Villarreal and Beyond

Striker Kylian Mbappe started in three matches while injured after Real Madrid diagnosed the wrong knee. The injury happened in early December; he was not properly diagnosed until after the holidays.

As El Desmarque reported, Real’s doctors took X-Rays of both knees in order to compare them. They realized that they had been looking at the wrong knee. The player, presumably frustrated, traveled to Paris to get a second opinion from his trusted French doctor.

As is the case with everything that happens to Mbappe, the news of the misdiagnosis rippled through the world. By the end of the day, everyone knew. A day later, Mbappe himself spoke about it at his national team’s press conference before the friendly match against Brazil and his teammate Vinicius Jr.

The information that [Madrid] examined the wrong knee is not true.

He also took apparent ownership over the mishap.

Perhaps I bear some indirect responsibility for the situation, because when you don’t communicate about what you have and what is going on. It leaves the door open to interpretation, and everyone is rushing to fill in the blanks.

The drama doesn’t end here. That same evening, sources in Spain doubled down on the story. Miguel Ángel Díaz “Miguelito”, a reporter for Spanish Radio Cadena Cope who has exclusively covered Real Madrid for years, was direct: “As we reported last night, Mbappe played three matches in December with an injury the Real Madrid medical staff failed to identify as they were looking at the wrong knee.” He also said that RMC Reporter Daniel Riolo, who initially broke the news, told him that “Real Madrid is asking Mbappe to lie.”

Real’s player fitness and number of long-term injuries have been a point of discussion for years. Many point at the physical staff as responsible for the good as well as the bad.

For Real Madrid fans the names of Niko Mihic and Antonio Pintus will sound familiar. Both have led the physical side of Real Madrid for years and have been praised for the team’s recent achievements. They also are front and center when injuries appear at key times. No repercussions seem to come from their employer, as Florentino Perez likes to keep both men close. He has done so through most managers in recent history: Lopetegui, Zidane, Ancelotti, Alonso, Arbeloa and others. Perhaps the only exception being an occasional “organizational restructuring” when things got too hot.

The truth is that injuries have punished Real Madrid in recent times. During COVID, manager Zinedine Zidane was clear on the matter when several starters fell off the team.

It is not just bad luck. Zinedine Zidane, ESPN, 2021

Back then, Los Blancos played against Valencia with seven starters injured, including Sergio Ramos, Militao, and Eden Hazard. Zizou was frustrated. “We have talked about it several times… I hope we can get them all back. We need them.” That weekend, Real Madrid hosted Valencia on Valentine’s Day and won 2-0. The team’s fitness levels continued to drop through the season; immediately after that match, Dani Carvajal, who had just made it on time for Sunday, was injured again.

The Spanish defender ended up missing another two months. It was Real Madrid’s 40th injury of the season. Their direct competition was far behind: Barcelona counted 25 injuries at that time. Atletico, only 15. Zidane reportedly asked his physios for an explanation and continued to speak frustratedly on the matter. His team had won La Liga the season before, his second domestic title as a manager; they had managed to achieve the best defensive record in 30 years.

In May 2021, Zidane left, trophyless. The continuous stop-and-go in the injury front meant the starting eleven never truly gelled, which meant less fluidity in attack. A team that counted with Benzema, Asensio, Modric, Vinicius Jr., Rodrygo and Hazard in its ranks only had the French striker score more than seven goals across all competitions.

In 2023, Niko Mihic was fired after 18-year-old wonderkid Arda Güler was reported injured for the third time in six months, having only joined that summer. Mihic felt as though it was not necessary to perform surgery on the Turkish player, which caused the player’s healthy leg to carry the bulk of the pressure. The end result was two more injuries in a matter of months.

Mihic had been working with Antonio Pintus, who as of this writing is lead Physical Trainer for Real Madrid under Arbeloa. He also held that role under Zinedine Zidane and Carlo Ancelotti; however, Pintus was not part of Xabi Alonso’s plans, but he was not asked to leave. The Italian coach was named “Performance Manager” and kept on the payroll. The new manager wanted to bring his own staff from Germany; Florentino Perez wanted to keep Pintus close regardless of Xabi’s intentions.

Seven months after Alonso was announced as the new Real Madrid manager, he was already gone. Immediately after appointing Alvaro Arbeloa from the B team, Florentino told Pintus to go back to managing the physical aspect of the first team. The writing was on the wall for Alonso, as a month before his sacking, Mihic himself was back at the club. Regardless of Alonso’s request, Florentino was stepping in.

He’s surely one of the best in the world, and he’ll be in charge of the physical side of things. Alvaro Arbeloa, January 2025

The situation mirrored that of 2018, when another Spanish manager, Julen Lopetegui, brought his own staff. Florentino kept Pintus on the payroll and 138 days later, the fitness coach was in charge after Lopetegui was dismissed. Pintus eventually left and joined Antonio Conte at Inter Milan for a short stint, but the return of Carlo Ancelotti meant his return as well.

