Brutal injury blows for Spain should serve as a wake-up call for football - and for clubs like Arsenal

It was, according to Spain manager Luis de la Fuente, the “most bitter victory I have experienced in my life” – a 3-1 win for the men’s national team over Georgia, which was marred by a cruciate ligament injury for Barcelona midfielder Gavi. The 19-year-old, one of the finest young talents in the global game, will almost certainly miss the rest of the season, and likely Euro 2024 as well.

Gavi, who left the pitch in pain and apparently in tears, wasn’t the only young Spanish player to suffer a cruciate ligament injury during the international break – Villarreal’s 21-year-old winger Yeremy Pino, who had missed out on the Spain squad and was with his club, picked up precisely the same injury in training last Wednesday. Elsewhere there were major injuries for Eduardo Camavinga and Vinícius Junior, with neither expected to play again for Real Madrid until the new year.

And then there were the injuries suffered by Erling Haaland, who had taken a knock playing for Manchester City a couple of weeks earlier, and Jarrod Bowen, while Jude Bellingham was among the players who withdrew from the England squad with medical issues. Then today, a new report by BBC Sport found that Premier League injuries were at a new high, with a 15% increase in players unable to play. It seems unlikely to be entirely coincidental.

The age of the players struggling with medical problems also seems notable. Gavi, Pino, Camavinga, Bellingham, Haaland and Vinícius are all no older than 23 – and the same is true for Gavi’s club team-mate Pedri, who has recently returned from his fourth spell on the sidelines lasting more than 10 games, Bayern Munich’s Jamal Musiala, who withdrew from the Germany squad last week after his second injury of the season, and Arsenal’s Bukayo Saka, who has limped from the field twice already this season and withdrawn from one England squad.

Injuries are part and parcel of professional sport, but it should be cause for concern that they are happening at a higher rate and appear to be disproportionately impacting younger players. The BBC report suggested a fixture backlog from the 2022 World Cup in Qatar, which was played over the winter in the middle of the traditional European season, may be a factor, but stressed that it could not draw conclusions as to whether the uptick in injuries was coincidental or not, as all injuries are different and are caused by different incidents. This is undeniably an area which needs proper research by The FA and other governing bodies, but the trends are very worrying.

In general, sports medicine professionals seem to agree that younger athletes are less inherently prone to injury as they have greater flexibility and muscle strength compared to older sportspeople – and the consensus is also that they can recover better from the injuries they do sustain. But there is little doubt that players are breaking into first teams at the elite level at a younger age than ever before, and that under-21s are playing more minutes at the highest level than was once the case. Combined with an ever-increasing workload and a groaning fixture list, and it seems reasonable to infer that young footballers are being put through too much, with insufficient rest.

Saka provides an example – he has played an average of 52 matches per season for Arsenal and England since he was 18, and has twice limped from the field of play this season, first against RC Lens on 3 October and then again a month later against Sevilla. On the first occasion, he missed the following week’s game against Manchester City and withdrew from Gareth Southgate’s England squad, but on the second occasion, just weeks later, he was back playing against Burnley a mere three days later before joining the national side and playing against Malta.

He is just one of countless Premier League players who are constantly encouraged to play through knocks – or encourage themselves to do so – and who risk aggravating injuries as a result. The stakes are perceived to be so high in almost every game now that it is rare for teams to be willing to rest key players unless there is no meaningful choice, and many players take painkilling injections to get through games they would otherwise miss, a practice that has been linked to drug addiction issues.

Many clubs seem unwilling to put their players’ health first, preferring to prioritise results – and many players are themselves culpable of trying to push themselves through the pain barrier. The same indomitable mindset that helps so many young athletes reach the elite level can often endanger them too. Attitudes from coaches and players alike do not seem to have caught up with the risks being taken.

The issue may also extend beyond the sphere of professional sports. There has been an apparent rise in ‘overuse’ injuries in young athletes, from children to young adults, with some studies suggesting this could be caused by an increasing tendency for young sportspeople to be trained in sustained, intensive drills focusing on the same bodily movements.

An article by the UCLA Health Centre in California, for instance, notes an uptick in the number of ulnar collateral ligament (UCL) reconstructions being performed on under-18s and claims that UCL injuries in children were almost unheard of prior to an age when children were playing sports like baseball much greater frequency. In other words, even outside of professional academies, there is a risk that many young people are being pushed too hard, too young, from the schoolyard to the top of the sporting pyramid.

The only conclusion that can be drawn is that there are too many games, and too much pressure to play at the top level of sport – and that too much of that pressure and pseudo-professionalisation is trickling down to the aspirational levels of youth sports. At the top level, rest weeks need to be built into the schedules, whether that’s in the form of winter breaks or simply regular down weeks, with space found by culling some of the matches. At the amateur level, coaches need to develop better understanding of the medical risks of excessive training.

Nobody wants to watch or play less football, or any other sport, but the health of the players may well depend on it. Somebody needs to step up and take on the duty of care, because it seems clear that the clubs won’t. That leaves the onus on football associations, and they need to act, or the awful injuries suffered by players like Gavi may become a more and more common sight.