ACL rehab stories - Barry O'Hagan

By John Harrington

In the second of a series of interviews with top level Gaelic games players across the four codes who have sustained ACL ruptures, Down footballer, Barry O'Hagan, spoke to GAA.ie about his own rehab journey to help promote the GAA Medical, Scientific and Welfare Committee’s ongoing research into the injury.

GAA, LGFA, and Camogie players and administrators are being asked to assist this research by completing a short survey.

The Player Survey can be completed HERE.

The Administrator Survey can be completed HERE.

Go HERE for more information on the MSW's research in to ACL injuries in Gaelic games.

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GAA.ie: Barry, you've been unfortunate enough to rupture your ACL twice. Can you tell us what both experiences were like?

Barry O'Hagan: The dates will always be stuck in my head. I can tell you the day and hour when I did my first cruciate which was February 23rd on a Saturday night against Antrim at about ten past six. That's still very much vivid in my memory. I'd go so far as to say I've never felt pain like it ever.

The second time I did the cruciate the pain wasn't anywhere near as bad as the first time. I don't know why that is. Maybe becuse the first time I unfortunately tore a wee bit more than just the cruciate, I tore the ACL, the MCL and the meniscus, so possibly that was the reason why I was in a lot of pain.

I'll never forget that pain, it's just something that always stays with you. A buddy of mine in the club, James Guinness, tore his ACL recently at training. I came home to my wife that night and she was like, 'what's wrong with you?' I said, 'I'm just so scared'. She said, 'Why?' I told her that one of the boys had tore his cruciate, and it just sent shivers up my spine and I hardly wanted to train after that.

That's the second time for James to do the cruciate as well. When you see someone like that doing the knee it just brings flashbacks and a shiver up your spine. You think all over again what you went through.

It's been difficult, it's a shitty injury. I suppose for me, having done it twice, the first time when I did it it's a wee bit more like a wake nearly in your house. Everyone is coming to visit you and bringing tea and sandwiches and biscuits and and trying to console you and stuff like that. Everyone is tip-toeing around you.

When you find out you have done your knee, it's shit. You have all the different emotions of anger, anxiety, sadness, and regret. My experience with my first ACL was that I was very interested in getting the surgery sorted and getting stuck into the rehab. I was really motivated to do all I could to get back and I very much did my rehab to the letter of the law and didn't really miss any days.

Then after doing the second ACL the eagerness to do the rehab again knowing what I went through the first time just wasn't there.

GAA.ie: How did you rupture it the first time? Were you tackled or was it a non-contact ACL rupture?

BOH: Both of mine were non-contact. The first one was probably partly due to fatigue. I planted my right leg outside of my centre of mass and went to change direction in mid-flight as such and the knee just collapsed. I was tackling and trying to chase back the ball at the same time but fatigue was definitely setting in at that stage of the game.

GAA.ie: The first rehab must have been tough because you didn't just tear your ACL, you also tore your MCL and meniscus.

BOH: It was very annoying because I had to go into a brace for eight weeks. The surgeon's advice was to protect the MCL. He didn't want to give me a graft on the MCL and I had a load of swelling. You could hardly distinguish my hip to my knee to my ankle. It was just one big swollen leg if that makes sense, there was no defining any part of the leg there was that much fluid.

So I had to get rid of that first and once I had the priority was to keep the MCL protected to a certain level. But when I then went for the surgery he changed the operation from an ACL reconstruction to an ACL and MCL reconstruction. I had to use the right hamstring for the cruciate and the left hamstring for an MCL.

That meant being back in a brace for another eight weeks so in 2023 I was in a leg brace for 16 weeks of the year. I had to wear it for 24 hours a day. The only time it would come off was if I was trying to get some flexion and extension in the knee or to have a shower. I was stubborn and stuck to that. I was given advice not to take it off and I stuck to that advice.

The hardest thing about it was sleep. You just couldn't get comfortable in bed wearing the brace. I spent a couple of weeks on the sofa because it was just more manageable and I found I got better sleep there than I did in bed where I couldn't get comfortable.

