Compassion, Support, and a Christmas-Free Zone: Life Inside a Football Club’s Medical Team
“What you are having to do is balance risk all the time,” comments Robin Chakraverty. “That’s the job.”
Chakraverty, who served as the England men’s football team doctor from 2016 to 2020 and previously held the position of head of performance and medicine at Wolverhampton Wanderers, reflects on what he considers to be the most challenging aspect of working in a football club’s medical department.
Medical professionals are rarely acknowledged by name, even by the most passionate fan, yet they hold vital significance within a club — and face immense pressure. Their decisions can impact a player’s health, a manager’s prospects, and the overall success of a club. They are committed to their patients’ well-being, while fully aware that every moment a player is sidelined is seen as lost time from the club’s viewpoint.
Despite the high demands, the role can also be profoundly fulfilling and rewarding.
As the busy Christmas season approaches — one of the peak periods for the medical staff — eScored engaged with several medical experts who have worked in or around football to explore the highs, lows, pressures, joys, and ever-changing landscape of the profession.
Over the past 25 years, football has transformed significantly, and medical departments have evolved alongside it.
The Guardian noted that when Manchester United achieved a treble in 1999, their medical team consisted of only two physiotherapists and a masseur. In contrast, a Premier League club may now have up to 25 people in their medical department, including doctors, physiotherapists, masseurs, strength and conditioning coaches, performance coaches, rehabilitation fitness coaches, and nutritionists.
“You’re not operating in an ideal world where everyone can play free of pain or risk,” Chakraverty states, having also served as the chief medical officer for British Athletics. “If the goal is simply to prevent injuries, that’s nearly an unachievable target.”
“No one enjoys seeing injuries, but being part of a medical team means you share that experience with the player throughout — it pervades the mind completely.”
He explains that commonly, a medical department’s efficacy is assessed based on team availability, the frequency of injuries throughout a season, and the return-to-play timeframe — whether that occurs quickly or slowly.
“Your toughest critic is always yourself,” adds Chakraverty. “No one wants to carry the responsibility for an injury, but you also don’t want to be the person preventing players from participating when there are few who can play or train.”
Dr. Robin Chakraverty shares that he ‘lived’ through his players’ injuries with them (Isaac Parkin/PA Images via Getty Images)
He believes that it is paramount for everyone at a club to be unified in their objectives, rather than pulling in various directions, and emphasizes the importance of clear communication.
“Everyone desires points on the board,” continues Chakraverty. “The intriguing aspect of the job is reconciling the often conflicting goals of facilitating an optimal performance for a player or the team while managing injury risks. That presents a challenge for everyone involved — one that is rewarding because it is not straightforward.”
“There will be instances when you realize that if an injury occurs, you will be held accountable. You must accept that reality. The key lies in presenting the information clearly so that informed decisions can be made.”
Andy Renshaw, who led the first-team medical department at Liverpool from the summer of 2016 until November 2017 (during Jurgen Klopp’s initial season), concurs with that sentiment. He notes the challenge of navigating the nuanced middle ground when conflicting opinions arise.
“There’s a significant degree of politics involved when managing a squad of 30 players,” he shares with eScored. “When a player returns to the field fast, the manager gets a key player back quickly, and the club regains their asset quickly. However, different individuals may have their own preferences regarding rehab processes, and we must manage expectations accordingly.”
“The trick lies in striking a balance between the players and the staff, mediating personalities, and keeping everyone satisfied. This can often be very challenging. From my experience, I never felt any pressure from a manager to rush a player back too quickly. Jurgen was not like that at all. His approach was simply: ‘When he’s ready, he’s ready; you just let me know.’ There was never any pressure from that end.”
eScored has detailed how the medical operations at Liverpool have become intricate, with various departments sometimes at odds over methodology, particularly regarding Andreas Kornmayer, the head of fitness and conditioning.
Andreas Kornmayer was considered an effective but sometimes polarizing figure at Liverpool (John Powell/Liverpool FC via Getty Images)
During Renshaw’s tenure, he mentions having minimal confrontations with Klopp, noting that Liverpool accomplished commendable success in managing injuries in the 2016-2017 season.
“Jurgen is a very commanding personality; he wasn’t shy about expressing his views when necessary,” Renshaw explains. “He would always ask questions if he thought it was warranted, like: ‘Why did you handle it this way, or what about that?’ He had his perspectives on various issues, but we never had any disputes.”
Geoff Scott is another medical professional with extensive experience at the highest level of English football. After leaving Tottenham last summer following a two-decade tenure, where he rose to become the head of medical, he characterizes his role as “situated at the intersection of the player’s health and the team’s demands.”
He stresses the necessity of cohesive thinking throughout the club. Scott highlighted that executives needed to be promptly informed about player injuries to consider potential cover or replacements during the transfer window.
