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Injury Time Episode 8. Medical teams for the crowd, Odegaard's Injury and player workload
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This week, we talk about what the medical setup is for a medical emergency in the crowd. We talk about Martin Odegaard's injury last weekend and talk about player workload with the Premier League players away on International Duty.
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Transcript
Introduction of Hosts and Episode Date
00:00:01
Jonathan Bird
Welcome everybody, ah this is another episode of Injury Time. I'm here with Shabazz Mergle and Ian Beazley as ever. Hi gents.
00:00:12
Shabaaz Mughal
Evening, good evening
00:00:15
Ian
No.
00:00:15
Jonathan Bird
Right, so ah we're recording on Sunday 12th of October. um We missed an episode last week. um Shabazz, you were available, urging us to record but
00:00:25
Shabaaz Mughal
was, yes
00:00:26
Jonathan Bird
Ian and I were were out and about and we weren't we weren't quite available.
Match Analysis: Victory over West Ham
00:00:31
Jonathan Bird
so um So what's been happening the last couple of weeks? Ian, you out of the West Ham game, were you, last weekend?
00:00:41
Ian
no
00:00:42
Jonathan Bird
No, but yeah I was there. Good win over West Ham, um one of our bogey sides. And I was in the pub watching Spurs play very well, actually. um Away at... Where were you away at?
00:00:56
Jonathan Bird
I can't remember now, it was in the pub, but they were wearing that really actually quite nice black top. um I do like a plain, I do like a plain top. ah um And yeah, I was, oh God, can't remember who that was against now.
00:01:06
Ian
Was the one, was the two one, yeah.
00:01:09
Shabaaz Mughal
Was it Brighton? i don't know. I can't remember either.
00:01:11
Jonathan Bird
It was away, it was away at Bournemouth. Oh dear, that's terrible. and well No, it wasn't Bournemouth, you'd known it was Bournemouth, wouldn't you Ian? Anyway, so there's a few things that happened.
Medical Emergencies at Matches and Stadium Preparedness
00:01:24
Jonathan Bird
One, we were going to talk ah initially about just just briefly there was saw what reported that was very sadly there was a a West Brom fan who was away at Shifford Wednesday at Hillsborough um who had myocardial infarction in so in non-medical parlance had essentially had had a heart attack his heart stopped and there was an in-depth
00:01:51
Jonathan Bird
dissection by the ah coroner into exactly what happened minute by minute from his initial collapse on the stands that could be seen on CCTV to his attempted resuscitation, both in the, in the stands and then on the concourse during halftime, because it was almost at halftime.
00:02:06
Jonathan Bird
I mean, I'm not going to get into details of that particular case, but we were talking just off air. It was interesting that, um, I wasn't really aware that how much medical support there is in a ground for the crowd dedicated just for the k crowd. That's right, isn't it? Um,
00:02:21
Jonathan Bird
so shabbat
00:02:23
Shabaaz Mughal
Yeah, um I mean, I think there's a green paper, green paper, I think you call it, or white paper, green book.
00:02:29
Ian
Yeah.
00:02:31
Ian
yeah
00:02:32
Shabaaz Mughal
Yeah. um But essentially, there's a certain, you know, if the crowd's over a certain 1000, maybe 2000, there's got to be dedicated paramedics available for the crowd.
00:02:43
Shabaaz Mughal
um Don't quote me on the numbers and forgive me for not knowing them exactly now. um But then if it's over a certain amount further than that, there's got to be a dedicated crowd doctor.
00:02:54
Shabaaz Mughal
And then that's got to be sort of multiplied to the size of the crowd. So yeah the bigger stadiums, you'll end up having teams, teams of paramedics and doctors. Basically, you'll have a central team, then you might have floating teams throughout the crowd.
00:03:10
Shabaaz Mughal
and then you'll have sort first responders and then secondary responders. you've got a big operation. It's a huge operation, actually, for the crowd and it's dedicated for the crowd.
00:03:20
Ian
Thank you.
00:03:22
Shabaaz Mughal
So it's completely separate from team medics. So the expectation is not really on us as a team medic to be dealing with any issues in the crowd because there is dedicated staff for that every game.
00:03:37
Shabaaz Mughal
And then normally I mean, certainly when we were planning the new stadium, obviously at the old stadium at Spurs, we had an established crowd doctor who led the crowd doctors and then had a team of crowd doctors.
00:03:50
Shabaaz Mughal
And we'd have quite regular contact, just making sure we're all off on the same page. They'd have the paramedics. they'd make sure everything's available.
00:04:00
Shabaaz Mughal
And they had to be there before the first crowd. So I think again, in that paper is you got to be there before the first person, the crowd turns up. So a certain number of hours before, and you can't leave until the last person's left.
00:04:13
Shabaaz Mughal
So it's quite strict in terms of the rules around it. And then when we were planning the new stadium, it was a massive operation, the crowd doctors and know in some ways because we we made sure they were the right type of doctors as well so you want you know and emergency medicine doctors doctors who deal with it every single day um And by the time, just going off slightly, but when we had tunnel doctors as well, we tried to get that mix because obviously as a team doctor, sports and exercise medicine consultant, you're not dealing day to day.