GAA.ie: It must have been cruel to tear the cruciate again in the same knee again a few weeks after making your comeback from the first injury?

BOH: I had invested a lot of time in coming back and the Down county board were very good to me and so were the Down management. I came back to full training nine months post surgery. I played against Westmeath in the Division 3 National League Final in 2024 when I came on for the last 15 minutes. Then, three weeks later, I played against Antrim in the Ulster Senior Football Championship for 55 minutes. So 11 months after I had ruptured the cruciate I had already played nearly 70 minutes of Gaelic football.

Literally two days before I was 12 months post-surgery, that's when I re-tore the cruciate in the Ulster semi-final against Armagh.

I took that second one much worse than the first. Mentally more than anything I just wasn't in a good place. I have a wife and two kids that I'm very, very proud of. But being a bit selfish, the emotion of it got just got to me moreso than ever. I locked myself in a room and just couldn't hardly talk to anyone. I was in a bad place, I was just gutted.

Anyone who has gone through an ACL rehab knows it's a lonely spot. When you do your knee everyone reaches out to you in the first 10 or 12 days to commiserate and tell you that you'll bounce back. But then after those 10 or 12 days, no-one really reaches out to you anymore. Only your true friends will dip in and dip out to ask how you're getting on, and your physiotherapist is the other person who really cares.

I was lucky that I had contact time with my physio twice a week, but you're rehabbing seven days a week. So for those other five days I'm by myself in the gym. It's cold, it's six o'clock in the morning, because I have two young kids so I want to be about the house in the evening. It's just a very difficult place mentally more than anything.

GAA.ie: When you're used to a team environment it's probably all the tougher to be going through that on your own?

BOH: It is. On reflection now, I was probably a bit selfish and feeling a bit sorry for myself because I left the team completely and even left the WhatsApp group. I do regret that. I was just feeling too sorry for myself. At that stage I wanted away from football, I didn't even go to our club games. I didn't go to watch any Down games either. The next game I watched was our club team playing in the county quarter-final. I was just pissed off and frustrated. I had put so much in to get back to football and for it to happen again was just tough to take and I took a wee break from football completely.

GAA.ie: When did you start feeling like you wanted to give it another go again?

BOH: I was still with the Down physio, Eoin Clarke, so for the second surgery I was prehabbing and rehabbing with him, but I wasn't rehabbing with the same intensity day in, day out. I was probably rehabbing three to four times a week rather than every single day like the first time, and most days after the first time I was rehabbing twice a day.

The second time I knew in my own head I was never going to play football again for a year. I wasn't even thinking about training again. I just made that decision. Whereas the first time I had surgery in April of 2023 and at that stage I was already thinking how can I get back into playing National League Football for Down the following year.

The second time my mindset was different. I realised I had rushed things the first time and I wasn't taking any risks this time. So I made the decision not to go back to Down last year because I knew my body needed some time away from it. I didn't play any football the second time around until around 18 months post surgery.

GAA.ie: What was your first training session or game back after the second cruciate?

BOH: In August of last year I went back training with the club and then three weeks after that we were straight into championship. I missed the first round and then in the second round I played the last 10 minutes and then 15 minutes the next championship game. Then we played Kilcoo in the semi-final and I got about 20 minutes under the belt then. So all the football I had in about two years was around 45 minutes over the space of three games.

GAA.ie: How did you feel about playing again? There must have been some nervousness or trepidation?

BOH: Yeah, a lot of nervousness. I'm nervous, and then the loved ones around me are just as nervous. My mum and dad and wife and children were at those games. The children are too young to really understand, but my wife was definitely scared. She's still scared to this day because I'm back playing with Down now. She's still waiting up every night for me to come home from football to see am I alright. She's there hoping not to get a phonecall that I've been taken back into casualty.

