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Injuries and Turgid Football: What to Expect for the Rest of 2020/21

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As the domestic schedule constricts, what should we expect for the rest of the Premier League season?

Jurgen Klopp, Manager of Liverpool gives their team instructions as Scott Parker, Manager of Fulham looks on during the Premier League match between Fulham and Liverpool at Craven Cottage on December 13, 2020 in London, England
Jurgen Klopp, Manager of Liverpool gives their team instructions as Scott Parker, Manager of Fulham looks on during the Premier League match between Fulham and Liverpool at Craven Cottage on December 13, 2020 in London, England
Photo by Mike Hewitt/Getty Images

While Liverpool have a new set of injury concerns, lengthy injury lists are certainly not solely Jürgen Klopp’s problem: given the challenging schedule and lack of preseason, injury levels look to reach a Premier League high this season due to an uptick in muscle strains, pulls, and soreness (leaving aside general fatigue) caused most likely by a lack of recovery time paired with overuse.

Have there really been more injuries?

Yes. As early as October there was a noticeable rise in injury in the Premier League. Writing in The Athletic, Ali Humayun noted that in just the first five weeks of the new season experts were already noticing a 42 per cent uptick in muscle injuries from the previous season, more than doubling the number from that stage in the 2017/18 season (a figure which included tears, pulls, tightness, strains and similar, but did not include fatigue or absences due to rotation needs).

Rather than being a fluke, the muscle injury uptick has continued, albeit as at a slightly slower rate: what was 78 muscle injuries in October became 133 by mid-November (now down to a 23 per cent increase since last season, which is, you know, still a lot).

That number has risen since. We are just 12 weeks into the Premier League season.

Given that injury concerns have affected everyone, the 2020/21 season has not only challenged the teams in Europe who are playing every few days, though they have certainly been hit; instead, the shortened preseason has taken its toll on all clubs, adding to the number of injuries that would occur in a normal season. Experts like former Arsenal and England physio Gary Lewin point to both of these elements as clear factors in the injury landscape.

This pattern is especially worrying because previous study by the UK College of Podiatry determined that Premier League footballers were already at greater risk for muscle injury than their competitors in other European leagues. Examining data from the 2018/19 season, they identified the infamous holiday period as the likely culprit.

“The research also found that the Premier League experienced a higher rate of injuries per game in the winter period, reporting 2.3 injuries per game on average, compared to the average of the four comparable leagues (1.94).”

So, Klopp was right to be taken aback by the winter schedule during his first full season at Liverpool, as such a crowded fixture list makes the Premier League unlike any other top domestic league in Europe.

“In 2018/19, 109 matches were scheduled over December/January, in contrast to France where 76 matches were played over those months and Germany, where just 62 were played. Due to this higher number of games, the Premier League accounted for 40% of all injuries reported across the four leagues during the winter period with a fifth (21%) of those injuries to the foot and lower limb. The average recovery time for Premier League players was 27.86 days.”

This should set off warning bells, as what we’re seeing for teams in Europe thus far this season has been akin to an extended Premier League December schedule — and now that the group stages are over, the domestic matches will themselves contract.

Alexander-Arnold lies on the ground in pain after injuring his calf against Manchester City in November. He has since returned to the side.
Trent Alexander-Arnold of Liverpool goes down injured during the Premier League match between Manchester City and Liverpool at Etihad Stadium on November 8, 2020 in Manchester, United Kingdom.
Photo by Simon Stacpoole/Offside/Offside via Getty Images

What can be done?

Not much, apparently. Because of varying monetary concerns in the various national and international football governing bodies, a decrease in actual fixtures never looked likely. Broadcasters have claimed innocence in their own power to make fixture scheduling choices, seemingly unable to provide even a few hours of recovery time for teams playing late games midweek.

Given the lack of flexibility in fixture scheduling themselves, the only thing currently on the table is a reconsideration of the five subs allowance — the Premier League is the only top league that voted not to put five substitutions in place.

Earlier this week, the Professional Footballers’ Association (PFA) got involved, submitting a letter (supported also by the International Players’ Union, FIFPro) condemning the Premier League’s choice in the matter and urging the league to reconsider:

“This is now paramount in the interests of player welfare and health and safety and we respectfully request the Premier League board of directors and its executive team to convince all of its member clubs to adopt and ask you to reintroduce the five subs rule with immediate effect.

“As you are aware, all major competitions and leagues in Europe have adopted the five substitutions rule. That the Premier League has not is entirely anomalous and is inconsistent with its position as a leader in footballing best practice.

“That competitor leagues have adopted this rule supports our strong view that this is not a matter of big clubs versus small, rather that it is a fundamental issue of player welfare and health and safety.

