- Interview by Cristiano Eirale, Qatar
When it comes to managing football, Marcello Lippi is one of the best. A player once himself, the Italian was the first man to lead teams to both Champions League and World Cup glory. At a club level, he famously coached Juventus for five successful seasons, leading them to wins in both the UEFA Champions League and Intercontinental Cup. In 2004 he was appointed coach of the Italian National Team, leading them to a FIFA World Cup victory in 2006.
With these wins and more, it’s no wonder he was named ‘World’s Best National Coach’ by the International Federation of Football History and Statistics and twice named ‘World’s Best Club Coach’.
Based on his extensive and prolonged experience in the game, he tells Dr Cristiano Eirale about the past and future of sports medicine in football.
You began your football career as a player in the 1970s and began coaching in the 1980s. Tell us about the evolution of the team medical staff throughout your career.
During the ‘70s when I played for Sampdoria, the medical staff consisted of a general medicine doctor who attended training and matches, an orthopaedic surgeon who attended one training and match and by a couple of masseurs. There was no such thing as a professional physiotherapist. Then, when I was a head coach in the first division in the 1989-90 season, clubs began using physiotherapists. However, at my club we still used two experienced masseurs. During this period, the position of professional field rehabilitation expert also started to appear. Prior to this, injured players were treated in the locker rooms by the physio or doctor, and when they were ready to return to the field they began working with the fitness coach. But in the 1989-90 season there were masseurs working on the field with injured players. During my last season as a head coach in 2010 my medical staff consisted of two medical doctors, two physiotherapists and one masseur.
Do you think there has been a progression in sports medicine in football and if so, have you taken advantage of this progression as a coach?
Yes, there has definitely been a progression. Sports medicine physicians have taken the place of the general doctor in caring for athletes and teams. I think I was advantaged by this progress as I had the chance to meet great professionals who I tried to bring with me into the national team that I later trained so that I could compose a medical team of the highest level.
What is the difference between the medical staff in a football club and a national team?
These two jobs are completely different. Medical staff who work in a club have daily contact with the players, while medical staff of the national team have just a short period of work. But this is evolving and this is not completely true in all situations now. These days, if a national team doctor builds confidence with the players he treats during the short period of national competition, he is likely to be called on during the rest of the year to work with the players. For example, the Italian National Team medical doctor is now consulted during the season by players who are keen to get his opinion and his treatment during the normal season. In this way, the medical doctor of the national team can become more than just the doctor who takes care of the athletes during those few weeks of the year when they train for or play in national teams.
Do you think a medical doctor can help to win matches, and if so, what percentage is his contribution?
Of course I think that a medical doctor is important for winning. I think all staff have an important contribution, from the kit man to the person who repairs the shoes, from the medical and performance staff to the head coach. All these people are important to the win. It’s difficult for me to give a percentage but absolutely, medical staff are a fundamental component to team’s success.
Which is the best profile for a football doctor i.e. do you have any preference for a male of female doctor?
I do not have any personal preference or prejudice, but I think in my experience and in Italian football it is a little bit premature to think that a female medical doctor would be preferred over a male doctor. The reason for this is that firstly, medical staff spend a lot of time in the football team locker room and secondly, football is a male-dominated sport so it is possible that a female doctor may not be seen to be competent enough in this atmosphere. However, I do think that in the future, this barrier will definitely be removed.
My advice is to study a lot, to be prepared and to do a lot of work on the field. Only by living daily with a football team can you become an expert in all of the areas of pathology that affect footballers.
Do you prefer the team medical doctor to have been an athlete previously?
No, I don’t think that it is important that a medical doctor was an athlete before practicing medicine.
Do you have a preference when it comes to the age of your team doctor?
I think that, regardless of age, being a football doctor is dynamic work. For this reason, a team doctor should not be so old that it is difficult for him to run onto the field to take care of the emergency injuries of the athletes. On the other hand, medicine requires a lot of experience so I think it would be unwise to recruit a doctor who is too young.
Do you think that a doctor should manage the injury of the athletes himself or delegate to the different specialists as much as possible?
I am convinced that the doctor should manage the injured players himself. Of course he should be surrounded by high level specialists in case of a particular situation and in case of doubts, but I think that if he always delegates, he will never get the confidence of the players. Players need a doctor that they can believe in. Sometimes players need to hear that there is no risk of playing with an injury or they need to be pushed to train with some pain or sometimes they need to be stopped and so having a doctor who always delegates is not acceptable. The reason for this is that if a doctor always delegates, when the time comes for him to give important advice, the players may not take his opinion into consideration.
