Football Medic & Scientist Issue 5 by Football Medicine & Performance Association

FOOTBALL MEDIC & SCIENTIST

The official magazine of the League Medical Association

FOCUS ON SPORTS PSYCHOLOGY Is it the way forward?

WORKING WITH GAZZA Former Spurs and Luton Physio John Sheridan

PUTTING THEORY INTO PRACTICE With James Moore of Saracens Rugby Issue 5: Summer 2013

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Contents Welcome 4 A Message from the Office / Members News

EDITOR’S LETTER/JON REEVES

Editorials & Features

5 Touchline Rants / On the Couch

fter what must seem like only a couple of weeks away from the regular cut and thrust of competitive action, most of you will be back at the training ground and busily preparing for the 2013/14 campaign by the time you read this.

6 Where are they now? John Sheridan 8 Bodyflow & Perform at St.Georges Park

10 Case Study 11 Major Developments for LMedA / Legal Representation 12 LMedA Recruitment 13 CPD / Reflective Practice 15 Calls for Sports Scientists to Change Perceptions Janine Nelson 16 Catapult Player Tracking Technology with Perform Better

I hope that you’ve all been able to enjoy some respite and relaxation away from the allconsuming industry that is professional football and that the batteries are sufficiently re-charged for another busy season. With the summer providing many with a chance to reflect on their careers and their role within the game, this issue widens the focus away from football with a fascinating insight into sports psychology, considering the relationships between medical staff and sports psychologists, and also discovers what can be learned from rugby union in terms of player preparation and conditioning. There is also some useful advice for sports scientists and we catch up with two physios at either end of the career spectrum, featuring two Gascogines. Firstly, Kate Gascoigne; a young sports therapist making her way in the game at Carlisle United, and then the famous Paul ‘Gazza’ Gascogine, who former Tottenham Hotspur and Luton Town physio, John Sheridan, worked with during his time in football. You will also find out about further major developments for the LMedA, which Eamonn talks about in more detail in his message, details on legal representation and how to boost your recruitment chances through the organisation. All the best of luck for a productive and enjoyable pre-season,

Jon Reeves

18 Forward Thinking Marc Sagal 20 Bringing Partners On-Board 22 Elite Medical Services at Perform St.Georges Park 26 Putting Theory into Practice James Moore

Courses 29 Upcoming Courses at Perform St.Georges Park 30 HE Seminars

League Medical Association. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, or stored in a retreval 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 LMedA.

WHERE ARE THEY NOW? FEATURES/JOHN SHERIDAN Former physio John Sheridan talks about his 25 year career in professional football, including the most memorable moments, “always putting a player’s health before the game” and reveals what he’s up to now.

ohn, who worked for Luton Town, the first and last professional club he was employed by, Tottenham Hotspur and also spent some time with Chelsea, feels privileged to have been involved in a different era of football. “I enjoyed my time in the game as it allowed me to meet some fantastic people and to experience travelling around the world, but I have never regretted leaving football when I did. “I was privileged to work in an environment that I loved over a long period

6 6

of time, but I believe that I was lucky to be involved in a great game before the TV, media and money took over.” A keen footballer in his youth, injury initially curtailed John’s progress in the sport and sparked an interest in the medical side of the game, as he explained. “I suffered a serious hip injury in my youth which sadly prevented me from playing football again. I then developed a keen interest in sports medicine and was working in non-league football when David Pleat gave me a chance to work at Luton Town FC as Club Physiotherapist. I am indebted to him for the opportunity he gave me. “My career in football was exciting because surgical and medical techniques were changing, developing and becoming more scientific all the time. The use of arthroscope was cutting down the trauma to players’ joints - mainly the knee. It was a period of quite radical changes in sports medicine.” The developments have continued since

John has left the game, as he has noticed. “Football medicine and rehabilitation are more scientific, the best equipment that money can buy is available and there are more medical staff per player ratio. Those factors will all contribute to the benefit of footballers’ physical and mental wellbeing.” John has enjoyed some fantastic moments in the game, from relegation scraps with Luton Town to FA Cup Finals with Spurs. “My most memorable moments include the 1982/83 season when Raddy Antic scored a wonderful goal in the final league game of the season against Manchester City at Maine Road to give Luton Town a 1-0 win and avoid relegation. I still have a lot of friends from football, especially the Luton Town side promoted to Division One in 1980. “My two FA Cup Finals with Tottenham Hotspur were also extremely memorable. The 1976 final against Coventry City was a classic, although we were beaten, and 1991 against Nottingham Forest, whom we beat, but unfortunately Paul Gascoigne (pictured with John) received a terrible knee injury. “Paul worked so hard on his rehabilitation to overcome an injury which would have prevented most sportsmen playing again. He was a great player and a very nice man. “Another highlight was sitting down with a cup of coffee and having a chat with a great man, Sir Bobby Robson, at White Hart Lane. It was a long time after I had left working in professional football but it was because he had asked to meet me again. It made me feel extremely humble.” Taking all of these highlights into consideration, John remains most proud of a simple philosophy that he followed throughout his career. “I have always put the interest of a player’s health before the game and I would not knowingly allow a player to play with an injury which would ultimately damage their health long-term. This, I am proud of.” Since leaving football, John has continued to practice and whilst conceding that he would’ve been drawn to working at a top Premier League side, he remains happy, both professionally and personally. “I have been fortunate enough to have been able to enjoy and continue my career in physiotherapy in my own clinic by helping to improve the wellbeing of my patients, as I have never lost the love of treating people. “I do not miss the modern game at professional level. I still watch football at a local level and, of course, on television. I am lucky that both my sons played football and now my grandchildren and they have all given me many hours of enjoyment. “I would have relished the opportunity to work with a top Premier League side with all the advantages of the latest medical equipment and medical staff. However, I am very happy having time to spend with my family, grandchildren and friends, enjoying pastimes, including a good game of golf.” John Sheridan runs his private Physiotherapy and Sports Injury clinic from 24 Compton Road, Leagrave, Luton, LU4 9AZ.

psychology professionals take the time to seek out and apply evidence-based research and information.

Every athlete’s movement is unique SAGAL - SPORTS PSYCHOLOGIST justCOVER likeSTORY/MARC their fingerprint.

FORWARD THINKING

PUT YOUR BEST FOOT T FORWARD

One of the best pieces of advice I ever received was upon arrival at a new club; “Make sure you get on well with the physios and the kit man.” It was spot on and a reminder that effective work in my field, Sport Psychology, is impossible without these strong relationships.

Nonetheless, this isn’t an article about hroughout my career in professional 2. Be evidence-based what a great job the medical profession in football, I’ve learned a great deal While things are steadily improving, the football is doing, or to lament the challenges working alongside medical staff. sport psychology community still relies too that sport psychology has. My goal as a Whether it’s physicians, physios, heavily on guidance that is more experiential performance consultant is to find ways massage therapists or any of the other than evidence based. By evidence based, to make us better. My objective here is members of the medical team, the level of I mean an approach that incorporates the to do the same thing for us as individual competence, devotion and credibility is as following: practitioners in our respective professions high as I’ve seen anywhere. and as members of a support staff Oh, what the Sport Psychologist • Formulation of a well-constructed collectively devoted to helping the teams and (Mental Coach or Mental Skills Consultant hypothesis players we serve. – whatever the title du jour) would give for • Identification of articles and that same reputation and credibility… for research that attempt to answer this In pursuit of just this, what follows is a series that ‘necessary part of the support team’ hypothesis of suggestions for our respective professions. label. • Critical appraisal of the validity of Why is it that despite the progress the evidence collected Three Things Football Psychologists Can Do that has been made, both to the actual • Application of the evidence that is Better practice and integration of sport psychology found to be applicable and valid in professional football, there is still not the • Critical evaluation of the evidence 1. Use a Diagnosis, Prescription and kind of penetration and integration that applied and approach taken Evaluation Model most other performance related fields have? There is still a tendency in Sport Psychology I suspect the reason is twofold. First, One reason for this is that there is to rely on a mental skills approach. This the simple fact is that we are relative more, and dare I say better ongoing research outdated model emphasises mastery of newcomers to the party. Second, and most in sports medicine and rehab than in sport a wide range of psychological skills over a unfortunately, I believe that there are just psychology. Increasingly, sport psychology is problem - solution framework. Since648 players too many poor practitioners. There may be www.dorsavi.com | mblackburn@dorsavi.com | +44 (0)777 5628 leveraging the growing and compelling body either present with a specific issue or desire other contributing factors to our diminished of research in Neuroscience (I love this work) improvement against an identified objective, brand, but, for me, it is clear that we still but even this research has its doubters (with the best approach is one that responds have much to learn before progress will be some recent research showing surprisingly directly to these targets. made. low statistical power). It’s vital that sport

Understand movement with

Enhance decision making on return to play Help athletes achieve & maintain peak performance Tailor training programs Reduce injury & guide rehabilitation

