“All About Culture”: Leeds United’s Ruben Crespo Discusses The Role And Responsibilities of a Premier League Rehab Fitness Coach
When journalists, fans, and pundits praise the performance of a Premier League team, we often hear about the technical exploits of the players, the tactical acumen of the manager, and perhaps the recruitment efforts of a sporting director. However, there’s a whole entourage of backroom staff that make an integral contribution to the success we see on the pitch.
Amongst these less-coveted contributors are the personnel of the club’s medical department; physios, masseurs, and doctors have long since played a critical role in supporting the health and well-being of players. However, one position that is becoming increasingly influential is the rehab fitness coach, who is of fundamental importance to the team and its capacity to deliver any short-term and long-term objectives. While the depth of their input is dependent on their experience and the nature of their relationship with the head of Medicine and Performance at the club they represent, there’s no doubting that rehab fitness coaches are now considered to be one of the key members of the ‘behind-the-scenes’ team.
Contrasting Approaches
Having commenced his career as a fitness coach over 15 years ago, Leeds United’s Ruben Crespo has witnessed this evolution firsthand. ‘’In Spain (his native country), fitness coaches have had a considerable profile for some time,’ Crespo said to R.org. ‘They are really valued, and command a great deal of respect from their colleagues. However, the role in the UK is still evolving.’’
The more traditional medical model of rehabilitation tends to be one-dimensional, as it focuses on addressing the injury in isolation. Ruben favours a performance-oriented approach, which enables him to adopt a more multidimensional process. In the former, roles are often rigid and task-specific—physios treat injuries, coaches train skills, and fitness staff monitor conditioning—without fully integrating these elements. By contrast, the performance approach adapts training and rehabilitation around the player’s limitations, ensuring that recovery is not just about healing the injury but also about maintaining and enhancing performance capacities. This integrated perspective avoids the pitfalls of reducing recovery to a single domain and instead ensures progress is achieved across physical, technical, and tactical levels.
“In football rehabilitation, true expertise comes from mastering three areas: the game itself, fitness coaching, and the science of rehabilitation. A rehab coach cannot operate effectively without a comprehensive understanding of all three, because only then can you fully connect the medical, performance, and tactical needs of a player.
Equally important is clarity at club level. Every department should know the club’s short-, medium-, and long-term objectives and set sub-objectives aligned with them. In the medical department, for example, we need to understand whether success is defined by minimising reinjury rates or by maximising player availability, even if that means accepting higher risks. We always operate in a grey zone, and clear objectives are the lighthouses guiding our decisions. Sometimes safety comes first; other times the context demands risk. I’ll never forget one case where we took a high-risk approach to make a player available for a key match. He played, he scored, and we won 1–0. The manager called me the next day to thank me—it was a reminder that our work is always about balance between risk, context, and club objectives.”
To achieve this, rehab fitness coaches need to work collaboratively with a broad range of stakeholders, including medical professionals, coaching staff, and the player and his representatives. This enables them to gain a clear understanding of the initial medical approach, alongside its potential implications. With that context, they can start to shape the rehabilitation strategy: setting realistic recovery timelines, deciding how progressive or conservative the approach should be, and identifying any associated risks. From there, a tailored recovery plan can be established, with clear expectations set for every stakeholder; the player, the club and the medical staff.
After the player has re-commenced full training and is once again part of the matchday squad, it’s vital that their condition continues to be monitored and appropriate steps are taken to mitigate against a potential recurrence.
“It’s important to understand the meaning behind the profession, ultimately, it’s about caring for the players and by extension the club. Depending on how a club or a manager structures their departments, the role of a rehab fitness coach can vary greatly. We may lead strength and conditioning sessions in the gym, design and deliver individual development plans to support activity on the pitch and in the gym, or guide prevention programmes for individuals or groups—all on top of managing individual rehabilitation plans with injured players. That adaptability is one of our key strengths: we weave football, fitness coaching, and rehabilitation together, covering a wider area than most roles and ensuring players get the support they need throughout their entire journey back to peak performance.”
Learning His Craft
So, why do the practices of some managers differ so wildly from others? ‘’It’s all about culture,’’ enthuses Crespo. ‘’For me, the best managers create an environment whereby every single member of staff – whether that be the players, chef, first-team coach, or kit man – is bought into what the team is trying to achieve, understand their importance, and feel comfortable enough to express themselves.’’ This is something he’s learned throughout his lengthy career, having worked with an eclectic mix of managers in various settings.
