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Coffee with Cynthia: Dr Tom Cross

Sydney Swans No. 1 ticket holder Cynthia Banham is an accomplished journalist and author. In a series for sydneyswans.com.au she has spoken with club staff to delve deeper into what makes the team behind the team tick. This week she’s caught up with Sydney Swans club doctor, Dr Tom Cross. 

What sport did you play growing up?

I grew up in Sydney and played rugby league and rugby union. I still love watching both codes. The highest level I played was for the Australian Schoolboys Rugby Union team (vice-captain) and I was Captain of the NSW Schoolboys Rugby team, both in 1986.

After school I played with Balmain Tigers in the Under 20s but found it very difficult combining medical studies with the training commitments. Injuries eventually forced me to retire at just 22 – I’d had four shoulder reconstructions over five years and suffered approximately 10 concussions.

Did you always want to be a sports doctor?

I initially wanted to be a GP, then in my early 20’s I wanted to be a paediatrician. I studied paediatrics for a year at the children’s hospital at Westmead. Certain specialities in paediatrics didn’t come easily to me and I found I wasn’t very good at the complex medications for oncology. I saw a couple of children die, which was most distressing.

Why did you choose sports medicine?

You’ve got to do something in medicine that goes with your grain and with your interests – like everything in life. When I was working in the hospital emergency department, I was much more excited to treat someone with an injured knee than chest pain. I simply gravitated towards orthopaedics and sports medicine.

Sport and exercise medicine physicians are relatively uncommon. There are only around 130 in Australia and 60 in New Zealand.

My father, Dr Mervyn Cross, was a tremendous example to me throughout my childhood and career. Dad had a magnificent career as a pioneering orthopaedic knee surgeon, and I am one of many very fortunate young doctors he trained and mentored.

What drew you to the Sydney Swans?

I’d been working with the Melbourne Storm NRL team when they played in Sydney. In September 2015, I was approached by Swans then Head of Football Tom Harley. I had a history with the club and respect the staff and players, so it was an easy ‘yes’.

I really enjoy treating AFL players. Like all athletes, they are human beings first and elite professional footballers next. They come from all different backgrounds from all over Australia and I find this very interesting and exciting.

I combine working at the Swans with private practice. Juggling the two is a challenge and I work long hours – usually up to 80 hours a week. But I get to combine all of my areas of interest: sport, medicine and treating children, who are a large part of my private practice.

What’s it like working at the Swans?

They’re intrinsically empathetic and very good people who care about each other – most significantly they give energy. When I walk into the football club there’s truly great energy, people are positive, and you can’t help but love being there.

In a typical game, are there players playing in some degree of pain due to injury?

Injuries unfortunately go with the territory of playing any sport at a high level and AFL is a very demanding sport on the human body. At the Swans we have a strong focus on trying to prevent and minimise the risk of injury.

It’s not uncommon for players in the team to play with pre-existing injuries from training or previous games. The players are so resilient and tough. Having said that, no one takes to the field unless they are able to as we always make careful medical decisions to minimise the risk.

The most important thing is to look after the health of our players and, on occasion, protect them from their competitive spirit. Players are highly motivated to get better – they do everything asked of them and more. Sometimes you have to hold them back because they may have a tendency to over rehabilitate!

What’s one of your stand-out games from a medical perspective?

One that comes to mind is Round 8, 2018 at the MCG. Ben Ronke came to me on the morning of the game with pain in his shin. It looked like he was going to have to withdraw from the game and be replaced with one of the emergency players. But after examining him I told the coaching staff that if we did all the right things from then until the bounce that night, and then during the game, I would be able to control the pain and get Ben through without any short or long-term risk. Not only did we successfully manage the injury, Ben exploded onto the MCG and kicked seven extraordinary goals.

What is the most common injury in the AFL?

Hamstring strain injury is the most common, mostly due to lots of fast running. Running at speed, changing direction, kicking, bending over, picking up a football – all activities that can impact a hamstring. There’s been so much research over the past 20 years so our understanding of this injury, in terms of prevention and treatment, has vastly improved.

You’ve done a lot of work with rugby league teams, what’s the main difference between the two codes in terms of injuries?

In AFL there’s approximately two hours of exposure time in the game and some players are on the field for most of that. In turn, they’re at risk of soft tissue and bony injuries, so there are more overuse injuries in AFL than NRL. In NRL, there are many more collision injuries given the nature of the front-on tackling and the number of collisions in the game.

What sport haven’t you covered that you would still like to?

I haven’t been a team doctor for the Winter Olympics, and I would absolutely love to one day in the future having been a skier myself since I was nine years old.

I respect Winter Olympians as athletes, love the various winter sports and think the mountain scenery is magnificent.

Your CV includes Royal Duntroon Military College, Les Misérables and Cirque du Soleil. Can you tell me a bit about those?

The Duntroon sports medicine experience was while I was in Canberra working at the Australian Institute of Sport. I relocated to the AIS to learn more about elite sports and learn from some of the best doctors, physiotherapists, sports scientists, dieticians, and allied health professionals in Australia.

At the AIS I looked after the gymnastics team, the Australian swimming team, and track and field. It was a feast of sports medicine and I savoured every opportunity. I was only rostered for working 30 hours a week at the AIS, so I looked for more work. At the time, Duntroon were looking for a sports medicine doctor.

I went and interviewed, got the job, and worked there for two-and-a-half years. At Duntroon I looked after the Royal Military College (RMC) and ADFA university students. The RMC young men and women were equivalent to professional athletes – many of them had a physique like Isaac Heeney – they trained incredibly hard and, unfortunately, in turn they suffered many injuries.

What was the most common injury at Duntroon?

Sprained ankles. RMC cadets do field exercises at night, often running down hills on uneven ground carrying 20-kilogram packs. In turn, unfortunately, they would often suffer very severe injuries.

The great thing about Duntroon was those young men and women were so inspirational and courageous. The culture at Duntroon was very similar to the culture at the Swans with enormous comradery, passion, inspiration and courage.

How did that compare to working with Cirque du Soleil?

Cirque du Soleil was one of the best things I’ve done in my life! The performers are elite artists and athletes, and really good people – so similar to the Swans! There’s this great energy and they’re doing the most extraordinary things. Unfortunately, many of the performers carry injuries and are performing in pain.

On the Les Misérables theatre show, it was the physiotherapist that approached me to be the doctor for the production. Both the artists on the stage and those working behind the scenes in production in theatre can get injured. This was a wonderful sports medicine experience as I love musical theatre and this group of people were so talented, friendly and inspirational.