Bob Ward is the chief physiotherapist at Middlesbrough Football Club. In his time at Boro’, the club have developed a state of the art training facility, complete with a fully up to date medical department. Probably more than any other physiotherapist he has had to deal with the comings and goings of numerous foreign players, and recently oversaw the rehabilitation of Juninho, after the Brazilian damaged cruciate ligaments in August 2002.
Name: Bob Ward
Where did you train and when?
“Salford School of Physiotherapy. 1981 to 1985.”
How long have you worked in professional football?
Where did you work before getting a job in professional football?
“I was a professional footballer at West Bromwich Albion, Blackpool and Wigan Athletic.”
The pace of Premiership matches seems to get faster each season. Do you think this has had an effect on the frequency and type of injuries that you treat?
“Yes – inevitably when objects move faster, collisions have greater momentum. Also, shear and torsional stresses when twisting and turning are greater.”
With international tournaments and competitions, like the Intertoto Cup, the top players are playing virtually all year. Do you think the Premiership should consist of fewer teams and incorporate a winter break like the rest of Europe?
“Yes. A winter break would be beneficial.”
How do you overcome the communication difficulties when treating some of the foreign players who don’t speak much English?
“With patience and pocket dictionaries.”
New laws over the past few years have targetted dangerous play such as the tackle from behind. From a physios point of view what one thing about the game would you like to see changed?
“Consistent refereeing regarding dangerous tackling – i.e. taking more action against ‘over the top’ tackles.”
What’s the worst injury you’ve had to deal with on the pitch?
“A blocked airway.”
And the funniest incident?
“Popping back in a player’s contact lenses!”
With Major League Soccer (MLS) well underway in the U.S, we feature the first interview on PhysioRoom.com with an athletic trainer. Theron Enns is the Head Athletic Trainer of the Colorado Rapids and we caught up with him as the Rapids finalised their pre-season altitude training camp in Guadalajara, Mexico. Certified Athletic Trainers are the North American equivalent of sports physiotherapists in the UK. In this interview we explore the similarities and differences of sports rehabilitation specialists in the US and UK.
In the UK, although there is no formal post graduate route, Chartered Physiotherapists working in professional sport usually complete a Masters degree in sports medicine after undergraduate training in Physiotherapy. Could you explain the pathway in north America and your own history prior to joining Colorado Rapids?
“In the US there is no formal postgraduate route for Athletic Trainers as well. The path to become a Certified Athletic Trainer begins at the undergraduate level where students study for a bachelors degree in a sports medicine field (athletic training, exercise physiology, physical therapy, etc.). While in college you also serve an internship under an Athletic Trainer, usually at the university or at a local sports medicine clinic. Once you have met all the requirements, both academically and in your internship, you take the national certification exam. If you pass the exam you are certified as an Athletic Trainer.
“My career began this way as well. After certification I obtained an Masters degree in Athletic Training and took my first job at Villanova University in Philadelphia, working with the men’s and women’s soccer programs. I then worked one year with the New York Jets in the National Football League before joining the Colorado Rapids in 1999. I became the Head Athletic Trainer in 2000.”
Is there a formal system allowing trainers to continue their professional development and, if so, is the MLS supportive of this?
“Athletic Trainers are required by the National Athletic Trainer’s Association to obtain 80 hours of continuing education units every 2 years to maintain their certification. This assures that ATC’s are staying up to date with the latest techniques and knowledge in the field. Major League Soccer requires ATC’s to be current with their certification.”
Theron, you have worked in professional (gridiron) football and soccer. How do the organisations differ and how does the medical care compare between the two sports? In the two sports what is the worst injury you have had to deal with?
“American football and soccer are very different sports but their medical care is similar. The biggest difference is the amount of money involved, which allows NFL teams to provide medical care on a larger scale. NFL teams employ 60 athletes and they have 3-5 ATC’s to provide medical care. In the MLS we only have 24 players and typically only 1 ATC.
“As far as injuries go, American football has more severe injuries due to the nature of the game, where collisions occur every play. In soccer, the players do not collide every time the ball is in play. The worst injury I personally saw in football was a crucial triad (ACL tear, PCL tear, MCL tear, Cartilage tear). In soccer the worst we have had in my 5 seasons has been a complete Achilles’ rupture. “
European football has a congested fixture list and there are many club versus country rows regarding the releasing of players for international matches. Do you have similar problems in the US or has the lack of history and tradition allowed the United States Soccer Federation (USSF) to solve this problem?
“We have the same problems here that they do around the world. Players who are called into their respective national teams must leave their club team often in the middle of the season. The 2002 World Cup in Korea saw our league continue to play while US National Team players were gone. Club coaches are concerned about not having their best players on the park because they are competitive and want the best for their club. Unless all national team fixtures are on days that there are no club fixtures this will always be a problem, no matter what country we are talking about. “
The MLS season runs through the summer from April to October each year. Arsenal coach Arsene Wenger has stated that a future European Super League would probably be run on a similar basis. How does this fit in with other American sports and what happens during a World Cup year?
“The MLS season begins as the basketball and hockey seasons are ending. The baseball season here in America is at the same time as us and the American football season begins as we are headed into the final 2 months of the season. So it is a crowded calendar here. As far as the World Cup, we continue to play during that time because if we took a break it would push us into the American football season too much. “
In recent seasons, European based players have sought expert treatment from surgeons based in North America. Do you refer your players nationwide/worldwide or are all referrals dealt with by local specialists?
“We have an extensive network of specialist here in Denver that we refer to on a regular basis. But, if needed, we will send athletes around the country to see experts. I have used physicians as far away as Chicago and Philadelphia to evaluate players.”
Thanks Theron, it’s interesting to hear that no matter where we are in the world, we encounter very similar problems. Good luck to you and the Rapids during the 2003 season!