Football Medic & Scientist Summer 2014

FOOTBALL MEDIC & SCIENTIST

The official magazine of the Football Medical Association

FMA INAUGURAL CONFERENCE Review and photo special

THE FMA NAME CHANGE Feedback so far points to bright future

ON THE FACE OF IT

Philip Earl gives his view on facial injuries Issue 9: Summer 2014

Contents Welcome 4 Members News

Editorials & Features 7 Touchline Rants 8 Wisdom & Teeth 11 On the Face Of It 14 FMA Conference Review 18 Sponsor Thank You 20 Chaplain and the Physio 25 An Accident Waiting to Happen 26 A Day to Remember 29 Getting to Know: Mark Nile 30 On the Couch: Lee Taylor

WELCOME/EAMONN SALMON There is no question, this conference was among the best I have ever attended. Now it might sound like that is what I am bound to say as I, my staff and others organised it, but it is one thing to plan an event like this and quite another for everything to play out absolutely perfectly.

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bit of luck no doubt has a part, but the sheer effort we all put in was clearly evident over the conference weekend and the huge success of the event was just reward for all those who contributed to the planning and delivery. A big thank you to everyone concerned.

Back in September last year, I met up with Dave Fevre in Leicester. The idea of hosting a Conference on FA Cup Final day and the format for the presentations was decided and after scouring around the region until late evening time, looking at venues, the Radisson Blu East Midlands Airport Hotel won hands down in terms of location and presence. That was it; announce the event, keep fingers crossed and work hard to make this the best ever.

Roll forward seven months and, having legislated for 150 delegates and representatives we had exactly that number as the Conference got underway. It was fantastic to see everyone meeting up with colleagues old and new in an environment so different to that during the season. The atmosphere was buzzing from the start. Having attended many conferences over the years I always figured that any event needs just one or two ‘exceptional’ touches to make it memorable and stand out. On reflection it seems that this one had at least half a dozen!

• A 5-star hotel venue with great location • End of season gathering for ‘teams’ of staff and old boys reunion • Top class speakers and fantastic format – including Les Parry who had us in hysterics!

• Thrilling FA Cup Final action • Champagne reception • Awards Ceremony • Fred Street, Rob Jenkins and Norman Pilgrim meeting after 25 years All fantastic and exceptional ingredients that made this such a success, not forgetting the delegates of course, many of whom have supported the FMA from the start and have continued that support by attending the Conference. At the end of the day they are the most important ingredient of all.

From the feedback we have received, there is no question that this is now set to become an annual event – as indeed it should be. Getting everyone together will allow the FMA to represent all medical and science personnel in Professional Football, moving forward as a united entity and determining our own pathway within the game.

Eamonn Salmon CEO Football Medical Association

Football Medic & Scientist, Gisburn Road, Barrowford, Lancashire BB9 8PT Tel 03334 567897 Email info@footballmedic.co.uk Web www.footballmedic.co.uk

Cover Image Thiago Silva pictured wearing a protective face mask.

Mike Egerton/PA Images Football 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 FMA.

Editorial & Design

Oporto Sports - www.oportosports.com

Chief Executive Officer

Eamonn Salmon

Senior Administrator

Lindsay McGlynn

Administrator

Nichola Holly

IT

Francis Joseph

Contributors

Gavin Blackwell, Owen Maddocks, Gary Webster, Robert Robinson, Philip Earl, Stuart Wood, Dr Mark Waller

Published by

Buxton Press Limited

Photography

FMA, PA Images

FOOTBALL MEDIC & SCIENTIST | 3

MEMBERS’ NEWS

SHEARER & ADKINS SUPPORT FMA

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ormer England striker, Alan Shearer and current Reading manager and former physio, Nigel Adkins, have both lent their support to the Football Medical Association, in the form of endorsements.

Alan Shearer said: “Medicine and Science has grown enormously during my time as a professional footballer and is now a key element in the modern game.

“As a player we rely on their expertise to prevent and manage our injuries and it is vital that they are given the support

necessary to develop and enhance their skills.

“I offer the Football Medical Association my full backing and support in their endeavours to keep our medical and science colleagues at the very top of their game.”

Royals’ boss, Nigel Adkins, added: “Having spent ten years as a physiotherapist at Scunthorpe United, I have an appreciation of the roles required. Also having been a professional footballer at Tranmere Rovers and Wigan Athletic, I have experienced time in the rehabilitation department and

appreciate the advice and care provided by the medical team.

“As Manager at Southampton and Reading Football Clubs, I have integrated, appreciated and understood the major contribution the medical department has regarding the availability of players to the team.

“I am happy to give my support to the Football Medical Association and the guidance it provides to the physiotherapists, sports scientists and medical practitioners working in professional football.”

SOCCEREX ANNOUNCE FMA PARTNERSHIP

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s we all know, football never stops and plans are already in motion as we look forward to this coming season. One of the new projects the FMA are going to be working on is our partnership with Soccerex and supporting their Global Convention, which takes place on 6-10 September in Manchester.

The partnership will see the FMA heavily involved in the conference programme, exhibition and also providing a number of opportunities for our members, like yourself, to be involved in the event.

As part of the agreement with Soccerex, each club registered with the FMA receives two complimentary passes to attend the Global Convention.

With performance playing a significant part of the Convention, there are a number of exciting developments we would like to share with you.

• Four-time Olympic gold medallist Michael Johnson, who will be delivering a speech on his elite performance and training, as well his company Michael Johnson Performance (MJP).

• Johnson will also be holding a private

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workshop specifically for club and league representatives; to discuss the variety of services MJP is involved with.

• FMA will be hosting a special workshop featuring a selection of club doctors, sport scientists, physiotherapists and conditioning coaches who will share their experiences on the evolution of performance within the game and how crucial it is to modern day football.

