medicine & performance The official magazine of the Football Medicine & Performance Association
Issue 28 Spring 2019
Feature
The Team Behind The Team
What exactly do large medical teams do to keep players in optimal physical condition
In this issue Sports Pharmacist: What the role provides Life After Football Spotlight on Substitutes FMPA Conference Awards 2019
Legal Education Recruitment Wellbeing
www.fmpa.co.uk
CONTENTS WELCOME
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Updates
FEATURES
10
Understanding The Team Behind The Team
37
Are You Surviving or Thriving? Caroline Marlow
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Sports Pharmacist: What The Role Provides Paul Moloney MPharm
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Spotlight on Substitutes: What Do We Know? Samuel P. Hills Steve Barrett Mark Russell
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Life After Football – Scott Pearce 40
FMPA Register
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FMPA Conference 2019
29
Translating Strength Into Speed Mike McGurn
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LightForceÂŽ Helping People to GoPerform
ABOUT
Football Medicine & Performance Association 6A Cromwell Terrace, Gisburn Road, Barrowford, Lancashire, BB9 8PT T: 0333 456 7897 E: info@fmpa.co.uk W: www.fmpa.co.uk Chief Executive Officer Eamonn Salmon eamonn.salmon@fmpa.co.uk
Design Oporto Sports www.oportosports.com
Executive Administrator Lindsay Butler admin@fmpa.co.uk
Photography PA Images, FMPA, Getty Images, FIFA via Getty Images, Jussi Eskola
Administration Assistant Amie Hodgson amie.hodgson@fmpa.co.uk
Contributors Mike McGurn, Samuel P. Hills, Steve Barrett, Mark Russell, Paul Moloney MPharm, Scott Pearce, UEFA Direct
Project Manager Angela Walton angela.walton@fmpa.co.uk Marketing/Advertising Charles Whitney 0845 004 1040
Print Media Village www.media-village.co.uk
COVER IMAGE Fulham Head of Sports Science Alastair Harris. Manchester City v Fulham - Carabao Cup - Fourth Round - Etihad Stadium Tim Goode / EMPICS Sport / PA Images Football Medicine & Performance Association. All rights reserved. The views and opinions of contributors expressed in Football Medicine & Performance are their own and not necessarily of the FMPA Members, FMPA employees or of the association. No part of this publication may be reproduced or transmitted in any form or by any means, or stored in a retrieval system without prior permission except as permitted under the Copyright Designs Patents Act 1988. Application for permission for use of copyright material shall be made to FMPA. For permissions contact admin@fmpa.co.uk
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SPORTS PHARMACIST: WHAT THE ROLE PROVIDES... FEATURE / PAUL MOLONEY MPHARM, SOUTHAMPTON FOOTBALL CLUB
T
he role of a Pharmacist in the multi-disciplinary sports medical team is one that is expanding and has plenty of potential to develop in modern day football. Medicine management already has had its place in a lot of clubs, which ensures: Improved record keeping Provide policies on Medicine Management and Controlled Drugs etc. Compliant storage & security of medicines Ability to monitor and keep auditable stock levels of medicines Audit and review practice effectively Medicine Optimisation has existed in healthcare for many years, yet is an area still relatively untouched by sports treatment. Sports Medicine optimisation can be defined as: An approach that seeks to maximise the beneficial clinical outcomes for players from medicines with an emphasis on safety, governance, professional collaboration and player engagement.
Medicines optimisation differs from medicines management in a number of ways but most importantly it focuses on outcomes rather than process and systems. It is a player-focused approach to getting the best from investment in and use of medicines that requires a holistic approach. Medicines optimisation is about ensuring that the right players get the right choice of medicine, at the right time. By focusing on players needs and their experiences, the goal is to help players to: improve their outcomes in treating injuries; take their medicines correctly; avoid taking unnecessary medicines; reduce wastage of medicines; and improve medicines safety, whilst complying with the WADA code. With the huge development in sports science, analytics and studies into rehab/injury status, it appears the medicine optimisation aspects are often overlooked. If we are administering medication as part of a player’s regimen or treatment plan, why do we not include medication experts in the process? Through increased resource into medicine use audit, in depth research and awareness, medicine optimisation could form as much importance in Sports Medicine as it does in all other areas of medicine specialities. The other key important part of the role as sports pharmacist is ensuring the governance arrangements around medication management. Clubs should be adhering to the safe storage requirements of medication, policy implementation etc. and there is no current mechanism of monitoring this, which leaves players and staff vulnerable to potentially substandard care and also risk of harm. A big forward step would be for the governing
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bodies, FIFA, UEFA, FA, Premier League or EFL to start to look at a governance framework around player medical care that mirrors what currently exists in all other care settings eg. Care Quality Commission (CQC) organisation, which currently monitors registered private and state provided care settings. This would in turn force clubs to prioritise clinical governance, which would lead to more roles for experienced clinicians such as sports pharmacists to be employed in. Do clubs have the required reporting mechanisms for recording all medication they give to players? Are they using these systems to full capacity? The recent ‘jiffi bag’ incident in cycling has highlighted the poor record keeping that has been historically in place in sports medicine, leaving the sports clinicians wide open to anti-doping investigation and litigation claims against ‘duty of care’. Pharmacists in post can implement and monitor these processes to provide support and reassurance to their medical team. Litigation risk for clubs: There are cases recently in the US where American footballers who have retired are making litigation claims into the amount/ type of pain relief they received as a player. In 2017 over 1,800 retired football players took legal action against the NFL for ‘plying them with powerful painkillers and anti-inflammatory drugs’ which eventually led to long-term organ failure. The players and their representatives claimed the NFL allegedly violated federal law in administering medications to players. The ex-players reported suffering health maladies caused by abuse of painkillers. Although it may be argued that the physicality and the rigors of the NFL don’t match the football in this country, we do have players who are receiving on going treatments to match with our ever demanding fixture schedule. Is it only a matter of time that a player/ex player looks at a potential medication treatment related incident and goes in this direction….?
