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Editor,—Waddington et al1 are to be congratulated on highlighting the need to provide the best available care to professional footballers. Their paper is, however, inherently biased by factors that detract from the validity of their conclusions. For example, they have provided no evidence for their postulation that non-chartered physiotherapists are more vulnerable to threats to their clinical autonomy than other qualified professionals.
Published quotations from the semistructured interviews are of an emotive nature, and the quoted questions posed by the interviewer are clearly leading. It is well recognised that responses in such interviews can be greatly influenced by the manner in which they are posed.
The authors make no comparison of methods used by chartered and non-chartered physiotherapists, and their outcomes. Similarly there has been no comparison between the performance of club doctors with or without postgraduate qualifications in sports medicine, and, moreover, no evidence produced of actual harm resulting. Indeed, in recent months in Scottish League football, the Dundee club doctor restored circulation to the foot of a player following a serious ankle injury, and the Dumbarton club doctor restarted the breathing of an apnoeic player.
In a recent survey of 15 players in a Scottish football club (unpublished work), 13 stated that they had been discouraged by the (non-chartered) physiotherapist and nine by the (non-specialist) club doctor from training or competing while injured, and none had been encouraged by either to return to playing before complete recovery. Indeed, 10 confessed to concealment of the true severity of injuries, perhaps reflecting the ethos at that particular club.
Care offered to professional footballers merits careful evaluation. However, this should be detailed, methodical, and independent of bias, such as that which can arise when studies are commissioned and funded by interested parties.
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