From the Premier League's elite to the soggy pitches of Sunday league, injuries are part and parcel of football - but which top-flight teams have been worst affected this season? With help from injury expert Ben Dinnery, of premierinjuries.com, external, BBC Sport examines which sides have been hit the hardest, the impact injuries can have on under-fire managers - and whether things are always as bad as they seem.

It is Friday lunchtime and Premier League media conferences are in full swing - then news emerges a key player has been ruled out of a crucial game because of injury. While this is a familiar story for every manager, the data shows some teams have been affected significantly more than others this season - including under-pressure Tottenham boss Thomas Frank.

Premier Injuries assesses both the number of days lost to injury by first-team squads, along with the total tally of injuries that have ruled any given player out of at least one league match - eliminating data for semi-fit players who may be rested for a domestic cup game. When combining both factors, Spurs are among the Premier League's worst-hit sides this season.

Tottenham have had 19 separate injuries in total - the joint-most of any club alongside Arsenal, Chelsea and Leeds - while they have also lost the second-most number of days to injury, behind only Newcastle. Frank's side are currently missing seven first-team players because of injury, including Dejan Kulusevski and James Maddison who are both yet to feature this season.

While the Dane has understandably come under pressure for a pragmatic style of play, injuries in attack have been a contributing factor. Tottenham's head coach, however, has not faced as many fitness problems as predecessor Ange Postecoglou did at this stage of last season. After 22 match rounds in 2024-25, Tottenham had already amassed 25 separate injuries and lost 707 days to injury - both comfortably the highest tallies of any club at that time - as their squad adapted to Postecoglou's high-octane approach.

Tottenham are far from alone in struggling with injuries, and ones to key players, this season. Newcastle have lost the most days of any club to injury, and Eddie Howe's squad has been stretched as they continue to compete on four fronts. As a result, the Magpies' away form in particular has been badly affected, with Howe's side winning just twice on the road in the league this season.

Leaders Arsenal have also been among the biggest victims of the amount of days lost to injury, and total number of injuries. However, their squad depth has managed to mitigate much of the impact - with the Gunners top of both the domestic standings and the Champions League league phase.

Among teams towards the bottom of the Premier League, Nottingham Forest and Leeds United have been the most badly hit. Collectively, England's top flight has lost 2,157 days fewer to injury than compared to the same stage last season - although the severity of certain common injuries appears to be increasing when examining data across a whole season.

According to Premier Injuries, occurrences of hamstring injuries dropped by 23% in 2024-25, but 60% of those injuries required a minimum of 30 days to recover - the highest ratio since they began recording such data in 2010. The landscape has changed massively since we began recording this data and injuries are now one of the main topics of discussion - in the same way xG has become part of the mainstream conversation.

We are working in a league that is considered the most intense and dynamic, and that is reflected in the statistical analysis of sprints and high intensity runs, but also lessening recovery times. You then throw in the football calendar and they are coming together to create an environment where players are being pushed, and sometimes broken, because they are not physically capable of tolerating those demands.

What everyone wants to now know is 'when will a player be back?' And we are seeing players rushing to get back and then some re-injuries due to the pressures relating to that.

There is also a lot of research to support a change of management as having an impact on injury - inherently you will see a rise in the number of injuries under a new regime, which can be due to the different demands and a change in philosophy.

Comparing injuries between teams boasting different budgets and managing different priorities remains a subjective task - while the timing of those injuries, and the positions in which they occur, can have a huge impact on teams' and managers' fortunes.

Arsenal, for example, have suffered with injuries this season, but Mikel Arteta's side currently have just three players out - the joint-lowest number of any team - at a crucial juncture of the season, with the added advantage of being able to buy in the January transfer window.

Aston Villa, conversely, have had injuries to three central midfielders in recent weeks, including a serious knee issue for Boubacar Kamara, which could potentially compromise their ability to compete for the title.

Bournemouth have already sustained 17 injuries in a difficult season for head coach Andoni Iraola - the second-most of any team. The Cherries are currently missing an unrivalled eight players and are also having to adjust after the sale of star forward Antoine Semenyo to Manchester City.

Liverpool have endured constant selection problems at full-back, Manchester City have faced injury issues in central defence - albeit somewhat addressed by the purchase of Crystal Palace captain Marc Guehi.

Everton have just lost England international Jack Grealish to a serious foot injury, while clubs battling relegation such as West Ham and Leeds currently have low numbers of injuries to contend with - but smaller squads with which to cope with any absences.

When and how certain players will return is likely to have a significant impact on a club's fortunes this season - just ask Tottenham boss Frank. After striker Dominic Solanke scored in Tuesday's Champions League win against Borussia Dortmund - his first start in eight months because of injury - Frank said: "I'm very happy that we won the game - for various reasons."