Tottenham Hotspur have launched a comprehensive internal audit to understand why their campaign was derailed by an extraordinary wave of fitness setbacks. Led by performance director Dan Lewindon, who arrived from the City Football Group earlier this year, the review zeroes in on a disturbing rise in anterior cruciate ligament (ACL) injuries and a player availability rate that hovered around 77%—far below the club's target of 90%. Across the season, squad members missed a combined total of more than 2,000 days through injury, undermining any hopes of consistency on the pitch.
The toll on key personnel was severe. James Maddison, Wilson Odobert, and Xavi Simons all sustained long-term ACL injuries that ruled them out for extended periods. Dejan Kulusevski missed the entire campaign after undergoing surgery to address a serious knee problem dating back to the 2024-25 season. These absences ripped through manager Roberto de Zerbi’s plans, leaving Spurs scrambling for cohesion and ultimately escaping relegation only on the final day with a 1-0 win over Everton.
Medical staff have acknowledged that the club has suffered more ACL injuries than would be expected, prompting a forensic examination of potential causes. One line of inquiry focuses on the playing surface at the Tottenham Hotspur Stadium, with tests comparing the pitch’s “bounce” to those at rival grounds and the Enfield training center. So far, no significant differences have emerged, but the investigation remains active. Some injuries, like Odobert’s, are viewed as unavoidable—he damaged his ACL after an awkward landing—yet the cluster of cases demands answers.
The audit has also scrutinized the on-field management of injuries after fan backlash over the treatment of Simons. Video footage appeared to show medical staff allowing the Dutch attacker to put weight on his knee despite the severity of the injury, stoking fears of additional damage. However, the club is confident that no further harm was caused during that initial response. Still, the episode has cast a spotlight on protocols and has likely accelerated changes in how Spurs handle acute situations.
Central to Lewindon’s recommendations is a shift toward highly individualized medical support. Moving away from a one-size-fits-all model, the performance team will create bespoke player profiles that account for physical markers like strength and fatigue, as well as psychological readiness. This data-driven approach aims not only to treat injuries more effectively but to prevent them by spotting warning signs early. The club also intends to grant more flexibility for players to conduct parts of their rehabilitation away from the training ground, provided all parties adhere to a unified recovery plan.
The human element is just as crucial. Spurs will hire a full-time head of psychology to work with both players and staff, acknowledging that mental resilience and confidence play a critical role in returning from long-term injury. This reflects a broader trend in elite sport, where psychological support is no longer an afterthought but a core component of performance. By embedding a psychologist within the setup, Tottenham hope to build a more robust support structure that addresses the invisible scars of injury cycles.
The upheaval in the dugout cannot be ignored either. Tottenham churned through three managers in less than 12 months, and the review suggests that the lack of continuity may have exacerbated fitness problems. Different coaching staffs bring different training intensities and philosophies, potentially leading to inconsistent load management. To counter this, the club will establish an integrated decision-making structure that brings together the head coach, medical department, and the player when determining the pace of a rehabilitation program.
The implications for next season are significant. If Spurs can move their availability numbers closer to 90%, the squad would have far greater stability, allowing de Zerbi to implement his tactical vision without constant disruption. The review is a clear admission that football success was not driving every decision in the past, and the new framework signals a more holistic, meticulous approach to player welfare that could become a competitive advantage in the Premier League’s attritional environment.
Tottenham’s willingness to examine such a sensitive topic in such granular detail suggests a club determined to break a vicious cycle. While some knee injuries will always occur in a contact sport, the measures being put in place—from pitch analysis to personalized recovery pathways—aim to cut the risk as low as possible. For a fanbase that has endured a season of frustration, the audit offers not just an explanation but a roadmap to a more resilient future. Based on reporting from BBC Sport.