00:04:50
Shabaaz Mughal
As an orthopaedic surgeon, you will be either with collapse and resuscitation. So you really want some A&E emergency medicine expertise there as well. So yeah, I mean, it's a big operation.
00:05:04
Shabaaz Mughal
Ian, what do you think?
00:05:07
Ian
I mean, is a big operation. I know at Highbury, I used to go and see the crowd doctor every every home game and say hello. But when you got to the Emirates, you know, because they've got, you know, strategically placed teams around the stadium so they can get access to any spectator that collapses, you want them to get there quick.
00:05:15
Shabaaz Mughal
Yeah. Mm-hmm.
00:05:27
Ian
So there's no point in just having one team, say, stationed by the tunnel. If someone collapses over the other side the ground, it takes 10 minutes to get there. So you have lots of teams in big stadium, and the bigger the stadium, the more teams.
00:05:42
Ian
And then you have the commensurate amount of ambulances. I think Man United had something like six ambulances outside, and they share between players and and crowd.
00:05:56
Ian
So is a massive thing, and the FA used to run, I'm not sure they still do, used to run a crowd doctor course. I did it years ago.
00:06:07
Ian
But the whole point is that they're much better at dealing with that sort of emergency. ah Whereas you know my job in life when I'm sitting on the bench is to deal with the the people in front of me, i.e. the players.
00:06:22
Ian
But obviously if someone collapses five yards from where I'm sitting, I'm not going ignore them. But I think for lots of reasons, they need specialist attention.
00:06:35
Ian
The real problem is in this case, from what I gather, although I don't know the ins and outs of it, is that, you know, practicing as a team, making sure that you all do the right things and that the right treatment and management is administered for the casualty, you know, it takes a fair bit of preparation.
00:06:56
Ian
And you get caught out when everyone's in a tizzy, you get caught out. because you suddenly forgot what to do even though you think you know what you're doing. So you've got to practice, practice, practice.
00:07:07
Jonathan Bird
There was...
00:07:08
Jonathan Bird
there was um
00:07:08
Shabaaz Mughal
I think we should do, we'll do one on emergency response because Ian just mentioned something really important there, which I don't think, you people may not fully appreciate the amount that you practice.
00:07:21
Shabaaz Mughal
So before every game, you would, mean certainly in terms of the team looking after the team you'd meet with the opposition doctor you'd take them through all your equipment checks so you check through all the equipment make sure it's working you'd take them through meet the paramedics and we would actually practice scenarios as well with our paramedics regularly So that we would be, as Ian said, you kind of want it to be an automatic thing.
00:07:51
Shabaaz Mughal
Because when something happens like that, it's a highly stressed environment. And you want it to be automatic. You don't really want to be sort of thinking, that's your role, that's your role.
00:08:01
Shabaaz Mughal
What should I do? What should you do? But I think it's probably a whole podcast that we can discuss that.
00:08:06
Jonathan Bird
Yeah, well, is it was it just reminds me, actually, suddenly, that, as some will know, i um I was a doctor in the army, and there was a guy called Rob Wainwright who played, he's a rugby player, he played in the back row of Scotland, and he was also in the um RMC, although he's almost 10 years older than me. And um when he was playing rugby in his first club he played at, can't remember, but he was he was playing...
00:08:33
Jonathan Bird
and someone collapsed in the crowd and he left the pitch to go and start resuscitating this this supporter in the crowd, one but one of the players.
00:08:43
Shabaaz Mughal
Amen.
00:08:43
Jonathan Bird
I presume you've never personally had to go into the crowd, have you?
00:08:50
Ian
I did at Orient, I remember we had a spectator collapsed at the turnstile.
00:08:51
Jonathan Bird
Everybody?
00:09:00
Ian
So,
00:09:04
Ian
survived actually, which was nice. But yeah, I mean, it's very, very difficult. And at Orient in those days, I mean, that's in the, what is it, early That, you know, that wasn't what there is now.
00:09:21
Shabaaz Mughal
I see here.
00:09:21
Ian
I mean, emergency action plans is one of the first thing you look at when you go to a club. You know, where's the ambulance? Where's the exit? Where is everybody?
00:09:32
Ian
How do I get in touch with these people? How do I communicate with everybody? Are there radios for everything? I mean, it's a massive, and doing EAPs and getting them all sorted out, emergency action plans, that is.
00:09:46
Ian
It's nearly a full-time job.
00:09:48
Shabaaz Mughal
Yeah, definitely. Keeping them up to date.
00:09:50
Jonathan Bird
um Okay, so that's an interesting topic again and yet another one of these ones that we can maybe talk about. You were saying the emergency action plan, which must have been changed a lot post sort of Hillsborough and stuff like that.
00:10:07
Jonathan Bird
um anyway look
00:10:08
Jonathan Bird
so We were going to be talking last weekend, but we didn't manage to do a poll on Martin Odegaard, the Arsenal captain, had an unwanted record of being the first player to be subbed off for injury in the in the first half three three games in a row um for what we reckoned was a
00:10:09
Ian
They weren't before then.
