In mid-February, we invited requests from our subscribers for articles you might like to read on The Athletic as part of our latest Inspired By You series. Richard D asked for a piece on how Nottingham Forest have managed to have so few injuries this season.
Nottingham Forest’s players have missed the fewest minutes of football in the Premier League this season — and had the fewest injuries overall.
When Nuno Espirito Santo’s side faced Ipswich in their last Premier League outing, the only player sidelined was back-up keeper Carlos Miguel.
Danilo and Ibrahim Sangare are the only players to have sustained serious injuries, with the Brazilian breaking his ankle in the first game of the season against Bournemouth and Sangare suffering a hamstring problem before the end of August.
Other than that, while Taiwo Awoniyi did struggle with a niggling groin issue that limited his impact during the first half of the campaign — as well as suffering a concussion more recently at Exeter City in the FA Cup — Forest have had no serious injuries according to data from Ben Dinnery, founder of Premier Injuries.
Outside of domestic competition, Chris Wood picked up a hip injury while playing for New Zealand in the recent World Cup qualifiers but the club are optimistic it is nothing serious.
When asked about the overall situation in a press conference shortly after the last international break in November, Nuno seemed almost alarmed that the subject had been brought up, as if speaking about it would jinx their luck.
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“You’re joking, right? One game in, we lost a player (Danilo). A few games after that we lost Sangare as well,” said Nuno. “I didn’t know that statistic but we need all of the players, we need all of our options over the course of a season.”
With 14 first-team players on international duty over the next fortnight — ranging from Morgan Gibbs-White with England to Eric Moreira with the Germany under-19 side — Nuno can be forgiven for his caution.
Forest’s injury record has played a significant part in building a challenge for Champions League qualification. It has allowed Nuno the luxury of consistency with only 1.6 changes to his starting XI per game — the joint lowest figure in the division, along with Fulham and Newcastle. He has named an unchanged line-up seven times, with only Fulham (eight) having done so more often.
Forest have nine players who have started 22 or more of their 29 Premier League matches. Matz Sels and Ola Aina have started every game, while fellow key figures Murillo, Nikola Milenkovic and Chris Wood have started 28. Anthony Elanga has been involved in every game, starting 23, while making six appearances off the bench. Elliot Anderson has been involved in 28, starting 24. Gibbs-White has started 25. Callum Hudson-Odoi has started 22 games, while making a further three substitute appearances.
Put simply, Forest’s best players have been available for most of the campaign.
The prospect of any of them getting injured remains a concern. The two words Nuno used to describe his emotions at seeing his players called up for international duty were “pride” at their achievement and “anxiety” over their return.
But why do Forest have so few injuries?
“There are two factors. Style of play is definitely very important,” says Luke Anthony, who has been head physiotherapist at Watford, head of sports medicine at Reading and an injury prevention specialist at Norwich City, and is now clinical director of GoPerform, a sports injury and performance centre.
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“I’d use the example of Tottenham here. Tottenham are the opposite of Forest, in terms of having an aggressive press, a high line and needing their central defenders to cover, often at high speed. They have a relatively small squad and are putting those demands on the same group of players all the time, repetitively playing the same players, which is a risk factor.
“It is the style of football… and the opposite is true with Forest. When they are playing in a system that is less aggressive, press less when it comes to high-speed sprints… it does make a difference. It is a big factor in the number of injuries they are getting this season. The style of play will be helping Forest on that front.”
To explain the chart above, passes per defensive action (PPDA) is a proxy of pressing intensity at the team level, used to try and capture the degree to which an opponent is pressuring the opposition when they don’t have the ball. This metric counts how many passes a team allows the opposition to make before attempting to win the ball back with a defensive action, such as a tackle, interception, or clearance.
Importantly, it applies only to a certain area of the pitch — the final 60 per cent to be precise — roughly in line with the edge of the centre circle in a team’s own half. A low PPDA number indicates higher intensity when trying to win the ball back and a higher figure indicates a team that is more passive.
Forest have maintained their approach after the opening 10 games, regardless of the opposition they face, as the graphic below demonstrates.
They press the least in the division but have conceded only 35 goals in 29 matches. And it has been no fluke. The xG among opposition sides facing Forest this season has been just 34. Only Fulham (33), Liverpool (25.1) and Arsenal (24.7) have achieved lower. At the same time, their rampaging counter-attacking style has given them plenty of threat at the other end, even if the 49 goals they have scored has been a significant overachievement in comparison to their xG of 36.5.
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“We are all comfortable when our team has the ball — but it’s impossible in football (to have it all the time),” said Nuno when asked about it in December. “That’s why I always say the moment you know yourself really well, the things you are capable of doing well, you cannot change. You have to do what you are and what you believe.”
Forest are content for the opposition to have possession in areas where they feel they are in control. When opposition sides push up the pitch, it merely provides more space to exploit with counter-attacks.
Alongside playing style, sports science also has a role in injury prevention. “The data and how you load the players, it is a big issue,” says Nuno. “We really take care of that. A lot of it is about prevention. We have a good platform on which to grow and improve. I really believe we are growing something together. Something nice. Something that will allow us to compete.”
Forest are armed with an approach that has less impact on their bodies. But the other major factor in their positive injury record, according to Anthony, is their lack of European football — something the club very much hope will change as they continue their push for the top-five finish that would almost certainly deliver Champions League qualification.
“The non-European sides tend to do better (fewer injuries) because they have so many free weeks,” add Anthony. “Midweek allows you to do so much with the players. It is not just about preparing for games, it is about doing the conditioning work — the high-speed runs and some of the things that help protect players from injury.
“When I was at Norwich, we were a newly promoted Premier League team and my job was easier because we had so much access to the players, because of the schedule. You generally get time to work with the players on Monday, Tuesday and Wednesday, before the work begins for the following game. That is so conducive to reducing injury risk. You can get good work into them, without overloading them.
“Not having midweek games is such an advantage. There is just a lot of conditioning work that you can do if you do not throw a European fixture into the mix.”
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Many clubs will carefully monitor the loading of their players on the training ground, using advanced GPS systems to look at how much ground they have covered and how many high-intensity runs it included. But there is a misconception that this means players are regularly hooked out of training sessions because they are doing too much work.
“Old-school players might believe there is a world in which players are now monitored too much; that they get pulled out of training early and they are not allowed to do too much work, in terms of extras,” says Anthony. “But in my experience, one of the main areas where data is useful is when it comes to players being under-loaded.
“One of the biggest factors in hamstring injury is being overly exposed to sprint distances or sprint frequency. Some of that means that if you are not regularly loading yourself by sprinting, when you then try to hit top speed in a match and you have not done it recently in training, you are going to be more vulnerable.
“You might look at the data and see that Player X has not hit his top speed in training, which would immediately ring some alarm bells and you would be able to address it. You would add in a small amount of sprint speed running. It is hard to predict which players are overloaded just with training data, but it does make it easier to understand when players might need to put in some more work in certain areas.”
And the Forest players you would think need to put in the additional sprint work to keep themselves ready, might not be the ones you expect.
“Players like Elanga, Hudson-Odoi and Aina will actually be well conditioned to the demands of sprinting, because it is such a big part of their game anyway,” says Anthony. “It is about looking after those players who might not do it so regularly so that when they do, they are ready.”
While he may continue to be cautious when speaking about Forest’s lack of injuries, Nuno’s efforts so far this season have worked wonders.
(Additional reporting: Mark Carey and Liam Tharme)
(Top photo: Ola Aina by Michael Regan via Getty Images)