“The manager faces immediate short-term pressures,” Scott remarks. “For him, the upcoming game is always paramount. Players naturally want to participate, yet they often sustain injuries that make it unwise to play, and missing being unavailable for a single match can pose considerable risks resulting in longer absences. Therefore, balancing the diverse needs and preferences of different stakeholders is consistently the greatest challenge.”
Medical staff must also be ready to adapt to changes beyond their control — such as the arrival of a new manager. A new leader on the sidelines not only tends to implement different tactics but also alters training methods. Players accustomed to the previous coach’s routine and intensity can face increased injury risks during this transition.
Scott recalls that this was particularly challenging at Spurs. “Shifting from a high-intensity style to a low-intensity approach can lead to injuries promptly,” he notes. “Some managers at Tottenham had more aggressive playing styles, like Mauricio Pochettino. We would need to pivot accordingly and evaluate the attributes players would need to meet the demands of that new leadership.”
Moreover, the role also comes with the acute pressure of making critical judgment calls — often in the presence of an expectant manager.
“Having a discussion with a manager when a player suffers an injury during a training session, or throughout the week, only to find them unavailable is a highly unpleasant situation,” remarks Luke Anthony, the former head of sports medicine at Reading. “Certain managers can make it feel nearly personal, as if it’s your fault. It’s challenging to convey bad news.”
“When injuries are on the rise, it becomes particularly tricky, and those discussions can be tough since the manager is under substantial pressure and stress too.”
Luke Anthony: ‘Some managers can almost make it feel like it’s your fault’ (Lynne Cameron/EMPICS/Contributor)
Anthony elaborates that an additional pressure comes from the necessity of bringing an injured player back to full fitness. Some footballers may be more cautious, hesitant to play if they experience any tightness or pain, while others may endeavor to play through contact injuries.
The medic must strike the precise balance. “When players are in the process of returning, you must push them vigorously in their rehabilitation,” remarks Anthony. “However, this approach carries a risk of setting them back.”
“Sometimes that will yield positive results, other times it may work against you. If a player participates in training or a match when they’re not fully prepared and re-injures themselves — although rare, it can happen — that’s an awful sensation. You are continually navigating the line between excessive caution and the urgency to reintegrate players.”
Steve Hard, the current head of medical at Portsmouth, explains that the higher a club ascends through the leagues, the greater the complexities they encounter.
“Players are valued at higher amounts, with clubs offering bigger salaries,” he states. “As you rise through the ranks, the interaction with agents increases because the player is an asset for them.”
One notable shift is the rise of players having individual medical teams who assist them with personalized programs outside of their club. In June, eScored featured Volt Sport Science, a firm that collaborates with Arsenal defender Gabriel. The Brazilian is not alone in this trend, especially among foreign players who might favor working with someone fluent in their native language or with whom they have previously collaborated.
“I understand that it can be challenging when it comes to communication,” Hard continues. “I’m not going to stop it. If the player wishes to work with familiar professionals, all I ask is that there is open communication between the club and those individuals.”
Scott echoes this viewpoint. “At the larger clubs, some players may come with their entourage,” he remarks. “It’s crucial to ensure everyone is operating under the same objectives. This setup can function effectively, but it also has its challenges. However, I believe this is the current trajectory. Clubs have their staff, and players have their own teams too.”
The trust between a player and the medic overseeing their recovery is essential, though it can lead to unexpected situations.
During his initial job at Millwall, Hard once found himself needing to rush out at 2 AM to assist a player who had encountered trouble at a nightclub. Given his previous experience working as a doorman, Hard successfully defused the situation by “pulling a few strings” and transporting the player safely in his car.
“I told the player, ‘Do not mention this to the manager — it never occurred,’” he recalls. “He owed me considerably after that.”
In many cases, medics take on roles as caregivers, confidants, and counselors to their players.
Hard, who previously worked with Bournemouth, had to convey the heartbreaking news to Callum Wilson on two occasions that he had ruptured his anterior cruciate ligament — highlighting the difficult conversations that medics regularly face with players who become more than patients.
Callum Wilson’s ACL injury at Stoke in 2015 (Malcolm Couzens/Getty Images)
“I’ve been in situations where I’ve had to call a player or sit them down to discuss their results, and that can be difficult because a relationship has been established,” he explains. “You become invested in them. They’re like family to you, and you’re telling them they can’t engage in something they love. That’s challenging.”
All the medical professionals eScored consulted recognize that the all-consuming nature of the job represents one of its most significant challenges. Christmas Day is treated just like any regular working day, similar to players and coaches, making it tough to balance work and personal life.
“You can’t simply switch off your phone,” Anthony clarifies. “A player might attempt to contact you on a Saturday evening or Sunday, and it may become necessary to respond. The demand is constant. You’re on-call at all times.”
“I’ve tried coordinating a medical appointment while on holiday during the summer. While dining with my wife, I had to venture half a mile to find a place with phone service to sort it out. You end up upsetting a lot of people.”
