injured footballer

Back pain should not exist in the UK Premiership. 18-30 year old men at peak fitness should not suffer back pain. The fact that it is endemic throughout our clubs, is a conundrum.

I’m not a club manager, but I have observed the extreme, if not unbearable pressure placed on them to deliver the undeliverable – organizing a bunch of hyperactive, driven, world-exposed young men into a co-ordinated & flawless team delivering world class football on a weekly basis. Peak performance is required from every single player every single day. Each of those players has a whole life outside the club, with any number of things that can happen to affect their performance – mothers get cancer, girlfriends have arguments, cousins have car crashes, brothers fail exams….. the list is terrifyingly long and terrifyingly unpredictable, uncontrollable and un-knowable. Any number of things can happen to affect the performance of a premiership player that the manager and his team have absolutely no way of controlling.

The manager therefore needs every single preventable barrier to peak performance identified, and either prevented, or knocked on the head and nipped in the bud as soon as it appears, to stand any chance of having a team delivering the impossible dream.

Why then, is such an obvious barrier to peak performance as chronic back pain so prevalent in the UK Premiership?

You can get everything right – perfect training, perfect form, the perfect team line up, the perfect strategy…but if your player has a day with a high level of back pain, he won’t be able to action the strategy.
As a city centre clinic based Osteopath & yoga teacher making the transition into the world of elite athletes, I was expecting to be drowned in hamstring injuries. Having worked in a clinical world where back pain is prevalent in the 35+ age range, I didn’t expect a bunch of super-fit 20 something’s to have even heard of the words ‘back pain’. How wrong I was. Indeed I was surrounded by hamstring injuries, but of equal if not higher prevalence in the club I was working in was back pain.

And I’m not talking a slight niggle or ache, I’m talking 8/10 pain, bench you for 2 weeks back pain. Throughout my time at the club I became more and more aware of the number of players experiencing severe back pain, just not mentioning it. For some reason it’s a pain that footballers accept and just learn to live with….only taking notice when the whole back goes into ‘spasm’ and they can’t stand up straight.

This ‘play through the pain’ attitude is admirable for sure, and is the reason these extraordinary people succeed at such a high level of sport… but if the players knew how much their performance was being affected by them choosing to ‘grin and bear it’, they would not feel so noble. In my opinion (and take that as much or little as you wish), resolving back pain is one of the quickest and easiest ways to improve the performance and goal scoring of a footballer.

I discovered this by accident after working with 2 players who had suffered severe long term chronic low back pain for several years. Both of them had not scored a goal for several months, and did not know why. Both of them proceeded to scored their first goal within 7 days of their back pain reaching 100% resolution. In essence, they were pain free, and able to play at their peak. The barriers to peak performance had been removed. In my opinion it was not simply the resolution of pain that improved these player’s performance, it was the installation of confidence in the player that they were not the victim of back pain, that it wasn’t something they had no control of. Players who have experienced back pain live in fear of it returning at any moment – without warning, and benching them for 2 weeks.

When a player is instilled with an understanding of what causes back pain in a footballer and what they can do before, during and after a match to prevent or quickly resolve it, their confidence returns, and their subconscious fear of giving 100% falls away.

The key

Back pain will stop a player giving 100%. It will make them run at 80% of their maximum speed, kick for a goal at 80% power. They will play from a point of fear and anxiety rather than from a place of power and control.

Here’s the scary fact: even if a player doesn’t have current back pain, if they have experienced a back spasm in the past, the subconscious fear of a re-occurrence will affect their performance.

Everyone knows how much of an influence mental confidence plays on the performance of a player. Even football commentators accept that for the first few months after a player moves clubs, he is likely to be unrecognizable as a player in comparision to his form at his previous club. Subconscious, unexplained, fear / doubt / loss of self belief….all perfectly accepted in the psyche of a footballer as reasons for their lack of form. Bring in the sports psychologist, give it a bit of time, and the player eventually emerges from their shell, better than ever, back to their former self, proclaiming to the newspapers “I’m back at last”.

But what about the subconscious fear of injury? How is that addressed in a player? Without doubt, a player who has been badly injured makes subconscious and also very conscious decisions to play differently after recovery. A player who snaps an ACL in a tackle will simply never have the courage to tackle at 100% ever again. The memory of 15 months in rehab is simply too painfull to forget, and they make the decision that it is better to play at 80% of peak than not to play at all.

For most injuries, I agree with this decision. A player is more benefit to their team on the pitch at 80% for every game of the season, than off the pitch for the whole season after one great match. However, when it comes to back pain, there is another way.

Back pain is completely controllable in a footballer. They are young, fit and healthy. A UK Premiership footballer should have confidence to play at 100% even after multiple back spasms for several years, because a footballer, in my opinion, should not experience back pain or back spasms.

Once the player’s back pain is resolved to 100%, the player needs to be educated with a deep understanding of what causes their back pain. Only knowledge and understanding of what tissues are causing the pain, what mechanism got them to the point of pain, and what techniques / methods will take those tissues out of pain and how the player can prevent the pain in the first place, will instill the player with the confidence to know that the tension levels of their back muscles are completely in their control.

The players I have worked with transformed from being players living between back spasms, a cloud of vulnerability over their head with the not knowing when the next spasm would come, to confident, prepared, fearless players, who knew that they were self responsible, prepared, in control, and therefore able to give 100% to their game.

One more interesting thought to consider:

The fear of back pain is itself a contributing factor to back pain. There is a proven direct correlation between mental stress and muscle tension levels.

When the player reaches a point where he no longer fears back pain, his back pain comes into his control. Only the understanding of what back pain is, and the understanding of how to prevent and resolve it, will remove the fear, and restore the player to peak performance.

If you want to improve the goal scoring potential of your strikers, the reach of your goalies and the tackling form of your defenders resolve and control their back pain permanently.