It wasn’t all that long ago when the medical team in all the 92 professional clubs consisted of one full-time physiotherapist and club doctor who would be available for home matchdays and also have a clinic at the club during one afternoon a week, where he would see the walking wounded, and also be on the end of the phone should a player be ill, need a prescription or require to pop to the local surgery.
The only other member of the medical staff was a part-time guy who looked after the youth team on a Saturday morning, along with the schoolboys at the centre of excellence and possibly the reserves in midweek if the club physiotherapist wasn’t contracted to cover more than 40 games a season.
Outside of the club, the orthopaedic backup would most likely be a general surgeon who specialised in knees, for example, but would also look after any other joint problems that may or may not require surgery.
The level of qualification wasn’t of any real importance until the 1990/91 season when criteria were implemented, saying that all physiotherapists must either be chartered or hold the FA Treatment of Injury diploma, either the two-year or as previously known, the three-year certificate in the treatment of injury. For the club doctor, it was a general medical qualification and usually, a club appointment was made as a friend of the chairman or a fellow director who he knew from the Rotary Club for example.
The remuneration paid was usually tickets for games and the enjoyment of board room hospitality on matchdays or, as former Scotland doctor Stewart Hillis who was Clydebank doctor for 27 years said, it was a turkey at Christmas!
Nowadays, the doctors and physiotherapists have to have far more qualifications to work in football a profession that is seen to be an ever-changing role as we see doctors accompanying the physiotherapist for pitchside management.
The medical department is headed by club doctors, who now hold sports medicine diplomas, and clubs also employ a number of physiotherapists, masseurs, fitness coaches plus other associated medical staff.
The physiotherapists have to have masters degrees and essential pitchside qualifications, and the majority also have other core qualifications like acupuncture.
The diagnostic procedures have changed, with MRI scans now the norm following most injuries. Even pre-signing medicals have changed beyond recognition with specialists in every injury being at the end of a phone or email.
Club doctors and consultant surgeons have a specialised interest in sports injuriesÂ with diagnostic and surgical skills which facilitate the work done in the treatment room. Indeed, the progress in surgical procedures such as arthroscopy has cut down the post-operative physiotherapy required dramatically.
So all in all, things have come a long way. But to finish where I started, ‘The more things change the more they stay the same.’
No matter how much techniques, facilities, budgets, and nuts and bolts change, you still need the right people to implement these changes and motivate the players through sometimes difficult and desperate parts of their career. Things have come a long way today, with clubs employing people who specialise in different joints and can be called upon to look at injured players if needed, so every bit of detail associated medically is now covered within the clubs.
The facilities have changed as well, many of us can remember the days when players would get changed at the ground then go and train at a local park or sports ground. Injured players would be treated at the ground and rehabilitation took place in the back of the main stand that also housed a multi gym, a bike if you were lucky, along with a few dumbbells and a medicine ball. If you were really lucky, you would use a local fitness centre and may have even had access to a pool.
IÂ remember a kit man telling me once that the injured players asked him for better kit when they went to these fitness clubs and he used to reply that they were going there to work, not to look at the women! How much work actually took place in maintaining the fitness of injured players is debatable.
Fred Street said that working for a football club in whatever capacity was not so much a job but more a way of life, your job description gave a narrow view of your role. The football team physiotherapist needs to be equipped with specific knowledge in what we might call the normal practice in civilian life, where patients come and go without really creating a human relationship. However, in a dressing room, the relationships are different, the pace is different, and in fact, everything is different.
This was nicely illustrated in the TV programme many years ago about Paul Gascoigne’s ‘road to recovery’. He gave a lot of credit to John Sheridan, the then-Spurs physiotherapist, for the time he spent with him during the long months of recovery, keeping his chin up.
Well done Paul… and well done John.
It used to be fit for Saturday but now itâ€™s fit for whenever Sky wants it!