Grant Downie on the duty of care

He started his career in the NHS, before moving into football in 1987 as a physio for the Football Association (The FA) at Lilleshall. Lengthy spells as Head of Medical at Glasgow Rangers and Middlesbrough followed, before he joined Manchester City in 2011 after the Abu Dhabi takeover.

His last five years at the club were as Head of Academy Performance, managing a sizeable staff, establishing a philosophy, and making sure the department remained at the cutting edge in terms of science and medical.

In 2013, Grand was awarded an OBE in the Queen’s New Year’s Honours for his services to physiotherapy and young people. Now he works as a mentor and consultant for clients including City Football Group, the Premier League and Scottish Football Association (SFA).

In order to develop any successful culture in a performance environment, it is vital you align your mission, your values, and philosophies to that of the club and coaching department. The performance department needs well led, guided, supported and challenged from the leader and they must be able to hold their area to account but more importantly themselves and they must create ‘psychological safety’ so that staff members can thrive and feel empowered to make decisions, even if these don’t always work out.

A clear line of communication and clarity in everyone’s role and celebrating small successes on the journey and undertaking significant event analysis for any events that could have gone better and those that have done very well. There needs to be an annual review of each person’s role and the department functions and generally they should be a ‘healthy dissatisfaction’ of your current level of performance services. This culture drives future success and combines sound scientific principles but applied in art form. Football, like many sports, is not a pure science and in our data rich world we must never forget this.

It is vital that each and every member of the performance team understands the bigger picture and the role in setting out a clear understanding of what are the longerterm objectives of the club/ organisation and how their role contributes to this. Each person will have an area of responsibility and they must feel empowered, supported, and challenged at the appropriate time.

Winning and losing is the outcome of a process and often we lose and perform well and sometimes we win and perform badly. It is vital that the performance lead understands the long-term goals and can deflect from the emotional noise of defeats and ensure all staff focus on this bigger picture. This doesn’t mean that our course of action will not change, and it should be annually reviewed for what has worked well and what we could have done better.

I’ve always stated that any player below the age of 16 is a schoolboy first and a scholar in football second. If they are offered a full-time scholarship at 16, then they become a footballer first. However, personal development throughout all of this is as important as the football in my view and if undertaken➡

correctly, will not only give them much needed life skills but will also make them better, more humble players.

“The person always comes before the footballer in my view and we are all uniquely different and have different backgrounds, ethnicity, and values. These must be understood to help in the development of the person and give them a clear identity. The academy system is best when multi-sport activity and personal development is encouraged to the age of 16 and from 16 to 21, specialising in football and more personal development.

What we should be encouraging is a life journey of continual growth and development and if we create the right environment for children to thrive, those who don’t make it in the academy system as footballers will have a happy, healthy and successful life. This is my view is how we should be judged on, as well as the number of footballers we produce.

30 years ago, every member of the coaching and medical team cared for the player as a person but had no specialist training or skills in player wellbeing and lifestyle management. Today we thankfully have specialists in both, and many clubs are genuinely looking to have a duty of care to their players long after they have finished playing. This I feel is a vital and improved level of service and care for the whole community of football and I hope eventually will spread not only in the men’s and academy system, but to women’s football too. Many more people need to understand that dedicating your life to a sport like football is not normal and the players have to make many sacrifices along the way. Therefore, helping them back into a ‘normal life and society’ is a duty of care we should all take seriously.

I would finish by saying this is not just for players, this should be for the many dedicated coaching and performance staff who may work in football for 20+ years and one day walk into the office to be told to leave and never return. These dedicated people need a duty of care every bit as much as every player.

The modern-day player lives in a goldfish bowl where every action they undertake on and off the pitch is scrutinised on social media and national & global television. It is so important that we train those who make it that there can be dangers and pitfalls by being sucked into this type pf circus. We also owe a duty of care to all those academy graduates who won’t be successful and I am a great believer the academy system must evolve to a dual career pathway so from an early age scholars, and most importantly parents, see the bigger picture and how difficult it is for their son/ daughter to make it onto the elite professional stage.

Football like any sport or industry can learn from others and it is vital we have an open mind to positive change, especially around player care. The type of player care required in an academy, in women’s and men’s football are slightly different and many football clubs are now employing lifestyle managers who have previously worked in Olympic sport to help & develop player care appropriately.”

It is vital that football clubs employ staff with a diversity in their background, their performance career and in different sports to maximise their ability to care for the player as an individual and I feel that having a non-football background is not a hindrance, particularly in player care. This can be seen as a fresh pair of eyes, approach & a different diverse perspective.

The role of the physio over the 34 years I have been involved in professional football has evolved extensively. However, the one thing that has not changed is we care for players’ health - short, medium, and long term.

Today, there are performance physios who focus on the matches and there are rehabilitation physios who look after the long-term injured players. There is also I feel a sub speciality in paediatric physios who require a different skill set to work in the academy system and I for one don’t feel that progressing to work at a first team is not a natural progression as the two skill sets required are very different. We also have physios who have a specialism in the treatment of specific injuries, e.g., hamstring management, ACL management.

The bigger clubs will have a number of physios and the key is matching their skills up to complement each other. The growth of the women’s game will bring in a different pattern of injuries and those physios specialising in female sport will need a slightly different skill set as this is a specialism in its own right. The picture you see here is of the four medical staff working at Rangers for the men’s and academy team in 1997/98 and shows four staff. Today, in many big Premier League clubs, the number would be in excess of 20.

I have been fortunate enough over my 34 years to have won 28 major trophies and each team will always hold a special memory or time for me. But without doubt, my personal highlight was being awarded an OBE in 2013 for my physiotherapy services to sport and working with young people. I felt especially proud as I was a young 11-year-old dyslexic boy taken out of mainstream education to go to, at that time, a school for remedial children. Without the help of such great teachers I wouldn’t have had the career I did and in receiving this honour, I was delighted to share the news with these people as they had such an impact on my life.

I also have been fortunate to now lecture on six continents of the world and I often think of these teachers and the value they gave is priceless to many who aren’t thick or stupid but just learn a bit differently. To this end I still get tremendous pleasure from helping younger children who write for advice regarding their chosen career and anyone who has ever taken the effort to write to me for such advice I have always replied. U