18 18

www.dorsavi.com

3. Be There and Work Tirelessly I’ve seen first-hand the devotion and tireless work ethic of most medical staff. They are often the first ones to arrive and the last to leave. This dedication isn’t lost on me or on the players who are able to count on both the physical presence and directive nature of the football medic. There simply is no substitute to being in the trenches day in and day out. Camaraderie and trust gets built during the tough times. When you are around virtually all the time, the opportunity to forge strong connections is maximised. Football Psychologists often struggle here, with several causes lurking, including that many of us are either hired part-time or tasked with working both with the first team and academy squads. This reduces important face time. Perhaps just as relevant is the fact that many football psychologists are not ‘wanted’ in the dressing rooms, benches or around training. This robs us of invaluable opportunities to connect with players (and other staff) at the most important moments. Recognising that there should absolutely be opportunities to meet privately with a team’s sport psych person, my suggestion is that clubs must do a better job providing private space for these meetings to take place, but also that they be more open to the regular and ongoing physical presence of the football psychologist in and around the players and staff - wherever they are. Three Things Football Medical Professionals Can Do Better 1. Encourage Open Communication The strong relationships that develop between footballers and medical professionals are wonderful. But in the politically loaded world of football, this closeness can often blur the lines between a friendship and a professional relationship. Because of the often tenuous relationships between the players and coaching staff, the medical staff can often profoundly influence how issues are interpreted and dealt with. Medical staff can use their power for good or evil - helping to ‘keep the peace’ or sowing the seeds of discontent. I’ve seen first hand how undermining it can be when medical staff stoke these fires. I’ve seen disenchanted medical staff criticise coaches, management or ownership in remarkably insidious ways. And while ‘going native’ is completely understandable given the partisan, absurd and sometimes-corrupt world of English football, my suggestion is that strong alignment and solidarity serves the club best. And just so you don’t get too holierthan-thou an impression of me, I’ve been guilty myself of this kind of undermining behaviour – something I am trying to be much more mindful of. Where there are real concerns about how the manager or club is handling issues that intersect with medical professionals’ responsibilities, my guidance is that concerns get raised directly with the responsible party

rather than back-channelled or gossiped about. There is a saying in consulting that you can’t be afraid to lose the business. The problem is that most of us really are ‘afraid’ to lose our job. While some managers and players are fortunate enough to manage the economic repercussions of being sacked or voluntarily leaving a post, most of us are dependent on our job to feed our family. I’ve not ever taken on a full-time position with a club, instead opting to bring each on amongst a roster of clients. And though it can be challenging to balance needs, it has allowed me not to be overreliant on any one source of income and has helped me be less afraid to walk away from ‘bad’ clients, and to be a ‘truth teller’ to the organisations I work with. 2. Look for Ways to be Flexible and Creative I’ve seen boredom and routine set in at some point at every football club I’ve worked with. This is a by-product of a number of factors. At successful clubs, there can be an “if it ain’t broke, don’t fix it” mentality which encourages sticking with the status quo. Managers and medical staff also get used to doing things a certain way and get comfortable with an approach that they are confident in. Knowing when it is time to mix things up is not always easy. My sense is that there is more room for creativity within the medical team. I’m not talking about breaking with tried and true methods of rehab or injury recovery but rather an approach that seeks to provide additional stimulation through purposeful variety in strength and conditioning models, rehab programs and rest and recovery strategies. ‘Players get bored easily’ is one of the top complaints I hear. At one club I was at, this long-standing issue amongst the players finally made its way to the manager – who actually listened and vowed to make some

changes. Small adjustments were made to not just the technical and tactical training but also to warm-ups, fitness and strength programs and a number of other areas. These weren’t radical changes mind you; even small modifications go a long way. Challenge yourself to keep things fresh. 3. Help the Sport Psychologist We need your assistance. I’ve been fortunate enough to develop some very close relationships with medical staff. I’ve also had some contentious ones. There is no doubt which ones have been more advantageous to the players and to the club as a whole. Given the closeness between players and medical staff, it’s understandable that there will be a strong desire to preserve and protect them. Confidence, focus and drive are lynchpins of performance. Motivation, persistence and the ability to perform well under pressure are immeasurably important. I believe there are times where medical staff unwittingly play the role of player psychologist. As understandable as this is given the closeness that develops, I think it’s important to monitor boundaries. Ultimately we are all pushing for the same thing with the people that we work with and for. As the Latin saying goes -Anima sana in corpore sano -- A sound mind in a sound body.

Marc Sagal is Managing Partner for the Winning Mind, whose clients have included Manchester City FC, US Army Recruiting, J.P. Morgan, New York Rangers, Atlanta Braves, the Chris Evert Tennis Academy and the United States Marine Corps. For more information visit www.winningmind.com

FOOTBALL MEDIC & SCIENTIST | 19

Football Medic & Scientist Gisburn Road, Barrowford, Lancashire BB9 8PT Telephone 01282 614505 Email info@lmeda.co.uk Web www.lmeda.co.uk Editor Jon Reeves Chief Executive Officer Eamonn Salmon Senior Administrator Lindsay McGlynn Administrator Nichola Holly IT Francis Joseph Design Soar Media - www.soarmedia.co.uk Marketing/Advertising Charles Whitney - 0845 004 1040 Published by Buxton Press Limited Photography LMedA, Soar Photo

FOOTBALL MEDIC & SCIENTIST | 3

A MESSAGE FROM THE OFFICE WELCOME/EAMONN SALMON In many ways this is one of the most exciting times we have had within LMedA.

brand new logo, and fresh new artwork and design for our magazine have set in place a definitive brand for us that will become instantly recognisable throughout sport and across all disciplines within it. What we started out with was all well and good at the time, but as a company develops concepts change and what looked ok at the beginning can sometimes become outdated. Finally reaching a definitive concept and design that you know will stick is a great moment and one to be proud of. That’s not to say there won’t be one or two further tweaks here and there - there most certainly will. But, on the whole, we have arrived in terms of branding. The logo, by the way, can now be used on members’ stationery and will be underscored by the word member. Anyone wishing to use this can request a copy from the office via email. The same concept is also available to companies and business partners

that we engage with, who will display our logo with ‘Business Club’ or ‘Partner’ attached. Just as exciting is the development of the new website. We have seen a proof of the framework and it is much more up-todate and mobile friendly. There is also a more commercial feel to the site, particularly with the LMedA Recruitment page and the Conferences/Courses section. I think we have in some ways surpassed other sites that you might be familiar within football/sport, so in this respect at least we might now be leading the way! Commercially we are also growing. Companies are now contacting us to come on board as partners and advertisers which means they can clearly see we are the pathway to reach their target audience. This commercial viability is crucial to LMedA not just as a revenue stream, but in partnering clubs and members with companies that have products that add real value to our industry.

At the start of this year the business plan was dominated by the word ‘consolidation’. This is precisely what we are now doing. There’s no point in keeping adding bits of benefits here and there. We have enough in place already - the best legal team and support possible; we are at the forefront of recruitment (see article on page 12). Reflective practice CPD is now in place; our own magazine; medico legal services; career support; CV and contract appraisal options, and the best database around. As a community, as well, we have consolidated and together can begin to identify needs and steer our particular industry accordingly. And though this is an exciting time, I would have to say that even more major developments are in the pipeline. Watch this space.

Eamonn Salmon CEO League Medical Association

FURTHER LEGAL SUCCESS FOR LMedA AND SLATER GORDON

MedA’ s lawyers have scored a major triumph yet again in representing three members who lost their positions at a League Two club over 12 months ago. Financial constraints at clubs at this level means they will often do what they can to avoid any compensation to staff. Though this has been a long battle, our lawyers have stuck to the task determinedly with concerned parties describing them as “Brilliant to have on side.” and “I really needed their experience to sort this out,” being two of the comments received at LMedA

MEMBERS NEWS 4

The result was that a significant pay-out has been finally received by one member and guaranteed settlements have been agreed on behalf of the other two. An article we once came across said… “The Managers have the LMA and the LMA will not go away.” Neither, it seems, will we

Touchline sid!e Pete Rant hs by Pitc

MEDICAL STAFF AGENTS

very week, I receive emails and CV’s from medical staff trying to get jobs within football. There is a bit of a merrygo-round for medical staff in the top teams as well. I often hear that there is a closed shop that is difficult for inexperienced staff to get into. Over the years, several player agents have said to me that they’ll ‘find me a new job’… none of them ever have! Maybe the time is right for an agent to think about us for a change? Since we are entrusted with caring for the biggest assets that every club has – surely clubs would

want to be in the ‘transfer market’ for the best medical staff. We could even command transfer fees! Having someone else doing the work of sending off CV’s and making contact with the influential club personnel would seem an attractive prospect to medical staff… Then again – would you want to give away 10% of your wage to someone else? Now I see why agents don’t bother with medical staff contracts…

10% of not a lot is…

ON THE COUCH... FEATURES/KATE GASCOIGNE 6. How’s the job going at the moment? The job is amazing. I love every minute of it, working within a professional sports team is a pretty exciting place to be. All the staff, coaches and players have been really supportive throughout my first season, especially my boss, head physiotherapist Neil Dalton. I’m really lucky to work with and be able to learn from someone who is so knowledgeable and experienced.

