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Injury Time Episode 9
25 Plays2 months ago
This week, we talk about Virgil Van Dyk "interfering" with the medical team at Brentford and how to manage that as a medic and also delve into how to manage players when therre are a lot of games with players in the "red zone"
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Transcript
Introduction and Guests
00:00:02
Jonathan Bird
okay um Hello everybody, um welcome to another episode of Injury Time. I'm here with Ian Beasley and Shabazz Mughal. Hello gents.
00:00:12
Shabaaz Mughal
Evening on.
00:00:12
Ian
Oh, yeah.
00:00:13
Jonathan Bird
um So we had a we had a little extra episode that we recorded separately on Thursday. not quite sure and that's going to come out, it's little 10 minute vignette.
00:00:24
Jonathan Bird
um But anyway, how's your we're we're recording on was it Sunday 28th, 26th, even October.
Challenges of Watching Football with Kids
00:00:31
Jonathan Bird
um How's your week been so far?
00:00:36
Jonathan Bird
been Been to any games, watched football?
00:00:41
Shabaaz Mughal
What's much of the day?
00:00:44
Jonathan Bird
i mean, Shabazz has, of course, quite young children. Anyone who would know with young children doesn't don't tend to get to that much football.
00:00:51
Shabaaz Mughal
yeah Very difficult ear to do anything.
00:00:52
Jonathan Bird
um as it's no longer his job to be pitch-eyed at Spurs, he's allowed a few years off.
Fan Incidents at Atletico Madrid Game
00:00:58
Jonathan Bird
um So i was ah i was at spurs game a spurs game I was at the Palace game today at home, and on Tuesday at the Atletico Madrid game, um where I've had flares thrown at me, I've had pints thrown at me, lighters and coins.
00:00:58
Shabaaz Mughal
yeah the
00:01:20
Jonathan Bird
And that's first time that we got spat at by their fans, which was unpleasant. but never Never mind. um um Madrid.
00:01:25
Shabaaz Mughal
Which team was that?
00:01:28
Ian
Let's Madrid.
00:01:28
Shabaaz Mughal
Wow.
00:01:29
Jonathan Bird
Yeah. Atletico Madrid. I mean, they they got they got they they got pretty exercised in the second half when they scored four goals and and not not very many minutes.
00:01:35
Shabaaz Mughal
Yeah.
00:01:37
Jonathan Bird
But um the European teams tend to get, away fans tend to get very, very exercised. But they were just, I mean, spitting is bit beyond the pearl. But anyway, at least it wasn't flares, I suppose.
00:01:48
Jonathan Bird
um But yeah, it was it was it was interesting.
Liverpool's Losing Streak and Van Dijk Incident
00:01:52
Jonathan Bird
We're talking about injuries. The Liverpool match on last night, which it was a real shame Liverpool to lose that for Premier League games in a row. That's awful for them um ah them. Virgil van Dijk went up for a header towards the end of the match and he elbowed one of the Brentford players in the head. And it was and it was its it was it was deemed to be um non-deliberate which i think was fine um and the brentford doctor came on and did the head injury protocol it's interesting you can see on telly um virgil started having having words with the brentford doctor and it was not pleasant words and you can see the brentford doctor asking to sort of back off
00:02:35
Jonathan Bird
whilst he was trying to assess him, I think it was really, i think it was in the middle of them doing a VAR check but about whether it was a penalty or not. I just wanted to know from you two guys if there's been any kind of, you know, when when you when you come onto the field play, you're assessing a player.
Do Players Interfere with Medical Assessments?
00:02:49
Jonathan Bird
Do you ever get any interference from from the other players, from the opposition players that sort of interfere with you trying to do your work?
00:03:00
Ian
No one's ever really interfered with trying to do my work. I wouldn't have it. I don't mind telling the referee to go away if I think the referee's getting in the way.
00:03:08
Jonathan Bird
See you, everybody.
