What's up Doc?

Thursday 14 March 2002

From Ian McCulloch

In the latest in the series, Fulham Today takes a look behind the scenes and catches up with Club Doctor, Charlotte Cowie.

Having joined the back-room team earlier this season, Charlotte Cowie, Fulham's first full-time doctor is the latest addition to what is fast becoming one of the finest set-ups in the whole of the Premiership. Seated in her office in the magnificent new medical facility, Charlotte described her role, her background, and how she is finding things at Fulham.

Charlotte, what exactly are your responsibilities are at the Club?

Basically I'm responsible for the medical care of all the players at the Club. The professionals are my main responsibility, but I also look after the full-time academy boys, the sixteen to nineteen year olds. We now have an academy doctor who looks after the under sixteens and shares the care of the scholars with me.

My involvement can range from pre-season screening blood tests, to dealing with coughs and colds, through to investigating and managing the sporting injuries. I coordinate treatment between our physios, outside specialists and anyone else who might be involved, so that we can get the players back playing as quickly as possible.

This is now a full time role?

Yes, Simon Kemp who was the doctor before me, was here one day per week and went to all the home matches, but that really was as far as it went. It changed because the Club did want a full time doctor.

Is this the same at all Premiership Clubs?

Not many Clubs, even in the Premiership, will have a full time doctor. Man Utd, Chelsea and Spurs do, but I think that's probably about the extent of it. It is rare, and some of those appointments have only been made this year, so it's quite a new concept. Usually, a Club doctor will be at a Club for only one or two days a week.

What was your background before you came to Fulham?

I trained in sports medicine, which is my speciality. I completed my medical degree and then I did an extra degree in sports medicine. I've since done a lot of things related to that - I looked after Millwall Football Club for about six years; I looked after the England women's football team for about the same length of time; I worked at the National Sports Centre at Crystal Palace; I worked for the British Olympic Association at the British Olympic Medical Centre and at the Olympics in Australia; and I looked after the England Team at the Commonwealth Games.

So I've had a quite a lot of multi-sports experience. I started off in football, then came out of it to do lots of different sports and work in a sports injury clinic, and have now come back into football.

Are you dealing with the same sorts of things across all sports, or are there specific football-only related problems?

There are typical injuries that you get in football; ankle injuries are very common and so are knee injuries - a serious injury could be a cartilage tear or a cruciate ligament injury that can take between six and eighteen months to get back from. Groin and abductor pain is another common football one, brought on by kicking - stress is put on the pelvis by the kicking motion.

They are injuries you find in other sports; you'll find the ankle injuries in hockey and other sports where you play in studded boots and change direction a lot. It's the same with the knee injuries - the cruciate ligament problem is very common in skiing. And groin problems are very common in rugby.

Unless you're a goalkeeper, shoulder injuries are fairly rare, whereas if you're a swimmer it's a very common injury.

What is it like working for a professional football club and being in the Premiership?

It's great. It's on matchdays particularly that it really hits home that you're in a very special place and that you're doing a very special job. On a day-to-day basis, the problems I get are not that different to what you would see in sports injury clinic. But the reason that it's important for the Club to have a good sports medicine team is that it's all about the quickest possible time that you can get people back playing. It's not acceptable to say someone will be all right in a month or so's time - if we can slice a couple of days off a recovery time then that could make the difference between a player making a game or not, and that could result in points gained or lost at the end of the season.

It's the time pressures on us to get people back quickly rather than just get them better, which is the biggest difference in working in this environment. I am used to that from working in the other sports disciplines, especially the Olympics, where people who have been training for an event all their lives, might be just two weeks away from competing. So I'm used to that sort of pressure.

Fulham seem to adopt a very scientific approach to the care of players, and concentrate very much on the prevention of injuries.

"I think our injury rate is low and I think that's down to a mixture of things. Jean Tigana's approach is very much that the prevention of injuries is the most important thing, and that's why the players work so hard with Roger Propos on their fitness. And that's not just making sure their heart and their lungs and their muscles are strong, you're talking about suppleness and agility and the ability to prevent themselves being injured by being flexible and well balanced.

Once someone is injured, every possible angle is looked at. It is a very scientific approach. We tend to scan people earlier now and if they need extra treatment of any kind then they get it - my budget is getting bigger by the day! The most important thing is to get them back - as quickly but also as thoroughly as possible. The great thing about Jean, which is very different from other managers I've worked with, is that if someone needs the time to get better he will give it. He trusts that you will get them back as quickly as possible and he won't push it.

