School of Radiology Alumni Spotlight: FIFA’s Medical Director, Dr Andy Massey

Former AECC University College student, Dr Andy Massey has had an exciting career in Sports Medicine. Over the years, he has worked with a number of top sports teams, including his recent role as Head of Medicine at Liverpool Football Club, working alongside Managers Brendan Rogers and Jürgen Klopp.

Andy is now the Medical Director for FIFA and is tasked with the important challenge of ensuring the health of players is at the core of football globally.

In this article, he discusses his role at Liverpool FC, what his new job with FIFA has in store for him and how studying on our MSc Medical Ultrasound course helped him further his career and stay on top of his game.

Starting out

“I was a very average professional footballer in Northern Ireland, and I guess I have a similar story to many, I got an injury and was told it would take about 12 months in rehabilitation. At that stage I thought, surely nothing takes 12 months to recover from. I didn’t have a broken bone, I didn’t rupture my anterior cruciate ligament, I really questioned what I was being told by the doctors and thought I’d go and research this myself. I liked reading about rehabilitation principles and that led me into studying Physio - I undertook a four-year degree in Northern Ireland. And, when I got through, I realised that the injury I had would take about 12 months to heal, so perhaps I should have just waited the year to find out!

“Following a physio elective in Australia, I decided to commence my Sports Physio Masters out there. At that stage I felt Australia was leading the way in sports medicine and learned so much from the many great practitioners out there, both medical and physio. Working with the Sports Doctors, I got a real buzz from the medical side of things and decided I would like to retrain in Medicine, so applied to universities in the UK as a post-grad. Whilst studying Medicine I was still able to maintain my part-time work in Physio at the same time and that got me into working with sports teams. The first team I worked with was an Ice Hockey team in Northern Ireland – one of the biggest attended teams in Northern Ireland and I loved that. I finished my degree in medicine and started a Sports Medicine Masters – during this time I fell into a job with the national Football team and then on to Liverpool.”

Liverpool Football Club

“I’d been working at The Irish Football Association and saw an advert for the job as a full time Academy Doctor at Liverpool FC, this was back in 2012. It was quite rare to have a full time position within an academy, so I expected there would be a million and one applicants for this, so did not seriously consider applying. However, I was encouraged to apply for it by a recruitment firm and, thankfully, got the job. It was a brilliant job. You had the independence to work in professional football with some really good physios at the Academy and it was a really great atmosphere.

“We had top level footballers without egos and it was a job where I could do exactly what I loved doing, working on the rehab programmes and working day to day with players. One thing led to another and the Club needed a Head of Medicine, so I went from working with a small group of physios to heading up the whole medical team, including the whole physiotherapy department and the sports science department. Brendan Rogers was the Manager and I had about ten months with him before Jürgen Klopp came in and, of course, we had to work with him to adapt and embrace different philosophies.

“While working with Liverpool I had the opportunity to create an instant replay system by the side of the pitch. I was used to sitting on the sidelines, but everyone who watches football at home sees four or five replays of every injury, in super slow motion and you actually pick-up so much from it. But when you’re on the sidelines it’s very difficult as you only get one chance to see something. And if you’ve got linesmen, a manager and substitutes walking up and down the pitch, it obscures your vision – I never wanted to be the doctor that missed something that 80 million people around the world picked up on so easily.

“I find so much from seeing the mechanism of an injury alongside assessing a player, so we decided that we would find some way to bring replays onto the pitch. It was difficult as the Premier League weren’t too keen on having tackles replayed, so we had to explain that this was purely for medical purposes. Liverpool were actually sanctioned by UEFA in our Europa League Final for the same reason. We also tried smart glasses where you could see what had happened while running on to the pitch, but it didn’t quite work, the technology was/is just not there to support this.

“We eventually got buy-in from the Premier League and now pretty much every club in the Premier League is doing the same. The best thing is having someone you really trust pitch-side to review the footage so you can get to the player straight away and you have a trust-worthy set of eyes who can relay the mechanism of the injury to you. It’s all about improving the welfare of the player. Although, I still haven’t thrown away the idea of smart glasses – but I need someone to help with the technology!”

