Scholes & Carra's Most Gruesome Injury Stories | The Overlap Fan Debate

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2:14I had a blood clot in my eye that just burst. See, you went blind, they'll get more hits on the show. Medical departments do not injure players. I can remember Steven Gerrard getting an epidural. That's a childbirth, isn't it? Nicky Buck took a throw and I saw about three balls coming up there. I used to look at a lot of my teammates in the treatment room with a lot of disdain. If I'm being totally honest, sometimes I'm thinking, I think you can play. Because he's on loan from Arsenal, who does the medical care for him? Do physios cover their arse a little bit? You're looking at the scans and you're like, to be honest, mate, we think you can play.

2:48The fans just, oh, is he injured again? There are actually some managers who think they're doctors as well, aren't there? Well, yeah, there are. Some doctors who think they're managers. Yeah, yeah.

3:04Welcome to a new episode of The Fan Debate brought to you by Skybet, and we're delighted to be joined by our special guest, physio and sports scientist, Russ Hayes. Well, Russ, put me right and tell me sort of, you know, your background and what's going on. Yeah, so I've been a physio for sort of 20 plus years. Worked in the NHS like most do initially and then moved into the MOD, so worked for the military for six or seven years, or musculoskeletal, which is sort of sports injuries, orthopaedic-related injuries. Really enjoyed that, got to work with some sort of really privileged people. And then my wife met her at uni.

3:41She's from Manchester. We travelled north, settled and got invited into United, worked initially as an academy physio, sort of casual, as you do, worked up through every age group. And then sort of my last job really before I finished was working the reserves for the last six, seven years and looking after the players that were transitioning from the reserves into the first team. Scholes, that Manchester United paths didn't cross now at any stage? No, no. I think I worked with, you know, Tom Hughes. so remember Tom he did and Meza Meza yeah of course Meza yeah so yeah Dava and obviously Huff Meza Dava Leighton

4:29Dava Jesus good to remember them I'll ask you then first of all because we we probably came through when sports science sort of started becoming a big part of it because I always remember when I first started at Liverpool the first day I joined Liverpool in terms of full time so just left school at 16 you go to Melwood every day that was the first time Liverpool had ever employed a physio every day you know at the club so that was sort of mid 90s so I mean how was it for you at sort of you know probably the cliff in those young days about you know sports science physios yeah there wasn't much of it to be fair I think I was early 90s going into the cliff full time if you're injured Jimmy Curran he was Jimmy C he used to put a biscuit tin on you like a little machine for 15 minutes so you had to come in the morning 9 o 'clock 15 minutes had he switched it on?

5:23might as well I've not done and then a little bit of ultrasound I've got a baby in my knee and then you came back at 12 o 'clock you never did any rehab you never went in the gym you never did any running you'll know Day Fever Day Fever first came to the club it all started all of a sudden because it was quite easy to be injured early, you'll know that Jimmy and all of a sudden it became quite difficult so it's amazing how much the injury room emptied once it became quite difficult but yeah look it's changed and then sports scientists started to come along with the physio I didn't like that, I didn't like sports scientists No?

6:02No because I just wanted to go out and kick a ball and doing warm ups in the gym and afterwards I just want to play football I don't need that on this do you know what we see that many injuries these days it's that many sports scientists and doctors and physios at home clubs I don't ever think there were that many when we were playing well you know what I used to say my dad used to run an amateur football team so when I was a kid I used to go and you know watch the Merton Villa you know these are my heroes I'm only filled to five or six I must have been watching them say four or five years before I start going to Everton game no one ever pulled the amateur thing so I used to come in and speak to the physios and the sports why doesn't anyone would ever pull off hamstrings.

6:41They don't do a warm-up. They're on the air the night before. They're going on the air after it. And we're pulling hamstrings left, right and centre. Rush, come on, fill me in. I was at work. Yeah, hamstrings. The rates of hamstrings have increased over the last sort of 20 years. That's for sure. I don't want to bore you with too much of the research, but a guy called Jan Axtrend, he did a study that looked at 21 seasons. He published this sort of research in 2023. And he looked at the rates of hamstring injury and essentially had gone from 12 % to 24 % and they also looked at the numbers of, or the burden, the injury burden and that's the number of days away from playing or training with that injury and that's also essentially doubled.