00:10:11
Ian
They were.
00:10:31
Jonathan Bird
ACJ, which is where you your collarbone attaches into your shoulder, he injured it the first time and then he had you he then he re-injured it the second game. And his third game this time round, these he's injured is <unk> injured his knee.
Player Fitness and Game Readiness
00:10:44
Jonathan Bird
Before we go into the injury itself, Shabazz, you were talking, you were sort of wanted to talk about maybe um the importance of making players available versus getting them robust to last the season, you know, squad depth, that kind of thing.
00:10:59
Shabaaz Mughal
Yeah, I mean, that's always the question. So I think it's always tricky and you've got to, it all comes down to the thing I always talk about is you need communication with your coaches and you've got to be on the same page and you've got to be, there's got to be that mutual trust and relationship because there will be times where you'll take a chance on the player.
00:11:24
Shabaaz Mughal
But you've all got know that, you know, there is a risk that he's not going to last the game.
00:11:33
Shabaaz Mughal
And equally, there are times where you know, you feel maybe the risk isn't worth taking. It's quite likely they're not going to make it. There's quite a few times where you'll do a fitness test and, you know, what is a fitness test?
00:11:48
Shabaaz Mughal
So you can't really replicate what's going to happen in a game.
00:11:58
Shabaaz Mughal
And or fall and he'd be fine.
00:12:00
Jonathan Bird
Yeah, because it because of course that was his shoulder injury and you don't you don't really expect it so you' expect to have a ah a hard blow to your shoulder when you're playing football, if if you're if you're not keeper.
00:12:01
Shabaaz Mughal
Equally, a minute into the game, so yeah.
00:12:09
Shabaaz Mughal
Yeah, so then equally, no, but but it's like, um it's invariable, isn't it, that when you're protecting something, it gets hit.
00:12:19
Jonathan Bird
Yeah.
00:12:19
Shabaaz Mughal
um
00:12:20
Shabaaz Mughal
So I think it's such a tricky one, and you'll sit the bench, you've got your fingers crossed, and there might be 80% the time they'll get through it, and no one makes any comment about it because no one knows.
00:12:34
Shabaaz Mughal
but maybe the 20% of the time they come off, then it's a big deal. But that's where, know, as a club, you've all got to be on the same page that you accept, you took the risk. It's worked the last eight times, but this time it didn't work, then fair enough.
00:12:50
Shabaaz Mughal
And the danger is the sort of finger pointing and trying to blame people. And you should, you know, in retrospect, this should have happened, that should have happened. Um,
00:12:58
Jonathan Bird
Well, we mentioned, didn't we, in one of the previous pods about Saliba, who injured his ankle in the warm-up and then went off after sort of two or three minutes. And, you know, we were talking about the...
00:13:11
Jonathan Bird
You know, how that that kind of risk-benefit ratio when when that's happened. And both of you have had that, haven't you? Where the players had a tweak and between announcing the team sheet and and them and and the start of the game.
00:13:24
Jonathan Bird
So, you know, it like like like all these things, it's, you know, what what what we don't hear about, of course, is the number of times that the medic has decided, i think he'll be all right. And he is all right.
00:13:35
Shabaaz Mughal
Yeah, exactly. Yeah.
00:13:38
Ian
yeah Yeah, but the
00:13:41
Ian
the issue there is that it's not always the medic that makes the decision.
00:13:45
Jonathan Bird
Yeah.
00:13:46
Ian
It usually isn't the medic that makes the decision.
00:13:46
Shabaaz Mughal
true. Yeah.
00:13:51
Ian
Certainly, the manager will ah will make that decision. and you know The manager will go and speak to the player and say, how do you feel? Do you think you're ready? And the player and the manager have a relationship that's interdependent and doesn't involve me.
00:14:09
Ian
So the player wants to please the boss because he wants to play and that makes a big difference and depends on when his contract is up and is he normally in the team or isn't he or that sort of thing.
00:14:21
Ian
And the boss needs the player because he needs to win games or he's not going to be the manager anymore. And often that discussion will happen between them two and, you know,
00:14:36
Ian
you suddenly find out they're playing, even though you'd rather not have. I had this discussion, were interviewing for a doc in a club that work with, and had this discussion and he was saying, yeah, well, if the medical team say no, we have a multidisciplinary meeting, and if they say no, it's no.
00:14:56
Ian
And I said, are you telling me that the coach doesn't have anything to do with this? And he said, well, it's not the coach's decision. And it often is, unfortunately.
00:15:03
Shabaaz Mughal
But
00:15:06
Ian
And, you know, often the coach, if players get injured all the time, the coach will often say, you know, the medical and performance team aren't getting my players fit enough to cope with my style of play.
00:15:22
Ian
It's not an uncommon complaint.
00:15:27
Jonathan Bird
when when When in fact when when when in fact you you could argue that actually it's them not listening to you.
00:15:27
Shabaaz Mughal
but that's what i was saying.
