Richie Sadlier: Managers and medical staff have never seen eye to eye - I saw this first-hand wit Roy Keane
They are guided by different priorities and will be forever locked in a clash of cultures
On the day before my return to the first team following a second hip operation in 2003, I was called to the manager's office along with the physio.
We were due to play table-toppers Portsmouth at home and there was a dispute as to how much of the game I would be able to play.
Because of the length of my lay-off and the seriousness of the injury, the physio felt I should be kept for the last half-hour. Given the importance of the game and the strength of the opposition, the manager wanted me in the team from the start. I was just relieved to be so close to playing again, but both were claiming to be acting in my best interests.
Much of the commentary on Jose Mourinho's behaviour in the past week has spoken about the importance of player welfare. If a player needs treatment, he should receive it. If a doctor has a concern, it should be heard.
The wider context of a result shouldn't be considered when dealing with an injury, and the health of a player should never be compromised in any way. It's hard to argue against any of that, but in professional football it can be just as difficult to apply it in practice.
The guidelines for players are clearly explained on posters hanging on medical room walls. If you have an injury or illness, you report it. I assume the ethical principles that physios are trained to abide by are equally straightforward.
The welfare of the individual is paramount, but I'm sure most footballers have experience of the "tell him he's Pele and send him back on" approach to injury management. That was former Partick Thistle manager John Lambie's often-quoted response when he was told one of his players, Colin McGrashan, didn't know who he was after suffering concussion during a game.
The result is what matters most.
Managers fall out with doctors and physios all the time. Jose Mourinho's row with Eva Carneiro and Jon Fearn is just one recent example. One of my more bizarre memories of this was when I was getting treatment in 2006 at Sunderland after my third hip operation.
Manager Roy Keane was furious with a physio when he walked past the medical room and heard laughter coming from inside. We didn't get the explanation first hand, but our ability to laugh in each other's company apparently showed we either weren't injured enough or working hard enough.
Rather amusingly, the physio's thoughts on the importance of morale didn't go down well.
The culture of playing through pain is well established in English football, which is why managers and medical departments are so often at odds with one another. It's sometimes seen as a sign of weakness or a lack of character if you regularly miss games because you are sore. It is still the norm to hear players speak about managers ignoring them if they are unavailable for selection.
In my day, players who dropped out of training to see the physio would often be mocked by staff for not fancying the work. There's a hierarchy within every squad and injured players are generally at the bottom. And that was the case long before Mourinho arrived in England.
Carneiro and Fearn won't be on the bench for Chelsea this afternoon. The specific reasons for this have not been explained by the club. Their replacements, whoever they turn out to be, will have to contend with the same pressures as most medical personnel working in professional football today.
The players on both teams will have to deal with the same issue too. Whatever their personal values on injury management or even fair play, their job is to do their bit to help get a result. Everyone on the outside can debate the merits of everything else.
It's hard to make any argument in defence of Mourinho on this one. So what if he's annoyed Chelsea dropped points at home on the opening day of the season, or if he's angered by Carneiro's post on social media thanking people for their support?
It seems irrational in the extreme to respond as he did, but don't think he's the only manager who might have different priorities to his medical team. In a job where you're often judged by your ability to tolerate pain, even players themselves disregard intervention from physios and doctors.
In the end, the decision was taken not to play me from the start against Portsmouth, and I came on in the second half as planned. We were 4-0 down by half-time and ended up losing the game 5-0, but I was able to train fully on the Monday because I wasn't in any pain. To this day I'd say both the manager and physio see this as proof they were right.
As is so often the case in professional football, though, they were coming from two different worlds.
Sunday Indo Sport