7:24So, hamstring injuries without a shadow of a doubt have increased. But is that, it can't be more games, I don't think we're playing more games in terms of the numbers, is it just the actual intensity of football now has just gone through the roof and bodies can't cope. I think so. I think you're right. I think intensity has definitely changed. Also, in terms of high-speed running, that's increased. Sprint distance has increased. So players are having to run faster further. And that's clearly having an impact in terms of rates of injury. What were the changes that you saw then in terms of sports?

8:00We're talking about it from a player's point of view. But how did it change for you on the other side of it in terms of sports science almost being as big a part as the football club as anything else in some ways. Yeah, it's a funny one really because my background has been military and the essence of hard work, brotherhood, and these sorts of themes are really important in sport as well. And I think that that also has a sort of impact on dressing rooms and perception of injury. and I've seen where players are disgruntled and injuries are then so much worse in their mind. And that's when it comes down to your relationship with the player, your relationship as a clinician, as a physio, as a doctor, as a sports scientist.

8:46I was just going to say, Russ, I think mentality is a big thing when people get injured. A lad does an injury, does an armistring and a physio, I tell him, look, it's eight weeks, ten weeks, whatever it was. my attitude was always when I got injured look I never pulled a muscle never did I'm sure it was always more knees and ankles and the first thing I wanted to know was what have I done obviously how long is it going to be and then my mentality switched to right I'm going to beat you I'm going to get back before I'm going to break it by two weeks a week whatever it is and I can imagine I was a pain in the ass for the physio because I was always going in every day saying come on what am I doing today can I step up to the bike when am I going outside I don't see that in many players these days.

9:33You know what I mean? It's hard when you're not around it. I think once you say 12 weeks answering, that's it. They're taking 12 weeks and I'm not coming back before that. I think, you know, there is, you can't cheat Mother Nature. So there is a physiological period of time for healing to occur when you can then, you know, once that's complete, then you can start to incrementally. Aren't we all different in that respect though? We are, but there's sort of general sort of periods. So when they sort of say, you know, that's a grade two medial collateral knee ligament injury, that's probably going to be in the region of sort of six to eight weeks or whatever.

10:04You know, you can give sort of rough approximations. But yeah, there is variation between different people. You're absolutely right. And a lot of that comes down to mentality and, you know, the person, characteristics of the person. You know, sport, for me, it's a survival of the fittest, like it is in the military, you know. So you come in and depending on how driven you are, the further you go. It's the same with sports. I think that is something that you have to try and tap into and sort of nurture in injured players. Do physios cover their arse a little bit? Do you know what I mean? When a manager comes and says, look, how long is it going to be out?

10:45You tell him eight weeks. It could be six. Well, I've seen it before. They may embellish it a little bit Because sometimes it's better to err on the side of caution than say, no, he'll be ready for you in six weeks. And then he's back in seven. That then can have an effect on your relationship with the manager. And these relationships are really important. When injuries occur, no one wants injuries to occur, but it's a byproduct of the game that we play. Exposure. If you're out playing, you're getting exposed to injury. So injuries will happen. It's how we sort of mitigate injuries from happening.

