Performance Health Management in English Professional Football A Mixed Method Study

  • Kunle Odetoyinbo

Student thesis: Doctoral ThesisPhD


Background: Teamwork effectiveness studies illustrate that multi-disciplinary teams working in highly pressured environments can produce sub-optimal outcomes from their work without due consideration of their team’s structure and processes. In professional football, multi-disciplinary performance and healthcare teams (PHCTs) are increasingly being employed to risk-manage football squads in a highly challenging, fast paced and competitive environment. To date, the teamwork effectiveness of PHCTs remains unknown.

Aim: Using the framework of an adapted Integrated Team Effectiveness Model (ITEM), this study sought to determine whether the structures and processes adopted by a PHCT in the English Championship football league, predicted an outcome of their work, namely, the number of players available (PA) for competition during varying match frequencies.

Design: A sequential explanatory mixed method case study

Method: A team process, followed by team structure questionnaire and focus group discussion, were administered during and after the season respectively, to full-time practitioners involved in the delivery of performance and health support services. Match frequency and the number of players available for each match were also recorded, where ≤3 days recovery between matches was considered to represent “match congestion”. The reported data were analysed using Pearson correlation and content or framework analysis where, the qualitative data was used to further inform the quantitative findings.

Results: Player availability (PA) over the course of 39 matches averaged 80.6±4.9% (range 75-89%) during which the PHCT had an average of five days (SD=4, range 2-14) between matches to apply their work. However, for 16 of 28 weeks investigated, preparation took place during match congested periods. During match congestion, 78.1±3.2% of the squad were available for selection compared with 84.2±4.7 outside of these periods, supported by a strong positive correlation between match frequency and PA [r= - 0.68; 95% BCa (.324, .929) p = 0.008]. Interdisciplinary as opposed to multidisciplinary teamwork processes in meetings were associated with more players being available for competition where the PHCT’s ‘teamwork approach’ had a moderately strong correlation with PA [r= 0.53; BCa 95% (.087, .888) p = 0.035]. The higher the number of meetings [r= 0.46; BCa 95% (.219, .821) p = 0.048] and the more satisfaction that PHCT members had with those meetings [r= - 0.41; BCa 95% (.042, .714) p = 0.043] were both associated with higher numbers of players being available for competition. Similarly, the more PHCT staff evaluated of their work and provided feedback for innovation and change, there was a tendency for more of the squad members to be ready for match selection [r= - 0.44; BCa 95% (.374, .878) p = 0.009]. PHCT members interacting negatively towards one another through communicated behaviour, opinions and suggestions during meetings was associated with lower PA [r= - 0.57; BCa 95% (-.087, -.097) p = 0.03].
PHCT working relationships were conceptualised as a ‘structured interdependency’ to reflect important structural aspects of their team which were associated with shared practices focused on optimising PA and winning the next game. A certain degree of disruption to ‘interdependent working’ because of human resource and team premises challenges were evident during match congested periods. This resulted in multidisciplinary rather than interdisciplinary processes being adopted in meetings, contributing to the relationships between PHCT processes and PA.

Conclusion: This study is the first to illustrate that the structure and processes adopted by a PHCT in professional football during varied match frequencies are related to the number of players available for competition. The PHCT’s structure further informed an understanding of these relationships where match frequency was strongly associated with the availability of players for competition. This research provided a unique perspective of the teamwork factors, using the framework of an ITEM, to reveal important aspects of performance and health management in a professional football club.
Date of Award20 Nov 2019
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorCarly McKay (Supervisor)


  • Football
  • Health
  • performance management

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