As the man responsible for overseeing England's fitness at Euro 2012, Gary Lewin has spent the past few weeks with fingers crossed, and one of his fears was realised when Frank Lampard limped out of training on Wednesday, joining a list of midfield casualties that already included Jack Wilshere, Jack Rodwell and Gareth Barry.
The worry on Lampard's behalf – and it ought to nag Joachim Löw even more than Roy Hodgson – was that he took part in the Champions League final. Germany had seven participants to England's three (unless you count John Terry, which only John Terry could) and Lewin has traced a link between the climax of the European club season and readiness for a tournament summer. Check out his theory: not only did Spain, winners of the European Championship in 2008 and World Cup in 2010, have no club side in the final in either year but that Italian sides fell similarly short before lifting the World Cup in 2006.
The search for physical and mental condition has fascinated Lewin since he became England's physiotherapist after Euro 96, starting under Glenn Hoddle in the Moldova match more widely remembered as David Beckham's debut. Once an apprentice goalkeeper with Arsenal, he switched careers at 19 and served the club through two title-winning campaigns under George Graham and three under Arsène Wenger before turning full-time to the national cause in 2008. And Lewin does subscribe to the notion that the intensity of club football in England takes a toll.
"Ask the foreign coaches who come here," he said, "and they'll tell you that the physical demands of every game are identical. It doesn't matter if you are playing Wigan or Manchester United – it will be demanding. With due respect to Spanish and Italian football, which technically are amazing, you watch some games and they are like testimonials. You could never say that about the Premier League. Every opponent will fight to the end."
As testimony to the effect on internationals, he traces the fortunes of France: "In 1998, when they won the World Cup, they had hardly any players in English football. In 2000, there were more but they didn't have a lot in our League until 2002, which was a disaster [the team beaten by Senegal in the opening match of the World Cup and ejected at the group stage included Fabien Barthez, Patrick Vieira, Emmanuel Petit, Marcel Desailly, Sylvain Wiltord, Thierry Henry and Youri Djorkaeff]. It would be very interesting to talk to European players. David Silva, for instance. He was brilliant in the first half of the season but sometimes looked tired in the second.
"That's why, like a lot of coaches, I'm a strong advocate of the winter break. Even if you didn't cut down on the number of games, it would help, mentally as well as physically. Physical trainers and scientists will tell you that we have a period of deconditioning – that's our summer break – and then a period of conditioning before you're ready. Then we in England have nine or 10 months before the process is repeated. Even if we had a small break, I believe that the mental relaxation a player enjoyed in that time – without deconditioning much – would have a beneficial effect towards the end of the season.
"Uefa have even done studies which indicate that a player is four times more likely to be injured in the last three months in the Premier League than other leagues in Europe." Lewin did a tour of the clubs – he now monitors England players rather than waiting to discover their condition when they report – in the closing weeks of the season and then began working closely with the suddenly-parachuted Hodgson. At least the players have been spared the lengthy and – some claimed – tedious preparations for the World Cup two years ago.
Asked if performances in South Africa proved that a waste of time, Lewin sighed. "To be honest," he said, "we've tried every way of preparing the England players. We've tried training them hard, giving them a beach holiday, locking them away, taking them up into the mountains and I can't say that any one has stood out as the way forward." The hotel in downtown Krakow is the latest part of "the search for our Holy Grail".
But Lewin is excited about the future. He was speaking at a conference involving the Isokinetic Medical Group, who are due to open a Fifa-approved centre of excellence in London next year, and before that will come the opening of the long-awaited St George's Park. "To have world-class facilities on our doorstep," he said, "will be like waking up every day like a child on Christmas morning." And England should be in ever-safer hands.