Tottenham Hotspur have launched a sweeping internal audit into the fitness crisis that blighted their season, with particular attention given to an "unusual" cluster of anterior cruciate ligament injuries that disrupted their entire campaign.

The club only secured their Premier League survival on the final day, edging past Everton 1-0, but the season was defined by a relentless stream of injuries to key players rather than any consistent football.

Scale of the problem

Performance director Dan Lewindon, who arrived at Spurs from the City Football Group earlier this year, is leading the review. The scale of the disruption has been stark: squad members were unavailable for a combined total of more than 2,000 days last season, with average player availability sitting at roughly 77 percent.

Tottenham are targeting a significant improvement — closer to 90 percent availability and fewer than 1,000 days lost — though the club acknowledges those benchmarks will be difficult to meet in the short term before next season begins.

Among the most damaging setbacks, James Maddison, Wilson Odobert, and Xavi Simons all suffered long-term ACL injuries during the campaign. Dejan Kulusevski missed the season in its entirety after undergoing surgery on a serious knee injury sustained at the close of the 2024-25 season.

Pitch and treatment under scrutiny

As part of the audit, Tottenham are examining multiple potential causes. One area of focus is the surface at their home ground — specifically, whether the "bounce" of the pitch differs meaningfully from those at rival clubs and at their Enfield training centre. Current findings show no significant difference, but testing continues.

The club has also faced scrutiny over the on-field handling of Simons' injury, after footage emerged showing medical staff allowing the Dutch attacker to bear weight on his knee following what turned out to be a serious injury. Tottenham are understood to be confident that the initial treatment did not worsen the damage to his knee.

Overhauling the medical approach

Lewindon's key recommendation is a shift towards highly individualised medical support. Staff will build bespoke profiles for each player — incorporating physical, psychological, and personal data — to both treat and prevent injury more effectively.

Spurs are also set to grant injured players greater freedom to carry out part of their rehabilitation away from the club's training facility. Across the Premier League, players increasingly rely on external practitioners, and many overseas footballers return home for treatment. Tottenham are willing to accommodate that, provided all parties agree on a single shared recovery plan, with the club retaining ultimate responsibility for any complications.

The medical department will work closely with head coach Roberto de Zerbi and his staff throughout the summer. There is an acknowledgement at the club that cycling through three managers in under 12 months may have contributed to the injury burden.

Going forward, an integrated structure will ensure De Zerbi or a member of his coaching staff, the medical team, and the player are all involved in decisions about accelerating rehabilitation timelines.

Psychology will also play a greater role, with the club set to hire a full-time head of psychology to support both players and staff.