Lakhasly

1.2 The team
physician in football
1.2.1
The roles of the team physician
in football
In football teams, either national teams or club
teams, there is a uniform organisational structure within
which the coaching staff, administrative staff, medical
team and players function. The team physician (TP) is the
head of the medical team. Medical teams in different
leagues form a continuum, with the simplest form
consisting of a resident physiotherapist working with
a consulting doctor acting as a TP. In more advanced
forms, a medical team consists of a resident TP with
physiotherapists, trainers, masseurs, a nutritionist and a
podiatrist. In the absence of an elaborate medical team,
the TP would have to perform numerous tasks, e.g. advise
players on nutrition including meal selection and assist
in some cases with physiotherapy and ankle strapping,
especially when on tour.
Regardless of the composition of the medical team,
the TP is ultimately responsible for the short- and long-
term health condition of the players and staff. Injuries and
illnesses that occur beyond the expertise of the doctor
should be referred to a suitable specialist and a referral
network should be established both at home and when the
team is travelling.
The TP advises the coach about the health status of
the players and makes the fi nal decision with respect to
the players’ eligibility for competitive football. The TP must
respect players’ confi dentiality, especially when addressing
the media.
The TP as described in this chapter is in keeping with
a simple medical team comprising a doctor, physiotherapist
and possibly a trainer. The roles of a TP mainly refer to eight
broad activity fi elds:
– Injury management
– Illness management
– Prevention of injury and illness
– Emergency care
– Acclimatisation issues: jet lag, heat and humidity, altitude
– Anti-doping issues including prevention of doping
infringements
– Optimising performance: nutrition, hydration, screening
for overtraining of players
– Counselling players and staff
Injury management
One of the major roles of a TP is to determine that
a player is injured, accurately diagnose the complaint and
institute treatment. Most injuries in football are mild and
involve the soft tissues. Diagnosis may rely on the use of
clinical acumen in simple injuries but sometimes complex
imagining is required for more complicated ones. The TP
heads the rehabilitation team and this team plans the
treatment for the injured player. The TP is responsible for
notifying the coaching staff of the injury and the expected
time that the player will be out of team training. He is
also responsible for declaring that the injured player has
recovered and is suffi ciently well to resume full training after
undergoing rehabilitation.
Illness management
Footballers and other athletes suffer illnesses that
occur commonly in the general population such as asthma,
upper respiratory tract infections, skin rashes and diarrhoea.
The TP is responsible for diagnosing and treating such
conditions. The TP should travel with medications that
would be used to treat the common medical conditions seen
in general practice. However, it is of particular importance
that he knows about the applicable restrictions on the use of
prohibited substances by players subject to doping control.
He should be aware of the different types of common
conditions that could be encountered when travelling to
foreign countries, e.g. malaria and travellers’ diarrhoea,
and be prepared to treat these conditions. The TP again
notifi es the coaching staff about the illness of the player and