Ask the Expert: Dr Jeff Cullen (Scottish Rugby)

Dr Jeff Cullen is has been heavily involved in providing medical support in rugby for many years, both at a local and international level.  He also recently contributed to an article on Concussion management on the British Journal of Sports Medicine Blog. I was privileged to work alongside him in this years Scotland U16 and U17 Age grade programs.

1)What has led you into youth sport (background etc)? 
I have spent over 20 years working in sport, mainly Rugby Union. I first started as Club Doctor at Selkirk RFC, an amateur club currently playing in National League 1, in 1995. In those early days, sports and exercise medicine (SEM) was at a very early stage, and was not a separate speciality in training for doctors. I gradually built up my experience over the years, combining it with my other job as a General Practitioner. I started working for the Scottish Rugby Union in 2009, and much of this work involved looking after youth players, in various settings and at different levels in the sport. Recently I was appointed Team Doctor for the Scotland Under 16 and Under 17 National Teams, a role I have enjoyed immensely.
2) What has been the biggest influence in your practice in youth sport?
My biggest influence in youth sport has probably been undertaking a Sports Medicine Diploma, organised through the International Olympic Committee. I completed this in 2015, graduating with a distinction, and also becoming a Member of the Faculty of Sports and Exercise Medicine. The Diploma had a particular emphasis on injury prevention, and also youth sports, and it has been a major influence on my work in youth sports today. I am currently in the process of applying to work at the next Youth Olympic Winter Games in 2020.
 3) What is your philosophy when it comes to working with young athletes?

My main philosophy working with young athletes is not to treat them as ‘mini adults’. The health benefits for participation in sport at a young age are considerable, but child and adolescent athletes have a particular subset of injuries that can occur. This is due to a combination of factors, including non-linear growth, maturity associated variation, the adolescent growth spurt, a unique response to musculoskeletal injury, and immature proprioceptive/coordination/neuromuscular skills. For example, some musculoskeletal problems (e.g. Osgood- Schlatters disease) are common in this age group but rare/unheard of in adults. It is very important to understand fully the population of athletes you are dealing with. Not only do young athletes vary in physical maturity, but also do in emotional maturity. It’s therefore important to try to get to know them well, and which individual approach will encourage them to get the maximum benefit from sport participation.
4) Do you have a particular area of interest and how do you think this particular area applies to youth athletes? 
I have two main areas of interest in youth sports. The first is Concussion, which not surprisingly still demands a lot of media attention. I was particularly influenced by the story of Ben Robinson, a 14 year old rugby player from Ireland who tragically died following two concussions while playing in a school game, which were not recognised at the time. His father Peter has now become an important campaigner for concussion awareness. I am also keen to ensure that all coaches working in youth sport are fully aware of the concussion protocols. Sport Scotland recently updated their national concussion guidelines, which can be found on the Sport Scotland website. My second main area of interest is in injury prevention. There are some excellent examples of injury prevention programs, which can dramatically reduce the risk of injury in youth athletes (e.g. FIFA 11+).
5) What is the best piece of advice you’ve received?
The best piece of advice I received was from my old GP mentor at Selkirk Health Centre when I first started 25 years ago. It is not directly related to sports medicine but to the practice of medicine as a whole. ‘Treat your patients the same way you would wish your own family to be treated’.
6) What advice would you give to coaches working with youth athletes? 
My advice to coaches working with youth athletes would probably be the same as my own philosophy – don’t treat them as mini adults! However, I would also urge them to be patient with them. Over the years I have seen how youth athletes can mature considerably, both physically and emotionally within a short space of time. The player who is struggling one year, can become an important member of the team the following year.
7) Can you recommend any particular resources for youth sport coaches?
There are now a multitude of resources out there on the internet and social media. I find Twitter and Linkedin the best media for making connections and information on sports medicine and the following websites may also be useful:

  1. Scottish Concussion Guidelines
  2. British Association of Sport and Exercise Medicine
  3. Faculty of Sport and Exercise Medicine 
  4. UK Antidoping 
  5. UK Sport 
  6. World Rugby Player Welfare 
  7. IOC Consensus statement on youth athletic development

8) Where can people find out more about you and your work? 
My main social media platforms are Twitter: @jeffcullen0 and LinkedIn: Jeff Cullen
I also run a Sports First Aid Course designed for coaches which is SYFA approved called Selkirk Magic Sponge – Sports First Aid.
We are grateful to Jeff for his time and valuable contributions! To stay up to date with more great content like this, please follow us on Facebook.
Are you a youth sport coach or PE teacher who wants to improve the athleticism of your athletes? Check out our Fundamental series programs here.