Dean Henderson said three days after Crystal Palace’s FA Cup final win he did not want to get out of bed. He went from a high to a low, felt depressed, did not know why, and had never spoken about it before. Players carry those “individual battles” alone.

Henderson said Palace had played “quarter-finals with the Carabao Cup run-in every three days” and that “people don’t realise the toll it takes on them.” ^{1 2}

Before a coach writes the team sheet, staff still need to ask about sleep, mood and emotional load. A player can train and still be a risky starter if the week has left him under-slept, sore, emotionally flat, or unable to repeat high-speed actions.

Staff use those answers to decide whether to start him, keep him on the bench, cap his minutes, wait for the final meeting, or leave him out.

Late calls and medical limits

Nottingham Forest left Morgan Gibbs-White’s place open until a final meeting before a Europa League semi-final second leg against Aston Villa. Gibbs-White had collided with Chelsea goalkeeper Robert Sanchez, needed stitches, and was being assessed two days before the match.

Vitor Pereira said the decision was “between the player and medical department,” and that Forest had “a plan with him and without him.”

Pereira said the substitution was not concussion-related, so Forest could treat Gibbs-White as a late fitness decision rather than a concussion-protocol case. A concussion judgment probably would have ruled him out, because players must not return to activity for at least 24 hours before a 48-hour rest period and a six-stage return-to-play process. ³

Geoff Scott, who spent 20 years in Tottenham Hotspur’s medical department, wrote that players often push to stay on the pitch and that self-assessment is useful while still incomplete. Scott wrote that medical staff sometimes have to remove a player to protect long-term health and availability.

For head injuries, he wrote, the Premier League gives medical staff three minutes to assess and the player’s input becomes secondary; he also said Hugo Lloris’s 2013 concussion led to a rule change giving doctors final authority over player removal rather than managers. ⁴

World Cup call-ups and Jorginho’s injury left Flamengo short for the weekend after their 3-0 Libertadores win over Cusco. Jardim said Flamengo had “only 13 players” for Saturday and he “did not want them arriving without minutes.”

For Coritiba, he said Flamengo would see which players were available “not only on paper, but physically,” then start the best team and keep three bench options. ⁵

A thin bench changes the same medical and performance information. A player who would be protected in a deeper squad may become emergency cover. A player with safer alternatives around him can be held back without weakening the next phase of the match as much.

Load over days

A 2023 PLOS One study monitored 13 professional male players from one European first-division club for 16 weeks, covering 70 training sessions and 15 official matches.

Players reported fatigue, sleep quality, muscle soreness, mood and stress on a 1–5 scale; the study also used RPE, session-RPE and GPS measures for high-speed running, sprinting, accelerations and decelerations. Match day produced the highest internal and external load, and the day after the match produced the lowest wellness values.

The study found match-day demands were associated with lower next-day wellness, especially sleep quality, fatigue and muscle soreness. ⁶

The PLOS sample covered 13 players from one men’s team, so it supports monitoring rather than injury prediction. If sleep, soreness or fatigue drop after a heavy game, the coach has reason to reduce load, delay the call, or use the player for fewer minutes.

UEFA’s Elite Club Injury Study has tracked elite-club injury data since 2001, with one initial goal to monitor increasing load and possible effects of over-playing. At the start of 2014/15, 36 clubs were in the study, and participating clubs submit training and match injury data every three days.

Clubs receive mid-season and end-of-season reports comparing their injury trends with previous seasons and anonymous peer clubs, which lets them review and adjust their practice. ⁷

FIFPRO’s 2025 player workload report tracked 1,500 men’s players against recommendations from 70 medical and performance experts. After the Club World Cup, Chelsea players had 13 days of preseason and Paris Saint-Germain players seven; among sampled Euro 2024 players, only 14% had the recommended 28 days of offseason rest.

The report also points to elite players facing two-game weeks and less than five days of recovery. Short recovery windows push staff toward smaller roles, later calls and stronger reasons to rest players. ⁸

Before the team is named, the coach and medical and performance staff need to know whether a protocol removes the choice, recent load has left poor sleep, fatigue or soreness, the player feels ready to handle the role, and the squad has safer alternatives.

A doubtful player can still help as a substitute or limited-minutes option. A player carrying too much medical, physical or emotional risk should be held back, even when the availability sheet says he can play.