Lifting the lid on the world of football

The Secret Physio
29 Nov, 2012

New boss, new broom, new ideas

Well, it took a little longer than we expected but, last week, two Premier League managers lost their jobs. With only a quarter of the season over, clubs are getting concerned as to whether their teams will avoid relegation – or compete for trophies – and want to make changes while they have time.

With the many alterations that occur in a club under new management, the physios and medical staff have to adapt if they want to survive. Losing a familiar management team can be disruptive to the day-to-day running of a club and its medical team. We all expect a few changes in routine, recovery strategies and how the new manager communicates with the team but the biggest influence on the medical team can be a sudden switch in training.

This can have a major impact on the medical team’s workload, with a sudden increase in injuries. Training is the most significant factor on a player’s fitness, whether it is too much, too little or even just very different. If training is altered, in terms of volume or intensity and is implemented too quickly, the players don’t have time to adapt before the next game and can go into that game feeling tired and sore. This renders the vulnerable to injury.

At smaller lower-league clubs, there may be only one physio and they will have a very close working relationship with the manager. When I was the sole first-team physio and a new manager came in, I did feel uncertain about my future. It was up to me to prove to him that I could provide an efficient medical service. When the new man arrives, you try to see what he requires from a medical department and adapt to him and his demands.

At the larger clubs with a larger medical team, physios tend to be quite protected. There will be a head of department who will usually be either a doctor or physiotherapist and they fall under the control of the board of directors. Many of the top Premier League clubs now have four to five first-team physios; even many Championship clubs have two or three, each with their own specialities.

Their contracts don’t necessarily follow the managers and are organised separately. In fact, they are relatively protected. Also, these guys earn good wages and have close ties with the players – as do most physios in a club – therefore changing them can be very disruptive and expensive.

A new manager’s first job in a team is to affect change as soon as possible. That’s the reason that they have been brought in. But not all managers are the same; they all have different approaches towards injured players and a medical team’s involvement in preventing those knocks.

I have worked with managers who see injured players as no more than malingerers and believe that they are injured on purpose. They want injured players in at 9am, well before the others, and not to leave the training ground before 4pm, in order to inconvenience them as much as possible. There is only so much treatment you can provide a player before you actually make things worse. I have played cards with players until it’s 4pm, just to fill the time … and usually lost!

Most managers I have worked with communicate well with you. They want to know how injured players are coming along, how long they will be out for, even helping out with the board when money is tight and budgets don’t cover extra medical costs. Some take it to the extreme and get heavily involved in medical issues.

I remember, after a player had sustained a cut to his head, that the manager was not taking my word that we could just bandage it for protection in the next game two days later. He wanted him to wear a skull cap, as Petr Cech wears, but the player couldn’t head the ball and was petrified he was going to be made to play with it. After some persuasion – and poor heading demonstrations with the cap on – he played with just a few stitches and a bandage.

Within days, it is essential to meet the new manager and discuss what he expects from you as the team physio and what he expects from the medical department. I have been pleasantly surprised how many managers are willing to listen to your experiences at the club and are quite happy to see how the department runs for a while before making big changes.

If you are doing a good job and he sees that, he is unlikely to alter things. In fact, you can be of great help to a new manager and his new staff, providing feedback on players and previous practices that have gone on. The physio room can be the hub of team gossip, so having the physio’s ear can be really helpful to the new boss.

Unfortunately, I have known physios who do not survive new management. This has been due to a conflict of views so extreme that they just cannot continue to work together. Or the manager just wants to bring in his own person.

In reality, it is quite unusual for physios to follow managers. The wages aren’t great so, once the boss has left, you cannot afford to wait around for him to get his next job. And he may never will!

About the author: The Secret Physio


I have been working in professional football for more than 15 years, operating at the highest level in the Premier League and experiencing the excitement of European nights. I've had both the pleasure and pain of working with various managers, coaches and players, all with their own ideas and philosophies.

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