We would encourage you to take up your two complimentary passes to the Convention today by getting in touch with Soccerex on enquiry@soccerex.com using the code FMAMember.

Other guest speakers include: • FIFA President Joseph Blatter • FIFA Vice-President Jim Boyce • British Olympic Association Chairman Lord Sebastian Coe • RFU CEO Ian Ritchie • England and Manchester United legend Sir Bobby Charlton Here’s to a prosperous 2014/2015 football season!

NAME CHANGE POINTS TO BRIGHT FUTURE M

any of you will have noticed the change of name for the association.

Certainly delegates attending this year’s conference were taken by surprise at seeing ‘Football Medical Association Inaugural Conference’ displayed prominently at the venue entrance. Yet that same surprise was met with approval as it was instantly recognised that the new title says exactly who we are and what we are about.

While LMedA set us on a path, we are in a very different place now to when we started four years ago and the move to ‘FMA’ was roundly applauded.

The new title has given us fresh impetus going forward and as an abbreviation, FMA sits kindly alongside the PFA and the LMA which is exactly where we want to be.

Commercially this title is much more amenable to companies wanting to associate with football medicine and thus certainly sparked interest from potential sponsors.

Finally, the ‘FMA’ is much more memorable as a title. Heard once, it sticks, which is essential in developing a brand and who knows we may yet become a household name!

The FMA official website (www. footballmedic.co.uk) can be accessed via searching for ‘Football Medical Association’ now as well as LMedA. In due course, the site will respond to FMA. Please note that our email addresses have changed to: info@footballmedic.co.uk eamonn@footballmedic.co.uk lindsay@footballmedic.co.uk

NEW APPOINTMENTS AT FMA M att Salmon has been appointed student liaison officer for the FMA. Any issues pertaining to student membership or enquiries please contact Matt at matt@footballmedic.co.uk Carolyn Clay has been appointed grass roots liaison officer for the FMA. Any enquiries regarding medical and science provision at local levels please contact Carolyn at carolyn@footballmedic.co.uk

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NEW APP UNDER DEVELOPMENT T

he FMA has been developing its own app in partnership with software company Spontly.

Twelve months on from the launch our mobile friendly website, the app will continue to drive the association forward in terms of member engagement.

The new FMA Spontly powered app is a full social platform medium that brings the FMA community together. The app enables Football Medical Association members – and the wider sporting community – to receive the latest FMA news and events delivered directly to their mobile device enabling them to keep in touch with everything that’s going on at FMA and within sports medicine. It allows users to uniquely interact with each other and the FMA, and will bring a new element to live events and information delivery.

All upcoming FMA events and news of interest are listed within the app which is the catalyst for user engagement. The apps allow users to bookmark upcoming events and check-in to those that are live. Users will be able to view events from a new perspective

and take part in events and discussions by publishing their own photos, posts, thoughts and comments to the stream. This will give all members the chance to get the most out of events and pull the community together into one coherent, focused place. Whether a user is sat at home, watching a live event or is directly involved in the event, the FMA app gives every user a voice and a platform to be more involved in the community network.

Using the Spontly platform gives the FMA direct access to members and the whole sports fraternity but more importantly enables a direct communication channel to the FMA and the most powerful knowledge database existent in the game – each other.

Russell Scott, Head of Operations at Spontly, said: “The Spontly platform is quickly becoming the primary channel for sports clubs, associations, venues, and event organisations around the UK, improving communications, bringing communities together and allowing users to feel more engaged.

“We are delighted that the FMA have chosen to help communicate with their

community more effectively and I look forward to seeing how the community interacts with each other and the FMA. I’m sure this will develop into a fantastic source of knowledge advice for all FMA members and sports clinicians.”

The FMA app will be free to download.

Watch out for further details.

SWIRE RETIRES AFTER YEARS AT THE TOP

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he FMA would like to take this opportunity to congratulate Rob Swire on his career, following his recent retirement.

Swire was Manchester United’s Chief Physiotherapist, and had been at the club for 23 years. He took over the Chief role following Dave Fevre’s move from Old Trafford to Blackburn Rovers in 1999.

Swire gained his physiotherapy qualification from the University of Salford’s School for Physiotherapy, then went on to complete his postgraduate degree in Sports Injury, Neuromusculoskeletal Dysfunction and Manual Therapy and earning an MSc in Sports and Exercise. He first joined Manchester United in 1991, as an assistant to then main physio Jim McGregor.

Speaking about his retirement Swire said: “It wasn’t easy, it was a big decision. I’d been thinking about it for a year or more, working out when it would be right to retire.

‘It’s been a fantastic job, a brilliant job, I

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couldn’t have wanted anything better, but after 23 years at United, and the best of 30 years in total of working pretty much seven days a week, I couldn’t keep doing it forever.

I had to decide at some point when to stop and now’s the time.”

During his time at the club, Swire dealt in many high profile injury cases including; David Beckham, Cristiano Ronaldo and Wayne Rooney, which includes Rooney’s injury before the 2006 World Cup in Germany, where he was declared match fit weeks before he should have done, allowing the striker to take part in the World Cup. His impact on the club has been huge, so much to the extent that both Ryan Giggs and Sir Alex Ferguson have gone out of their way this morning to lavish praise onto the physio.

Sir Alex stated: “‘I worked with Rob for such a long time and I’m very proud of the job he did. He served the club so well and I wish him all the very best for the future.”

Ryan Giggs added: “Rob has been a great

servant to the club and has been here for as long as I can remember. He has always taken great pride in his work and is a true professional.”

Manchester United will miss this man in the coming season, but they are left in the cape able hands of Neil Hough who is the new Chief Physiotherapist at the club.

Credit: www.vavel.com

by Pitchside Pete THIN ON TOP It struck me whilst looking round at the delegates at the FMA Conference recently, how many of the medical and sports science staff who have been in the game a long time are going a bit ‘thin on top’.

