Being the ESFA U18 International Sports Therapist

Monday 03 November 2014By ESFA Office

Last Updated:
10/02/2021 10:49:32

Dave Burns

Dave Burns

The ESFA recently spoke to Dave Burns, former England Under 18 Schoolboys' sports therapist, regarding his experience of being a sports therapist.  Here is what Dave had to say...

The position of Sports Therapist to the English Schools’ Football Association Under 18 International Team is a voluntary and honorary posting for three years. Traditionally, the commitment includes staffing the High Level Coaching Week held at Repton School in August, the International Trials process which runs from October into January culminating at Lilleshall National Sports Centre with the selection of the England Squad for the international season ahead, a training camp with the England Squad during the February half term, and the four Centenary Shield matches against Northern Ireland, Republic of Ireland, Scotland and Wales, and any potential Invitation Internationals the International Committee of the English Schools’ Football Association arrange.

Specifically, the role also includes ensuring the players are given advice on diet, hydration, and physical conditioning as well as dealing with injuries and their rehabilitation. Good knowledge of each player’s medical history is vital to help ensure the correct pathway is followed to maximum fitness to play. Although a good working relationship between the Sports Therapist and the England Manager is essential as to the condition and availability of players, the relationship with the Team Doctor is absolutely vital. Sport Therapists always work under direction of the Doctor. Whilst the Sport Therapist will focus on muscular-skeletal conditions, and the Doctor medical, there has to be constant consultation and referral to the Doctor so that clarity exists at all times as to medical issues and the treatment of players. This is helped greatly by precise record keeping of players’ conditions and treatments, but it is ultimately underpinned by good communication and dialogue.

During the season, there is continuous contact with the players and their medical teams at home by telephone and email. Therefore, advance knowledge of any injuries and their treatment is always available. However as far as hands-on rehabilitative work is concerned, the longer the time you have to work with players, the better. Unfortunately, coaching weeks apart, this time is very limited. With regard to International games, the team generally reports at lunchtime the day before for an evening kick-off. If a fitness test(s) are required, they take place after lunch with the Team Doctor and the player(s) concerned as assessment needs to be made in order to make a recommendation to the Manager as to the possibility of the player(s) being available for selection.

Sport Massage is increasingly becoming part of the treatment regime from a preventative as well as a rehabilitative measure during International gatherings. Players take advantage of this opportunity after training or on the afternoon of a match day. This area of the Sports Therapist’s role needs to be reviewed as Sports Massage is a very specialised and an integral skill, and perhaps the combined role is now too much for one person.

What a Sport Therapist should take to a match

This very much depends on what facilities you have at hand. I remember hearing Gary Lewin, the Physiotherapist to the Full England Squad, say that even at a World Cup sometimes the facilities are basic and you have to work with what you have to hand.

I always wear two pairs of protective gloves once dressed in my match kit. This is because I might have to deal with a multiple injuries and I am at least prepared for the second player. I also carry a two-way radio with an ear piece and can communicate on the pitch with the Team Doctor either to request his presence or to inform the Manager that the player is not going to continue and to substitute him.

In a live match, and when called onto the pitch by the referee, the S.A.L.T.A.P.S procedure is followed. S.A.L.T.A.P.S refers to the mechanics of the incident: did you See it? Ask the player what happened; Look at the injury site; Touch the injured part of the player will allow; can the player Actively move the injured part?; can you move it Passively?; can they Strength resist/work against the Therapist’s movement? There is limited time to do complete S.A.L.T.A.P.S and once a player fails any of the constituent parts of S.A.L.T.A.P.S, he is removed from play for further assessment.

Treatment generally takes place when the player is removed from ‘live’ play. Apart from the contents of my ‘running –on’ bag which are shown elsewhere on the website, and access to ice, I have with me in the Technical Area a Defibrillator and a Frac-Pac. Of course, I am accompanied by the Team Doctor. As to the Defibrillator and Frac-Pac mentioned, they relate to serious conditions, and the Defibrillator obviously life-threatening.

International matches will generally have para-medics in attendance, and an ambulance on stand-by, as part of the stadium’s remit to host a match. Grounds such as Wembley even have a hospital near the dressing room complex.

