When England take to the field today against South Africa spare a thought for the team holding them together. From broken bones to battered bodies. The team behind the team.
You will find one member of that support team, kneeling on the touchline this afternoon. Eagle eyed, scanning, spotting, sprinting, shouting and supporting. This is a day in the life of England Rugby physio Lesley McBride.
Lesley’s association with England Rugby goes back over 15 years. As England line-up for the national anthem to belt out God Save the Queen, there will be no prouder person than McBride. After 163 renditions, England’s dedicated physio will sing just twice more before ‘hanging up her boots’.
“The anthems get me every time,” admits McBride.
“What a privilege to stand in front of these young men about to play for their country and sing the national anthem with them, it’s always a very moving and a proud moment.”
Pride will soon turn to professionalism though, once that whistle goes it’s not just the players that need to switch on.
The magic sponge
McBride’s day will start at 9am when it’s not just the players who need attention but coaches also – as former players many suffer with post-retirement injuries.
That will be followed by a breakfast meeting with the strength and conditioning team to ensure plans are in place for non-playing players and injured members of the squad who are not available for selection for the day’s match against Australia but will be available for the next one - the semi-final.
For the next three hours the medical room at England Rugby’s base in Georgia at the World Rugby U20 Championship is manic. Players in, players out. McBride and her colleagues will spend the time assessing, treating, massaging and preparing. Players stretching, rolling and flexing.
McBride has over 30 years of clinical experience and 18 years of lecturing experience, her journey started in 1986. Having qualified in physiotherapy from Nottingham University, her first job in rugby was with Barkers Butts. Andy Wood was captain and his son a certain Tom Wood had just been born.
“I was running on with a bucket and sponge. Rugby was amateur; it was the days of a magic sponge.”
That is just a small insight into how the industry she loves has changed so much.
World-class medical care
It’s 1pm back at England Rugby’s hotel and just over seven hours until kick off. The medical team are just about to undertake a very crucial part of their pre-match preparation - extrication practice.
Before every match they practice an extrication using the split scoop stretcher board and vacuum mattress. Communications officer Jamie Hopkins is the ‘pretend’ injured player and the team practice his removal from an awkward position so that if it happens on the pitch they are fully prepared.
McBride will undertake an advanced life support exam annually, the passing of which is a pre-requisite for working pitch side so that they can give world-class medical care to every injured player on the pitch.
While the players nap, McBride is still busy at work. She will spend the next hour typing up notes from the morning and discussing with the rest of the medical team (doctor, physio, masseur) anything of note from who they saw in the morning that needs to be considered. In a tournament where the team play five games in three weeks, no minute is wasted.
They also discuss the team for the afternoon – reminding themselves of who wears contact lenses and making sure they have spares and who in the squad is only 18 as they come under different rules for concussion management.
Tape, tape and more tape
McBride will then pack up her pitch-side equipment for the game. From a bucket and sponge in 1986 to a carry-on bag in 2017 that includes 10 varieties of tape and 17 other items - one of which is a closely-guarded secret. Surprise items include a mirror and jelly tots.
The next hour will then be spent planning recovery sessions for the following day. No minute is wasted.
“The profession has changed massively since 1986 through to 2017,” explains McBride. “Our scientific knowledge has changed, there was no real physiotherapy research in 1986. There is so much of it now of it now that we can use the evidence to implement current best practice which we trust”
Experience is key, McBride adds: “I know what works and what doesn’t.”
If you’re new into a rugby environment, several things will take you by surprise. One of them is tape. 10 different varieties and the players are covered in ‘strapping’.
Head, shoulders, knees and toes - almost every member of the team has something strapped. Some players have several parts with different types of tape on. It takes a full hour to strap up the squad.
The team will have a final squad meeting before a police escort to the ground. The bus is silent, everyone is focused.
Pride and emotion
After a pre-match warm-up and more strapping, it’s anthem time. Pride and emotion. The whistle goes, mind focused. Scanning and spotting.
“I’m quite nervous all the way through a match, because anything could happen at any moment right up until the final whistle,” explains McBride.
“What’s going through my mind during a game? Has everyone got up, is anybody injured, is anybody behaving differently? You’ve got to get to those injuries as quickly as you can.”
Time is crucial, every second counts.
“You have about 90 seconds to assess, diagnose, treat and make a decision on whether they can play on or not and you have to make sure you are in a safe position as often the play is going on around you,” adds McBride.
If you’ve ever wondered why teams have a physio/doctor either side of the pitch, it’s to reach a player as quickly as possible. Rugby is a contact sport. It’s brutal and explosive. Every second counts.
In that 90 seconds, McBride will have to assess the player, communicate to coaching staff and deal with the referee. Despite the chaos that is surrounding her, McBride will show amazing composure and clarity of thought.
“It’s hard but the experience of dealing with this is hugely important to a successful decision being made on the pitch in that moment.”
Clarity of thought
Half-time: check everyone is okay, ice towels, ice packs, ice jackets, patch up strapping, More tape, communicate with coaches. 10 minutes of commotion, but total clarity of thought.
The second half goes smoothly, McBride and her colleagues will mainly deal with fatigue-related issues. The final-whistle goes and with victory comes elation for many different reasons.
“I’m elated, not just because we won but because we didn’t sustain any major injuries and did a good job on the pitch,” explains McBride. “We made all the right decisions at the right time and communicated well throughout with the coaches.”
The hard work continues, McBride will then start writing down all newly-reported injuries, assessing and compressing dead legs and encouraging the players to have an ice bath – in an attempt to reduce their temperature and enable a better sleep on return to the hotel.
It’s midnight and the players will return to the hotel and eat, McBride will continue working.
The medical team will have a clinic to assess all injuries and treat with ice, compression and advice.
Coaches will be provided with an injury status as the next match is in just five days’ time. McBride will then write up her notes from the match before a well-earned glass of wine and a phone-call home. After 15,718 steps, it’s definitely well-earned."The best bit is helping the development of these young ambitious men."
So after 14 World Rugby Junior World Championships and 10 semi-finals, what will McBride miss about the job?
“The best bit is helping the development of these young ambitious men, who, whatever they go on to achieve, often say that the one or two years spent with the Under 20s is one of the best times of their life. I still keep in touch with many of them and wish them luck at times – when they get their first senior caps or Lions caps.”
After a casual glance at the Lions squad, McBride calculates she’s worked with 15 of the players currently in New Zealand. Every single one of them owes a little part of their success to her. The team behind the team.