Skopje, Macedonia
Thursday 14th May 2015

Since the early 2000s, I have made a significant effort when traveling the globe to visit sporting organisations, teams or athlete groups around the world.

The benefit of this was first relayed to me by, the then Leeds United head physiotherapist, Dave Hancock, who had presented as a guest lecturer on my MSc in Sports Physiotherapy.  Dave went on to become head of physiotherapy at Chelsea & in more recent years crossed the Atlantic to work for the New York Knicks in the NBA.

It was no surprise, therefore, that my first club visit was to spend three days working with Dave at the Leeds training ground, Thorpe Arch.

Since then my travels have taken me to every continent & I have been fortunate enough to be welcomed in sporting facilities in each.  Some visits have been a couple of hours, others a couple of days, whilst others have resulted in consultancy work & on the odd occasion, even a job.

The relationships I have built up over these visits have often become close friendships & there are several teams I sometimes visit a few times in a year if schedules align.

The are are several benefits to visiting colleagues in their own environment, both professional & social.  Whilst you can discuss approaches to treatment, conditioning, monitoring or departmental organisation, it is only when you get on the ground that you can evaluate the practical limitations to the theoretical ideals.  

You get to see the interactions between the key decision makers, the daily routine, the time constraints, the facility lay out, the flow within the components in that lay out & the utilisation of space.  These observations help contextualise the thoughts & ideas that are discussed & help me assess whether or not what I see, would work in the environments I currently work in or will work in, in the future.

On the flip side, any ideas or techniques that I use can be demonstrated or trialled in a real life situation for my colleagues, which helps identify practical issues unique to their environment & brain storm solutions on how to resolve these.  I think this also increases the impact of knowledge sharing, as once you have tried strategies in your own environment, compliance & uptake is often increased.

I have been fortunate enough to visit so many facilities that have inspired me & others that have been less than impressive but where it has been apparent that the skill sets of those staff working with in them have ensured successful outcomes, in spite of their environmental limitations.

I often get asked which of the facilities, that I have either worked in or visited, have been the most impressive & it’s hard to identify one particular example of excellence, although a couple recently have certainly raised my expectations of what is possible.

What I have observed, however, is that the biggest factor, I believe, in delivering a successful performance science & medical/therapy service is communication.  Those departments that have made the biggest impression have been those where the doctors, therapists, trainers, scientists, conditioning staff, consultancy staff & coaches obviously interact closely throughout the lines of service.

Those teams that clearly demonstrate dysfunctional service provision are, without exception, those where “solo silos” (as Kevin Roberts of Saatchi & Saatchi calls them) prevail; where staff retreat to corners of segregated offices; where “them & us” mentalities dictate the relationship (or lack of) between medical services, performance science/conditioning & coaching staff.  

As a result components of the lines of service do not integrate, accountability is deflected & responsibility is shirked.  Mediocrity is allowed to fester, excuses contest with blame to rule the roost & problems continue unchecked to harbour poisonous undertones throughout the facility.  

That may sound dramatic but I can assure you, that in a high pressure/high consequence environment, when each member of a team is not working together, striving to achieve a shared goal, individuals start looking after number one, allowing egos & insecurity take control.  In these situations, the energy levels plummet & no matter how you try to insulate players or athletes, they become embroiled in the situation & performance suffers.

Often in those situations, a newly appointed director of sport or head of department is best off clearing the decks & starting again.  Again, that may sound like an over-reaction but it is an approach I have discussed with several successful & intelligent people that I respect in the sports performance field & they agree.

If you stick, you end up wasting time & energy entertaining finger pointing, witch hunts or turf wars that engage precious resources.  Yes, you might lose a couple of innocent casualties but where a large team or organisation is concerned, no individual can be allowed to disrupt the efforts of an entire organisation in achieving the overall goal.  

That said, such actions have to be handled humanely, honestly, quickly & with appropriate ongoing support of the casualties.  I again refer to Kevin Roberts who says “it’s not personal but it is business” & sometimes tough decisions need to be made for the greater good.

With that in mind, having seen the facilities I have visited, are there certain physical or environmental factors that can influence the quality of working relationships?

I would have to say, unreservedly, “yes”.  One of the most impressive facilities I have seen recently, was designed from the ground up, with the planning process lead by a four person committee, which comprised the Head of Medical Services & Performance Science, the Head of Human Science (psychologist), the Director of Operations & the Sporting Director.

The flow of the building took into consideration the tasks that have to be undertaken by each person on a daily basis.  The office space promoted inter-disciplinary interaction (both formal & informal) & gave great lines of sight to the working space of the gym & practice fields.  There were no corners to hide in, no small box offices to host silos or cliques…conversations between all departments were environmentally facilitated.

Contrast that with facilities where it takes a couple of minutes (or more) to walk from the gym & sports science office to the physiotherapy/training room & medical services offices, or up a couple of flights of stairs to the coaching office.  No flow.  No spontaneous conversation.  Easy excuses to minimise professional interaction.  Demands of effort breed habits of avoidance.  Physical walls build walls of communication.

Lines of service, whether biased towards the medical services professions or the performance science professions are never best executed in disciplinary isolation.  Strategic success in supporting the coaching effort depends upon integration of knowledge & skills that no one person possesses alone.

Unfortunately, these biases are often driven by the departmental director, inherent in their professional training.  If a medic, trainer or physiotherapist heads up the department, the medical model usually prevails without sufficient consideration for the performance science, physiological or conditioning input.

Conversely, if a performance science lead is directing operations, there is often a lack of sensitivity for the attributes that can be contributed by the medical services team.

These biases can often influence budgetary assignments, space allocations & colour the voice of reasoning in informing coaching decisions.  Either way performance is the victim & results can suffer.

The best medical services & performance science departments I have been privileged to visit have either had a director with a multi-disciplinary education; a true leader with an exceptionally healthy dose of humility & security underpinning his/her character; or two leaders (one from a medical services background & one from a performance science background) with a great working relationship, founded upon respect, both reporting to a sporting director or GM figure.

Without exception, the best leaders I have met, have surrounded themselves with an army of exceptional people, openly more knowledgable in the areas in which they operate than the leader themselves.  

These departmental directors identify their key role as promoting the tone as dictated by the culture, providing a focus by relaying the vision of the organisation & providing the support needed for each member of the team to do the job they excel at, whilst being on hand to solve any problems that arise, quickly & decisively.

It is these leaders whose departments exhibit the attention to detail, that have provided the small components that allow the team around them to make a big difference.  These facilities are centred around the holistic performance needs of the athletes, not image, not fads & not isolated silos of the performance model.

I would like to extend my sincere gratitude to those leaders & teams at Manchester United, Manchester City, Red Bull USA, Philadelphia 76ers, Brooklyn Nets, P3, AkiLabs & the Miami Dolphins that have welcomed me so openly over the last couple of months.

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