What happens at a football medical? | INSIDE FC Bayern
Articles,  Blog

What happens at a football medical? | INSIDE FC Bayern

A mid-August Sunday morning. Munich airport. Philippe Coutinho on the way to his new club. Hi guys! The Brazilian is due to sign a contract with FC Bayern. However, the 27-year-old must first complete a medical. So it’s straight from the plane to the Barmherzige Brüder hospital in Munich. This mandatory examination is required by the German Football League, before a transfer can go through. The DFL requires every Bundesliga professional to provide annual proof that they are fit to play. Meaning you have to spend a whole day dealing with the player. It starts with the anamnesis, or the medical history. The players tend to forget about injuries. So now I have to get informed using the internet and by reading old newspaper reports. I do that for my own benefit so that when the player arrives, I’m fairly clued up. He can’t spin me any tales. Dr Müller-Wohlfahrt has been the FC Bayern club doctor for over 40 years. For several months now, he and his team have had a new home. An orthopaedic and radiological practice with state-of-the-art equipment has been built on an area of more than 500m2 on the Säbener Straße complex. It’s the very best, the absolute ultimate! And we’ve also been able to equip everything generously. The club was also very far-sighted in that respect. So now we are, I think, the best. We can do everything here. We have CT, MRI, ultrasound… From an orthopaedic point of view, the facilities leave nothing to be desired. The Barmherzige Brüder Hospital in Munich: Here Philippe Coutinho completes the first part of the medical: cardiological and internal examinations. Prof Dr Roland Schmidt, who is also a club doctor at FC Bayern, is responsible for this part. The player is put through his paces, in the truest sense of the word. All of the important organ systems are analysed as part of the internal cardiological examination. All blood levels are monitored, urine tests carried out. Then there’s the part of the medical that’s ultimately essential – stress and fitness tests. Because the various tests and examinations are extremely important for the doctors. They paint a first picture of the player’s health and provide valuable data on his performance capability. So his cardiovascular system has to be healthy, he must be sufficiently resilient, he can’t have any structural heart condition. And the point of these tests is to determine that. There are also certain guidelines, e.g. from the American College of Sports Medicine, where performance criteria are defined, which in any event a competitive athlete must meet in the corresponding stress tests. These are things we also orient ourselves on. 90 minutes later the examinations in the hospital are finished and we continue on to Säbener Straße. Dr Müller-Wohlfahrt is already expecting the potential new signing there. The second part of the medical takes place in the rooms of the orthopaedic practice: the sports physical examination. This is not standardised, but varies from club to club. The doctor alone decides what is examined and how. Then it’s time for my physical examination from head to toe. Every joint, every tendon and every muscle is checked in terms of palpation and function. And then I can see any weak points, which are then examined more closely. Using his hands, Dr Müller-Wohlfahrt feels for the smallest changes in the structure of muscles and tendons and searches for pain points. His delicate touch is virtually unique. To start with, my hobby was actually the musculature. I made a discovery in the 70s/80s and lectured on it. I had the advantage that I had taken massage courses while studying and I had to examine muscles there day after day. Every patient gets the hands-on treatment, I form an impression. But how do new players who are not yet familiar with Dr Müller-Wohlfahrt react to this technique? It creates an affinity. It creates trust. He says to himself: “Gosh, this is someone who really wants to do it properly. He’s examining every muscle, every joint, every tendon.” It gives you easier access. If you then suggest a treatment, the acceptance of it is greater. He says: “Doctor, do what you think is right!” So, there’s actually no objection. The FC Bayern medical unit combines the best of both worlds. Craft and technology, expertise and know-how, experience and innovation. Following the extensive examination by the team doctor, his diagnosis is enhanced using modern equipment to get to the root of a potential new player’s weak points. We have the possibility to do this by x-ray, magnetic resonance imaging, CT and ultrasound. So there’s already a focus on the problem and then I really get to the root of it. As the orthopaedic and radiology departments are close to one another, the examinations can be carried out immediately. This was also the case during Ivan Perišić’s medical. The MRI was to provide information into any possible problems with the Croatia international. We’re now doing the pre-employment