Modern day soccer players are widely seen as the epitome of health. Rigorous training regimes, strict dietary programs and advances in sports medicine ensure that these athletes have the best possible physique.

Nevertheless, even the body of a professional soccer player is not immune to illness. Fabrice Muamba, Marc Vivien Foe and Miklos Feher all suffered cardiac arrests when their physique was really at its prime.

Recently, former Newcastle and Manchester United striker Andy Cole appeared on BBC’s Football Focus to discuss his battle with kidney failure (see below). He’s still only 44 years old and retired from the beautiful game less than 8 years ago.

Being a medical doctor myself, I closely followed Cole’s inspiring interview that helped raise awareness on his particular condition. In recent years, West Bromwich Albion midfielder Darren Fletcher and former Dutch international Fernando Ricksen gave candid interviews discussing their own medical ailments.

It’s never easy to accept that your own body is failing you, but it probably is even harder if you’re so young and have dedicated your life to push it to its maximum. In this article, I review the medical conditions these three individuals, who have given so much joy to fans of different clubs, have suffered, and are still suffering from.

My aim is simple: to raise awareness and to show my admiration to Fletcher, Ricksen and Cole’s personal battles.

Darren Fletcher – Ulcerative Colitis

“I owe him everything in my career but he rose to a different level for me in the way he supported me through this.

“He was also a really caring, kind individual who did everything to help me and protect me when I was ill. For me and my family.

“He gave me the time off I needed, told me not to worry about contract situations, told me to think of my health and my family first; to forget about football.”

These are the words of Scottish international Darren Fletcher as he thanks Sir Alex Ferguson for the overwhelming support he showed his compatriot during his fight against ulcerative colitis. Ferguson even used his retirement speech in Old Trafford to wish the midfielder well.

In 2011, Fletcher took an extended break from soccer, with the club initially stating that he was suffering from a virus. After a while, it became known that he was suffering from a type of inflammatory bowel disease – ulcerative colitis (UC).

As the name implies, in UC the colon (large intestine) becomes inflamed starting from the furthest point. In certain cases, the whole colon is actually affected. This results in patients suffering from debilitating diarrhea (Fletcher admits to having to go to the bathroom up to 30 times a day) that is usually mixed with blood and mucus. Such individuals lose significant weight while relapses can be fatal.

This condition can also manifest itself in an extra-intestinal manner with joint aches, eye inflammations and biliary infections only some of the documented effects of the disease.

Significant advances have been made in recent years regarding medical treatment but at times surgery may be the only option. Surgery may involve fashioning a stoma, usually temporarily, that can have a significant psychological impact on patients.

Thankfully, in ulcerative colitis, successful surgery is usually curative.

Watching Fletcher return to play at such a high level is truly remarkable. Medical therapy was not enough for him so he had to take the surgery route, a path he admits he was very reluctant to take. It took all the bravery he shows on the pitch and more to get back. But return he did and may that be a life lesson to all of us.

Fernando Ricksen – Motor Neuron Disease/Amyotrophic Lateral Sclerosis

The former Rangers fullback stated publicly in 2013 that he was suffering from motor neuron disease, or amyotrophic lateral sclerosis (ALS) as it’s more commonly known in the US. That’s the same year he retired from soccer.

[N.B. In certain classifications, ALS is actually one clinical type of MND but for the purpose of this article, these terms will be used interchangeably].

Awareness on ALS has risen in the past few years due to the viral sensation of the ice bucket challenge.

ALS is a degenerative condition affecting the nerves supplying the motor system, i.e. the body’s muscles, in this case the voluntary muscles. Nerve cells basically import/export electrical activity to and from the muscles. As these nerves degenerate, so do the muscles themselves.

Presentation of the condition can be subtle with gradual increasing difficulty in breathing, loss of power in any of the limbs or facial muscles and swallowing problems all possible initial features.

Nerve conduction studies are very useful in aiding diagnosis.

Motor neuron disease can really be classified in various different clinical presentations, but generally speaking all the muscles controlling swallowing, speech, breathing and power in all the limbs start to die out. Brain function and cognition is not usually affected, possibly making the experience of the patient even more scary as the power in the muscles starts decreasing one month after another.

Nowadays many arrangements can be done to aid breathing and even bypass swallowing. However no cure is available. Depending on the aggression of the condition, the life expectancy after diagnosis does not usually exceed 3 years.

Last August, Ricksen revealed that he can only communicate wth his wife via text due to his speech being affected. However, in the face of such a debilitating condition, his words are an inspiration to all people, not only those suffering from ALS:

“I have bad days but that’s natural. I just want to stay alive. I want to see my daughter grow up. I want to do absolutely everything.”

Andy Cole – Focal Segmental Glomerulosclerosis

Focal segmental glomerulosclerosis is a type of glomerular disease whereby the glomerular network in the kidneys are damaged. Glomeruli are microscopic structures that act as a filter for blood, removing excess fluids and maintaining a balance in the electrolytes, such as sodium, potassium and calcium ions, running around in the body.

A myriad of causes and triggers for glomerular damage to take place have been identified such as viral infections and certain drugs. As the glomerular network and kidneys start to fail, fluid is retained and accumulates in the legs, face and, most worryingly, in the lungs. The blood pressure can also spiral out of control.

Other common presenting features are nausea and unexplained fatigue.

Cole admits to finding it hard to accept himself swelling up. Moreover, the steroid therapy he’s on will increase his weight even further.

Apart from the fluid retention, kidney failure leads to electrolyte levels in the blood to go haywire and potentially interfering with the electrical activity in the heart resulting in a fatal rhythm disturbance.

A good number of glomerular diseases are “acute” and kidney function will eventually improve and at times can return to normal. Nonetheless, some conditions may enter the chronic stage and thus face a lifetime in kidney failure.

This can lead to further problems such as anaemia and bone disease. Such patients may face a lifetime on dialysis.

Thankfully, Cole looks to be on the way to recovery as his doctors have told him that there’s a good chance his kidneys will return to 70-80% of their normal function.