A native of the Spanish province of Pontevedra, Crespo was fortunate enough to conduct his internship at local giants Deportivo La Coruña. The club played a pioneering role in the development of the modern-day rehab fitness coach, providing a platform for them to thrive by fully integrating them into first-team affairs. In practice, this meant recognising that the rehab coach is central to the individual management of players—understanding how to balance their load, what activities accelerate recovery, and the harmful short/long-term consequences of not adopting a suitable training plan. From the very start, Crespo was exposed to a role that was far more than peripheral, but instead vital to everyday coaching, rehabilitation, and matchday preparation.
After completing his two seasons at Deportivo and navigating a two-and-a-half-year stint with nearby rivals Celta Vigo, he left Spain to pursue an exciting opportunity with Thai Premier League side Buriram United. A move to Russia then followed, which saw Crespo bring his expertise to Caucasus-based outfit Torpedo Armavir. During his spells in Thailand and Russia, Crespo further developed his understanding of what good leadership looks like, having worked closely with charismatic, passionate, and highly capable senior figures in both instances. “I was working for leaders who not only wanted to encourage unity and cohesion between players, coaches, and backroom staff, but were also attempting to galvanise whole communities.’’
Upon joining Buriram United, Crespo became part of a project which had earlier overseen the relocation of the football club from Ayutthaya – situated just north of Bangkok and around 350km from Buriram itself – to its rightful ‘hometown’. This not only gave residents far more convenient access to the club that represents their community, but also provided an unprecedented economic boost as visiting supporters patronized Buriram’s pre-existing and newly-created businesses before attending matches.
A similar scenario unfolded in Russia, where Crespo worked under the stewardship of Valery Karpin. After representing the likes of Spartak Moscow, Real Sociedad, Celta Vigo, and Valencia during a glittering playing career, Karpin turned his hand to management. Despite returning to Spartak as Head Coach and later taking the reins at Real Mallorca, the former Russian international midfielder opted to drop down the divisions to spearhead a revolution at lowly Torpedo Armavir.
‘‘Karpin wanted to build a football club that the city of Armavir could be proud of, but also invest heavily to provide better facilities and amenities for local people. He knew this would help to foster stronger links between the club and the community, which was mutually beneficial for all.”
Bielsa’s Brilliance
After his eye-opening experiences in Thailand and Russia, Crespo opted to return to slightly more serene footballing waters. A vacancy at Hull City – who had just been promoted back to the Premier League following a two-year absence – attracted his attention, and he was subsequently appointed as the club’s fitness and rehab coach. Although his role with the Tigers saw him assume a great deal of accountability as a lead figure in the club’s medical team, it was his move to Leeds United that really enabled him to spread his wings.
“I arrived at Elland Road at the exact same time as Marcelo Bielsa. I’d never previously worked with a manager like him. His attention to detail was frightening; every single part of the footballing operation was comprehensively scrutinised and subsequently improved. Even more importantly, he had this unnerving ability to knit everyone really closely together, ensure we all understood our shared purpose, and set us on the path towards achieving a common goal. He was absolutely incredible.’’
It’s no coincidence that the best period in the club’s recent history coincided with the Argentinian’s tenure, as Leeds United eventually returned to the Premier League promised land after spending more than a decade in the wilderness. As Crespo impressively articulates, Bielsa’s focus on the team’s long-term prosperity – rather than falling into the trap of just chasing short-term results – created a harmonious atmosphere, whereby teamwork, co-operation, and transparency were prioritised over reviewing inter-departmental performance.
“We all had the same simple objectives; improve every player and the competitiveness of the team. There were never any misunderstandings on that front. Although the coaching team was desperate to get injured players onto the pitch, they fully respected the rehab programme set out by the medical department, and fully trusted it. They knew we would invest every ounce of effort into our work, and take acceptable risks when it was absolutely necessary. It was great.”
It’s this balance between risk and reward that Bielsa manages so perfectly, while also forming genuine connections with those around him. The improvement of every single one of his players supersedes the importance of anything else, while he prepares for each individual game as if it were a final. The passion and love he has for his profession is unrivalled, which leaves an indelible mark on every person he encounters.
Having just entered his eighth season with Leeds United, Crespo remains committed to his own growth while helping the club’s medical department evolve, with the ambition of keeping it among the Premier League’s best. Consequently, he finds no reason to seek pastures new.
“I’ve been fortunate to have a diverse career to press, which has enabled me to work with some amazing personalities in various parts of the world. However, it’s rewarding to feel fully involved in the development of a club like Leeds,’’ he states with a notable hint of modesty. ‘’Of course, working in football, you never know where you are going to be in the future, but the Premier League is one of the best places to ply your trade. I really appreciate how lucky I am to be working in this environment, and do something I love every single day.”