Indeed let’s not be too politically correct here – bald as brass!

Is it the stress of working all those long hours? Are we tearing our hair out? Is it the barrage of pressure thinly veiled as ‘banter’ from the players? Or is it just the ‘manliness’ that the male medical and sports science possess? Luckily, the female FMA members don’t seem to have the same problem.

Looking at the FMA ‘1000 Club’, there wasn’t a great deal of hair to be seen at all.

Maybe we are simply taking our lead from the Guest of Honour – Fred Street?

The Conference, by the way, was a great success – and a great networking opportunity for us all, bald or not.

Maybe we should run a competition – photos of all the bald staff from behind and name each one?

In the end, it might simply come down to sheer hard work.

So remember, “If you’re not bald, you’re not working hard enough!”

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For more information visit www.footballmedic.co.uk Call 03334 567897 Or email info@footballmedic.co.uk

WISDOM

& TEETH FEATURE/Robert Robinson

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qualified in 1977, at Manchester University and have been a lifelong Aston Villa fan - we have a family history of Villa supporters and father and grandfather were also dentists. Luckily, the last 25 years have been spent working in conjunction with Aston Villa Football Club. My first contact was over 25 years ago was with the then club medical officer Dr Barry Smith, who was just about to depart to Norwich for an evening fixture when he lost a gold tooth. This was quickly re-cemented and Dr Smith and I then went on to talk about football and Aston Villa in particular. This led to an introduction to the newly appointed club physiotherapist Jim Walker, who himself became a patient, and I have been helping the Club with their dental requirements ever since.

The role of a football dentist is primarily to help the players achieve full dental health as acute dental problems are unwelcome at any time, but especially prior to or on the day of an important fixture. A lack of routine care, maintenance, regular dental examinations, and hygiene appointments can result in dental emergencies occurring even in previously disease-free mouths.

Wisdom teeth complications are a very common problem in young players in their late teens and twenties. Teeth erupting through the gum can easily become infected, causing pain, swelling and fever.

The regular and frequent use of sports supplement drinks by sportsmen can lead to dental decay and erosion, as most isotonic sports drinks have a pH value of lower than 5.5 which is the level at which enamel demineralisation occurs. Therefore it is essential for players to have regular check-ups so that the signs of dental erosion and decay can be detected early.

The symptoms can then be treated fairly simply and therefore more severe erosive destruction can be prevented.

Infection from gum disease can travel

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around the body in the blood stream and settle in other sites, causing problems.

This can lead to players feeling unwell, which is unfavourable when competing at a high level.

The dental practice is conveniently situated on the Erdington and Sutton Coldfield border, midway between the Club’s training ground at Bodymoor Heath and Villa Park.

Pre-season screening and examinations are essential. These were initially set up

by Jim Walker for both junior and senior players. An initial screening examination at the training ground is followed as necessary by a visit to the surgery where myself, along with a team of Dentists and dental hygienists are able to provide treatment to ensure that as far as possible players have a trouble-free dental season.

Any surgical treatment (e.g. of impacted wisdom teeth) is usually left until the end of the season.

Players joining in the transfer window are normally advised by the Club’s welfare officer Lorna McClelland to attend for a consultation. I still work full-time and I am available to deal with any emergencies (broken teeth, etc.) that may occur during daily training.

Dental injuries are the most common type of orofacial injury sustained during participation in football. The majority of these dental injuries are preventable.

A player is 60 times more likely to sustain damage to his teeth when not wearing a protective mouthguard. The team dentist can assist players in the prevention of dental trauma injuries by providing correctly fitting mouthguards.

Mouthguards are provided for players, although many are reluctant to wear them during matches as it can affect their ability to communicate clearly with other players.

On match days, I take my seat in the main stand, which provides quick access

to the dressing room area. However, I now have use of one of the physiotherapist treatment rooms where an emergency dental treatment kit box is kept, allowing simple remedial treatment to be performed and enabling any injured player to continue to play if at all possible.

Although rare, I have been called upon several times during matches to attend to loose or displaced teeth/crowns.

There was one incident during a match against Newcastle United when I received a tannoy call to report to the visitor’s dressing room. On arrival there, one of the players was lying on a couch holding his face. Examination revealed that he had one of his teeth pushed backwards.

Whilst attempting to reposition the tooth I received a tap on the shoulder and was politely asked by the manager Bobby Robson if I would mind leaving the dressing room, as he wished to give a team talk.

Treatment is not always exclusively for the players. On one occasion I received a Saturday morning phone call from the Villa Park announcer who had lost his front crown and was fearful he would not be able to be understood if it was not re-cemented. An emergency visit to the surgery sorted the problem and all was well for the afternoon match.

I continue to work with the current physiotherapist Alan Smith, club doctor Roddy McDonald and youth team manager Tony McAndrew. I still attend all home games and treat many past players and staff.

Watching Aston Villa matches can be stressful enough without the added pressure of waiting to be called in the event of dental trauma, but my contact with the Club have provided a lot of interest over the years, meeting and getting to know the players and staff.

FOOTBALL MEDIC & SCIENTIST | 9

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ON THE

FACE OF IT FEATURE/Philip Earl

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ess than 2% of all injuries in professional football in England affect the head, according to the FA’s Audit published in 2001. Only a proportion of these are facial injuries so these are not common. Further research suggests that professional clubs will encounter between 2-3 facial injuries per season on average. However, when they occur they may present serious challenges to pitch side medical teams and indeed to surgeons treating them in hospital.

During a match or training, two types of injury may present; an obvious or suspected fracture of the jaws or facial

bones, or lacerations to the scalp or facial skin.

