Erik ten Hag likes to keep details about injuries under wraps. That means both the type of problem involved and the length of time the player concerned is likely to be out.
Manchester United manager Ten Hag does tend to be honest in his press conferences when asked about the availability or otherwise of those in the squad, but he declines to offer specifics, and that is a message spread throughout the club.
The approach partly relates to a custom in the Netherlands, where Ten Hag is from and has spent most of his professional career, which treats footballers' injuries as medically confidential: as a general rule, only the individual concerned can reveal a prognosis.
But Ten Hag also wants to keep information out of the hands of opponents, to maintain a mystique and avoid any targeting during matches. For instance, when Scott McTominay was on the sidelines for five weeks at the end of last season, United never confirmed his injury because it was to his ankle and they did not want rival players trying to kick him on it when he returned to action.
Ten Hag is keeping a lid on more fitness bulletins than he would like at the moment, however.
United have nine players out through a combination of injury and illness, although Mason Mount (who missed five weeks) and Raphael Varane (a month) have now returned. Mount had a hamstring strain and hadn't played since the loss away to Tottenham Hotspur on August 18, while Varane's injury — after coming off at half-time at home against Nottingham Forest a week later — was never fully explained.
Even with those two back, United's treatment room is the busiest in the Premier League. Level with United on nine, according to premierinjuries.com, are Chelsea, Newcastle and Crystal Palace, who visit Old Trafford again tomorrow (Saturday) after losing there in the Carabao Cup on Tuesday night.
United are not alone then but, for supporters and staff, it has felt like one thing after another, not forgetting Sofyan Amrabat and Rasmus Hojlund having to wait for their debuts after both signing for the club this summer with recuperation required.
Hojlund's United debut was delayed by a back issue (Michael Regan/Getty Images)
Ten Hag says injuries are an occupational hazard but has hinted at frustration over the length of United's list of absentees.
“One thing is true, from the start of last season I almost never started with the best starting XI, it was always something like an injury,” Ten Hag said before the 4-3 loss at Bayern Munich last Wednesday in United's opening Champions League group match. “It's a concern but that's why we constructed the squad with depth, so we can deal with it.
“Injuries always come in top football because we're living on the edge and injuries are coming up. We analyse why things happen but we also have to deal with the facts and it's always about the players available.”
Senior figures at United feel the issues are an accumulation of many fixtures over several seasons played at an unrelenting pace. That is true of all Premier League clubs who had players at the World Cup last November and December, but United did play 62 matches in 2022-23 — more than any other club in Europe's top five leagues. Liverpool also had injuries at the start of last season, coming off a campaign that ran to 63 games.
Chief executive Richard Arnold told staff during an all-hands meeting that the majority of injuries have been impact ones. That is correct for Kobbie Mainoo (ankle) and Amad Diallo (knee), who were injured in collisions during pre-season. Tyrell Malacia suffered a significant knee injury early in the summer, with November seen as a potential return date, while Lisandro Martinez is believed to be out because of an issue with his foot, although that has not been confirmed.
Read more: Premier League injury news: Latest on Saka, Rice and Maddison ahead of matchweek seven
McTominay and Christian Eriksen have been unavailable through illness, and the same can be said for Sergio Reguilon, another new signing. Luke Shaw and Aaron Wan-Bissaka both sustained hamstring injuries, while the issues for Mount and Varane were also muscular. Wan-Bissaka got his after playing just five minutes as a substitute against Brighton.
It is in that context that questions have been asked about United's pre-season tour to the United States.
In the space of 12 days, Ten Hag's squad flew from a friendly in Scotland to the New York area, then across the country to the southern Californian city of San Diego, went halfway back again to Houston in Texas, returned to San Diego, then had a game in Las Vegas on the way home to Manchester, for a total of more than 13,500 air miles.
Chelsea, Newcastle and Palace, the three other teams at the top of the injury charts, all had tours in the U.S. too.
Collette Roche, United's chief operating officer, previously told The Athletic the club's summer programme for this year was planned during their 2022 pre-season tour to Thailand and Australia, with a then newly-appointed Ten Hag's guidance.
Roche said: “He had lots of input into the tour, how it was structured, where it was in the U.S., the climates, the time it took to get to the stadium, and the training facilities being a critical one.”
Ten Hag reduced the number of commercial-duty days for his players during the trip from three to two. Roche said: “One of the key things he said to me at the start, he really wanted to make sure the players had some rest. Because obviously, last season was so intense and very compressed. The whole plan for the tour was based on making sure the players had some R&R (rest and relaxation), so we don't have any injuries and they can play to their optimum.”
Mainoo leaves the field against Real Madrid in Houston (David Buono/Icon Sportswire via Getty Images)
The six-hour round trip by air to Houston from San Diego, after a flight from New York, also had Ten Hag's input. “There was an option potentially to stay closer to San Diego, maybe Los Angeles,” added Roche. “But he chose, when he looked at all of the options, that Houston was better as long as we got the right facilities and stadium. Once that had been sorted, he was really quite happy to go to Houston and was fully part of that decision.”
How much the travel played a part in United's issues at the start of this season is unquantifiable, but picking through the situation is Gary O'Driscoll, United's new head of sports medicine, who started last week.
O'Driscoll is a highly respected practitioner, having served as chairman of the Premier League Doctors' Group and a member of the Football Association Medical Committee.
Clearly, Ten Hag will hope there is an easing soon.
(Top photo: Robin Jones/Getty Images)