“We have been very concerned, and remain so, about the physical load on players who are now frequently required to play every two or three days or so.

“The physical load on players is therefore hugely increased and the consequent fatigue that players are currently experiencing is leading to avoidable and distressing injuries.”

What’s stopping the five subs?

Fourteen clubs need to be in favor of the change, and in previous votes only 11 voted for it, with some managers believing the change would benefit the larger clubs over the smaller ones — a perspective which the PFA letter suggests places self-interest on the part of clubs over player welfare.

Though the letter itself, combined with continued pressure from managers like Klopp (though he is not alone: Guardiola and others have been in favor of five subs all along, and managers like David Moyes have come around, as the West Ham United boss reports changing his mind on the sub number issue) will likely force another vote this month, a recent article in BBC Sport noted that the outcome of the vote is not at present expected to change.

But does this argument make sense?

Kind of, but not really. Certainly the larger clubs have bigger, better squads, but all clubs should be interested in doing anything they can to limit player injury in such a challenging season. Even if acting in cynical self-interest, the “smaller clubs” might benefit from five substitutions allowing them to rotate their best players slightly more often, rather than seeing these players get injured and having to play their apparently drastically inferior back-ups in their place in the long term.

We’re not even certain that the bigger clubs will benefit most, particularly since a number of them have lengthy injury lists as it stands. Are we certain Liverpool have five players to bring on? As many have noted, having five substitutes does not mean clubs will always make five subs. Instead, this added flexibility will help managers maintain their tactical plans while allowing for the management of minutes. If a manager has three planned substitutions in his game plan, but instead has to make two unplanned substitutions because of injury — or to prevent injury, if a player feels tightness, for example — the face of the game changes, and players who needed their minutes managed are now under risk.

This isn’t a perfect solution, and won’t always be necessary. But should something generally agreed to be helpful to players be avoided because of perceptions of unfairness? I’d argue not, particularly since there’s no proof that this is the case. The biggest winners in points-per-game improvement with five substitutes during Project Restart last season was Southampton, who improved by a whopping +0.82 points per game in this period. The biggest losers? Liverpool, who were confirmed as Champions a few games in, and Crystal Palace (both on -0.91 points per game). Interestingly, Burnley, who had a challenging run and who famously don’t make many substitutions anyway, improved by +0.33 points-per-game during Project Restart — and they cannot be argued to have a huge squad, especially in this period, as they called on U23 players after issues with first team contracts.

So we get five subs, what will happen?

Big picture? Not enough. In my opinion, the five subs is worth doing simply because doing something within the clubs’ power to help player welfare is better than doing nothing. But make no mistake, Fulham v Liverpool (or the Manchester derby, MY GOD; at least Fulham played well...) will not be the last slog of a match you’ll be asked to watch this season. The teams who finished their European group fixtures midweek last week almost all looked quite poor this weekend. Only Leicester won. There were more injuries.

Now all teams in the Premier League will be facing a grueling schedule, and this will likely take a human toll, as players will be more likely to become injured, and be less able to keep up an ideal recovery schedule. It will also probably take a toll on the quality of football on show, both due to fatigue and due to the unavailability of players.

Writing earlier this week in The New York Times, Rory Smith noted that this huge uptick in muscle injuries due to shortened preseason and harsher scheduling means that prestigious European competitions might be something like “Injury Roulette”:

“With muscle injuries rising and an unforgiving, pandemic-compressed schedule looming, Europe might not crown its best team this season, but the one that’s still standing.”

This might well be the case in domestic competitions as well, as the end of the UEFA group stages mean domestic league schedules can now be packed tighter: Premier League teams are now looking at a holiday fixture list that stretches beyond the traditional holiday period. While the “randomness” of being eliminated due to one bad night in the Champions League might usually make European competition harder to predict, the long-term nature of muscle injuries — and their seeming endless accumulation — might add randomness to the Premier League too.

Consistent levels of high performance are usually rewarded by a domestic title, but this season no one believes points records are in jeopardy as they have been for the previous two; instead, as managers are forced to rotate and make do with a half-fit side on any given matchday, randomness might just reign. The team that wins the Premier League in 2020/21 might well be the best team in the pack — but it’s just as likely it’s the healthiest and most strategic of any of a number of sides.

This randomness might seem to add to the competition’s “fun” for a cynical neutral, but challenges around a packed schedule and uneven fitness might take their toll on the players, injured or not, and affect their ability to play their best every few days. What can be done? Likely nothing. But try not to go too hard on your team’s players when they have an off day, and try to put player well-being above perceptions of a competitive edge.