1. Profession Academy and Reserve Team Sports Therapist, Carlisle United FC 2. Where did you train? What course? When? After leaving school I did a Sports degree at Durham University. Following my graduation in 2009 I spent two winter seasons working as a ski instructor in the Aosta Valley in Italy. Once I returned home after my second season, I decided that I wanted to enhance my degree and pursue a career in the treatment and rehabilitation of sports injuries. In October 2011, I began my MSc in Sports Therapy at Teesside University. 3. How did you get into football? I was really lucky to get the chance to undertake some shadowing hours at Carlisle United as part of my placement for my Masters degree, where I was able to assist the head physio with the treatment and rehabilitation of the players. At the end of the 2011/2012 season I was delighted to be offered a full-time position at the club.

7. What’s your long-term career plan? Long-term I hope to still be involved in professional sport and to continue to build on and enhance my knowledge and skills. Every day is a new experience and there is always something new to learn 4. Talk us through your career to date. I’m still really new to the profession having just completed my first full season at Carlisle United. One of the highlights of my first season has to be the youth team getting through to the national final of the Youth Alliance Cup for the first time in the club’s history, To be able to be part of that experience was fantastic.

8. Dream job? If I had been asked this question two years ago when I started my masters degree I would have said that my dream job would have been to work in professional sport, therefore I’d have to say I’m living the dream!

FOOTBALL MEDIC & SCIENTIST | 5

be involved in a great game before the TV, media and money took over.” A keen footballer in his youth, injury initially curtailed John’s progress in the sport and sparked an interest in the medical side of the game, as he explained. “I suffered a serious hip injury in my youth which sadly prevented me from playing football again. I then developed a keen interest in sports medicine and was working in non-league football when David Pleat gave me a chance to work at Luton Town FC as Club Physiotherapist. I am indebted to him for the opportunity he gave me. “My career in football was exciting because surgical and medical techniques were changing, developing and becoming more scientific all the time. The use of arthroscope was cutting down the trauma to players’ joints - mainly the knee. It was a period of quite radical change in sports medicine.” The developments have continued since John has left the game, as he has noticed. “Football medicine and rehabilitation

are more scientific, the best equipment that money can buy is available and there are more medical staff per player ratio. Those factors will all contribute to the benefit of footballers’ physical and mental wellbeing.” John has enjoyed some fantastic moments in the game, from relegation scraps with Luton Town to FA Cup Finals with Spurs. “My most memorable moments include the 1982/83 season when Raddy Antic scored a wonderful goal in the final league game of the season against Manchester City at Maine Road to give Luton Town a 1-0 win and avoid relegation. I still have a lot of friends from football, especially the Luton Town side promoted to Division One in 1980. “My two FA Cup Finals with Tottenham Hotspur were also extremely memorable. The 1976 final against Coventry City was a classic, although we were beaten, and 1991 against Nottingham Forest, whom we beat, but unfortunately Paul Gascoigne (pictured with John) received a terrible knee injury. “Paul worked so hard on his rehabilitation to overcome an injury which would have prevented most sportsmen playing again. He was a great player and a very nice man. “Another highlight was sitting down with a cup of coffee and having a chat with a great man, Sir Bobby Robson, at White Hart Lane. It was a long time after I had left working in professional football but he had asked to meet me again. It made me feel extremely humble.” Taking all of these highlights into consideration, John remains most proud of a simple philosophy that he followed throughout his career. “I have always put the interest of a player’s health before the game and I would not knowingly allow a player to play with an injury which would ultimately damage their health long-term. This, I am proud of.” Since leaving football, John has continued to practice and whilst conceding that he would’ve been drawn to working at a top Premier League side, he remains happy, both professionally and personally. “I have been fortunate enough to have been able to enjoy and continue my career in physiotherapy in my own clinic by helping to improve the wellbeing of my patients, as I have never lost the love of treating people. “I do not miss the modern game at professional level. I still watch football at a local level and, of course, on television. I am lucky that both my sons played football and now my grandchildren, and they have all given me many hours of enjoyment. “I would have relished the opportunity to work with a top Premier League side with all the advantages of the latest medical equipment and medical staff. However, I am very happy having time to spend with my family, grandchildren and friends, enjoying pastimes, including a good game of golf.” John Sheridan runs his private Physiotherapy and Sports Injury clinic from 24 Compton Road, Leagrave, Luton, LU4 9AZ. This feature was kindly produced with assistance from Gavin Blackwell MCSP.

Every athleteâ&#x20AC;&#x2122;s movement is unique just like their fingerprint.

PUT YOUR BEST FOOT FORWARD Understand movement with Enhance decision making on return to play Help athletes achieve & maintain peak performance Tailor training programs Reduce injury & guide rehabilitation www.dorsavi.com | mblackburn@dorsavi.com | +44 (0)777 648 5628

www.dorsavi.com

BODYFLOW & PERFORM AT ST. GEORGE’S PARK

ADVERTORIAL/BODYFLOW Bodyflow recovery technology is now being used by Perform at St. George’s Park as part of their cutting edge sports medicine and rehabilitation service. With its ability to help reduce swelling via increased lymphatic uptake and to enhance bloodflow, Bodyflow’s clinical and portable therapy devices will have a large scope for assisting not only elite athletes in their recovery from

injury and surgical procedures, but also those looking to recover proactively and enhance their overall health and fitness. Opened in summer 2012, Perform at St. George’s Park is a pioneering facility not just in the UK, but globally, with its doctorled Sports Medicine department providing support to athletes and clients from all over the world.

Having previously used Bodyflow to assist Premier League footballers in their recovery from injury and for pro-active recovery, following intense training and competition, Steve Kemp – Elite Football Physiotherapist at Spire Perform, played a key role in ensuring Bodyflow was made available to those receiving treatment at St. George’s Park.

“Having used Bodyflow extensively in the past and being aware of its benefits for lymphatic drainage for sports performance recovery and injury recovery, I was delighted to continue this relationship with Perform at St. George’s Park. With the number of professional footballers attending Perform for periods of intensive rehabilitation, the Bodyflow is a key part of our management of inflammation in injury and recovery post sessions. Whilst the players are residential for their rehabilitation, this allows us to use the system a number of times a day to optimise the benefits it may have.” Steve Kemp / Elite Football Physiotherapist / Perform at St. Georges Park

The collaboration follows on from a successful year for Bodyflow in 2012 with the Australian recovery technology playing a significant role in the recovery of a number of Olympic athletes in both the build up to and during the London Olympic Games.

Joe Di Santo, CEO, Bodyflow International, said: “With the network of Bodyflow customers growing worldwide it is great to be a part of such a cutting edge facility here in the UK. Having been a part of the recovery strategies of a number of Olympic

teams at the London 2012 Games, to now be a part of Perform at St. George’s Park is another significant step for Bodyflow in the UK market and we look forward to helping their staff and patients alike, gain benefits from using the Bodyflow Therapy.”

A CASE STUDY SHOWING THAT MATCH CONTEXT AND OPPOSITION TACTICS MAY GOVERN MATCH PHYSICAL ACTIVITY AND RECOVERY RESPONSES IN PROFESSIONAL FOOTBALL PLAYERS Ryland Morgans, Morgan D Williams, David Adams & Richard Mullen Liverpool Football Club, Anfield, Liverpool, England, UK, L4 0TH University of South Wales, Division of Sport, Health and Exercise, Upper Glyntaff, Pontypridd, Wales, UK. CF37 4AT. Introduction: During a regular English Championship League (ECL) season, matches are often scheduled within 72 hours of one another. The impact of short turn-around between matches on subsequent match performance is unknown, since no study has examined footballers from the ECL. If restoration between matches is incomplete there may be a greater likelihood of impaired performance caused by residual fatigue in subsequent matches (Ekstrand, Walden, & Hägglund, 2004; Hägglund, Walden, Bahr, & Ekstrand, 2005). Several studies have examined the physical impact of fixture congestion, where a number of matches are played with a short recovery period. Carling, Le Gall, and Dupont (2011) studied the acute impact of eight French League 1 matches in 26 days and found that the overall total running distance, and that covered at lower intensity, varied across matches. High intensity running performance remained stable throughout the period of fixture congestion and this was explained by squad rotation and post-match recovery activities. Similarly, Lago-Peñas, Rey, LagoBallesteros, Casáis and Domìnguez (2011) reported that professional Spanish footballers coped with fixture congestion that often included two matches in three days, since no differences in the distances covered at various speeds during matches were observed. Lago-Peñas et al.’s results, on the other hand, may suggest that the elite football players’ distance covered at various speeds is governed by contextual factors such as differences in possession and opposition tactics. When considered as isolated matchplay data, this information may be limited for many reasons. A more comprehensive assessment with the addition of salivary cortisol (sCort) and neuromuscular markers of fatigue may provide a detailed insight into restoration and subsequent match preparation and may better inform decisions regarding restoration modalities, player readiness and possibly team selection. The endocrine status of players during the post-match restoration period may include measures of sCort previously reported (Cormack, Newton, & McGuigan, 2008; McLellan, Lovell, & Gass, 2011) and may suggest disturbances in the overall anabolic-catabolic balance of the player (Cunniffe et al., 2010). To date, no study has investigated the acute impact of 72 hour recovery between

