In 1981, Dr Con Murphy came across his first cruciate ligament injury. He saw the footballer and sent him to a specialist for further diagnosis. The player was Pat Spillane.
At that time, an uncle of the Kerry great was a parish priest in Glasgow and he knew a lot of the players and staff at Celtic. They recommended a specialist in Cambridge who operated on Spillane and, despite being advised to hang up his boots, he went on to win three more All-Ireland titles.
In the doctor's first ten years with the Cork hurlers from 1976 to 1986, they had one orthopaedic operation, now they have one a month. Although there are many additional medical avenues available, over-training is largely responsible for this worsening crisis and in many cases it's leading to burnout.
"There is no doubt that people are over-training and that's because kids are involved in too many teams and it is very difficult for them to turn down the different managers. The GAA is all about winning, you have managers from outside clubs and other counties and they are only interested in their own jobs," says Murphy. "The only way that you can address burnout is to make it a rule of the Association; you can't rely on common sense in the GAA."
With the league and the colleges competitions in full flow, February is one of the most physically demanding times to play Gaelic games. Fitness isn't 100 per cent, the ground is heavy and the rain pours. Yet it's still the most congested time of the year for fixtures.
In one week dual player Matt O'Hanlon played two NHL games for the Wexford hurlers, freshers' hurling and football games for UCD, and trained with the Wexford seniors. He is also on his county's under 21 hurling and football teams and has club commitments.
"There are times when I question what I'm at but the managers talk to each other and sort it out," says O'Hanlon. "The onus is on yourself to tell them whether you feel you can play or not. At times there is an element of pressure, you are expected to be at training and in turn expected to perform in matches but I wouldn't stay playing if I didn't enjoy it."
Laois senior footballer John O'Loughlin is in a similar boat. On top of playing inter-county football, he is playing both Fitzgibbon hurling and Sigerson football and is set to join the St Brigid's club in Dublin.
"It can be hard fitting everything in but I do my best to get a balance and get a rest," he says. "Managers are very accommodating and they always understand if I tell them I need a break but it's not easy to take that break when you are playing with so many different groups."
Kilmacud Crokes have set an example where they have decided to keep their players exclusively for themselves until after the All-Ireland club championship. There are one or two scholarship students on their team who have to play for their colleges but aside from them it's club over county and college.
Manager Paddy Carr has been firm in this stance. He has left Pat Gilroy plough on without the Kilmacud representatives, Longford have had to do without Brian Kavanagh and Dublin lost to Meath in the first round of the Leinster under 21 championship last Wednesday without their three Kilmacud panellists, Craig Dias, Eoin Culligan and Mark Coughlan.
After the game, Dublin under 21 boss Jim Gavin was outspoken in his criticism of the congestion and Laois boss Pat Roe slammed the Sigerson Cup for taking too much out of his players after his side suffered a heavy defeat at the hands of Westmeath.
Although a committee has gone to the GAA with proposals to help address this problem, no changes have been made. The level of expectation on players is rising every year and the safeguards are not being introduced to protect their welfare. Eventually something has to give.
Sunday Indo Sport