Dr Niko Mihic, the medical supervisor of Real Madrid's first team, has fired off a strongly worded warning about the mounting pressures on footballers from fixture congestion. Players' health must come before competitive interests, he insists, with rest periods too short and injury risks climbing.
Speaking to the Spanish newspaper "AS" on the sidelines of the fifteenth World Congress of Sports Medicine, hosted by the Santiago Bernabéu, Mihic called for a review of the calendar and longer breaks for players. Let the current situation continue, he warned, and their physical safety is on the line.
"If they were racehorses, we would be accused of mistreating them"
The Croatian doctor reached for a striking comparison to capture the scale of the strain. "I have said this several times before, if our players were racehorses, there would be protests and accusations of animal cruelty for forcing them to run all the time," he said.
"But here no one protests," he added. "Another match and then another match, and matches piling up on top of one another, without anyone asking about the player's condition."
This culture has to change, Mihic stressed. "Awareness must be increased, and priority must be given to the athlete's health at the expense of competition, by reducing the number of matches and giving players longer rest periods. The player must be empowered and given a bigger role, as our sport is fundamentally based on the player's health, and therefore health must be placed above competition."
Warning about cruciate ligament injuries
Turning to the sharp rise in anterior cruciate ligament injuries, Real Madrid's medical supervisor pinned the density of matches as one of the factors leaving players more exposed.
"Players have never played this large number of matches as is happening now, and therefore they are exposed to greater risks," he said.
He also flagged a medical puzzle that still has no answer. Women suffer anterior cruciate ligament injuries at a rate reaching eight times that of men, yet doctors have not yet landed on a clear explanation for the difference.
New techniques to protect players and extend their careers
On a separate front, Mihic revealed progress in research into repeated blows to the head in football. The international and European federations, he noted, are studying what are known as concussion-causing events or partial concussions.
Modern techniques could help. He explained that blood brain injury markers and portable electroencephalography devices may diagnose injuries more accurately and protect players.
Medical advances have also stretched out sporting careers, he confirmed, citing Cristiano Ronaldo, Luka Modric, Lionel Messi and Novak Djokovic. Progress in surgery and injury treatment lets athletes return more quickly and keep competing even at ages once considered very advanced.
He closed by stressing the importance of tailoring nutritional care to each player's needs. Real Madrid, he revealed, uses DNA analysis through saliva samples to pin down players' needs for carbohydrates and iron, and the best timing to take them on board.