More than 59 years lost to Premier League alone in injuries this season - what can be done?

PremierInjuries.com records injuries in England's top division, calculating the numbers and days lost. As of April 15, the second figure had exceeded last season (injuries themselves had not) and hit 21,555 days – or 59 years. Sheffield United had lost 1,471 days – or four years.

It explains the thinking behind the controversial scrapping of FA Cup replays, if not the expansion of the World Cup, Champions League and World Club Cup. But it is far from just an "elite" problem.

Relegated Rotherham United have only named a full bench in 14 Championship matches all term. Huddersfield Town got four starts each out of strikers bought in January to save them. Hull City would surely already have reached the play-offs had Liam Delap not missed three-and-a-half months.

Middlesbrough's injury list got so long they had one specialist centre-back over Easter. Leeds United have got off lighter than most, but Pascal Struijk has not played this year.

Already missing Luca Connell through post-viral fatigue, League One Barnsley’s midfield lost Josh Benson for six months. Doncaster Rovers have been crippled by injuries, captain Richard Wood making one League Two start in five months and first-choice goalkeeper Ian Lawlor not playing in 2024, just as Alex Pattison has not for Bradford City.

"There's no magic bullet," says Ben Dinnery, analyst and founder of Premier Injuries.

(Up to and including 15/4/24)

"If it continues on its current trajectory we're looking at around a 15 per cent increase in the number of injuries in the Premier League, based on a four-year average.

"We've looked at it that way because in recent years you're not comparing like for like with things like the (2022) winter World Cup and the pandemic (which paused 2019-20 for three months and delayed the start of 2020-21). In terms of days lost, it could be 30 per cent."

So what can be done?

"The schedule is a factor in whether teams get optimum recovery," argues Dinnery. "Anything over 72 hours (between games) is about right.

"You often hear reference to distance covered and generally speaking, there hasn't been a great difference but what has changed is the intensity, with players required to run at greater speeds more often.

"When you're playing two or three times a week it's difficult to get the right intensity in training.

"If you throw in more games full of stopping and starting, twisting and turning, and lung-bursting runs, you can see why there would be more hamstring, adductor and calf injuries."

And although the Blades played more games in the last two seasons, Dinnery still thinks this one will have been physically tougher.

"Championship players need stamina but you have to adapt to Premier League levels of intensity and the pressure of having to play at the top of your game so often," he argues.

"Thomas Partey had around 95/96 per cent availability in La Liga and you can see what the Premier League's done to him (starting just seven Arsenal games this season)."Even playing players out of position (often a knock-on effect of injuries) is a factor because they're moving in slightly different ways."

Clubs perhaps need to look more carefully at who they sign too.

To try to get more Championship experience within budget, Rotherham signed free agents such as Daniel Ayala and Tyler Blackett, and injury-prone players such as Grant Hall. Shortly before his sacking as manager in April, Leam Richardson said player availability was "around 64 per cent" this season.

"It would be foolhardy to think a player can go from 30 to 40 per cent availability to 70 to 80 per cent and if you carry a small squad with too many players like that, you're set up to fail," says Dinnery. "The more pre-season training sessions or games you miss, the more at risk you are."

Richardson was also scathing about Rotherham's training pitches, an issue until work last season for Sheffield United.

"Ideally training pitches would mirror matchday ones to keep the continuity.

"I've spoken to coaches at clubs with massive drainage problems on their training pitches and it causes players to slip and muscles to get into positions they don't want to be in."

Manager Grant McCann is relieved Doncaster got one issue out of the way, but their Premier League counterparts are less fortunate.

"I'm pleased they stopped the madness of the injury time," he says. "I remember sitting down with the sports scientists after the first game and he was saying it was going to be a 54-game season with the minutes they were adding on.

"They stopped it after the third or fourth game in terms of things like the 18 minutes or so we had against Harrogate – it was just mental."

Big additions remain in the Premier League, many for video assistant referee interruptions.

"If (Premier League) games are finishing within 100 minutes these days you're a bit surprised and it's an accumulation of stopping and starting. When players are standing around for three or four minutes at a time waiting for a VAR check in weather that isn't really conducive, players are more susceptible to injury, especially very explosive players like tricky wingers or wing-backs."

And whilst Chris Wilder is trying to identify what Sheffield United must do better he does think there is another factor – "Maybe a few years ago stuff won't have been scanned and players just played through it."

Clearly, though, too many fans are paying too much – at the gate and via TV subscriptions – to be denied so many top performers so often.