I am sure many of us involved in the game of football savour those precious moments in a game when a striker produces a rare touch of magic to score the match-winning goal. And we are, I think, just as generous in our praise of the defender whose last ditch tackle prevents a certain goal. Or of the goalkeeper, whose skill and agility prove decisive with a crucial save in the dying moments of a match.
But how many of us, I wonder, ever stop to think of the work that goes on behind the scenes to turn top players into the superbly fit athletes that they now are? Do we sometimes perhaps too readily forget the efforts of “the team behind the team”? It is one that not only has specifics tasks but also has a role to play in creating an atmosphere around the team. For a manger having built a ‘team behind the team’ the manager is required to lubricate the machinery to ensure it runs smoothly in all conditions. It is the importance of fully integrating the backroom staff-including the Medical Team-in to the daily life of the squad. These days it is not unusual for a manager to arrive at his new job with a member of his medical staff at his side.
After his sides triumph at The 2018 World Cup, manager Didier Deschamps made special mention to his medical staff’s contribution to France’s success. This is clearly a sign of the times in recent years the roles of sports medicine and science in football and therefore the medical staff have grown in importance. Gone are the days when team doctors and their colleagues dealt almost exclusively with the treatment and recovery from injuries. The demands of today’s game mean that top players now have to come in to contact with numerous aspects of medicine that was barely considered just a few years ago. These range from safeguarding the players health and specific fitness training through to stress management, psychological preparation of players the problems of doping and increasing risk of alcohol and other social and recreational drugs being used within the game. They are also responsible for implementing injury prevention, care and rehabilitation, and lifestyle counselling, including the use of leisure time, hygiene in living habits, nutrition and safety.
published in 1999 following France’s World Cup triumph, Aime Jacquet wrote “sports doctors are not just there to treat injured players they are involved in the team’s fitness training and give advice on the players workload they must offer guidelines concerning sunbathing and training schedules.” In short, apart from purely technical and tactical there is no area in which the doctor and Physio may not and should not be in constant dialogue with the manager.
Sir Alf Ramsey, another World Cup winner, appointed Middlesbrough FC vice chairman and medical officer Dr Neil Phillips to the position of Honorary Team Physician to an Under 23 tour. In his autobiography Doctor To The World, Champions Phillips explained details of his appointment.
Alf set set aside two hours for a personal meeting and wanted to discuss the role as he saw it. He assumed I would provide high quality medical care for the players. He also wanted me involved in all players activities. “Whatever the players do and wherever they go, I want you to be there with them.” I was to attend all training sessions, team meetings. My meals would always be taken with the players, I was to attend all the players social functions. He trusted I would become over time, just another member of the squad. “Most of all, I suppose, I want you to become ‘the players friend’ I want them to be able to discuss matters with you they may not wish to discuss with me and the coaching staff. If you have any concerns any time do not hesitate to discuss them with me.”
However the single most crucial aspect remains the same the ability to deal with an Emergency and life threatening injury on the FoP. In the last week we all saw the importance of the development of this field in football. When Christian Erickson shockingly collapsed while playing for Denmark at the European Championships. The fast work and expertise of the medical professionals on hand have likely saved Erickson’s life suffering after he suffered a Cardiac Arrest. Such was the excellent response by the Danish team doctor and Physio.
In recent times across Europe there have been several significant injuries on the field of play that have required immediate emergency medical care and evacuation of the player to hospital. The main types of injuries requiring on-field emergency care are
• Cardiac arrest
• Head injuries
• Injuries or suspected injuries to the spinal column. Vital to all this is a well rehearsed and practiced (EAP) Emergency Action Plan.
Following on from a number of these type of injuries a special Emergency Care for Players steering group was set up in 2008/09 with a specific trauma course (AREA) in the The Pre hospital setting now known as the FA Trauma medical management in football both advanced and intermediate level. Endorsed by the Royal College of Surgeons of Edinburgh.
Lower down the leagues there is still a lack of concept of the physio and medical aspects.
“The physio has an image of somebody who knows how to do a bit of massage and who runs on to the pitch with a magic sponge, the miracle water and a bag that sometimes makes him run in an odd way that the crowd laugh and treat him as a circus act. The sad thing is certain people within the game treat us like clowns as well as well…”
It is usually one of the last to get rewarded and the first to get cut, but like Didier Deschamps, now and again, a manager makes a special reference of his medical staff.
Former England manager Ron Greenwood said “Fred Street our physiotherapist, was another first-class chap, gifted, enormously experienced and a real football man”.
I will end with the words of Sam Allardyce “If you haven’t got a good physio and medical team, you might as well not bother. They are worth 15 points a season. It doesn’t matter how many good players you buy. If they aren’t fit it’s money down the drain.”