In the Hot Seat: Dr Mark Fulcher (Editor in Chief - FIFA Football Network)

For our first ever NSW Football Medicine Association (FMA) interview we wanted to get the thoughts of someone that represents exactly what the FMA is all about. It was our great pleasure to interview Sport and Exercise Physician, Dr Mark Fulcher, the Editor in Chief of the FIFA Football Network and a FIFA Medical Committee member. Dr Fulcher works out of the Axis Sports Medicine Clinic and is possibly one of the busiest people on the planet, wearing many hats at once!!

Enjoy!!

1. Tell us a bit about yourself and what your role is at FIFA.

I am a Sport and Exercise physician based in Auckland, New Zealand. I have a lifelong interest in football (and am a Liverpool supporter)! I have been involved with New Zealand Football (NZF) over the past decade. I am currently the NZF Medical Director but have previously worked as a team doctor for a variety of our representative teams, including the All Whites. I am currently the Editor in Chief of the FIFA Football Network and a FIFA Medical Committee member. I will be a venue medical officer at the upcoming World Cup in Russia.

2. What is the Football Medicine Diploma?

The diploma is a free online resource that is designed to teach clinicians about all aspects of football medicine. Our aim is to make football medicine education accessible to all - and to improve the standard of care that players around the globe receive. The diploma has 42 individual modules with topics including concussion, sudden cardiac arrest and modules addressing key groups including the referee, kids and the athlete with a disability. Users may use the site to answer a single clinical question, may complete one module or can complete the complete course. When they are finished a user will receive a certificate of completion from FIFA.

3. What is the target audience for the diploma?

Any clinician who has an interest in football medicine

(or sports medicine in general). The course is especially designed for those who have limited existing knowledge, however there is still content that is relevant to any clinicians. Many of the modules are also relevant for coaches, players and administrators. In short we are happy for anyone to enroll in the diploma!

4. Tell us more about the newly formed Education Network and how can we get more involved?

The network is a forum for clinicians who are interested in football medicine to stay up to date with current best practice and current literature. It also gives users an opportunity to connect with their peers, and with medical experts, from around the globe. Regular material includes research reviews, radiology cases and expert talks. There is also a forum where users can post their own material and discuss cases or problems with their peers.

5. What do you believe are the biggest challenges facing those of us working in sub-elite and elite football?

In all levels of football a lack of education about best practice treatment is a real challenge. This is highlighted by the very low uptake of proven injury prevention strategies in elite football (the UEFA Champions League studies are fascinating and well worth reading). Many players and coaches, as well as some clinicians, have fairly fixed ideas about how injuries are treated (and how we can prevent injury). As a result it can be hard to implement your desired management plan. To be an effective clinician in a football setting you need to work hard to gain the trust of the players, and coaches, which you work with and to careful consider how you might implement change and how you sell your message.

6. Where do you see the future of football medicine heading?

At the elite level I think we are going to see some interesting injury prevention strategies using GPS data. While this technology is widely used at an elite level it is hard to know what to do with the data. As this practice becomes more commonplace I think that we will be able to interpret this data better. This should allow us to better regulate load and to limit injury risk. At a community level I see real scope to try to reduce the risk of injury, and to improve the overall experience for players, through greater uptake of injury prevention programmes like the 11+.

7. What are you top 3 take home messages for those working in football medicine?

Make sure that the player is at the centre of all of your decision-making. It is easy to become distracted by external influences (including coaches, parents and administrators).
Engrain prevention into all of your interactions. For example when you are treating an injury can you influence the probability of this injury re-occurring? For example don't send your hamstring patient back to quickly and tell your ACL patient about prevention programmes.
Try to implement evidence-based medicine – but try to disguise it as something else.