two matches during an ECL competitive season. Purpose: Report physical and technical data from an ECL team, including total distance; sprint; high intensity distances; and total team pass frequency and the change in running distances at the various speeds from first to second half. It would be expected, if fatigue was present in match two, that the difference between halves would be larger compared to match one. In addition, to ascertain if restoration was complete following the first match, sCort and neuromuscular responses were obtained spanning the week. Methods: Nine professional footballers (age = 25.7 ± 3.4yrs, stature = 1.70 ± 0.06m, and mass = 78.1 ± 8.0 kg) were monitored daily during a competitive week. Both matches were filmed using a multi-camera computerised tracking system (Amisco Pro®, Nice, France) to report physical and technical match data during competition. Amisco Pro® Stadium Manager was then used to analyze key physical and technical performance parameters during both competitive matches. Physical parameters included: total time on pitch (min), total distance (m), total sprint distance (m), and total high intensity distance (m). The technical parameters were team possession and team total frequency of all passes (total number of all passes). All saliva and CMJ1 data, except for immediately post-match, were collected between 0900 and 1000 hours on all nonmatch days. Saliva was collected from all participants within 15 minutes post-match; between 1645 and 1700 hours for match one and 2135 and 2150 hours for match two. The two matches played and their context differed: Match 1 was televised and the opponents were positioned higher and aiming for promotion, out of possession and played a ‘high press’, as opposed to a low defensive strategy; a more typical approach in the CL. Measures included: Amisco data, countermovement jump performed on a forceplate; salivary testosterone and cortisol concentrations. Results: The ‘high press’ style adopted by the opponents in Match 1 limited ball possession (48%) compared to Match 2 (62%). In addition, passes were lower in Match 1 (32 ± 5) compared to Match 2 (63 ± 5). Physical performance was no different. However, the opponent’s style of play in Match 1 did force the three attackers to

make a greater number of sprints and high intensity runs covering further distances. Additionally, post-match responses were different between matches. Only Match 1 elicited changes from baseline measures where cortisol concentration was elevated immediately post-match and jump measures were suppressed up to 48 hours post-Match 1. Conclusions: This study shows that an ECL team did not experience impaired physical performance in a second match after 48 hours of restoration, indicating that the team coped with short turn-around. Support for the need of team rotations when competing in two consecutive home ECL matches within 72 hours was not established. Endocrine and neuromuscular restoration was found to vary between matches and is a reflection of the dynamic nature of ECL match-play. Such fluctuations should be investigated to reveal the impact of contextual features of match-play, such as possession and pass count, which differed greatly between the two matches. A better understanding of such contextual features of football matches may inform coaches when planning their team’s style of play and match preparation. Many of our members are currently involved in MSc and PhD education programmes. We are happy to publish papers and /or abstracts with the intention of sparking interest and receiving feedback, which will be useful to the author. If any members have an article of interest, whether through education or other, please let us know and we will gladly put it into print for you.

MAJORDEVELOPMENTS FOR LMedA A s most of you have noticed the LMedA have recently undertaken a re-branding exercise, which includes a new logo and the impending launch of a new, more interactive website. The mobile concept of the web design will allow you to access the site from your smartphone more easily than before, and this is clearly the way forward for social media and communication. The Logo is much stronger and stands out alongside others, which is important commercially. It also fits with the magazine, website design and artwork that have become our standard We know from your feedback that two of the most important and most popular aspects of our site are the job section and the CPD/education facilities we offer. But, before we come on to these, we need to highlight just why you need to be a member of LMedA!

Pictured above: New front page design for www.LMedA.co.uk

LEGAL REPRESENTATION ‘An exceptional work environment requires exceptional representation’, has long been our mantra. And, perhaps, nowhere ‘is a more exceptional place to work’ than professional football. To demonstrate the point a little clearer, let’s just take a look at the physiotherapists and their organisational body. The Chartered Society of Physiotherapy (CSP) has upwards of 45,000 members working in all aspects of medical care. As far back as the 1950’s, it was recognised that those practitioners working in private practice required additional and ‘exceptional’ support since their work environment was clinically more precarious and practitioners were seen to be at greater risk of lawsuits and claims by working in isolation and as first contact practitioners. That the Organisation of Chartered Physiotherapists in Practice (OCPPP) emerged was testimony to this belief. But we are working in a much more difficult, demanding and precarious environment than most of our colleagues in Private Practice.

Scrutiny, risk of high cost malpractice claims, working beyond the scope of practice, clinical autonomy, pressure to undertake reflective practice, the need to be 100% right in diagnosis and treatment, and the risk of major consequences for all concerned if something goes wrong, puts untold pressure on everyone in the game, resulting in risks that are high and serious. Surely if anyone needs an additional support network it is those working in top flight football? Those physiotherapists going into private practice almost all join the OCPPP, now known as Physio First, automatically and are encouraged to do so by the CSP. This shows the way forward for those working in professional football who need to take stock and choose a similar path by joining LMedA. Why? Because we understand the work environment you are in and have the knowledge and experience to address issues that you will face. For those unfortunate enough to lose their job, we have the best lawyers in the game with a vast knowledge of the industry and its machinations. Our medico-legal network is growing rapidly, ensuring you will have access to

those who can best represent you and, more importantly, understand your working environment as well. Indemnity cover remains an issue for us all and the pressures “from within the game” are a very real concern. Alongside the legal support facilities we now have in place we also have... • The support and guidance of a high profile committee • An established head office and staff • A quarterly magazine publication • A bi-monthly e-news facility keeping members informed • Commercial and business partnerships • Discounts on educational courses and services • Developing contacts within the game • The expanding jobsite facility; ‘LMedA Recruitment’ • Online education delivery pathway • Contract appraisal and advice This represents great value and support for all members across the disciplines, leading us nicely on to the latest developments, with the jobsite and education facilities... j

FOOTBALL MEDIC & SCIENTIST | 11

LMedA RECRUITMENT This is definitely one of the most popular sections of the LMedA website and rightly so. Furthering your career and being on the ball with access to the latest job opportunities is probably utmost in everyone’s minds.

hough it is very difficult to guarantee that every post is placed on our site, that is our aim. The advertisers – namely the lead physiotherapists/sport scientists – are very likely to be members and we think it makes sense to support your organisation by listing jobs with us. Yes money is tight –unbelievably – and there are free sites out there, but we most definitely have the best database to recruit from, listing current and ex-colleagues, plus those working hard to get into the game as our members. As a source for recruitment, this is a rich seam to be targeting. In developing this facility we have now expanded on our services to establish ‘LMedA Recruitment’, which offers three modes of advertising for recruitment... 1. 2.

A straightforward job advert with email alert to members as currently exists. Job placement with an option to filter applicants, via LMedA, to specific criteria, for example: qualifications, experience, years qualified. A search and find option for clubs that do not wish to advertise a post but have an interest in recruiting through LMedA’s database.

These types of arrangements are common place in the job market and give options that recruiters are familiar with and now wish to use. The third option requires some initial development but it is the way forward if we are to keep up with current trends. It is unheard of these days to see advertisements for top positions, such as managers, CEO`s and coaches. Rather, such positions are discreetly appointed using those in the know to source candidates. Such a procedure is a major departure for medical/Science recruitment in football and alien to most of us. But we can see the benefits here and the LMedA is in the unique position of having an outstanding database from which to recruit from. In short, we want to ensure our members are the source for future positions and establishing a procedure of recruitment such as this, will appeal not only to recruiters in this country but to others who are developing their game in the far East, Asia and beyond. So, in order to position yourself for enquiries that arise, what do you need to do? Simple... Within the new website will be an opportunity to upload and edit your CV and any further details you think appropriate. This will have some standard fields to fill in which will highlight the criteria that clubs might request. Members meeting the criteria

will surface and we will then contact you to see if you are happy to be put forward for the position. In the past, clubs have used agencies to source staff, most notably Manchester City advertising for nine positions last year. What such agencies don`t have is access to a database such as ours. In establishing this system we are making sure LMedA members are at the forefront of the jobs market. Following the launch of the new website, we will be having a major drive to notify managers, club secretaries and HR departments of this facility and will work hard to ensure all aspects of our recruitment services become established practice. No need for agents yet, but one or two of our members have been headhunted in the past with compensation going in the opposite direction!