Medical Director for FIFA

“My current role is essentially to advise FIFA on the medical aspects of football. The role can be split into two parts. The first concerns itself with FIFA tournaments, of which we have nine, ranging from the men’s World Cup and women’s World Cup to football at the Olympics and beach soccer. So, we’ve got lots of tournaments that we need to prepare for medically and that involves putting people in positions such as pitch-side Medical Officers, looking at anti-doping, and looking at the medical regulations for each of the tournaments.

“The other part of the role, which I really enjoy getting my teeth into, is how we ensure that the health and safety of footballers is paramount throughout the world. This is all about how we integrate sports medicine into football and how we increase inclusion, across all genders and races. This has a public health responsibility. There’s a lot of policy writing and a lot of policies in connection with other organisations, such as the World Health Organisation where we try and say that we can make football safe and try and increase the numbers of people that are playing, addressing the obesity crisis that the world is seeing. A lot of the role is about ensuring sports medicine is at the core of what FIFA is doing.

“We have three hot topics that we’ve been working on since I’ve been in this new role that are ultra-important and issues in the public domain that we have to address. Sudden Cardiac Death is still a massive issue and it’s one of those subjects in medicine that we don’t have all the answers for, so a lot of that is about implementing screening protocols, educating people and minimising the risk as much as possible, as well as how can we support those who cardiac conditions to still play football.

“We’re involved in the biggest register in the world of Sudden Cardiac Death in football and fund various research projects looking at the cardiac health of footballers. Another issue we face is concussion in football – it still hasn’t been addressed properly in football, we still lack a lot of education and awareness around that. So, we’re redeveloping our education activities to put Sudden Cardiac Death and head injuries at the core of those programmes which will be disseminated out to all the different federations and associations.

“The third point that we really want to tackle is mental health issues, both those playing football and those who are in professional roles where they no longer play football and are, perhaps, finding it hard to transition. We’re working on a really exciting project along with the Players’ Union with FIFA which hopefully we can get kicked off later this year that will help support all ex footballers throughout the world.”

Career successes

“It’s not the performances of the players that I consider a huge highlight of my career. Liverpool winning the league was entirely down to the team. Although, it is great seeing the coaches animated on the side-lines, it gives everybody a lift and there’s nothing better than when Liverpool score and you get coaches jumping up and down or Jürgen running onto the pitch. It makes a brilliant spectacle, but for me, just having the opportunity to work with organisiations such as the Irish Football association, Liverpool and FIFA are my career highlights. It’s important to work hard and gain the expertise, as well as the respect of those that put you in the position because you’ve earned your right to be in it. I look back at the work we did pioneering the pitch side injury replay system and now see it has been implemented through all aspects of football, so perhaps I have done something right (although just a very small cog in a very big football medicine wheel).

“My desire to improve has also come through continuing to learn. I’m a stickler for education and I really buy-in to continuous professional development. I started studying as a Physio in ’97 and since then there has been no stage where I haven’t been doing a graduate or postgraduate course. The Masters at AECC University College in Medical Ultrasound is a career highlight that sits alongside some of my other qualifications, and, without doubt, has been one of the most useful and enjoyable courses I have ever undertaken.”

Studying Ultrasound at AECC University College

“I initially tried a few short ultrasound courses at AECC University College and always came away learning so much more than I knew when I went in, but I would quickly forget because I wasn’t confident enough to use ultrasound on a regular basis to make decisions. Working in professional sport you need to adapt to the technology of the day. I find there are many doctors who are happy to make a decision on an MRI scan and I get that, but I felt that Ultrasound was the perfect modality to assess a patient. It either confirms your initial thoughts from examination or gives you other ideas and you can have another go at assessment until the two add up. I’ve found that ultrasound is great for research purposes too. There are so many questions that we don’t yet have answers to and every so often working with players at Liverpool, we would have an idea and think, let’s look at that a little closer. Ultrasound lends itself to that so well because it’s such a quick and easy modality to use. The avenue for research is huge.

“I studied on the postgraduate course at AECC and felt I got a really personalised and tailored experience – I got out of it exactly what I needed for my role. There was, of course, a solid structure to the course, which was perfectly suited to working in sport.

“AECC University College is the best educational course that I’ve done because it has had the biggest impact on my professional practice, I enjoyed it and I’m certainly a little bit cleverer than when I started!”

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