Towards the end of this month, the England and Wales European Championship squads would have gathered fresh from a long hard season to prepare for the European Championships across Europe. Due to the Coronavirus, it has been postponed until 2021.

When we watch a live game, the presenter will often say we will be going live to the England or Wales camp.  Along with any other home nations who may have qualified to see what they have been up to. Either before the game half time or at the end of a game. Being a member of the FA Medical Society and having attended many a post-World Cup or Euros talk by either former physios Gary Lewin, Fred Street and team doctors Vernon Edwards and John Crane. I thought I’d give some insight on the life of the medical staff at a major tournament.

Fit for kick off

Broad preparation and planning would have been going on since qualifying matches started two years ago. That planning, coupled with experience and knowledge gained from participation from previous tournaments, is aimed at providing a backcloth against which the players can perform to the best of their ability.

The medical team

The Football Association via its many departments provides and organises the facilities that would of been required, and left nothing to chance. There are backup and contingency plans for everything that might or might not be needed.

The fine-tuning of the day-to-day detail is, of course, in the hands of the manager. In order for him to plan efficiently, he needs feedback from his coaching, training and medical staff. The team doctor, physios and fitness coaches are responsible for the daily availability of as many fit players as possible to train, and for reporting back on the general health of players, and observing any other points that may be relevant to the well being of the group.

Those are in fact the terms and reference under would operate for all national team matches. The difference in a tournament is that they are together for a few weeks instead of a few days, with the problems that travel, foreign food and  unaccustomed climate can superimpose on the usual caseload of ‘running repair’ injuries and the ever-present of serious injury.

To minimise the hazards of food, travel, climate, etc, the doctor takes all the usual sensible prophylactic measures and advises the players long before they arrive, on the part they can play in keeping fit and healthy. They will carry every possible medication to facilitate this situation and feedback from all members of staff (and players’ observations) is used to monitor the most important factor.

Team spirit

The treatment of injury is in many ways no different from the training and playing of any other international match. The main difference is that they are together for a series of matches, and can only use twenty-two named players for the whole tournament so a national team party takes on a club-like attitude to the injured player.

“One-off” national team games have players selected from a fit squad. Any serious injuries are returned to the club and a replacement is bought in. This means that in practice only injuries under treatment are “running repairs”.

This is not possible in a tournament and rehabilitation of players becomes part of the scene. Players can be left out of training and games as part of treatment regimes and bought back in for later games or to cover injured players.

As I have said it becomes like a club, where you are trying to have as many fit players available for the manager to choose from for training and playing. This involves much discussion on a daily basis with the manager about the advisability of players training too hard or too long or if at all, and even late fitness tests which again are more of a club feature than a routine international.

Setting up camp

In order to provide this sort of backup service to the manager and players, the doctor and physios set up a base at the hotel and at the training camp (often a facility of a local professional side with the equipment needed).

They take all the own machines, ultrasound, pulsed shortwave, interferential and all the usual strappings and dressings that are familiar in any injury unit.

The room they convert in hotels tends to be the engine room of the party, where everyone gathers. It is crossroads of gossip, information, supplies of kit, medication, a chat with the doc, usually with a recreation room  and TV/DVD room next door.

You will have gathered that they are ‘on the road’ a familiar scent to any club footballer and anyone who has worked in football as a physiotherapist/trainer with a club.

The job is a tracksuit job, with as much time spent on the pitch and track as in the treatment room. As well as maintaining some fitness with injured players there are other players who may not have played in the last game and need to do some work when those who have played would be involved in a recovery session which may include some non-contact work in the swimming pool followed by massages. The injured players would obviously receive treatment whilst those that did not play would train.

There is also morale and boredom to deal with ‘killing time’ the name of the game although it is a little bit different for players nowadays with the internet, mobile phones, laptops, etc, a maintained wi-fi connection would be a priority for staff. Things like, tennis, golf and cycling can be used to ring the changes, especially during the two-three weeks acclimatisation period in the run-up to the finals.

All hands on deck

A major tournament is not all about treatment and academics but is all about joining in. A former England doctor has been seen cooking breakfast with a chefs hat on and apron taking a lot of leg-pulling from the players as he served them baked beans. An hour later he would be taking blood tests for altitude and acclimatisation tests. All without any loss of professional dignity or integrity. A neat balancing act that not everyone is equipped to perform.

The aim of all this is to field a team on matchdays with players who are as fit and healthy both physically and psychologically as possible. The analysis of who or what makes the most contribution to this end is both unrewarding and undesirable. What is important though is everyone is pulling on the same rope in one direction. For medical staff, a tournament can sometimes be defined not so much by results as injuries. Like Gordon Banks in ’70, Kevin Keegan and Trevor Brooking in ’82 and Brian Robson in ’86 and ’90, Wayne Rooney 2004 and Michael Owen 2006.