00:15:32
Shabaaz Mughal
Yeah, definitely.
00:15:32
Ian
No, no, way it's what it is. And that's what Sipai is just about to say. It's all about communication.
00:15:35
Jonathan Bird
Sorry, I can't shoot.
00:15:37
Ian
It's, you know.
00:15:38
Shabaaz Mughal
Yeah, it's about... So I agree you because there's been coaches where you're not really... You have a discussion and then, like you say, and the player will have... Or they'll go to the player and the player will never say no to the manager directly.
00:15:52
Shabaaz Mughal
But that's where, you know, there are other coaches who are a lot more sort of... They understand people a lot more and they realise that that's what the player going to say anyway.
00:16:03
Shabaaz Mughal
So then if they have that trust in you and, you know, they know that on the last five occasions when he said, yes, it was fine. But if he's saying no this time, I've got to trust him because he's not going to So that's the thing as well.
00:16:19
Shabaaz Mughal
They've got to trust you're not someone who always says no. You say no when you think genuinely it's not going to work out. But then sometimes you might all think, actually, you know what, this is like a, it could go either way, but if it goes, you know, we're in it together.
00:16:36
Shabaaz Mughal
And I think that's, it's so important to get that good relationship with the coaching staff. And if you get that, I mean, your job's like amazing, it's bliss.
00:16:47
Shabaaz Mughal
But a lot the time in football, there's a lot of, you know, clashing, I think, between coaching and medical problems.
00:16:55
Ian
I understand it. Coaches, like I said, have to win games. You know, look at Ange Postacoglu at Forest. He doesn't win the next game.
00:17:03
Shabaaz Mughal
Yeah.
00:17:08
Ian
it's hard. mean, I think it's hard for everybody. And, you know, our job, I think, is to advise. The real problem is that the manager looks out of his window at the training ground and sees a player who's 85%
00:17:25
Ian
getting back to playing and he looks great on the practice pitch on his own running with the physio or the fitness coach looks fantastic suddenly the manager's thinking oh well you know we'll have him on the bench for the weekend you know happens all the time and you know you have to set your stall out early as Shabazz implies really and make sure that the manager understands what the steps are before you get to full fitness so it's yeah
00:17:41
Shabaaz Mughal
Yeah.
00:17:55
Ian
And sometimes it works and sometimes it doesn't work. It's a bit like the rest of life, really.
00:18:01
Shabaaz Mughal
Do you think at the moment, though, I think things over the last years, see football changing a bit because of squad depth and the trust that they have in the whole squad. So for Arsenal, for example, I mean, with their signings this year, their depth is so good that you can kind of see him leaving out some of these, you know, like Rice has been left out, Odegaard's been left out, where normally you'd not leave these players out, but because he's got the depth,
00:18:30
Shabaaz Mughal
He can take a longer-term view and there's probably a lot more security. The manager, the coach feels in his role. So all of this plays a part and if it does, then they can take their time with Odegaard and they can get more robust and take the longer-term view, get him fit for most of the season.
00:18:47
Shabaaz Mughal
You don't need to rush him back for this game or that game. And that' that's, again, an ideal situation.
00:18:51
Jonathan Bird
yeah i mean what ah through so um Three seasons ago when we made that surprise sort of run for possibly winning the title and finished the first time we finished second and um William Saliba had a back injury towards the end of the season.
00:19:08
Jonathan Bird
He got sort of jumped on and ah two players jumping for the fifth of the ball. And the guy that came in for him was Rob Holding, who was a good player that helped win the FA Cup in 2020, but he was definitely on the wane of his career.
00:19:22
Jonathan Bird
And just wasn't good enough that point. It just wasn't good enough.
00:19:26
Shabaaz Mughal
Thank you.
00:19:28
Jonathan Bird
And the step down from such a good player down to him, um is exactly what we don't have now. and you know We've had a bit of a run of injuries at start of the season, but yet we are now in the international broker top. And that is because of squad depth.
00:19:44
Jonathan Bird
And that perhaps, you know you were saying, weren't you, before off-air, that maybe with the intensity of and of the ah of of the playing calendar nowadays, you know we're all on we're all on an an international break, it's not a break for the players.
00:19:59
Jonathan Bird
You've got these, ah the Premier League players, are half of them are from, you know, all the Brazilian players are off in, they're flying to Japan this week, and then they're all due back next weekend.
00:20:04
Shabaaz Mughal
Yeah. Yeah.
00:20:09
Jonathan Bird
um Should we have, you know, perhaps the Premier League needs to have expanded squat lists or allow to have an expanded squad list?
00:20:18
Ian
Yeah, no, I agree. mean, the other thing to say is even those players who don't go on international duty, don't imagine they're off in Dubai for a week. They're training every day.
00:20:28
Jonathan Bird
Yeah, yeah.
00:20:29
Ian
They might get a day off, whereas they wouldn't normally. or they may get a weekend off in the middle of the window, but they're training.
00:20:36
Shabaaz Mughal
Yeah. Mm-hmm.