11:32I'm a little bit like you. I was always like that, trying to cheat when I could get back. And I had a really old-fashioned view of injuries, to be honest, because I never got injured. Yeah. And I used to sort of look at a lot of my teammates in the treatment room with a lot of disdain, if I'm being totally honest. Sometimes I'm thinking, I think you can play. Yeah. And I know not everyone was built the way I was built and brought up but I actually think now I don't know if it was the same for you at United but same at Liverpool if you had a player who was injury prone and everyone will know the fans is he injured again but I actually think even now social media is so toxic I do think there's a greater understanding when I see I see a lot of Liverpool fans on social media how they react to certain players when they're injured and I think it wasn't like that 25 years ago when I was playing it was just if someone was injury prone it was just it was like everyone just wanted to kill him didn't they you know what I mean for missing games now it's a bit like oh he's unlucky he's a bit I mean I'll ask you that Gareth because I see that a little bit like say someone like Joe Gomez is injury pre-run and you feel for them and I feel them because I had my son having similar situations you know a few years ago injury wise and I sort of understand it a little bit more do you agree with that from a fan's point of view there is more understanding about you know sports science and the red zone or players getting brought off at certain occasions I think that has been yeah because that thing you mentioned there the red zone thing was a big thing on the clock wasn't it and we knew that the players were categorised red zone amber and green whether they could play or not we've had unfortunately quite a few injury prone players as well so we've had to get used to it but it's definitely changed just in my lifetime of going the match I mean I can remember you breaking your leg at Blackburn and still trying to play I can remember Steven Gerrard getting an epidural and playing which was mad when that came out I was like that's for childbirth isn't it and he's having that to go and play footy so I feel it feels like there is a lot more understanding about it now and perhaps more of an understanding at the clubs as well I mean I spoke to you before didn't I and I was saying to you you know that epidural situation even Jamie's trying to carry on with the broken leg you know do you think there's better care for them now where you would maybe talk the player out of almost this like masculine thing of no I've got to play through every injury and I've got to be the man is there more an arm round now saying well actually you might do yourself more damage there I think there's sort of medical and legal accountability definitely and this you know this is a sort of serious side of sort of medicine and technology and you know there's been huge improvements in terms of imaging so you know 10 15 years ago the levels of detail that they when they do an MR the levels of detail are totally different to what you see now you see you know very very fine detail and so I think that's also you know part of of the issue so previously 20 15 20 years ago they may have been playing with you know a grade one a grade two injury muscle injury now because it didn't really pick up on the MR or or they weren't scanned now we sort of scan everything and quite quickly we can see well yeah you have got a muscle injury there it looks like it's bled Maybe it's not a structural injury, but there's definitely a change there.

14:44Russ, what's the relationship with managers? Because something that really stood out for me when we brought Gennard Hulier and obviously 25 years ago or so was the relationship with the physio and the doctor and where it was almost like at loggerheads over different players. And how much of that is a fight now? and it almost feels to me like sports science has won that fight in terms of, you know, you could... I'm thinking of head injuries. I'll use an example now. You have the concussion stuff now. I got knocked out at Arsenal and the game was on a Sunday and our next game was on a Saturday. And obviously I've come back around in the dressing room and I just remember a buzzing in my head just for the days after.

15:31But our next game was on a Saturday and it had to be a week supposedly. and I was just like our doctor was saying you've got to wait a week and I was just like having none of it I was playing and Kenny's like he said well you're playing if you want to play that was the end of it there was no like I didn't train I just walked around I just played on a Saturday I mean that situation wouldn't be able to happen now would it that certainly wouldn't happen now because for one if you have a head injury your capacity to make decisions is impaired so you may say I'm playing I play as well on a Saturday

16:04yeah so yes you know concussion is a huge thing at the minute it's going to get bigger and bigger and bigger as more research is done the more we understand the effects of concussion both short term and long term effects i think that's that's the most important thing long term effects of having a head related injury and having a succession of these injuries so if you get knocked out um there's a very high chance you'll you'll sustain another injury it might not be another concussion but you can get another concussion if you play but you may get another injury non-related to the concussion but you know the concussion I suppose that's probably that's almost black and white now isn't it that's almost like that that's almost like feels like a real say that was a hamstring injury and you know would that still be in the hands of the manager and the player if you were adamant that someone wasn't ready to play do you know if you've got conflict between your manager and your sports science and your physio and your medical team then you're in trouble you're in big trouble because it's not a space where you can have that sort of level of disagreement it's about nowadays work in practice it's about collaboration and i get it you know there has to be a final decision made but it needs to be a collaborative decision where everyone sort of offers their piece of the jigsaw and then you can see what the jigsaw looks like you can see the picture presented in front of you and the biggest part of that jigsaw is the player because the player if the player doesn't want to play you won't play and and that's really important that's when it comes back to these relationships you have with people and you've got you've got you know for me it's about relationships you've got to have trust transparency honesty you know patience sometimes patience and you've got to you know there's so much pressure in the modern day game on everyone but you've you've got to just filter that out if you want to truly return players properly you've got to filter it out and you've got to focus on the needs of the player and they've got to be able to speak to you and trust you and give you honest information because you're saying you said earlier that you wanted to play so there's always a drive to play and you wanted to get back two weeks before we'd sort of said and that's obvious, that happens and that's what makes you you and that's what makes you so successful because that drive to sort of perform that drive to sort of play Flav sorry to go just need to bring Flav in I mean you're a club this season's probably known as having so many injuries have you got a question or any thought process about the set up of Tottenham or how maybe Ange plays does that contribute to it?

