Following the weekend’s results, Nuno Espirito Santo’s side are back in the relegation zone, one point behind 17th-placed Tottenham Hotspur with three games to go. West Ham face the daunting challenge of hosting league leaders Arsenal this weekend, but at least they will be able to do so with a fully-fit squad.

It is in this area where the east London club continue to thrive. West Ham have suffered the second-lowest amount of injuries in the division this season, with only Leeds United doing better.

Pablo Felipe, Crysencio Summerville (both calf), Ollie Scarles (shoulder) and Niclas Fullkrug (hamstring) are the squad’s only senior first-team players to endure lengthy absences. Third-choice goalkeeper Lukasz Fabianski, who rejoined the club last summer after initially being released, also damaged his back earlier this campaign.

West Ham are fighting against dropping down to the Championship for the first time since 2010-11, and having faced so few matches with key players unavailable has hugely boosted their survival chances.

Club captain Jarrod Bowen has been ever-present in the league across the first 35 games, starting every one. His last major knock was a foot injury against Liverpool in December 2024, which led to the England international missing five matches.

Mads Hermansen and Alphonse Areola, their top two goalkeepers, have not had any fitness issues this season. Neither have midfield pair Tomas Soucek and Mateus Fernandes. In January, key centre-back Konstantinos Mavropanos was carried from the pitch just before half-time in the FA Cup third-round win against Championship side Queens Park Rangers following a head injury, but was mobile post-match as he left the London Stadium and played the full 90 minutes away to Tottenham Hotspur in the league the following weekend.

Mavropanos was stretched off against QPR but was back for the next game (Justin Setterfield/Getty Images)

Winger Summerville picked up an unspecified knock in the fifth-round defeat of Brentford in early March but only missed three games, while Pablo returned to fitness ahead of schedule after developing a calf problem shortly after coming on as a substitute in February’s 2-0 victory away to relegation-scrap rivals Burnley.

“Yeah, happy and delighted,” said Nuno, in his pre-match press conference before the 2-0 loss to Brentford in the league on Saturday, when asked about their good injury record. “But it says a lot about the players. They’ve been really taking care of themselves, respecting their body and the routines that we have in terms of nutrition and recovering. It says a lot about them.”

This season is not a one-off for West Ham in regard to injuries, either. They perennially have a good record when it comes to keeping players fit and available. The driving force for this are a medical team consisting of Richard Collinge, Richard Weiler, Joshua Ewens and Adam Paxton, among others.

Players at West Ham are constantly graded green, amber or red, depending on their physical condition. Green indicates they are fine, amber suggests there may need to be modifications to that individual’s training, to avoid potential injury, while red is commonly used in reference to those who do have an issue.

Since succeeding Graham Potter in late September, Nuno has overseen 30 league games and has made 50 changes to the starting XI across them. The weekend defeat at Brentford saw him name the same XI for the fourth consecutive game. Although the Portuguese clearly has a favoured line-up, it is crucial that the players on the fringes of it keep themselves in top condition. Those who are not first-team regulars have their fitness levels maintained with gym work, occasionally on their days off, and high-intensity runs after games, along with lower-limb conditioning.

The starting XI often do running drills of their own, in between sets of cones, when they re-emerge on the pitch for the second half of a game. During the interval, they sometimes sit as long as 12 minutes in the dressing room, so these exercises are designed to get their heart rates back up and activate muscles.

When it comes to recovery, once a week the players will use cryotherapy chambers, in which temperatures drop as low as -130C (-202F). This helps stimulate blood circulation and muscle recovery. There is also an altitude chamber at the club’s training hub in Rush Green, east London, which simulates a low-oxygen environment to help players improve their endurance in preparation for gruelling Premier League matches.

Axel Disasi, the on-loan Chelsea defender, had used a hyperbaric chamber to help him stay in shape ahead of his arrival in February, as he wasn’t getting any game time. The 28-year-old Frenchman, who trained separately from Chelsea’s first team during the first half of the season, otherwise known as being in “the bomb squad”, worked with a personal trainer and did solo sessions in his garden at home.

Disasi used a hyperbaric chamber to stay in shape ahead of his move to West Ham (James Fearn/Getty Images)

Although Disasi did feature as an over-age player for Chelsea’s under-21s on three occasions between November and early January, West Ham did not have any of his recent match data, but information about his performances in training were received. An acute chronic training ratio readout also showed there was no spike in his levels during those sessions. This is information used by the medical department to understand the injury risk of a player in the short and longer terms.

The five-time France international has since been a key performer under Nuno and would be interested in joining West Ham on a permanent basis if they manage to avoid relegation.

Disasi is not the only new player to buy into the club’s culture: Callum Wilson, a free-agent signing after leaving Newcastle United last summer, struggled with hamstring problems during his five seasons on Tyneside but the 34-year-old striker has not sustained any significant injury since coming to the London Stadium.

Michail Antonio, West Ham’s record goalscorer in the Premier League who was released in August after 10 years on the books, was considered injury-prone for much of his career. But after seeking advice from the club’s performance department in 2022, his physiotherapy and gym regimen was modified, along with his diet. He was informed he was not eating enough polyunsaturated fat and needed to increase his intake of fish. Antonio went one step further and cut out red meat altogether. This helped lessen his niggling injuries and enabled Antonio to continue representing Jamaica’s national team.

West Ham’s clean bill of health is in stark contrast to that of Tottenham, who look set to be their primary rivals in the Premier League relegation scrap over the coming weeks.

Their list of casualties includes Mohammed Kudus, whose only absences in his two years at West Ham were due to international call-ups and suspension. Since making the short trip across London last summer for around £55million, the midfielder has missed 22 matches through injury, and is still out with a thigh problem suffered in January. Others, including Ben Davies, Dominic Solanke, Guglielmo Vicario, Rodrigo Bentancur, Cristian Romero and Dejan Kulusevski have all been absent from the XI at various points.

Spurs have also suffered a glut of anterior cruciate ligament (ACL) knee injuries, with Radu Dragusin, James Maddison, Wilson Odobert and now Xavi Simons all missing part of this season. Interestingly, Angelo Ogbonna, who left the club in summer 2024, remains the most recent player from the West Ham men’s first team to be lost to ACL damage, and that was in November 2021.

There were eight Tottenham players missing for their game at Aston Villa on Sunday, and although they have now won back-to-back Premier League matches, those injuries are denting their hopes of finishing above West Ham.

Nuno will hope this clean bill of health helps his team in the remaining games against Arsenal, Newcastle and Leeds.

At a time when other sides in the division face challenges to keep key players fit, West Ham continue to show how it is done.