Their payslips might raise a few eyebrows, but it can’t be denied that few jobs are as physically demanding as that of a Premier League footballer, and it shouldn’t be forgotten that those playing football for a living are aware they risk a career-threatening injury whenever they go to work.
Premier League clubs, therefore, have an obligation to minimise the dangers to their employees as far as possible, and naturally they are also well aware that an injury to a key player at the wrong time can cost them promotion, or survival in the league. So, in conjunction with the FA and other authorities, they tend to adopt a three-pronged approach of Risk Assessment, Risk Management, and Risk Mitigation, when it comes to the health of their players. Here’s details of how it works…
A careful balance needs to be kept between functionality and safety. Does making boots as flexible and lightweight as possible, for instance, make feet injuries more likely? And if a player has a condition that requires them to wear something that isn’t standard equipment, should that be allowed? For the average person, wearing hidden hearing aids to sharpen the sounds around them isn’t an issue. For a footballer, the FA or referees can raise objections over safety. Some footballers may feel forced not to disclose certain conditions, knowing that if they do it may keep them on the bench.
All clubs employ a team of highly-trained physios and medics, who will perform regular checks on players both before and after matches to spot any problems. The physio needs to be prepared to encounter anything from a cruciate ligament tear to a heart attack to a serious head injury, and make an immediate, accurate assessment as to whether the player can carry on, should be subbed, or receive hospital treatment. That can make the relationship between the physios and manager fraught with difficulty at times, something that was brought into sharp perspective earlier this year when Jose Mourinho had a public falling-out with the Chelsea physio Eva Carneiro.
The vast majority of injuries are likely to be incurred on the pitch, either during matches or training. That’s why great emphasis is placed on correctly warming up and warming down, and pressuring footballers to play in a safe manner, such as by avoiding obviously dangerous actions such as dodgy tackles. Eric Cantona apparently suffered a slight memory loss during the infamous Man United / Crystal Palace match back in 1996.
Before any player is signed they have to go through a medical, which is usually thorough but often that is dictated by how close it is to the end of the transfer window – some signings are made after just a cursory check. Most clubs don’t go into too much detail of what is involved in a pre-signing medical, but they will normally involve a cardio check, while others might delve into hearing, vision or dental tests, musculoskeletal stability, and urine tests. They might even be thought of as a cost-risk analysis – determining the player’s injury status, and how that will affect what the club requires of him – is he worth the price involved?
The quality of healthcare available for injured Premier League players is, no surprise, astounding, and just as technological developments at NASA eventually feed down into other industries, so advances in medicine in the Premier League no doubt influence what goes on in the NHS when it comes to rehabilitation.
Treatment might include ice baths for hamstring or groin strains to increase blood flow, or oxygen tents such as the one Wayne Rooney used for his metatarsal injury. Surgery will occasionally be needed, potentially taking a player out of action for months, although things like broken legs are not the challenge they once were, and some players who have suffered nasty breaks at the start of a season have been able to return to see out the last few matches. Again a balance must be sought, between the urgency of getting a player back into rotation, and getting them as close to 100% again as possible to avoid a possible recurrence of the injury.
Of course it’s not just on the pitch that problems can arise. It’s believed that many top-flight footballers are affected by mental health issues, often caused by the extreme pressures involved in playing football at the highest level. Where promotion/relegation, huge salaries and bonuses are at stake, not to mention the need to keep the supporters onside, it’s no surprise that some may find it difficult to cope. And there are other risks – Mourinho, again, was forced to sequester himself from his team after he became ill before a match, naturally making management that bit more difficult. And readers of a certain age will no doubt recall Gordon Banks, the legendary England goalie, who succumbed to food poisoning before the quarter-finals at the 1970 World Cup and had to be replaced. England lost, and were out of the tournament.