I've had enough surgeries over the years to know that once you get a contact tackle on you, once you get a hit, you're fine, that settles you. You're nervous, but the nerves last about 10 seconds because once the ball is coming at you then you don't think about the knee anymore, you think about the ball, you think about where you need to be or where the next pass has to go.

I wasn't that nervous but the other night when James (Guinness) did the knee definitely sent shivers up my spine. It made me wonder am I wise, to tell you the truth.

GAA.ie: You mentioned the nervousness of your loved ones...an ACL injury is a challenge for them too because the player has to be single-minded about their rehab at the expense of family time, they're also probably being asked constantly about how their loved one's rehab is going, and they're going to be naturally worried about the injury happening again. Is it fair to say a ruptured cruciate doesn't just take a toll on the player who suffers it?

BOH: I have two daughters and the first time I did the cruciate the youngest one was only seven months old. Some people can walk immediately after a cruciate is torn and be fine. But my first cruciate I wasn't fit to put any weight on my leg for a couple of weeks and that was purely because of the damage done to the knee and all the swelling. So in terms of helping my wife Aoife I was useless.

She was a full-time teacher going back to work and had to basically nurse me as a third child while trying to get our two kids to bed. Our eldest had just started school so she was trying to do homework with her as well while trying to look after me and look after her own mental state and do her own things she enjoys like going to the gym and pilates herself.

There was a lot of pressure put on my wife and I'm extremely grateful for all she did for me. I wouldn't have gotten through it without her. Mum and Dad too. My mum was coming to the house seeing if I wanted lunch and stuff like that.

So it definitely takes a toll on your loved ones as well because people don't like to see you sore. I wouldn't be the sort of person who would go down too easy and the first time I hit the ground with a smack my wife knew something was up. The second time I did the knee I was smack on the ground again because the pain is pretty intense at the start. So they knew it had gone again. They'd be down and depressed too as much as you are. My brother played inter-county with me for 10 years and he was more annoyed than anyone.

GAA.ie: Did you have to think hard about going back in with Down this time?

BOH: Aye, I'm 32, so should I be just focusing on giving the club more? Because I do want to give the club more. It was a big decision and it wasn't solely on me. The decision was made with my wife as well because I want to be about as a father as much as I can but the demands of inter-county are mental. You're out of the house four nights a week minimum.

As I talk to you now I'm getting ready to go to Limerick on Friday afternoon and I'll have to leave work early to travel down to Limerick and then play Limerick on Saturday and then drive up the road that night. So basically from Friday morning until Sunday morning I'll not see the kids. That was a big thing that played on my mind.

In the current Down panel there's only myself and one other player who has kids. I'm not extremely old, but it is a young man's game now. You need to nearly have a girlfriend and that's about it to really commit and give everything, which I am doing. To tell you the truth, I haven't looked after my body as well as I have for the last year or two because being older you need to help your body recover.

The decision wasn't easy. I probably wasn't the most popular person in the club for a while because I came back on the club scene and was moving okay and I'm sure they don't want me to get injured again because in our own opinion we're not a million miles away from a club championship. So I suppose people in the club want to see me on the pitch representing Clonduff more than they do want me to represent Down.

GAA.ie: You probably feel like you've been robbed of a few years of playing at the highest level so I can understand why you'd want to have another cut off it again and make up for lost time.

BOH: I suppose you just want to see can you throw everything at it and see can you still physically play at that level. Look, I don't know yet, there's still a question mark there. My first game for Down in nearly two years was 10 minutes against Clare and it was nice to wear the red and black jersey again. I haven't won too many medals unfortunately but I'm hugely proud to play for Down and always will be.

I suppose being competitive you always want to test yourself. And also the medical care that I get with Down it couldn't be any better than it is. They've looked after me so well. Not all clubs can offer that so it's another reason why I did go back, what they can offer me to get myself in the best shape possible, and I believe that they are doing that and hopefully I can reap the rewards and repay them for that support.

GAA.ie: You should be proud of yourself to have come back from the sort of experience that would break most people. It's a great achievement to have been able to pull on that Down jersey again.