18:37Yeah I've got a couple really Ange Postacoglu is known to bake in injuries into his system he's said that he's been on record at Celtic that he understands that injury's going to be a part of his approach to football there's that but there's also I wanted to ask a question about van der Ven and how they're bringing him back because he played for 45 minutes of football, came off. We haven't seen him for a couple of weeks since then. And they've talked about retraining the way, or his approach or the way he moves on the pitch to potentially prevent any further serious hamstring injuries. Could you tell us a bit more about that, how that might be?

19:14So the answer to the first question... What do you think is baked into his approach? Whenever you get a change in manager, then you have a change in coaching philosophy. and intensity of training sessions. There used to be a saying, you train high, play easy. But I think with the change in the modern game, every game is a tough game. But in terms of when a new manager comes in, then players have to get used to how the manager trains. And so if the intensity suddenly ramps up, so you get spikes in load, high-speed running, sprint distance, then players will take a period of time to accommodate to that.

19:50so you typically get a rise in sort of injuries I think um when Van Gaal came in he was very much you know I remember looking at the injury board and he was very much he liked a lot of repetition and we we picked up quite a lot of sort of groin related injuries but um I think there there is a period of accommodation but you should be well and truly through that now um and in answer to the second question um players coming back really really challenging and that's where it's so important that you've got incredible relationships with all the staff and the player and the manager in terms of very delicately especially with hamstrings or re-injuries of hamstrings reintroducing them and the load has to be tapered right um for me the way I used to sort of manage hamstring related injuries I would probably keep them a little bit longer which frustrate the player but then it came down to educating them and I would always so I'd look at their sort of general sort of GPS profile, and I will always exceed every sort of metric by 15 % to 20%, not just once, but over a period before I knew, where I felt that they're in the best possible position.

20:58But going back to playing match play is totally different to training, totally different to being on a real pitch with a physio. You know, and that's another element you sort of factor in. I think there is, sorry, James, my point was, I think the relationship between the physio and the manager is probably one of the most important ones in the club, really. I remember we had Owen Argreaves, who, very unfortunate, a great player he'd have played along with England, brilliant player, Owen, but he was injured a lot. And the manager, eventually, they become frustrated because they can't get him back, and I'm sure...

21:35And our manager was really good in that way. He always trusted the physio. So he took their word, you know what I mean, as gospel really. I remember one game, I think we were playing Arsenal at home. Owen had been out for quite some time, was nearly coming back and then always breaking down. I think it was against Arsenal, he went out for the warm-up and he came in, said he felt his answering and you could just see the anger in the manager's face, the frustration you're playing. And that was it. Obviously it didn't end that well within 15, 20 minutes. I think Colin was actually off and out for a long time again.

22:09So I think that relationship and trust, there has to be frustration from managers as well. And we're all human and frustration is part of it. But it's being able to have those open conversations. If you can't have them or you sort of shy away from them, that's, again, problems. There are actually some managers who think the doctors as well, aren't there? Yeah, well, yeah, there are. Some doctors who think the managers. Yeah, yeah. Yeah, you're not wrong. James, have you got a question? Can I ask Scorsi a question? Oh, sorry, go on. Remember that game against Blues when you took the bang to the head?

22:44Yes, sir. Against Bournemouth City, you took a bang to the head and you lost your eyesight and you were out for a big chunk of the season. What was that like, discovering that, not having... Were you proper blind in one eye? No, I did actually take a bump to the head. It was about 10 minutes ago. I remember, I think I just looked into one of the floodlights and my eyes went funny. and Nicky Butt took a throw in and I saw about three balls coming at me. I was just getting the middle one. And anyway, I didn't think anything about that. I told the physio and the doctor afterwards and I went to see a specialist the day after and apparently I had a blood clot on my eye that just burst.