Plenty of water is taken to the match as players are always reminded to hydrate before, during, and after the match. Also taken along are carbohydrates mainly in the form of Jelly Babies or Jaffa Cakes for consumption at half time and post-match. Cryo-cuff, dressings, bandages/strappings, etc. are available in the Technical Area should a player be finally removed form play and action taken.

How you qualify to be a Physiotherapist / Sport Therapist?

The Football Association, as part of its Education programme, devised a qualification for people who wanted to work in sports medicine in football under the direction of a Doctor, and this is The Football Association Diploma in the Treatment and Management of Injuries and is the F.A.’s senior medical qualification. Historically, and although completely different in activity, the FA Diploma in the Treatment and Management of Injuries sat alongside the F.A. Advanced Coaching Licence / UEFA ‘A’ in their Education Department range of courses as to the duration of course and hours of study. One could argue that these vocationally based courses did not access into the outside world of higher education, and indeed F.A. staff tutored the programmes of study. Many Sports Therapists in football hold the F.A. Diploma as it was considered the minimum standard to work in the highest echelons of the professional game, although the higher divisions now require a Chartered Physiotherapist (see below), and some have taken their qualifications further up to Master of Science degree level.

Today, Physiotherapy and Sport Therapy tends to be entered at degree level, however the Society of Sports Therapy and the Football Association’s still offer study at Diploma level although there is a move away from this.

Physiotherapists, (and this is a name which can only be used by Physiotherapists who are members of the Chartered Society of Physiotherapy), combine their knowledge and skills to identify an individual patient's functioning needs and improve a broad range of physical problems associated with different systems of the body, e.g., they treat neuromuscular (brain and nervous system), musculoskeletal (soft tissues, joints and bones), and cardiovascular and respiratory systems (heart and lungs and associated physiology). Therefore, they are multi-disciplined in their studies and activities and not solely focused on sports-related treatments, and help anyone of any age with their health concerns. Physiotherapists work autonomously, most often as a member of a team with other health or social care professionals. They may be employed or self-employed and can work alone.

Physiotherapists are not only there to solve problems - they are also there to help prevent them from arising in the first place. Each person makes different demands of their body, depending on their lifestyle and the activities they carry out. How their body responds to those demands is governed by a range of factors, including their overall physical condition.

Physiotherapy is a protected profession, which means that it is regulated by law to ensure that only people who have passed Government approved training courses and have registered with the state regulator, may practice. The state regulator for physiotherapists is the Health and Care Professions Council (HCPC).

What is the difference between Physiotherapy and Sports Therapy?

In short Physiotherapists who have dedicated their career in the treatment and rehabilitation of sports related injuries are indeed Sports Therapists. It is a specialised pathway taken post-graduation from the intense and holistic health related studies of the physiotherapy degree. In basic terms, a Physiotherapist will cover the full range of conditions one would encounter with the National Health Service, a much more general experience, whereas a Sports Therapist works in a much narrower field, but with it, greater specialism in sports injuries.

There is however a relatively new degree called Sports Therapy that does not include the intense multi-disciplined health studies of physiotherapy. It is a very good degree that appears to fast track students into the world of sports related injury and rehabilitation. Unfortunately in reality, the career pathway in most cases is stunted at graduation as the regulatory body for health, the HCPC, does not at this time recognise Sports Therapists as sufficiently “health qualified” to practice as health professionals. As such Sports Therapists cannot work in hospitals or healthcare establishments nor provide treatments whose fees are redeemable by health insurance companies such as BUPA or PPP.

Originally, Chartered Physiotherapy courses were at non-degree, Diploma level, however in recent times, the Chartered Society of Physiotherapy has moved to a degree entry programme. The Society of Sports Therapists, who promote Sports Therapists and are at present attempting to persuade the Government to allow Sports Therapists to be granted HCPC status, as part of a move towards a graduate only profession.

Just a final point with regard to Sports Massage: it is an increasingly important area for development within the injury prevention and rehabilitation process, and is becoming a specialist role in its own right. Schools of Sports Massage exist to teach expertise and provide the qualifications to validate their learning, and play an important part in supporting the work of Physiotherapists and Sports Therapists. Many sports clubs now have a specialist Sports Masseuse employed to work with the Physiotherapist and Sports Therapist.

David Burns, M.A., F.A. Dip T.O.I.
Sports Therapist to the England Schoolboys’ Under 18 International Squad 2009-2012

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