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How do club physios assess a footballer's fitness?

There's much we can learn about monitoring our own fitness and health from the way that elite footballers are assessed by their clubs

Club doctors and physios have an important role to play in the fitness of footballers.
Club doctors and physios have an important role to play in the fitness of footballers. (AFP)

It is that time of the year again when football clubs in Europe and elsewhere are working overtime, as the leagues get underway. They will seek to push deals for new players behind the scenes before deadline day. Through this process, there is one phrase we hear a lot: footballers undergoing a medical. But why do some of the fittest and most athletic people in the world need to undergo a medical? 

During a football medical, a player undergoes a detailed medical examination to assess their physical condition and overall health, explains Dr. Joe Wilbur Gonsalves, the team doctor for Indian Super League team FC Goa. “During the medical we review the players' medical history, conduct blood tests, and perform imaging studies such as X-rays or MRI scans as and when required. The results help the medical team evaluate the player’s fitness for the sport and identify any existing or potential health issues that could impact their performance on the field. The tests include routine blood parameters (complete blood count, Vitamin D, Iron levels, etc.), cardiovascular fitness, lung function, joint mobility, muscle strength, and potential injuries,” says Gonsalves.

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The tests are conducted to give a player the green light to do high levels of physical activities: in this case, to play football without risk for his health, adds FC Goa’s strength and conditioning coach Jose Carlos Barroso.“The medical teams follow Fifa’s medical assessment system, which includes a full interview regarding medical history, family history medication or examination, followed by an ECG and a blood test, along with musculoskeletal examination,” says Barroso.

According to Barroso, the primary goal of a medical in football is to avoid health risks, such as heart attacks, and also to avoid future injuries that can affect the career and sporting life of the athletes. From a team doctor’s point of view, Gonsalves says that conducting a medical on football players is very critical to assess any potential conditions, injuries, or fitness issues that could affect their performance. 

“This helps teams make informed decisions about player acquisition, ensures that the players are fit to participate, it also helps prevent any untoward exacerbation of existing health problems. It’s very important to assess a player from an orthopedic surgeon’s point of view as it helps in prognosticating injuries during the season,” he says. 

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Football medicals are pretty much the same across the world as football federations have to follow Fifa rules and medical guidelines. However, there are some minor differences. “Sometimes, in some places, tests can be more detailed or some aspects of the medical test may be more specific. For example, sometimes the maximal aerobic test is conducted as part of the medical, while at other times a sub-maximal test is done. Sometimes, even this is optional,” says Barroso. 

Gonsalves adds that there could be differences in football medicals from country to country and club to club due to varying medical standards, facilities, and practices. However, all football medicals evaluate cardiovascular health, musculoskeletal condition, and overall fitness.

It’s not just the new signings who undergo a medical before joining a club. Similar medical tests are conducted for all contracted players of the team at the start of each season. The decision on whether a player has passed is made collectively by the club doctor and the strength and conditioning coach. The club doctor has the final word.

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Club’s strength coaches work closely with the medical team, especially towards the beginning to understand the status and limitations of players. They are usually involved in the musculoskeletal aspect of the medical, giving exercises to the players as a solution for any specific mobility problems or weaknesses in joints and muscles. “This way we can have better athletes who can manage the load and demands of the sport well,” explains Barroso.

Expanding on the strength and conditioning coach’s role in this process, Barroso says their emphasis lies on two things: keep players available for selection by minimising the injury risk, and maximise performance. “The medical team is responsible for the recovery and wellness of the players. Hence, both the medical team and the strength and conditioning coach work hand-in-hand towards a common goal,” he adds.

Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.

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