The importance of tailoring medical care and performance management to the needs of the individual player was a recurring theme during the final sessions of the UEFA Medical Symposium in Frankfurt.
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Ron Maughan, chair of the IOC Medical and Scientific Commission’s nutrition working group, examined the effects of playing football in extreme heat, which include significant increases in perception of effort, body temperature, sweating, dehydration, and risk of heat illness, alongside a marked reduction in exercise capacity. He stressed the importance of heat mitigation strategies, which include acclimatisation and hydration protocols that take individual player traits into consideration and the education of players, coaching staff and administrators on ways to mitigate the associated health risks.
Christopher Carling from the French Football Federation (FFF) looked at the reasons why elite footballers may be at risk of excessive overload, including congested match schedules, limited squad rotation, regular and/or long-distance travel, and training rhythms which are either overly intensive or monotonous. The difficulties involved in applying standard models to aspects of player preparation, performance and well-being were then explored by Alan McCall from Arsenal FC and Iñigo Mujika from Spain, who respectively focused on acute:chronic workload ratio (ACWR) and recovery strategies.
The players' view
The closing session of the symposium was a round-table discussion on health care for players in club and national teams, featuring former footballers Thomas Hitzlsperger, Niko Kovač and Josephine Henning alongside the doctor of the Belgium women’s team, Elke Van Den Steen.
Hitzlsberger’s career took him from his native Germany to England and briefly to Italy, and he explained how moving clubs means adapting to new methodologies on the pitch and in the treatment room. He also underlined the importance of trust and mutual respect in the relationship between a player and a physio.
Kovač enjoyed an illustrious playing career before becoming a coach, first with the Croatian national team and then with Eintracht Frankfurt, Bayern Munich, Monaco and now Wolfsburg. He revealed how as a player he was fully focused on maximising his physical performance through proper diet, rest and recovery. From a coach’s perspective, he reiterated the importance of open communication and detailed advance planning with the medical staff to ensure proper management of player workload and recovery from injury.
Henning, a gold medal winner with Germany at the 2016 Olympics, recounted the mental strain of suffering a serious knee injury while playing abroad. However, she noted how great strides have been made in recent years to improve the level of sports science and medical care in the women’s game. She mentioned that however a medical follow-up for recently retired football players is currently lacking, especially the first few years after the end of a professional career.
Van Den Steen emphasised the importance of understanding the specific physical conditions that affect female players, such as a greater tendency towards ligament injuries when compared with their male counterparts, and adapting training and recovery routines accordingly. As the level of data improves in line with increased research, so too will the ability of the football medical community to keep female players fit and healthy throughout an extended career.
The symposium concluded with three practical workshops on electrocardiogram (ECG) interpretation, neurological baseline screening and emergency management, which served to complement the CPR training and education programme launched by UEFA and the European Resuscitation Council on Tuesday.
Zoran Bahtijarević, UEFA Chief of Medical:
"The 2023 UEFA Medical Symposium was an enormous success. Participants were extremely satisfied on the quality of the lectures and the unique opportunity to meet and network with the core stakeholders in football medicine.
"UEFA is continuously striving to offer the highest quality of medical care for football players and hopes that at the next Medical Symposium some of the challenges presented over the last two days will be addressed.
"The most important message, that was reiterated throughout the Symposium and was mentioned by many speakers as a take-home message, was that medical doctors, other medical personnel, sports scientists and coaches should base their decisions not on emotions, or pressure from any side, including media, but on the scientifically proven, evidence-based methods. This may take time, but, at the end of the day, is the only way which will bring benefit for the health of players."