BOH: Ach, it is, but I don't really see it like that. I see it more as an opportunity to play for Down again. I don't know if the management think I'm fit enough or not, but I suppose they must if they're putting me back in there.

There's a man I'm friendly with since school, he'd be a teacher, David Wilson, and he was probably, believe it or not, moreso a reason why I went back and he doesn't really know it. I was chatting to him about going back and he just turned to me and said, 'If you have an itch, scratch it.' Something that simple just really resonated with me. Deep down I did have an itch to go back so his advice to scratch that itch probably sold it to me more than anything else. I just thought, frig it, you're a long time retired as people often say.

GAA.ie: What advice would you have for anyone who tears an ACL about how to tackle their rehab?

BOH: When you do your knee and you get your MRI result and they're telling you that your cruciate is completely torn, you have to face reality pretty quickly and that's probably something I didn't do the second time. The first time I did, the second time I probably tried to prolong it and get a way around it but the advice would be to really, really go after the first couple of days post surgery and make sure that you follow to the letter of the law whatever advice your surgeon and physio give you because that definitely speeds up your recovery.

The second thing, and this is purely on my experience, I would go for the patella tendon graft every day of the week. I know there can be complications further on down the line which is why I went with a hamstring graft the first time, but I found that the patella graft the second time was a lot easier to rehab.

Granted, I tore a bit more the first time so I'm not sure if I had just tore the cruciate what the hamstring graft would have been like. But I found the second rehab easier after the patella tendon graft.

My last bit of advice would be to enjoy life a wee bit more. There's a young man on our team now coming back from his ACL, Danny Magill, and the advice I give him now is to explore options that you may have not explored before. Because to be an inter-county footballer is to be very selfish. You do have to miss those nights out, miss those weddings, sometimes birthday parties and miss even eating a nice dinner because you're paranoid about how it might affect your performance. So I suppose if you do your ACL, try to get yourself focused on something else as well. Because if you do get involved in your rehab very heavily it can nearly consume you.

I even bought a WHOOP the first time I did the cruciate and I was looking at my sleep, I was just too intense about it the first time. There should be a happy medium to your rehab.

When you're in the bubble of inter-county football there's nothing like it but when you're outside it life goes on. I've been inside the bubble and then outside the bubble and now I'm back in it. It is brilliant being back in the bubble, but I'm enjoying life away from it moreso than ever. I love training but I also love the nights I don't get to train a whole lot more now.

GAA.ie: The hope would be that through initiatives like this ACL survey the more we learn the better equippped we'll be to prevent ACL injuries.

BOH: 100 per cent. I'm hugely supportive of the work that Liam Moffatt and the GAA are doing. It's getting to the stage now where ACL tears are just too common. If you even go back just 10 years, it just didn't seem nearly as common as it is now. You'd hear about one or two a year back then, whereas now I'm hearing about one or two a week and it's across all sports. It's Gaelic, it's hurling, it's camogie, it's soccer. Are we doing too much? Are we too mechancially minded in terms of the gym? I don't really know.

I think now more than ever there needs to be more research put into it because I'm hearing of people as young as 16 doing their ACL now. I wouldn't say I'm lucky, but I'd prefer to do it towards the end of my career like I did. I don't know how I'd cope at the age of 16, 17, 18 years of age. I coach a MacRory team here and we had a young lad who tore his cruciate last year at 17 years of age. You wouldn't wish it on your worse enemy.

What the GAA are doing now, it's only right that they're looking into it and trying to see how we can best go about preventing it if there is a way to do that.

GAA.ie: Thanks for your time Barry and well done to be back playing at the highest level again after such a tough couple of years, it's a great achievement.

BOH: I suppose it is. At the minute I've gotten a new lease of life, I'm really enjoying football again, I've got a real skip in my step again. I'm back in Down for whatever capacity they think is feasible. If it's 15 minutes here, 10 minutes there, or possibly starting, for me it's just about giving all my energy to push on and see where the body can go.

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