23:21So I just couldn't see it. And that was the longest I was out. I was out for three or four months. It was the rest of the season, I think. Yeah, three or four months. I came back for Roy's Test of Moria against Celtic just to play half a game to try and get back into it. Yeah, but that wasn't even a bump. it was a little bit scary what was it like having to go through that because it's almost like I remember Giggs used to have issues with his hamstrings and he just starts doing yoga and kind of but with an eye injury you go blind especially someone that I didn't really go blind it was just a little bit of blurred vision well it was a lot of blurred vision at the time and he'll never go see you went blind they'll get more hits on the show yeah when I was just blind nightmare when I was going through it there was a player in Scotland who was blind in one eye he was actually playing so have you still got an issue with it or I think so well it's still there in my eye but they say you just get used to it and it took ages to get used to it but yeah so you played blind no you played in the program blind some of it passes yeah you might think so no just a little bit of blurred a lot of blurred vision it's like having a I don't know if you ever had a migraine it was like that but for for four months sorry

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26:56I find the psychological aspects of injuries really fascinating. And like we've heard Jamie and Paul talk about how they, you know, they're that sort of classic footballer type where they wanted to beat the time span, get back as soon as possible. Do you ever have the inverse of that, where you've got players who, you know, you're looking at the scans and you're like, to be honest, mate, we think you can play, but they're saying I've got pain or I've got an issue. And what do you do if you find yourself in that situation? Yeah, it's tricky. Yeah, again, that comes back to your relationship with players.

27:24And I can't sort of labor it enough. It's really, really important because even, you know, I was saying about the advent of technology in terms of MRI and diagnostic imaging, and it's much, much better, but it's still not perfect, you know. So there may be, we call it subclinical, there may be something there that we're not seeing, but it's clearly impacting on the focus and attention of the player because they're not happy you know so and it's a tricky one because we could sort of say well yeah there's nothing there looks pretty clear get out and train so they go out and train and then you pull a hamstring so then well I told you and then your relationship is is totally gone it's about knowing your player that's really important having you know knowing what they're like knowing what their characteristics are like are they a warrior that will sort of run through a brick wall and if they are then that sets your arm bells off more so than somebody that is probably less inclined to be like that.

28:21So, yeah, knowing your player, good relationships, good communication. Do you know what I do like sometimes when players, especially, you probably had at your club, with foreign players, when they got injured, they used to fly off. What's wrong with our medical staff? That's tricky. That's a big thing now. All through Premier League, players have their own physios, medical staff, personal trainers. That must be very difficult when you're inside the club to keep control of that. It's a disaster. and that may be a key contributing factor to rates of re-injury. That's not published, there's no evidence for that, it's just my only opinion, but it's really hard.

28:59Sir Alex wouldn't have any of that. Very rarely, I think there was one or two that made the exception. Can't say now, and Ronaldo. Van Persie, wouldn't he? Now there's a few that he let go back to his own country and didn't get a dream. I always felt where's the confidence in that maybe it's just to go back to a bit of nice weather I don't know there is probably that and that probably helps when a player's come back that can't help two sets of medical staff looking after it so if you go to the NHS and see a consultant and you see someone the next time someone the time after that it's a disaster you need that continuity of care you need that relationship with that player with that person Sarah you got a question?

29:44Yeah, it sort of carries on from what you were just saying there. So we've got Rhys Nelson on loan from Arsenal at Fulham at the moment. Pulled up with his hamstring just before Christmas and came back, did his first training session. And then he's now done his other hamstring and he's now needed an operation and he's probably out for the rest of the season. So it's sort of the first injury. Could that have exacerbated the second injury that he's now had? And also, because he's on loan from Arsenal, who does the medical care for him? Is it Arsenal or is it Fulham or would it be joint? Yeah, so that's a discussion between the two clubs, really.

30:28So they will speak to the players, speak to the club. Obviously, Arsenal have got overriding control, so they will decide what's most appropriate, probably liaised with a player to determine that. you know so yeah in terms of injuries um spoke about tom hughes before so tom was a physio at say united 15 years he did a like really incredible piece of research looking at prognostic factors against gets a bit sort of scientific so looking at prediction factors in relation to injury um and you're saying about you know is he more likely to get you know an injury because he's had an injury and uh tom looked at all the sort of data at united um over many seasons and he found the only two factors that would predict future injury were age of the player.

31:15So the older you are, you're more likely to get injured and previous injuries. So if you've had a history of injury, and it sounds, we're all sitting here and probably going, well, that makes sense. It's common sense. But all the other sort of metrics we look at, there's no link in terms of prediction of injury. And he did, he spent years on this piece of work and he did it properly. I think, again, other problems with research is, people quote different studies, but if the research isn't done properly and it's not robust research, then where methodology, research design is done perfectly, you really can't judge and you can't accept the findings of the study.

