We need a pre-signing medical

Consent is taken from the player to undergo the medical and for details to be shared with the club CEO and manager. The medical then starts in earnest. A history of his playing record is taken and this is compared to a “Scout 7” report available on all players. This is compiled by scouts who have watched the payer over a number of years with comments attached but the playing record is more useful for the medical staff. A medical history is gained in a similar process to that of any standard “medical insurance examination” carried out by a GP, with a much greater emphasis based upon the musculoskeletal history and previous injuries. It is quite incredible that very few players attending to sign for a new club recall sustaining any injuries at all! The Google information however often seems to jog their memories!

An extensive examination takes place, involving every system of the body, again with added focus upon the musculoskeletal system. The physio plays an important role and will immediately be considering the potential risk of injury based on his findings and considering what can be implemented on a daily basis to prevent injuries if they are to sign. Bloods are taken and an ECG (showing the electrical activity of the heart) is performed. Cardiac screening is a major part of the sports doctors work these days in an attempt to reduce the risk of SCD (Sudden Cardiac Death) so an Echocardiogram (ultrasound investigation of the structure of the heart) is also performed by a specialist team. Players ECG’s routinely look highly abnormal because they are so well conditioned from many years of high intensity training and players are often diagnosed with an “athletic heart”. If a member of the public turned up to A&E with an ECG like a professional football player it would trigger great concern and an urgent bleep to the on call cardiologist. I know of one player, who when lying in an anaesthetic room before undergoing a career saving operation, only managed to muster a pulse rate of 35 beats per minute! (Normal 60-80)
The player is then taken for his MRI. The scan will take on average 90 minutes, examining spine, hips, knees and ankles. This gives me time to write up notes from the morning and have a relaxing coffee or two. A musculoskeletal specialist consultant radiologist reports on the scan immediately after which these findings along with all other details are compiled into a final “pre-signing medical report”. On returning to the training ground I then meet with the CEO and club manager where all the medical findings are discussed. I am often asked if the doctor makes the decision whether or not a player “passes” or “fails” a medical. I’m afraid it isn’t as simple as that and no one person makes the call. The medical doesn’t have set standards to “pass”. What it does do however is to provide a risk assessment. On occasions it may mean that a player doesn’t sign, on other occasions however it may influence fees paid, contract length or even their weekly wage.