00:03:10
Ian
I mean, yeah, I just, I think that when you're on the pitch, You know, that's it really. And if Virgil van Dijk would say anything to me, I'd really tell him where to get off because got nothing to do with him.
00:03:26
Ian
And if he started saying anything, I'd call the referee over and tell him to get Virgil van Dijk out of the area. That never really happened to me, to be honest.
00:03:37
Ian
I was just saying earlier, I remember giving Andre Pirlo a drink of water and told him he played very well in a game, England versus Italy, when we got beaten 2-1 in Brazil.
00:03:49
Ian
Apart from that, don't talk to the away players.
Challenges in On-field Medical Assessments
00:03:55
Shabaaz Mughal
Yeah, I think similar. I can't remember ever an away player really getting in your way or saying anything. mean, whenever you're running on a pitch, quite an interesting psychology behind it actually, which we probably should touch on.
00:04:11
Shabaaz Mughal
So you run on the pitch. I mean, it's so loud. The whole stadium is quite a surreal moment. But in terms of what you do, it's quite It's quite odd actually, it's kind of like nothing else exists.
00:04:24
Shabaaz Mughal
You're just focusing on your task at hand.
00:04:25
Ian
Yeah.
00:04:27
Shabaaz Mughal
And I always remember I wasn't really aware of too much else going on. So even if someone did try and say something, I probably, it was all blocked out. I was focusing on the task in hand. You're dealing with your player, you're focusing on what you need to do and you're relaying the message back to the bench because there's so many things going on in that moment.
00:04:46
Shabaaz Mughal
So, you know, when you go on and check a player, there's a million things to consider. not quite a million, but there's a lot of things to consider. You know, there's the injury you're dealing with.
00:04:57
Shabaaz Mughal
Are they okay to continue? Is it something they can try and see, you know, what's the message you're give back that they may give it a few minutes and see how they feel? Where is the injury?
00:05:09
Shabaaz Mughal
Obviously, head injury is very different from maybe a knee injury or a contusions very different from they felt a bit of a pull. So, All of these things that are going through your mind, you're dealing with, you're getting the information back to the bench, you're hearing back from what they're saying.
00:05:25
Shabaaz Mughal
You know, there's no time for the opposition player. And if an opposition player is trying to get involved, that's really poor on their part. And especially an experienced captain of another team, know, that's quite poor to approach one of the medical staff from the opposition and try and interfere with what they're doing.
00:05:45
Shabaaz Mughal
You
Referee's Role in On-field Injuries
00:05:46
Shabaaz Mughal
should probably look at yourself and think, why am I doing that?
00:05:46
Ian
Thank you.
00:05:50
Jonathan Bird
So does the referee, because of course does the referee come in and chip in and say, is he going off, is he staying on, is it head injury, what's what's happening?
00:06:01
Shabaaz Mughal
Yeah, yeah, that's
00:06:01
Ian
Yeah, sometimes. In internationals, they get a bit more, and in Europe, they get a bit more animated. Usually, in this country, the referees certainly, can remember going on, looking round where the ref is, the ref's 10 yards away, and I say to the ref, we're just assessing him, and the ref will say, don't worry, take as much time as you want.
00:06:09
Shabaaz Mughal
Yeah.
00:06:22
Jonathan Bird
Okay.
00:06:23
Shabaaz Mughal
Mm.
00:06:24
Ian
When you're internationals, and the referee is under a lot of pressure, then it's different and you know there was a famous head injury that the game England versus Uruguay in Sao Paulo we one of their players was kneed in the head by accidentally by Raheem Sterling and he was knocked out knocked out on the pitch and the referee continued the game
00:06:55
Ian
I started to walk up towards this player thinking someone better get there when their doctor ran past me. And he wouldn't come off. He carried on. And the referee really didn't know what to do.
00:07:06
Ian
Didn't have any idea about what to do. And it was a bit of a shambles, really. But he stayed on and they won 2-1, of course. But nevertheless, you do see these things that happen.
