Living in Paris I kept coming up against a guy on the poker circuit who never said anything and always looked ill, with huge black rings under his eyes. He never showed much emotion whether he won or lost. One day we had a coffee and he told me that his sports-mad son had collapsed and died playing football, and since then, everything in his life seemed irrelevant, trivial.

I’ve played in games where players have suffered serious injuries, though not to the heart. Once, in France, a player swallowed his tongue. He fell in a heap, unable to control his body, like he was in a coma. I forgot all about the ball. Panic sets in — you wave on the physio, feel helpless as the medical staff crowd around the body and tension drifts around the stadium. It’s hard to get on with the game after a shock like that. You lose all your focus, drift aimlessly until the 90 minutes are up. There’s no spirit, no “come on, let’s win it for him!” More like “let’s just get changed and get out of here”. Teams are like families, there’s a special bond.

If more players are developing cardiovascular problems, then on one level it doesn’t make sense because medicals these days are more thorough than ever, with the top clubs conducting detailed health checks, from toes to teeth. But are heart problems in professional football on the increase? That’s not logical unless something about the sport has changed. A growing drug problem? I doubt it. So you’ve got to wonder if the pace and demands of the modern game are putting lives at risk. Whether football is evolving to a point where players are being pushed beyond their limits.

It could be just a horrible coincidence that Clive Clarke has heart failure the day that Antonio Puerta dies, that several players have passed away from cardiac problems in recent years. People drop dead. It doesn’t matter whether they are footballers, farmers or shop-fitters. It’s pure dumb luck. But it’s also a numbers game. And while exercise can reduce illness, overexercise can cause it.

If players are fitter than ever, that means their workload is heavier than ever. Training is more tiring and matches are faster. We know that the modern game is more intensive and more hectic than it used to be. Clubs want athletes, players who run quicker and longer. Naturally, they want to push players to their limits. When anything is operating at its maximum, be it a factory, a car or a human being, it’s more likely to break.

Players spend a lot of time in the gym now, but you ask yourself if that makes some parts of their bodies more developed than others and what effect that might have. We’re all different, but outfield players tend to do the same training exercises for the same amount of time. In this team sport, clubs don’t optimise sessions for individual benefit, even though athletic ability can vary widely. Goalkeepers, who do the least cardiovascular exercise, seem less likely than outfield players to suffer heart problems.

The heart, after all, is just a muscle. If Michael Owen and Kieron Dyer can have repeated leg-muscle injuries, why shouldn’t the same logic be applied to the heart? But logic and reason don’t do anything to ease the pain of a tragedy such as Puerta’s death.

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