“You miss weddings and various events because they often fall on Saturdays in the season. It would be unthinkable to say you’re unavailable. That’s one of the more challenging aspects personally.”
Renshaw concurs. “To be honest, it consumes your life,” he says. “Even when you’re relaxing on a sunbed in June — during the only two weeks you truly get off — your phone will ring with urgent requests regarding player screenings or logistical necessities.”
“For the staff, it is undeniably intense.”
If this depiction of working in a football club’s medical department seems more like a test of endurance than a source of enjoyment, that would not be entirely accurate.
There are numerous bright moments among the challenges, particularly the satisfaction of watching a player return to peak performance after a serious injury. For Scott, that serves as recognition for the “hundreds of hours (of rehabilitation) invested in a player across various specialties.”
This is also why Hard remembers a dreary match between Bournemouth and Accrington Stanley as his all-time favorite.
“It was probably one of the most tedious games I’ve ever witnessed,” he recalls. “We won 2-0. The reason it stands out for me was that (defender) Shaun Cooper had been sidelined for nine to ten months due to a significant hip operation. There was initial uncertainty about his ability to return to that level. However, he made it back, played, and maintained a clean sheet. That was my favorite match, simply because I got to see him back on the pitch after his ordeal.”
There are also additional benefits, such as the excitement that comes with being part of a team environment.
“What I appreciated was being part of a team, part of a collective,” Anthony shares. “You work towards a shared objective. Throughout the season, achieving that leads to a tremendous sense of satisfaction.”
Scott experienced a thrilling journey as part of the Tottenham team that reached the Champions League final in 2019 under Pochettino.
Tottenham players and staff celebrate their journey to the 2019 Champions League final (Dan Mullan/Getty Images)
“The victories over Manchester City (in the quarter-finals) and Ajax (in the semis) were remarkable,” he reflects. “That journey, along with witnessing the development of players like Dele and Harry Kane, truly inspires the staff to continually strive for success.”
“I miss the relationships,” adds Renshaw. “It’s incredibly stimulating to challenge yourself professionally.”
So how has the role transformed, and what does the future hold?
Hard reports observing significant changes during his 15 years at Bournemouth, starting in 2006.
“When I first joined, it was just me. I was the sole physio, managing gym sessions and nutrition,” he recalls. “It wasn’t until 2011 that I was able to hire someone full-time to support the medical department.”
“We succeeded in bringing in someone specializing in sports science to oversee on-field fitness. This shift occurred when Ed (Eddie Howe) came on board. Gradually, the staff numbers increased. By the time I departed Bournemouth in 2021, there were five physiotherapists, five full-time sports scientists, a dedicated doctor, three masseurs, and additional ad-hoc staff, including a chiropractor. It expanded considerably.”
Scott experienced a similar transformation during his long tenure at Tottenham.
When he started, the medical department for the first team comprised seven or eight individuals. By the time he left, this expanded to include 25 total staff covering all specializations — including sports science, doctors, physiotherapists, and nutritionists — all tasked with managing the growing demands of a sport that continues to excel in intensity and volume each season.
“Ultimately, each year, the Premier League speeds up; the physical expectations placed on players increase constantly,” he summarizes.
There have also been technological advancements shaping the industry — a trend that will persist as artificial intelligence continues to evolve.
Within a football club, each training session and match undergoes exhaustive analysis — GPS trackers, now a standard tool at the elite level, log every player’s actions — leading to a significant volume of data for a medical department to assess. This information must be distilled down into the most pertinent aspects for deeper analysis.
GPS trackers monitor players’ workload (Benjamin Cremel/AFP via Getty Images)
However, AI has the potential to process these data more adeptly, across a broader scale, assisting in spotting future injury threats. “It enhances the accuracy of the GPS data,” Scott elaborates. “AI offers higher processing power, enabling rapid analysis and assessment.”
Virtual reality (VR) headsets also represent a promising area for future development, allowing players to engage in specific tasks designed to enhance various skills, including reaction times and cognitive agility.
For his rehabilitation, Chelsea player Romeo Lavia frequently utilized a VR headset to assist in simulating game situations while preparing for various positioning against teammates and opponents.
Additionally, technology firms now deliver specific services to clubs aimed at enhancing multiple facets of physical fitness: from muscular strength to balance, jump techniques, and agility in movement.
“These solutions scarcely existed even five years ago,” Scott remarks. “They provide us with a means to assess players’ strengths in different roles, which is tremendously beneficial.”
In many respects, it remains a bold new world, and despite the advancements in data utilization and technological resources at clubs’ disposal, medical care is still fundamentally a human-centered process — requiring understanding, empathy, and judicious decision-making. All of which will likely be put to the test amid the rush of festive fixtures.
(Top image: Sean O’Reilly for eScored, photos: Getty Images)