Pintus’ approach, laser-focused on aerobic preparation, meant exigent summers where everything is measured and very specific dietary demands are made. His plan also famously includes a “pit stop” — a break which allows the team to breathe before the Spring title push. The technique even has a name: The Pintus Valley. He even went to NASA to present his method.

Pintus’ ability to force the best physical version of the players early in the season, then again towards the end, has been praised — but equally blamed when mid-to-late season injuries appear. As of late, they have been appearing a lot. The method which catapults Real to titles every year may also have a potential flaw: it seems to push performances and recovery windows regardless of the individual fitness moment of each player.

The summer ramp-up comes tied to a non-negotiable break in January regardless of individual condition, and a strong end of season push whatever the cost. On top of that, there is an understanding between club and player: no questions asked. If the player wants to play, the staff won’t get in the way.

For some like Eden Hazard, injuries were not a problem until he arrived in Madrid. The Belgian winger had missed 26 matches over the last four seasons at Chelsea; an average of a little more than six per season.

He missed exactly 26 matches in his first season at Real Madrid, and 90 over the course of four seasons, spending over 500 days on the injury list. In March 2022, Real Madrid announced a “successful surgery” after the player was diagnosed with a fissure of the fibula — the same injury he had two years before. In between, countless muscle injuries, hamstring issues, and ankle problems.

The Spanish press was left asking what had happened to the Belgian lightning in a bottle Real Madrid had finally captured. By season two, Hazard was barely more than a wage problem. The media spoke of a potential loan to alleviate the wage limit, but even that never came. Instead, Real Madrid spent 120m Euro on the winger, and after 76 matches and seven goals in four seasons, Hazard retired at 32.

Four months later, he spoke to Marca about the experience. “Real Madrid are a bunch of braggarts. I am not like that.” His thoughts on his stint at Real read as a mixture of decisions made seemingly without any guidance from the club, and flat out unchecked behaviors with no repercussions from his employer.

I had the wrong injuries at the wrong time, I had surgery, they put a plate in; then COVID hit. I’d come back, it would hurt, I forced things. Then Ancelotti arrived, we prepared well. But then, my body, pain, the injuries. I lost my place, my confidence, and then my drive. Eden Hazard, Marca

Real Madrid seemed to give up on him as they leaned on Benzema, Asensio, and the exciting growth of players like Rodrygo and Vinicius Jr. Looking back, Eden mentioned he felt “as though I disappointed Real Madrid fans. I want to tell them that it was not my fault; my body failed me. I tried, but it did not work out. I’m sorry.”

Whether his body failed him or whether it was the lack of support amidst very different physical demands, the pattern at Real Madrid is one of no questions asked as long as titles follow. Work hard and be ready come Spring, whichever way possible.

Gareth Bale — another stratospheric transfer from England — spoke on playing for 13 years with a hernia in his back which was never fully healed. The Welsh player finally admitted to Marca that he had been dealing with constant pain and that injections were required when a performance was required. Real Madrid denied in 2013 that the player had a spinal disc hernia, even though they admitted he had a “small chronic disc protrusion” common in footballers.

That no questions asked approach is apparent as the squad is pushed to overperform both early and late in the season. In the past few years, record-breaking injury numbers have followed, but they push through regardless.

In the current season, when Manchester City visited Madrid in the Round of 16, seven key players were out of the call-up. That did not include Kylian Mbappe, on the bench but unable to play.

Players have tried to keep check on how hard they are pushed by traveling away from Real’s doctors for the sake of a second opinion. The last was Mbappe, who did just that earlier this year, traveling to Paris to have his trusted medical staff look at the knee. The right one this time.

Over the past few days, Spanish media have reported on the lack of communication from Real Madrid and whether they would own up to the injury misdiagnosis, and whether medical staff sackings would follow. A potentially aggravated injury for Mbappe after playing three matches without understanding the full extent of the injury could have meant a much more serious problem for him, for Real Madrid’s biggest asset outside of its stadium, and for France’s chances to reclaim the World Cup this summer.

Real Madrid has a history of pushing for titles despite players’ fitness and not respecting manager’s wishes when they want to get involved in this area, as was Alonso’s case. As a result we have seen a higher number of short and long-term injuries than other teams involved in multiple competitions.

Expectations never let up for Real Madrid. As expected at this stage of the season, La Liga and the Champions League are still in the running. The club that this season averages an injury every six days has also won five Champions League and four Spanish league titles over the past ten years.

Florentino Perez has built a club that is made to compete, but he does not necessarily know how to set the foundation for the next evolution of the club. Looking at the trophy cabinet, he may never need to.