THE OSTEOPATH WITH 200 CAPS!

Dr Carl Todd Interviewed by Dr Simon Lack

Since 2005, Dr Carl Todd has consulted as an osteopath for the medical team at The Football Association and in particular the men’s senior football team. As a result of working for over 17 years with the England national team, in June 2022 he reached a remarkable milestone of covering his 200th game…

For this edition I had the privilege of interviewing Dr Todd whilst he was in Munich covering the Athletics European Championships, to get beneath the surface a little and understand what are some of the real highlights, and low-lights, of working in this elite environment. Carl kindly took me through some of the exemplars of good osteopathy practice that he had been witness to, and also what he saw as the future of osteopathy in the elite sporting environment.

What have been the highlights?
Many of the successes that have been shared with the teams or athletes that Carl has worked with over the years have been described as highlights.
“Sharing in the successes of the team that I have been a part of is a real high”.
Carl describes the privilege of being involved with such a talented group of players. He made particular mention to the Champions league title in 2012 with Chelsea FC, describing how the first champions league title was the most memorable.

What have been the low-lights?
The most salient point Carl raises is not to forget the pressure it brings to your family life. He described how it takes “a really special type of partner to ‘hold the fort’ whilst you go off and do the things that you do” particularly if you have a young family. The other reality is that your calendar is dictated by the sporting calendar! Time off is limited. But the enjoyment of the job outweighs the sacrifices that are having to be made.

The other reality of working in elite sport is that some performances do not go well. In these scenarios the heart break is felt throughout the whole team.

After these losses, the transition from the sporting environment or ‘family’ back to real life is hard. Carl stopped short of describing this as depression, but certainly did feel that it represented a period of lower mood as you come to terms with what this outcome means.

What are the bright spots of exceptional clinical practice – through your osteopathic lens?
When in elite sport, it is not about any one profession, it is about the MDT was Carls clear answer to this question. He took me through a fantastic example of this working well, where he described a player with a significant hamstring injury. When they arrived on camp, the optimal management saw them back on pitch playing 90 minutes without reaction after only a couple of weeks. Carl describes the role of nutrition, optimising sleep, from an osteopath perspective looking holistically at spinal-pelvic mechanics, hip, ankle & knee mechanics, whilst working alongside the physiotherapist as the player starts to load the affected area. Backed up by the soft tissue therapists to aid recovery and the strength and conditioning coach taking the progressions going forwards. Couple this with constant communication between the medical team and the performance director and coaching staff, to ensure all are singing from the same hymn sheet.

Creating an environment of ‘belonging’ within the medical, performance and coaching team, really helps to draw the athlete along with them.

The real strength of the practitioner comes from effectively finding the balance of doing your job and then stepping back, not creating a reliance on the intervention, but rather providing effective interventions and then helping the athlete to realise that they can cope without you.

A team with great experience and credibility also promotes buy-in from the injured athlete, trusting the process that underpins the decision making and management approaches. The real strength of the practitioner comes from effectively finding the balance of doing your job and then stepping back, not creating a reliance on the intervention, but rather providing effective interventions and then helping the athlete to realise that they can cope without you.

Where are the areas for progress for Osteopathy?
Historically you were trained as a primary healthcare practitioner, he describes. What was not that well highlighted within undergraduate university programmes is working effectively within the team. Carl feels this may be the demise of post graduate education, providing the insight in where the skill sets that you have developed fits within the wider MDT.
“Understanding and acknowledging your strengths and limitations as you start to work your way into a sporting team or club is critical”

One aspect Carl presented as an example was that, whilst an osteopath may have excellent manipulative skills and works with the team once a week, they are unlikely to be the first choice clinician for a player who receives treatment on a daily basis from the club physiotherapist. It is important not to be “put out” by the player not going to you, but rather provide the specific hands on skills when required or asked of you. Carl described nicely this aspect of working within your boundaries, but that progress for osteopathy will be to further integrate the manual therapy skills into the improvement of movement quality and onto strength and conditioning.

What is next for you Carl?
A holiday! Before getting back into clinic in September. Carl then has his hands full once again as he looks set to travel with CFC and then on to the World Cup preparation for Qatar.

If the clinical work has not kept him busy enough, Carl has managed to get pen to paper in writing a Clinical text book that is getting published in November. In the book, Carl presents the reasoning that underpins his treatment approaches, with a nice framework of the 5 ‘ATEs’ to help focus this approach (EvaluATE, EducATE, ManipulATE, ActivATE and IntegrATE). Look out for his textbook if you would like to know more!

 

Article featured in BASEM Today 61