The football industry is becoming increasingly diverse with the advent of so many different areas- nutrition tactical monitoring video analysis and more, but the role of Physio remains absolutely vital.

Every manager seeks the man in control of this aspect of the club to not only be competent in the medical area but a father figure/confidant/counsellor and more. Every player is human and often needs comfort and reassurance.

After injury and during recovery the treatment table can become a confessional were the player not only seeks recovery but assurances. A physio’s bedside manner is important as his medical knowledge when injured players need to be nursed back to fitness with the compassion of a Florence Nightingale!

Managers and coaches want a player back fit. But the trust in him must be paramount. There are occasions when vital players are risked when less than 100% fit but the guidance of the Physio must be based on trust and longer possibilities of breakdown.

The manager and physio relationship is probably one of the most unique and important partnerships within a backroom staff a very close one that is second only to the assistant manager. A role that involves much more than treating knocks and strains and easing aches and pains and many encompassing factors to the role. The relationship between a football manager and his physiotherapist is a bit like a marriage, I suppose if it is going to work, it has to be based on mutual trust, respect and understanding. There are bound to be tiffs along the way-one party standing the ground over a point of discipline, perhaps knowing how to handle the youngsters-but a sound relationship will help them ride the storm. Too many rocky patches, however due to personality clashes or differing opinions and it just won’t last the distance.

The ideal gaffer, from a physio’s point of view is one of patience and understanding and gives your medical team total responsibility and allowing players to return in the safest possible time. One who also knows not to ask them too many questions! Any footballer will tell you if any players have any problems or grievances the physio is their comforting ear. They will usually speak to the manager if we think it is relevant and necessary. I don’t tell them everything. It is important you communicate they never pressurise me we always talk and have a chat either prior to a match or even before training. He will ask me the situation I will tell him the ones that can’t play or the ones that shouldn’t train etc. They listen obviously they want them fit for Saturday.

Over the years we have seen many a high-profile manager fallout with their physios including Pep Guardiola at Bayern Munich, Roberto Martinez when Everton manager, Gerald Houllier at Liverpool and Peter Reid whom on interviewing a physio would ask them if they like a drink. Reid liked to socialise with his staff the night before and after games. He was well known for his fallouts with many a medical man including Roy Bailey who he showed the door to at Manchester City ending 23 years in the job. Falling out with many Physio when manager of Sunderland.

The former Everton boss David Moyes described landing the services of Preston North End physio Mick Rathbone as his best ever signing at Everton. A manager needs someone who is speedily able to diagnose an injury a profound medical knowledge an ability to get players fit which absolutely vital in the treatment of professional footballers. Also, to have a pleasant outgoing demeanour, compassion, the ability to relate to people, confidence and knowledge. The physio is a part from part of the management and part of the players a football man but the secret is to keep out of the football don’t get involved and get on with your own job. Leaving the football to the managers and coaches the players can have complete trust in you. Not an easy tight rope to walk. At the same time, you have to understand football and footballers but stay out of the hysteria of results. A physio is like an agony aunt and managers have learnt not to ask us to many questions. However, like Derek Wright at Newcastle United, we have both seen a number of managers come and go during our respective careers. I’ve had 19 in total all very different whilst not naming names I have had my frustrations compared to Derek’s 25. Us physios are the team behind the team and match days are the most special as well as stressful.

Player care must come first even though a return to play is vital to the club. Thus, it is absolutely essential that the Physio has a great relationship with the manager you have to slightly change the way you work and adapt. How they want you to communicate with them?

What boundaries do they put in place! What information do they want you to give them? Some want to know absolutely everything; others want selected decisive information. Can he train, can’t he train, when will he be available to play? Is he fit yes or no. Also, they can make the important decisions. Others want to know if we do this can he join in on a certain day then they may make the game. I have had some managers who hardly talk to you and just want the injury list of who is available and leave you get on with it. However, this is rare, especially when the star striker gets injured and they are under pressure. They don’t leave you alone. So, these problems have to be agreed since each manager is different but all want the injured players back as soon as possible. The communication aspect is vital managers are always looking for the championship, promotion, playoffs a good cup run or even more urgently survival and they will usually prefer a nearly fit star rather than an up and coming youngster.

It’s important to let the manager have the facts as you see them, and not what he would like to hear, and give your views as advice upon which he may act or not. A manager may play a player that you feel is not quite right. But that does not mean he is overruling your view; he has to make a decision based on advice from many sources against complex backgrounds.

I remember a coach saying that a particular player was worth having in the team even when carrying a slight problem, and I understand what he meant. So, it is not all black and white. For a manager it is one of the most important parts of a football club. But not detached from the other aspects of the game. It is just as important as the tactical, physical and physiological elements of football, but importantly these all have to function correctly and together. An area which can lift you to win a trophy, but at the same time not done correctly can cause a team to fail.

For a manager his priority is his off the field team people who not only know the business but are honest loyal and devoted to the ultimate cause winning, who have an aversion to anyone outside the coaching staff wanting to be a tactical expert and getting carried away on the touchline. That is the prerogative of the manager and his coaches.

I have always let them do the ranting and raving preferring to be a wise owl carrying out my work calmly, quietly and complete serenity. Many times, managers have needed me as much as the players and many other occasions needed my multi-skills but these remain amongst ourselves what goes on in the dressing room stays in the dressing room. Players with respect come and go but good off the field teams are the heartbeat. Your job title gives a narrow view of your function and being a member of the staff team is probably more accurate.

“I probably couldn’t say I have enjoyed every minute, but most of the time I have loved it. It’s been a fantastic journey. A good physio can be your best ever signing a bad one gets you sacked.” Sam Allardyce once said.

However, you’re doing your best clinically and technically injuries are injuries the fact that the game kicks off tomorrow evening at 7:45 – injuries don’t acknowledge that.