00:07:19
Ian
And I think in this country, things are slightly different. And that's really because everyone in the game has good educational input about head injuries and what's going on.
00:07:32
Ian
They don't necessarily have the same about other sorts of injuries. Fair enough. But head injuries, definitely.
00:07:39
Jonathan Bird
Yeah, because I know that um the you know things have changed now that um if there's a stoppage for play stoppage for an injury, the player has to come off with the medical team, don't they? And they have and then and there's certain and there is a like a time they have to wait, isn't there, before they're allowed to come on? Is there an actual set of time? or
00:07:58
Ian
30 seconds. Unless it's goalkeeper, which is why the whole thing about goalkeepers, the goalkeeper goes down, they don't have to come off.
00:08:06
Jonathan Bird
Okay, of course. Yeah. Yeah. So, I mean, is there a point when the referee will say you have to sub on another keeper? Or is it just down to the discretion of the ref?
00:08:17
Ian
Yeah, no no, nothing to do with the ref. and That's nothing to do with the ref.
00:08:22
Jonathan Bird
Jeremy, how much is there? Is there any influence at all from the ref in terms of what you decide with ah but with with with ah with a player in that moment? You're you're completely in charge.
00:08:32
Ian
Yeah, but the referee will say, is he staying on or not? Because, and certainly the World Cup, the referee would turn round and call for the stretcher.
Balancing Player and Club Schedules
00:08:43
Jonathan Bird
Oh
00:08:44
Ian
Hmm.
00:08:46
Jonathan Bird
really? That's not your decision? A stretcher will just appear?
00:08:50
Ian
Yeah, they'll call for the stretcher and then everybody in the medical team and the rest of the players will turn around and say, we don't need you. And then you walk back off. That's the usual scenario.
00:09:02
Ian
But yeah, so sometimes a referee, again, they're under a lot of pressure to keep the game moving. So often the referee will turn around say, it looks like he's going come off or she's going to come off.
00:09:14
Ian
I covered the under-17 Women's World Cup in Mumbai few years ago and then the referees are very animated and if a player went down and looked like they were in pain they'd call for the stretcher straight away and I was part of the pitch side team.
00:09:32
Jonathan Bird
it seems interesting i to know mr it's that It's that interesting kind of balance between getting the game moving but keeping the players safe.
00:09:41
Jonathan Bird
I don't know, sometimes even you know even just even just a knee surgeon like myself from the from the from the side when I'm watching at the Emirates, I just think, i mean the guy's fine.
00:09:41
Ian
Yeah.
00:09:56
Jonathan Bird
you know i mean You don't need all this, surely. you know, get him up, get him off force or or something. But everyone just seemed, everyone, any anything, anyone who's not medical just seemed so panicked.
00:10:08
Ian
Yeah, I mean, sometimes. So if a player goes down and you think, you know, I think it might be all right, but I'm not sure, you call to the bench, warm the sub up, and they're getting the sub warmed up, and you need time.
00:10:22
Ian
You need to give the sub time. So sometimes you'll call the stretcher on, the stretcher will come on, and then the stretcher will get there, and then you'll say, no, we don't need you after all. It gives you a bit of time.
00:10:32
Jonathan Bird
Yeah. Shabazz, any input?
00:10:36
Shabaaz Mughal
um I used to kind of leave the ref to the physio. So if you're dealing with whatever you're dealing with, I kind of didn't really respond to the ref.
00:10:46
Shabaaz Mughal
And then normally the physios with you, I'd let them talk to the ref and deal with that side of things. So sometimes that can buy you more time as well if they are trying.
00:10:57
Shabaaz Mughal
And I agree with Ian, they used the European refs definitely wanted to hurry things along. But you could, There was always ways to sort of slow things down.
