Injuries, in a very dangerous spiral: the data that explains the decline in elite football

Since his debut in LaLiga, Gavi had not suffered a single injury with Barcelona. Since August 29, 2021, under the orders of Ronald Koeman against Getafe, the young midfielder had only missed two games with the Blaugrana due to covid. In fact, under the command of Xavi Hernández, this season he had already played 1,172 minutes between the League and the Champions League, 86.5% of the total.. With the Spanish team, he was also a starter in the six qualifying days for the Euro Cup, where he was only absent for 67 minutes.. At the age of 19, in full physical splendor, the Sevillian was not only experiencing an amazing moment of form, but he seemed like an indestructible footballer, immune to any contingency.. However, this Sunday, Gavi broke badly on the José Zorrilla grass. Yesterday's tests confirmed a complete tear of the anterior cruciate ligament in his right knee, with damage to the meniscus.. An illness that will keep him out of competition for eight months. That is to say: goodbye to 27 games with Barça and goodbye to the Euro Cup and the Olympic Games with Spain.

The Gavi case is the latest episode in the extensive list of misfortunes that the national team break has left behind.. A plague that stirs up, like every year, the debate on the health of footballers and in the face of which three options are open: reduce the load of matches, accept injuries as something inherent or undertake an ambitious reform of the business model.. In search of answers, this newspaper has contacted top-level professionals, although, given the slippery nature of the matter, none wanted to reveal their identity.

«International players cannot enjoy the most precious asset: their time and rest. “They are prisoners of an increasingly overloaded calendar, where injuries are the consequence and the calendar is one of the main causes,” says the physiotherapist of a Madrid First Division club.. The development of his approach outlines a perspective perhaps little known to the general public.. «For them it is always difficult to find moments of oxygen. On a mental level, they can live close to burnout, that is, emotional exhaustion.. And at a physiological and biological level they live continuously exposed to stress, something unsustainable in the long term,” he maintains.

“Less responsiveness”

During the last two decades, top-level football has evolved in a worrying way. This is not a mere speculative assessment, but rather a fact scientifically verified by UEFA itself.. Since 2001, the highest European body has been developing a research project, under the acronym ECIS, among 3,909 footballers from 54 clubs to better understand the phenomenon of injuries.. According to this study, led by Swede Jan Ekstrand, the incidence of thigh problems had increased from 12% in 2002 to 24% in 2022.. In the same proportion, the sick leave periods linked to these muscular problems had increased from 10% to 20%.

«No one can question the evidence between the increase in workload and the percentage of injuries. But we should not limit ourselves only to muscle overloads or tears.. There is a high percentage of traumatic injuries,” a renowned specialist tells EL MUNDO.. «Increased activity and fatigue not only cause more trauma, but also reduce the ability to respond. That is, if you turn your knee in a strange way while very fatigued, you have less ability to defend yourself from that possible injury,” he adds from his clinic, recognized since 2013 as a FIFA Center.

According to data from FIFPro, the majority union of footballers, between July 2022 and April 2023, more than 3,000 injuries were recorded in the five best European leagues (Premier, LaLiga, Serie A, Bundesliga and Ligue 1). An average of 30 per year for each team. 64% of them affected soft tissues, such as muscles, tendons and ligaments. LaLiga, with 487, was the least affected, far behind the Premier (686).

There must be direct communication between clubs and federations. Only in this way can we protect the footballer

Even more interesting is the comparison that FIFPro establishes between generations. One of the most illustrative examples is that of Jude Bellingham. Before turning 20, he played 14,445 minutes at the highest level, compared to 9,187 for Michael Owen or 10,989 for Wayne Rooney, other English stars of early explosion.. The differences in workload were also abysmal in other case studies. For example, Kylian Mbappé participated 37% more than Thierry Henry at the same age and Pedri, 20% more than Xavi Hernández.

