Cutting edge

November 12, 1999

The plight of boxer Michael Watson has highlighted the need for professional sports to monitor injury frequency and treatment.

Euro 2000 qualifier: the predicted outcome is Scotland 5 - England 4.

It takes a brave Englishman to predict that the outcome of any football match between England and Scotland will result in the Scots winning. Funny things happen in football that make it difficult to predict the final outcome. Uncertainty is one of the great attractions.

Injuries to football players, however, are not uncertain. It is inevitable that a number of English and Scottish players will be injured during their team's training sessions and the matches.

Previously, injuries would not have been considered to be too important. However, the recent civil case of Michael Watson against the British Boxing Board of Control has changed this perspective. In this case, the plaintiff proved that the BBBC owed him a duty of care and had not made adequate medical provisions during and after a world title boxing match.

The BBBC's failure to arrange for adequate medical support caused a delay in treating a blood clot that formed in Watson's brain during the fight, a delay that was deemed to have caused him to suffer irreparable brain damage.

One key issue raised in the case was that the BBBC should have been aware of the risk - there had been 45 recorded sub-dural haematomas in professional boxing during the previous 20 years. The fact that this incident occurred in boxing is immaterial. The judge's ruling will have ramifications in all sports.

Over the past five years, my research has addressed the issue of injuries to players in professional football. Video recordings of matches from the 1994 World Cup, the 1996 European Championship and the English Premier and other football leagues were analysed to identify the number and severity of injuries.

The research showed that footballers are injured nearly nine times per 1,000 hours of training and nearly 28 times per 1,000 hours of competition. This means that virtually every professional player will be injured in a season, while the consequence of these injuries is that players will be unfit for training or competition for 15 days per injury on average.

Football authorities are now taking the risk of injury to players more seriously. The Football Association's Medical Education Centre at Lilleshall has implemented its own prospective study of injuries, with almost every English Premier and football league club providing details of injuries to their players each season. This study will provide a comprehensive database of injury information.

The data will assist the Football Association in a review of medical provisions at football clubs for injury prevention, treatment and rehabilitation, a review that is now essential in the light of the Michael Watson case.

The International Federation of Association Football (Fifa) has established a research group, the Fifa Medical Assessment and Research Center, to address the issue of injuries to players.

I am providing support for one part of this research programme, which looks at the number and severity of injuries occurring during Fifa world competitions. The results from this study will provide Fifa with comprehensive information on the causes of injuries and will help to shape the future of football throughout the world.

Returning to the England versus Scotland encounter, current research results indicate that, during the two matches and all training sessions undertaken by the two teams, Scotland will record five injuries but England will manage only four, assuming that extra time will not be needed. Unfortunately, the research is of no help whatsoever in predicting how many goals each team will score.

Colin Fuller is a lecturer in the centre for hazard and risk management, Loughborough University.

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