This week Arsenal hosted their annual Sport and Exercise Medicine Conference at the Emirates, reports Tom Goom.
Attending as both a physio specialising in sports injury and a lifelong Arsenal fan was an illuminating experience. It shed a little light on the ongoing question of why do we get so many injuries?
Our medical team took centre stage as Dr Gary O’Driscoll, Colin Lewin and Shad Forsythe all spoke expertly about various topics. Shad was especially impressive, giving one the best presentations of the day. Bearing in mind who else was on the bill this was quite some achievement. He was on a par with Karim Khan, arguably the biggest name in sports medicine, and Dr Nigel Jones, the England Rugby Team Head Doctor.
The talks from the Arsenal medical staff highlighted just how knowledgable they are. The theme of the conference was marginal gains in sport and I’m sure our medical team are fully aware of how to get that extra 1-2% from our players. Specifically, Shad’s discussion of strength and conditioning was really impressive, showing they are fully aware of the key role of strength and how to vary and structure exercise to suit the individual and stage of the season.
My impression from the day is that the medical team are doing everything they can to prevent injuries and provide the highest level of treatment. It’s clear they monitor training and game loads intensively, provide training targeting to both individual and team need, fully understand the demands of the game and carefully plan return to play after injury. In a nutshell they are striving to make our players physically and psychologically tough enough to cope with the rigours of the game. The problem is they can’t do this alone.
Relying solely on a great medical team is like driving a car with one wheel. It won’t get you very far. Injury prevention is very much a 4 wheeled-drive (though not one of those Chelsea tractors that yummy mummies drive). The remaining 3 tyres are the player, the manager and the fixture schedule (plus maybe a spare in the boot – luck.)
The player is vital and a host of factors affect resilience and injury risk including history of previous injury, strength, flexibility, agility, movement control, role within the team, psychology and communication skills. Thierry Henry spoke at the start of conference (more on that here) and said he was, “on a mission” to do everything he could to perform for the team. Are all our players that committed? Do they do their rehab? Are they consistent with their strength and conditioning?
Shad Forsythe showed a picture of Aaron Ramsey in the gym in jeans and a dodgy tank-top cardigan, making sure he got his strength work in! Medical advice is useless if a player won’t listen to it and equally useless if a player doesn’t honestly communicate how they are feeling. Was Alexis honest about his hamstring before he injured it in the Norwich game? Did he tell the medical team if it hurt during testing, or decide to just push on through?
Throughout the conference we heard examples of managers making decisions that had big medical consequences. It was, unsurprisingly, fairly mute when it came to stories of Arsene Wenger though. Much of injury prevention comes down to managing risk and weighing up risk v reward. Ramsey’s recent injury is a good example of this; Arsenal were 1-0 up against Hull and playing their 6th game in 18 days. Was it worth the risk of introducing Ramsey without a proper warm-up when he has a history of muscle injuries? Him leaving the field just 16 minutes later with yet another thigh strain suggests not. Le Boss is not alone though in this and other managers take even bigger risks. It wouldn’t be dramatic to say that when AVB allowed Hugo Lloris to play on with concussion he gambled with his life.
The final ‘wheel’ is one we have little control over – the fixture schedule. Coaching and medical staff work hard to monitor and modify training workload but there’s far less they can do about game time. If you overload muscles, tendons, joints etc with too much football eventually they are going to hurt. When we compare Arsenal’s injury troubles with other clubs we have to compare like with like.
How are other clubs managing that play 38 league games and at least 8 Champions League games (actually, sadly it’s usually just 8), as well as UK cup competitions? 4 out of 5 of the teams currently topping the physiorooms.com injury league have been juggling European and domestic commitments.
We have to take into account our player’s considerable international commitments too and sheer volume of games is not the only factor – frequency and intensity are also key. Our recent run of ‘crucial’ games against Watford, Barcelona and then Everton demonstrated a perfect storm of high frequency, intensity and volume at a stage where the manager is forced to take risks in order to perform.
When I think back to what I’ll take from this week’s conference (apart from a bright pink lanyard and a selection of free pens) it’s a new level of respect for our medical team. While medical professionals are always learning and developing I’m sure they are at the cutting edge of sports medicine and doing everything they can to prepare our players for the demands of one of the toughest leagues in the world.