Tuesday, March 1, 2022
The role of medicine and the team doctor in football has become crucial in the modern-day game – with UEFA making its own vital contribution to the area of football medicine, injuries and sports science.
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All UEFA's medical projects are managed by UEFA's medical unit under the direction of the Medical Committee, which is made up of 18 elite football doctors from around Europe, most of whom are either current or previous national team doctors with specialisms in orthopaedics, cardiology and sports medicine.
The Medical Committee meets twice per year to discuss the ongoing medical projects and provide their expertise to the medical unit. Every four years UEFA hosts a Medical Symposium, which brings together experts from clubs, associations and the wider football family to review and discuss key medical issues in football such as prevention of injuries, sports medicine, women's and youth football, and current and future developments in the relevant domains. The latest UEFA Medical Symposium took place in January 2018.
UEFA Medical Regulations
UEFA is constantly striving to update and improve the medical regulations to maintain and further develop the current high standard of medical service that is provided in UEFA competitions. The latest version of the UEFA Medical Regulations is available here (2022 edition, in force as of 1 July 2022).
- Pre-competition medical examination (PCME)
UEFA medical regulations specify a detailed medical screening process which players as well as referees undertake prior to their participation in UEFA football competitions. The medical examination includes a general examination as well as cardiological screening, specific neurological baseline screening, laboratory and orthopaedic examinations.
- Minimum Medical Requirements (MMR)
In its continuous attempts to protect the health of everyone involved in UEFA matches, the UEFA Medical Committee defined minimum medical requirements (MMR) for players, team officials, referee teams and match officers at matches and tournaments which entered into force at the start of the 2012/13 season. These requirements are contained in the UEFA Medical Regulations and are designed to provide a minimum standard of equipment and medical services to deal with accidents at matches which might threaten lives or cause permanent injury.
The host club or national association is required to provide a minimum level of medical service in four key areas:
- Pitchside medical equipment (e.g. defibrillator, spinal board, resuscitation equipment)
- Ambulance (which must be an advanced life support ambulance)
- Medical staff (including a dedicated pitchside doctor and stretcher team)
- Emergency medical room equipment (equipped with emergency drugs and medical materials)
Furthermore, the host must submit its stadium medical plan to the visiting team(s) in advance of the match or tournament stating such points as emergency evacuation routes, the contact details of the host team medical officials and the contact details of local hospitals.
The MMR requirements are designed to ensure a standardised minimum service across UEFA competitions and to ensure that travelling teams and their medical staff can be sure that a certain standard will be provided regardless of the country in which the matches are played. Medical equipment is inspected by the UEFA match delegate on the day before the match during the official training session (where applicable to the competition) and again on matchday. Clubs and associations who fail to meet MMR requirements are referred to the UEFA Control and Disciplinary Body for non-compliance.
The MMR are reviewed by the Medical Committee each year to ensure that the medical needs of players and officials can be met with the least possible burden on clubs and associations in providing equipment and services. Flexibility is also built into requirements where possible to allow for local variations, such as the different brands of emergency drugs that may exist in different countries.
In addition to the MMR, UEFA also requires the hosts of its final tournaments to provide a full tournament medical service which includes the production of a comprehensive medical services concept containing additional information on hospitals, imaging facilities and dental services, procedures for obtaining prescriptions and immunisation requirements for the host country.
UEFA publishes guides to the provision of MMR in seven languages, the 2022/23 versions of which will be published here soon.
Guide to minimum medical requirements – 2019/20 season
Guide to minimum medical requirements – 2019/20 season (French)
Guide to minimum medical requirements – 2019/20 season (German)
Guide to minimum medical requirements – 2019/20 season (Spanish)
Guide to minimum medical requirements – 2019/20 season (Italian)
Guide to minimum medical requirements – 2019/20 season (Portuguese)
Guide to minimum medical requirements – 2019/20 season (Russian)
Pre-match medical information – 2019/20
Pre-tournament medical information – 2019/20
UEFA pre-match medical information form
UEFA pre-match medical information (form filled example)
Guide to provision of medical and anti-doping services at youth final tournaments – 2019/20
Pre-competition Medical Briefing
UEFA developed a Pitchside Emergency briefing to raise the awareness of the on-site medical team. It is the responsibility of the host Chief Medical Officer (CMO), or equivalent officer, to read the briefing in advance of every match with the rest of the pitchside medical staff and identify the roles of each member of the medical team. Additionally, at all UEFA finals and final tournaments, the Pitchside Emergency briefing will be conducted by the UEFA Venue Medical Officer (VMO). Scenarios such as sudden cardiac arrests and spinal injuries will be thoroughly discussed to make sure that the roles of the Pitchside Emergency Doctor (PED), the ambulance crew, the stretcher teams and the team doctors of the participating teams are clearly defined.
Football Doctor Education Programme
The UEFA Football Doctor Education Programme (FDEP) is a three-part programme teaching doctors from all 55 of UEFA's member associations the key skills of the modern football doctor. The programme adopts a blended learning approach, marrying face-to-face workshops where doctors learn and practise techniques with an online e-learning support platform containing instructional videos, tests of participants' knowledge and process guidelines for doctors to refer to at any time. An online forum is also in operation, allowing course participants to discuss and resolve key issues between themselves outside of the workshops.
All workshops are run by recognised international experts in the relevant fields, and members of the Medical Committee, many of whom have years of working as team doctors for their senior national teams.
A key aspect is that participants are required to undergo a rigorous testing process at the end of each workshop to evaluate the skills and knowledge obtained. This evaluation is essential because as well as learning key skills, one of the unique aspects of the FDEP is that all participants are taught how to 'cascade' their own version of the course for doctors in their own country. It ensures that only those participants who demonstrate competence in the topic area are authorised to pass those skills and knowledge on to their peers at a cascaded workshop.
