But Dr James says the high of playing tens of games per season is only temporary, with the lows risked by increased possibility of injury and constantly having to be switched on to the elite level being far worse.

He says players are turning to coping mechanisms, such as using snus, to stay focused.

“Football still does not really appreciate the recovery needed physically and psychologically,” he said.

“Players need to be people. Mental detachment is much trickier when there is increased fixture density. True recovery is about stepping away from our professional responsibility.

“The physical load can lead to more injuries, which can have a greater psychological impact. That will add a lot of stress – who am I if I am not playing? They will then also be worrying about contracts.

“It’s about education – feeling good in the moment (by playing a lot of football) does not mean it is good for them. They might feel they are physically capable of playing these matches in a row, but mentally they may feel wrung out.

“This is where clubs can be doing a better job of educating players – the benefit of downtime. You must sell to players why this is worth something.”

Dr Richardson says some clubs are better at supporting players, citing Brentford as having a strong sports psychology team.

But with the Club World Cup introduced, the World Cup potentially expanding and no sign of a reduced number of games in the Premier League, domestic cups or Uefa competitions, there looks to be no clear path forwards.

“The players have got little control over the calendar. As we have seen, some of them will decide to step away,” said Dr Richardson.

“That lack of empowerment is difficult – that and the fear factor of not participating, of losing the place in the pipeline. But if you play and get injured, you lose your place anyway.

“Damned if you do, damned if you don’t.”



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