Tottenham Hotspur have conducted a sweeping review of their performance and medical departments, with the retractable playing surface at Tottenham Hotspur Stadium identified as one area of concern in an investigation into the club's worsening injury crisis.

Spurs lost more days and games to injury than any other Premier League club this season, with their players missing a combined 370 appearances across all competitions. The toll nearly proved catastrophic — Roberto De Zerbi's side required a final-day home victory over Everton to confirm their top-flight survival, finishing 17th for the second successive season.

A second straight season of misery

Since the beginning of the 2024/25 campaign, Tottenham have suffered 123 injuries — only north London rivals Arsenal, with 146, have recorded more in the Premier League over the same period. The back-to-back 17th-place finishes represent a troubling return for the world's ninth-richest football club.

Dan Lewindon, the club's new performance director, has spent three months conducting a thorough review of the injury situation. Among the specific incidents under examination are serious knee injuries suffered by Dejan Kulusevski and Radu Dragusin at home last season, James Maddison's ACL tear sustained in a home fixture in May before a full rupture during pre-season in South Korea, Ben Davies' ankle break against West Ham in January, and Wilson Odobert's ACL rupture in the home defeat to Newcastle.

Tottenham are understood to commission regular independent external testing of their home surface, measuring its bounce characteristics against their training pitch. Results so far have been inconclusive, but further detailed analysis is planned in the coming weeks to compare the surface against other Premier League pitches.

Real Madrid's Bernabeu also in the spotlight

The scrutiny arrives at a moment when retractable pitches are drawing wider attention across football. Real Madrid have faced a spate of ACL injuries since the reopening of the Santiago Bernabeu, and reports in Spain indicate the 15-time European champions are investigating surfaces at both the Bernabeu and their Valdebebas training ground. Spurs' stadium has been in use for seven years — far longer than the Bernabeu's three — though the injury problems at Tottenham have intensified only in the last two seasons.

Structural problems within the club identified

Lewindon's review is understood to have uncovered structural weaknesses in Tottenham's performance set-up, specifically a lack of integration, communication, and shared decision-making that has contributed to both new injuries and recurring ones. In response, the club plans to introduce a small-team model in which up to six players are assigned to a single physiotherapist, enabling more tailored programming and better-informed decisions around training load and physical preparation.

Tottenham are also exploring the appointment of a psychologist for the men's squad to improve communication across the department. Additionally, the rapid succession of four head coaches in a single year — Ange Postecoglou, Thomas Frank, Igor Tudor, and De Zerbi — is believed to have increased injury risk through constantly shifting training demands and tactical methods.

Simons handling defended

The treatment of Xavi Simons during his ACL injury at Molineux also came under scrutiny, with some supporters critical of the decision to allow the attacking midfielder to return to the pitch after receiving ice spray before he was eventually stretchered off. The club defended the call, with Lewindon understood to be fully satisfied with how the medical team handled the situation. Simons had wanted to continue playing, and with an ACL injury difficult to diagnose at pitchside, the club maintains no additional damage was caused. Simons is expected to be available for next season.

Maddison calls for answers

Maddison, limited to 3 substitute appearances at the end of the campaign following his ACL injury, did not mince his words after Sunday's win over Everton.