NOTE: ALL DETAILS WILL BE HELD IN STRICT CONFIDENCE AND NO CLUB OR INDIVIDUAL OUTSIDE THE LMedA OFFICE WILL HAVE KNOWLEDGE OF YOUR DETAILS BEING POSTED ON THIS SECTION. NO CV WILL BE FORWARDED FOR A POSITION WITHOUT PRIOR AUTHORISATION FROM THE MEMBER.

CPD/REFLECTIVE PRACTICE One of our initial aims was always to be involved with CPD/Education but not to replicate what was being delivered by other established bodies.

t took some time to figure out the FA’s educational profile, especially with the move to St. George’s Park and to see “what was out there” in terms of courses and conferences. But, having studied the arena, it was clear that very little was being delivered online. Perfect! Since we know how tied up our members are, we figured that the “least they had to do to engage with CPD the better.” An online delivery of some kind was the answer. In setting the ball rolling, the process by which we embarked on this was very simple. The British Journal of Sports Medicine (BJSM) was out there, but who had the time to register and then patrol each edition looking for relevant material of interest? So this is what we do now on your behalf.

“This is an excellent resource from LMedA.” Championship Club Doctor “This is truly brilliant.” - Head Physio, Premier League BUT FROM NOW ON THIS WILL BECOME RECOGNISED READING MATERIAL FOR REFLECTIVE PRACTICE!

Having registered LMedA with the BJSM we are able to collate and deliver such articles to all our members via a simple email. Twentyeight articles have been distributed and a self-endorsed certificate has been sent to all members.

Each set of articles we send you over the 2013/14 season will be accompanied by a reflective practice procedure format that you can use. Engage with articles, fill in the form attached and place in your portfolio as legitimate CPD evidence. Now this is most definitely an excellent resource and, of course, you never know when you might need it!

CALLS FOR SPORT SCIENTISTS TO CHANGE PERCEPTIONS

FEATURES/JANINE NELSON

new report examining the relevance of sports science is calling for more user-friendly research, specifically for coaches.

‘Sport Science relevance and application: Perceptions of UK coaches’, which was published in the Journal of Sports Sciences, claims many football and other sports coaches are turned off by academic jargon and would like research papers to be easier to read. The study looked at perceptions of sport science from coaches across four different sports (football, rugby league, curling and judo) drawn evenly from novice, developmental and elite groups. There was significant variability in the extent to which sport science was considered relevant and to whom, although this was not strongly related to coaching levels. Researchers found that availability of sports science support is on the increase but funding to provide it is still relatively new for many sports, and it is most often aimed at elite level coaches and teams. Many sports coaches felt that that transfer of sport science knowledge to them was poor. They admitted to preferring other sources of information over sport science, such as coaching conferences and talking to other coaches, and blamed a lack of time to read journals and limited access to sport scientists. The research showed coaches are more likely to go to sports periodicals and multidisciplinary journals using lay-language, and concluded that better communication was needed. Perception

There was a wide variety of perceptions regarding the applicability and usefulness of sport science. Some coaches felt it was only relevant to elite coaches and athletes. Others felt it wasn’t appropriate for younger age groups. A further group felt it was “useful and applicable to every level” claiming it had an important role for younger athletes. Need for Education Better communication by sports scientists would help significantly in engaging coaches in the short term, claims the report. One coach told researchers: “Coaches may need to be helped to understand and see the relevance and application of sports science. Indeed, coach education courses may usefully facilitate a coach’s ability to utilise information and distinguish between what is applicable and non-applicable within any given context.” A football development coach added: “I think there’s a place for it, it’s just a matter of how you use it and actually understanding it and what happens to them.” Be a Team Player The report suggests sport scientists need to become better integrated with the medical staff – “fit in with the team” – though this is currently difficult because a lack of funding means the majority don’t have enough time with coaches and athletes, which has also had a detrimental effect. There is still a long way to go to achieve a widespread integration of sport science. One of the top priorities is to develop effective working relationships between coaches and sport scientists. The report says: “There needs to be regular opportunities for dialogue between coaches and sport scientists to help them

target needs effectively and apply specialist knowledge in a way which is relevant and effective across the pathway. This requires coaches to have a good enough knowledge of sport science to help guide this process and help bridge the gap.” Mind Your Language Language in reports and research papers needs to be user-friendly, say researchers, with academic terminology kept to a minimum. One suggestion from those coaches interviewed was to offer another less technical version of the research findings specific to certain contexts and sports. However, “it works both ways and coaches also need to meet sport scientists half way and learn some of the jargon that has to stay”, claims the report. The report concludes that national governing bodies need to develop a clear strategic direction for the integration of sports scientists and also for the way information is disseminated. It added: “There needs to be an appreciation that much of the sport science information is often not directly applicable to specific sports, and more needs to be done by academics to attempt to target relevant questions.” Revised criteria by which universities are awarded public funding based on their research ‘quality’ will help, and the ability for academics and institutions to demonstrate the ‘real world’ impact of their work is increasingly becoming a priority.

SPORTS SCIENTISTS - MAKE SURE YOU’RE COVERED. Register with the LMedA

FOOTBALL MEDIC & SCIENTIST | 15

THE CATAPULT PLAYER TRACKING TECHNOLOGY IS REVOLUTIONISING FOOTBALL ADVERTORIAL/PERFORM BETTER

ince the introduction of GPS/ athlete tracking devices over eight years ago, sport science and medical staff have utilised the technology in a number of ways to integrate it within their current monitoring processes. With quantification of external loads possible now through these devices, practitioners and researchers have been investigating its application in return to play strategies, reducing risk of injuries and determining when players are susceptible to injuries. Catapult technology is being used by club physios to monitor players during their rehab programmes. The accelerometers allow physios to look at individualised traces in the three axis and therefore monitor if there are changes in players’ loading patterns due to pain/injury and then monitor their progress back to baseline values and return to training/play.

So how does a technology used by all Premiership Football and Rugby Clubs, monitor players? Modern tracking devices are sampling GPS at 10hz (10 times a second) which allows them to accurately track fine athletic movements in all sports. GPS is only one of the inertial sensors within the units to monitor players’ loads in training. Catapult units also include 3D Accelerometers sampling at 100hz, Gyroscopes at 100hz, Magnetometers at 30hz and heart rate monitoring. Each of these has their own specific use within monitoring athletic performance. However, the integration of all three can have a more accurate and powerful message for coaches, medics and scientists on how to interpret an individual’s training loads. For example, accelerometers will measure all accelerations, decelerations, turns, jumps, sprints, tackles etc, while using algorithms to accumulate all this information

into one number (Catapult’s Player Load). Anecdotally, practitioners have illustrated the use of player load within their monitoring programmes to assess the alterations in loading patterns to predict injury and assess when normal loading efficiency returns to a player as well, through analysis of the individual planes. Catapult devices also include 3D Gyroscopes sampling at 100hz - these sensors measure body angle in three planes - vertical, lateral and rotational (roll, pitch and yaw). In sports such as rugby the Gyroscopes are used to help measure tackles by measuring an impact through the accelerometers followed by a change of body orientation of the player going to ground. They will also measure the tackle time, i.e. time until the player is back on his feet again and back in the game. The devices also collect heart rate data from Polar HR belts to monitor the internal load players are experiencing in a session.

Each sensor has increasing value to monitor our players/athletes during training and match play when possible. However, current advances to integrate the inertial sensors into one platform now allows practitioners and medics to quantify the load associated with changes of direction, jump height, when

term monitoring will hopefully support the reduction in injuries, with accurate data interpretation. With the availability of this data instantaneously while players are training through a wireless receiver in to the Catapult software, physios and sport scientists can

also be exported into Sportscode Video Analysis system and the physical data coded along with other events from a game - in addition it is possible to import video into the software and play raw Catapult data alongside video footage. Nearly half of Premier League and Championship Football

players are in free running and the angle/ velocity at which players are accelerating/ decelerating at within any environment thanks to the newly released IMA (Inertial Movement Analysis). Where GPS data is restricted to outdoors, the IMA enables information to be collected indoors, allowing medics/sport scientists to collate data on rehabilitating players within any domain they are based in, regardless of what stage of rehab they are in. This will allow consistent and accurate monitoring of players throughout the entire rehab programme, whereas long-

assess the loadings of their players live, to further aid the injury prevention and control of loading during training programmes, the software allows staff to set up performance targets for players and the ‘live’ screen will show if players have achieved these targets. The latest units will have a vibrating alarm included to feedback to players if they have achieved the planned velocity, load, heart rate, distance etc in a rehab/ training session. The software can be used on IoS devices such as iPads, iPhones etc, to allow coaches to view data while taking sessions. Data from the Catapult system can

Teams and an increasing number of League 1 teams are using Catapult Technology. In addition, half of the English Premiership and Rabo 12 Rugby teams have invested in the Catapult system and it is currently being used by the British and Irish Lions on their tour to Australia. “The Catapult system is at the core of our performance monitoring operation at West Bromwich Albion FC. It allows us to better understand the balance between internal and external stresses on players.” - Chris Barnes, Head Sports Scientist, West Bromwich Albion FC “The accuracy of the data the Catapult system provides allows us to gain detailed feedback on our players. This feedback is used to provide objective load monitoring, along with helping organise future session content. The technology maximises individual playing performance in training and helps reach peak performance in games.” - Bryce Cavanagh, Head of Fitness, Munster Rugby Club

