We offer you the second part of the interview that the
head of Spartak’s medical department Mikhail Vartapetov gave to the experts of
the web portal Yuri Butnev and Alexander Prosvetov.
— Why does Spartak work with a Roman clinic? Before that the club used to send its players in Germany and they underwent surgeries there.
— We never tried to work with only one clinic and of course we didn’t look at the outdoor signs when we were looking for a partner. We needed to find a really experienced surgeon and confirm that the technique of the surgeries he performs will allow the players to recover fast and in a safe way. Spartak worked with one of German clinics until 2013. When the number of knee injuries became higher we encountered some problems. I can’t say anything about all doctors from Germany, but some of the surgeries performed by German specialists led to relapses and complications. The club didn’t have a medical department back then. One of the reasons why this department was created was the desire of the club’s Board of directors to have one place where we were going to send our players.
In some degree we found the Roman clinic called Villa Stuart by accident. However, after two or three surgeries of our players, after numerous visits to the operating room, discussions with the doctors and professor Pier Paolo Mariani we decided that we were completely happy with the services of this clinic. We also had a great contact with Italian specialists. They never prevented our representatives from visiting the operating rooms, they even encouraged it.
This clinic is oriented on early recovery of players. The rehabilitation period starts even before the surgery: physical therapists and rehabilitologists offer the players some exercises one day prior to it. It’s also important that this clinic is one of a few clinics in the world which received FIFA’s accreditation as centers of sport medicine and surgery.
We also have a list of medical institutions we are allowed to work with. This list was approved by the Board of directors. It includes clinics from Spain, Finland and the USA. However, you may go farther and fare worse. We are happy with the current results. In some cases Mariani had to redo the work of his predecessors even though the surgeons really don’t like doing it. Even in such cases he was brilliant.
— Does Mariani know anything about football?
— As he himself admitted, he roots for all the teams where his former patients play, even though I think that it must be really hard to make a choice. FC Roma uses the services of this clinic and Totti was its honored patient. Their internal curative department looks like a football history museum. There are T-shirts of players everywhere. Recently they sent me a video: the doctors in the operating room were periodically looking at the TV with some live broadcast and jumping with joy when somebody scored a goal.
— The most important thing for them is to avoid throwing
scalpels in the air. You mentioned the creation of a medical department in the club.
Who works in this department?
— This department unites three teams — the first team, the youth team, Spartak-2. It also deals with the Academy. 21 medical workers, including nine doctors, work in it.
— Is it the same kind of department that the leading western clubs have?
— When we feel courageous enough we say that the structure is like in FC Bayern Munich.
— What is the difference?
— I don’t know if it’s good or bad, but our team is more ‘doctor oriented’. Eastern European clubs mainly use doctors as consultants. Many of them have their own clinics. They only visit the team if they are needed. They have a physiotherapist who solves everyday problems.
Those European clubs also act according to protocol. They do MRI, X-rays and CT all of the time and sometimes the doctors feel like they are bound by these protocols. MRI can’t be used for final diagnostics. It should be in the doctor’s head. There were many cases when the MRI showed one result, but the surgeon saw something else. Our doctors generally think more because of the way they were educated in Soviet times. They use their experience, practice, intuition more than instrumental diagnostics.
— It feels like this is true for the whole Russian medical community, not just the football doctors.
— Yes, it’s true for everyone. I spent many years in the ER. All of the foreigners were surprised when they saw our special teams. They said: ‘It’s too expensive to use highly qualified doctors for this! Paramedics (it’s the common name that also includes professional doctors sometimes, but most of the times it means medical assistants — Editor’s note) are the ones who work in first aid teams. After receiving first aid the patients are transferred to hospitals’.
— Do you think that it’s okay to use the services of Italian, German and other clinics from abroad?
— We have experience but we need some practical things to use it. We lack equipment, facilities and rehabilitation means. There is also the factor of prestige. If you tell some foreign player whose contract costs 20 million euro that some Russian surgeon from a small hospital is going to do the surgery he won’t be happy. They have to go to Barcelona, Rome or Munich instead of Khimki.
