Man Utd’s injury crisis dissected: The key reasons behind Erik ten Hag’s problems

Manchester United's Victor Lindelof leaves the pitch with an injury during the Premier League match at Brentford

Manchester United head into a potentially defining week in their increasingly desperate battle for Champions League qualification with yet another injury crisis.

Lisandro Martinez and Victor Lindelof have been ruled out for at least a month with muscle problems and will miss Thursday’s trip to Chelsea and the visit of Premier League leaders Liverpool three days later, along with fellow defenders Luke Shaw and Tyrell Malacia.

Raphael Varane and Jonny Evans have trained after injury problems of their own but manager Erik ten Hag must decide whether he can risk the pair.

According to the website Premier Injuries - Sports Injury Insights, United have suffered 30 separate injuries this season that have led to a player missing at least one Premier League fixture. Only Newcastle (32) have a worse injury record this term.

On average, United have suffered 8.5 injuries every 1,000 minutes in all competitions this season and have lost a total of 1,136 days to injury up to the latest international break.

Telegraph Sport looks into some of the factors behind the injury nightmares that triggered an internal investigation in the autumn.

Training loads

Some United players have harboured concerns about the volume of high-intensity training sessions between matches and privately expressed fears the approach may have contributed to the team’s injury issues this season. Those misgivings date back to the summer when Christian Eriksen complained there was “probably too much travelling around” on the club’s pre-season tour of the United States. United’s summer tour included games in Norway, Edinburgh, New Jersey, San Diego, Houston, Las Vegas and Dublin. But Ten Hag has refuted suggestions the squad are overly worked. “We need to be fit [but] we don’t train too hard,” he said. The Dutchman also insisted United were barely training at the moment given the emphasis on recovery between games. “We don’t train because we recover then you go to the next game,” he said.

Internal injury review

John Murtough, United’s football director, confirmed in October the club had launched an investigation into their injury problems as part of a wider review of the medical set-up being carried out by Gary O’Driscoll, who took over as head of sports medicine last September after 14 years at Arsenal. Robin Sadler, United’s long-standing head physiotherapist, left in January as part of the shake-up. Ten Hag said the review had thrown up some answers but would not disclose them. “We have an idea and we will work on it,” he said. “Internally, we will deal with it.” But Ten Hag admitted he could not be certain things would be better next season. “You can’t 100 per cent avoid this,” he said. “It is impossible.”

Congested calendar

United have played just 13 fixtures over 91 days in 2024 – eight fewer matches than during the corresponding period last year when they endured a marathon 62-game season – but the injuries continue to rack up. Yet Ten Hag says this is a consequence of the accumulation of games and fatigue dating back to the winter World Cup in Qatar in the middle of last season. “The huge amount of games we have had in the last 18 months… still has an impact on our squad,” he said. Ten Hag believes it is incumbent on the game’s powerbrokers to rethink an increasingly chaotic calendar. “Absolutely,” he said. “The players get overloaded and can’t bring the performances anymore. We are already over the point where we demand what we want from our top players. The levels for teams will keep dripping if you keep going in this process by overloading the international competitions.”

More ‘robust’ players required

Captain Bruno Fernandes has started all bar one of United’s 29 Premier League games and Diogo Dalot has played 26 league matches. But United’s squad is littered with players unable to cope with the demands of top-level football every few days. Recruiting players with the physical and mental attributes to deal with such a workload will be a pressing issue for Ineos. “You need very robust players, that is the requirement,” Ten Hag said. “I think we have more players who are very robust like Bruno is but, yes, that is the type of player you need. When you go into Christmas with many injuries and then you have to bring them back ... they are free from injury but they are not match fit. They are not straight back into the form, that also needs a couple of games before you get back into the rhythm, [so] it still has an impact.”

International issues

United had 13 players away on international duty in March and Ten Hag believes the international calendar is becoming an increasing problem, especially as he says there are countries who ignore the suggestions of clubs around player workloads. Casemiro picked up an ankle injury in Brazil’s draw with Venezuela in October but was declared fit enough to play 90 minutes in a defeat by Uruguay four days later, only to then miss United’s next two league games against Sheffield United and Manchester City. “We have national teams five times a year,” Ten Hag said. “You give players away and you don’t have any impact [on them]. OK, some national teams we have a very good connection [with] and we manage the programmes but there are also others that do what they want. You don’t have anything in hand on what they are doing there.”

Broaden your horizons with award-winning British journalism. Try The Telegraph free for 3 months with unlimited access to our award-winning website, exclusive app, money-saving offers and more.