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Are we running our footballers into the ground?

The physical and psychological effects of player burnout

Are we running our footballers into the ground?

“Footballers should be paid soldiers’ wages.”

“I’d give my right arm to play in the Premier League every week.”

“If I earned millions to kick a ball for 90 minutes, I’d never be tired.”

If you’re a football fan, you’ll have heard – and maybe even made – comments like these. From the groans in the ground as a player goes down with cramp, to the moans on the phone-ins as clubs’ injury lists mount, the health of footballers is often a target for supporters’ frustration, rather than their sympathy.

However, tales from the treatment rooms and physio tables tell the brutal, bone-crunching reality of life as a professional footballer. It can, at times, be one of overtraining, overplaying and overstraining. “I can trace all my injuries back to my first ever major one, when I snapped my cartilage in half when I was 21,” recalls ex-Crystal Palace and Norwich City striker Leon McKenzie. “After that, I was always going to be chasing my career – I was always going to have injuries.” 

Both broke through in the late Nineties as teenagers, a blur of roadrunner legs who would breeze past defenders. Both, however, would suffer devastating injuries in the spring of their careers that would shape their futures – Owen has pinpointed a torn hamstring playing for Liverpool at 19 as leaving him forever ‘compromised.’ 

“You get one big injury, your biomechanics change,” says McKenzie. “When you’re young and you’re doing it week in, week out, so much is demanded of the body. Towards the end, we both ran into similar problems: we kept breaking down, our bodies would be in bits. We burned out.”

Michael Owen ruptured his anterior cruciate ligament at the 2006 World Cup

Fans want to see their team’s best players on the pitch, every game. The idea of resting the star names is anathema to them. And yet a recent study by FifPro, the world players’ union, found that the current number of matches across the globe is ‘too high.’ It begs the question: are we inadvertently grinding down and destroying the teenage and twenty-something athletes who take to the pitch, for our entertainment?

Footballers will always want to play football, and fans will always want to see football. However, there is a sense that 2018 was a watershed year. Never have there been greater physical demands placed on so many footballers. At the start of July, as England were about to face Colombia in the second round of the World Cup, Premier League clubs were opening their doors for pre-season training. Only 26 days after Paul Pogba was lifting the trophy in Moscow, he was starting for Manchester United in their opening league fixture. Then, just a month later, he and many other World Cup and Premier League stars were travelling across the continent, lining up for their countries in the inaugural Uefa Nations League.

“If you keep pushing, something eventually breaks.”

By the time England play their Nations League semi-final in June, captain Harry Kane may well have chalked up 120 games for club and country since the beginning of last season. It might seem like all footballers do is jog around and kick a ball occasionally a couple of times a week, but the gruelling, unforgiving schedule has its physical consequences. “Professional athlete or not, the human body can only cope with so much,” says ex-Manchester City physio Jeff Ross, now clinic director and head of Harris & Ross’s football rehabilitation department. “If you keep draining the tank again and again, it becomes harder to refill it, and impossible to refuel to peak levels. That’s when fatigue sets in, effectively placing stress on the muscles, tendons, joints and ligaments, causing injury.”

Of the 12 Spurs players to have featured at the World Cup, nine have suffered muscular injuries so far this season. Those who went deep into the tournament would barely have had a week off before they reported for a short-circuited pre-season – six weeks’ training slashed down to less than a fortnight. “It leaves them little chance to recover from the previous season, get their bodies conditioned to the training-playing loads, and correct imbalances ahead of the new season,” explains Ross. “That’s the sort of thing that can catch up with players. It’s tough – they want to play for their country, but the club want them back on the field quickly, too.”

Harry Kane is set to hit the 120-game mark by the time England play their Uefa Nations League semi-final

Some players are effectively midway through a two-year long campaign, fighting on several league, cup, and international football fronts, interspersed with two-week breaks only here and there – a fixture list that frequently resembles an assault course. “In tournament years, a two-month extended holiday whittled down to a three or four-week break total,” says ex-Arsenal and England defender Martin Keown. “It was tricky. You never, ever really switched off completely. You might have had a week where you could relax on a beach somewhere but, in the back of your mind, you knew you had to return to your club soon. We saw it this summer: the likes of John Stones and Kyle Walker returning for Man City just three weeks after playing in the final weekend of the World Cup.”

