Interview: James Bird
Images: Flora Maclean

Dr Amelia Woodhouse’s role at Liverpool FC Women is crucial to the daily wellbeing of the footballers and staff at the club. As Club Doctor, her job begins from the moment she wakes up, with players getting in contact to inform her of any wellbeing issues through her phone before arrival at training. And on top of her day-to-day input to the medical team, Dr Amelia is also key to the preparations for a match itself, with the systems for potential on-pitch situations all mapped out before they occur. But that’s not all Dr Amelia Woodhouse’s weeks consist of.

Alongside her work at Liverpool, Dr Amelia combines a job as a General Practitioner in Manchester with her preparations for a master’s degree at Bath University, which will look at the impact of the menstrual cycle on female footballers. There is a gap in the research on the menstrual cycle’s effects on elite performance that is completely unfair, and yet also completely typical of our society. And, that’s why people like Dr Amelia Woodhouse researching the subject are so important.

Liverpool sit second in the FA Women’s Championship, train at Tranmere’s 'The Campus', and, as a rainbow painted itself across a grey and yellowing sky, we sat down in one of the classrooms of the adjoining college to talk. With the club preparing for their Women’s Football Weekend clash against top of the table Durham on Sunday, this is A Day in the Life of Dr Amelia Woodhouse…

When I wake up in the morning, the first thing I have to do is check my work phone to see whether any of the players have texted me. They’ve all got my number, and they’ll either get in touch with myself if they’re feeling unwell or have a query about something to do with a longer term injury, or they might message Hina Chauhan the physio or Chris Underwood the sports therapist if it’s a muscular or joint related problem. I live in Manchester, so I’ll work out if there’s anything I can think about actioning during the day, and then jump in the car and head across to The Campus.

By the time I get here, the girls will already be doing their prescreening tasks before training with the strength and condition coach Colm Smith and normally Hina, too. They’ll be doing things like testing their groin squeezes and using the force plate, and if they’re down on their normal readings, then this is the type of thing that can tell us if they’re potentially brewing an injury, and we may need to modify the rest of the day based on that. Then there are their wellness scores, which indicate more how they’re feeling, and there’ll be a checklist and pain score that we’ll need to review before training starts. If a player is carrying a long term injury and suddenly their pain scores have spiked, it will be up to us to decide whether to take them off the training pitch for the day and get them in the gym.

I’ll also be reviewing any scans that the players may have had, say if they’ve picked up an injury from the weekend. The manager will need to know straight away if they’re available for training and match day, so that’s a big priority. A lot of this is quite admin based, co-ordinating specialist appointments, various cardiac screenings, and then if Hina is working in the gym with injured players, I’ll go pitchside whilst they train in case anyone needs anything or if there are any emergencies. Then we’ll have lunch, and the medical team will get together to do a meeting that lasts around an hour and a half, where we’ll discuss each player’s injury status and rehab protocols. It’s important that we run through the entire squad individually before the day is over. Being in and around the squad environment and feeling like you're helping the performance come the game is my favourite part of the job.

I'll be involved in the match day situation, too. The players will get any treatment, taping, or strapping done before kick-off by the physio or the sports therapist, and I’ll be there in case anyone needs any medications pre-match. And then once that’s done, myself and the medical team will go out and run through the emergency action plan with the opposition physio and the paramedics that are there. Basically, this is so that if an emergency should occur, everyone will know what their roles are. The first responder will be the physio who’s running on, and then my role will be to bring the emergency bag, and then the other therapist or physio will bring the fracture pack and the oxygen. Depending on the scenario, roles will change, but for example, if it’s a cardiac arrest you’d have the first responder start on chest compressions and the second responder will bring the defibrillator and put the pads on. Those roles change, but it will always be the same in terms of who brings what on to the pitch and who communicates with the paramedics and onwards hospital transfer if that's needed.

When I watch a game in my free time, I find myself drawn to looking for players who look after themselves in terms of things like injury prevention. I probably watch the game in a different way to other people, looking at what the medical team are doing and seeing how they respond to an injury when they get onto the pitch, even looking at how a player has gone down and starting to work out what could be wrong.

I work two days a week at the club, and then the other of my working days are spent as a GP, and it’s absolutely worlds apart. In a football setting like at Liverpool, you’re always a step ahead and trying to work things out before they’ve even happened. As a GP, especially now, you’re seeing a lot of people that have left it a number of months before seeing their doctor. I see around 35 patients a day on my GP days, whereas at the club you’ve got 25 players in the whole squad, and I’m only really seeing one to two per training day. Any problem here will go through a discussion in a medical meeting; we’ll discuss each player in depth from my point of view, from the physio’s point of view, from the sports therapist’s point of view, from the psychologist’s point of view, from strength and conditioning, too. Whereas in the GP surgery, we've got a weekly practice meeting where we'll discuss the patients that we can, but then the list size is something like 8000, so it doesn't really scratch the surface.

The players ask me a lot about period symptoms, alongside Covid vaccines it’s the thing I’ve been asked most recently.

I think getting people to talk about it is the main thing. Players will feel more comfortable and more open as the subject becomes more prominent in the media and even talking about it just between themselves. 

There is a gap in the research and, comparatively, hardly any bodies of evidence about the menstrual cycle in elite athletes. But, over the next couple of years there's gonna be more and more research coming out, and I think there's gonna be a lot of stuff around tracking and adaptation of training. Recently, there’s been a lot more work around it which has seen elements of training and other preparations that are tailored to boost performances based around the menstrual cycle—which is really good.

For my project with Bath University, I’m going to be sending out questionnaires to the players which ask them to list their symptoms, how often they experience them, and how these symptoms affect them on training and match days. I want to know how well supported they feel in this area in terms of both the coaching staff and the medical staff. For instance, do they feel comfortable going to a coach or a member of the medical team with problems related to their menstrual cycle? And if they don't feel comfortable, what can we do to make help more accessible?

If a player was really heavily on their period and they had a game that day, are they worried about leakage? Are they worried about pain? Are they worried about tiredness and fatigue? How does that affect them differently on training days and match days? Does some of the England kit, the shorts and stuff are white, pose a problem when they are on their period? Are they worrying and have they sought help for that type of issue? And then classic menstrual cycle symptoms like pain, tiredness, bloating, breast pain, have they ever had to seek help for that? And if they experience symptoms but they haven't sought help, why is that and what can we do to bridge that?

But I think we're quite lucky here that the environment's quite open and players are happy to share and come to us when they need support and help really.

We spoke to Dr Amelia at Liverpool and Tranmere’s ‘The Campus’ as part of the FA's Women's Football Weekend initiative on the weekend of November 13th and 14th. You can find out more about that, including fixtures, ticket information, and how to watch the games from the comfort of your own home, here.

For more information about the menstrual cycle’s effect on football, you should read The Athletic’s brilliant ‘What’s it like to play football on your period?’ piece by Katie Whyatt from last year.