31:53Tom's work is absolutely solid. So they're the two factors that predict injury, age and previous injury. Ross, can you tell us about the Howden report? Howden report, yeah. So it's an insurance-based report for the Premier League. It looks at It looks at numbers of injuries over each season and offers a bit of a comparison. In terms of injury rates, it looks at that. Cost of injury is another thing. Financial cost to the club. So it gives you a indication on that. How much does an ACL cost? Average, well... Are you going to chip in? £20 ,000. Cost of surgery or cost of... The entire club. Also the club, yeah.

32:37So it's difficult because I can't give an exact figure because the longer the injury, probably the higher the cost. But you factor in wages and all that sort of stuff. But as an average, an injury in the Premier League will cost the club about£350 ,000 as an average. I want your injuries down to genetics. You look at the people like Luke Shaw, now who just, the lad can't stay fit. And also another part of the question, When you're signing a player, you definitely take into consideration his previous injuries. I look at Mason Mount for us, Adam. He didn't play for such a long time. I'm sure he played so well as the end, but he missed a lot of it.

33:21The clues were there as well. He was an injury-prone Chelsea player. Yeah, that's me quite aware. How much is it down to genetics? How much is it down to genetics? I think there's a component, definitely. You know, injuries are multifactorial. You know, someone pulls up a hammerstring, you can't say, well, it happened because they played, you know, 90 minutes sort of two days ago or whatever. You know, it's multifactorial. There's so many factors that go into the pot that cause an injury to happen. And we're only talking about some non-contact injuries. Contact injuries, you know, that's totally out of your control.

33:54Did you deal with Luke Shaw while you were there? No, John Davin dealt with him. I got a bottle of champagne off Luke Shaw for being late consistently, though. um well you were late consistently no no he was like he was like i was gonna say

34:14what do you think his issue is and what's john dava told you well he told me you've never warmed up that's what i was never injured exactly so and that's that that's the thing that you know we talk about genetics You know, you never warmed up. You know, once you've been injured that many times, though, for so long, do you think it has to be mental a lot of it, does it? But it's very difficult for a physio or someone to prove that. It's really hard. But, yeah, there's definitely a component of psychology. You know, anyone that suffers bad news, we've all received bad news. And when you tell someone you're not going to play for 9, 10, 12 months, that's the world destroyed, isn't it?

34:55So, you know, it's really hard how people manage and cope. And it's a process. It's almost like a bit of a bereavement process when you get a big injury. And it's, again, sort of catering to that. See, that's where I thought our mentality was probably right and helped in that way. When you say bereavement, look, I was never out for 10 or 12 months. I don't know how it feels. But if I got told I was out for 10 or 12 months, I'd be thinking eight months, I'll be back. And that was like a win. the day I broke my leg Garrett was talking about Milan Barris broke his leg in the same game but he broke his leg before me and our doctor went with him to the hospital I don't know if I've told this story on this before but when I go into the office I'm with the black man doctor who was actually employed by the FA at the time so Lucas Neal's broken my leg he's been sent off he comes in my dad comes flying he knew I wouldn't go off unless it was something serious what the fucking hell's happened you know just goes with a bad tackle so the doctor's in there and he's going oh he's got away with one he's a lucky boy you know what I mean and all that so they're laughing so not having a bit of banter I'm not fucking lying there like that so my doctor's not there so I then crutches on the coach everyone's going oh you were lucky it was a terrible tackle all that stuff so I just get home that night and I go kip on me front I sleep on me front but I'm like my leg it's just like it's got an arp and I'm just on my back like that because I can't get on my front.

36:23I go, the first time I see our doctors the next morning, he looked at me for 10 seconds and went, you broke your leg. So I didn't know I'd broke my leg until the next day. Because when you talk about medical, whatever, people expertise or whatever, our doctor wasn't there. So I didn't realise until the next day. But the point I'm making is, because Barros had broke his leg at the same day, for me it was a competition. I'm coming back before him. you know and it was just I was told it was six months I got back in four months and played my first reserve game against Devon at Haig Avenue yeah but that was my thing when you talk about how people deal with it my thing was like is he running or is he jumping or is he training yeah it's like I've got to be thin I've got to be thin did you get back before Barris?