An overload of games is nothing new. In the Division One days of 21 teams, cup replays and 15-man squads, Liverpool’s three-trophy haul in 1983-84 saw some play a 67-game season. However, Bobby Barnes, president of FifPro Division Europe and deputy chief executive of the Professional Footballers’ Association, says the heavy burden of matches isn’t shared between teams now – it’s multiplied. “It’s a different game now, it’s much faster. Whereas in the past one English club would compete in the European Cup, now, there are at least six clubs in European competition every season.” The bloated fixture list adds the draining complication of air travel, too.

It’s now, when the winter schedule ramps up a notch to two games a week, every week, that we typically begin to see the physical toll on players, and a surge in injuries. However, the consequences can be far graver than a tweaked hamstring or groin. “Fatigue means they might be half-a-second slower reaching the ball, then overstretch and cause themselves a serious injury,” Ross explains. “Likewise, if you keep stressing your ligament too much, bang, it ruptures. If you keep pushing, something eventually breaks.”

There’s more to this than an over-pampered multimillionaire straining a calf muscle as they overcommit for the ball. Mental health is at play here, too.

“My injuries psychologically damaged me”

Football fans and casual observers can just about get their heads around the physical wear and tear that comes with fatigue, but for those of us who work hard all week, and then want to watch football on the Saturday, it’s harder to empathise with players feeling psychologically drained from the churning, relentless wheel of fixtures. However, it comes down to science.

“Football is a much more cognitive sport than some might realise,” says Dan Abrahams, sports psychologist to AFC Bournemouth. “On the pitch, players are constantly searching, scanning and deciding. There’s a load on the brain that eats at the sugars and glucose of the frontal lobe, exhausting the part of the brain which recognises patterns and makes decisions. Fatigue can cause it to shut down, meaning footballers play with greater tunnel vision – they’re slower making decisions and anticipating play.”

Mental strain isn’t just reserved for the pitch, either. “Footballers constantly think about the game and rehearse it in their heads. Often, it’s in a negative manner. On matchday, with a 3pm kick-off, they’ll spend all morning focused on the game. Science shows that the brain and nervous system doesn’t know the difference between reality and imagination. So, ahead of the game, adrenaline can spike in players, depleting its stores. By kick-off, it can leave them feeling tired, fatigued and lethargic.”

The psychological grind of too many games goes hand-in-hand with the physical side. Often, injuries leave wounds that carry deeper mental scars. “My injuries psychologically damaged me,” says McKenzie. “When your body is breaking down constantly and it’s something you love, something you’ve done all your life and it’s being taken away without your control, you should see what the mind does then.”

Towards the end of McKenzie’s career, as he played lower down the football league ladder, the injuries piled up – his body and mental health began to break down. Now, there wasn’t only pressure to recover to return to the team – there was pressure to play in order to secure a new contract. “The care factor isn’t there in football,” he says. “If it was, we wouldn’t have players playing so many games and suffering so many injuries. A break from football seemed long enough.”

FifPro recommends a minimum of 72 hours between kick-offs for players in a two-game week, and that no player should feature in back-to-back congested weeks. For most clubs, with stretched squads heading into a four-games-in-nine-days slog over Christmas and New Year, such a luxury is an impossibility. However, there are some positive signs.

From next season, for the first time, the Premier League will pause, take a moment, and allow everyone to regain their collective breath. The two-week break in February 2020 will no doubt be welcomed by the players themselves. In a recent FifPro survey, only 46 per cent of footballers said they were playing too many games. However, 88 per cent supported a mid-season break. It makes sense: footballers will always want to play, but they’ll always a break, too.

“If you were to train a racehorse, you’d assess its optimal fitness as to when to put them in a race,” says Barnes. “It should be the same with footballers. It’s hard to get public sympathy, some might say, ‘I’d play seven days week for that sort of money.’ However, players are under constant pressure to perform at their highest level – fatigue and injuries caused by too many matches and lack of recovery will compromise that.”

A mid-season break came too late for McKenzie, who finished his career playing non-league football, retiring at just 34. “Today, there’s a lot more being done for players who are physically or mentally struggling. We may be athletes, but we’re also human – we need to rest, too.”

Martin Keown is part of the BBC’s FA Cup coverage. Follow the third round on the BBC across TV, online and radio – January 5-7; harrisandross.co.uk