00:20:38
Ian
They're training just like they normally do, and it's just a bit more boring because everyone else is on international duty. So, you know, there's no respite for them, and top players are playing 60, 70 games a year.
00:20:52
Ian
With the new Champions League format, they're playing more games, and Champions League will change again to get even more games in because everyone makes loads of money
Impact of Match Frequency on Players
00:21:01
Ian
out of it.
00:21:01
Jonathan Bird
And then, you know, there's the whole Club World Cup and there's always something, isn't there?
00:21:05
Ian
yeah
00:21:05
Shabaaz Mughal
to I think I heard something, is it the UEFA, is it Infantino, he wants to have more Winter World Cups and extend the season into June.
00:21:07
Ian
Yeah,
00:21:18
Jonathan Bird
course he does.
00:21:20
Shabaaz Mughal
So yeah, basically it's going to be football all year round.
00:21:23
Ian
which is great, isn't it?
00:21:24
Shabaaz Mughal
Yeah.
00:21:24
Ian
But honestly, I mean, can you imagine what it's like?
00:21:25
Shabaaz Mughal
Yeah.
00:21:29
Ian
know and every time you run out of the Emirates you've got 60 000 people expecting you to turn up on that day no no excuses and i'm one of them so know it's
00:21:40
Jonathan Bird
Well, I mean, it's interesting that it was leading on from there is there is just perhaps too much football and and you know that Tuchel criticised the Wembley crowd against against wales that it was all bit that the atmosphere was a bit flat.
00:21:56
Jonathan Bird
um And that it's maybe just just just a dip in, there's just so much. You're watching football all the time. And there's not just a three o'clock on a Saturday. Obviously, it's not just three o'clock on Saturday. that's That's gone forever. But not only do you get to watch your own team, but because the games are all spread out, you can watch seven, eight games at the weekend and there's three or four midweek and it's just all too much.
00:22:19
Ian
I mean, I've watched Scotland and Belarus this evening.
00:22:24
Ian
Well, you know, I mean, I'd like to see Scotland go to the World Cup, but the Scots wouldn't like to see England go to the World Cup, but I would like to see Scotland go to the World Cup. And they've just about won.
00:22:34
Ian
But, you know, if there's football on...
00:22:35
Jonathan Bird
I know it was good. Well, i i I was born in Glasgow, I am of course Scottish, but I've i spent most of my life living living in England and um I have to admit, ah the sort of international football, it's um i got far more interesting club football than I have international football in terms of as a fan.
00:22:51
Shabaaz Mughal
hold I think international football, when it's a major tournament, great. But anything around that, it's not really that interesting, to be honest.
00:23:02
Shabaaz Mughal
It's kind of...
00:23:04
Ian
What a great.
00:23:04
Shabaaz Mughal
Because the World Cup qualifiers, Euro qualifiers, by and large, the better teams or the bigger teams get through anyway. And these international friendlies a bit pointless.
00:23:16
Shabaaz Mughal
I find them even more pointless when... It's interesting because England manager, he criticises the fans, the fans who sort of pay for his salary in essence.
00:23:29
Shabaaz Mughal
But then they don't use those friendlies to actually play different players and try and see what England can do. So it's kind of like, it's a whole circle of kind of nothing really, isn't it?
00:23:41
Ian
I agree. And I think that, you know, it's pointless. England are going to qualify for every big tournament unless they have an absolute disaster. And then when you get to the tournament, if there are groups of four, then the first couple of games, it's all, you know, making sure you don't get beaten and this sort of stuff.
00:24:02
Ian
And, you know, I was at the last World Cup. And when you're in the knockout games, it all comes alive. And it's the same in Champions League. in the knockout games, that's the best football of the season, Champions League knockouts.
00:24:16
Ian
But got to wait for it.
00:24:18
Shabaaz Mughal
Yeah.
00:24:20
Jonathan Bird
Yeah, I mean, though ah so I was at the, you know, when we played PSG in the group stage and then PSG in the semi, it was a very, very different game, both of them. It was kind of PSG going through the motions in the group stage.
00:24:30
Ian
Yeah.
00:24:32
Jonathan Bird
we we beat them 2-0, and then, of course, it was very different in the in the knockout stage.
00:24:33
Ian
Yes.
00:24:37
Jonathan Bird
um And it does become a little bit sort of routine. And i was at the Olympiacos game, and there was there was still a lot of spare tickets on on non day the match for Champions League.
00:25:01
Jonathan Bird
Yeah.
00:25:01
Ian
fantastic. A proper game of football. You know, you don't see him now. But you're right, Shabazz, Jonathan, in a way there's too much football and the quality gets diluted.
00:25:15
Ian
That's what happens.
00:25:16
Jonathan Bird
yeah But um we were going to talk just briefly just about about the specifics.
00:25:18
Shabaaz Mughal
Yeah. yeah
00:25:21
Jonathan Bird
I mean, we've gone off we've gone off gone off track a bit here, but the kind of specifics of the actual Odegaard injury, we were it was interesting that it was it looked like a direct knee-on-knee blow.
