Tottenham Hotspur survived a catastrophic 2025-26 Premier League campaign by the thinnest of margins, dodging relegation with a desperate 1-0 win over Everton on the final day of the season. But the severe medical crisis that dragged the London club into a relegation dogfight has triggered an extensive internal investigation.
The club suffered 37 separate injuries across all competitions, costing the squad over 2,000 combined player-days on the treatment table. With their average squad availability plummeting to just 77%, well below the internal target of 90%, new performance director Dan Lewindon is now leading a root-and-branch audit of the medical and performance departments to find out exactly what went wrong.
Lewindon’s team is looking at every possible environmental factor. That includes testing the actual bounce and spring of the retractable pitch at the Tottenham Hotspur Stadium to see how it compares to the turf at their Enfield training base.
The sheer volume of knee problems devastated the roster. Long-term ACL tears sidelined James Maddison, Wilson Odobert, and Xavi Simons for significant chunks of the calendar. Dejan Kulusevski did not play a single minute of the campaign as he recovered from his own severe knee injury.
Front office executives acknowledge that the chaotic turnover in the dugout actively worsened the fitness crisis. Tottenham cycled through three different managers in under 12 months: Thomas Frank, Igor Tudor, and finally Roberto De Zerbi. The constant shifts in tactical demands and training intensity under De Zerbi took a heavy physical toll on the players, leaving Sporting Director Johan Lange’s future in serious doubt.
The fallout from back-to-back 17th place finishes has forced a major policy shift behind the scenes. Historically strict on in-house treatment, Spurs will now allow injured players to conduct their rehabilitation away from the club’s facilities with external medical practitioners, provided they agree to a shared recovery plan.
The medical department is also transitioning to a pod-based model for bespoke player treatment and is actively hiring a full-time lead psychologist to help the squad cope with the mental strain of long-term absences.