The former, generally, will require removal from play, exclusion of any more serious injury such as concussion and transfer to hospital. The signs and symptoms of the different types of maxillofacial fracture are varied and the key signs and symptoms of mandibular, zygomatic and orbital fractures are listed in Table 1. Signs that hospital clinicians see such as gross swelling and bruising do not occur usually as an immediate clinical feature. Airway risk from gross displacement or internal bleeding is

exceedingly rare but something to keep in minds when assessing players.

Lacerations present a different challenge, as in many cases players can return to play after treatment so the challenge is to find a rapid way of closing the wound to keep the depleted team number to as small a time as possible.

Since 2004, wounds have been closed where practical with skin staples without local analgesia with good effect and good cosmetic results. The shortest time to return to play has been measured at 48 seconds. If for whatever reason, medical or tactical, the player is not going back to

Table 1: Clinical features of most common fractures Signs Abnormal Mobility Fractured mandible Gingival bleeding Malocclusion Fractured zygoma

Fractured orbit

Symptoms Pain Malocclusion Numb lip and chin Pain Flattening of face Restricted mouth opening Palpable step of orbital rim Numbness below eye, side of nose and anterior teeth Pain (especially on moving eyeball) Restriction of upward eye Numbness below eye, side of nose movement and anterior teeth Double vision

FOOTBALL MEDIC & SCIENTIST | 11

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the game; traditional suturing under local analgesia can be undertaken Players transferred to hospital will be treatment planned following detailed examination and imaging, often including CT scans with 3D reconstruction (example pictured right). Not every player will need an operation, in our pilot study looking at return to sport less than 50% of patients required surgery. This study, published last year, looked critically at returning to play competitive professional football or rugby union three weeks after injury, whether an operation took place or not.

One player took the decision to retire from playing and move to management but all the other 19 were able to be available for team selection after three weeks.

The use of face masks (left) post injury is controversial. These devices have been introduced with no basic scientific evidence to support their use, such as an understanding of impact strength of the material compared to immature bone and what risk there might be to either player should the device break during a clash. Certainly their use after three weeks would seem illogical. They may have a psychological role, particularly in re-introduction to contact training prior to playing in a game. However, there will continue to be a demand for them and Consultants in Maxillofacial Surgery all have access to Prosthetic Technicians in laboratories who can assist in constructing these.

During my 24 seasons as a pitch side medic, I encountered facial fractures rarely, as expected, but did manage fractures of the mandible, zygoma, nose and orbit and actually operated on one of the team’s players myself.

This player suffered his injury towards the latter part of an FA Cup tie and all three substitutes had been used. Despite the risks he refused to come off and almost scored the winning goal! Four days later he was on my operating list having his zygomatic fracture reduced and plated. He was back playing three weeks after his injury.

On another occasion I was woken at 12.45 am by my resident who informed me had seen a footballer in A&E with a severe middle third of face fracture (Le Fort 3) where his entire facial skeleton had been pushed back under his skull base. I questioned him as to whether it was really a football injury as this type of injury is more in keeping with motor vehicle incidents. Hi replied that he was certain he was a footballer has he still had his kit and boots on! This semi-professional footballer required a five hour operation with several plates and screws. Incredibly he did return to playing football for a number of seasons.

Like most doctors in football most of my time was taken with managing acute and chronic conditions of the lower limb and groin. However on occasions there has been an array of challenging injuries including a compound tibia and fibula at Chorley, a fractured skull with airway compromise in the pouring rain in January

at Sutton Coldfield, and, predictably, at the end of my last game ever at Kidderminster, a head injury with unequal pupils (that turned out to be normal for that player) that resulted in stadium evacuation and helicopter despatch from the pitch!

It has been a privilege to be involved with the AREA course for several years, meeting many doctors and physiotherapists that do this job full time, and to have a keen interest in sports medicine and witness the development of SEM as a bona fide specialty. One of the highlights of my career was attending symposium at the Emirates last year where Fabrice Muamba spoke of his near death experience. It was also humbling

to witness a clip of the full spectre of his resuscitation at White Hart Lane (bottom) by the brilliant team that sprang into action to save his life that totally vindicated the requirement of AREA training.

I have now moved ‘upstairs’ and have seen promotion, relegation and the award of a grant for an artificial grass pitch in my two and a bit seasons with Bedworth.

Never a dull moment in football!

Philip Earl is a Consultant Maxillofacial Surgeon at Worcestershire Royal Hospital.

He has had a longstanding interest in facial injuries in sport and was team physician for various professional and semi-professional clubs from 1987– 2012, most recently Kidderminster Harriers in the football conference.

He is on the FA’s Steering group that set up and monitor the AREA course compulsory for Doctors and Physiotherapists in the Premier League and taught on many courses in the past. He is now a director at Bedworth United Football Club.

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“FANTASTIC” Inaugural

FMA CONFERENCE

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he Football Medical Association (LMedA) Inaugural Conference held at the Radisson Blu Hotel on Saturday 17th and Sunday 18th May, turned out to be one of the most successful events ever hosted for medical and science staff in Professional Football. And it is not just that we say so, judging by the testimonials we have received since and which are listed below.

“Just a quick note to congratulate you on delivering an exceptional weekend at the Radisson Blu. It was great to see it well attended which demonstrated that there is a place for this conference every year.”

- Les Parry “What a really fantastic result and triumph for you both and the FMA. The venue, programme content, dinner, awards, supporting team of ladies, weather and atmosphere were all spot on and really made for a great and very inclusive occasion for all members and exhibitor.”

- Neil Redman

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“Congratulations on a fantastic event over the weekend!”

- Craig Smith “Just a quick note to say a big thank you for arranging a fantastic weekend. All your hard work and effort I am sure was appreciated by so many people. It was great to meet old friends and talk about new techniques and methods. The course content was excellent, all be it that I missed a few to further my conversational skills! The evening I felt went really well and Les was superb. A big thank you too for the awards you gave out.

