1 Footballers' GUIDebook LIFE AS A PROFESSIONAL FOOTBALLER AND HOW TO handle IT Shifting attitudes to mental illness. 2 CONTENTS P3 FOrEwOrd P5 iNTrOduCTiON P6 SECTiON 1 Injury & Depression P6 P12 SECTiON 2 Change & Anxiety P18 SECTiON 3 Contracts & Stress P24 SECTiON 4 Performance & Panic P30 SECTiON 5 Retirement & Anger P34 CONTaCTS aNd Disclaimer: The illustrated FurThEr scenarios and examples set out in this guidebook iNFOrmaTiON are fictional, and all names, characters, places, and incidents either are the products of the authors’ P35 aCkNOwlEdgEmENTS imagination or are used fictitiously. Any resemblance to actual events or locales, organisations, or persons, living or dead, is entirely coincidental. 3 FOrEwOrd Clarke Carlisle, PFA Chariman. n the 10 November 2009 Good mental health is vital for I am proud then to present what German goalkeeper peak performance in sport. I think is a groundbreaking Robert Enke took Mental health problems affect one guidebook for players. It is first his own life. He had in six of the population at any one and foremost a football book – Obeen depressed since time. Depression alone affects up fabulously illustrated by artist the death of his two-year-old to half of us during our lifetimes Paul Trevillion (You are the Ref daughter Lara who died of a and affects every family at some and Roy of the Rovers) whose rare heart condition in 2006. stage. Despite this, many people vibrant comic strips present Enke’s death at the age of just are unaware of the symptoms of scenarios which will be familiar to 32 illustrates the most extreme mental health problems. every footbaler and fan. example of how mental health Unsurprisingly, players known for Paul’s illustrations and the text of issues can affect an individual – to physical fitness rarely talk about this guidebook take the first steps the point they take their own life. mental distress. Indeed many to talking about mental health But talking about mental health may not recognise what it is or in professional football – and to problems has traditionally been know how to seek help for stress, offering guidance as to where one of sport’s great taboos. When anxiety or depression when it players can find support and help boxer Frank Bruno was sectioned strikes. at an early stage. under the Mental Health Act, the The Sporting Chance Clinic, Football is the beautiful game but tabloid press ran the headline founded by Tony Adams, the it is also a tough game that makes ‘Bonkers Bruno locked up’. former England captain who has huge demands on its players. Unsurprisingly, given this attitude written and talked about his own This guidebook acknowledges it is very rare for sports men struggle with mental ill health the pressures and it also and women to ‘come out’ about and alcohol dependency - was set acknowledges that professional mental ill health voluntarily. It up to support sports men and players are human beings not is sadly far more common that women who experience similar machines. any vulnerability is ‘outed’ by the problems and need professional sports media. help to overcome them. 4 FOrEwOrd Gary Lewin, Physiotherapist to England Senior Men’s Team ootball is all about Players are under enormous That’s what this guidebook is all fitness and my job is to pressure to stay fit, to perform, about and why it is so welcome. keep players fit. But a to recover quickly from injury and I believe that players will read, player’s fitness is not get back on the pitch. And for recognise and perhaps identify Fall about the state of some that pressure proves too with some of the comic strip his knees or ankles. Very little much. Drink, drugs, sex, gambling scenarios illustrated here by has been said until now about and other addictions have been Paul Trevillion. I hope they will the mental health of players, the the release and the downfall of feel comfortable enough to use pressures and stresses they face a number of players who have some of the good advice, tips and to keep fit and perform 100 per needed help but not known it. contacts provided in the book. cent every time they run on the pitch. We hear little about the lows players feel when unfit to play, the worry and anxiety that not being selected may cause them or the depression and emptiness many of them face on retirement. 5 iNTrOduCTiON n October 2008 Shift, the national anti stigma and discrimination initiative its partners The Football iAssociation (FA) and the Professional Footballers Association (PFA) held a conference called Mad about Football at the City of Manchester Stadium. One of its aims was to raise awareness of the fact that mental health problems affect one in six of the adult population at any one time – including professional footballers. It proved difficult to attract players to speak at the conference, the taboos and stigma around mental health problems The list of football casualties is I think the scenarios illustrated in sport precluded many from well known and backed up by by Paul Trevillion do just that – wanting to get involved. But the the evidence of many football they present situations, anxieties, conference did secure a video autobiographies, biographies emotions and fears that will be message from Stan Collymore, and column inches. How many familiar to all. of these casualties could have and was supported in person by We can’t dispel stigma and taboo been avoided if the players had Tony Adams, former England in one publication but we can been able to speak out earlier captain and founder of the support players to understand about their distress and had been Sporting Chance Clinic. that their mental health is as supported to seek help before important as their physical health. Both the FA and PFA were keen to things got out of control? support the event because both We can also signpost the support organisations are aware of the These were the issues that led that is availalable to them. to this guidebook and which mental stresses and strains of playing the game. are highlighted in it with comic strip scenarios and the text which features clips from player autobiographies. We wanted to raise awareness of the factors that can lead to mental distress but put them in a context that would be familiar to players, their families and friends. 6 Section 1: injury & DePreSSion Below we set out some facts and figures about football injuries, how common they are and how injuries can cause injury that is not just physical. Facts about injury some common Football • an injury can cause you to be off the injuries field and on the bench for weeks or • most football injuries affect the even months at a time lower half of the body – the groin and • football has a higher incidence of pelvis, hip and thigh, knee, calf, foot injury than other sports – including and ankle boxing and rugby • most football injuries are caused by • *In two seasons there were 6030 trauma, such as a collision with an injuries resulting from training and/ opponent or landing awkwardly from or competition affecting professional a jump. Approximately one quarter players. Around 75 per cent of to one third of all football injuries are players were injured at least once due to overuse and develop over a • around 50 players a year are lost period of time, and thorough permanent disability* • on average players miss four • the average number of injuries per matches per injury, with 78% of the club per season is 39,* and injuries leading to a minimum of 1 match missed. The average number • the older you are the more likely you of days lost per injury is around 24 – are to get injured. and based on the incidence of injuries * Source: an audit of injuries in professional per month the average number of football. Chairmen/Directors/Managers injuries per club per season is 39.* report. January 2001. 7 8 FiCTiONal ExamplE I’ve been playing in the Premier League for around 8 years and know that years of wear and tear have weakened both my knees – but especially my right one. It aches after training and I know that my Facts about DePRESSION hamstrings and other leg muscles Every year one person in ten will aren’t as strong as they used to experience depression or anxiety be despite all the conditioning and strengthening I do. I’m always wary disorder. This often follows trauma going in for a tackle, but last game or upset and is more likely with I really went for it and ended up stress. twisting wrong and heard the click and just knew it was my cartilage. depression can affect anyone at any Straight off I’m thinking that’s me age and at any time. out for three months. • depression is among the leading The physio explains that I’ve got two menisci within each knee joint that causes of disability worldwide are made from tough fibro cartilage affecting about 151 million people – one of which is badly torn. He says at any one time* the flap of torn cartilage has made the knee joint give way – which it just • 21.5% of women and 13.6% of men did. are experiencing depression or Later after X-rays, the physio tells anxiety disorder at any one time** me that previous damage to the • mixed anxiety & depression is the cartilage and this big new tear means that physio alone won’t sort most common mental disorder in it. I will need a meniscectomy – Britain affecting 11.8% of women surgical removal of the torn fibro and 7.6% of men at any one time cartilage.