37:07yeah yeah again it just goes to show the relationship you have with how close the relationship is with the medical staff because if your doctor had seen it he would have probably said well I know Jamie you know that's that's definitely you know that's that's clearly a fracture this is not like the other guy the blackburn doctor the FA doctor no relationship probably with you doesn't really know what you're like you know and you rely on we couldn't spot a broken leg either because he's bone sticking out you're lucky did you ever sleep in the oxygen chambers I know Rooney had to for a while didn't he we had them at the club we had the sort of yeah sort of enriched you don't sleep in them do you?

37:48No. I thought like oh I'm sure you saw No you lie down in them you lie down in them but you don't sleep in them Alright We'll cut that bit out Lee have you got a question? Yeah it was actually funny I found out about Rooney and Beckham What's sleeping in? No no it was more like the gear that they wear the last 30 years the football has got smaller and smaller and lighter and lighter and you also look at like shin pads nowadays they used to be like in the 90s they were like these big thick things now, the leg, this way, that. Does that upset me? Yeah, it does really upset me. Do you get more injuries?

38:24Yeah. We've got a lad playing in the first team at United now. He's a lovely kid and I've gotten really well with him. But, you know, he would wear the smallest shin pads and he had a car, he had a sort of contusion. It kept him out for, I think, five weeks. It was a really nasty one. And I'm trying to have a conversation with him. So I'm saying, you've lost five weeks, five weeks of your development. Five weeks of an opportunity in the first team, you know, because you're wearing this sort of gear, you know. And again, it's, you know, trying to listen to their rationale for using it. But ultimately, yeah, it's about sort of risk and mitigating risk all the time.

39:03Shimpads, boots, you know, playing surface. You know, there's so many factors. Because players nowadays want to get an edge now. They want to get ahead by feeling light, running quicker, as you say. I get that. I get that. You know, that feeling. And if you don't feel right, it doesn't feel right. It'll be in the back of your mind the whole game. And you won't focus on what you need to focus on. So it'll be a distraction. But I don't know, sometimes society today, it's about, you know, there's always something. And at the end of the day, strip it right back. You're there to perform at your best, you know.

39:38And getting into that mindset of that is really important. And having people around, you know, emphasizing that point. I think often there's too many distractions, there's too many voices, there's too much nonsense, and that impacts on performance, in my opinion. That's a good point. There is, from me and Jamie, when we were playing, there was probably one physio, if you were lucky. And now there's so many people. There's so many people around the football club. You might have two or three physios, you might have two or three sports scientists. And I always feel like when you're in the morning, maybe having a massage, there's always somebody to complain to, isn't there?

40:14There's lots. There is always something to say to somebody. Yeah, there's a lot of work to do. And that's fine. It doesn't necessarily matter if you have more people, but everyone has to be on point with the same information. And that's what it comes down to, sort of creating a culture where there's a togetherness and everyone is giving, imparting the same information. Problem happens where I give a piece of information, somebody else gives a different piece of information. it starts to create distrust a bit of disharmony because i'm like well why are you talking you know why have you said that you know how everything's a subscription now music movies even socks i swear to continue this ad please upgrade to premium plus platinum uh what no anyway blue apron this is a paper listen ad please confirm your billing oh that's annoying At least with the new Blue Apron, there's no subscription needed.

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42:26How much of a problem is that when we look at clubs? I'm thinking of Liverpool here because I don't necessarily think Liverpool are a million miles better than they were last season, but the players are fit. players last season were injured a lot now there's a slight different sort of shift maybe in style with Klopp a little bit more sort of gung-ho end-to-end I mean when there are injuries at a club who's almost getting the blame it almost feels like there's a blame game if there's injuries is it the style of player, the manager is it the medical staff how do you see that when you're looking at your own club but also other clubs as well Gerrit really it's one of those things that really sort of annoys me because you constantly a player gets injured or they have a club will have a problem with injury and the medical department are to blame.

