CONCERN over the growing influence of sport scientists in the AFL fuelled some direct warnings by league boss Andrew

Demetriou early this season. The issue came to the fore when Melbourne

Football Club doctors Andrew Daff and Kal Fried resigned after disagreement with some of the Demons’ conditioning staff.

It is likely that this dispute was the final straw for the doctors who shared 40 years experience at the club.

Shortly afterwards, it was widely reported that the AFL had “unofficially declared war” on AFL high performance managers, with Demetriou forecasting fines for breach of AFL rules in relation to decisions on medical matters by staff other than the club doctor.

Experienced doctors with the expertise to work in AFL clubs are not easy to come by.

The positions held by these medicos are demanding and typically not full-time.

As a result, club doctors also work in private practice, which brings with it the advantage of maintaining knowledge and skills in a mainstream medical environment.

On the flip side, it adds to the demands of doctors’ already heavy club workloads.

The AFL is concerned that if the influence of sport scientists is not curbed, more doctors will leave.

In an AFL club, decisions on player well-being are typically informed by input from a range of specialists in various fields – medicine, sport science, physiotherapy, strength and conditioning, and rehabilitation.

AFL Medical Association chief Dr Hugh Seward said input from the various professionals would vary depending on the type of injury to a player.

“Some injuries, such as concussion, need more emphasis on a medical decision; other injuries, such as a hamstring strain will need more emphasis from the physiotherapist,” Dr Seward said.

“There is often strong overlap, especially with respect to return-to-play decisions. Situations vary and the best approach is one where all parties are involved.”

Dr Seward added that the general agreement was that “a flatline model, rather than a pyramid model”, was the best process to have in place, rather than having one person making all decisions.

The situation at Melbourne is unlikely to be isolated.

Disharmony between medicos and sport science staff at other clubs must be present for the AFL to be cracking down the way it has.

However, Collingwood sports science director David Buttifant describes a strong relationship between the sport scientists, physiotherapists and club doctor.

The management of Luke Ball’s knee injury is a good example of the co-operation required.

“We have a round-table discussion where there will be a definitive diagnosis and prognosis, and then we work out the best action plan,” Buttifant said.

“We design a road map to accelerate his recovery from the injury, and also take an holistic approach so we’re not just looking at the injured part.

“We look at other deficiencies that he needs to develop as well, whether it is body composition,

strength or endurance, as well as getting him to contribute to other parts of the program.

“After the initial round-table discussion we have regular meetings for communication with key stakeholders working with him, such as medical, physio, the rehabilitation co-ordinator (also a physio) and a weight specialist as well.

“Together we set both short and long-term KPIs (key performance indicators) and their continual review.”

At Collingwood, a case manager, usually the physio or rehab co-ordinator, is assigned to each injured player.

Luke Ball’s case manager attended the reconstruction surgery to repair his ruptured ACL.

“The case manager accompanied Ball to the surgery and for the review with the orthopaedic surgeon,” Buttifant explained.

“Then he’d present all of the data (including strength tests), and short and long term criteria would be developed.

“To return back playing, Ball will have to meet all of those criteria.”

Collingwood players with short-term injuries are reviewed by all stakeholders on a weekly basis, whereas for players with long-term injuries, reviews are conducted every two to three weeks.

The right environment and the building of strong relationships between staff is important to successful management of player welfare.

“Because the doctor is not full-time, they are not entrenched in the daily operations of the club,” Buttifant said.

“Development of an inclusive environment to

engage stakeholders is very important. Everyone needs to understand their role.

“At Collingwood we have one collaborative working environment. Everyone has their own area of expertise. As sport scientist we may provide more texture and more tangible indicators to help our medico, Dr Anthony Page, create an informed decision, but emphatically the doctor makes the final call on issues of player welfare.”

The collaborative approach is also in effect at Adelaide.

Crows senior medical officer Dr Andrew Potter believes that good communication and a mutual respect between departments is essential.

He adds that doctors are spending more and more time at clubs.

“One of the issues is that most of the sport scientists are full time, physiotherapy is becoming a full-time position where all of the medicos are part-time”, Dr Potter said.

“The whole organisation has become more professional; one of the problems is there is a need to make quick decisions and if certain staff aren’t around at the time, you can forget they’re there or need to spend the time to chase things up.

“This has probably been the cause of some of the issues, I suspect.”

Dr Potter estimates that he spends the equivalent of full-time hours at the club, including games, and also works the equivalent of two full days in private practice.

“I attend all training sessions and games, as well as being at the club all day Mondays, which allows

me to have discussions and meetings with the other people in our physical performance team,” he said.

“Being there on a Monday enables me to chase up results,

be involved with discussions with coaches and do a lot of administrative work, which is becoming more and more appropriate to allow good communication between the parties.

“We have two formal meetings a week but I meet informally with the physios every day.”

Adelaide’s physical performance team is headed by Stephen Schwerdt who oversees the whole group, which includes the medical department, physiotherapy, rehabilitation, strength and conditioning, nutrition, podiatry and the trainers.

Drs Seward and Potter both commented on the enormous contribution that sports science had made to the game in general, as well as to the fitness and condition of players.

“Sport science has an equal input to that of medical and physio; I think we all bounce off each other,” Dr Potter said.

“The contribution of GPS to monitor workloads in games which can then be reproduced in training, recovery strategies, nutrition, sleep, improved rehabilitation of injuries along with the physiotherapists; there is some real science around strength

and conditioning where we can be very specific as far as injury prevention and conditioning goes, about rehabilitating or working on specific muscles or muscle groups or functional work.

“The sport scientists and their expertise have an enormous role to play in helping to prevent injury and improve conditioning and therefore improve performance.”

Demetriou has not disputed that AFL sport scientists have

a role at clubs but referred to them disparagingly at one point as “phys-edders”.

While physical educators are themselves qualified professionals, the role of a sport scientist within an AFL club is vastly different to that performed day to day within schools.

Professor David Bishop, a board member of Exercise and Sports Science Australia, and Research Leader, Sport at Victoria University, says suggestions that a doctor has been unduly influenced by a sport scientist (or high performance manager) are concerning.

“In particular, the reference by AFL CEO Andrew Demetriou to sport scientists as ‘phys-edders’ reflects that either the AFL’s thinking is 30 years out of date or that there is a deliberate lack of respect for the many highly qualified and highly respected sport scientists who work in the AFL,” Prof. Bishop said.

“While the profession may be young, Australian sport scientists are highly sought after and respected throughout the world for the contribution they can make to maximizing athletic potential and performance.”

Most sport scientists working with AFL players have university degrees and many have or are undertaking a PhD. This means a minimum of seven years of university training.

Buttifant adds: “AFL sport scientists are highly qualified, you’re talking about an elite, exclusive group of people. Sport science is integral to the game and has been embraced by coaches.”

InsIde Football Wednesday, May 16, 2012

FIRST RESPONSE: A Magpie trainer attends to Luke Ball. RIGHT: Dr Andrew Daff.

Medicos and sports scientists have endured an uneasy relationship in some quarters, but the key is co-operation, writes DR JODI RICHARDSON.

‘Luke Ball’s case manager attended the reconstruction surgery to repair his ruptured ACL.’

‘ ’You have to develop ‘your boys’. They will love you because you are giving them an opportunity.

– Robert Walls on how a new coach should rebuild a side.

SPORTS SCIENCE takes its medicine

Sam Iles 2009 3 Gold CoastPicked by Collingwood in the 2006 pre-season draft, but also failed to make his mark in his three years on the list.