Healthcare in football was given centre stage in Budapest over the last two days as delegates from FIFA’s 208 member associations gathered in the Hungarian capital for the FIFA Medical Conference.

The two-day knowledge-sharing platform was the second event of its kind following the inaugural conference in Zurich in 2009. This time, however, the conference was held for the first time in conjunction with the annual FIFA Congress, enabling football’s medical experts to impress the importance of effective medical care upon executives from the world’s 208 member associations.

With so many leading executives from FIFA’s member associations present, the second day of the conference, held in Budapest’s HungExpo conference centre, was the main focus of attention. President Joseph S. Blatter welcomed the delegates with a call for everyone involved in football to work together for the health of footballers.

“Health is a very important item, which is why we’ve put it on the Congress agenda,” he said. “I’m not a medical doctor, I’m a Development Officer,” he said, recalling his early days at FIFA. “But development means education and taking care of the people you educate. And humanity means taking care of the health of our players. Let’s work together for the health of our players. Not only the players, but also their families should benefit from our programmes.”

First on the agenda was anti-doping, with Professor Jiri Dvorak, FIFA’s Chief Medical Officer, presenting FIFA’s strategy to combat illegal drug use and Dr Martial Saugy of the Anti-Doping Laboratory in Switzerland explaining the innovative approach of biological profiling. Director General of the World Anti-Doping Agency (WADA) David Howman then spoke about the joint measures being taken by his agency and world football’s governing body and confirmed that FIFA is compliant with the WADA Code.

Let’s work together for the health of our players. Not only the players, but also their families should benefit from our programmes.

In the last three months, there have been six cases of sudden cardiac arrest (SCA) in football. While Fabrice Muamba of Bolton Wanderers survived due to the speedy and effective response of the pitchside medical staff, the other five players, including Italian Serie B player Piermario Morosini, tragically passed away.

One of the most poignant topics on the agenda was therefore emergency medicine, and more precisely, how medics should administer first aid in the case of sudden cardiac arrest. Professor Efraim Kramer from Johannesburg’s Witwersrand University called for all healthcare personnel to be shown how to administer football-specific CPR and use automatic external defibrillators. Kramer said AEDs should be “non-negotiable” at football matches.

Howard Webb, the FIFA referee who officiated the match between Tottenham Hotspur and Bolton Wanderers in which Muamba suffered his arrest, Bolton Wanderers team physician Jonathan Tobin, and Craig Hulse, an American player who survived a sudden cardiac arrest during a match three years ago, took to the stage to recount their experiences.

Perhaps the importance of emergency medical care was best summarised by Hulse, who said: “Football is life for hundreds of millions of people, but without life, there is no football.”

Prevention rather than care was the watchword as Mario Bizzini, Astrid Junge and Colin Fuller from the FIFA Medical Assessment and Research Centre (F-MARC) described how their Football for Health programme can help prevent injuries and ensure players don’t reach the treatment table, before Dr Michel D’Hooghe and Prof. Dvorak were joined on stage by representatives from countries who have benefited from the 11 for Health programme, including the President of the Malawian Football Association Walter Nyamirandu.

Close-up examination While the second day of the conference provided a platform for football’s medical staff to highlight the most pressing medical concerns to leading football executives, the first day of the conference, held at the Semmelweis University, brought together doctors from almost 200 member associations worldwide for a more technical discussion of the healthcare topics.

FIFA Medical Committee member Dr Bert Mandelbaum from USA got the presentations underway with an update on the latest trends in cartilage regeneration, before Norway’s Dr Thor-Einar Andersen highlighted the importance of stringent application of the Laws of the Game by outlining the results of a study in Norwegian football showing that tougher sanctions by referees reduce contact injuries.

Dr Philippe Tscholl from F-MARC then called on team physicians to reconsider and reduce their prescriptions of non-steroidal anti-inflammatory drugs (NSAIDs), especially when simple painkillers often prove to be equally effective. Following Prof. Kramer’s presentation on sudden cardiac arrest, the morning’s discussions were rounded off by Dr D’Hooghe, who emphasised the need for greater communication between national team doctors and their club counterparts.

After lunch, the participants were divided into four smaller groups to attend practical workshops focusing on the most pressing topics in football medicine.

In the first workshop, the participants were given insights into the role of echocardiography in pre-competition medical assessments, the use of ECG in the prevention of sudden cardiac deaths as well as the correct procedure for inspecting the range of movement in a player’s knee and the hip and groin region.

The second and third workshops also turned the morning’s theory into practice by giving presentations of the techniques described earlier in the day. Prof. Kramer followed up his impassioned demand for defibrillators to be introduced in stadiums by providing a highly engaging presentation of how football medical staff should react in the case of sudden cardiac arrest, and showed participants how to carry out football-specific CPR, while F-MARC’s Bizzini, assisted by two sporting assistants, talked the audience through the different exercises that make up the FIFA 11+ programme.

The medical and legislative pitfalls of using banned substances and methods were examined in the fourth of the workshops, with Malaysia’s Gurchuran Singh, a FIFA Medical Committee member, providing an overview of FIFA’s anti-doping activities and talking his audience through the conditions set out in the WADA provisions, as well as the doping control procedure to follow before and during competitions.