When football players are injured, all they care about is returning to action as soon as possible. This is not always wise, and a doctor who enables players to do that is not necessarily the best choice. So who is, then?
A better option would be to find a doctor who will allow players to come back at just the right time in their recovery process to make sure they can enjoy playing for many more years – and at their personal best level of performance. This already implies that optimum care for football players requires experience not only in state-of-the-art diagnosis and treatment of injuries, but also in aftercare and prevention. However, the term “football medicine” coined by the FIFA Medical Assessment and Research Centre (F-MARC) means much more than that. Doctors trained in this highly specialised field also offer their expertise in football-specific health assessment and performance optimisation, including mental and psychological strategies and diet, as well as comprehensive advice on doping matters.
For example, a midfielder who has suffered a tear of the anterior cruciate ligament of his right knee not only requires a detailed diagnosis with an exact definition of any collateral damage to other structures, thorough consultation on the different treatment options and a detailed and meticulously planned physical therapy and rehabilitation programme. He also needs advice on how to adapt his diet during the period of immobilisation and on any physical deficits which he can actively influence to prevent future injuries. He may also require assistance in developing a personal coping strategy for his enforced absence from play and in combating his fear of being injured again or readiness to take certain risks.
MULTIDISCIPLINARY
However, players need to know where to find such quality care — and that can often prove difficult. In order to assist teams, coaches and players of all levels in finding such expert care anywhere in the world, should they require it, FIFA now officially accredits established medical centres that have demonstrated leadership in football medicine.
“FIFA is committed to protecting and improving the health of football players worldwide,” says Michel D’Hooghe, MD, chairman of the FIFA Medical Committee. “After all the research and education that has been done, it is only a logical consequence that we offer the football community access to centres of excellence that not only support the mission of FIFA and F-MARC, but actually live it in daily practice.” That mission puts the health and well-being of the player first, regardless of playing schedules, conflicting interests between the different stakeholders within the football community and financial and political issues.
Under the leadership of Prof. Jiri Dvorak, FIFA Chief Medical Officer and chairman of the FIFA Medical Assessment and Research Centre F-MARC, the first FIFA Medical Centre of Excellence was inaugurated at the Schulthess Clinic in Zurich, Switzerland, in May 2005. Since then, many players have been treated in a comprehensive manner thanks to the bringing together of different services and disciplines at what is Europe’s largest orthopaedic clinic in an effort to provide state-of-the-art care. “Often, football players have medical issues that exceed the knowledge of a single expert,” explains Prof. Dvorak. “Therefore, a strong multidisciplinary approach is a precondition to optimise all the different aspects of players’ health.”
PREVENTION VITAL
In November 2007, the FIFA Medical Committee carefully selected five more centres in Munich, Los Angeles, Johannesburg, Kawasaki and Auckland, thus ensuring that Europe, North America, Africa, Asia and Oceania had at least one centre each. All centres had to submit a comprehensive application based on exacting standards designed to prove their clinical, educational and research expertise as well as their practical involvement in the care of football teams and their active commitment to prevention. All applications were critically reviewed by an independent team of F-MARC experts.
“Knowledgeable individual counselling within a multidisciplinary setting lies at the root of a successful football medicine concept,” stresses Dr D’Hooghe. “This applies not only to the treatment of acute or chronic problems, but also to prevention.” The FIFA Medical Centres of Excellence are committed to promoting injury prevention. The injury prevention programme “F-MARC The 11″ is an integrated part of their practice and they contribute to its further development through their own research projects.
In addition, the FIFA Medical Centres of Excellence will play a vital role in educating and training the next generation of clinical specialists committed to football medicine as well as in developing the FIFA network of football physicians worldwide. “Centres themselves are encouraged to exchange information and discuss problems in a virtual network to enlarge the knowledge on practically applied football medicine and further improve standards of best practice,” adds Prof. Dvorak.
ANNUAL REPORT
The first phase of selected applications has been considered a test of the practicability of the application procedure. It will be completed by the official inauguration of the new partner clinics. Accreditation is granted for a period of five years before the centres have to reapply. All accredited centres will annually report on their activities. In future, centres worldwide may apply for official accreditation as a FIFA Medical Centre of Excellence, provided that they follow the procedure laid out in detail by F-MARC.
“I want every player to know where to turn to when it comes to health issues,” says FIFA President Joseph S. Blatter. Under his leadership, FIFA has continuously extended its commitment to health care, thus acknowledging its responsibility as the world’s governing body to football and setting an example as an international sports federation.

FIFA has set up its own project, designed to protect the integrity of football, namely the Early Warning System GmbH, which monitors the sports betting market all over the world on behalf of FIFA. The company assesses any suspicious movements and, if necessary, immediately warns FIFA. How exactly does the system work? Here is a look behind the scenes.
In the old days, anyone who wanted to place a bet on a football match took his cash to a bookmaker. Nowadays, you can confirm your bet with a simple mouse click via the internet. This procedure has demolished barriers and simplified access to sports betting all around the world. What is more, the opportunities for betting have multiplied over the past few years to the extent that people can place their bets on practically anything and long after kick-off. For instance, who will score the first goal, or who will be shown the yellow card first, or will a losing team manage to turn the score around, or by how many goals will Team A beat Team B?
This brave new world of football betting, however, has its shady side. A number of recent betting scandals connected with football matches prompted FIFA to take the bull by the horns in an effort to protect the integrity of its sport, as dictated by the world governing body’s Statutes. In doing so, FIFA is exercising viable options to do everything in its power to prevent the negative effects of the betting industry on football. On the other hand, it is up to government authorities to prosecute and judge any betting offences that have been committed.
