Sunday Supplement - 02/04/17

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State of Sport: Fifa's former doctor says painkiller use risks footballers' health
By Simon Mundie & Jonathan Jurejko
BBC Sport

Elite footballers' "abuse" of legal painkillers risks their health and could "potentially" have life-threatening implications, says Fifa's former chief medical officer.

About half of players competing at the past three World Cups routinely took non-steroidal anti-inflammatory drugs like ibuprofen, claims Jiri Dvorak.

He says it is still an "alarming trend" among players, including teenagers.

"It has become a cultural issue, part of the game," said Professor Dvorak.

"It is absolutely wrong," added the Czech, who left Fifa in November after 22 years.

"For me it's clearly abuse of the drugs - that's why we use the word alarming."

However, the Professional Footballers' Association - the players' union in England - said misuse of painkillers was "not a major issue" among its members.

BBC pundit and former England defender Danny Mills says painkillers in football have always been widespread - "and always will be".

"I've been in many dressing rooms where I've seen other players pressured into playing with painkillers," he said.

He added players at the top level of the game did not see them as an issue because they were legal and often monitored by health professionals - but he felt some players lower down the league ladder might suffer problems without that safety net in place.

Professor Dvorak spoke to the BBC as part of State of Sport week, which on Thursday examines the balance of athlete welfare against a winning-at-all-costs culture in sport.

A government-commissioned review into safety and wellbeing in British sport, headed by 11-time Paralympic champion Baroness Grey-Thompson, is due to be published imminently.

It is expected to recommend significant reforms designed to improve the way athletes are treated by governing bodies.

Professor Dvorak collected data about the intake of medication by all players at every Fifa tournament between 1998 and 2014, discovering almost 50% took 'everyday' anti-inflammatory drugs and painkillers that are available over the counter.

He says some clubs prioritise success over player welfare, leading to players feeling "pressured" into taking medication to overcome minor injuries and play in important games.

Professor Dvorak previously raised these concerns when he was employed by Fifa, but claims the world governing body has still not addressed the issue appropriately.

Fifa says its stance on the issue has not changed since Dvorak first warned about the long-term implications of players misusing painkillers in 2012.

The misuse of legal medication could "potentially" have life-threatening implications for players, claims Professor Dvorak.

"We have to make a strong statement for the players: wake up, and be careful," he said. "It is not that harmless and you can't think that you can take them like cookies. It has side-effects."

Not a major issue for us - PFA
Only one footballer based in England has raised concerns about the misuse of painkillers directly to the PFA in the past decade, according to head of player welfare Michael Bennett.

"It was an individual with a back problem and he was taking ibuprofen tablets to get through games and training with it," Bennett told BBC Sport.

"The issue arose more when he left the game, when he realised he was still taking them and it was a continual problem for him.

"He addressed the issue by going to see his personal GP and decreased the medication he was taking, and coming off it.

"In my time of working in this field, about eight or nine years, that is the only person who has had an issue with painkillers.

"It is not a major issue for us."

The footballer's view
BBC pundit Danny Mills made more than 320 appearances for sides including Manchester City and Leeds United in a 14-year career that ended at the age of 32 through injury. He saw painkillers as part and parcel of football and thinks players are unlikely to see them as an issue as a result.

When you're talking about painkilling injections, painkilling drugs, anti-inflammatories, it's widespread in football. Always has been, always will be. As a player the first thing you ask is, "Is it legal?" and if it is, fine. Is it going to help, is it going to get me through a game? If yes, then generally, without too many questions, without too much concern, you take what's being offered.

Most professionals are dictated to now by physios, by doctors, and things are monitored, so they do not see it as a huge issue.

I've been in many dressing rooms where I've seen other players pressured into playing with painkillers. Myself as well, I had pain-killing injections in a broken toe for six months - one before the game, one at half-time. I'd wake up at midnight screaming in agony as it wore off but it was my choice, I wanted to do it. Was it good for me long-term? Probably not.

