When I applied for a doctorate, the coach of the under-19 football national team called me. He wanted me to join them as a physiotherapist. However, the date of the association matches coincided exactly with the entrance exams. I flipped a coin, and as it flew, I told myself that I was more drawn to the doctorate," says Andrej Matonok, a physiotherapist at Spartak Trnava and currently a full-time doctoral student at the Faculty of Health Sciences at UCM, who worked as a physiotherapist at FK Pohronie since 2017.

You became a sports physiotherapist during your studies at the Faculty of Health Sciences at UCM. You spent five years at FK Pohronie Žiar nad Hronom Dolná Ždaňa. How did you manage this at such a young age?

I played football in this club until my teenage years. However, I wasn't such a talent to make a living from it. Although I didn't know much about physiotherapy at that time, the club knew I was studying it, approached me, and I gave it a try. At first, I was more of a masseur, but as the years went by, I supplemented my education, and eventually, I got a full-time job as a physiotherapist at the club.

You also experienced a period with the club during which it first advanced to the highest Slovak football competition. Were higher demands placed on you in this regard?

Definitely. New players gradually started coming to the club, who had interesting football destinations in their CVs. With their greater experience, higher expectations also came. It was a motivational factor for me; I had to keep up with a faster pace.

"I don't even call what I do work; it's more like a paid hobby."

I assume that in most cases, someone becomes a physiotherapist in a professional football club who not only has the necessary education but, as in your case, also harbors a love for this sport. What does football mean to you?
I would describe it as my everyday life. I'm at the stadium from eight to three, and when I come home, I prepare training and rehabilitation plans. Of course, I also watch football in my free time on TV—sometimes two or three broadcasts at once. It's been my favorite since childhood. Even before my involvement in football clubs, I used to go to matches of the highest competition as a fan, as well as European ones. Simply put, I don't even call what I do work. It's more like a paid hobby. The feeling that in the morning I'm not going to work but doing what I really enjoy, I would wish for everyone to experience.

 
Let's move to the present. Since October last year, you've been a sports physiotherapist at Spartak Trnava. What does your work entail?

I take care of the players from the moment they arrive at the stadium. Every morning before training, we assess their current health status and provide information to the coaching staff. We check if they have any bruises from previous training sessions or matches or any other untreated issues. My colleagues then take the players to training, while I usually stay back to rehabilitate injured players on the pitch or in the gym.

A significant part of your work revolves around caring for injured players?

Yes, I utilize elements of sports medicine, physiotherapy, and strength training. I also focus on re-athletization, rehabilitation, and reconditioning after injuries so that players can fully engage in the training process again and later in full match load. The whole group of people enters the process at the stadium, and my work is based on interdisciplinary relationships. I exchange information about the players' condition with colleagues from the medical team, fitness coach, assistants, and, of course, the head coach. When I leave the stadium, my work doesn't end, of course. Based on the current condition of the players, I plan training sessions, rehabilitation, and consult with the fitness coach on the results from the GPS system we use in player preparation.

Do you only focus on the first team players or also lower categories?

Currently, only on the first team players. However, alongside my work at Spartak, I also oversee physiotherapy for the extraleague volleyball players of HIT UCM Trnava.

"I always argue that elite sports of adults are not about health but performance."

What facilities does Spartak Trnava provide in terms of physiotherapy?

Regarding equipment, I believe we are among the top three teams in the Fortuna League in Slovak standards. We have ultrasound, cryotherapy, TECAR therapy, the guys have saunas, whirlpools, or devices for measuring jump height, dynamic strength. In short, everything a professional club should have.
 
As a layperson, I have the notion that elite athletes are strictly obedient professionals who follow coaches' or physiotherapists' recommendations to the letter. Is that the case, or do you have to approach each player individually and incorporate elements of psychology into the process?

Perhaps it's a common perception, but in general, not every player is a hundred percent professional. In many cases, it depends, for example, on culture. Young players may have a different work discipline than older ones. Some are introverts, others are extroverts. A football team consists of many different personalities from various cultural or religious backgrounds. Therefore, it's necessary to individualize the approach to them and try to build positive interpersonal relationships in the locker room. Psychology certainly plays a role in this. For example, players from Muslim culture observe Ramadan, a very strict fasting period that significantly affects their eating habits. We can provide them with recommendations, but they may not adhere to them. We can't force them into something that doesn't come naturally to them.

Various factors come into play in elite sports. Interests of players, coaches, owners, or shareholders. Can you resist if someone pressures you to put a player back into the game pace after an injury, which, from your perspective, they're not ready for?

One thing is what textbooks and manuals tell us, and another is the actual reality. I always argue that elite sports for adults are not about health but performance. However, it's essential to realize that players are aware of this aspect. They've chosen this lifestyle and are aware of the risks it entails. Therefore, we don't try to treat athletes at this level in terms of seeking the causes of health problems because we simply don't have time for it. On the contrary, we do everything to ensure that the athlete is a hundred percent ready "just for the next week."

In essence, you only address those health complications that are most acute and "burning."

Exactly. Of course, if I'm not convinced that a player can handle full match load, I'll point it out and inform the coaching staff about possible risks. There must be trust built between us in my professional abilities. Although, fortunately, it has never backfired on me, in the beginning, I often succumbed to pressure from coaches. I didn't have enough knowledge and experience. However, the final decision always lies with the head coach in any case.

What have you changed in this regard compared to the past?

Over the years of experience and continuous education, my knowledge has deepened. I can better assess many other risks, look at the situation from a much wider perspective, and at the same time, argue my position to the coaching staff more effectively from a professional point of view.
 