43:11Medical department do not injure players. They're the ones that pick them up, put them back together. If you've got a problem with re-injuries, then yeah, that is worth a discussion. But medical departments up and down the country through the Premier League do not injure players and keep parping back to it. It comes back to those relationships with people. You can be an incredible physio. If you can't talk to people, you're stuffed. you know and for me that's really really important you got to be semi all right at what you do as a physio but you got to be you know absolutely world-class at talking to people building relationship with people building rapport and delivering good messages you know other things that really bothered me when i'd go into the training ground is you know if the treatment room is flat right it just creates you know a low mood and you know you don't want anyone in that treatment room but people get injured you've got to you've got to lift them you've got to get them going again and you've got to give them a target to get them out and often i see treatment rooms where it's just it feel it just feels you know dead and that's the problem the treatment room is always that room in a football club you know you might come in early or you might be in the canteen you don't know where everyone is and you just go to the treatment room you know everyone will be in the treatment room it's just that that room and everyone just sort of thing and i always remember someone describing it as the room of truth.

44:34There's always that relationship. Physios and sports scientists, they find out everything. They're sat on the bed with the lads and they're just chatting away. They build that relationship, myself, sports scientists. It feels like, you know, I always think you've got to be, I'll be honest with you, I always think you've got to be very careful with medical staff in terms of... Telling the truth. We're into management. We talk about a bad dressing room. I think if you get a bad treatment room and you've got to a couple of physios or a mass series who are just, they've got negativity, just planting seeds into players' heads.

45:08They're just, they're negative people, you know, and it's just, oh, this, oh, I don't fancy him, or what do you think about the manager? Oh, I can't believe he did that. And it's, I think it can be the best of places, but it can also be a cancer in a football club. 100%. 100%. And, you know, I've worked with people in the past where they've sort of looked at a player for a certain injury, and they've sort of gone, actually, this is out, that's out. You know, we need to sort of readjust that. And I'm like, what are you talking about? Do not say that. Do not say that. Concentrate on his injury, get him back out.

45:40You know, you start to put seeds of doubt in players' minds, and it's a problem because that will play on the players' minds. I didn't perform very well in training because, yeah, I've got, you know, this is sort of derotated. I need to sort of, you know, I need to go and see him. And then there's a dependency, and that's another problem, dependency between player, athlete, and sort of clinician. Trust. There has to be a trust as well, don't you? Like, as Jamie said, as the player, you're going to be spending a lot of time with this physio and you might sometimes tell him stuff that you probably shouldn't.

46:09Yeah. You know what I mean? About things that may be up in the dressing room or things you aren't happy with. Then there's that concern. Is this going to get back to the manager? You know what I mean? So there has to be a big trust between the physio and the patient as well. That's sort of medical incompetence. So, you know, that's, you're ethically bound to not, you know, if you had a discussion with me, then I'm bound. not you know by my sort of um discipline not to discuss that with anyone else or impart that information but it's you don't want to get to that stage you want to you want openness and transparency so you want you know i'll be having a conversation with you and sort of saying well you know this this is what you're saying is really important information and you you know you need to sort of disclose that to to them to the boss that's the manager you know because it's going to impact on his selection choice you know and and and how he manages going forward so yeah so yeah You're absolutely right.

47:01Football can sometimes be the most unprofessional professional arena for clinicians. And I think that's where clinicians need to be really careful. It's important to have relationships with people and it's important to have fun and banter, but you've got to deliver on what you're there to do. You know, when City won the treble, we had almost every player, maybe not fully fit, but available for the final. How much of it is down to luck? Because when I think back about that season, we were pretty lucky with some of the players that stayed fit. De Bruyne had a hamstring injury in the quarterfinal against Bayern Munich and still kept playing.

47:35And then it was only in the final where it completely went and he had to come off. So how much of it is down to luck? Can you think of any particular seasons, maybe, at United where they've been very lucky or unlucky? I could do the latter part. De Bruyne, for example, he played on with that and then he suffered the consequences of that for months and months and months after. so luck is a part of everything you know you get in the car in the morning to come here and you you know you hope you're not going to crash yeah that's the analogy so you put your seatbelt on you know you've not had any beers before you got in the car you've put your phone away you know you're concentrating on driving that vehicle so you're mitigating risk and I think it's about risk mitigation but the best the best teams the most successful teams they're the ones with sort of consistent availability, you know, players available to play.

48:30That's proven. Well, Russ, I want to say a big thank you for coming in and joining us on The Fan Debate. And that is another episode of The Fan Debate brought to you by Skybet. See you next time.

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