But players will always look for the short-term fix. Most players would take the attitude, 'it's painkillers, it's legal, it's monitored'. There are times when it might not do the injury any good, there's a good chance you might make it worse but you take that risk. Sport is all about risk and reward. As long as there is that reward, people will always take risks. You're going to win a medal, you're going to get three points. Ultimately it has to be down to the individual to make up their mind. But would I do it again? Yes.

Case studies: 'My body could not cope'
Three former Premier League footballers have blamed the overuse of legal anti-inflammatory drugs and painkillers on health problems.

These include over-the-counter pills, such as ibuprofen and vitamins, as well as stronger pain-relief injections like cortisone.

Daniel Agger, former Liverpool and Denmark defender

Agger, 32, retired from competitive football when his contract expired at Brondby in June 2016.

Fifteen months earlier he collapsed in the dressing room after being substituted just 29 minutes into a game against FC Copenhagen.

He was an injury doubt and, in a desperate bid to play, had taken more than the recommended maximum dose of anti-inflammatory drugs in the week leading up to the game.

"The body could not cope with it," he told Danish newspaper Jyllands-Posten in July 2016.

"I have taken too many anti-inflammatories in my career.

"I know that full well, and it sucks, but I did stop it [in the end]. I am not gaining anything personally from saying this but I can only hope that other athletes do.

"It could be that others take a pill or two less."

Ivan Klasnic, former Bolton Wanderers, Werder Bremen and Croatia striker

Klasnic, 37, suffered kidney failure while playing for German club Werder Bremen in 2007.

He blamed team doctors at Werder Bremen, saying they failed to diagnose his problem in time and continued to prescribe painkilling medication to him which can be very damaging to kidneys.

The doctors at the club say the problem was caused by genetics and not painkillers.

He was left critically ill in September after his body rejected a transplanted kidney provided by his mother.

Dominic Matteo, former Liverpool, Leeds and Scotland defender

Matteo, 42, said he took painkilling injections "for years" during a career spanning more than 350 appearances, and had to have spinal surgery two years after he retired in 2009.

He added he thought under-pressure managers did not consider the long-term effect of players having this treatment and then taking part in games.

"I took painkilling injections to play football when my body was telling me to do otherwise," he said in a 2011 interview.

"Even though the operation was a success, I don't think I'll ever be completely fine but hopefully I'll be able to lift my kids again.

"This problem all dates back to when I was at Liverpool and I had injections to play games. Then, after Liverpool, when I was at Leeds nothing changed; I'd get an injection every Saturday just to play."

'Pressure' led to cyclist taking powerful painkiller
Last week, British cyclist Josh Edmondson told the BBC he broke the sport's rules by secretly injecting himself with a cocktail of vitamins when riding for Team Sky.

The 24-year-old, who was on the team's books in 2013 and 2014, also said he had severe depression after independently using the controversial painkiller Tramadol.

Speaking to BBC sports editor Dan Roan, he said he risked giving himself a heart attack by self-administering the medication secretly at night.

"In 2014 I was under a lot of pressure, not just from the team but from myself," said Edmondson.

"You want to renew your contract for one thing, and for me the bigger thing was not letting anyone down - this team had given me a chance by signing me."



http://www.bbc.co.uk/sport/39333763

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Air Products and ProCare develop tailored cryotherapy for Fulham FC

Air Products, in collaboration with ProCare, has developed a tailored PolarFit® Care cryotherapy vessel for Fulham FC Elite Sports Club to boost player recovery and performance.

The English Football League (EFL) Championship club, which has been trialling cryotherapy over the last three seasons, has received expert training to adopt PolarFit Care, the world's first and only fully customised Whole Body Cryotherapy system, developed by Air Products and sports scientists ProCare.

Fulham has already seen positive results including a reduction in player muscle soreness and reduced injury time as a result of its existing approach to cryotherapy. It expects to boulster these results still further by applying the individually tailored and bespoke approach afforded by PolarFit Care.

