgery.

Doing a consultation over Zoom with those players who were recovering at home has been quite challenging, at times frustrating, for both athlete and staff. The more exposure we have had to these challenges though has meant for a much smoother process now.

The lockdown period in Melbourne provided a chance to discuss these challenges with other professionals in differing sports, and I would like to think that from those conversations we have been able to translate better practice to our athletes as a result.

One of the most rewarding parts of our job is spending time with the players and having conversations on the physio table, as that is often a place they might offer an insight into their personal lives or whatever. It helps building that connection, you develop more rapport and that earns more respect day-to-day. 

Having been away and spending good, quality time with each athlete, I feel very prepared to say to the coach what the player can do tomorrow knowing that I’ve invested time in them and I understand where the player is at. If anything, this has been the huge bonus of being away on tour, rather than players leaving for home at the end of the day back in Melbourne.

I’m on a staff touring team of 10 that includes a rehabilitation physiotherapist so we can split the load, meaning we can each take some time away, otherwise you just grind yourself into a little bit of  a hole—and that’s not healthy long-term.

On tour, our staff have been keeping active, bonding through participating in exercise or fun activities such as surfing. We are playing weekly soccer, some are going for morning runs or have the ability to use the hotel gym together.

Maintaining a good mindset here has been fuelled by these activities, and I think just as we have bonded more with the athetles, staff have a better connection now also.

I believe there’s an opportunity to learn from everything presented to us, even in our darker moments or mistakes. It took me 10 years to learn that from a clinical point of view; however, I believe you have to make mistakes sometimes to get where you want to be.

If you review it, identify the gaps and then build on it, this is where you get clinical gains 10-fold.

I was fortunate enough to work my way through the ranks after volunteering with the Rebels when they were a new team.

I began with the academy and younger player groups to get my foot in the door after moving to Australia from Liverpool in the UK in 2010. That turned into a full-time role with the main team in 2016.

My advice to those looking to work on elite sporting teams or with elite athletes is this: start off as that volunteer physio and stick with it. Stick with it and find opportunities, because better chances end up being thrown your way. Hopefully that piece of advice will help start many young physios on their own journey.

>> APA Sports and Exercise Physiotherapist Liam Robinson is head physiotherapist at the Melbourne Rebels. Liam is currently completing his Master of Sports Medicine at the University of Melbourne.