Injury Analysis: Martin Odegaard’s Knee Injury
00:25:34
Jonathan Bird
and um And I was really surprised to hear them talk about an MCL injury. and I went back and had a look at the injury as Ian did as well, that um it was a direct blow on the, so so the MCL, the medial collateral ligament is on the inside of your knee.
00:25:50
Jonathan Bird
So it's on the, you know, it's on the left hand side of your right knee, the right hand side of your left knee. And what normally happens to to to stretch that ligament, the MCL, you have to have a blow to the other side of the knee so that the inside, so that your knee buckles inwards and it stretches that MCL.
00:26:11
Jonathan Bird
Now he got bashed um on directly onto the MCL it looks like. So that, I just can't see that that could be an actual MCL injury. And I had a player last week that I'd seen, a low level amateur player, that he'd had, he'd been smacked directly on the knee.
00:26:28
Jonathan Bird
um And when I tested his MCL, so this is where I hold the knee and I push the foot outwards to to stress the MCL, he had no pain at all.
00:26:39
Jonathan Bird
But when you pressed on the inside part the knee where the MCL is, it was really, really painful. And the radiologist report was grade two MCL injury and there whole load of bruising around the MCL. So there was bleeding in the soft tissues around the MCL, but not the MCL injury, which I think is an important distinction.
00:26:57
Jonathan Bird
um which would suggest that recovery would be quicker but you think perhaps not Shabazz, don't know.
00:27:03
Shabaaz Mughal
Yeah, so I think we call that an MCL contusion.
00:27:06
Jonathan Bird
Hmm.
00:27:07
Shabaaz Mughal
And often can mimic an MCL injury in terms of time frame and the pain they get with flexion. Ultimately, pain limits their rehab and limits their ability to rehab.
00:27:20
Shabaaz Mughal
So you've got to allow the pain to settle, all of that inflammation to settle. And there are things you can do try and speed that up. Ultimately, it still takes a bit of time. And I remember we've had players where And I think this is the thing that it's a knock basically.
00:27:36
Shabaaz Mughal
And in football, it's always, it's only just a knock. So the expectation is someone gets a dead leg, i.e. a knock contusion to quadriceps. They should be back on the pitch, know, in a few days.
00:27:49
Shabaaz Mughal
But sometimes, know, you can have quite significant bleeding from that contusion, can really limit the function. And I remember we've had like cases where it's been out for quite a while because it's just not settling down, pain's not going down enough, despite you might drain the fluid off, you might offer various analgesia, but unless a player feels comfortable enough, they're not be able to push through their rehab.
00:28:19
Shabaaz Mughal
So you've got to have a bit of a, you know, it's never just a knock basically.
00:28:24
Jonathan Bird
So what do you reckon, do you think? How long do you think he'd be out of that? that's Three to six weeks?
00:28:32
Ian
Three.
00:28:33
Shabaaz Mughal
Well, yeah, probably about four weeks maybe.
00:28:34
Ian
I think you'd be at three. And I think the other thing you're right, Shabazz, and the other thing is, is that if they don't train for a week, then they're going to need to get back into training.
00:28:44
Shabaaz Mughal
Yeah. Yeah.
00:28:45
Jonathan Bird
Yeah.
00:28:46
Ian
And, you know, it's like everything. It's not an automatic, oh, I'll just have a week off and then I'll get back on Saturday.
00:28:51
Shabaaz Mughal
Yeah.
00:28:52
Ian
I'll be fine. I'll play again. It doesn't work like that.
00:28:55
Shabaaz Mughal
Hmm.
00:28:55
Ian
So they have to get back and train. have to feel comfortable training. And they have to be sort of reintegrated into full training. And that can take up to a week.
00:29:06
Shabaaz Mughal
Yeah,
00:29:07
Ian
I'd say five days is the sort of median time. And if there's a midweek match for the team, then they ain't training for a couple of days because there's match day minus one, match day, match day plus one.
00:29:20
Ian
So it all depends on what goes on.
00:29:23
Shabaaz Mughal
Yeah. Because we take for granted that when we talk about rehab, that people understand that essentially it's not just someone gets injured, they don't sit there, have treatment and are then medically fit and then straight back to playing
Rehabilitation and Post-Recovery Reliability
00:29:40
Shabaaz Mughal
football.
00:29:40
Shabaaz Mughal
They then get back on the pitch in the gym and they go through a whole process.
00:29:40
Ian
Mm-hmm.
00:29:45
Shabaaz Mughal
to get back to the point that they were at before. So it's like when someone gets a fracture, for instance, John, and you offload them, they detrain, then you've got to retrain them back to the level they were at before they can then...
00:29:54
Jonathan Bird
Yeah.
00:29:58
Shabaaz Mughal
And all this time, the group has moved on in terms of their training load and their intensity. So they're catching up to the group as well. So really, any even minor injury can set you back quite a few weeks because you're still trying to catch up what the group Or doing otherwise.
00:30:17
Jonathan Bird
because all your muscles switch off, don't they? As soon as you become injured.
00:30:17
Ian
Yeah, I mean, yeah.