 
Physiotherapist Jan Brázda stated in an interview for Denník N that incorrect exercise techniques are not only a problem for recreational athletes but also very often for professionals. He mentioned that training with one's own body is a significant issue. Do you encounter this as well?

Yes, it happens to me that after an injury, I take care of players who don't perform certain strength exercises correctly during rehabilitation. Subsequently, we find out that they've been performing them incorrectly throughout their entire careers. Together with the fitness coach, we emphasize the correct technique and try to explain it to them. However, it's relatively challenging to unlearn something for more experienced players in this regard since they have ingrained certain motor movement patterns. To learn something new, it's necessary to perform approximately 300-500 repetitions, whereas to change an ingrained movement stereotype, you need to perform approximately 2000 repetitions of the new pattern.

However, in general, every professional athlete has their own habits because the biomechanics of movement are individual for each person. If I line up ten footballers next to each other, each of them will run differently. I attended a conference where the physiotherapist of the triple Czech Olympic speed skating champion Martina Sáblíková also participated. He mentioned that they tried to correct her movement and body asymmetries, which, however, reduced her performance. Therefore, it's true that if a player is not frequently injured and doesn't have health problems, trying to unlearn something at all costs may not have a good effect.

Let's go back to your education. After obtaining your Ph.D. title, you decided to continue with full-time doctoral studies at FZV UCM. Why?

In my free time, I constantly strive to educate myself in the latest research and read specialized scientific portals. I enjoy it, no one has to force me, so I thought I could combine it with further studies. When I applied for the doctorate, the coach of the under-19 national football team called me. He wanted me to join them as a physiotherapist. However, the date of the association matches coincided exactly with the entrance exams.

So you had to decide between the national team and the study.

Yes, I flipped a coin, and as it flew, I said to myself that I'm more drawn to the doctoral studies. The opportunity to work for the national team may still come, but if I took a year or two off from my studies, I don't know if I could return to it.

Does the study at FZV provide you with enough space for specialization in sports physiotherapy, or do you have to continually educate yourself externally, for example, through additional courses?

In Slovakia, there is currently no separate study program focused on sports physiotherapy. Therefore, I have to continue my education externally in this area. I conduct most of the research for my dissertation independently. I love going to conferences, and for a year and a half, I've been publishing articles in the Czech sports magazine Level Up, where I already have 17 articles focusing on various sports injuries. If I put it all together, maybe it could already make a book (laughs).

How do you manage to combine the work of a physiotherapist for a first-league club with doctoral studies?

It's demanding; I also spend weekends working. During busy periods like autumn, which involved traveling within the European conference league to places like Turkey or Denmark, sometimes I don't have a free day for three weeks. Since, in addition to research, I also have to perform teaching duties at the faculty, I must thank Spartak for accommodating me.

When I recently interviewed your colleague from the faculty, physiotherapist Ondrej Machovič, he told me that many people call him a better masseur because they still don't have an idea of everything physiotherapy entails. Does this happen to you as well?

While I worked in the private sector, some patients called me "Mr. Doctor" on the contrary. In a sports club, you need to put your ego aside. Nobody really cares what "alphabet soup" you have before or after your name if you don't perform your job reliably. In my work, massages are also included; if it's necessary to unload bags from the bus, I do it. Everyone has to strive to work for the team so that the players have the greatest comfort possible.
"Much higher demands are placed on present-day football compared to the past."

What is the fundamental difference between a "regular" physiotherapist for the general population and a sports physiotherapist for a professional football club?

For a recreational athlete, you may have an hour in the clinic, and then you won't see them for another two weeks, if at all. You don't know what they're doing and to what extent they're following your instructions for the remaining 23 hours of the day. Progress is difficult to measure in this case. Moreover, it doesn't bother you if things don't go as quickly as they could.

I spend seven hours a day with professional players at the club, and we communicate online in the evening. Therefore, the approach is incomparably more individualized and intensive, and time pressure is extreme to prepare them for match rhythm as soon as possible. Sometimes it's literally miracles, but people from the outside don't see it. Much higher demands are placed on present-day football compared to the past.
 
 
It's a rather paradoxical situation. On one hand, we are raising generations of children who struggle with physical activity, while on the other hand, we expect much better performances from a narrow group of professional athletes compared to their predecessors.

When it comes to footballers, this also concerns the number of matches. Of course, this is closely related to funding and television rights. At Spartak, due to the UEFA Europa League qualifiers and cup league matches, we played as many matches in the autumn as some Nike League teams do in an entire season.

In an interview for the Slovak Chamber of Physiotherapists website, you mentioned that the tragedy of today's era is that people often judge expertise by the number of likes on social media. How can one distinguish a good physiotherapist?

That's very difficult. The average person doesn't have enough knowledge to determine if the therapy chosen by the physiotherapist is adequate for their health condition. The body is a great self-regenerating mechanism. Tissues can heal on their own, and unless we significantly interfere with the process, they can do so without our help. However, it takes time. For me, a warning sign is the complexity of individual exercises. They may look good on social media, but the more complicated they are, the less effective they tend to be. People should stick to movement patterns that are natural for the body.

A minimum requirement should be education in the field, although even a university degree is not necessarily a guarantee of quality. What matters is how one continues to educate themselves, what specialization they have, and what additional courses they have completed. After all, physiotherapists work with people's health, which can be permanently damaged in case of a significant mistake.

Foto: Sofiia Yurasova/archív A.M.