Injuries in football - Ignorance is not bliss

Brendan Rodgers at Liverpool FC has won deserved praise for his approach to keeping players fit.

Firstly, some of it has to do with the very English, very working-class attitude of ‘getting on with it’. Football players are seen as the very antithesis of the poverty-stricken workers in the industrial revolution, the individuals who instilled this social mentality, where missing a day of work meant missing out on food and medicine for you and your family, often for days, so the very least footballers could do when they hurt themselves is to shut up and get on with it in the same manner as their ancestors, right? Wrong. Football players need more rest and recovery time and this simply isn’t being given to them. We now know more than enough about the body to ignore this archaic mind set. ‘Getting on with it’ has seen so many football players suffer horrific recurring injuries.

The ‘getting on with it’ mentality can lead to horrendous consequences, as demonstrated by US athletes during the Atlanta Olympics in 1996, presumably reinforced by being on home soil. Jane Leavy, reporting in Sports Illustrated, details how a young American gymnast named Kerri Strug became injured after her first vault during the games when, “her left ankle gave way. “There was such momentum,” she [Strug] says, “the bone was shoved forward and then back in place,” tearing the medial and lateral ligaments.” Even so, Kerri had to complete a second vault with the shattered ankle to guarantee a gold medal for her country which, unbelievably, she did. The cost? She had to retire as an athlete shortly after the games. Similarly Kurt Angle, current professional wrestler and former amateur Olympic wrestler fractured two of the cervical vertebrae in his neck before the Atlanta games, and still competed and won gold in 1996. By his own admission he became addicted to a painkiller known as Vicodin as a result.

So, the image of Paul Ince or Terry Butcher with a bloody bandage doing little to prevent the constant flow of blood pouring from their heads, far from the accepted rite of passage for any aspiring England captain, is a failure in attitude toward player health. Football players often nurse injuries and delay any required surgery or treatment until a suspension or even until pre-season. Whilst playing on with painkilling injections is commonplace in football, it’s the wrong thing to do for the player and the club.

The second reason recovery time is so unhelpfully short is the player. If you’re Thierry Henry in the World Cup final or Lionel Messi, who visibly rocked and tapped his feet in nervous excitement waiting to come onto the pitch against PSG, then you want to play. Players need to be more honest with their managers and doctors and inform them what hurts, where it hurts, and why they shouldn’t play. Some of the reasons why they don’t no doubt ties in with the ‘get on with it’ notion. Players have to stop hiding their injuries from their medical staff.

The third reason is the product. The club don’t want a player’s absence to effect their team’s performance, á la Stramaccioni’s nightmare, and the fans want to see the best players all the time. This pressure creates a huge demand for Messi and Henry to get back on the pitch against PSG and Italy respectively, and have a hand in turning the result. It has a huge positive effect on television, media and supporters alike, but Lionel Messi only made his injury worse, and was noticeably affected in the next round of the tournament where Barcelona were eliminated.

All this considered, another area that needs improvement is injury prevention. Injury prevention is much better than injury recovery, but not perfect. FIFA ban tracking and monitoring equipment on players during competitive matches, and you have to feel this removes the ability for clubs and medical departments to monitor players during an entire season of competitive fixtures. Of course, monitoring technology is often utilised in training environments, but this only goes so far. Health analysis in training though, is advanced, and can give clubs on accurate impression of a players match day levels.

David Tenney, Head Fitness Coach of the MLS team the Seattle Sounders, reveals how this is done using software called Omega Wave, which specialises in fitness monitoring, “one of the relatively unique things about soccer is that the match is by far the heaviest load or outlay for that particular week. You can use questionnaires and other things, but Omega Wave becomes a critical piece when you really need to quantify each individual’s response to that very heavy load. The day after the game, the players will do the Omega Wave test with a set of five electrodes and a full EKG (electrocardiography- heart rate monitoring), some heart rate readings, and we get a pretty good sense just based on that sort of data for a player.”

There are clubs that seem to have much fitter squads than most ,which implies there is a way of avoiding a long list of absentees. Glen O’Driscoll, who works as Head of Performance under Brendan Rodgers at Liverpool FC has won deserved praise for his approach to keeping players fit. O’Driscoll states, “Each individual player has individualized recovery sessions. In sessions leading into games, we also modify training so they are fresh and well prepared. That’s pretty unique. We determine that based on the individual player and lots of variables go into that. Each individual player has a different injury history so a lot of the individual care, screening, therapy and conditioning that we bring in depends on that player and the injuries he has had in the past — we prioritize and focus on those areas.”

However, the attitudes at Liverpool and Seattle, as O’Driscoll implies, are not commonplace. Astrid Junge and Jiri Dvorak illustrate in their paper ‘Injury surveillance in the World Football Tournaments 1998–2012? that, “a total of 3944 injuries were reported from 1546 matches, equivalent to 2.6 injuries per match“, in their study of World Cups and international tournaments between those years. It showed, “on average, 1.1 injuries per match were expected to result in absence from a match or training.”

There is still a long way to go in injury prevention therefore. For every Liverpool FC 2012/13 campaign there is a season like the one Inter Milan had, who could not seem to keep their players fit. Even clubs such as Inter Milan’s city neighbours AC Milan, who have a laboratory dedicated to player fitness, don’t seem to be able to enhance fitness in their team. A massive spate of long-term injuries at the club left many players disillusioned and Alexandre Pato, a former AC Milan player, decided to leave the club in part because he believed he could get better physical treatment in his native Brazil.