Alex Ng, MSc ADV. MANIP, BSc (Hons), MSCP – Loans and Emerging Talent Performance Physiotherapist, Tottenham Hotspur Football Club

Introduction

According to CIES Football Observatory, an average of 50.8 matches were being played in the 2023/24 season, by clubs competing in the five major European leagues and UEFA Champions League, which averages a game every 7.18 days all year round (CIES, 2024). Alongside with international fixtures, which was not included in the report, player workload and wellbeing is a constant topic of discussion. As performance and medical teams, balancing risk and player availability remains a challenge within the football medicine world (Read & Rosenbloom, 2024).

Manual therapy is a low risk, non-invasive modality that is widely used across various football environments, it is “a specialized area of physiotherapy that manages neuro-musculoskeletal conditions using clinical reasoning and highly specific manual techniques” (IFOMPT), including joint and tissue mobilisation, manipulation, passive physiological movement and muscle energy technique (Claret al, 2014). Despite being an integral part of many professional athletes’ care, there is a lack of high-quality evidence on how it contributes towards availability, performance and injury management (Short et al, 2023). This editorial aims to explore the clinical reasoning for incorporating manual therapy into multidisciplinary holistic care.