A spate of high-profile heart problems and collapses among professional footballers in recent weeks are likely to be coincidence, rather than an indication players are struggling to cope with the high-intensity game, according to a leading cardiologist.
Football has been rocked when three players were hospitalised this week after falling ill during training sessions or matches.
Wigan striker Charlie Wyke, 28, collapsed in training, Sheffield United’s John Fleck, 30, collapsed on the pitch at Reading and Adama Traore 25, went down clutching his chest while playing in the Champions League for Sheriff Tiraspol against Real Madrid.
Sheffield United midfielder John Fleck was taken to hospital after collapsing on the pitch
While the cause of those collapses are being investigated, Barcelona striker Sergio Aguero, 33, was diagnosed with cardiac arrhythmia having been forced off with chest pains in a 1-1 draw against Alaves last month and Icelandic midfielder Emil Palsson, 28, required resuscitation after a cardiac arrest in October.
The incidents have renewed concern over the welfare of footballers coming hard on the heels of the harrowing collapse of Denmark midfielder Christian Eriksen, 29, who suffered a heart attack at Euro 2020.
Professor Guido Pieles, who leads the Sports Cardiology Clinic at the Institute of Sport, Exercise and Health, said there was no evidence that heart problems were occurring in footballers more frequently and he believes any cluster of incidents is a ‘coincidence’.
Adama Traore of Sheriff Tiraspol went down clutching his chest in the Champions League
Denmark midfielder Christian Eriksen suffered a cardiac arrest against Finland at Euro 2020
‘At present I would say this is still a coincidence,’ Professor Pieles told Sportsmail.
‘I don’t think we can say this is suddenly increasing, I don’t think it is increasing particularly in football.
‘Footballers are certainly not the athletes that have the highest volume and intensity of training. Endurance runners, Tour de France cyclists, and rowers they train much longer hours.
‘It cannot be said that in the last year or two years they train more but over the last 10 years that is true.
‘The game has got faster but also people are fitter. If you play football in the Premier League, you have done this since seven or eight years old.’
The Barcelona striker Sergio Aguero was taken ill on the pitch and treated by medical staff
However, the expert suggests footballers, and elite athletes, should undergo cardiac screening more regularly throughout their career to give them the best possible protection.
‘The evidence says players aged 15 or16 should be screened because the highest incidence of sudden cardiac arrest is 16-18,’ the cardiologist, who advises the FA, told Sportsmail.
‘But I do believe we need to do it more often. Players in their twenties need to be screened.
‘Diseases can occur within the 20 years of a player’s career. There should be intermittent screening.’
Sudden cardiac arrest can occur where a player has an underlying heart condition and while most problems are picked up through screening, a small percentage may go undetected.
Wigan forward Charlie Wyke (pictured against Solihull Moors on November 16) is in hospital after he collapsed in training. The club have confirmed he is now in a stable condition
In addition, an inflammation of the heart, called myocarditis, may occur after a viral illness making a person more susceptible to heart problems, even a cardiac arrest, during exercise.
Prof Pieles said the FA’s cardiac screening programme is one of the most developed in football and it is effective.
‘Compared to other associations the FA has a fantastic screening programme. We are quite advanced. It is a rigorous programme for the first four leagues.
‘This is as good as it gets in professional football.
‘Screening is mandated by the FA and it the responsibility of the clubs to do it. Experts review the scans. It is mandatory at 15 or 16 and recommended for older ages.’
Barcelona striker Sergio Aguero has been diagnosed with a heart problems at the age of 33
Players at many top clubs are screened annually using an electrocardiogram to monitor the cardiac rhythm and electrical activity, and they undergo an ultrasound scan to examine the heart. But this is not necessarily the case further down the leagues.
Prof Pieles, who also works with some of Europe’s leading clubs, including Manchester United, added: ‘The recommendation is that players should be screened more frequently but we have not set an age when this should happen.’
Research undertaken by Prof Pieles and other cardiologists, who work with the FA, has found that since English football’s screening programme began in 1996, six players died as a result of sudden cardiac arrest.
All of these players had been screened at 15 or 16 years of age, but they died around seven years later.
‘If a player is screened at 16, we cannot give an assurance that when he is 29 everything is still normal,’ said the expert. ‘Some diseases come up in the late 20s or 30s that is why we recommend also longitudinal screening.
Eriksen’s teammates formed a human shield around him as he was being treated on the pitch
‘This is a little bit dependent on clubs. All clubs make all efforts they can to do this, but it does vary. I think more education can be done to make screening more efficient and more frequent.’
In particular, the cardiologist believes support needs to be given to clubs below the highest level to ensure players are screened throughout their careers.
‘These tests are not expensive, but it is the practicalities of it for clubs in the lower leagues,’ said Prof Pieles.
‘It is more challenging. We need to work together with clubs and coaches and have strategies to make this better and make it more accessible’
Manchester City midfielder Marc-Vivien Foe died while playing for Cameroon in 2003
‘Governing bodies need to work together to see how this strategy can be implemented,’ he added. ‘I can see it is different for a fourth-tier club to implement cardiac screening. They have less staff, the set up and strategy have to be embedded.’
It will be 10 years next March since Fabrice Muamba’s career was ended after he suffered a cardiac arrest on the pitch while playing for Bolton at Tottenham but the 33-year-old said recent instances proved how much more there was to be done.
Muamba said: ‘There’s a complacency about it. We have a high profile incident, talk a lot about it and think we have solved it but that’s not the case.
”We are supposed to be the fittest of the fittest. If it can happen to them it can happen to anybody else.’
Wigan are yet to confirm what caused their player to collapse. The former Sunderland forward collapsed during a session as the League One team prepared to face Cambridge United, who they drew 2-2 with on Tuesday night.
In a statement Wigan confirmed medical staff immediately attended to Wyke after he collapsed and he has since been transferred to hospital where he remains in a stable condition.
Sheffield United’s player, Fleck, was released from hospital on Wednesday morning and headed back to Sheffield, where he will be monitored by the club after speaking clearly to medics and his family.
Fabrice Muamba collapsed during Bolton’s game against Spurs at White Hart Lane in 2012
In Moldova, Traore committed to a 50/50 challenge on the touchline with Real Madrid’s Nacho Fernandez and when the ball went out of play the Tiraspol player appeared distressed.
Traore turned to walk away from the ball, which had gone out for a throw-in, in the 77th minute when he immediately became uncomfortable, clutching his chest before slumping to the turf.
He remained breathing throughout but after a few seconds of lying on the ground and clearly concerned, the medics raced on to help.
He was seen shaking his head in responses to questions by the medics and was eventually raised to a sitting position before being helped off the field.
Former Newcastle midfielder Cheick Tiote died in 2017 after suffering a cardiac arrest in training while playing for Chinese outfit Beijing Enterprises Club
Players suffering cardiac arrest is not a new problem. Former West Ham and Manchester City midfielder, Marc-Vivien Foe, died at 28 while playing for Cameroon in 2003 and ex-Newcastle United midfielder Cheick Tiote collapsed and died aged 30, while training with the Beijing Enterprises Group in 2017.
And it is not only elite players, who are affected. In September, 17-year-old Dylan Rich, a popular and talented left-winger for West Bridgford Colts, died after a suspected cardiac arrest during an FA Youth Cup game in Nottinghamshire.
Bolton Wanderers’ Fabrice Muamba in 2012 and Porto goalkeeper Iker Casillas in 2019 are among those to have had lucky escapes.