When Real Madrid played Espanyol at home on September 21, there was a heart-in-your-mouth moment as Jude Bellingham fell to the ground, clutching his shoulder.
The 21-year-old was treated by Madrid’s physios on the pitch and manager Carlo Ancelotti, in his press conference after the 4-1 victory, said there was no reason to fret.
But the incident resurfaced worries over a problem that dates back to the early stages of Bellingham’s debut season last term, when he was out for about a month after suffering a dislocated shoulder and began to wear protection on the area to avoid it happening again.
Of the several Madrid sources spoken to for this article — who all preferred to speak anonymously to protect their position — nobody had serious concerns about Bellingham’s fitness right now. They all said there was nothing wrong that affected his immediate availability to play.
However, the question of how to manage the Englishman’s shoulder has again become a topic of discussion around the Spanish club.
Watching him in recent weeks, it is hard to avoid the conclusion that he cannot be at 100 per cent and the medical experts consulted here agree that shoulder dislocations often require surgery and a lengthy lay-off — at some point.
Here, The Athletic explains the latest.
How long has Bellingham had a shoulder problem?
Bellingham’s first officially known injury to his left shoulder came 11 months ago at Madrid. He dislocated his shoulder in a 0-0 draw at home to Rayo Vallecano in La Liga on November 5. He completed the match but did not feature in Madrid’s next two games — also missing England’s final two Euro 2024 qualifiers that month.
Bellingham holds his shoulder during the match against Espanyol (David Ramos/Getty Images)
It is not fully known whether Bellingham has suffered previous shoulder dislocations, but last year Real Madrid staff sources said they were aware of shoulder problems during his spell at Borussia Dortmund (2020-2023). Photos show him wearing shoulder support on two occasions when playing for the German club in August 2022 and March 2023.
Has it been affecting his game?
After his shoulder dislocation at the Bernabeu last year, Bellingham started wearing an orthosis imported from the United States. It is one of the best protectors on the market and was arranged by Dr Manuel Leyes from the Olympia Quironsalud clinic in Madrid, who usually treats Madrid players externally.
It is a device often used in the NFL and also in the Premier League, according to another staff source at Madrid. Its purpose is to help support the shoulder during matches to alleviate pain, as well as reduce the risk of another dislocation.
Bellingham played a number of matches wearing the device last season — a remarkable debut campaign in which he scored 23 goals and provided 13 assists in 42 appearances as Madrid won La Liga and the Champions League.
Madrid beat Borussia Dortmund 2-0 to win the Champions League last season (Cesare Purini/Mondadori Portfolio via Getty Images)
Before the European Championship in the summer, where England made the final but lost to Spain, sources at Madrid said Bellingham’s shoulder was no longer bothering him so much.
By the start of 2024-25, he was no longer wearing the orthosis. Madrid sources say he asked to stop using it because he felt it prevented him from breathing normally during games. Those same sources said they believed the device also slightly limited his mobility — especially his ability to jump.
“He has always played with protection,” Ancelotti said after the Espanyol match last month when Bellingham hurt his shoulder and had it bandaged by physios. “He was better and has been without it for a month. The problem was solved today because he didn’t ask for a change. It won’t be a problem, but he has to take care of himself.”
Since the Espanyol game, Bellingham has been wearing shoulder protection again, with both player and club agreeing it was important to do so despite the annoyances.
Does it need surgery?
Real Madrid staff sources say their understanding is that Bellingham will require surgery to ensure the shoulder fully heals properly — and to avoid a high risk of further dislocations. This is a view backed up by Dr Santiago Arauz, an expert in shoulder injuries at Clinica Cemtro, a specialist surgery clinic in Madrid.
“The risk of recurrence is very high, up to 90 per cent,” Arauz says.
“I have patients who have had 20 years with episodes of dislocations, but in many cases, surgery is recommended the first time. The problem is that some patients have many dislocations, which end up causing further damage. Nowadays, if you have had three episodes, there is a 100 per cent consensus that it is better to operate.
“He (Bellingham) will know for sure in which position it (the shoulder) is going to pop out. Typically, it’s when you throw your arm up and backwards, like when you go to grab something at the back of the car from the front seats.
Bellingham has made seven appearances for Madrid this season (Gonzalo Arroyo Moreno/Getty Images)
“As it is not a vital thing for a footballer, he can go on — but it doesn’t mean that it is harmless or that it doesn’t affect his game.”
Dr Mikel Aramberri, director of the ALAI sports medicine clinic, has worked with Real Madrid and the Spanish rugby team.
He says: “In principle, as he is an outfield player, I don’t think it will limit him too much. But if recurrent instability causes more and more frequent episodes of dislocation, the logical thing to do would be to find a period of the season where you can operate and solve the problem.”
So what might happen next?
Everyone at Madrid assumes Bellingham will undergo surgery at some point, but for the moment the calendar has not given him a chance to do so and the player has tried to take care of it with the help of the physios.
When Bellingham suffered a muscle injury in August, it was estimated that he would be out for around a month. Madrid considered the idea of operating on his shoulder, but in the end it was not done because the time off that would have been required was much longer.
Coaching staff sources think Bellingham would need about two months to recover, while Aramberri puts his estimation at “12 weeks at least”.
So far, the club is content to wait, while continuing to monitor the situation closely and taking medical advice on the best course of action. They follow a similar plan with Aurelien Tchouameni, who has suffered from recurrent stress strains in his left foot.
But a further dislocation for Bellingham may bring new problems, which is why everyone is being careful.
(Top photo: Gonzalo Arroyo Moreno/Getty Images)