It was really good to see that all the hard work a lot of people put in is being appreciated as you very rarely get a well done at a football club. I hope that was just the first of many.”

- Dave Galley “Thank you so much for a fantastic evening and weekend. It was great to catch up with old friends.

The format and organisation was absolutely top class.”

- Alan Sutton “Many thanks for the great weekend and for your hard work in organising the FMA conference which was a huge success. From my point of view it was great to meet with some of the club physiotherapists from bygone days. I would also like to thank FMA for the award given to me for attending 1000 games. I am

sure the organisation will go from strength to strength.”

- Mike Varney “The Conference was brilliant thank you. I did not think the Conference could have been any better.”

- Scott Alldrick “Many thanks to everyone involved in organising a thoroughly enjoyable Conference and Presentation Dinner. It was good to meet up with so many old friends again and hopefully this event will become a permanent fixture on my calendar. Well done the FMA” - Phil McLoughlin “I just wanted to forward my thanks for all your work behind an exceptional first conference at the weekend. The setting around and including the FA Cup Final and the ‘tone’ of the event and speakers was brilliant – relaxed, but educational. The ‘boxing Dave Fevre Fred Street Derek Wright Rob Swire Mark Howard Phil Hayward Ian Weston Jon Urwin Gary Armer Malcolm Stuart Alan Raw Richard Mackey Mike Varney Gavin Blackwell Les Parry Rob Swire Derek Wright Dave Fevre Dave Galley Jim Walker John Sheridan Alan Sutton Dennis Pettitt Phil McLoughlin Mark Leather Mel Pejic

rounds’ on Sunday morning was again appropriate, informative and even entertaining. Please pass on thanks to Dave Fevre and those involved in planning the programme. It was relevant to whatever level of the football leagues we work in, and to whatever role we have in our clubs.

We need FMA to continue to lead this from our football ‘workplace’ perspective, and invite specialists to support us – not the other way round –as has been so in the past.”

– Dr Joyce Watson Delegates were greeted by our official photographer and staff and on registration were given delegate packs and refreshments giving time to meet up with colleagues for once outside of the work environment.

Following an opening address by Eamonn Salmon, lectures began at 1.00pm with a terrific line up of speakers led by Neil Roach who was duly followed by Lynn Booth, Bryan English and Tom Little all of which were exceptional in terms of content and delivery and much applauded by all delegates.

With lectures drawing to a close at 5.00pm the bar opened and the FA Cup Final was shown on the large screen as well

Outstanding Contribution to Professional Football Lifetime Achievement Award Long Standing Service to Football Premiership Championship Division One Division Two Exceptional Contribution Award 2014 Officiated at over 1000 games in Professional League Football

as in the hotel bar area, giving everyone a chance to socialise, network and enjoy an end of season chat with colleagues old and new. Even though the final went to extra time, the hotel were exceptional in accommodating our programme and 7.30pm saw a champagne reception prior to a three-course dinner set out in exemplary fashion. During dinner, guests were asked to provide a caption for three pictures of staff displayed on the big screen with Dave Galley inadvertently providing fodder for a hilarious series of captions read out at the end of the meal, all in good spirit.

Eamonn Salmon gave an after dinner summary of the foundations of the FMA and his vision for the future of the association which was sincere, thoughtful and clearly illustrated his personal drive and ambition going forward.

The award ceremony that followed was long overdue recognition of the services and commitment that many of us give to the game. The winners, voted for by members, were all much deserved.

The 1000 Club award was an especially popular category and was received by 20 past and present delegates who had travelled from all over the UK to be at the event. The final award of the evening was the Lifetime Achievement Award, which was given to Fred Street. Thorough research had enabled the FMA to seek out two of Fred’s student colleagues from the 50’s who had also gone on to be involved in football; Rob Jenkins and Norman Pilgrim (who had flown in from Northern Ireland especially). This was the first time the three had been together for some 25 years and rounded off a fantastic series of awards.

Finally, it was left to Les Parry to give his unique take on his experiences in football which was a hilarious finale to the evening’s events. Unless of course you headed to the bar where delegates continued well in the small hours with a few seeing the sun rise!

Sunday saw the opening session of a ‘boxing’ format that was to set the stall for the morning’s speakers. Grant Downie sparred with Jon Fearn, Dave Fevre followed in his bout with Duncan Robertson, Lynne Booth took on Neil Roach and finally Chris Barnes went several rounds with Phil Hayward, Chaired

by Professor Graham Smith, this was a lively and entertaining format, perfect for a morning after the night before presentation.

The closing address saw Eamonn Salmon thank delegates for their attendance and contribution and ask that each one of them act as an ambassador for the FMA and the event next year.

Judging by the feedback, next year’s event looks certain to be a sell-out.

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IN PICTURES: FMA CONFERENCE 2014

The 1000 Club

Left to right; Rob Jenkins, John Sheridan, Norman Pilgrim, Fred Street & Mike Varney

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FOOTBALL MEDIC & SCIENTIST | 17

A THANK YOU...

We would like to thank all the below for supporting the conference, engaging with delegates and being an important part of our conference success...

conference sponsors

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The Chaplain and The Physio FEATURE/Stuart Wood

I

am very fortunate in my role as Chaplain at Cambridge United that the Club Physio, Greg Reid, is a friend and fellow Christian.

Indeed, he was the first person I ever spoke to at the club ten years ago, about the possibility of me offering to serve the Club in this capacity.

In becoming Chaplain at Cambridge United in 2005, I also joined Sports Chaplaincy UK (actually SCORE as it was then), the organisation working to train, appoint and support Chaplains, which provides a great way for us as Chaplains to share experience and knowledge, as well as offer support to one another and also perhaps significantly, individuals moving between clubs.

