"Almost all aspects of the process of appointing club doctors and physiotherapists give rise to concern," concludes the report, `Managing Football: the Roles of the Club Doctor and Physiotherapist', which was compiled by the Centre for Research into Sport and Society at Leicester University. "At the moment these processes constitute a catalogue of poor employment practices."
The report - which is based on questionnaires and interviews with more than 100 club doctors, physios and players from the Premiership to the Third Division - highlights how players are regularly asked to play when unfit, how some are lied to about their conditions to keep them playing and how, in one case, a player was blackmailed with his medical history so he would not leave his club.
The report, which was compiled confidentially over 18 months, also shows football's amateurish approach to medicine. Only one doctor surveyed had been recruited via a medical journal. "Only nine of the 58 doctors who completed the questionnaire currently have a specialist qualification in sports medicine," the report adds. It concludes: "The day-to-day management of injuries is in the hands of physios who are not qualified to work as physiotherapists within the NHS. This should be regarded as a matter of concern."
There are many instances in the report of footballers being encouraged to play with bad injuries and in pain. One international with a Premiership club said: "You get used to the shit, and that's what I was doing. You never say `No, I'm not doing it'."
One club doctor admitted that he kept news of a serious injury from a player in case the player decided to take time off. "He'd suffered a major ankle fracture at some stage, the whole thing had fallen half and inch," the doctor said, adding that the player should not be playing. "The physio said `Don't tell him. Don't tell the player that he's gone and broken his ankle otherwise he'll start being off'."
Another player wanted to leave his club when his contract expired at the end of the season. His team doctor told the player, who had had an injury: "If you're thinking of leaving the club and we made [your injury] common knowledge then no one would buy you." The incident happened several years ago and the player stayed at the club.
"Uniquely in medicine in football, there is no good practice model and no attempt at a code of conduct," Professor Ivan Waddington, the author, said. "That needs to be addressed."
The report will be featured on Radio 5 Live's `On The Line' tonight, at 7.30pm.Reuse content