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Mike Davison — Organisational Design Principles — Injury Rehab Network

The latest Injury Rehab Network event with BASRaT featured a fascinating presentation from Mike Davison, an expert in the strategic management of performance support teams. The online event took place on the evening of Thursday 26th February with 145 practitioners in attendance.

Attended by sports rehabilitators and sports medicine practitioners, the session explored how the architecture, leadership, and communication of medical departments influence player availability and success in elite sport.

Mike’s presentation considered Organisational Design Principles for Performance & Medical Departments. The recording is available to watch here.

Mike Davison

Mike Davison MBA, MA, BA – Advisor, The Nxt Level Group

Mike has been part of the international Sports Medicine and Performance community for over 25 years. A former Strategy & Business Architecture Consultant with Accenture, his professional path diverted into the Sports and Health industries whilst undertaking his MBA at Oxford University.

Since 2001, he has actively worked to professionalise and raise standards within Performance and Medical departments in sport globally, through the recruitment of diverse talent, building global knowledge networks, and working practically with organisations on their people, systems, and processes. His passion is to connect people and implement world-leading ideas.

He currently works with Brighton & Hove Albion FC, Houston Texans, Portland Fire and Phoenix Suns. Other Teams that he has worked with include Chelsea FC, the Brooklyn Nets, San Antonio Spurs, OKC Thunder, Liverpool FC, The Football Association, Brighton & Hove Albion FC, Brentford FC, Aston Villa FC, Isokinetic Medical Group (FIFA Medical Centre of Excellence), NY Liberty, NJ Devils, and Red Bull Performance. He is also academically published in the field of injury epidemiology and injury prevention. He serves as a Board Member of the Football Research Group, which conducts injury and performance analysis studies for UEFA.

Organisational Design Principles for Performance & Medical Departments

Mike Davison – Performance Support Strategist

Mike Davison designs and helps strategically manage performance support teams in professional sport. Often acting as a “plug adapter” between sporting directors, head coaches, and medical staff, Mike boasts an incredible resume, having worked with Chelsea FC, the Houston Texans (NFL), the Phoenix Suns (NBA), and the UEFA Football Research Group.

Mike’s advice for practitioners is to follow your passion, think globally, work as a team and aim for the top!

The Power of Communication and Leadership

Mike discussed research conducted with the UEFA Elite Club Injury Study. The findings were clear: the quality of communication and leadership directly impacts injury rates.

  • Communication: High-quality communication between the medical team lead and the head coach resulted in higher player availability in both training (up 4-5%) and matches (up 6%).
  • Leadership: A “transformational” leadership style—one that fosters trust, involves staff in decision-making, and is supportive—correlates with fewer injuries compared to autocratic or adversarial environments.

Football Players

The Modern Context & Injury Rates

The landscape of elite sport has shifted dramatically since 2018. Mike highlighted that departments are exploding in size; for example, Chelsea’s performance support staff grew from 17 to 34 individuals in just three years. This growth is driven by US-style ownership models, multi-club networks, shrinking off-seasons, and the immense off-field demands placed on modern players to be content creators and brands.

Despite these growing departments, football still faces a fundamental issue with muscle injuries, particularly hamstrings and rectus femoris injuries, which predominantly occur during matches.

Organisational Design Models

As departments grow, how should they be structured? Mike outlined three common shapes for “Performance Support Teams” (encompassing player care, medicine, rehab, psychology, and fitness):

  1. The Classic H-Shape (Crossbar): A Director of Medicine and a Director of Sports Science operating side-by-side.
  2. The A-Frame (Tip of the Spear): A single Performance Director overseeing the two distinct heads of medicine and science.
  3. The Spectre Model: A “team of teams” approach with a single Performance Director managing multiple specialized heads (Insights, Therapies, Medicine, Wellness, Physical Performance).

Regardless of the model, Mike stressed the importance of “horizontal working”—ensuring different specialties collaborate seamlessly, much like musical counterpoint where independent rhythms create harmony.

Footballer with hamstring injury

The 7S Pilot Study

To understand if organisational design truly makes a difference, Mike adapted the McKinsey 7S Model (Strategy, Structure, Systems, Skills, Staff, Style, Shared Values) to survey elite football clubs across Europe.

The findings revealed an interesting dichotomy:

  • Strengths: Teams scored themselves highly in Style (fostering trust, positive vision) and Skills (staff development and capability).
  • Weaknesses: Teams scored poorly in Systems. Many elite environments lack documented Standard Operating Procedures (SOPs), regular formal performance appraisals, and truly integrated Athlete Management Systems.

Q&A

Mike kindly answered several questions from the audience following his presentation.

Q1 – What is the role of “Performance Insights” compared to Applied Sports Science?
Answer – Mike explained that “Performance Insights” moves beyond just monitoring GPS data. It involves taking data, turning it into information, and finally into actionable insights or provocations for the coach or player. It’s about discovering performance advantages, integrating AI responsibly, and answering the questions that actually matter.

Q2 – How do you balance the fundamentals (nutrition, recovery) with innovation and “shiny new things”?
Answer – You must have systems that allow the “brilliant basics” to run efficiently on repeat. Once you have that efficiency, you earn the right to explore the new and novel. However, Mike warned that when introducing new innovations, teams must perform regression testing to ensure they aren’t disrupting the fundamentals that actually work.

Q3 – Do you advise hiring practitioners from differing sports outside of football?
Answer – Yes. Mike advocates for a “Noah’s Ark” approach to hiring to ensure cognitive diversity and avoid groupthink. While core physiotherapy might require football/ team sport specific experience, roles in recovery, data, or psychology can hugely benefit from backgrounds in cycling, Olympic sports, or even the military.

Q4 – What advice do you have for practitioners at the grassroots level with limited resources?
Answer – Think globally. Access to world-class education and experts is easier than ever via LinkedIn, YouTube, and online courses. Find a “critical friend” to learn from, keep active reflective notes on your cases to build your own experience database, and always put the player first. Authentic communication goes a long way, even without top-tier resources.

Presentation Recording

The recording of Mike’s presentation is available to watch here

2026 Injury Rehab Network events

The next Injury Rehab Network event is on March 18th, featuring Mike James (The Endurance Physio), who will be discussing the fundamentals of exercise prescription and rehabilitation.

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

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