00:30:20
Shabaaz Mughal
Yeah.
00:30:21
Ian
And at Bournemouth, there had to be, you had to, you know, you weren't allowed to, you had to have a day sort of half intensity training. Even if you had a cold and you missed vomiting and diarrhea, you missed a day, then you had recovery for a day and rehydrated.
00:30:32
Shabaaz Mughal
Yeah.
00:30:36
Shabaaz Mughal
Yeah.
00:30:38
Ian
Then you had to get back on the pitch and do an ordinary, say, half intensity.
00:30:43
Shabaaz Mughal
yeah
00:30:44
Ian
And if that went well and no reaction, then you got back in.
00:30:47
Shabaaz Mughal
Yeah.
00:30:48
Ian
So, you know, that's just about three days training missed.
00:30:52
Shabaaz Mughal
Yeah. We'd call it a clearance session. You did have to do a clearance before joining the group.
00:30:56
Ian
Yeah, exactly.
00:30:57
Shabaaz Mughal
Yeah.
00:30:57
Ian
Clearance. Yeah, exactly right.
00:30:58
Shabaaz Mughal
Yeah. And this, again, it comes back to the coaches you're working with and the ones who understand and they want that because they don't want a player returned to them who's sort of there in terms of the group being there.
00:31:12
Shabaaz Mughal
They want that player to be able to be close to the group so that they will train for, you know, then obviously they're going catch up while they train and then they monitor them and decide when they're ready to play.
00:31:24
Ian
I mean, it's about reliability, really. The coach has to be able to rely on a player.
00:31:29
Shabaaz Mughal
Yeah.
00:31:31
Ian
And if they can't rely on a player, then often they'll just, they just won't pick them. And that's, there's lots of reasons they don't rely on a player and fitness is just one of them.
00:31:41
Jonathan Bird
but then but but but then But that formula and a changes if they're an important player, though.
00:31:46
Ian
It can do. If there's, you know, if it's, it's like everything, isn't it? I mean, I used to say, I still say to players, oh, know, if it was the FA Cup tomorrow, you know, we might do something with this, but it's not the FA Cup final tomorrow.
00:32:00
Ian
So therefore, you know, you're going to have to do your rehab like normal. And I think managers and players, coaches and players approach it in the same way. if it's a World Cup final, no one's going to keep a player off the pitch as long as he can walk.
00:32:18
Jonathan Bird
Yeah.
00:32:29
Shabaaz Mughal
Is that right, Ian? And he he played the final. He had some interesting treatment before he played the final, according to folklore. um And then he was out for, i think he was at Bayern, he was out for like three months or something afterwards.
00:32:43
Shabaaz Mughal
Was it three months even longer? Basically missed most of the next season.
00:32:43
Ian
yeah yeah I think that's when Bayern sued them
Risks of Playing Unfit Key Players
00:32:51
Shabaaz Mughal
Yeah, yeah.
00:32:53
Ian
but you know then that's the thing players have a say in this and big time players will have lots of say
00:33:00
Shabaaz Mughal
Yeah, exactly, yeah.
00:33:05
Ian
I think I went to, I was at the um Champions League final when Spurs played Liverpool and Harry Kane hadn't played very much because he had an ankle injury. And he played, he started in that game.
00:33:16
Ian
And I said to my son, he should be starting in such an important game. And he didn't really play very well at all. And, but he he didn't look fit.
00:33:25
Shabaaz Mughal
Yeah, but if he didn't play, everyone would have said he should have played. So you can' I think you can't win.
00:33:30
Ian
um Well, yeah, maybe some people would have said, yeah, but,
00:33:32
Jonathan Bird
Yeah, but then but but he's yeah but but that but that's perhaps taking up a place, isn't it?
00:33:35
Ian
He won't fit.
00:33:35
Shabaaz Mughal
ah you Okay, so ah say all right let's say England get to the World Cup final, but Harry misses um from the group stage to the final.
00:33:36
Jonathan Bird
And you know everyone's expecting him to play at the same level. i mean, it was the same in the World Cup.
00:33:40
Ian
Yeah.
00:33:49
Shabaaz Mughal
Do you think he gets straight back in the team in the final?
00:33:52
Ian
No.
00:33:53
Shabaaz Mughal
really i think 100% straight in.
00:33:53
Ian
but I I think he's on the bench. I think he's on the bench and it comes he comes on 60-70 minutes played if they're not winning.
00:33:57
Shabaaz Mughal
No chance. No.
00:34:03
Jonathan Bird
Well, of course, um famously in the 66 World Cup final, Greaves got dropped, didn't he?
00:34:08
Shabaaz Mughal
Oh yeah, Jimmy Greaves. Yeah.
00:34:12
Jonathan Bird
So, i mean, it can happen.
00:34:14
Shabaaz Mughal
Was he injured or did he get dropped?
00:34:17
Ian
Jimmy Greaves, I think he got dropped.
00:34:18
Shabaaz Mughal
Yeah.
00:34:19
Jonathan Bird
He was dropped.