examination, which typically involves an MRI of the lumbar spine, knee joints, pelvis and occasionally also an MRI of the ankle joints, if the player’s previously been injured there. We do these one after the other in the MRI scanner. He’ll spend one to one and a half hours in there to generate these images. You can discover previous damage that may be relevant for the player’s future career, like meniscus tears and cartilage damage. Old injuries can be unearthed and whether they have healed or not, or whether there may be problems with the intervertebral discs. All this can be easily determined during this examination. Summer signing Lucas Hernández is a special case. During the World Cup winner’s sports physical examination it was found he had some damage to the inner ligament in his right knee. An operation was unavoidable. And yet Dr Müller-Wohlfahrt ultimately supported signing him. I knew exactly who would be operating and how he would go about it. It was all discussed beforehand. And then I gave my point of view before the board, the coaches, the player and the player’s agent and the decision was approved. Following the operation in March, he underwent a complete rehabilitation programme at Säbener Straße so that he could recover as quickly as possible and return to his old performance capability. At the moment I’m continuously in training. I hope to be 100% fit by the start of the season. I keep going step by step and I’m improving every day. Time and again the club medical staff are the ones who tip the scales when it comes to pending transfers, because they have to decide whether possible previous damage or injuries pose a risk. After the examinations, we discuss whether we’ve detected medical things that may entail further tests or if, in the worst case, we even see problems or potential problems. There was also a need for discussions during Arjen Robben’s transfer to FC Bayern in 2009. The Dutchman was due to be signed from Real Madrid, but there were a few question marks behind Robben’s fitness. With Arjen Robben it was a case of Uli Hoeneß asking: “Doctor, do you think you can make it work?” We knew he’d had problems at Chelsea and Real Madrid. But Bayern were interested in him and then I was asked: “Can you make it work?” And then I examined him and I said afterwards: “Yes, I think I can do it.” And then there were some wonderful years for him and for us. And that’s also the hope with Lucas Hernández. The Frenchman toiled away for several hours a day throughout the summer. His progress was clear to see. On returning to the pitch he initially trained individually. Just a few weeks later, he returned to full training during the pre-season training camp in Tegernsee. Philippe Coutinho is also undergoing an MRI to check the structure and function of the tissues and organs in the body. The equipment delivers high-contrast images of enormous depth of detail, but you also have to be able to read them. You have to have the anamnesis, the painfulness and the symptoms as a whole in your head, to then be able to marry them up with the images. And that is very, very difficult! Next stop: X-ray. These examinations have long been routine for a player. Almost every professional has changed clubs at least once and knows what to expect on this day. Here, too, the doctors’ primary concern is being able to rule out any previous damage, thereby not taking any unforeseeable risk. The knee joints and the spine are routinely examined. I would say that these are the regions that cause the most problems. I make absolutely sure, and I do these investigations from the outset. Even if I’m not able to find anything myself and the player says, “I don’t have any problems”, I’m a little suspicious and say, “I’d rather take a closer look.” Portable devices are used for ultrasound examinations in the practice rooms. The two team doctors Dr Jochen Hahne and Prof Dr Peter Ueblacker know exactly what’s required. It’s important that we have good resolution and of course that the kit is relatively user-friendly so we can easily examine the patient. In the end, it’s the synopsis between the anamnesis, our findings and the imaging that leads to the diagnosis. But of course it’s important for us to have powerful devices which will help us to make the right diagnosis. We have the advantage of always having the portable systems with us. That’s advantageous when we’re travelling, so we can also take ultrasound pictures in the hotel and in the dressing room. Back to Philippe Coutinho. It’s shortly after 6pm. The tests and examinations have taken the whole day. But now it’s over. Dr Müller-Wohlfahrt and his team have no objections to the transfer. The Brazilian has successfully passed his medical and is fit to play. The contract can therefore be signed. The Brazilian’s move to FC Bayern is complete. FC Bayern have signed six new players during this transfer window, and they all passed their medicals. Now they can go on the hunt for trophies with their new team.


Leave a Reply

Your email address will not be published. Required fields are marked *