Non-league football opening to performance staff for injury prevention

Boston Town FC’s first performance specialist, Arun Gray, is a one-man operation for injury prevention, strength and conditioning, rehab and return-to-play. He works under an unusual mix of incentives, maintaining his players’ readiness for the pitch and for their day jobs.

Three of the Premier League’s most expensive players are out of the lineup with injuries. Romelu Lukaku, Paul Pogba and Alvaro Morata each make several hundred thousand dollars per week. Their prolonged absences will cost Manchester United and Chelsea millions of dollars. The medical and performance teams at these clubs must bring these players back to match readiness – and minimize their risk of re-injury –to protect both the clubs’ title ambitions and financial interests in these players.

At the other extreme of the English football pyramid, Arun Gray manages a much different set of pressures and expectations. When any athlete suffers a significant injury we talk about how it affects his livelihood, his identity and career as an athlete. But for semi-professional players at Boston Town FC of the United Counties League, an injury on the pitch truly can derail their ability to make a living.

“The players at this level are paid per game. If they do not play they do not get paid, which creates an entirely new incentive,” Gray said. As semi-professionals, the players all hold day jobs. Boston Town players hold a normal range of full-time jobs, which means some of them will take a double hit from a football injury.

“We have one player who is in a cast because of an ankle sprain. Because of the cast he cannot do his day job. Our goalkeeper dislocated his collar-bone and is out of football for six months. He is also in the Army, so you can imagine the impact his injury has there.”

As Boston Town FC’s first performance specialist, Arun Gray is a one-man operation for injury prevention, strength and conditioning, rehab and return-to-play. In many cases he is the only professional with any experience or training in sports that an injured player will see in their recovery. “Teams at this level do not have in-house medical staff, so the majority of players go to the National Health Service, where they will not find someone with a sports background.”

Gray was a non-league player himself – while attending school and working in sports performance – until he tore his anterior cruciate ligament last season. Rather than play and risk re-injury, he decided to cross the touchline to join the coaching staff.

Before Boston Town, Gray worked at Peterborough United FC in League One (the third tier) and with the Premier League as a fitness testing specialist for youth players. Each league’s resources dictate the extent of testing, assessments and training, but the priorities remain the same.

“About 70% of testing looks for injury risk factors, and the other 30% is performance attributes. If they are injured, they cannot play. There is daily testing, like subjective wellness questionnaires: how they are feeling, how difficult they felt training was, how well they slept.

“Mobility and flexibility testing is a few times a week, if not daily. We would do a full testing battery maybe quarterly, and then compare daily assessments to those baselines.”

The constraints of semi-professional football – two games plus one practice session per week, no gym, limited budget, players with full-time careers – demand a particular creativity from the coaching and performance staff. “You have to be intelligent with your programming, find things that produce a similar benefit without requiring much equipment.”

Since this was his first year with the team, Gray put the players through a pre-season fitness test to understand who he was working with. A chat with each player gave him a foothold to build his first programme. “We started with a talk through their training history, what kind of volume and intensity where they used to. What was their injury history, what injuries were most common across the team. Last season there were several hamstring strains, so we started including injury prevention sessions into training and specific elements to the warmups to get the hamstrings firing before the game.”

The team has one training session per week: Thursday nights, after work. That session is the only opportunity for the head coach to work on playing strategies and skills, and for Gray to do conditioning and injury-proofing. Injured players perform additional work with him before the twice-weekly games on Tuesday and Saturday. Gray can give the players unofficial training to do independently on the other days, but must balance that against their overall loading from their day jobs and other commitments. Rigid compliance could be as counter-productive as non-compliance.

Like the players he serves, Arun Gray has a day job or two. He has his own rehab and performance practice, on top of also being a lifeguard supervisor (like its namesake in the United States, the original Boston is on England’s east coast). He hopes that a greater emphasis on injury prevention and player performance will lead to more opportunities at the lower levels of the football pyramid for students and – eventually – full-time professionals.

“More coaching and medical staff are becoming qualified, and the field is growing. About half the clubs in our league have someone like me. That alone shows the increased commitment to injury prevention and return-to-play. I’d like to develop this side at Boston Town with interns or student work experience to bring in new ideas and help with prevention and rehab.

“It would be good to see more money filter down to the lower clubs specifically set aside for performance and injury prevention. An injury to a non-league player can affect much more than their playing career.”