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This is an important study for two reasons. Firstly, it documents—as did another recent paper1—the high level of OA among retired footballers, a matter that the authors correctly describe as a “significant cause for concern”. Secondly, and more worryingly, it is one of a growing number of studies all of which raise serious concerns about health and health care in professional soccer in England.
For example, in addition to specific concerns about OA, dealt with in this paper, recent research has indicated that the overall risk of injury to professional footballers is no less than 1000 times higher than the risk of injury in other occupations normally considered high risk, such as construction and mining.2 Another study of five English professional clubs found that they were not meeting the legal requirements set out in the Management of Health and Safety at Work Regulations of 1992,3 while a risk assessment of grounds for player safety indicated that only 42% of English clubs (but 71% of Scottish clubs) achieved an acceptable score.4 Yet another study concluded that “it appears that English professional football clubs have a long way to go to provide high quality sports science advice to players and to meet the standards of health and safety management acceptable as common practice amongst leading continental football clubs”.5 And most recently, research on club doctors and physiotherapists in English professional clubs has cast doubt on whether they have appropriate qualifications and experience, and has described all aspects of the appointment and remuneration of club doctors and physiotherapists as a “catalogue of bad employment practice”.6
These studies collectively paint a picture of risk management and health care provision in professional football clubs that is a matter of serious concern. It has recently been calculated that many English clubs spend only about 2.5% of the asset value of their playing staff on medical care; this may be compared with a typical company car fleet where the annual maintenance and insurance costs would be in the region of 20–30% of the value.7 One might reasonably ask how much more evidence the Football Association needs before it requires the clubs to take the long overdue measures required to meet the “duty of care” that they have, in both a legal and a moral sense, to the players in their employment.
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