Have you ever gone against the opinion of your team’s doctor in regards to an injured player? Do you think that this could compromise your relationship with the doctor?
Yes, I have previously made a decision that was not in line of the advice of the medical doctor. You have to understand that a head coach has many things to consider when he chooses a team or makes a decision. I have been in the situation where an important player was injured just before an important competition and was not able to play the first few games, so the doctor’s advice was to replace this player with someone without injury. In this case, I preferred to bring the injured player with me because there are certain players who are important for the group and have a positive psychological impact on the other players. There are also players who you can ask to play injured. My decisions are made by analysing these different elements. Even if my decision is not in line with the advice of the medical doctor, if there is confidence between a coach and the doctor, it will never compromise their relationship. So in this particular case, it did not cause a problem between us.
I think all staff have an important contribution … All are important to the team’s success.
Was there ever a situation in which you later thought “I should have followed the advice of the doctor”?
No. To be honest, I don’t remember an episode where I regretted my choices. I think that all my decisions have been made after honest and clear discussion with the doctor. The most important thing is the trust between the coach and the doctor. It’s important to be ready to take risks together. It’s important to be ready to discuss things for the interest of the players and the interest of the club and it is important to be ready to win or lose together.
Do you include the doctor in the daily meetings with your technical and performance staff?
Yes, I include him in our meetings. I want to talk with our doctor daily about the players, their training program and about all the decisions that we have to make. I want to hear his advice and moreover, I think that the doctor should interact with the team every day. This includes attending all matches and training sessions. Also, I don’t like a doctor who stays in the locker room during training. It’s important for them to be on the field to see the mechanism of an injury and to see the performance of the athletes in order to evaluate their training and physical fitness.
Do you choose your team doctors? What is the basis if this choice: his CV or your relationship with him?
Yes, I choose the doctors for my team if possible. I’d say that I choose them on the basis of both CV and experience and my relationship with him. I think that when an elite club or national team chooses a first level coach, so too should they choose a first level doctor. Clubs often spend a lot of money on the players but then place them in the hands of staff who are not necessarily in the top of their field. Clubs should invest much more in their medical staff. They are an important part of the team’s success. I think that the relationship between a doctor and coach is fundamental. If there is no confidence between them, it’s a failure for all the whole team.
When a coach moves teams, he usually takes staff such as the assistant coach, goal keeper coach and fitness coach with him. Do you think it is a good idea for a coach to also take the team doctor as part of his technical staff?
I think that this could be a really good idea. As I told you before, sometimes I select the doctor for my club and I strongly believe that this role is very important. So this could be the way of the future: the medical doctor will be part of the staff that moves with a head coach in football.
What advice do you have for a young football doctor?
My advice is to study a lot, to be prepared and to do a lot of work on the field. Only by living daily with a football team can you become an expert in all of the areas of pathology that affect footballers. As I stated before, I think that in football there is more and more specialisation so clubs need to consist of high level football players as well as high level professionals. This includes coaches, assistant coaches, fitness coaches and medical staff. If a club wants to be the best, it has to be the best in all areas and in this case, to become the best football doctor you should study but you also have to have experience on the field on a daily basis.
In your experience as a player and then coach, do you think that doping exists in football?
No. I don’t think that doping exists in football. Of course high level footballers should utilise nutritional supplements under the management and supervision of a specialist, but if we are talking about the use of banned substances, I don’t think that this exists in football.
An issue that is important for a sports physician is that of confidentiality. Do you expect your doctor to report all of your athlete’s medical issues to you?
Yes, I expect this. I know that sometimes there can be the issue of confidentiality, but I think that when a player accepts to be part of a club they also accept that the coach needs to know things that are normally confidential regarding his health. Of course it is my responsibility not to release this information to anybody. I think that for football players it’s a little different compared to normal patients. I think it is expected that the confidentiality relationship stretches further so that instead of patient doctor confidentiality, it includes the patient, doctor and coach.
Thank you for your time Mr Lippi. We hope to see you soon on the bench of a big club or national team.
Thank you and congratulations on your job and your willingness to improve medicine in football. The next time I am on the bench you can be sure that I will have a competent doctor among my staff whom I have personally selected and who has my complete confidence.
Image by Hao Ke