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SoccerSoccer's hidden medical dangers

Posted: Monday, April 23, 2012 | 10:22 AM

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Professional soccer players collapsing on the pitch with undetected medical ailments is not that uncommon. (Getty Images) Professional soccer players collapsing on the pitch with undetected medical ailments is not that uncommon. (Getty Images)

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The subject of professional soccer players with undetected medical ailments losing their life on the pitch is back on the front burner in 2012, with the soccer industry having done little to prevent such tragedy.

This might have been his final season. He would have been contemplating retirement for a while.
 
In a matter of days, he would have turned 37. After nearly two decades of professional soccer, it was probably time to call it a day and maybe consider a move into coaching. Or perhaps a return to his homeland as a football ambassador, mentor or scout.
 
Marc-Vivien Foe never got to choose.
 
The Cameroon midfielder was struck down at the peak of his powers. It is nearly nine years since Foe, then aged 28, collapsed on the field in Lyon, France, while representing his country during a Confederations Cup semifinal. Frantic efforts to revive him failed. An autopsy revealed a hereditary, heart-related condition as the cause of death.
 
Foe's sudden death shocked the football world. A high-profile professional losing his life on the field of play made worldwide headlines in 2003. But it was no means an isolated incident. Perhaps, more shockingly, the soccer industry has done little to prevent such a tragedy happening again.
 
2012 has brought the subject back into sharp focus. In the space of a month, two young players have needed emergency treatment in an attempt to save their lives. Against all odds, one survived.
 
Fabrice Muamba has described his recovery as "more than a miracle." The 24-year-old English midfielder is out of hospital and talking about the moment his heart stopped in the middle of a game. Incredibly, it stopped for well over an hour before medical staff managed to resuscitate him.
 
In Italy, cardiac screening is mandatory. All players are examined at 16 and can expect regular checkups throughout their career. Yet Piemario Morosini is dead at the age of 25. The Livorno midfielder could not be revived after suffering a cardiac arrest just four weeks after the Muamba incident.
 
The medical world is baffled. There is seemingly no logical explanation why some elite athletes in their prime are susceptible to such catastrophic heart failure. One theory is that their conditions are not permanent and such abnormalities don't always show up during the scanning process.        
 
Perhaps it has to do with the nature of the game. Professionals are required to use explosive speed in short bursts, which puts tremendous physical strain on the body. Though they train specifically for this type of action, there is little time to recover during a competitive match, when every player is constantly in motion for 45 minutes at a time.
 
Like Foe, Zach Herold never got to choose. But Herold is still alive. The American teenager's dream of a pro career ended before it began. A top defensive prospect, Herold was drafted by Toronto FC in 2010 at the age of 17 after signing a six-year contract with Major League Soccer.
 
Despite his tender years, Herold was already a soccer veteran, had travelled extensively and was the first choice right back for the U.S. team at the U-17 World Cup in Nigeria in 2009. A few short months later, after being selected by the Canadian franchise, Herold checked in for his pre-season medical.
 
Among the tests was an electrocardiogram (ECG). The results were alarming and devastating for young Herold. A second and third opinion confirmed the worst.

He was diagnosed with hypertrophiccardiomyopathy (HCM), which causes abnormal thickening of part of the heart muscle.
 
Herold's condition was almost identical to that which had killed Foe and others. A career in professional sports was out of the question. Though Herold had been involved with the U.S. youth system for several years, it wasn't until he arrived in Toronto that he underwent an ECG. His mother, Beth, conceded Zach had "dodged a bullet."
 
Death on the field, though horrific, is not that uncommon. In the years since Foe's passing, there have been around 20 recorded similar cases either during games or training sessions. The incidents have taken place worldwide. But Morosini's was the first in Italy since screening became compulsory in 1982.
 
Football's approach to ECG's remains piecemeal. Herold's potentially life-threatening condition was flagged by a routine test in Canada which had never been performed in America. Morosini would certainly have been screened in Italy, where it is estimated such calamities have been reduced by as much as 90 per cent in the last 30 years.
 
The physical strain of playing is matched by the emotional stress of soccer management. In England, the League Managers Association (effectively the managers' union) runs a program called Fit to Manage. It offers extensive checks, including ECGs, to all its members.
 
So is soccer taking its most valuable commodity for granted? Without the players, there is no game. In England, young players are scanned at 16. Thereafter, it is up to individual clubs to decide whether to follow FIFA guidelines, which suggest heart screening every two years.
 
Inevitably, money is part of the equation. England alone supports 92 professional clubs. But the vast majority operate on shoestring budgets. Despite financial support from the Professional Footballers' Association for medical expenses, such as ECGs, there is no uniformity among clubs about when -- or even if -- their players are checked on a regular basis.

Muamba is one of the extremely lucky ones. Medical records show he was screened four times after joining Bolton in 2008. But nothing led specialists to suspect the time bomb was ticking.

The Premier League's chief executive Richard Scudamore has since ordered a review of medical procedures. Probably not a moment too soon.

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