Interestingly, as the appointment of Sports Chaplains up and down the country continues, with, in the football world, Saturday afternoon village teams as well as Premier League clubs seeing the value of the role of the Chaplain, the relationship between the Physio and the Chaplain is generally one of the strongest within the clubs.

For many, the treatment room is one of the first destinations when visiting the club. Christian Wienkamp, appointed as Gateshead FC Chaplain at the start of the 2013/14 season, spoke of the strong relationship he had established with the Club Physio, who herself was serving in her first season at the club, and how they had found mutual support and encouragement in their newness, but also respect for what each could offer.

But this isn’t a new phenomenon. Going back to the early days of Sports Chaplaincy in the 1970’s with Rev Mike Pusey at Aldershot and Rev John Boyers at Watford (now at Manchester United), the relationship between Chaplain and Physio has always been an important one.

But why is this so? I would like to offer a couple of reasons that I believe help us to understand this connection.

1. The Focus on the Care of the Individual

“Club Chaplains see helping injured players as a high priority in their work of pastoral care at the club.”1 So writes Rev Peter Amos, Chaplain at Barnsley FC, as he explored the role of the Chaplain within the treatment room in a chapter entitled “Who ate all the Pies?” in the book “Footballing Lives”.

As Chaplains, we are people centred. Our focus is on the individual, whether they be a

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first team regular, a match-day steward or a fan. Our role in our clubs is to be of support to the people within our clubs – and we seek to prioritise their needs above all else, which includes watching the game!

And being people centred is also the role of the Physio. In a forward to the Chartered Society of Physiotherapy’s new Code of Professional Values and Behaviour, Ann Green, Chair of Council 2010-2011, states that the new code “presents a personcentred approach to professionalism. As such, it puts patients’ and clients’ needs to the fore.”2 The Physio is required to prioritise the need of the individual – it is about doing what is right for the player, making decisions that put their long-term needs first. This can, as I’m sure we all acknowledge, lead to conflict with management and their priority of winning games. Peter Amos gives a number of examples in his chapter of this, including quotes from Niall Quinn (pictured), the former Premier League player and Republic of Ireland International.

Perhaps within the scope of a football club, the Chaplain and the Physio (and other medical staff), are the two who have that unquestionable focus on the individual’s needs.

2. The relationship between the Physical, Emotional and Spiritual Some of my strongest relationships with players at the club over the years have been forged out of their spell on the side-lines.

Players struggling with an injury can often also suffer emotionally by not being involved in the games or in training, struggling with spells at home away from the club environment, questioning their futures, dealing with doubt, frustration or loneliness, amongst many things. As the Chaplain, I have been privileged to be there in person or on the end of the phone to offer support.

It is my experience, both personal and that learned from talking with other Chaplains, that Physiotherapists understand this dynamic as well. In the absence of a Chaplain, it is often the Physio who is the sounding board or listening ear. A player’s emotional state can hinder their physical recovery.

It is often the experience of Chaplains that a player will be referred to them, or pointed in their direction, by the Physio. This has been the experience of Rev Paul Deo currently at York City (previously at Bradford City). It is his observation that “while players are ‘open’ in terms of physical treatment,

FOOTBALL MEDIC & SCIENTIST | 21

they also tend to be ‘open’ in terms of pastoral care and discussion - after all, they have nothing else to do while they’re on the table!”

Canon Roger Knight, currently at AFC Rushden (formerly at Rushden & Diamonds) speaks of his relationship with the Physio: “He was always approachable when I went in during the week letting me talk with players receiving treatment, tipping me off about any concerns/bereavements etc and referring any players who needed specific ‘counselling’ or support.”

As Chaplains, we have a high regard and respect for the medical team at our Clubs – whether that is the part-time Physio in the Ryman Premier club, or the larger teams that form part of the backroom staff at the top clubs. As we seek to become more professional as Chaplains, we have learnt our boundaries and our place (that isn’t to say that some will from time to time overstep the mark!) and we work in support of the club staff.

But alongside a player’s emotional state, it is also true that a player’s spiritual state can also play a part in their healing – “At times of great physical and psychological difficulty it is often the spiritual that gives strength and drive.”3 In some clubs and in some contexts, offering to pray with, and for, players is part of what Chaplains do.

Linvoy Primus (right) is a high profile and public example of how the relationship between Chaplain and Physio can work. It is also the experience of a number of Chaplains where they have been asked by a player to pray for them, or have themselves offered, an offer which has been accepted.

As Chaplains we know that the care of an individual goes beyond the strapping and physical treatment so ably given by our Club Physios. Our role is to support their work by offering help with the emotional and spiritual well-being of a player, and their families. If a player has a different faith, we would put them in touch with their own Spiritual leaders if they don’t know who they are. We are well-placed to be able to offer a home or hospital visit if necessary or required. We are also wise enough to know that not every injured player will want to talk to us, or appreciate what we can offer. And we can live with that.

It seems to me that Chaplains and Physios share similar values, which in turn provides a strong basis for their close working relationship.

I greatly value my relationship with Greg at Cambridge United. I know some of the pressures he faces week-in, week-out, I have learnt what is appropriate and what isn’t, and I believe we both value our respective roles in the care and support of players.

I also believe it is worth highlighting that as Chaplains, we don’t see our role as simply being there for the playing staff. The Physio can end up shouldering a lot of responsibility and they also need someone to listen to them. Our role is to support them as well as working with them in support of the players they are looking after.

Different clubs and different Physios will obviously approach things their own way, but from my own journey as a Chaplain, and from the experiences of the many

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other Chaplains up and down the country, I passionately believe that the Physio and the Chaplain can work as partners in serving the clubs in which we find ourselves. As an organisation, Sports Chaplaincy UK is seeking to continue to drive our standards up, that we give the best service and support we can to our clubs. Your help in doing that is greatly valued and appreciated.

Keep up the good work – and remember we are there for you as well as those you’re treating.

