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Mark Leather — Professional Football Medical Support Q&A — Injury Rehab Network

The Injury Rehab Network, in partnership with BASRaT and Sterosport, recently hosted an engaging Q&A session with Mark Leather, a highly experienced physiotherapist with an extensive background in elite sport and professional football. Hosted by Andrew Watson from Sterosport, the session offered attendees a candid look at the realities of working in high-pressure sporting environments and insights into the evolution of sports medicine in professional sport.

The online event took place on the evening of Wednesday 15th April with 150 practitioners in attendance. The recording of this Q&A session with Mark is online here

Mark Leather

Mark Leather, Physiotherapist

Mark Leather qualified as a physiotherapist in 1983, spending four years in the NHS before transitioning into a career in professional football. He has worked in the Premier League for over a decade, including six years as Head Physiotherapist at Liverpool FC, and more than 20 years as Head Physiotherapist at various clubs, such as Sunderland, Preston North End, Burnley, and Brighton. More recently, he served as Head of Performance and Medicine at Bolton Wanderers.

Beyond football, Mark has served as Head Physiotherapist at Wigan Warriors RLFC and has worked at the Commonwealth Games (1986) and the World University Games (2007). He was a Physiotherapist to the England Futsal Team for ten years, lectured for the Football Association for over 20 years, and has acted as a Consultant Physiotherapist for IPRS.

Following a successful period at Edge Hill University, Mark joined the University of Central Lancashire as a Senior Lecturer and Course Leader for the MSc Football Science and Rehabilitation and the MSc Football Medical Leadership & Performance programmes, both of which are delivered online. He is Director of Mark Leather Physiotherapy Ltd and a guest columnist for the Daily Mail and The Times on sports injury matters.

After semi-retiring in September 2024, he continued in his university role until June 2025 and now holds the position of Honorary Senior Lecturer at the University of Lancashire. He is currently a Subject Matter Expert at Setanta College, Dublin, and an External Examiner at St John’s York University and the University of Essex.

Footballer with hamstring injury

Professional Football Medical Support Q&A

Here are the key highlights and takeaways from Mark’s insightful discussion.

Unconventional Beginnings and the Value of Resilience

Mark’s journey into physiotherapy wasn’t a standard academic progression. Following a severe knee injury in his youth, he was treated by “remedial gymnasts”—practitioners with military physical training backgrounds who focused heavily on exercise rehabilitation. Inspired by their approach, he eventually pursued his qualifications, gaining early experience in demanding environments like young offenders units and primary schools.

Breaking into football required immense persistence. Mark wrote letters to all 92 Football League clubs offering his services—and received 14 rejections, with the rest ignoring him entirely. However, his willingness to volunteer and put himself out of his comfort zone eventually led to roles at Port Vale, Brighton, Preston North End, Burnley, Liverpool, Bolton, and Sunderland.

“Soft Skills” Are Essential Skills

For students and graduates looking to enter elite sports, Mark emphasised that academic grades are often just a “tick box”. What truly sets a practitioner apart are their interpersonal skills.

When building his department at Liverpool Football Club from scratch, Mark prioritised hiring individuals who were inquiring, organised, and trustworthy. The ability to communicate effectively, be assertive, and function cohesively within a multidisciplinary team is what helps a practitioner survive and thrive in a football club.

Navigating Club Dynamics and Standing Your Ground

Working in elite football means navigating high-stress environments and demanding management. Mark shared anecdotes from his early days at Liverpool, where he had to establish strict discipline—such as locking the treatment room to prevent players like John Barnes and Ian Rush from using it as a lounge for midday naps.

He also spoke candidly about the difficult compromises practitioners face. While building a strong relationship with the manager is important, Mark stressed the necessity of holding the line on medical ethics. He recounted instances of being pressured to declare unfit players as fit to play, ultimately making the difficult decision to leave a role rather than risk medical negligence or compromise player welfare.

Injury Prevention and Rehab Strategies

When discussing lower-limb soft tissue injuries, Mark noted that prevention starts with recruitment and comprehensive medical screening. From there, individualised prehabilitation programmes based on a player’s profile and injury history are crucial.

Mark highlighted that rehabilitation principles should closely mirror strength and conditioning (S&C) training principles—focusing on progression, regression, tissue adaptation, and safe overload. He advocated for strong collaboration between physiotherapists and S&C coaches to ensure athletes transition safely from the treatment room back to the pitch.

The Evolving Landscape of Professional Football

The conversation also touched on the broader landscape of professional football:

Women’s Football: Mark acknowledged the explosive growth of women’s professional football and the pressing need for longitudinal research into female-specific injury burdens, such as ACL tears and the impact of hormonal changes.
Player Burnout: In the men’s game, the relentless fixture calendar is pushing players to physical and mental saturation, inevitably leading to spikes in injuries. Mark suggested that a theoretical 10% reduction in player minutes could help, though he recognised the financial realities of the sport make this unlikely.
The Qualifications Barrier: Addressing a common frustration, Mark discussed the systemic barriers faced by BASRaT and SST registrants in elite football compared to HCPC-registered physiotherapists. He argued that sports rehabilitators often possess superior exercise-based skills, and while league regulations currently favour HCPC registration, practitioners should focus on building their networks and working confidently within their scope of practice .

We would like to extend a huge thank you to Mark Leather for sharing his time and expertise, and to everyone who joined us live.

Further information and follow Mark Leather, Physio

Mark Leather Physiotherapy website

Recording

The recording of this Q&A session with Mark is online here

2026 Injury Rehab Network events

The next Injury Rehab Network event is on Monday 27th April at 7pm with Professor James Hull. James’s presentation, “Breathing to Win” will consider respiratory problems in sport. Find out more and register here

Find out about and register your interest for all the Injury Rehab Network events with BASRaT planned for 2026

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