Cryotherapy unit

Chris Hansen, Head of Physiology at Fulham FC, explains, "We tailor most aspects of the players' schedules, from training to therapy and even diet, based on things like body type, age and position in the team."

"Any treatment that can be intelligently applied based on the needs of an individual player is bound to increase its effectiveness. It only makes sense that a more tailored approach will improve the already positive results of cryotherapy treatment. We've been really impressed by the PolarFit Care offer and are excited by the potential to boost recovery and performance to the next level," Hansen added.

The software, developed by Air Products and ProCare, pulls data from nearly 1,000 peer-reviewed papers on cryotherapy, cold water emersion and local cold therapy to deliver tailored programmes to improve the recovery time, injury prevention, metabolism and even sleep of each individual player.

Martin O'Connell at Air Products says, "Tailored cryotherapy should give Fulham an edge next season and in elite sport, an edge is everything."

"Whole Body Cryotherapy is gaining in popularity as a treatment but most clubs and athletes take a 'one size fits all' approach to its use."

"We know that individuals respond differently to Whole Body Cryotherapy depending on their physical and genetic make-up, so PolarFit Care represents a huge opportunity for forward looking clubs," O'Connell continued.

The PolarFit Care treatment package is new to the UK market, following extensive testing in the Netherlands, and emphasises the benefits of a safe and tailored approach. All PolarFit Care cryotherapy vessels use indirect whole body cryotherapy. This is the safest kind of cryotherapy on the market, ensuring the nitrogen (N2) used to cool the chamber never comes into contact with the athlete's body.

https://www.gasworld.com/air-products-develops-tailored-cryotherapy-for-fulham-fc-/2012552.article

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Ryan Sessegnon Exclusive: Ex-Fulham ace reveals how club could benefit from big sale

WONDERKID Ryan Sessegnon has been urged to snub Premier League interest and stick with Fulham.


A host of Premier League clubs are interested in Fulham starlet Ryan Sessegnon

The 16-year-old is rated as one of Europe's hottest prospects after starring for Slavisa Jokanovic's side this term.

A host of clubs including Liverpool, Chelsea and Arsenal are reportedly keen.

Ex-Fulham forward Leroy Rosenior believes Sessegnon would be best served to stay at Craven Cottage but thinks a sale could benefit the club.

Rosenior told Starsport: "I think he's the best left-back talent in England, there's no doubt about that.

"All things being equal, he should stay at Fulham and develop but opportunities come and if Fulham get an offer which is difficult to refuse and it means that he could progress then as long as it's amicable and it's done in the right way then he will move on.

"I'm sorry Fulham fans but this is life.

"Also, sometimes it allows your football club to move on.

"When I was a youngster the players would come through and have that ambition to go and better themselves.


Ryan Sessegnon has starred for Fulham this term

"It doesn't mean that you think any less of your football club but that's the way it is.

"Believe me there are lots of Premier League clubs interested in Ryan Sessegnon and that's a fact.

"I think sometimes when you sell a young player and you have a manager like Jokanovic - whose recruitment has been incredible - then you have to trust their judgement.

"Sometimes you get a left-back and even if he's wonderful player, how much can a left-back affect a game?


Leroy Rosenior believes Ryan Sessegnon should stick with Fulham

"Maybe if you get an experienced left-back for two years that could do a job and get a winger and centre-forward then it makes your squad more rounded.

"You could lose Ryan and make your squad better."

Fulham have a host of exciting talents coming through their academy including Dennis Adeniran and Tayo Edun, and Rosenior believes the club is the perfect 'stomping ground' for young players.

He added: "It's an amazing environment to learn your trade. When a team in the top echelons come knocking it's difficult for players to say no.

"[Sessegnon's] a special talent but Fulham will always take credit for that."

'IT'S ONLY BANTER' - The Autobiography of Leroy Rosenior By Leroy Rosenior with Leo Moynihan is out now via Pitch Publishing www.pitchpublishing.co.uk


http://www.dailystar.co.uk/sport/football/600979/Ryan-Sessegnon-Fulham-Transfer-News-Leroy-Rosenior-Gossip

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Fulham set for summer transfer battle with European giants for international striker

According to a report by Get West London, Fulham are set to compete for the signing of Emmanuel Emenike in the summer.