1 Pg 81 – Peter Amos in “Who ate all the Pies?” Chapter 8 in “Footballing Lives”, edited by J Heskins and M Baker, published by Canterbury Press 2006 2 Ann Green - Code of Professional Values & Behaviour: foreword, October 2011 on www.csp.org.uk 3 Mark Nesti, Existential Psychology and Sport: Theory and Application, Routledge, 2006 (quoted by Peter Amos in “Who ate all the Pies?”)

FOOTBALL MEDIC & SCIENTIST | 23

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an accident waiting to happen COMMENT

C

ertainly as colleagues we all felt for Gary Lewin who dislocated his ankle during England’s opening world cup match recently. But now that he is back home and recuperating after surgery it may be worth reflecting on not what happened, but why.

With the heat playing an important part in this opening fixture it seemed appropriate to scatter drinks containers around the pitch for players to ‘re-hydrate’ when the opportunity arose. All well and good but even before Gary’s misfortune I couldn’t help but think they were a potential hazard – to the linesman and players who run beyond the touchline. Surely this was an obvious health hazard and an accident waiting to happen. Which indeed it did.

This led me to wonder whether a second factor may have contributed to Gary’s downfall. The member of ‘staff’ sat on the by-line. Back in September 2012, the Independent newspaper ran an article on UEFA’s technical report which questioned the need for an army of assistants on international duty.

They, UEFA, asked: “Is it appropriate that the team behind the team can be more numerous than the footballers?” At Euro 2012 there were 23 allowed in the technical area (dug-out) alone. For World Cup qualifiers the figure was 20. That’s a lot of people jumping on each other.

Now we all know that, working in football, such is the tension in the lead-up to games that when our team scores, we are like a

coiled spring exploding with relief and joy.

You kind of need to have to have been there to understand why grown men and women leap about so frantically when a goal is scored. But with so many staff around, is it any wonder that in the mayhem an individual could befall such an incident as Gary’s?

Not too long ago the bench consisted of manager, assistant, coach and physiotherapist and a couple of subs. Now the list is too long to even put to paper.

The question now becomes whether there is a lesson to be learnt. Clearly there is, but as the World Cup continued the drinks containers remained pitch side and the number of people in the 2 technical areas remains 40!

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A DAY TO REMEMBER FEATURE/Dr Mark Waller

T

he build up for the FA Cup final for the medical and Science staff was an amazing experience for all involved.

For some it was their first time in a cup final which only increased the excitement.

For myself and our Head of Medical Staff, Rob Price, we had both been to several finals but despite this we were both like children looking forward to Christmas. The emotions were immense with a combination of excitement, apprehension, eager anticipation, and a professional concern over a number of players who had on-going injuries.

The difference from a normal game was that it was at Wembley Stadium, and it made history for the club in the respect that it was Hull City’s first FA Cup Final. We had three players with significant problems but it would be unethical to explain what they were or who was affected. The physiotherapy staff did a wonderful job with all three of them and each of them played 120 minutes.

The planning entailed looking at all possible scenarios that might come our way.

The big difference from a normal league game was that we could face extra time and penalties. Consequently the heat was

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considered earlier in the week as a possible issue, and on the day we were prepared for cooling measures at half-time.

Rob was extremely proactive on the issue that all medical staff should have an involvement and should all go to Wembley.

However, we kept the normal routine so as not to compromise the smooth running of dressing room pre-match physiotherapy activities.

Members of the medical staff set up the dressing room medical area on matchday.

The dressing room was palatial, with excellent facilities. Some of the Hull media staff decorated the medical area with large pictures of players which was a thoughtful gesture. I had the chance to visit the medical facility at Wembley Stadium before the game. They are really well equipped and have every facility we could have needed.

The staff were extremely helpful and I had exchanged e-mails with the medical director before the semi-final and final.

We flew down to London at lunchtime on the Friday to start what was a memorable experience for everyone concerned.

The journey to Wembley was an experience in itself to savour. There were thousands of Hull fans travelling to the stadium, some of whom were still driving next to the coach as we approached. When we turned into the stadium area, the noise was immense with fans in gold and black shirts surrounding the coach. They were so good natured and were fantastic, not only on our arrival but throughout the whole game.

The staff didn’t appear at all nervous in the dressing room. We would not want to show any apprehension which may affect the players. We just wanted to appear positive throughout, despite a few butterflies all around. Even though the result didn`t go our way I have never seen so many fans of the defeated team stay in the stadium to savour the moment and support their team. I know how grateful the staff and players were of the support received.

After the game, two of our players had a doping test as is normal after such a fixture.

No player wants to be chosen after a loss but it has to be accepted and our players were extremely helpful to the doping control staff despite their profound disappointment.

When in the doping control station one becomes quite philosophical and I have to say that all of our players can reflect on a splendid performance and two of our players will always be able to tell their children, grandchildren (eventually) and anyone else that will listen that they scored in the FA Cup Final at Wembley Stadium on a sunny afternoon in 2014.

The day was a wonderful experience and one that none of us will forget. So much exhilaration after taking a 2-0 lead, but Arsenal have quality in all positions and they fought back courageously. Next year, however, we will just have to go back to Wembley again, and this time emerge as victors!

FOOTBALL MEDIC & SCIENTIST | 27

28

WHERE ARE THEY NOW?

l

e l i N k r Ma

List of previous clubs worked for…

Barnsley, Middlesbrough, Leeds United, Bolton Wanderers and England C.

was qualifying for the next stage of the Champions League in the San Siro in 2000, with Leeds United but not that close!

be the head honcho without interference.

Also, I can’t remember my phone ringing off the hook lately!

What are you doing now?

I work at the Rehab Physio Infantry Training Centre, at Catterick Garrison.

What was your biggest disappointment in the game?

