Medical role vital in modern game

"This is essentially a football meeting, but medical subjects are of extreme importance for all sports and the whole of society." The words from Mikael Santoft, general secretary of the Swedish Football Association, set the scene for the fifth UEFA Medical Symposium in Stockholm from Tuesday to Thursday.

The programme did include some specialised features, such as an in-depth review of the accuracy of modern-day doping controls; an appraisal of surgical and non-surgical treatment of metatarsal stress fractures; recovery times and levels (among the general population as well as elite footballers) after anterior cruciate ligament reconstructions; the medical specificities of women's football; and rapid response to cardiac arrest scenarios on the pitch and in the stadium. However, the core elements of the symposium were the prevention of injuries and the role of the medical staff at clubs and national associations.

"The symposium was a success, because everyone was convinced that medical matters are not exclusively in the hands of doctors," commented Michel D'Hooghe, chairman of the UEFA and FIFA Medical Committees. "Medical care has become so complex that one person cannot play alone. Medicine has become a team effort."

This standpoint was reinforced by former elite referee Markus Merk. "The players' most important capital is their health, and referees have a role to play in protecting it," he commented. "We have to take instant decisions on how best to sanction behaviour which puts their well-being at risk and we have to make correct assessments about fallen players. On the one hand, we want the game to flow, but we also have a duty to stop play immediately if we feel there could be a serious injury."

The team ethic underlying the need to protect players was highlighted during a review of 'the team behind the team' by UEFA technical director, Andy Roxburgh, on the opening day. The importance of the medical staff to the smooth running of the squad was also emphasised by former Swedish national team coach, Lars Lagerbäck. "They were always fully integrated into all our daily meetings and were made to feel that their contributions were appreciated," he said. "Their feedback in areas such as performance analysis and individual fitness assessments was extremely valuable."

Among the audience on the second day was UEFA honorary president Lennart Johansson, who commented: "It doesn't make sense if a national association engages a medical expert and then refuses to listen to what he or she has to say."

One of the questions posed to the discussion groups was what more UEFA could do to help medical staff. Among the responses was unanimous appreciation of UEFA's ongoing injury research studies which, after nine years, cover 11,000 injuries and approximately 1.1 million hours of exposure in training and matchplay.

"We sometimes see stories about the incidence of injuries increasing, but this is not the case," reported Professor Jan Ekstrand, vice-chairman of the UEFA Medical Committee who coordinates the project. "Even so, the data indicates that a top club can expect to record an average of around 50 injuries per season, nine of them serious, with hamstring injuries the most frequent."

The injury data can be correlated to performance and, as Michel D'Hooghe remarked: "If it can be demonstrated that league positions can be influenced by the incidence of injury, this is a powerful argument to be carried into the boardroom. But the symposium in Stockholm covered an extremely wide range of subjects and I am happy to say that we all came away with ideas for the future and lessons we have learned."