Tottenham Hotspur’s management has implemented significant changes to address persistent injury challenges that have plagued the club in recent seasons.
The north London outfit has experienced periods where double figures of first-team players were unavailable for individual matches, creating substantial difficulties for coaching staff.
The situation reached a critical point with multiple instances of players suffering repeat injuries, suggesting that existing protocols were insufficient to protect player welfare.
The club has since undertaken a comprehensive review of its medical and performance operations under new leadership.
Dan Lewindon, who assumed the role of performance director in February after joining from the City Football Group, discovered an organisation requiring stabilisation across several departments upon his arrival.
The timing coincided with a period of significant transition for the club’s infrastructure.
Prior to this restructuring, Tottenham had operated with considerable continuity in its medical department.
Geoff Scott, a New Zealander who spent more than two decades as head of medicine and sports science, departed the club in 2024.
His tenure was followed by the exits of Adam Brett, serving as director of performance services, and Nick Davies, who held the position of head of sports science, both completing only twelve months in their respective roles.
Nick Stubbings arrived at the club during the 2025 summer transfer window, taking on the medical lead responsibilities for the men’s senior squad after an eleven-year stint at Brentford.
His appointment formed part of a broader overhaul that saw several former Bees staff members relocate to north London alongside him.
Lewindon’s appointment brought extensive experience in performance, science and medicine spanning elite football, tennis and rugby environments.
The former City Football Group recruit quickly established working relationships with the first-team coaching staff, engaging in regular discussions about departmental improvements and alignment with world-class standards.
Under his guidance, initial steps included a comprehensive renovation of the first-team training facilities along with modifications to existing practices.
An independent investigation examined whether the Tottenham Hotspur Stadium pitch might contribute to the high number of long-term injuries sustained by players.
Testing revealed no significant deviation in the surface characteristics compared to other Premier League venues, prompting consideration of more in-depth analysis.
A pod-based approach was introduced for player rehabilitation and injury prevention.
Groups comprising four to six individuals now receive integrated support from dedicated physiotherapists and sports scientists, replacing previous systems where staff covered wider responsibilities.
This structure allows personnel to develop deeper understanding of specific players’ requirements, positional demands and physical needs, facilitating improved collaborative decisions regarding training loads and match participation.
Rebuilding confidence between the playing squad and medical department represented another priority.
Some individuals had previously relied on support from staff members at former clubs or their national team set-ups rather than internal resources.
The new framework aims to address this by fostering stronger internal relationships.
Italian head coach Roberto De Zerbi has embraced the revised approach despite occasional frustrations.
During a league encounter at Nottingham Forest, the 47-year-old was required by medical personnel to withdraw Savio and Destiny Udogie from the contest, though both appeared capable of continuing.
The decision followed pre-established protocols targeting approximately the 60-minute mark for those specific individuals due to associated risks.
When questioned about the substitution, the former Shakhtar Donetsk and Brighton manager acknowledged the circumstances.
Savio’s physical conditioning reportedly limited his capacity for full ninety-minute performances at that stage, while integrating substitutes mid-match presented its own difficulties.
The head coach recognised the rationale behind the instructions while accepting they occasionally conflicted with his desire to utilise available squad members.
De Zerbi demonstrated similar principles during his inaugural weeks at the club, exercising caution with Mohammed Kudus following the player’s setback in April.
Dejan Kulusevski continues undergoing careful management after seventeen months without competitive football involvement, with no urgency applied to his return timeline.
The strategic shift means supporters should anticipate more frequent rotation of the starting eleven.
Rather than fielding identical lineups and risking further physical deterioration, the coaching staff intends to manage fatigue levels more actively, potentially drawing criticism from sections of the fanbase accustomed to seeing consistent selections.
The long-term objective involves achieving equilibrium between cautious player management and competitive requirements.
Those who have worked alongside the Italian report his preference for comprehensive information when determining availability.
Individual welfare reportedly takes precedence over immediate competitive advantage in his decision-making framework.
Despite the adjustment period creating some friction, De Zerbi comprehends the necessity of these measures following years of problematic unavailability statistics that exceeded those of most Premier League rivals.