In this connection, a pilot project initiated at the 2006 FIFA World Cup Germany™ was set in motion by the company, Early Warning System GmbH (EWS), in Zurich. The trial proved to be useful even though EWS head of strategy Wolfgang Feldner claimed that final competition matches did not show many significant match-rigging characteristics and that the conclusions were therefore limited. In 2007, the FIFA Congress granted EWS a mandate to set up an early warning system with a view to the 2010 FIFA World Cup™.
In a nutshell, what happens is that bookmakers warn EWS whenever they notice unusual betting patterns. Unusual movements, for instance, occur when unexpectedly large amounts of money are placed on certain betting outcomes within a short space of time. Such activities automatically arouse the suspicion that some players or officials have perhaps been prevailed upon to manipulate a result.
“Our work also involves preventive action,” explains Feldner. The early warning system is intended to discourage potential swindlers from even attempting to carry out their criminal activities or at least to nip their would-be gains in the bud. Basically, the system is split into three pillars: information is collected, then analysed, after which EWS passes it on to FIFA.
THE THREE PILLARS
Collecting information
EWS works together with government and private betting providers, internet bookmakers, betting exchanges and associations, contracts being concluded with as many partners as possible. The betting providers agree in these contracts to inform EWS of any suspicious betting activities, as a result of which they reap double benefits. Firstly, as EWS warns them of any unusual movements, they can withdraw certain bets from their range and thus reduce their risks and, secondly, the contract shows punters that EWS is an agent that defends the integrity of football. Several hundred providers are already associated with EWS, either directly or indirectly, and the number of adherents is constantly rising. These include all national lotteries and major private betting operators located all around the world.
Analysis
EWS’s contractual partners can report any irregular movements via a secure system. They themselves give the suspicious activity a certain rating, ranging from mere rumour to acute threat. EWS then assesses the information and if certain criteria are fulfilled, the alarm is sounded according to an established procedure. Because matches can kick-off at any time of the day in various parts of the world, EWS monitors movements practically all around the clock.
Passing on information
If certain activities sound the alarm, EWS immediately contacts FIFA’s Legal Affairs Division. All of the betting operators associated with EWS are immediately instructed to withdraw a certain bet or match from their range of offers. FIFA then has a number of options. It can, for instance, inform the teams involved that their match is being strictly monitored, or it can change the referee and assistants, or, in extreme cases, cancel the match.
ASSOCIATION PILOT TRIAL
At the core of the system is software developed by technician Detlev Zenglein. Zenglein, like Feldner, joined EWS after working for several years for a betting agent. Nowadays, he sits in front of a screen in Zurich and watches football matches while simultaneously keeping an eye on betting movements. “Suspicious bets usually coincide with upcoming matches,” he points out. EWS cannot possibly prevent outright fraud. “There will always be a hint of risk,” explains Feldner, “especially on the grey and black markets.”
The warning system is currently being applied to the preliminary competition of the 2010 FIFA World Cup™ and will eventually be implemented for domestic and confederation matches. A pilot project is already being conducted at one member association of FIFA. “Our ultimate aim,” comments Feldner, “is to create awareness of the problems created by sports betting among the associations and confederations.” One of EWS’s strategic goals is to offer its services generally, such as to sports organizations outside football or the IOC, explains CEO Urs Scherrer, a sports law specialist. This is one of two main reasons why EWS was set up outside FIFA. The other reason for EWS’s independence is the legal situation.
Technically, the early warning system could easily be made available to other sports associations, many of which have already declared their interest in using it. EWS is nurturing relations with several sports organisations, exchanging views and acquiring know-how.
Over 100 qualifying matches for the 2010 FIFA World Cup South Africa™ have so far been monitored, none of which produced any significant betting movements. All the more reason, warns Feldner, not to shrug off the inherent threat. “It would make sense,” comments Feldner, “for FIFA to extend the system to other competitions in future.”
Later this year, EWS and FIFA will be holding a symposium at which the associations, betting agents, clubs, sponsors and the media will be given the opportunity to exchange views and ideas. Both Wolfgang Feldner and Detlev Zenglein earnestly hope that EWS’s work is safeguarding FIFA’s matches from any form of manipulation by betting crooks.

Josef Hickersberger has seen it all. As a player, he won the Austrian league title with both Austria Vienna (1969, 1970) and city rivals Rapid (1982), and as a manager, he has led Al Ahly (Bahrain, 1996), Al Ittihad (Qatar, 2002) and Rapid Vienna to domestic glory. His success with Rapid Vienna, who he also guided into the UEFA Champions League, paved the way for this son of Lower Austria to make a return to the Austrian hotseat, having already spent 29 games in charge of his country between 1987 and the autumn of 1990 when his team fell to a shock 1-0 defeat at the hands of the Faroe Islands. The highlight of his first spell in charge was leading Austria to the 1990 FIFA World Cup™ in Italy, even though they failed to make it past the group stage. Josef Hickersberger the player was almost as much of a go-getter as Josef Hickersberger the manager, gaining the reputation of a “globetrotter”. The midfielder was the first player to represent both Austria and Rapid Vienna and he also spent six years in the German Bundesliga with Kickers Offenbach and Fortuna Dusseldorf. Hickersberger was also a member of the legendary Austria team that claimed a 3-2 victory over West Germany at the 1978 FIFA World Cup™ in Argentina and he scored five goals in 39 international appearances. Hickersberger, who is now 60, is a passionate golfer and has often said that he will move back to the Arabian peninsula once his managerial career is over.