And if we bring the numbers closer to the immediate present, few have gone as far as Raphael Varane, who last February, at just 29 years old, announced his retirement from the French national team.. According to the specialized platform Football Benchmark, the Manchester United centre-back had completed, between 2018 and 2023, almost 230,000 km during 324 hours of flight.. Throughout these five campaigns, only in 2019 and 2022 was he able to enjoy four weeks of summer vacation. And no year did he rest the recommended two in the middle of the course.

In a similar sphere, although not so extreme, it is worth remembering that Vinicius, victim on Thursday of another relapse in his left thigh, played 16 consecutive games last fall. Between August 2022 and May 2023, he participated in 59 matches in nine different competitions, 75% of them without the mandatory five-day rest.

«The daily bread in grassroots football»

The relapse of the '7', who with all his good faith announced that he would “give everything” to play today against Argentina, must be explained by the emergencies, both those imposed and those assumed by himself.. A wild race to which the stars became accustomed from their early adolescence. «Of course this is the daily bread in grassroots football. Parents are the first to not ask you how their child is doing, but rather when they can play again.. So many have already assumed, from a very young age, this insane modus operandi,” says a senior youth manager, who combines his activity with teaching work at the European University.

The moment of Camavinga's injury, after a kick from Dembélé. AFP

As for the economic consequences, the ones that worry the clubs the most, the example of Liverpool is enough, where 19 players were absent at least one day of the last Premier League for medical reasons.. After being eliminated from the Champions League seven years later, the Anfield club saw more than 65% of its income from its participation in European competitions disappear.. Not to mention the financial disaster caused by the absence of Thiago Alcántara – with an annual salary of 12 million euros – during 60% of the matches or Diogo Jota – with a salary of 8.5 million – during 49%..

What to do then, faced with such a panorama? A professional in the field, with 13 years of experience in another Madrid Primera club, offers his point of view. «I understand that it is not an easy task, because the player always wants to compete, but recent cases show that there must be direct communication between clubs, which are the ones that handle first-hand information, and federations for the common good.. Only with this consonance can we protect the footballer.”.

While waiting for this alignment of interests, the short and medium term future looks rather bleak.. Without going any further, the new format of the Champions League, which in 2024 will go from 32 to 36 participants, will require 17 games for the finalists, four more than now.. Likewise, FIFA's plans for its Club World Cup include expanding the format from seven to 32 participants, with a group stage and a maximum of seven days.. Its inclusion, between June and July, will mean another twist for exhausted athletes. In this way, the 80 games of the 2021-22 campaign would give way to 89 in 2024-25, with a jibarized preseason, increasingly further away from the four weeks recommended by specialists.

The time has come to follow an example and follow in the footsteps of the NBA, NFL and NHL

«We are aware that there are other types of needs of the clubs. These are risks that are assumed, because they surround the football business.. However, from our point of view, based on excellence, we resist talking about what should be done and prefer to focus on prevention policies,” reveals the doctor in contact with this newspaper..

The pressure, of course, ends up emerging sooner or later. According to a FUTPro survey, carried out shortly after the World Cup in Qatar, 20% of international players confessed to feeling more mental fatigue than in other years around the same time.. And 53% of them admitted that they were on sick leave or at serious risk of ending up in the infirmary.. “I always recommend the need for psychological work, carried out by the club or through a professional hired by the player, to identify their context and manage stress situations”. In light of these statements, perhaps it is better to understand that Saturday when Ousmane Dembéle broke down during his debut with Barça at the Coliseum.. Or that afternoon in September 2013, when Gareth Bale could not appear in front of the Bernabéu, due to overload during the warm-up.

It seems, then, that the time for change has arrived.. This is what the physiotherapist consulted by this newspaper considers, who sends a message of hope.. «In other sports, the bubble already burst decades ago. They fought for better calendars and Christmas holidays. Perhaps now is the opportunity for the players to return to their seats at the decision-making table.. Because they are, without a doubt, the main protagonists of the show. “The time has come to follow an example and follow in the footsteps of the NBA, NFL and NHL, which in this sense are years ahead of us.”