00:11:12
Jonathan Bird
OK, so I thought we'd we'd also talk a little bit about... um So this week for a lot of teams or the top end of the Premier League,
00:11:23
Jonathan Bird
They've had European games last week, there's been weekend games this weekend and then there's Carabao Cup next week. So, you were saying just off air that Palace had European game on Thursday, Arsenal had one Tuesday and then they played together on Sunday.
00:11:40
Jonathan Bird
And, you know, Arsenal had two extra came two or two extra days to recover. But then also, you couldn't move the game to Monday because it's Carabao Cup. Arsenal have got ah Brighton Wednesday. not sure if Palace have got.
00:11:55
Jonathan Bird
then there's And then there's Premier League again next weekend. And when you've got this midweek, weekend, midweek, weekend, and that sounds relatively straightforward, but we're sometimes not really midweek, is it? It's Thursday to Sunday.
00:12:11
Jonathan Bird
how do you How do you balance that? Maybe if you're you know if you've got if you've got a club to the sharp end of the table, there may be a bigger squad, but in some of the lower-down clubs, it can be it can be difficult to manage that squad. And how do you balance that between the needs of the player, the medical needs of the player, and what the manager wants?
Managing Player Fatigue and Injuries
00:12:31
Jonathan Bird
Shabazz, what's your thoughts?
00:12:34
Shabaaz Mughal
I think it's difficult, isn't it? Football is sort of... We have talked about this before. Football is so now.
00:12:42
Ian
you
00:12:42
Shabaaz Mughal
There's literally a game on every day. calendar's expanding. This has been going on over the last few years, hasn't it? And then we're seeing increased trends of injuries.
00:12:55
Shabaaz Mughal
There's no doubt, increased workload increases injury load. I think that's the way football is going and squads are getting bigger to accommodate for that.
00:13:05
Shabaaz Mughal
So I think what you see or the fairness or unfairness of it is kind of the price of success. So, you know, a team like Palace have won the FA Cup, got into Europe this year.
00:13:19
Shabaaz Mughal
So it's a new thing for them. Whereas someone like Arsenal, they've slowly been building their squad to make them sort of robust and be able to, you know, rotate the squad basically so that they can cover these eventual, you know, whatever the fixture list throws up, they can cover for it, can't they?
00:13:44
Shabaaz Mughal
Whether it's right or wrong, I'm not sure. What are the rights and wrongs here?
00:13:48
Jonathan Bird
but but But then, I mean, that's like like a general thing, but i mean g do you get, is there a conflict within a club about when you, I remember, you know, Wenger had his players were in a red zone about they were maybe ah about to be injured because because their level of fatigue was too high.
00:14:09
Jonathan Bird
I mean, how much influence do you have on the medical side to to to to say to him to a manager, you can't play this player?
00:14:12
Shabaaz Mughal
Thank you.
00:14:15
Ian
Yeah, but that's... The trouble with the red zone is, you know, you don't really know if they're near injury. You don't really know.
00:14:26
Ian
I think that there's a couple of things...
00:14:27
Jonathan Bird
I mean, you were at Arsenal under Fingo, weren't you? So was it was that...
00:14:31
Ian
Yeah, yeah.
00:14:32
Jonathan Bird
I mean, was he very receptive to the medical side or
00:14:35
Ian
Yeah, he was, but it's like every manager, really. If it's a big game, you need your big players. And it's the need to win versus the need to care.
00:14:48
Ian
You need your big players and you're going to take the risk, probably.
00:14:51
Shabaaz Mughal
Amen.
00:14:56
Ian
The other thing to say is that when you're in a competition like this, there's no time in the week to do strength work and preparation work. It's all recovery.
00:15:08
Ian
It's like being at tournaments, as I've said before, it's all recovery. You're not looking at conditioning, you're not looking at strengthening, you're not looking at all the stuff that you really should do and that rugby players get to do because they play week to week and NFL players get to do because they play week to week.
00:15:26
Ian
But in football, in soccer, you don't get that time. So, you know, hamstring injury is really common. Can you do your hamstring preparation work? Well, no, you can't because, you know, you can't do that in the gym.
