Medicals That Can Save Lives. Almunia, Foe, Muamba and More

A Football Blog. @All_Blue_Daze looks into the power of the medical and how a stumbling block to furthering some players careers could perhaps have saved their life.


When the transfer window is open, we’ve all took the opportunity to peer through it and seen a multi-million pound superstar footballer lying on an hospital bed hooked-up to all kinds of electronic gadgetry monitoring everything from pulse rate to brain waves and all points in between. It’s the pre-transfer medical. Smile on the face and thumbs up signal all is fine and dandy. Tomorrow morning the news is confirmed that your club has a new star player and the season ahead looks there for the taking. Sadly however, sometimes it doesn’t work out quite like that.

Even with an athlete supposedly in peak physical condition, a medical can reveal some kind of deep-rooted injury, or even worse an illness that would make any signing perilous at best, a disaster at worst. The medical is failed. Doctor, rather than computer, says no. The deal is off. Months of work and intricate negotiation are suddenly deposited in the nearest bin. There’s no arguing however. Doctor knows best.

News recently broke that the former Arsenal and Watford goalkeeper Manuel Almunia had failed a medical and his proposed move to Cagliari had collapsed. The 37 year-old, once touted as a possible England international – he had never been selected for his native Spain – had enjoyed a fairly chequered career. After touting around a number of clubs in La Liga, he was snapped up by Arsene Wenger for a move to north London as understudy to Jens Lehmann.

Although his time with the Gunners as number one was probably fleeting, he still managed over a century of appearances for the club, before a brief spell at West Ham, and then a further 76 games in a couple of seasons at Watford. The point being of course that in his moves between seven or eight clubs, medicals were taken and passed at each turn. All of that cut no mustard when tests first undertaken in Sardinia and then confirmed in Padua showed that Almunia was suffering from Hypertrophic Cardiomyopathy, a heart condition that can cause Sudden Cardiac Death. The deal was off. Given the player’s history, with a series of clean bills of health behind him, was there a temptation to push on regardless? Obviously not. Clearly sometimes doctors get it wrong, but all they can do is make recommendations on the evidence they see. The rest is up to the club – and the player.

It’s not a new situation. Older readers will remember back to the 1970’s when a young midfielder player named Asa Hartford was destined for a big money move to Leeds United. The Yorkshire club were, at the time, one of the country’s top teams, and a move to Elland Road was almost a guarantee of success, medals and glory. When the medical was undertaken however, it revealed that the player had a ‘hole in the heart’ condition. By modern standards, the fee involved was minimal, but at the time it represented a major investment. Without approval by the medical staff, obtaining insurance was virtually impossible. The deal collapsed. Hartford however went on to play many more years afterwards and represented Scotland on numerous occasions.

A fellow countryman of Hartford’s, the centre-back Colin Hendry suffered a similar fate when a proposed transfer from Glasgow Rangers to Derby County fell through after the medical revealed a knee problem. The clubs had agreed a £1.5million fee but Derby, armed with the medical evidence, pulled the plug. Hendry eventually signed a two-and-a-half year deal with Derby’s midland neighbours Coventry City and went on to complete a full career, apparently without trouble.

Welsh striker John Hartson was primed for a move from Wimbledon to Spurs. The north London club were keen to secure the muscular hit man to lead their line. The fee involved was a reported £7million, so this was no minor transaction. Terms were agreed, and the Welshman undertook the obligatory medical. The test revealed however that problems related to a knee operation completed some months earlier had caused damage to the joint. Spurs released a statement confirming that: “John Hartson has had a thorough medical and as a result we have reluctantly decided not to proceed.” Hartson played on, and later in life survived a battle with cancer.

Demba Ba, now plying his trade in Turkey following stints with West Ham United, Newcastle United and Chelsea has also fallen foul of the medical. Moves have been questioned due to doubts about a knee condition. One transfer actually went through at a reduced fee as the risk was taken into account. Suffice to say however that goals are still littered along the trail Ba continues to follow.

It is of course easy to pick out the occasions where the medical seems to have dealt the player a poor hand; a move to fame and fortune, sabotaged by an over-cautious medical opinion. That, however, has to be an entirely partial view. There are also celebrated cases when a cautious appraisal of the medical has proved to be precisely ‘what the doctor ordered.’

One of the more famous of these, concerned the potential signing of Ruud Van Nistelrooy. The Dutch striker was seen to be the ideal piece to complete Sir Alex Ferguson’s latest Manchester United title-winning jigsaw puzzle. Fees were agreed and the deal was all but done and dusted ahead of the medical. A knee ligament issue appeared at the test however, and United were counselled to wait until the player had proved he was over the injury.  They took the advice on board and postponed the deal. Soon afterwards, van Nistlerooy broke down with a recurrence of the injury. Medical opinion had saved United a chunk of money, and the deal went through a while later when the player was cleared.

Sometimes of course, there’s a suspicion that a failed medical may even be a cover for something that doesn’t quite fit in a transfer move. Loic Remy was apparently destined for a move to Anfield a few weeks ago, until the Anfield club pulled the plug, citing a failed medical as the reason. QPR boss Harry Redknapp, said it was a barely believable situation given the Remy had passed a number of medicals in England over the past couple of years. Nevertheless, Remy returned to action with the Loftus Road club and is still playing now. Was there another reason behind the failed deal? Perhaps all will become clear in time. Perhaps not. At the moment though, no-one can question the medical.

Back to where we began. Almunia’s failed medical was enough not only to cause any proposed deal to fall through, but also sufficient to persuade the player to retire in order to avoid his condition becoming fatal. It’s pretty obvious therefore how serious the advice was taken. There have been salutary lessons before.

Some years ago, Manchester United were in the market to buy a midfield player. The deal was struck at £5.5million for the move from French club, Lens. The medical revealed however that the player had not recovered sufficiently from a broken leg. Old Trafford chairman at the time, Martin Edwards, declared that the player must prove his fitness before any deal could be done. West Ham United then moved in and picked the player up at a reduced fee of £4.4million. The failed medical had chopped over £1million from the player’s value.

The Hammers’ new acquisition played almost 40 games in London’s East End, until a deal took him back to France and Lyon. After a single season though, he returned to the Premier League for a loan period with Manchester City. No other problems showed up in subsequent medicals. The player was Mark Vivien Foe. He was never diagnosed as having the same condition that befell Almunia and the Cameroon international paid for that with his life when he collapsed and died during a Confederations Cup match in France in June 2003.

Sadly, he’s not the only such case. Hungarian striker Miklos Feher collapsed and died during a game playing for Benfica. He had passed a number of medicals in his career, the latest with the Portuguese clubs a matter of less than two years before his death. Phil O’Donnell had also been passed a number of medicals before he tragically collapsed and died on the pitch.

Whatever caused the deaths of these players had not shown up on the medicals they had undergone. As a result of these and other tragic occurrences including the near fatal experience of Fabrice Muamba, clubs now specifically screen for such conditions. This is why medicals today involve the intricate measures and tests at hi-tech medical centres. Risks are minimized to the benefit of all parties involved. It’s a measure of how far the medical side of the sport has improved. It may well be that such advances have saved the life of Manuel Almunia.


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