football medicine & performance
Anti-doping role The Pharmacist can also play a key role in anti-doping education (first team right down to academy players and staff), and ensure compliance with the WADA code reducing risks of players being banned (e.g. Samir Nasri). Expert advice on Therapeutic Use Exemptions, providing alternatives to banned treatment options and promoting clean sport. The barriers for clubs in utilising the sports pharmacist is often budget. Granted it is often hard to justify the budget on a position that is not directly linked to an ‘increase in performance’ or increasing revenue. However I feel the governance provided reducing the litigation risk and banned players, would justify a salaried pharmacist. Nutitrition Much of Sports nutrition crosses over into a Pharmacists knowledge base, e.g. monitoring blood results and implementing supplements and nutritional products, allowing the pharmacist to provide supplement and regimen/dietary advice with a strong clinical background/skillset.
Sports science support Most current Pharmacists have done a 4 year Master’s degree that included advanced human physiology, biochemistry (as well as lots more). They can contribute heavily to the sports science team if utilised in either the day to day analysis, or by using their clinical research skills in longer term projects.
Paul Moloney MPharm
Health, wellbeing and player liaison Pharmacists also work and have experience in wellbeing, mental health and have the “one to one” consultation skills to liaise with players, confidentially and professionally on lots of aspects of care that doctors do not always have the capacity for. With overseas travel to every corner of the world these days, vaccination, travel medication and prophylactic treatments are all elements ideally placed with a pharmacist as healthcare professionals.
I now work in football, as I have always had a passion for sports medicine and through persistence, I have found a department at Southampton FC that is forward thinking and aware of its duty of care and responsibility to its players. I’m sure the players themselves and clubs would also welcome the extra support and governance that a pharmacist ‘in situ’ can add in value to their care. People expect a high level of clinical governance in general healthcare, why are there no standards in place when players are receiving care at their clubs? With my other experiences in a healthcare, I have also been able to contribute in Southampton to other aspects of clinical governance to support an already superb sports medical department e.g. Infection control, clinical audit programme etc.
Clinical Governance Clinical audit, incident management, risk assessment, clinical policy review/ implementation, etc. These all skills that can be included in a sports pharmacist job description.
Having recently done a Leadership PGcert and a holding a CV which includes being Managing Director of my own pharmacy/company- I feel I also have the transferable skills, drive and business acumen needed to be successful in other football posts.
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It is hugely rewarding to see the response and feedback from our members to our endeavors to promote their practices and the FMPA in general. Clearly the FMPA Register is continuing to grow from strength to strength. However, it is important to keep your profile at the forefront of your audience’s minds, so at a time when they are in need of your services, they know exactly where to turn. We understand how hectic your schedules are but you can have peace of mind knowing that Amie and I are continually marketing and promoting you through a variety of channels to grassroots football. We’ve been coming up with some great new ideas this week to engage this audience even more - one of them being the development of a Medicine & Performance Hub which will be hosted on the FMPA Register pages, and contain an array of information for the grassroots community. Our talks continue with various organisations to help create a greater awareness of the Register and the support our members offer and our most recent exciting news to share is the new partnership which we have secured with Manchester FA. One of the most appealing aspects of our register is that members are happy to support the initiative to `give back to the game` by offering discount on fees to grassroots players. This is widely popular and will help to cement your position as the go-to practitioner in your area. Amie and I are always here to help our members, so please get in touch if there is anything you need.
Angela Walton Project Manager
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