Emmanuel Emenike looks set to leave Turkish giants Fenerbahce in the summer after growing increasingly frustrated with his lack of playing time.

Championship outfit Fulham have been alerted to this situation and his potential availability but they will have to fend off interest from a number of top flight Russian clubs to land Emenike.

The Nigerian international is said to be keen on a return to Russia, where he previously scored 23 goals in 42 appearances over two years with Spartak Moscow.

Emmanuel Emenike has previously played in England, too, spending half a season on loan at Premier League side West Ham United but he failed to make much of an impact in East London.

The 29-year-old scored twice for the Hammers in 16 games, both of which came against Blackburn.

Fulham boss Slavisa Jokanovic is believed to be interested in Emenike as he looks to strengthen up front in the summer.



https://footballleagueworld.co.uk/fulham-set-for-summer-transfer-battle-with-european-giants-for-international-striker/

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Sevilla enter the race for Liverpool target Ryan Sessegnon
There is a long line of potential suitors for the 16-year-old but Fulham are confident of keeping hold of the wonderkid in the summer


Stick with Fulham: Ryan Sessegnon (Photo: Nathan Stirk/Stringer/GettyImages)

Sevilla are reportedly the latest club to enquire after Fulham's Ryan Sessegnon.

The La Liga side are currently sitting third in the Spanish top flight, eight points off Real Madrid in top spot, and according to Bleacher Report are interested in signing the 16-year-old in the summer.

However, Sevilla's sporting director Monchi is to leave the club to join Roma, while manager Jorge Sampaoli is widely rumoured to be on the shortlist to replace Luis Enrique at Barcelona at the end of the season. which could put a stop to their interest come the transfer window.

Liverpool are the favourites to sign Sessegnon should he leave Craven Cottage, but in his first interview he stated his love for Fulham , revealing he wants to help get his club back into the Premier League.

The 16-year-old is still on youth terms at the Cottage but will sign a professional deal when he turns 17 in May.


http://www.getwestlondon.co.uk/sport/football/transfer-news/sevilla-enter-race-liverpool-target-12823963

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Birmingham City youngster Wes McDonald discusses his decision to swap Fulham for Blues
Attacker moved from his home town for more opportunities at BCFC

Birmingham City hotshot Wes McDonald believes his decision to leave Fulham and move away from his family as a 16-year-old is paying off.

The youngster scored for the third game running in Blues Under 23s' 1-1 draw with Colchester on Tuesday night.

And it was announced yesterday the club have decided to retain the services of the in-form 19-year-old who has developed well this season.

McDonald's purple patch has taken his goal tally to six in 25 games, with Tuesday night's effort a vindication of the hard work he has been putting in off the ball as he won possession high up the pitch and finished himself.

His campaign also vindicates the brave choice he made after four years in the academy at Craven Cottage.

"At the time I couldn't really see myself getting a shout at Fulham," he said.

"I knew Birmingham had a good pathway for young players so I thought it was a good place to try and kick on.

"I was 16, it was a big step for a young lad from London, I had to leave my family to come up here but the club was really good with me, they helped me settle.

"I am pleased with that decision, it seems to be paying dividends.

"I have been happy with my season so far. I have played more games this season, I have scored more goals than I did last season.

"I take that as a positive - and also my defensive side of the game has really improved."

And like every young prospect McDonald's eyes are fixed firmly on the senior prize.

"I want to try and get into the first team as soon as possible.

"I have had quite a few training sessions with them, I think I have done well and showed the new gaffer what I can do as a player."

McDonald's goal against Colchester followed up strikes against Sheffield United and Coventry in the last couple of weeks.


http://www.birminghammail.co.uk/sport/football/football-news/birmingham-city-youngster-wes-mcdonald-12824335