Injuries across Europe's five major leagues rose by 20% last season and cost clubs in the region of half a billion pounds, a new study has found, raising concerns about player welfare amid fixture congestion.
Insurance broker Howden's European Football Injury Index for the 2021-22 season estimated that injury costs went up by 29% to 513.2 million pounds ($559.6 million), with French champion Paris St Germain topping that list at 34.2 million pounds.
Injury cost is calculated by multiplying the daily cost of a player by the number of days they were unavailable. Wage inflation also played a part in that increase.
The Premier League reported the most injuries (1,231) followed by the German Bundesliga (1,205) and Spain's LaLiga (848).
Real Madrid recorded the highest number of absences at 114 while Bayern Munich and Chelsea both suffered 97 injuries.
"If you look at the last two seasons, it's reasonable to conclude the disruption to fixtures (due to COVID-19) and the congestion is having a knock-on impact in terms of injury occurrence," said James Burrows, head of sport at Howden.
Burrows added the intense playing style of English and German clubs, coupled with them reaching the latter stages of continental tournaments, contributed to their mounting injury lists.
Players under the age of 21 were especially affected, with their number of injuries rising tenfold in the last four years, from 30 in 2018-19 to 326 in 2021-22.
"Of all the analysis, that jumped off the page the most," said Burrows. "If we look at the last two seasons and the impact of the pandemic, we saw that clubs lost several senior players and were forced to use youngsters more frequently.
"And again with the pressing style of the Premier League and the Bundesliga, you would hypothesise that there's a greater demand for those younger cohorts of players."
While COVID-19's impact is on the wane, clubs will confront a new challenge this season with the November 20-December 18 World Cup in Qatar, the first time the showpiece event is being held in winter.
The six-week shutdown of club games will necessitate tighter match schedules and a shorter winter break for players.
"It's the first time we've ever seen a disruption to the middle of a season that looked like this," said Burrows.
"The winter break has a very clear effect in terms of reducing the prevalence and occurrence of injury over December and January in particular, and that being lost this year, you would say is going to have a significant impact."
Non-COVID-19-related absences dropped during the winter break across leagues - 352 in January compared to 411 the previous month.
However, Burrows said players not selected for their national teams will get a longer mid-season break which could offset potential injuries suffered during the tournament.