Our players are normally surrounded by experts in sports medicine, nutrition, fitness and physiotherapy, constantly in routine contact with people who can help them be as fit and healthy as possible.
But social distancing and lockdown measures have posed a number of problems for our staff and our players. Here are some of the ways in which we have tackled the hurdles that have presented themselves.
Problem: The general conditioning of players.
Whilst at home, players have been able to undertake non-football speciﬁc training, such as cycling or straight line running and, with limited access to equipment, some strength training. A major problem with this is the deconditioning of speciﬁc muscle groups and a loss of muscle strength and mass that occurs. This is in addition to the obvious technical deconditioning that results from non 'football' speciﬁc training. We also had to give extra consideration to players’ body fat percentages with some dietary alterations for the squad.
Players were all given maintenance programmes based on the physical demands of the game; these focused on mobility and ﬂexibility, strength programmes for both the upper and lower body, central stability/core programmes and injury prevention strategies. They were also given weekly sessions directed towards cardiovascular ﬁtness with on-ﬁeld running sessions and bike programs for aerobic conditioning – treadmills and exercise bikes were relocated to players’ homes where this was needed. We are trying to replicate as best we can the normal input they receive - with the obvious exception of football speciﬁc, technical training.
Problem: Risk of injury.
Several players had returned to training following signiﬁcant injuries just before training was suspended. So there was an issue surrounding our ability to effectively achieve the last stage of football-speciﬁc ﬁtness for those players, including the build-up of match minutes before competitive games. The threat of deconditioning posed even more of a problem for these players and we had to mitigate against any risk of re-injury as a result. We developed a series of maintenance programmes tailored to each individual and designed to maintain injury-speciﬁc and general conditioning as much as possible.
Problem: Treating currently injured players.
Regular remote consultations via the phone or video conferencing have been used to maintain contact with the injured players. However, it has naturally been diﬃcult to continually reassess their injury and appropriately progress their rehabilitation as would normally happen. While we are unable to 'treat' players, we have provided them with home exercise programmes for rehabilitation, taking into consideration the limited access to facilities or certain equipment we would normally use.
Naturally, with the NHS and the healthcare industry working so hard to combat the virus, we have been unable to access some of the normal services we reply upon for managing our injuries, such as specialist consultations or scanning facilities. However, this period has of course provided our injured players with a rare commodity in football…time. This period without matches or training has given some of our injured players more time to return to full ﬁtness and we have ﬁrst team individuals now available for selection who would have potentially missed matches had the ﬁnal nine games been played as scheduled.
Problem: The mental health impact on players.
The lack of routine for footballers along with the lack of an end point and a return to training and games is bound to affect player motivation. To add to this, some players are spending lockdown at home alone, often away from their families who are living in different countries.
So our aim has been to help the players with regular contact from staff, including group conversations, virtual meetings and the delivery of different variations of fitness programmes to keep the sessions new.
There are of course still a number of unknowns with this virus and its ongoing impact on football. As considerations turn to how we might return to training and when we might be able to consider matches again, there will be an increase in the demands placed on the medical department.
It’s likely that we will need to continually monitor player symptoms and potentially turn to regular testing for COVID-19. We will also need to consider how we all use PPE and sanitise medical, as well as training environments and equipment, when we return to the training ground. And, of course, there are concerns about the likelihood of a truncated build-up 'pre-season' period ahead of the start of competitive football - combined with the possibility of more games being condensed into a shorter period. This obviously poses increased risk to the players in terms of injury and a challenge in terms of regaining their ﬁtness to appropriate levels before competitive matches restart.