In order to maintain UEFA's high standards, all cascaded courses must follow the course manual and course structure used for UEFA's own workshop. UEFA offers both translation support for course materials and logistical support for practical sessions, with national associations able to borrow the medical kit required for the course from UEFA free of charge. Doctors are also allowed access to the FDEP's e-learning platform to further supplement their skills.
As regards the educational aspects of the cascaded courses, strict requirements are set by UEFA to ensure that all tutors have the specialist medical knowledge required in order to teach other doctors. This is necessary in order for a cascaded course to be recognised by UEFA.
As a result of the cascading process, UEFA has now begun to create a network of skilled medical tutors disseminating the skills learned on the course across Europe's wider football community. This, combined with UEFA's Minimum Medical Requirements (MMRs), which require clubs and associations to provide emergency medical equipment and services at all UEFA matches, means that considerable steps have been taken to improve the medical support available to players.
Thus, as the cascading aspect of the FDEP develops in tandem with the MMRs in future, UEFA's matches and competitions will be supported not only by a set of guaranteed medical services and standards, but also by increasing numbers of doctors trained to apply techniques and use equipment that could make the difference between a life being lost and a life being saved.
1. Injury study
In 2001, UEFA initiated a long-term research programme with the aim of increasing the safety of players in its competitions and contributing to the wider understanding of injury in sport. This injury study has now been conducted with elite clubs in the UEFA Champions League and UEFA Women's Champions League as well as national teams in the UEFA European Championships (men and women) and UEFA Nations League (men) as of the 2022/23 season.
- The specific aims of the study are to evaluate the risk and severity of injury as well as the patterns and circumstances of injury, and to monitor trends in these measures over time.
Data collection is performed using standardised forms with all participating teams' medical staff required to submit individual injury and player minutes data to the Sweden-based Football Research Group headed, from the 2022/23 season, by Dr Markus Waldén. This process was initiated in 2001 by renowned injury expert and former vice-chairman of the UEFA Medical Committee, Professor Jan Ekstrand.
Injury is defined according to time-loss from football which means that only injuries which result in the player being unable to participate fully in future training sessions or matches are recorded.
All participating clubs receive a mid-season and end-of-season report to benchmark their results compared to the average measures and to their own in the previous seasons. These reports, together with the post-season meetings with the clubs' medical staff, allow clubs to review their own statistics and performance and to make adjustments where required. For the injury studies conducted on national teams, a final report is sent following the end of the final match of the tournament.
Injury study reports
UEFA Women's Elite Club Injury Study: 2019/20 season report
UEFA Elite Club Injury Study: 2019/20 season report
UEFA Elite Club Injury Study: 2018/19 season report
UEFA Elite Club Injury Study: 2017/18 season report
UEFA Elite Club Injury Study: 2016/17 season report
UEFA Elite Club Injury Study: 2015/16 season report
UEFA Elite Club Injury Study: 2014/15 season report
UEFA Elite Club Injury Study: 2013/14 season report
UEFA Elite Club Injury Study: 2012/13 season report
2. Concussions and head injuries
The topic of concussion was raised within UEFA following several high-profile cases that occurred across UEFA's leading competitions. Consequently, UEFA launched its first Concussion Awareness Campaign in 2019 aiming to educate the players, coaches, doctors, referees and the wider audience on the actions to take when a head injury occurs on the field.
UEFA also decided to implement several measures to improve player health in terms of concussions. Neurological baseline screenings have been included in UEFA's PCME to allow doctors to assess players with a head injury during a match. A specific Medical Video Review System (MVRS) is provided at UEFA's competitions, which have the Video Assistant Referee (VAR) system. This allows doctors to instantly review the images of an injury using various angles. Each team participating in UEFA's competitions must also sign a Concussion Charter, which aims to reinforce the importance of good practice in concussion management and highlights the concussion procedures to be followed at UEFA men's and women's club and national team matches.
3. UEFA Research Grant Programme
The UEFA Research Grant Programme is designed to establish a series of awards of up to €20,000 to support the valuable work of doctoral and post-doctoral researchers studying European football. By shedding new light on football and the myriad ways in which it interrelates with wider society, quality research can help the members of the European football family fulfil their mission and reach more informed decisions.
Medical sciences awards
- Thor Einar Andersen – The preventive effect of an Adductor Strengthening Programme on groin problems in Norwegian male football players: A cluster randomised controlled trial
- Hans Tol – An innovative MRI technique for acute hamstring injuries: A feasibility study of micro-structural recovery at return to play
- Kevin Enright – Scheduling of concurrent-training preceding non-contact injuries in elite European football players
- Jolien Gooijers – Repetitive Subconcussive Head Impacts: Brain Alterations and Clinical Consequences
- James Morton – Quantification of energy expenditure in elite youth soccer players: implications for population specific nutrition guidelines
- Gil Rodas – Impact of sleep in young football player's health, cognition and sport performance
- Ioannis Fatouros – The UEFA 120 min Study
- Javier Sánchez – Understanding the recovery time course in elite football referees during a congested match schedule
- Bert Bond – Clearing the confusion from concussion: A multi-disciplinary approach to examine heading
- Sigitas Kamandulis – High-velocity hamstring muscle training strategy: implications for injury prevention
- Stefanie Klatt – Additional Substitutions in European Football: Effects on individual and match performances, player load reduction, tactical influence, and promotion of young players
- Dimitrios Stergiopoulos – Effects of consecutive international air travels of different duration on sleep patterns, sport-specific performance and recovery indices of football players