00:15:39
Ian
And then the next day going to training, you've got whole match day minus one. or two days to the game, so you can't do that work. So you end up, it's all recovery and no preparation.
00:15:50
Ian
And that's the thing also that opens you up to injury. So, you know, it's really, really difficult. And as Shabazz rightly says, you know, squads will get bigger and bigger to cope.
00:16:02
Shabaaz Mughal
The thing I'd add as well with that is you can have the data and you can look at the red zone, you can look at the acute and chronic load, but unless someone's actually complaining that I feel tired or I feel something in my calf, feel something in my groin,
00:16:24
Shabaaz Mughal
It's virtually impossible to say no, they can't play when they feel fully fit. It's like, yeah, it's basically, it's not gonna happen.
00:16:33
Ian
No, and you can't go to the manager and say, oh, we've got five players in the red zone.
00:16:36
Shabaaz Mughal
Yeah, don't play them.
00:16:37
Ian
Yeah, the whole of your back four are in the red zone. Oh, we won't play them at the weekend then.
00:16:40
Shabaaz Mughal
Yeah, and the manager's gonna go, oh yeah, great, yeah, thanks for that, yeah.
00:16:41
Ian
Do me a favour. Never going happen. Never going to happen.
00:16:46
Shabaaz Mughal
Okay then, yeah.
00:16:47
Ian
And, you know, and as Shabazz says, you know, you can be in the red zone and, you know, might not get injured. And there's no prediction. You know, people will say, well, what percentage you think?
00:17:00
Ian
Well, no one really knows. Or you can say, yes, they may be more likely, but... but you know if it's Bakayo Saka probably going to play him the manager will say is he fit to train though and he will say well yeah well if can train and he's not injured then tell me why I can't pick him at the weekend
00:17:22
Shabaaz Mughal
I think we've got to be careful as well as medical teams to be, you know, we're there to facilitate, we're there for player welfare, but we're also there to facilitate.
00:17:36
Shabaaz Mughal
So it's a difficult balance. Your job is to make sure the players are safe and well, but also to provide your coaching staff with a group of fit, healthy individuals who will
Data's Role in Player Safety
00:17:49
Shabaaz Mughal
play.
00:17:49
Shabaaz Mughal
So The data, there's already, I think there's quite growing resentment from quite a lot of coaches and even ex-players, players about data and this obsession with data and sports science.
00:18:02
Shabaaz Mughal
So you've got to temper that with the reality of it as well and take a balanced view.
00:18:06
Ian
Yeah, and make sure you do recovery properly.
00:18:06
Shabaaz Mughal
You can't be, you
00:18:12
Ian
If someone is in the red zone or has done more accelerations and decelerations, you say to your soft tissue therapists, this plan needs more work. You say to your physiotherapist, this plan needs more work.
00:18:25
Ian
That's the use of your medical team in the right way. It's not, as Shabazz rightly says, you know, you're there to advise.
00:18:37
Ian
You may feel knackered one day if you've had a big weekend, Jonathan, you've had family round, you're really tired on the Monday, you're in the red zone, but you've still got to go work.
00:18:47
Jonathan Bird
Yeah.
00:18:48
Ian
Your player's job in life is to turn up to train. They get picked or they don't get picked, that's the manager's discretion. But their job in life is to turn up and train.
00:18:58
Shabaaz Mughal
The other thing I would say though is, again, it's sort of anecdotal and there's probably a lot more to this, but
00:19:05
Ian
you
00:19:05
Shabaaz Mughal
you know, there has been more instances of sort very serious cardiac arrests and things within football. So what we don't know is, is there an increased incidence?
00:19:18
Shabaaz Mughal
Is it reported more? What's the link? The question is, I don't know that the answer I don't know. But I think you look at load.