There was a survey done a few years ago that showed that a third of all injuries at any given time are actually re-injuries. If you bring back someone too early you don't really save time in the long run because they'll be back with you a few weeks later.

One of the unusual things that we have here is that we have osteopaths working with us. It's very popular in France but not really used by Clubs over here. I'm actually a registered osteopath as well as a doctor, so it helps that I understand both disciplines, because osteopathy isn't traditionally a very scientific approach - it's regarded as being a bit alternative. But the French players feel it's a very important part of their fitness regime.

Measurement is big part of what we do here. The only way you can improve fitness is to measure it, work it, and then measure it again and get some sort of objective about where you're heading.

How do you rate the facilities here?

They're great. When you want to work with injured players one of the most important things is to have the space, and we've got tons of that. The facilities are first class, and to have the room as well where everything is new and clean is wonderful. We've got all the right equipment as well, we don't need to have tons of expensive equipment - we have some - but we've got a very good gym to work with people and eight or nine treatment couches so that we can deal with a lot of people at the same time. We might have two physios, an osteopath, a massage therapist and a doctor all working together, so the amount of treatment that a player can have in one day is quite large.

What's it like on matchdays?

Once you're out there on the pitch the game seems to go so quickly. It's a slightly different perspective if you're there in a medical capacity. It's very important that although there is an exciting match going on, that your focus of concentration is slightly different to everyone else. You're looking to see if someone is injured, so you may be looking away from where the ball is, and if someone sustains an injury you will be watching that player and what they are doing for the next five or ten minutes rather than the game itself.

Basically I'm there in case something happens. I arrive at the same time as the players because sometimes on the day people are sick, so I can help in ensuring everybody is fit and ready for the match. If they're short of a pair of hands then I'll help out at whatever.

During the game, I'm there so that if an injury happens, something serious like a broken leg, it can be properly managed from the start. It's always useful that if someone gets injured, that you can see the mechanism of the injury when it happens. Ideally if I'm not there when an injury happens I like to see a video of it so I know how it happened.

If there's a cut or something during the game then it will be my job to do the stitching. Quite often that will be for both sides if their doctor isn't there. Many times you can get people back on to play, particularly if you can stitch them at half time. Suturing is probably the most common thing I would do on match day in terms of medical treatment.

What's it like being a female in a traditionally male dominated world?

The set up at Fulham is very unusual because we have a number of females here. I think there are only two other female doctors in the whole of the football league. Here we've got a female academy physio and of course Alex Court who works on the fitness side.

One of the things about Fulham is that it is very forward thinking and very progressive in the way it selects its personnel. They advertise wherever they think they will be able to recruit the top people and they recruit very openly and fairly - their recruiting procedure is very transparent and they obviously aren't scared to employ a woman if they think she's the best person for the job. This is unusual and I've come across Clubs and managers that are very uncomfortable at the thought of working with women and that's still the case in a lot of places.

If I'm in the changing rooms and the players are having showers then I will probably leave them to it a bit more than a male doctor would. If we're at home then I'll stay in the medical room, but if we're away then I make sure I give them some room. At the end of the day I'm a doctor and I've seen it all before and I'm sure they're not bothered, but I try to be sensitive to the situation.

The atmosphere here is fantastic. As a woman, you've got to be able to be one of the lads and I think that there are female doctors who would find it difficult in this situation - there are probably some male doctors who would too! It very much depends on your personality.

Would you call yourself a Fulham fan?

I've really got into it since I've been here. My family are all Leicester city supporters so that's where my traditional family loyalties are, and I love watching football, but I wouldn't say that I have supported one team. When you work with players, and you get to know them, then you want them to do well. So now I'm here all I want is for Fulham to do well - I do support them and it makes me happy to see them happy and see their work rewarded and see your own work rewarded, so I always, always want them to win.

What are your hopes for the future for yourself and for Fulham?

I gave up my nice, safe nine-to-five job in a sports medicine clinic with every weekend off, because when I first spoke to the Club they said that they wanted to put together the best medical team in the Premiership. That is my ambition also, and we're still working very hard towards that - we are working on techniques, staff, equipment and everything else. I think that the manager's ambitions are very similar in that he wants to take the Club as far as he possibly can. They've done amazingly well so far, but everybody's ambition is to go a lot further yet. I think that reflects the medical team's aspirations as well - if you want to be the best on the pitch, you have to have the best back up behind the scenes.

As has been said on many occasions before, the ambition at this Club is phenomenal. Charlotte Cowie is one more example of that ambition being put into practice as Fulham Football Club realises its dreams of becoming the best there possibly is.