Episode 9 | Patient Story | Guest: Connor, patient at LBSM
The world of semi-professional sport rarely makes the sports pages. It sits below the radar – unglamorous, financially precarious, and demanding in ways that most people who follow elite sport would not recognise. Players juggle full-time jobs with twice-weekly training sessions and weekend matches. Budgets fluctuate. Contracts often don’t exist. And when an injury strikes, there is no medical team on standby, no sports scientist monitoring your load, and no one paying you to rest.
Connor plays for Cray Valley PM in the Isthmian and South East League. He is a bricklayer Monday to Friday. In this episode of the London Bridge Sports Medicine podcast, Dr Ajai Seth uses Connor’s experience of a debilitating groin injury to explore what it really means to look after your body at this level of sport – and what recreational athletes and weekend warriors can take from it.
How the injury developed
Connor’s groin problem crept up on him. It started as a dull ache – something he put down to tight hip flexors and a generally stiff lower body. He worked through it with his club physio, trying to loosen things off, and kept playing. Weeks passed. The pain worsened. It moved into his pelvis. He wondered about a hernia. He was checked, reassured it wasn’t, and referred on. More physios, more investigations.
An MRI eventually showed inflammation around the pubic bones – the pubic symphysis, the joint at the very front of the pelvis where the two sides of the pelvis meet. It is a region under significant compressive and shear load in footballers, and when it becomes irritated and angry, the pain can be debilitating. For more on groin pain in sport, see LBSM’s guide to groin pain.
The context matters. This all happened coming out of the first lockdown, when a prolonged period of inactivity was followed by an immediate return to a full and compressed match schedule – played almost entirely on artificial turf. “There were back-to-back matches week after week on Astro after a period of playing no football,” says Dr Seth. “The load you experienced in those months just set the groin off.”
By the end, Connor was playing twelve to thirteen consecutive matches with no training in between – just games, and then work. “It crippled me,” he says. “I couldn’t move towards the end. I was struggling to work sometimes.” He kept playing because the club had a good cup run. He just kept going.
Treatment: from tablets to injection
Dr Seth initially tried anti-inflammatory medication (naproxen) to settle the inflammation, which helped partially. Rehabilitation exercises began, but Connor’s pain was limiting what he could do – the physio would ask him to perform a movement and he simply couldn’t. The basic core work he could manage was not going to prepare his body for the demands of a return to football.
After Christmas, the decision was made to proceed with an injection directly into the pubic symphysis, guided by imaging. The aim: to reduce the inflammation enough to allow proper rehabilitation to take place.
Connor’s response was rapid. Within two to three days he felt the pressure ease. Within two to three weeks, he describes it as “perfect.” The injection unlocked the rehabilitation – suddenly he could do the movements his physio had been asking for, and the programme that would actually prepare his body for football became possible. “It was unbelievable, really,” he says.
The real story: what semi-pro sport actually looks like
Connor’s groin injury was not bad luck. It was the predictable outcome of a set of structural pressures that affect athletes at this level routinely.
A typical week: train Tuesday, train Thursday, play Saturday. Two 90-minute sessions and a 90-minute match. That is it. No time in that schedule for strength and conditioning work. No sports science support. No load monitoring. And Connor is also a bricklayer – a physically demanding job – five days a week.
Strength and conditioning work exists at this level, but it is the responsibility of the individual player to find it, fund it, and fit it in. “It’s definitely down to the player,” says Connor. “You choose to play at this level. So it’s also down to you to look after yourself.” The managers are not worried about individual load. They are paying players to perform. The infrastructure of elite sport – recovery specialists, physio teams, gym access – simply does not exist here.
Money compounds everything. Proper footwear, gym memberships, specialist appointments – all come at a cost that is hard to justify when you are a semi-pro earning modest match fees while working full time. “There’s no two or three year contracts,” says Connor. “Some players aren’t even on contract. You never know where you’re going to be from A to B.”
The boom-and-bust trap
One of Dr Seth’s key observations from working with patients like Connor is the boom-and-bust pattern: a period of reduced activity (lockdown, off-season, injury) followed by a rapid return to high load, before the body has had time to readapt.
This is not unique to semi-professional footballers. It applies equally to the recreational runner who takes six weeks off and then jumps back into their usual mileage, or the gym-goer who returns from holiday and immediately lifts the same weights as before. The body deconditions during rest. Load needs to be rebuilt gradually.
Connor acknowledges he knew this was happening. “Everyone was sort of like running long distance [during lockdown] and that probably didn’t help. And then coming back to football on Astro, plastic weather, and that don’t help.” The combination – deconditioning followed by compressed schedule on an unforgiving surface – was the perfect setup for injury.
What Connor would do differently
“Look after yourself a bit better. Do the strength work. If you feel any niggles, go and see someone and actually get looked at. Don’t just think, oh yeah, just get through it. That was my attitude – I’ll be all right – and in the end, you’re just playing games and you’re no good to nobody.”
He is candid about the lifestyle factors he knows matter but has not always prioritised: diet, sleep, recovery. “I’ve been pretty terrible,” he says of his diet. “You sort of rely on the athlete side of you to come out. But if you’re giving advice to someone else, you’d definitely say, eat the right things. If you can get eight hours, do that.”
The harder message is the one about self-responsibility. At this level of sport, no one is going to do it for you. The club is not going to monitor your load. The manager is not going to ask how your body is feeling. If you want to stay fit, stay playing, and stay injury free, that is your job. “It’s all about the choices you make,” Connor says. “If you put aside half an hour a day – it’s not hard, but if you actually do it and fit it into your day, you’ll reap the rewards.”
What this means for recreational athletes
Most people listening to this are not semi-professional footballers. But the pressures Connor describes translate directly: balancing sport with a demanding job, limited time and money, no specialist support, and a tendency to push through niggles rather than address them early.
Dr Seth’s key takeaways from Connor’s story:
- Understand your body. Learn to recognise when training is not right, when load is too high, and when something needs attention rather than being pushed through.
- Do the strength work. There is no one-size-fits-all programme. A strength and conditioning approach that suits your sport, your body, and your schedule is the best injury prevention tool available.
- Avoid boom and bust. After any period of reduced activity – lockdown, illness, injury, holiday – rebuild load gradually. The body deconditions faster than people expect.
- Act on niggles early. Connor spent months pushing through pain that, caught earlier, may have been resolved much more quickly. A niggle that has been present for two or three weeks is always easier to treat than one that has been running for six months.
If you are managing a sports injury or want to discuss load management and injury prevention with the LBSM team, we can help – whether you are a semi-professional athlete, a weekend warrior, or anything in between.
Book an appointment at lbsm.co.uk/booking
Listen to the full episode below ↓