There is a good doctor though; his name is Alexander Barkov, who performed surgeries for all of our young players starting from the members of Spartak-2. For instance, he was the one to perform surgery for Vanya Khomukha who had a serious fracture a year ago. He’s good even though the center of the Ministry of Defence of Russia where he works lacks prestige.
That being said, it is possible to find a clinic with luxurious patient rooms and prices higher than in Eastern Europe. There are marble walls and luxurious carpets there. The problem is — we can’t be sure that the specialists are really good.
— Have you met the
players who are educated in medical field and who even can diagnose themselves?
— Football players often give their doctors some hints. I think that an experienced specialist must pay attention to the information he receives and to the complaints of his patients. However, patients are not able to cure themselves. Of course some of the players have wives who work as doctors. For example, Denis Glushakov’s wife is a dentist. Of course she can do some procedures at home. By the way, Artyom Rebrov is a veterinarian, so we often make jokes about the animals being left without treatment because of football.
— Do you feel that you have to work more and more every year?
— All the years are different in terms of injuries, but we always have work to do. There are many organizational problems that we have to solve, starting from forming the budget and covering it and ending with the medical committee of the RFU which I am a member of. We traditionally arrange international seminars of sport medicine at our stadium and give medical lectures for our stewards. Every single event takes time.
Of course it’s also important to conduct thorough medical examinations of newcomers before they sign a contract. On the one hand we have a standard scheme of pre-contract tests they can undergo in Europe and in Russia. It’s not cheap, but this procedure gives the management a 95% guarantee that they won’t get a sick player.
On the other hand I am personally responsible for any
mistakes. There were cases when I had to write negative reports. This is one of
the hardest moments of my work because I understand that I can destroy careers
of some players, especially of those players who are young. Usually the player
who is interested in signing the contract, his representatives and relatives do
not accept the fact that he has a problem. I need to give them solid facts that
confirm that they can’t sign the contract.
— However, some things are not made public…
— Of course they aren’t. However, there are always some rumors and people start thinking about the reason why they weren’t invited.
— Were there any complicated cases when you had to accept the responsibility?
— I had some doubts about Yura Movsesyan. It’s always hard to approve the contracts with those players who recently underwent surgery, even if it was because of a usual meniscus injury. You understand that in a month this player should be healthy, but there is always a risk: something can go wrong. We encountered such a risk when we invited Serdar Tasci. This player had to undergo surgery and this allowed the management to get lower transfer price during the negotiations with FC Stuttgart.
- What is the first question that the coach asks when his player gets injured? Are they usually interested in the prognosis and the terms of recovery?
— It depends on the coach. Some of them say: ‘I had this problem in the past’ and give their own prognosis. Of course usually they are concerned about the terms of recovery.
It is important for the doctor and the coach to have full trust in each other. There can be some discussions. It’s bad when the coach doesn’t trust the doctor and the doctor expects a negative reaction because of a negative experience he has. Such things happen with some teams. I can give you an example — FC Bayern Munich, they fired their doctor Hans-Wilhelm Müller-Wohlfahrt. This man gave this club forty years of his life and Josep Guardiola asked him to leave because in his opinion the process of his players’ recovery was taking too long. After Guardiola left the legendary doctor returned to the club, but only as consultant, so he doesn’t play such an important role as he did before.
There are other situations as well.
People tried to defend Eva Carneiro when José Mourinho refused to work with
her, but I’m on the coach’s side because a physical therapists who works for a
football team needs to understand football and know everything about it. Eva
ran to the field during the last minutes of the match to help Eden Hazard. The
player had to leave the field, but another one of Chelsea players was already
suspended, so there were only nine players left on the field.
— The situation was different. During the last minutes of the match Bocchetti got a head injury and he needed wound dressings. The referee told the player to leave the field. In the meantime Dzyuba scored a goal and Spartak lost the opportunity to win because they were outnumbered. The final score was 2:2. Everyone was upset, they kept blaming the doctor. However, the only mistake of that doctor was leading the player outside the field boundaries as a disciplined person instead of staying on the field without listening to the referee even if there was a possibility to be punished for this after the match.