James Maddison opens up on year-long ACL injury nightmare and Roberto De Zerbi impact at Tottenham

Maddison has opened up about being "in the trenches" at home while recovering from a serious knee injury. The 29-year-old missed most of the 2025-26 campaign after suffering a ruptured anterior cruciate ligament August last year. During his lengthy rehabilitation period, Maddison's partner gave birth to their second set of twins.

The playmaker now has five children aged four and under at home, making his recovery both physically and mentally demanding. Maddison described the prolonged absence from football as the "toughest year of his life" but credited his growing family for helping him through the ordeal.

Despite the chaotic nature of a busy household, the England international embraced the situation. "A lot of nappies flying about, a lot of accidents at home, but it'll all be worth it," Maddison said in an interview with the BBC.

"I needed that positive distraction of my partner being pregnant and having to be there for her and forget about myself, even though I was going through a traumatic experience."

His extended absence even confused his eldest son, Leo. Maddison revealed that his four-year-old assumed he had left Spurs, as he could no longer remember watching his dad play competitive football.

"I missed a year of football, and a year in a child's life - from three and a half to four and a half - it's obviously massive," he added. "He couldn't even remember over a year ago when he was at all the games. It would be nice for him to come to the games again and actually remember Dad playing instead of just Dad sat at home watching him with a machine on his knee."

Spurs endured a difficult campaign last term, securing their top-flight survival on the final day. Maddison admitted it was incredibly tough to watch his team-mates struggle without being able to offer his creative spark on the pitch. However, the arrival of head coach De Zerbi helped transform the atmosphere. Maddison praised the Italian tactician, noting that he simply wanted the squad to rediscover their love for playing football.

"We probably struggled a little bit for creativity and I'm watching the games thinking, 'what would I be doing there?'," he said. "He's very clever. He's very tactical. He's obsessed with football, you can see that.

"But to be honest, when he first came in – in comparison to pre-season and what we're training now - he didn't want to make it too complicated. He just wanted us to get the love back for playing football."

Maddison eventually made his long-awaited return to action against Leeds on 11 May. However, the club have opted against risking the playmaker during their pre-season preparations so far.

Despite the careful management of his fitness, the 29-year-old remains highly optimistic about the upcoming campaign. It remains to be seen whether the midfielder will feature when Spurs face Brentford in their Premier League opener.