There have been times over the past couple of seasons when the treatment area has been more crowded than the first-team dressing room at Hearts.
It took the legs out from under their early-season title challenge last term and they have been unable to pick themselves up since.
Which is why, with many key players due to return from long-term issues, the current overhaul of the football department will include investment in the medical department.
Over the past two seasons, there have been more than 20 lengthy lay-offs involving first-team regulars, for the team and, ultimately, the management to contend with. Some of them have rushed back, shy of their peak, and found it even more difficult to stem the negativity in a struggling team, while others have been paid but helpless and frustrated spectators for months.
As a consequence, players have been played out of position and the squad has swelled as stand-ins have been sought. The recipe has not been one for success.
While there is no way to avoid niggles and the odd inopportune sidelining of an influential player, Hearts’ record has gone well beyond simply bad luck. While there seems no obvious reason that the Gorgie squad are more susceptible to knee ligament damage, broken bones or hamstring tears than any other team, if injuries do occur again, club owner Ann Budge wants to be sure it is not due to anything the medical or coaching staff are doing wrong nor that they can be attributed to the training facilities used by the players or the personal programmes they are instructed to follow.
“For the last two seasons we have been asking: ‘Why are we getting so many injuries? Why are we getting so many of a particular type? Are they happening on the training ground or during games?’
“We have been analysing whether we have been doing something wrong or whether something else is contributing to the injuries, including if it was the Riccarton pitches our players train on. We have asked if we could be guilty of doing something that is contributing to this.”
The investigation threw up no obvious and concrete answers to those conundrums but they did highlight areas that need addressing.
“As part of that review, what became clear was that we had sports scientists, physiotherapists, doctors and consultants,” said the chairwoman, “but, if we want our players to be the best then we need to give them the best in other areas and what occurred to me was: they are getting good service, but are they getting the best?
“We do not skimp on treatment – but that is after the fact. What we want to do is pull the sports scientists, the physios and the doctors more closely together so we can get a more rounded view on what the issues are.”
Frustrated by watching important players dropping like ninepins, Budge says she wants proactive care rather than more of the reactive treatment and the subsequent lengthy rehabilitation periods that have undermined their first team form for too long.
“I want to get the medical department sorted and that will be another senior appointment,” she added.
With the help of former manager Craig Levein, she is looking for that person she can trust to make sense of what each department is telling her and put an end to the idea of Riccarton as part training ground/part hospital.
“I can speak to people separately but I don’t know whether the sports scientist or the physio is correct. Neither does the manager! So, I want someone who has a sports science background and a medical background who can understand all the information and pull it together.
“2018-19 was another successful year and got off to a fantastic start and then it all went horribly wrong.”
Describing the time since as a period beset by injuries, she wants a more sturdy and robust future.
“Craig has been here for six years and he still has a lot to offer in continuing to develop the youth side of football and he is also working with me to see how we strengthen and build a better medical department. There are all sorts of different groups who all have to work together to try to ensure not just our first team get the best possible attention but our reserve team and our academy. It is actually quite a big operation and we need to invest a bit more in that.”
In a huge shake-up of the football side of the business, Budge recently informed shareholders that there is also an ongoing review of the club’s scouting system, saying they have had to amend how they identify and select players, insisting there has to be greater scrutiny.
“We need to take our time to assess individuals more rigorously than we have in the past.”
While the academy is in a far healthier state than it was when she first took control, Budge admitted that they are not yet blessed with “wall-to-wall academy graduates” knocking on the door of the first team.
But she maintained it is a work in progress and one that has borne some fruit.
“I think from our current group we will have four progressing into the first team. If we can get four in every single year then I don’t think that’s too bad,” she said. “It was always going to take time but I still believe [investing in it] is the right thing to do.”