Tottenham Hotspur star James Maddison spent almost an entire season fighting his way back from a serious knee injury. But while football temporarily disappeared from his daily life, an extraordinary situation at home gave the England midfielder something else to focus on: raising five young children, including two sets of twins.
For professional footballers, a long-term injury can turn a packed schedule of matches, training sessions and travel into months of rehabilitation and uncertainty.
James Maddison knows exactly what that feels like.
The Tottenham Hotspur midfielder ruptured the anterior cruciate ligament in his right knee during a preseason friendly against Newcastle United in Seoul in August 2025, forcing him into surgery and beginning one of the longest injury layoffs of his career.
But while Maddison was dealing with the physical and psychological strain of rehabilitation, his family was going through a major change of its own.
His partner welcomed their second set of fraternal twins—a boy and a girl—bringing their family to five young children.
And for Maddison, the chaos of fatherhood became an unexpected part of his recovery.
Family Life Became Maddison’s Escape From Football
Maddison said having so much happening at home stopped him from spending every waking moment thinking about the injury.
Rather than concentrating only on his damaged knee, rehabilitation schedule and uncertainty over when he would play again, he also had to support his partner and help care for their expanding family.
There were sleepless nights, nappies and all the everyday complications that come with having several very young children under one roof.
Yet Maddison has described that hectic family environment as a valuable distraction during one of the most difficult periods of his professional career.
His second pair of twins also placed the Maddison household in unusually rare territory. Tennis legend Roger Federer and his wife Mirka famously have two sets of twins as well—twin daughters born in 2009 and twin sons born in 2014.
The Injury Came at a Painful Time in Maddison’s Career
Maddison’s ACL rupture was especially difficult because it followed another knee problem only months earlier.
He initially injured his knee during Tottenham’s Europa League semifinal first leg against Bodo/Glimt on May 1, 2025. That problem ruled him out of the Europa League final.
Then came another major setback during Tottenham’s preseason tour of South Korea.
The club confirmed on August 7, 2025 that Maddison had suffered a ruptured ACL in his right knee and would require surgery.
The result was months of rehabilitation and almost an entire Premier League season away from regular competitive football.
By January 2026, Tottenham reported that Maddison was making progress and had returned to working with the ball, although several months of rehabilitation still remained.
‘Dark, Lonely Days’ During Rehabilitation
Long-term injuries are rarely only physical challenges.
Maddison has previously acknowledged that his recovery included difficult periods away from the adrenaline and routine of competitive football.
For a player accustomed to training every day, preparing for matches and performing in front of tens of thousands of supporters, rehabilitation can become repetitive and isolating.
That made his unusually busy home life even more significant.
Instead of returning from rehabilitation sessions to an empty schedule, Maddison returned to a household filled with young children who required his attention regardless of what was happening with football.
The demands of parenthood may have been exhausting, but they also offered something professional rehabilitation could not: a reason to temporarily stop thinking about his knee.
His Youngest Fans Were Waiting at Home
One particularly emotional part of Maddison’s story involves his eldest son, Leo.
Because Maddison spent so long away from regular Tottenham matches, he joked that his son had started becoming more accustomed to seeing his father at home than on a Premier League pitch.
A year represents an enormous portion of a young child’s life.
Maddison said his son had effectively gone from being around three-and-a-half years old to four-and-a-half during his father’s absence from football.
That meant memories of attending Tottenham matches and watching his father play had begun to fade.
For Maddison, returning was therefore about more than restarting his own career.
It also meant giving his children the chance to watch him play again.
Emotional Tottenham Return After 375 Days
That moment finally arrived in May.
Maddison returned to competitive Tottenham action against Leeds United at Tottenham Hotspur Stadium, ending a 375-day wait to play competitively for Spurs.
Tottenham said the midfielder had spent 277 days recovering from the ACL rupture itself.
His family was in the stadium when he returned.
Maddison later spoke about how much the reception from Tottenham supporters meant after such a long period away from the game.
Once he got his first few touches of the ball, he said the feeling quickly became familiar again.
It was a significant milestone after months dominated by surgery, rehabilitation and uncertainty.
Another Small Preseason Concern—But Spurs Refused to Take Risks
Maddison’s comeback has not been completely straightforward.
During Tottenham’s 2026 preseason preparations, new manager Roberto De Zerbi revealed that the midfielder had developed what he described as a “small problem.”
Tottenham consequently kept Maddison out of the remainder of part of its preseason tour as a precaution.
De Zerbi made clear that the club did not want to gamble with a player who had already endured such a lengthy absence.
The decision was particularly understandable given Maddison’s importance to Tottenham’s attacking game.
Before the setback, Maddison had spoken enthusiastically about working under De Zerbi, whose possession-based and attacking philosophy he believes should suit his playing style.
Maddison Enters a New Tottenham Era
Tottenham’s wider circumstances have also changed dramatically during Maddison’s rehabilitation.
Roberto De Zerbi took charge in March 2026 after interim manager Igor Tudor departed, eventually guiding Spurs to Premier League survival.
Tottenham finished 17th after securing safety late in the campaign.
Maddison has said the club now needs to improve after several difficult seasons, while embracing De Zerbi’s attacking approach.
For the 29-year-old midfielder, staying healthy could be just as important as anything tactical.
After losing so much football to injury, consistent availability would represent a victory of its own.
The Bigger Story Behind Maddison’s Comeback
Football careers are normally measured through appearances, goals, assists and trophies.
Maddison’s last year has been measured differently.
There were operations and rehabilitation sessions. There were months without competitive football. There were moments when one of Tottenham’s most recognisable attacking players could only watch from the sidelines.
At the same time, there were babies arriving, nappies being changed and five young children demanding attention at home.
It was hardly the recovery programme a professional athlete would design.
Yet Maddison believes that may have been exactly why it helped.
Football temporarily stopped being the only thing occupying his mind.
And after spending much of the previous year watching Tottenham from outside the pitch, Maddison now has another motivation for staying there:
making sure his children grow up remembering their dad as the player on the field—not simply the one sitting at home rehabilitating his knee.
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