At numerous points this season, it has felt as though Tottenham Hotspur’s injury crisis would never end. Any glimmer of good news has generally been quickly quashed by another pinging hamstring.
For the best part of three months, Ange Postecoglou has been unable to select four of his first-choice back five.
The frontline has also been decimated with the club’s three top Premier League goalscorers this season – James Maddison, Dominic Solanke and Brennan Johnson – all missing the last five matches. Spurs have had at least eight players sidelined each game since the end of December.
The various absences have resulted in the few fit and available players playing more minutes than they would have anticipated. Pedro Porro, Dejan Kulusevski and Son Heung-min have been largely immune to aches and strains and twists and pulls; all three look spent.
Kulusevski has already clocked up 2,850 minutes of game time this campaign, just 114 fewer than his total from last season.
Following last weekend’s FA Cup exit to Aston Villa, Postecoglou launched an impassioned defence of his squad, and by extension himself, for the tough spot that Spurs find themselves in: 14th in the league, out of both domestic cups and clinging onto the Europa League as their last hope of salvation from a brutal campaign.
“What I’m saying is you can’t be critical of players or players’ performances at this time,” he said.
“Because if you do, then do that with everyone else. Be as critical of other clubs when they’ve got 9 or 10 or 11 players out. And none of them have.”
As Spurs’ injury crisis has dragged on through winter, so the sympathetic voices have diminished.
Other clubs have encountered similarly debilitating injury issues. Bournemouth have had nine players out for the last few weeks, including both centre-forwards lost to serious injuries. Arsenal are currently down to their last three attackers as the others have succumbed one by one to hamstring tears.
Nevertheless, Tottenham have certainly been hit hard. Ben Dinnery, founder of Premier Injuries, a website that tracks player absences across the division, has logged 27 “time-loss injuries” for Spurs this season, which are defined as those that cause a player to miss at least one match.
That will be up to 28 by the time they play Manchester United on Sunday after Richarlison suffered a calf strain during last week’s Carabao Cup defeat to Liverpool. They had 37 across the entirety of Postecoglou’s debut campaign and only Brighton (with 30) have had more in the top-flight this term.
Hamstring injuries on the rise
A big problem that Spurs have had, as other teams have experienced, is that a number of those setbacks have been muscle-related which can be harder and in some cases longer, to recover from than a bone fracture.
Judging when a player can return to action after a muscle strain or tear is very difficult, a highwire act of risk mitigation. A player is only cleared to play when they, the club’s medical department and the club’s management team, have all signed it off.
Of Tottenham’s 28 time-loss injuries, 18 have been muscular. More eye-catching still is that 10 of those have been hamstring-related, just one fewer than they had in the whole of last season.
The rise in hamstring injuries, and in particular severe ones that cause a Grade Two or Grade Three tear which often require surgery to mend, is not Spurs-specific and is fairly common across the Premier League.
The relentlessness of the schedule is an obvious root cause. With more summer tournaments and pre-season tours around the globe, elite players basically have an 11-month season to get through. As Postecoglou mentioned, his depleted squad have had games on Thursdays and Sundays for months.
A seven-day rest between fixtures against Villa and United is the longest Spurs have had since the last international break in November when most of their players were in action for the countries anyway.
A ubiquitous “high press” playing style across the league is another factor. When Mauricio Pochettino implemented a relentless pressing game at Southampton and then Spurs, it was still something of a novelty in the English game and more associated with teams from the Bundesliga.
Now it is everywhere, in no small part due to Pochettino and Jurgen Klopp’s influence.
In Tottenham’s case, the immense physical demands of Postecoglou’s playing style have also been suggested as a major factor.
Is Postecoglou’s playing style to blame?
Data from Opta shows that Spurs rank top in the Premier League this season for total sprints with 4,200 (175 per match), and pressures in the final third (1,505) and second to Ipswich for distance covered.
That last stat is especially interesting given Tottenham have had the fourth-highest possession share (Ipswich have had the 18th). A general assumption would be that teams with more of the ball do less running but that is evidently not the case with Spurs where every action, on and off the ball, is done at high intensity.
The obvious conclusion to draw from the data is that the more sprints a team does, the more likely they are to succumb to muscle injuries.
Postecoglou’s high-line approach is particularly demanding of the defenders as they are required to sprint up the pitch to engage with their opponents and race back towards their own goal if a team gets in behind them. Centre-backs Micky van de Ven and Cristian Romero and left-back Destiny Udogie have all been out at the same time due to hamstring injuries.
“The reality is this: if you insist on only driving in the fast lane, your tyres are going to wear quicker,” quipped Jamie Carragher in his latest Daily Telegraph column.
Spurs have also suffered from players enduring re-injuries, a situation described by one source as “every medic’s worst nightmare”. Van de Ven missed eight games due to a hamstring injury between October and December, suffered a recurrence on his comeback game against Chelsea and then missed another 14.
The Dutchman returned to play 45 minutes of Tottenham’s Europa League clash with Elfsborg at the end of January but has subsequently sat out their next three games, including two crunch ones against Liverpool and Aston Villa in the cups and will be absent again this weekend.
Summer signing Wilson Odobert has been similarly unfortunate. He injured a hamstring in September, came on for the final few minutes of a game against AZ Alkmaar on his return at the end of October, and hasn’t been seen again since.
While at Celtic, Postecoglou acknowledged that injuries were an inevitability due to his tactics but that they would settle down once players became more accustomed to his methods. That proved to be the case in Glasgow but hasn’t been replicated in London.
Modifying training to ease players back in is difficult. As one source said to The i Paper, training at a lower intensity to then play a match at a higher intensity puts the risk of injury “through the roof”. There is a delicate balance when it comes to reintegrating a player and it’s one that Tottenham have struggled to find.
In Postecoglou’s defence, he has tweaked his style slightly of late. Spurs have played noticeably deeper in recent matches, to good effect against Brentford in their last league game when they won 2-0 and much less successfully at Anfield when they were trounced 4-0.
However, given Postecoglou’s unswerving faith in the methods that have served him well over a 29-year management career across continents, it is surely a temporary reprieve.
He even bristled at the suggestion that Spurs played a “low block” after the win at Brentford by insisting the pressing intensity was less because the players were fatigued.
It seems reasonable to conclude that the extent of Tottenham’s injury woes has bought their manager time.
Crisis starting to ease
Defeats to Ipswich Town, Everton and Leicester City all had an end-game feeling, but he clung on. His position remains in a precarious state after exits from both cups this month.
If Postecoglou’s future is going to be judged once he has a deeper squad to work with, the coming weeks are going to be crucial. The injury list is slowly starting to clear up.
Guglielmo Vicario, Maddison, Udogie, Odobert and Johnson are all in contention to face United and according to Postecoglou, Van de Ven, Romero and Solanke are all two to three weeks away.
Postecoglou has been adamant that Spurs will be an “outstanding team” as more key players return. As the season enters its pivotal final third, he will hope that the switch can be flicked quickly.