00:19:29
Shabaaz Mughal
Is it just overall is there is load a an issue and is it becoming sort of a life-threatening issue that therefore you need to look at it in more detail
00:19:40
Jonathan Bird
But surely anyone who has any has a a heart problem has
Cardiac Health Screenings for Athletes
00:19:45
Jonathan Bird
a congenital... i mean isn't it Surely no no one no one who doesn't have a congenital problem is going to have a cardiac problem from from from from training a lot, are they?
00:19:59
Ian
well
00:20:00
Shabaaz Mughal
i don't know the answer to that because
00:20:02
Jonathan Bird
No, mean, i'm i you know from i mean i i mean my my own personal sport is is is running.
00:20:03
Shabaaz Mughal
Yeah.
00:20:08
Jonathan Bird
There's a dreadful footballer, as anyone who knows me would know. And there's a lot of people doing ultra-marathons who are running for hours and hours and hours without without stopping.
00:20:19
Jonathan Bird
And they're all dropping down with cardiac arrests. I can't imagine that the the the load from the high-level sprinting and stuff. even at the evening that even at the elite level, would put anyone into danger in terms of serious danger from ah cardiovascular point view?
00:20:38
Jonathan Bird
Surely not.
00:20:41
Ian
There's lots of stuff, isn't there, about myocardial scarring, being present from basically influenza or an upper respiratory tract infection.
00:20:57
Ian
They get over that. It doesn't get picked up. until the next time they have a cardiac screen, someone finds some scarring in the myocardium.
00:21:02
Jonathan Bird
Okay, interesting.
00:21:05
Ian
wasn't there before. Maybe these are the things that predispose. And I think, you know, the nice thing in a way about...
00:21:17
Ian
cardiac issues is that the players do get screened regularly and the screening is very, you know, it's pretty good and pretty diligent.
00:21:30
Ian
Plus we've got some of the best sports cardiologists in the world in this country. So we're very lucky really. And players are very lucky. But people fall through the net and not everybody gets picked up and that's the problem.
00:21:43
Jonathan Bird
And then of course there's no control group, is there? Because it's not there isn't isn't a normal the normal population that's not been regularly screened from a cardiac point of view.
00:21:49
Shabaaz Mughal
Mm-hmm.
00:21:50
Jonathan Bird
and you know maybe Maybe I'm talking rubbish, maybe people who are doing a lot of ultras are in fact giving themselves cardiac scarring.
00:21:57
Ian
Yeah, they may do. But, you know, maybe they're predisposed to it.
00:22:02
Jonathan Bird
Yeah.
00:22:03
Ian
And, you know, I was on a two-day online thing, you know, interpreting ECGs. You know, there's going to be some new guidelines out.
00:22:15
Ian
And again, you think ECG, surely we've done it all, we know it all. And every now and again they get together and they refine, they refine, they refine, they refine. And when they looked all the FA screenings over 30 years when I was at the FA, they found that there were players that were playing who slipped through the net, had probably had abnormal screens and not been diagnosed as such.
Cardiac Screening Processes
00:22:47
Jonathan Bird
So that cardiac screening you talk about, is that how far down the professional game does go? How far down the league it go? Is it all four professional leagues or is it only Premier League? or
00:23:01
Ian
Yeah, every professional player in the league. So the PFA pay for every player at 16. When they get their professional contract at 16, they get a cardiac screen of questionnaire, ECG and echo paid for by the PFA, the Professional Footballers Association.
00:23:25
Ian
I'd say top clubs and you tell me what you think about this Shabazz what it was like at Spurs but most top clubs will screen every year
00:23:34
Shabaaz Mughal
Yeah, we did it yearly. Yeah.
00:23:37
Jonathan Bird
So that they said that's a full cardiac screen.
00:23:39
Shabaaz Mughal
Yeah, so that would be...
00:23:39
Ian
yeah and it costs I think it costs something like about 25 odd thousand quid to screen a full squad
00:23:51
Jonathan Bird
So then who's doing...
00:23:51
Shabaaz Mughal
Yeah.
