Seeking salvation on the touchline
West Brom's coach was a member of United's golden generation, but, he tells Sam Wallace, botched surgery forced him into early retirement
When his club play Birmingham City today, it will be the crucial three points at stake in the battle against relegation that will occupy the mind of Michael Appleton, West Bromwich Albion's first-team coach. But there will be a part of him that recalls it was this fixture more than nine years ago that was his last game as a professional footballer. He was 25.
Appleton is a former Manchester United player, part of the golden generation that produced Gary Neville, David Beckham, Paul Scholes and Nicky Butt. More recently, he was West Brom's caretaker manager for their game against West Ham last month, which fell between Roberto Di Matteo's departure and Roy Hodgson's arrival.
That 3-3 thriller, in which West Ham came from three goals behind in the second half, has only sharpened his hunger to be a manager one day. In the seven years since he was forced to retire from playing, he has coached at every level from U-14s to first team and has every coaching qualification including the UEFA Pro Licence and the "football manager's degree" from Warwick University.
And in the week that Ryan Giggs reached 20 years as a professional footballer, Appleton's story is a reminder that the good fortune and high levels of medical care relied upon by elite footballers should never be taken for granted.
Giggs, whom Appleton succeeded as the captain of Salford schoolboys more than two decades ago, was one of his former team-mates who gave evidence at the medical negligence hearing into the botched operation on Appleton's right knee in 2007 in which he was awarded £1.5m in damages.
Appleton was just 27 when he was told by a different surgeon that, after two years attempting to recover from the disastrous first surgery on a partially torn posterior cruciate ligament, his career was over. It is not just Giggs' longevity that reminds him that, in different circumstances, he might still be playing. He often bumps into former team-mates who are not yet retired.
"They say -- that at the age and at the level I had to give up -- retiring from football is a bereavement and you need time to get over it," Appleton says. "When I started to get over it, after 12 months the new GP at the club said if he had known me before, and seen my personality change, he would have prescribed me with anti-depressants. I was an angry man."
Appleton's original injury was picked up in training. A midfielder, he had left United in 1997 after two senior appearances in the Carling Cup to join Preston North End. West Brom signed him in 2001 and were chasing promotion to the Premier League when he was hurt in a collision with team-mate Des Lyttle in November. In his own words, Appleton "went into the operation with one injury and came out with three or four".
His original injury, a partial tear to a posterior ligament is nothing like as serious as a tear to an anterior cruciate ligament. But the level of damage done in Appleton's original operation was enough to end his career.
"They tried to fix the new graft in -- a new ligament to make it tight and strong -- and they didn't attach it correctly," he says. "The hole they drilled into me was in the wrong place and because of that the screw wasn't fixed in properly and was protruding through my joint line. So every time I bent my knee the screw was going straight into my joint.
"It destroyed all the cartilage in the knee. I remember going back and saying: "This doesn't quite feel right, I have got a decent pain threshold but this is severe."
"I kept having, 'Oh, it's just a bit of scar tissue' thrown back in my face. I felt as if I had a wooden leg because I didn't have full control of it. If I ran I couldn't stop properly. If I was to go downstairs, I had no control over it."
Eventually he turned to a former United doctor, Phil Batty, now at Blackburn Rovers, for help. Batty took one look at the scan results and said: "I hope you have a good lawyer."
"He said to me: 'This knee is going to need some saving.' He took out of the knee two massive tubes of blood and all sorts that shouldn't have been there. It was a horrible murky colour. Then he said: 'There is something in the knee and I'm not sure what it is.' He worked out it was the original plastic screw. I had been trying to run and do all these hop and skips and I've got this bloody screw in there."
Two years of rehab followed in which he had bone "chiselled away" from his thigh to fill the hole in his knee. He had an osteotomy in which his tibula and fibula bones were broken by surgeons in order to straighten his leg and take the pressure off his knee. Three major operations and five keyhole procedures later, at the age of 27, he was told that he risked ending up in a wheelchair if he did not give up playing football.
The original surgeon, Medhat El-Safty, later came to admit in the High Court in Manchester that he should never have done the operation.
As well as Giggs, Appleton's friend Gary Neville and Alex Ferguson himself also gave evidence.
"The day they came in there was such euphoria in the courts," Appleton says. "It was like something from a movie. Crazy. People were coming out of the other courts to have a look!"
The judge ruled that the original injury would have ended Appleton's career, a verdict which is still a source of great disappointment to him.
Not just because it meant he was only awarded compensation for potential earnings up to the age of 31 but because he believes that had he been properly treated, he would have made a full recovery.
As a teenager, Appleton witnessed the emergence of the greatest group of youth-team footballers in United's recent history and those memories, as well as the friendships, are strong.
Born in December 1975, he was in the intake one school year behind Beckham, Gary Neville, Scholes and Butt but was eventually moved up to train with them having been one of only four in his year awarded a place on United's then youth training scheme.
"When we went there we would joke that it was the worst time you could ever join United as a YTS player because the year before us had Scholes, Neville, Beckham, Butt [with Giggs two years ahead of them].
"They were all these great players who all went on to be internationals.
"We knew then they would. They had all signed four-year professional contracts at about 17. When the four of us [in the next year] were told we were getting professional contracts, we were like: 'Great, four-year deal! New car!' We went in a few days later and were told: 'You've got a 12-month contract'. So we had to keep proving ourselves year on year because we had that much talent ahead of us."
He still remembers the effect of Alan Hansen's: "You'll win nothing with kids" pronouncement on Match of the Day after United's opening-day defeat to Aston Villa in the 1995-96 season.
Ferguson had just promoted his "kids" into the first team, having sold Paul Ince, Mark Hughes and Andrei Kanchelskis in the summer.
In their next match, United beat West Ham 2-1 at home.
"The West Ham game could have gone either way, it was scrappy and there weren't a lot of chances but the euphoria even back then to win that game was massive," Appleton says.
"For those players it was almost like 'We've arrived. We can play at this level. We are good enough'. They went on to win the league.
"You talk about defining moments and everyone mentions Nottingham Forest away -- the FA Cup third round win in 1990 -- that is supposed to have kept Alex in the job but looking back, that win over West Ham was a big, big game for everyone concerned. If we had lost, Alan Hansen and all these big pundits would have been saying: 'I told you so'."
At West Brom he has worked his way up the coaching hierarchy. The club are expected to announce this month that Appleton is to be the assistant to Hodgson. Another step upwards.
The consolation of a curtailed playing career is that, at 35, he has more coaching experience than any of his peers who are just approaching retirement.
Today at St Andrew's, he will be able to reflect on the lesson he has taught many young players.
"When I first started taking the youth team I would say to the players that, as cruel and as daft as it might sound, the next training session or the next game could be your last," he says.
"I was not saying it to shock, I was talking from experience. I didn't go into that Birmingham game thinking it was my last game."