The financial collapse of Leeds United in 2002/2004. Myself, and lots of other staff were made redundant as a direct result.

That team should have gone on to win the Premier League and I loved working for them. I never got to a cup final but it’s not that big an issue really.

How did you get in to football?

I was working part-time in Rugby Union, Wakefield RUFC who are now defunct, and the job at Barnsley came up (where I worked in the NHS). My superintendent put me forward to one of the directors, who had a shop in the hospital. I suppose I was in the right place at the right time.

Do you miss the game?

Not the modern game. I miss the game of the 80s and early 90s, before it became corrupted with money and self-seekers.

Best and worst part working in football?

The best was travelling to great places and staying in fantastic hotels (usually!) but nothing beats getting a seriously injured player back to full fitness.

The worst would be working 7 days a week, listening to players petty gripes and moans!

Where was the last club you worked?

Bolton Wanderers in 2007 with Sammy Lee, which was a short but interesting time.

What’s your most memorable moment?

Getting promoted to the new Premier League with Middlesbrough at Molineux on the last day of the 1991/1992 season, which was a great day. Pretty close to that

How have things changed?

The money has made the players untouchable. They can virtually get away with most things compared to the average guy. A 21-year-old can be a multi-millionaire without even playing 50 first team appearances and that is crazy.

It is very difficult to apply pressure to make players perform unless they want to. Also, back in the day, the physio ran the medical department (nutrition, conditioning, science) and knew what was happening. Today there are lots of other professionals such as sports scientists, strength and conditioning coaches, and sports doctors who all want a slice of the pie.

Do you have happy memories of your time in football?

Too many to mention, eating fish and chips on the bus with a can of lager on the way home from a rare away win with Barnsley, and having a drink in the old boot room at Anfield with Joe Fagan, Phil Thompson and Ronnie Moran, after a reserve game. As a Liverpool fan I was so excited I couldn’t sleep for a week!

Did you have a mentor or a physio who you looked up to and inspired you?

No, not really. Out of my physio college year, which contained ten lads, five of us went on to work in professional football. I think I was inspired/challenged by my peers, but no one in particular.

I am not saying they don’t have a role, but speaking to other physios it can be very difficult to keep a handle on things. You hear stories of players employing their own physios or going back home for treatment. I couldn’t/wouldn’t want to work in that kind of environment.

Are you still in touch with players, managers, or physios?

A few friends are still physios in the game and I keep in touch with them, and sometimes scrounge tickets off them! I still live in Middlesbrough, so I bump into some ex-players from my era there.

Would you consider going back to the game?

I don’t think I could, unless it was an academy job, where you could probably still

FOOTBALL MEDIC & SCIENTIST | 29

ON THE COUCH...

FEATURE/LEE TAYLOR

1. Profession?

Sports medicine / High Performance.

2. Previous clubs?

Maidstone United (Player), Scarborough FC, Leyton Orient, Antigua FF, Barnet FC, Luton Town, Wimbledon FC, Boston United and Liverpool Academy, Notts County FC, Wellington Phoenix FC, Notts County FC (current).

3. How did you get into football?

I started out my professional football career as a trainee at Maidstone United FC, but soon took the physiotherapist / High Performance coaching route. My physiotherapy career began at Scarborough in the old Division Three (League 2) before going on to Head the Medical Departments at Barnet, Luton Town, the ‘Crazy Gang’ at Wimbledon, Boston United. I also had spells working for Antigua Football Federation and at Wellington Phoenix in Australia. I then then worked for NATO in Afghanistan Performance / Rehabilitation Manager for 15 months until returning to UK and opening Physiofix Sports Injury & Wellbeing Clinic / Online Shop. I then had a call from Shaun Derry (Manager Notts County FC) to re-join the club as Head of Performance and join back up with Head of Sports Medicine, Jonny Wilson.

4. Any fond memories in the game?

I’ve so many memories and stories from over the years. From getting absolutely terrorised by the original Crazy gang at Wimbledon to joining Boston United with Paul ‘Gazza’ Gascoigne and living with him for three

months in a dodgy hotel - with him in the honeymoon suite and me next door in the broom cupboard! What a three months that was by the way.

5. Best manager you worked with?

The best manager I ever worked for has to be ex Spurs and Sheffield Wednesday Manager, Peter Shreeves, then he took me to Barnet FC from Leyton Orient. There wasn’t one day where he didn’t have a story, to say he was a friend of the stars was an understatement.

He held court and soon over time I became his right hand man - great person, great coach and loves a small lager. Then there was Ricki Herbert, the World Cup 2010 New Zealand national team coach, and coach of the A league team Wellington Phoenix. He took me over to be his No2 where we ended up in the finals series, the highest the club ever been. I learnt so much with from him for my coaching development.

6. Best player worked with?

Players are a hard one cause ultimately weather you like it or not they get you the sack! My Dad Ex England international and West Ham United ‘Tommy Taylor’ told me this when I first started out at Scarborough FC in the old 3rd division when I was 19 - he was dead right. I think that’s why I’m so disciplined now as a person and professional.

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7. Current Club?

I’m currently at Notts County FC as Head of Performance, and work in a fantastic Sports Med Dept with Jonny Wilson who is Head of Sports Medicine (currently PHD student) and Becky Knight, First Team Physiotherapist.

We probably have the best sports med dept in the football league. Jonny’s undertaking his PHD and has driven me to the next level with my development - research is king we say, he’s made me go back to UNI at 38! I love it and wished I did it earlier in my career. But I wouldn’t change my pathway for anything.

Experience is what counts.

8. What are your long term plans?

Long term career plans for me is to complete my MSc and move back into the Premier League or over to Australia in the NRL. 9. Dream job?

Dream job is plain and simple - NRL or top 3 clubs here in UK.

FOOTBALL MEDIC & SCIENTIST | 31

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