For further information on the Catapult system please contact Perform Better Ltd on 01926 813916 or sales@performbetter.co.uk or visit www performbetter.co.uk

FOOTBALL MEDIC & SCIENTIST | 17

FORWARD THINKING COVER STORY/MARC SAGAL - SPORTS PSYCHOLOGIST One of the best pieces of advice I ever received was upon arrival at a new club; “Make sure you get on well with the physios and the kit man.” It was spot on and a reminder that effective work in my field, Sport Psychology, is impossible without these strong relationships.

hroughout my career in professional football, I’ve learned a great deal working alongside medical staff. Whether it’s physicians, physios, massage therapists or any of the other members of the medical team, the level of competence, devotion and credibility is as high as I’ve seen anywhere. Oh, what the Sport Psychologist (Mental Coach or Mental Skills Consultant – whatever the title du jour) would give for that same reputation and credibility… for that ‘necessary part of the support team’ label. Why is it that despite the progress that has been made, both to the actual practice and integration of sport psychology in professional football, there is still not the kind of penetration and integration that most other performance related fields have? I suspect the reason is twofold. First, the simple fact is that we are relative newcomers to the party. Second, and most unfortunately, I believe that there are just too many poor practitioners. There may be other contributing factors to our diminished brand, but, for me, it is clear that we still have much to learn before progress will be made.

Nonetheless, this isn’t an article about what a great job the medical profession in football is doing, or to lament the challenges that sport psychology has. My goal as a performance consultant is to find ways to make us better. My objective here is to do the same thing for us as individual practitioners in our respective professions and as members of a support staff collectively devoted to helping the teams and players we serve. In pursuit of just this, what follows is a series of suggestions for our respective professions. Three Things Football Psychologists Can Do Better 1. Use a Diagnosis, Prescription and Evaluation Model There is still a tendency in Sport Psychology to rely on a mental skills approach. This outdated model emphasises mastery of a wide range of psychological skills over a problem - solution framework. Since players either present with a specific issue or desire improvement against an identified objective, the best approach is one that responds directly to these targets.

2. Be evidence-based While things are steadily improving, the sport psychology community still relies too heavily on guidance that is more experiential than evidence based. By evidence based, I mean an approach that incorporates the following: • Formulation of a well-constructed hypothesis • Identification of articles and research that attempt to answer this hypothesis • Critical appraisal of the validity of the evidence collected • Application of the evidence that is found to be applicable and valid • Critical evaluation of the evidence applied and approach taken One reason for this is that there is more, and dare I say better, ongoing research in sports medicine and rehab than in sport psychology. Increasingly, sport psychology is leveraging the growing and compelling body of research in Neuroscience (I love this work) but even this research has its doubters (with some recent research showing surprisingly low statistical power). It’s vital that sport

psychology professionals take the time to seek out and apply evidence-based research and information. 3. Be There and Work Tirelessly I’ve seen first-hand the devotion and tireless work ethic of most medical staff. They are often the first ones to arrive and the last to leave. This dedication isn’t lost on me or on the players who are able to count on both the physical presence and directive nature of the football medic. There simply is no substitute for being in the trenches day in and day out. Camaraderie and trust gets built during the tough times. When you are around virtually all the time, the opportunity to forge strong connections is maximised. Football Psychologists often struggle here, with several causes lurking, including that many of us are either hired part-time or tasked with working both with the first team and academy squads. This reduces important face time. Perhaps just as relevant is the fact that many football psychologists are not ‘wanted’ in the dressing rooms, benches or around training. This robs us of invaluable opportunities to connect with players (and other staff) at the most important moments. Recognising that there should absolutely be opportunities to meet privately with a team’s sport psych person, my suggestion is that clubs must do a better job providing private space for these meetings to take place, but also that they be more open to the regular and ongoing physical presence of the football psychologist in and around the players and staff - wherever they are. Three Things Football Medical Professionals Can Do Better 1. Encourage Open Communication The strong relationships that develop between footballers and medical professionals are wonderful. But in the politically loaded world of football, this closeness can often blur the lines between a friendship and a professional relationship. Because of the often tenuous relationships between the players and coaching staff, the medical staff can often profoundly influence how issues are interpreted and dealt with. Medical staff can use their power for good or evil - helping to ‘keep the peace’ or sowing the seeds of discontent. I’ve seen first hand how undermining it can be when medical staff stoke these fires. I’ve seen disenchanted medical staff criticise coaches, management or ownership in remarkably insidious ways. And while ‘going native’ is completely understandable given the partisan, absurd and sometimes-corrupt world of English football, my suggestion is that strong alignment and solidarity serves the club best. And just so you don’t get too holierthan-thou an impression of me, I’ve been guilty myself of this kind of undermining behaviour – something I am trying to be much more mindful of. Where there are real concerns about how the manager or club is handling issues that intersect with medical professionals’ responsibilities, my guidance is that concerns get raised directly with the responsible party

rather than back-channelled or gossiped about. There is a saying in consulting that you can’t be afraid to lose the business. The problem is that most of us really are ‘afraid’ to lose our job. While some managers and players are fortunate enough to manage the economic repercussions of being sacked or voluntarily leaving a post, most of us are dependent on our job to feed our family. I’ve not ever taken on a full-time position with a club, instead opting to bring each on amongst a roster of clients. And though it can be challenging to balance needs, it has allowed me not to be overreliant on any one source of income and has helped me be less afraid to walk away from ‘bad’ clients, and to be a ‘truth teller’ to the organisations I work with. 2. Look for Ways to be Flexible and Creative I’ve seen boredom and routine set in at some point at every football club I’ve worked with. This is a by-product of a number of factors. At successful clubs, there can be an “if it ain’t broke, don’t fix it” mentality which encourages sticking with the status quo. Managers and medical staff also get used to doing things a certain way and get comfortable with an approach that they are confident in. Knowing when it is time to mix things up is not always easy. My sense is that there is more room for creativity within the medical team. I’m not talking about breaking with tried and true methods of rehab or injury recovery, but rather an approach that seeks to provide additional stimulation through purposeful variety in strength and conditioning models, rehab programs and rest and recovery strategies. ‘Players get bored easily’ is one of the top complaints I hear. At one club I was at, this long-standing issue amongst the players finally made its way to the manager – who

actually listened and vowed to make some changes. Small adjustments were made to not just the technical and tactical training but also to warm-ups, fitness and strength programs and a number of other areas. These weren’t radical changes mind you; even small modifications go a long way. Challenge yourself to keep things fresh. 3. Help the Sport Psychologist We need your assistance. I’ve been fortunate enough to develop some very close relationships with medical staff. I’ve also had some contentious ones. There is no doubt which ones have been more advantageous to the players and to the club as a whole. Given the closeness between players and medical staff, it’s understandable that there will be a strong desire to preserve and protect them. Confidence, focus and drive are lynchpins of performance. Motivation, persistence and the ability to perform well under pressure are immeasurably important. I believe there are times where medical staff unwittingly play the role of player psychologist. As understandable as this is given the closeness that develops, I think it’s important to monitor boundaries. Ultimately we are all pushing for the same thing with the people that we work with and for. As the Latin saying goes -Anima sana in corpore sano -- A sound mind in a sound body.

FOOTBALL MEDIC & SCIENTIST | 19

BRINGING PARTNERS ON-BOARD FEATURES/BUSINESS PARTNERSHIPS LMedA continues to attract interest from companies who are keen to forge partnerships and connect with members. This is great news for all concerned and establishes us as a credible and commercially viable entity within football and elite sport. FourFourTwo

LMedA are proud to announce a working partnership FourFourTwo. We will work with the world-renowned FourFourTwo Magazine through the Performance section of the publication and on performance.fourfourtwo.com FourFourTwo Performance will liaise with LMedA members for content and input from the professional game, with both organisations aiming to share relevant written and video content for their respective publications, as well as attending events and sharing respective branding. FourFourTwo Editor, David Hall, added: “The partnership is an important step in the progression of FourFourTwo Performance. Players of all levels are constantly looking for more in-depth knowledge to give them that competitive edge. We feel that the quality of expertise we’re tapping into at the LMedA will be invaluable to users and readers of FourFourTwo Performance.” www.fourfourtwo.com

Sports Interactive / Football Manager

The LMedA have confirmed an agreement to work with Sports Interactive, makers of the world-renowned computer simulation game, Football Manager. The LMedA and Sports Interactive have agreed to embark on a long-term project designed to improve the way that player injuries and fitness levels are treated within the game. Miles Jacobson, Sports Interactive Studio Director, added: “Our access to the LMedA’s unparalleled experience and expertise will help to ensure that future versions of Football Manager will continue to give our fans the ‘real world’ experience they crave.” Football Manager, which is generally regarded as the most realistic football management game, is produced by Sports Interactive and published by SEGA. www.sigames.com

