"After the game is before the game."
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Interview with former DFB physiotherapist Klaus Eder
"After the game is before the game." This quote from the former coach of the national soccer team, Sepp Herberger, applies in particular to the medical department of the national team. Injuries need to be treated and preventative measures taken to get as many players fit for the next game as possible.
As chief physiotherapist of the DFB, Klaus Eder was part of the team behind the team and has accompanied the national soccer team to games and tournaments since 1988.
Klaus, important players like Bastian Schweinsteiger and Sami Khedira were fit again after a break from injury when it really mattered. How important is the role of the medical and therapeutic department around a tournament like the 2014 World Cup in Brazil?
We are excellently positioned in the medical field and also need a functioning, well-rehearsed treatment team in order to recover injured players as quickly as possible. Based on an exact medical diagnosis, it is then necessary to draw up a physiotherapeutic treatment plan.
If the player is then treated as best as possible, he can often be brought back into good condition by the next game, if the injury allows it. Especially during a world championship, our physiotherapy department is on duty around the clock.
What does your working day look like during a major event?
Between games, we take care of the players from 8 a.m. to 11 p.m., then we sit down with the medical department and discuss which player needs a certain type of treatment. We also celebrate victories and defeats in our treatment room, depending on whether the treatment works or does not affect the player's condition as desired.
Of course we are also challenged during a game. For example, if a player's ligament comes loose from its anchorage to bone, we cool the spot and slide the ligament back into place to make the pain more bearable and allow the player to continue. An exact diagnosis can then only be made after the game and, if necessary, lead to further treatments.
How has physiotherapy in top-level sport changed in recent years?
The requirements are constantly increasing and there are always new challenges to be mastered. Everything has become a lot more professional, not just the support staff, which has new fields added and has grown a lot, but also the players.
The foot alone has 26 joints. If one is not in its correct position, the functionality of the active and passive musculoskeletal system can be impaired.
What knowledge must physiotherapists have in top-level sport?
All physiotherapists who want to work for a senior national team need a license from the DOSB (German Olympic Sports Confederation) as a sports physiotherapist. Comprehensive knowledge of manual therapy and osteopathy is also necessary. Without proper knowledge of anatomy and biomechanics as well as appropriate training, it is not possible. Without a physiotherapeutic diagnosis, which determines the cause of complaints, the physiotherapist would end up treating in the dark.
Of course, the years of experience of a physiotherapist also plays an important role. In addition, you have to be prepared for the fact that the players occasionally unload their private problems or their frustration in the treatment room.
Can you give us an example of how important it is to have a correct diagnosis in physiotherapy?
If we look at muscle injuries, for example, we differentiate between structural damage with bleeding (muscle fiber tear, muscle bundle tear or muscle tear) and structural damage without bleeding, such as mechanical overload or incorrect strain, strains or trigger ligaments (twisted fascial ligaments).
Depending on the findings of the doctor or physiotherapist, a differentiated treatment plan can result in order to restore the functionality and performance of the musculoskeletal system. Of course, the treatment strategy can be erroneous if the diagnosis is wrong.
The cooperation and the same terminology of the medical department has the highest priority in order to be able to guarantee an appropriate treatment and rehabilitation of the patient.
What role does functional training play in athlete rehabilitation?
In functional training, not only is a muscle separated, but entire muscle chains are trained. Accordingly, not only the affected area is stressed during rehabilitation, but also the surrounding muscles. Exercises to increase strength, coordination and stabilization can be carried out with a variety of small devices. The exercises can be aimed specifically at later movement sequences.