Roberto De Zerbi has defended Tottenham's medical staff amid the constant injury problems at the club and has explained what £85million midfielder Mateus Fernandes must do to get into his starting line-up.
Spurs' treatment room has overflowed in recent years with previous head coaches left despairing the constant muscle injuries, long-term absences and re-injuries that have regularly left the club in double figures of missing stars.
The north London outfit have taken steps to remedy the issues with performance director Dan Lewindon brought in from The City Football Group in February and undertaking a large-scale review. That led to staff changes, an overhaul of the club's gym, a focus on buying more robust players and even an independent investigation into whether the Tottenham Hotspur Stadium pitch was causing problems.
Yet De Zerbi goes into the clash at Stamford Bridge, a place where Spurs have won just once in their previous 41 visits, without summer arrivals Savio and Mykhailo Mudryk, nor Destiny Udogie, Lucas Bergvall and long-term absentees Xavi Simons and Wilson Odober while another new arrival in Tosin Adarabioyo is a doubt.
James Maddison and Dejan Kulusevski did not train with the team in the days after Monday's win against Coventry having made their first start and appearance in almost 18 months respectively but are expected to be available in some capacity for the game at Chelsea.
Pedro Porro, who rarely missed a game for Tottenham in previous seasons, has suffered a couple of hamstring issues since the World Cup but should be available to face Xabi Alonso's side, while Rodrigo Bentancur remains suspended.
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There is a belief among some that Spurs have now switched to the other extreme of being too cautious with players and not taking risks with them, which may lead to fewer long-term problems but a wider range of missing stars for De Zerbi in certain weeks.
"It’s football. I am convinced our medical staff this season is high level. I follow them. I believe in them," said the Spurs boss. "I have big confidence because I know how they are working and I think they are good enough to believe in them. We are suffering a normal situation in football."
The huge injury list from last season seeped into De Zerbi's final games of the campaign as he looked to keep Tottenham in the Premier League and he believes that international commitments have not helped since.
"I can say in the last six games [of last season] there were many, many injuries but the focus was totally different and this season we can speak about Pedro Porro's injury," he said. "Pedro played at the World Cup. He won the World Cup. He came [back] after two or three weeks, maybe with the head or the body he didn’t recover enough to start this season without the pre-season. He already suffered in the World Cup the muscular problem of the hamstring.
"He felt it in the training session and played anyway against Aston Villa because he pushed to come back before the right time, and he suffered another injury. What is the responsibility of the medical staff?
"Or Bergvall. Bergvall, the first minute at Manchester United, when he regained the ball when Solanke had the chance to score in the beginning of the game, in the tackle, he turned his knee and felt pain. He finished the game and the day after he felt pain. What is the responsibility of the medical staff? Nothing."
He went on: "Or [Andy] Robertson. Robertson played four games in a row with the national team. Every three days he played and after that felt a small problem in Manchester and didn’t play, because we took no risk with him. He played 60/65 minutes against Coventry very well, especially played very well in the first half and was fatigued. It’s normal fatigue for a player who played six games in 20 days."
On Tosin, who came off on Monday night, De Zerbi explained: "I don’t know. He’s a doubt. He felt pain in the second half against Coventry but nothing important."
Spurs have no European football this season and the free midweek should allow for fewer injuries and less of an overload on the squad.
"It is better. At the end of this season we will make the total report and analyse the situation but so far we can’t say anything bad about the medical staff," said the Italian.
One player who the fans wants to see more of is £85million summer signing Fernandes. The 22-year-old, who became a father for the first time last week, has started just three Premier League matches since arriving from West Ham.
De Zerbi was asked what the Portuguese midfielder needs to improve in order to get into his starting line-up on a regular basis.
"I think he needs to understand the club, to better understand to come inside the environment of a bigger club. Different club, but he’s a good guy. I don’t change my idea about him, like the club [don't change]. We pushed together to bring him," said the Italian.
"We are convinced of his qualities and he has to stay with a calm head and confidence and enjoy on the pitch, enjoy with the ball – show his qualities because he will be one of the most important players of Tottenham for the future; for the present and the future."
When quizzed on whether he meant the extra pressure of playing for a bigger club, De Zerbi said: "No, it’s not a pressure. It’s different habits … it’s like this for a player when they change clubs. When your step is higher, you feel more pressure. You have more expectation and maybe he has to adapt something more."