Bodyflow

Bodyflow® Therapy was invented in the mid-nineties by Laurent Pujol a French Osteopath who had an interest in sports recovery. Bodyflow recovery technology is now being used by Perform at St. George’s Park as part of their cutting edge sports medicine and rehabilitation service. With its ability to help reduce swelling via increased lymphatic uptake and to enhance bloodflow, Bodyflow’s clinical and portable therapy devices will have a large scope for assisting not only elite athletes in their recovery from injury and surgical procedures, but also those looking to recover pro-actively and enhance their overall health and fitness. www.bodyflowinternational.com

Algeos

Algeos, who specialise in podiatry and footcare, supply and manufacture the widest range of appliance making materials available anywhere in the world, including foams, carbon fibre composites, metal items and plastics. With our own in-house cutting, splitting, laminating, printing and sewing machines on site, we are able to manufacture and convert materials to almost any specification. www.algeos.com

UK Sports

UK Sports Products works closely with manufacturers worldwide to offer the latest performance and recovery products for the elite athlete. Our aim is to enhance performance and recovery, focusing on the following areas; Cryotherapy, Hydrotherapy, Rehabilitation and Hyperbaric Therapy. www.uksportsproducts.com

Game Ready

The Game Ready System combines Intermittent Compression with Circumferential Cold Therapy in one fully adjustable and easy-to-use application. Developed by scientists and doctors using proprietary NASA space suit technology, the Game Ready System simultaneously delivers both adjustable cold therapy and intermittent compression, making it easy to apply the two most difficult-to-manage aspects of the RICE (Rest, Ice, Compression, Elevation) regime. www.gameready.co.uk

Polar heart rate

monitoring and gPS in football

Polar monitors assess fitness, adaption to training and performance based on playersâ&#x20AC;&#x2122; personal information such as age, heart rate, HRmax and VO2max. Using this information Polar has developed SMART COACHING to provide accurate feedback and help clubs improve both player and team fitness. Fitness Test Indicates how your fitness is developing, by giving a resting VO2max score. Run the test every 4-6 weeks to show accurate graphical changes in fitness. Training Load Shows your recovery status and how hard you worked. ZoneOptimizer Ensures you always train at the right intensity, taking into account when the heart rate is elevated and you may not be recovered, to help prevent overtraining. Recovery Test Helps you assess your personal training status using heart rate variability.

RC3 GPS

In addition, monitoring your performance with both heart rate and GPS feedback provides more detailed information on player performance. Polar GPS tracks your route and provides feedback on speed, distance and pace. Polar validate their Smart Coaching features to ensure that the science behind our monitors is credible and adds real value to training in professional sport. For further information or a demonstration please contact Liz Shenton, Performance & Training Manager on 07870 640666 or elizabeth.shenton@polar.com See the full range of hear t rate monitors and GPS at www.polar.com/uk-en

Pictured above: Burton Albion manager, Gary Rowett

ELITE MEDICAL SERVICES AT PERFORM ST. GEORGE’S PARK ADVERTORIAL/PERFORM

ntensive residential rehabilitation is one of the key offerings of Perform at St. George’s Park. Due to the high standard of medical departments in the UK, outsourcing rehabilitation for elite athletes has not often been considered in this country. However, you do not have to go far into Europe to find that this is a regular occurrence. The benefits of a new environment, a second opinion from clinicians who are experienced with professional athletes and a focused goal based rehabilitation programme has already shown to be a very positive experience for many professional players at St. George’s Park. Over 50 players from the Premier League, Football league, Turkish league and from Rugby Premier leagues have already attended Perform for residential rehabilitation; all have rated their experience as excellent and would like to return for further treatment with 75% having already done so. Players have attended as part of the PFA funded intensive rehab scheme and others have self-funded or applied for funding through their medical insurers. The rehabilitation begins with a comprehensive assessment day. This starts with an appointment with our Clinical Director, Dr Charlotte Cowie. Dr Cowie will carry out an extensive previous medical history and review all images and specialist reports. Following this the athlete then

joins our sport science team for further specific testing - dependant on the needs –of the athlete. These tests will vary from anthropometric assessment (bodyfat and muscle mass assessment) Biomechanical and function (FMS, Y balance, video analysis, pressure analysis biodex balance testing), Neuromuscular and power (isokinetic, jump testing field testing) Cardiovascular and metabolic (VO2 max testing, spirometry) and lab and sampling (blood and urine testing). This information is then passed to the physiotherapy team, led by Steve Kemp, to devise a specific treatment plan. The Strength and conditioning team will also work closely with the medical team to provide a strength and power development plan, and address all needs for cardiovascular work. Athletes will work with the physio team on their individualised rehab during day two and day four, including some cardiovascular sessions in our Strength & Conditioning gym. The rehab sessions will vary dependant on the athlete. Acute players may carry out their work in the altitude chamber, in the pool or on the bike. Players further on in their rehab may work in the sand pit or out on the sprint hill, whilst the players in late stage rehab will work out on the football pitch going through our return to play criteria. After these sessions the strength session will take place in the weights room where a specific

programme is prescribed for each player to improve power and strength. Day three is a regeneration day. Athletes will still focus on their movement dysfunctions and treatment with the physio team, as well as undergoing a reviewing progress with the Clinical Director. The afternoon is spent in the hydrotherapy facility where they will either recover in the pool or by using the contrast therapy. They will also work with our soft tissue therapists to aid recovery for the final day of rehab. The players’ nutrition is catered for during their stay, with protein and energy drinks and health snacks supplied throughout the day. At the end of day four, all players will be given a de-brief. Together, athletes will discuss the week, watch videos of the movement analysis assessment and of the exercises they have been working on. The player will leave with a flash drive of their exercises and videos and a comprehensive report will be sent to the players club. This will give the player direction and hopefully an empowerment to address their movement issues which are predisposing them to future injury. Players should then return three to four weeks later to be reassessed and retested to give them objective feedback of progress. Steve Kemp, Elite Physiotherapist

Elite Player Services at Perform St. Georgeâ&#x20AC;&#x2122;s Park

Perform works with footballers, physiotherapists and clubs of all levels. We combine elite medical expertise and leading technologies, enabling your team to perform at their very best. We offer a range of elite services;

Residential Rehabilitation

Facility Hire Cardiac Screening Training Camps Pre-signing Medicals

01283 576333 www.spireperform.com

FOOTBALL MEDIC & SCIENTIST | 23

the injury prevention specialists

The future of movement assessment Injury prevention solutions for football

The Performance Matrix Platform For athletes: to improve movement efficiency, optimise musculoskeletal health, reduce injury risk and enhance performance.

Screening and Report An innovative movement assessment system producing a report which details risk areas and assets to inform training. Scoring and comparison system for monitoring progress.

Training Modules Access to a comprehensive programme of eLearning modules and workshops.

Exercise Catalogue Create a quick and easy online athlete focused training programme based on the screen report.

+44(0) 1243 786555

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Available Wraps

ames completed his Masters in Musculoskeletal Physiotherapy at the internationally recognised Queensland University, and has also completed post graduate studies in applied biomechanics and strength & conditioning. He was the medical team leader for Gloucestershire County Cricket for two years, and was previously the National Clinical Lead Physiotherapist for UK Athletics, building towards London 2012. He also worked as a consultant Physiotherapist for England RFU in preparation for the Rugby World Cup in 2011. James teaches nationally and internationally and is well known for his course ‘The Sporting Hip & Groin’ as well as lecturing on ‘Hamstring Injuries’ and ‘The Grumbling Groin’. Football Medic and Scientist met up with James at the Saracens training ground in St Albans at the end of the rugby season: James, can you start by telling our readers, who or what inspired you to embark on a career in sport? Sport has always been a passion of mine since I was very young, I played all sports, but I was better suited to rugby and track and field. Unfortunately, I suffered two major knee injuries, one at 13 and the other at 18. Through this insight into physiotherapy I pursued this career and have always stayed in touch with sport throughout my development. I have moved around sports as I felt that it was the best way to develop all round skills, taking the principles of one sport and applying them to another. Tell us about your current role at Saracens? My role at Saracens is varied from direct hands on, looking at clinical standards and excellence, professional governance and management of the medical and therapy team, to having input on development of our new training facility. I have a great team behind me, especially the likes of my clinical lead Physio, Joe Collins, that allow me to do all this work efficiently. The senior management team at Saracens are also very supportive.

PUTTING THE THEORY INTO PRACTICE FEATURES/JAMES MOORE

In association with

James Moore is a highly experienced musculoskeletal physiotherapist and is currently Head of Medical Services at Saracens rugby club. In addition to private clinical work he has worked throughout the UK, USA and Australia with professional athletes, ranging from Premiership Rugby, American Football, Major League Baseball, Body Builders and Athletics.

