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To what extent do clubs respect medical confidentiality?

Gareth Bale asked Real Madrid not to publish the details of his injury

Real Madrid v CSKA Moskou - UEFA Champions League Photo by David S. Bustamante/Soccrates/Getty Images

Interesting to hear that Gareth Bale has reportedly requested that Real Madrid don’t publish the details of his latest injury; the one sustained while playing for Wales against Croatia in the same game that Luka Modrić picked up his thigh injury.

Gareth is said to be citing medical confidentiality as the reason behind this; and it could well set a precedent for other clubs to follow.

Real Madrid, as do so many other clubs, take particular care to be as accurate about the information released regarding players’ injuries as possible; but in most cases this is limited to a brief statement giving the site and nature of the injury.

Sometimes the above is accompanied by the severity of the injury described in terms of injury grading - i.e. grade 1, 2 or 3 muscular injury etc.

In most cases these injury reports normally end by stating that the player in question’s progress will be monitored and / or recovery times are dependent on how well the injury responds to treatment.

Other clubs are less informative; often only saying that the squad trained fully yesterday but that several players trained alone or in the gym. Another version is that before naming his team the coach will wait to see how the injuries respond without naming any names.

If the situation about Gareth Bale is true, then this might well be a sign of things to come.

Gareth is said to be citing the doctor- patient relationship over release of medical information without consent; something that applies in all walks of life but which tends to be treated differently in professional sport, not only in football.

We’re all familiar with the fact that the clubs only release injury information on a need-to-know basis and that the information made available in most cases is generally pretty basic anyway.

Usually this is limited to a vague statement about the player having suffered a muscular injury to the left leg for example but without detailing whether it’s a muscle in the thigh, hamstring or calf etc.

It might be that Real Madrid, in their eagerness to keep their supporters informed about player injuries are actually providing too much information; although in practical terms it’s debatable how much that information affects things going forward.

Media reports aren’t going to influence opposing coaches’ team selections and they’re certainly not going to affect whether or not other clubs make approaches to sign certain players.

Clubs are going to base those decisions on accurate medical examinations as opposed to reading a single line saying that a certain player has a calf injury. They’ll get their own medical people to decide on matters of that importance.

Perhaps Real Madrid need to re-assess their release of injury information policy to include the consent of the players in these statements, such as is the practice at several other clubs in La Liga.

Medical reports from Real Sociedad in particular always carry the addendum that the information has been made available with the consent of the player and the medical services; although it is the consent from the player that is ultimately the most important aspect of this.

It might well be that Gareth Bale is so fed up with being publicly lambasted for his injuries that he’s not relishing another period of relentless media speculation over the reasons for his current absence from Real Madrid’s team.

He may well be genuinely worried about whether his current injury constitutes a threat to his career and for that reason wishes to keep his own counsel as opposed to having everyone analyse the chances of him making a return and suffering another recurrence.

How far we take this discussion though is where the whole situation could potentially get out of hand. What happens if Gareth or one of the other players decide that they don’t want Zinedine Zidane to know the exact details of their injuries?

There have been incidences in the past of players asking the treating therapists not to divulge the full extent of their injuries to the coach (Malcolm and Scott, 2010) and also of players refusing club medical staff access to MRI reports etc., before they have had the chance to discuss these fully with independent specialists.

There is also the question of how much the coach needs to know about a player’s medical status; and this too has been debated at length and no doubt that debate will continue.

The issue of confidentiality in sport is not new; but with the media interest as it is today we have to acknowledge that there is considerable pressure placed on the clubs to publish information about players injuries, but without necessarily going into too much detail.

This is a difficult question to answer, because even if clubs stick to sharing just the basic information, there /will always be players who prefer not to have the details of their injuries discussed in public.

Cristiano Ronaldo, for example, managed his own return to fitness from the knee injury sustained in the Euro 96 final in Paris to such an extent that information released about his recovery process was virtually non-existent in terms of detail.

Even basic information relative to the extent and nature of the injury itself was controlled by Cristiano and readers may remember that I wondered then if this could be the shape of things to come.

Most players in general though, are happy to share information about their injury. Players normally love to talk about their injuries and often feel that the exchange of medical information that arises from discussing their conditions will help them in their recovery process through taking as many opinions as possible.

The medical room is often the place where players will openly discuss their injuries with each other and these discussions frequently extend to include other members of the coaching and medical staff as well.

Therein lies the problem if we are talking about confidentiality. Are we limiting this to the one-to-one medical situation Gareth is said to be referring to or are we talking about keeping injury matters ‘in-house’ amongst the medical team?

In addressing confidentiality, Giordano (2010) wrote that in team situations ‘‘the complexity of such interpersonal strategies stems from the recognition that the requirements of sports medicine may exceed those of ‘standard’ medicine’’.

Often it’s that complexity that leads to issues of confidentiality arising in the first place. How clubs address this could well be under increased scrutiny in the future.

References

Giordano S (2010) A new professional code in sports medicine. British Medical Journal. Available at: https://doi.org/10.1136/bmj.c4931 (Published 21 September 2010)

Malcolm D, Scott A (2013). Practical responses to confidentiality dilemmas in elite sports medicine. British Journal of Sports Medicine. Vol. 48 (19); 1410 – 1413.

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