00:34:20
Shabaaz Mughal
Okay.
00:34:21
Ian
Yeah, in favour of Hurston Hunt, wasn't it?
00:34:24
Jonathan Bird
But was Hurst injured earlier in the in the tournament and then...
00:34:30
Ian
Oh, I can't remember. God almighty, you're pushing me now, son.
00:34:32
Shabaaz Mughal
it was But that that has happened. there was think it was an Italian player. It might have been Beresi. remember someone, there a documentary recently, I think Italia 90, maybe.
00:34:45
Shabaaz Mughal
um This is proper long time, so i can't remember.
00:34:47
Ian
yeah
00:34:49
Shabaaz Mughal
But Beresi got injured in one of the group games. I think he had a meniscal injury.
00:34:55
Ian
He had a meniscal injury and he played in the final.
00:34:55
Shabaaz Mughal
had yeah Had surgery, played in the final, was amazing. Yeah.
00:35:01
Ian
But Franco Beresi was an unusual sort of player. and you know
00:35:08
Shabaaz Mughal
Yeah, but the ones they take the chance on, they normally are. It's those players, aren't they, that can...
00:35:13
Ian
but i also think playing
00:35:14
Jonathan Bird
and Which is exactly your point, Shabazz.
00:35:17
Shabaaz Mughal
Yeah.
00:35:17
Jonathan Bird
If you've got Harry Kane, one of the one of the you know one of the most prolific strikers that England have ever have ever produced, you know and if he's even vaguely fit, then you have to play him.
00:35:24
Shabaaz Mughal
Never, yeah.
00:35:28
Shabaaz Mughal
You play him, because he can, that one moment, he can do, he could win you the game.
00:35:33
Ian
Well, see, this is a discussion for the pub, isn't it?
00:35:38
Shabaaz Mughal
Yeah.
00:35:40
Ian
That's what you're always doing down the pub. You're talking about these things.
00:35:42
Shabaaz Mughal
Yeah.
00:35:43
Ian
believe one thing, you believe another. Probably, you know, who knows?
00:35:48
Shabaaz Mughal
Yeah, exactly.
00:35:48
Ian
mean, let's hope it doesn't come to that.
00:35:50
Shabaaz Mughal
Let's hope it doesn't happen. Well, we hope he gets to the final, but hope he plays all the games.
00:35:57
Ian
i think I think they'll do well in the World Cup. I just... If they keep on as they are, I don't think they have that X factor to win it.
00:36:06
Shabaaz Mughal
Really, I think there's almost an embarrassment of riches. They don't know to put the players because there's so many good ones.
00:36:12
Jonathan Bird
Yeah, i mean look at you know you look at that that forwarded that um forward firepower of Bellingham, Kane, Ollie Watkins, Bikai Saka, you know, it's just...
00:36:25
Shabaaz Mughal
I think it's more that you've got Bellingham, Palmer,
00:36:26
Jonathan Bird
Oh
00:36:30
Jonathan Bird
yeah, Palmer.
00:36:31
Ian
Rice.
00:36:32
Shabaaz Mughal
Foden, and then you've got like the young guys coming through Rogers, there's Grealish as well.
00:36:32
Ian
Rice.
00:36:38
Shabaaz Mughal
There's so many. How do you fit them in basically? Yeah. Rice, yeah.
00:36:44
Ian
Yeah, that's why he earns the big bucks, it, I suppose?
00:36:46
Shabaaz Mughal
Yeah.
00:36:47
Ian
I mean, I sat and watched England from the touchline in Qatar and they couldn't get the ball off Saka. Couldn't get the ball off him.
00:36:58
Ian
He was unbelievable.
00:37:00
Shabaaz Mughal
Yeah.
00:37:02
Ian
And then was at that same end when Harry Kane missed that penalty. And that's the trouble, isn't it? Every now and again, funny things happen.
00:37:10
Jonathan Bird
You know, I mean, you would you would bet your house on Harry Kane to score a pen.
00:37:13
Ian
Yes, exactly.
00:37:13
Shabaaz Mughal
yeah yeah
00:37:16
Jonathan Bird
yeah i've I've seen him score many pens at at the Emirates and you just know that he always scores.
00:37:17
Ian
Exactly.
00:37:22
Jonathan Bird
And then that one massive pen.
00:37:22
Ian
yeah
00:37:25
Jonathan Bird
But, you know, such a sport.
Episode Conclusion and Acknowledgements
00:37:27
Jonathan Bird
Anyway, look, we've we've we've rambled on for far too long. and We didn't even get to talking about ALS with Lewis Moody et al. We can perhaps come back to that um another time. look Anyway, look, um let's finish now and we'll publish this podcast overall. So thank you very much, everybody. It's goodbye from Asia Northenburg, Shabazz Mughal and Ian Beasley. Thanks, gents.
00:37:52
Shabaaz Mughal
Thanks John, thanks Ian.
00:37:52
Ian
Thanks, Jeff. Great to chat.
00:37:54
Shabaaz Mughal
Take care.
00:37:54
Jonathan Bird
Cheers.