Venkat Ananth

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A prescription for Indian cricket

Another IPL ends, and Virender Sehwag is injured, hence unavailable for national duty. Again.


Yuvraj Singh has a "lung infection" - opportunely contracted on the day the national team has to be picked.


Gautam Gambhir, we are told - the day his franchise was knocked out of the tournament - is injured.


Net net, the newly crowned world champions of one day cricket are reduced to playing their first one day bilateral series after that seminal triumph with six key members of the winning squad missing.


So what do we do? We distract ourselves - or allow the talking heads on TV to distract us - with yet another circular debate on club versus country; we "debate" patriotism; we rail against players who are "simply in this to make money".


What do we not do? We do not ask ourselves where the system is broken, and what we can do to put it right.


Take Gambhir as the test case to examine how the system currently works - or more accurately, how it does not work. We know now that the southpaw opener and captain in waiting was injured in the final game of the World Cup. We know that he was carrying two injuries, not one. We know that he had no idea of the extent and severity of these injuries; hence no data from which to make the choice of whether to play on, or get into medical rehab.


And - this is where the system, or lack thereof, comes in - we know all this because the physio of his IPL franchise told us so. And here's the clincher: his employers, the BCCI, knew all of this exactly at the same time we did, through the same medium we did - the headlines.


What's wrong with that picture?


The BCCI is supposed to be in charge of the product (and let's not even pretend that cricket is not an industry, with a product supported by marketing, sales and other functions). It's main product is the national team. And it had absolutely no idea of the health and well being of this product.


So again - what is wrong with this picture?


Simply this: the BCCI does not have a medical officer on board, to look after the wellbeing of its product. Or does it? No one knows, really. A senior BCCI official told me that the BCCI has a medical committee. However, on the BCCI's laughably inept website, this committee is not listed - even though dozens of other committees are itemized, including such bizarre confections as a 'Museum Committee.'


Dig a little deeper, and you are told that this mysterious committee is headed by Dr Anant Joshi (and includes, among its members, the peripatetic Rajiv Shukla). There is no question that Dr Joshi, a Mumbai-based orthopedic surgeon, pioneered sports medicine in India; his qualifications to fill the role are therefore not up for debate. 


The problem is, though Dr Joshi ostensibly heads the BCCI's medical committee, there is no official statement of intent to that effect. The post is honorary; there are no defined roles and responsibilities; therefore Dr Joshi has nothing to do. The players don't know that he is the go-to man, therefore they deal with injuries on their own.


In other words, even as the BCCI makes playing cricket a 365-day activity, it has no doctor on call to officially assess the players (the product) and report back on their fitness or lack thereof.


When the story of Gambhir's injury broke, BCCI secretary (and president in waiting) N Srinivasan waxed indignant about the board having been kept in the dark. No one asked him this: what was the board doing? Does the board monitor the fitness of its players on a regular basis? If not, why not? If you can't be bothered with such issues, why does it surprise you that you did not know?


So that is the problem. What is the solution?


The consultant/advisory role Dr Joshi performs currently needs to be converted into a full time position. Dr Joshi's calendar is packed, as befits one of the few orthopedic surgeons in the country, if not the world, with a specialization in Arthroscopy, sports science and fitness management. In order to ensure that the team has his specialized services, the solution is to create the post of Chief Medical Officer - a position that is almost a mandatory requirement in all sports today.


The CMO will have, under him, specialized medical professionals working full time with the team; they handle the smaller problems while Dr Joshi steps in for the big-ticket items. Also working under him/reporting in to him are the national team physio and the NCA physios.


The CMO thus is supervisory, advisory and slightly on the administrative side, and is empowered to take medical decisions (in consultation with the national team physio and the NCA physio) in the best interests of Indian cricket. And his word, in matters medical, becomes law. Thus, there cannot be a situation where a franchise, aware that a big player is injured, patches him up and plays him through a tournament, to the point where he breaks down and is unavailable for national duty.


Under such a system, cricketers undergo regular medical-checkups, upon the conclusion or the resumption of a bilateral/ICC tournament or even right before the international season begins. Essentially, this might amount to regular monitoring of the players condition, with a careful examination and progress assessment of serious/chronic and non-chronic injuries or what is termed as "Level 1" in medical parlance. He also becomes the point of contact for recommendations for further assessment and surgeries in case of a serious injury, quite similar to what the BCCI's medical committee does today.


The national team physio or even the NCA medical rehabilitation facilities, have an even more important role under this arrangement. Per the suggested hierarchy, the physio and the head physiotherapist at the National Cricket Academy report to the Chief Medical Officer and discharge their responsibilities in the same manner they are today, except that they report officially to a qualified medical doctor and not BCCI officials who I must assume are not specialists in either sports science nor medicine.


The National Cricket Academy is by-far one of the best medical and rehabilitation facilities that any cricketer, contracted or otherwise has in India, and I don't think it's relevance will ever be overshadowed by a newly-created authority. What in effect this arrangement might help in, is establishing a official communication channel between the board, the national team and it's academy, in case we're faced with the Sehwag/Gambhir situation all over again. In the case of the IPL and other such T20 tournaments, the respective medical batteries of the participating franchises must immediately report any injuries, prospective aggravation and change in conditions to the Chief Medical Officer of the BCCI, who then might be compelled to take a call on the further participation of the  contracted player in the tournament.


Likewise, the CMO will also be responsible for the establishment of the overall injury management mechanism at even the domestic level, thereby working towards a streamlined approach to tackling and managing injuries at all levels of cricket. All physiotherapists and medical batteries of the respective state associations could report to the CMO, again, with an intent of creating a database of cricketers' (as practiced in football) with their medical data. 


In England, the FA has a Chief Medical Officer who maintain official records of English-born/English-eligible players and England internationals across age groups, which by the way exceeds over 50,000 players ranging from the top division to non-league football. I wonder why the same can't be replicated in India, where we restrict the database limit to simply contracted, India A and possibly state association cricketers. This, indeed doesn’t mean there will never be injuries sustained by cricketers (both contracted and otherwise) in the future, but what it does, is gives the cricketer and the BCCI the best possible mechanism to manage these very injuries. As a former-India cricketer told me, "What's the point in getting the best experts in sports science when you don't have a conducive system for them to work in?" Unfortunately, or typically, while India may not/never opt for such an arrangement, it is a matter of fact that England, Australia, South Africa and even Bangladesh have a well-streamlined injury management mechanism in place in their respective cricket boards.


This is not to ignore the good work done by the BCCI, in the case of Irfan Pathan for example, where they went out of their way to help the all-rounder with injury diagnosis/determination to post-injury rehabilitation at the NCA, but that doesn't mean Indian cricket doesn't need a quality, professional and world class injury management mechanism. 


If Indian cricket is honest about the direction it wants to take, it'll quite clearly put the medical side of things at par with the marketing aspect of administration, which they've been great at. Equally, cricketers must now be viewed as humans, rather than machines that can be programmed to play the quantity of matches the suits in the house might want to. It's also time to evaluate our existing mechanisms and see where they're faulty, if they are in the first place, evaluate and take decisions that might eventually benefit Indian cricket, like for example - an appointment of a Chief Medical Officer. That time is now.

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