Roberto De Zerbi insists he has full belief in Tottenham’s medical staff despite his side’s mounting injury woes.

Spurs could be without as many as 10 senior players for Saturday’s trip to Chelsea, with Tosin Adarabioyo, Dejan Kulusevski and James Maddison all doubts despite playing in the 3-1 win over Coventry on Monday.

De Zerbi had also hoped to have Destiny Udogie back in contention after deciding not to risk him against Coventry.

Despite overhauling their performance department in the summer, adding Ali James (head of medical services), Tom Tombleson (head of athletic development) and Agostino Tibaudi (strength and conditioning coach) to De Zerbi’s backroom team, the club’s injury issues have persisted.

A disrupted pre-season, with commercial commitments, jet lag and players returning late from the World Cup, meant Spurs were physically ill-equipped heading into the start of the campaign.

De Zerbi has been vocal about his frustrations with Spurs’ pre-season preparations, but admitted it was not the fault of the club’s revamped medical team. Instead insisting that their current injury situation is normal.

“It’s football. I am convinced our medical staff this season is high level. I follow them. I believe in them. I have big confidence because I know how they are working, and I think they are good enough to believe in them. Nothing more. We are suffering a normal situation in football,” De Zerbi said in his pre-match press conference.

Destiny Udogie has been ruled out of Tottenham’s clash against Chelsea

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Spurs have been cautious with Maddison, Kulusevski and Udogie, who have struggled with long-term or, in the case of Udogie, persistent injury issues.

Pedro Porro, though, has been a figure of consistency for Spurs in recent seasons, yet he has played just three league games and only recently returned to training after a month out with a hamstring injury.

On Porro’s injury, De Zerbi revealed that the Spain international first felt discomfort in his hamstring during the World Cup and was therefore eased back by Spurs’ medical team after returning late to pre-season.

“Pedro played at the World Cup. He won the World Cup. He came 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,” De Zerbi continued.

“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?

Porro is fit to play against Chelsea, but De Zerbi is facing a selection dilemma in midfield, with Rodrigo Bentancur suspended and Lucas Bergvall out with a knee injury.

Bergvall picked up the injury in the first minute of Spurs’ 1-1 draw with Manchester United as he turned the ball over on the edge of the box to create a guilt-edged chance for Dominic Solanke.

Despite this, Bergvall played on and completed the game, only later complaining about the issue before missing Spurs’ warm-weather training camp in Marbella and the victory over Coventry.

“Bergvall, the first minute in Manchester United, when he regained the ball in the Man United build up 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.”

Lucas Bergvall was injured against Manchester United

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Spurs are in the midst of an injury crisis, but De Zerbi is reluctant to blame the club’s revamped medical team, fronted by performance director Dan Lewindon, and instead admitted the extended three-week international break has not helped his side.

“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, just because we take 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.”