00:23:52
Jonathan Bird
So that's... So Prem Championship, League One, League Two. ah i mean how far ah you judge Do you have any idea how far it goes down? Is it ist is it into... Because Nationwide Conference, they're all fully professional.
00:24:06
Jonathan Bird
and nationwide league north and south most of the i mean they're officially semi-pro but most of the players there are professional
00:24:06
Ian
Yeah.
00:24:15
Ian
The sort of rules and regs, if you like, say, you know, have to be screened every three years. And so in the clubs that can't afford that sort of money, they might get it done every three years.
00:24:29
Jonathan Bird
okay but but butab but i certainly ah certainly in the in the premier league you think it's probably every year that they've been screened.
00:24:36
Ian
Yeah, and if you're in a UA for competition, you have to.
00:24:37
Jonathan Bird
and and And is the screening picking up stuff?
00:24:40
Ian
If you're in a UA for competition, then you have to sign that all your players have been screened, otherwise they won't allow you in the competition.
00:24:50
Jonathan Bird
And is it is it picking up stuff? Is it worth it?
00:24:55
Jonathan Bird
Or is it just there to make people feel good?
00:25:00
Ian
Yes and yes, I suppose.
00:25:02
Shabaaz Mughal
Yeah, yeah, a bit both.
00:25:06
Shabaaz Mughal
I think it gives everyone reassurance, doesn't it?
00:25:06
Jonathan Bird
Okay, look.
00:25:09
Shabaaz Mughal
So it gives you the players, staff, yeah.
00:25:09
Jonathan Bird
Yeah, I know. i mean, I just, you know you know, if you're spending that kind of money, is it, is it is the, is, I mean, you know, screening within medicine is quite controversial.
00:25:20
Shabaaz Mughal
Mm-hmm.
00:25:20
Jonathan Bird
You know, doing a PSA for all people or, you know, um there is a reason why we don't have MRI scans annually for every single person.
Effectiveness of Regular Medical Screenings
00:25:31
Jonathan Bird
It would be vastly expensive, but also you pick up all sorts of stuff that may or may not be relevant.
00:25:37
Ian
yeah but the the real the problem with with cardi and you know so there's this big discussion about should they all have echo echoes all abnormalities 90 of them will be picked up with ecg only and in america that's what they do and in some states in america it's just physical examination rather than starting to interpret tests because the whole point is if something happens and you've interpreted a test you can certainly find another specialist that will say oh they interpreted this test wrong and then you know you're out on the street instead of in your big mansion somewhere in the states so you in the states it's slightly different but here yeah so that's that scheme started in the early to mid 90s because um terry yorath's son died of a cardiac arrest at lilishall
00:26:29
Ian
And so they started the scheme. And the PFA had been fantastic. All these years, they've funded it. No one knows about it outside the game, but they fund that.
00:26:42
Ian
But if you're with a national team, then you'll screen every year.
Cardiac Conditions in Athletes
00:26:50
Ian
Now the FA have database. And again, you can't go to the world. You have to sign something if you're the doc. with a team at the World Cup to say you've done all these screens or they won't allow you into the competition.
00:27:06
Ian
The last thing that FIFA won is someone having a cardiac arrest.
00:27:06
Jonathan Bird
just
00:27:10
Shabaaz Mughal
Don't they also before the World Cup and the Euros don't they you have to repeat it again with the national teams yeah so even if you yeah
00:27:18
Ian
Yeah. And don't forget, I mean, Ericsson had a cardiac arrest. remember had a cardiac arrest all these players been screened every year
00:27:32
Ian
hmm
00:27:32
Jonathan Bird
Yeah, could yeah um good point. I mean, if, you know,
00:27:35
Shabaaz Mughal
but that's what i was saying yeah
00:27:36
Jonathan Bird
Ericsson was being screened but but but they hadn't picked it up so is it is it is it working?