How was your first full season at Saracens? In a word, amazing! The rapport and energy at the club, combined with hard work makes for a really enjoyable environment where you are stimulated to achieve and push boundaries, we have been really successful in that. As a team, we have managed to reduce the injury rate by approximately 30%, and work really well with the S&C team to look at improving performance for each player. Was it a big blow to miss out on the Aviva Premiership Final? (Saracens lost to Northampton in the play-off semi-final having finished top of the League at the end of the regular season) Massive, we were all shell-shocked. I could not sleep that night, I could not get the thought out of my head as to why we lost and kept analysing the game. Taking nothing away from Northampton, they came with some serious intensity. It proves that despite how successful a season we have had you still have to win the big games, and we were competing on two fronts with the European

semi-finals, where we had lost two key players to unusual mechanisms of injury. That said, we will be a lot stronger for it next year. Outside of rugby, what else occupies your time? That is easy, I have a one-year-old daughter, and every day is amazing with her, so any spare time I have is spent with her. I still love to teach as you are constantly challenged and it stimulates new thought, and occasionally, I will consult on complex groin injuries that have been recalcitrant What has been the biggest change from your previous role as National Clinical Lead Physiotherapist for UK Athletics? That role was very clinical with an emphasis on dealing with a handful of athletes, where in rugby I have more managerial and administrative responsibilities, but also I am largely responsible for the whole squad. In Athletics you train for nine months, then compete for three, where the only really important event is the major championships, so you need to peak for a specific period. Whereas, in rugby, it is continuous with the next game being the biggest game and consistency is the key throughout the season, but again peaking for the end of season play-offs. What typical types of injuries have you and your medical team been dealing with this season? We have had a lot of ankle, foot injuries, that have resulted in lots of time lost relatively. However, we have also had some great wins with getting two plantar fascia ruptures back in five and seven weeks respectively. Then there is the usual shoulders and knee, which we have managed really well, with Grade II SLAP injuries back in three weeks, and very little time lost through knee injuries.

With the opening of Saracens brand new Allianz Park and its artificial playing surface earlier this year, have you had to make any changes to how the players train? Great question, the surface is certainly quicker, so the same amount of work that you would do on a normal field will result in relatively more load on the artificial surface. The key difference is we take a little longer to warm the players up and we slow the initial speed of the session with a gradual ramp up to full intensity. Interestingly, we have not noted any more injuries due to the surface

despite previous fears from outsiders. We have noticed a slight change in reaction in different joints and regions, but this has been managed well, with no real impact on time lost through injury. Has the new playing surface resulted in any unexpected benefits to the players? Definitely, the game is quicker with less re-set scrums so the ball is in play for longer, which makes for a faster and more exciting game, this has allowed the players to play a more free-flowing style rugby, which is evident in that we averaged four tries a game in our first four games on the new surface. You are well known for your teaching (particularly Sporting Hip & Groin courses) - do you have any plans to develop this side of your career? My priority is my commitment to Saracens, so I plan to slightly modify the format, and do some more evening lectures breaking the two-day course up into â&#x20AC;&#x153;bite sizeâ&#x20AC;? chunks. Also, I will split the course into a hip specific day, and a groin specific day where we cover assessment, treatment, rehabilitation and management for each region. What do you think professional football can learn from professional rugby in terms of player preparation and conditioning? In rugby there is a big emphasis on upper body and lower body strength (in the broadest use of the word), which is understandable due to the nature of the sport. This certainly needs to be balanced with football, as it has very different demands, but we have certainly noticed a correlation between leg strength in total through the kinetic chain and around specific joints and injury incidence. Furthermore the balance between leg strength and upper body has reduced our spinal incidence, with Saracens barely losing any time due to spinal overload. The key for me, not necessarily directed at football, is the communication and integration between medical S&C and coaching and how you balance the load of the player with the demands of the sport, while still working on their weaknesses, be it skill based or physically based. Certainly on discussions with colleagues of mine in Premier League football, at clubs like Arsenal, Liverpool and Fulham, they find that this is certainly a big factor.

Is there anything you think professional rugby can learn from professional football? Definitely, football is such a high pressured environment, where team work and decision making is paramount, the Premier League clubs are innovative and forward thinking and thus will start to use data and information early with their planning, their statistical analysis is second to none, and the integration of their sports science teams all working together is something that in time, and with greater resources in rugby, we will be able to do. I try and meet up regularly with colleagues of mine in the Premier League to discuss all matters around how we can do our jobs better, so I think the constant exchange of ideas between sports can have a great impact. Where do you see yourself in five years? There is so much to do at Saracens RFC, my focus is here at present. We plan to move into a new training facility in the next two years, to then build upon that and help to establish Saracens as a force in European Rugby. We also have great academic opportunities, where we will be able to research and publish some of our innovative work. Any tips for aspiring sports rehab professionals? Easy, understand your basics well, have a focus on anatomy, biomechanics, physiology, especially your exercise physiology, but also your pathophysiology, and then your rehab parameters. This will help your differential diagnosis, without which you will not have a specific treatment strategy. If you can get really good at each of the building blocks, treating patients and elite sports people will take care of itself. Your perfect job? One day I would like the challenge of being a head of performance. With my background in S&C, biomechanics and medicine, I believe I can offer the skills to help to develop all departments. Saracens has given me a great opportunity to develop my philosophy further and grow as an individual.

James Moore is one of the tutors that represent HE (Health Education) Seminars. For more information visit

www.heseminars.com

FOOTBALL MEDIC & SCIENTIST | 27

Fast and effective pain relief for sport professionals

Ice Power with scientiďŹ cally proven effect

algeos.com/icepower Contact us:

call us: +44 (0)151 448 1228 email us: sales@algeos.com visit us: algeos.com

REHABILITATION COURSES AT PERFORM, ST.GEORGE’S PARK Provider/Venue

Date

6th July 9.00am – 5.00pm

20th - 21st July 9.00am – 5.00pm

7th August 1.00pm8.00pm

7th- 8th September 9.00am – 5.00pm

11th September 2.00pm – 9.00pm

Course

One-day introduction to using SPORTTAPE 1 day course

Athletic Shoulder 2 day course

Kinnective Instrument Assisted Soft Tissue Mobilisation Course. Level 1 Afternoon / evening course

JEMS Movement ART (Analysis, Rehabilitation and Training) Part 1 2 day course

Fortius Clinic – Knee Masterclass Afternoon / evening course

Tutors

Details

Cost

Patrick Harding and / or Rob Madden

This is an intensive one day course which covers theory briefly with a heavy emphasis on practical. Within the theory section you will gain a general understanding about the benefits of kinesiology tape, the product make up and the basic techniques for muscle, ligament, fascia and mechanical correction applications. This will then be put in to practise.

£99 +VAT

Ben Ashworth

This new course has been created to combine systematic methods of assessment and functional rehabilitation of the shoulder, and is applicable to the elite sport and outpatient environments

Donna Strachan

Kent Fyrth, Jackie Zaslona

Andy Williams, Sam Church Mary jones

14th - 15th September 9.00am – 5.00pm

Myofascial Release level 1. 2 day course

John Annan

The objective of the Kinnective IASTM courses is to teach Instrument Assisted Soft Tissue Mobilisation techniques. As a therapist with an injured patient or a trainer who’s client needs more range of movement through various areas of their body this technique will enhance your current clinical practice. Includes tea and coffee. Taking into account their patient’s functional movement, occupation or sport, JEMS practitioners use specific tests and techniques to help their patients to take control of their situation, develop greater self-awareness and improve their physical functioning with accurate, progressive rehabilitation programmes. The masterclasses are a series of lectures from world leading specialists in the field of Sport Medicine. These will include short lectures, presentations and practical workshops. This is a two day seminar with the aim of providing a broad base introduction to the myofascial approaches to treatment The aim of the course is to develop the participant’s sense of touch and specifically how the connective tissues can change with the application of gentle pressure.

Contact

T +44 (0) 3301 222331 info@sporttape.co.uk

Ken Joy T +44 (0)1202 568898. £240

info@hesemiars.com www.heseminars.com/ courses

Perform Support T +44 (0)1283 576333 support@spireperform.com £175 www. spireperform.com/stgeorges-park/trainingcourses

Kate Lancey-Smith kvlprojects@googlemail. com TBC 01283 576333 info@jemsmovement.com

Louise Kingham T +44 (0) 1283 576235 £100

FALearningSupport@ TheFA.com www.eventspace.thefa. com/FALearning/ participant/s.aspx

T +44 (0)208 7875962 £237

info@physiouk.co.uk www.physiouk.co.uk/ courses.php

FOOTBALL MEDIC & SCIENTIST | 29

www.performbetter.co.uk

â&#x20AC;&#x153;

Specialists in Performance Sport

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performbetteruk

@performbetteruk

performbetteruk

Perform Better Limited 4 & 5 Warwick House Business Park Southam, Warwickshire CV47 2PT

Tel: 01926 813916 Fax: 01926 812469 Email: sales@performbetter.co.uk