As a manager you have a duty of care to your players to make sure that things are done correctly. Having been a player, I’m not a manager that wants to just wheel players out until they break, so I don’t take risks with players – it’s their livelihood, it’s their career.
The above are strong and very interesting words from England football manager Gareth Southgate today when asked about an increasing number of top-line players being withdrawn from his squad to face Germany and Brazil in friendlies over the coming week.
Harry Kane, Dele Alli, Raheem Sterling, Jordan Henderson, Fabian Delph and Harry Winks have all been made unavailable for selection by their clubs due to ‘injury’ – leading to a big national debate over whether football clubs are putting their own priorities ahead of the national team.
I’m hearing this talk of club v country. It’s a nonsense. The players are injured and cannot play, Southgate added this morning.
If we’re in a cup final or a critical game, maybe we have a really open conversation.
With some of the players it’s 100 per cent clear. With a couple of the other lads that have been in, there’s ongoing injury issues with them. I have man-to-man discussions with them around where they’re at with it and how much risk we want to take.
As a solicitor with a specialist interest in advising sports players whose careers suffer as a result of poor medical care, or poor management of their injuries, it is certainly interesting to hear Southgate talk about assessing ‘how much risk’ they take.
Substandard care, misdiagnosis of an injury or poor medical advice over an ongoing injury can have significant impact on future performance, leading to substantial loss of earnings or at worst the end of a career.
In sport, we know risks will be taken – players often want to play despite niggling injuries – but the medics in the game, the sports clubs and organising bodies, all have a duty to protect their health and their livelihoods – no matter at what level, and it was good to hear Southgate remind people of that this morning.
Sports clubs and bodies have a duty to protect players’ health and careers
Thankfully, there has been a much bigger focus on player welfare in recent years.
The days of serious injuries being accepted as ‘part and parcel’ of playing a physically demanding sport are long gone, and it has certainly been most welcoming to see issues such as head injuries and concussion being tackled, with stricter policies brought in across a number of sports to protect players.
Whilst we will often see debates like the one now around England, we have seen a clear move to better protect players from serious injury, especially during play.
In football, all matches now have an independent doctor – who is not subject to any commercial pressures or invested in the outcome of the game at all – in the tunnel to assist team doctors in recognising and diagnosing the signs of concussion.
If a head injury occurs and there is any confirmed or suspected loss of consciousness, a player must be removed from the field of play.
In rugby, the Head Injury Assessment protocol sees players undergo ten-minute assessment before a decision is made as to whether they are allowed to return to the field. The management of concussion is also subject to an independent review by no less than two experienced independent medical practitioners.
These are much needed for player protection and are designed to ensure the right decisions are made when and emotions are running high and in-play assessments are made.
Assessments during ongoing sporting contents are perhaps amongst the most difficult challenges of all for all those with responsibility for player welfare.
Players ‘must be looked after as human beings – not part of a team’
Maybe even more challenging than head injuries and concussions are the injuries which don’t have set policies around the treatment of them, and therefore become a judgement call for individual doctors and physios, in a snapshot of time.
With that in mind it was with great interest that I read an intriguing insight into player care in an interview with highly regarded sports doctor Eanna Falvey recently.
Falvey was head of medical for the British and Irish Lions rugby union team this summer, and was team doctor to the Irish rugby team for many years and Munster before that.
He was of the opinion that very few players in rugby play completely injury free at any given point, as most have slight muscle strains and tightness in joints as they play. I think that is accepted and understood.
However, he spoke also about how physios at the top sports clubs work under extreme pressure, where decisions have to be made as to whether players can continue in a maximum of around 30 seconds.
He spoke about how it is key that they don’t become ‘emotionally invested’ in the players who they get to know so well, or the fortunes of their team.
“It can be hard. You become reasonably friendly with these players. I teach a masters in sports medicine to doctors and physios, and one of the things I teach them is that you can’t afford to be a fan,” he said.
“You can’t afford to be emotionally invested in the outcome of either the team or the player’s input on the team. You need to look after the player as a human being rather than part of the team.”
His words are powerful and reflect the huge importance of the role of medics in protecting sports players from serious injury.
One wrong decision over injuries and treatment can lead to a serious long-term injury, perhaps the premature end to a career, and quite rightly a possible compensation claim for future loss of earnings that, given the modern day salaries, could reach astronomical levels.
Players will always want to get out on the pitch and do their bit for their team – they’ll always want to play.
But if you tell them doing so could risk their long-term career, could see them pick up an injury costing them hundreds of thousands of pounds – or even millions – and have a huge impact on their lives, they may see things differently.
Medical practitioners must, at all times, withstand any commercial pressures and exercise caution to avoid being caught between the club’s interests and the best interests of the athlete.
And the decision of those medical experts – with the player’s health the only concern – must be the only opinion followed – no matter what sporting result is at stake.
The players must come first.