00:27:39
Shabaaz Mughal
yeah Or you say it hadn't been picked up or if there's no abnormalities, then why are players still having cardiac arrests?
00:27:50
Shabaaz Mughal
So sort of the other way around. So say the screening is clear.
00:27:57
Shabaaz Mughal
You know, we can argue that screening screening is 100%.
00:28:01
Shabaaz Mughal
But screening's cleared and yet things are still happening. So could it be like Ian said, is there some respiratory tract infection preceding, during,
00:28:14
Ian
And you know, there's this thing called loan AF, which if you look at X, I found out about it because one of my ex international hockey players said to me, oh, you know, we had a get together from a team, a World Cup team, and everyone's got AF.
00:28:15
Shabaaz Mughal
what's the cost?
00:28:34
Ian
and I think it's because I caught an infection when I was in Pakistan. And I said, I don't think that's what it is. And looked it up, and there is this phenomenon called lone AF, where ex-athletes get it, they go into AF, and it's to do with an enlargement of the atrium and different hormonal profiles within the atrial wall and the ventricular wall and the way it responds.
00:29:00
Ian
and stretch receptors. It's a fascinating thing, but they get arrhythmia.
00:29:06
Jonathan Bird
So AF, sorry for everyone, that said that that's where as where the heart rhythm goes at a funny rate, essentially.
00:29:07
Ian
Yeah.
00:29:12
Ian
Yeah. it's I mean, it's it's it's absolutely fascinating. And the particular guy I've got in mind is on heart drugs because of it.
00:29:24
Ian
So I think there is, and you know, there's a fair few research papers out there, but it's a very strange thing. And like said, he said to me, it's because I got an infection when I was playing in the World Cup in Lahore in Pakistan.
00:29:41
Ian
I don't think it's that. So it may be that there's something in exercise and what it does.
Studies on Athletes' Heart Health
00:29:53
Ian
You know, they did this big thing in cross-country skiers in Norway have got the highest VO2s.
00:29:54
Jonathan Bird
That is fascinating.
00:30:03
Ian
oxygen capacities. And some of these people had some plaques in their coronary arteries, but they were calcified ones.
00:30:14
Ian
They're less of a problem than the ones that you can't see on a calcium scan. So all these things are happening to athletes' hearts. Never mind about what the genetics of it are.
00:30:28
Ian
So I think the more I talk about it, the more I think perhaps screening is not a bad thing.
00:30:28
Shabaaz Mughal
Thank you.
00:30:36
Jonathan Bird
Interesting. look Okay, look, so we've been, again, mumbled on
Episode Wrap-up and Future Plans
00:30:40
Ian
Sorry to go on.
00:30:40
Jonathan Bird
a little bit.
00:30:41
Jonathan Bird
I know, I know, it's interesting. It's all good stuff, Ian. So um that's like we're over a half an hour, so we didn't think we had much this week, but we seem managed. um Okay, look, ah good to talk.
00:30:55
Jonathan Bird
um I'm at St George's Park this weekend, actually. um there There's like a big knee conference, I'll have to try and work out when when when when we can record. Perhaps have to bring my microphone friend with me.
00:31:07
Ian
Are you staying at the Hilton?
00:31:09
Jonathan Bird
Yeah, yeah, yeah.
00:31:10
Ian
Oh, nice.
00:31:12
Jonathan Bird
Yeah, it's one one of the main knee conferences from next Sunday to next Tuesday. um Right, look, anyway, so thanks, everyone. That was another injury time.
00:31:23
Jonathan Bird
we have been We've been Ian Beasley and Shabazz Murgle. um
00:31:23
Ian
Thank you.
00:31:28
Shabaaz Mughal
x folks
00:31:28
Jonathan Bird
Good to see you all, and we'll see at the next time. Cheers, everyone.
00:31:32
Ian
Thanks, Jonathan.
00:31:32
Shabaaz Mughal
like thanks guys
00:31:33
Ian
Thanks, Shabazz. Nice to see Have a good break.