Of the 23 footballers fulfilling our inclusion criteria, eight participants gave their written informed consent to participate in the feasibility study and to undergo the ACC. The mean age, height and weight of the participants were 34 years (SD=1), 185 cm (SD=5) and 82 kg (SD=7), respectively. On average, participants had competed in professional football for 13 years (SD=4) and had suffered from four time-loss (14 days or more) injuries during their career. One participant had suffered from one concussion, one from two concussions and one from eight concussions (recovery within 2 weeks for all of them). Only one participant had been forced to retire from football. All but one were employed at the time of the study. The ACC revealed the following medical conditions:
With regard to the following, advices were given: (adapted) physical exercise and training (n=3); referral for further examination (n=2); altered nutrition (n=2); use or adapt insoles (n=2); and referral for manipulative medicine (n=1).
The outcomes of the electronic questionnaire revealed that all participants were highly positive with regard to the feasibility of the ACC. All five main domains of the ACC were assessed as relevant or highly relevant. The ACC as a whole received a positive appraisal, with high degree of relevancy and added value reported by the participants. These findings were confirmed by the players’ narratives, mentioning that ‘All five main domains of the ACC are of added value, especially education and employment’ and that ‘leaflets including relevant information could be of added value for most players and should be given in the early years of a football career.’ With regard to the future implementation of the ACC, participants mentioned that players’ unions were the key actors for the support of retired professional footballers but emphasised also that the collaboration of these players’ unions with the national football associations would be essential in order to implement sustainably the ACC. Concerning the potential role of the clubs, participants stated that ‘clubs were focusing on the short term and consequently were not likely to invest in the long-term well-being of players.’ A summary of an interview held with a retired professional footballer is presented in Box 3.
Box 3View of a retired professional footballer on the After Career Consultation
Being 33 years old at the time of the After Career Consultation (ACC), this retired professional footballer had played around 250 official professional football matches over 15 seasons. During his career, he suffered from several severe musculoskeletal injuries: (1) rupture of the ACL in the left knee (age: 20 years) that was surgically treated; (2) rupture of the ACL in the right knee (age: 23 years) that was surgically treated; and (3) deep vein thrombosis in the left leg. This player mentioned that after these severe injuries, he never regained his initial level of play and thus never reached his full potential. After the 2015–2016 season, he retired voluntarily from professional football and he is now employed as a youth football trainer. At the time of the ACC, he did not experience any mental health problems but he was still experiencing some thrombosis-related pain in his leg (no impairments during daily life, sport or work activities).
Interviewer: Did you, during or after your career, receive any information from your club or union about the transitioning period?
Retired player: No, I was never informed about the problems that might occur after retirement from professional football.
Interviewer: Would you have liked to receive information about the period of transition out of professional football at an early stage?
Retired player: Yes, I would have liked to receive this information a few years ago. For instance, an extensive booklet focusing on all relevant post-football aspects could be developed and distributed by players’ unions to all players. Perhaps to all players once they are 25 years old. This information and related general advice is particularly relevant for those that are forced to retire. Also, this booklet might play a positive role in the preparation of the after-football period and might stimulate players to think about their future post-football plan.
Interviewer: We developed the After Career Consultation for the needs of professional footballers. Was the After Career Consolation of added value for you?
Retired player: Yes, it was of added value for me. Perhaps not right now because I feel good generally at the present time but it has warned me about potential problems that might arise in the future.
Interviewer: Are all five domains relevant within the After Career Consolation? Do you have another domain to suggest?
Retired player: Yes, I believe that the consult covers all relevant domains, but I guess that colleagues might have other needs. This should be explored during the consultation. I guess also that some relevant information could be given to the partner of the retired professional footballer.
Interviewer: What is your view on the form of the After Career Consultation (duration, form, domains, location, collaboration…)?
Retired player: The location, duration, form and follow-up of the After Career Consultation was good. The only remark I have is that the After Career Consultation could be offered to retired players not only once but perhaps after two or three years, depending on the needs of course.
Interviewer: We want to implement the After Career Consultation in the next few years. Any ideas about how we can do that?
Retired player: A good collaboration between unions, clubs and federations would be ideal of course. The collaboration between a players’ union and a football association is essential in order to implement sustainably the After Career Consultation. It would be nice and fair if clubs were interested and supportive, but I’m not very hopeful that clubs will be.