With a minimum of around nine months having to be spent rehabilitating, it's often the end of a player's season.
Tottenham's James Maddison had only played for nine minutes of the pre-season friendly against Newcastle before it was obvious he couldn't continue.
Thomas Frank could only describe Maddison's bad luck as "brutal," and in a World Cup year to boot.
Plan B required ASAP
After having so many injuries last season which undoubtedly contributed to Tottenham's slide down the Premier League, Frank will be hoping that history isn't about to repeat itself.
In the meantime, a plan needs to be drawn up either ahead of the first game against Burnley or certainly before the transfer window closes as to whether the club look in house for a replacement or buy one from elsewhere.
There isn't anyone at Spurs with Maddison's particular skill set, but it isn't clear at this stage if Daniel Levy and the board of the club will approve further spending this summer.
Assuming the chairman keeps a tight hold of the purse strings, Frank may look to Pape Sarr to provide something different.
Though not a traditional No.10, he has been playing a more pivotal forward role in pre-season, scoring an incredible long-range effort against Arsenal to boot. Spurs legend, Chris Waddle, believes he could be the answer to the club's prayers.
"Pape Matar Sarr has had a great preseason with his energy levels and I could see him playing behind the striker," he said in a recent interview.
"He’s scoring goals at the minute, he’s confident, he’s got great energy, he can run off the ball very, very well and he’s quite intelligent at that.
"I’m not saying Sarr’s got the ability of Maddison, but he’s a very willing runner. You need somebody with legs who can get around a bit and that’s going to be interesting."
Like for like with James McAtee
If Levy can be persuaded to dip into club coffers, the standout candidate to slot in for Maddison would be England U21 captain James McAtee.
The 22-year-old is apparently close to a deal with Nottingham Forest, but his natural ability is ideal to fill the void Maddison's injury has created. A deal isn't done until pen is put to paper, so there's still time for the Man City outcast to change his mind.
Though records will show that McAtee played 15 Premier League games for City last season, he only started in three and his 342 total minutes is less than four full games. Despite this, he still managed to score three goals.
He also scored three in an FA Cup tie against Salford, which prompted gushing praise from his manager Pep Guardiola, and his passing never dipped below 83.8%. It even went as high as 96.5% in last season's Community Shield.
A £40m bargain?
Where the midfielder excels is not only in his ability to find space where there seemingly is none, but with his vision to pick a pass and then execute it. Given more of a run in a team, it would surely only be a matter of time before McAtee stakes a genuine claim for a place in England's senior World Cup squad.
Reports would suggest the asking price is £40m, and for a player with his supposed 'peak' years well ahead of him, it could represent a bargain.
Were the North Londoners to move that little bit too late for McAtee, and with Jack Grealish potentially on the verge of signing for Everton, their options are somewhat limited.
McAtee's fellow U21 colleague Harvey Elliott could be a consideration, and his season at Liverpool mirrored that of the former.
18 games played, only two started and 360 total minutes. Two goals and an assist in that time is unlikely to have Spurs fans drooling, though Elliott does have a massive point to prove and, whilst his output isn't great, his energy can't be questioned.
50% shooting accuracy and 33.3% conversion rate are both stats that are worthy of a more detailed look at the player's credentials, and with 85.1% pass completion, he too could slot seamlessly into the manager's vision to play the 'Tottenham way.'
Damsgaard the wildcard
One player who Thomas Frank knows all about is Mikkel Damsgaard.
The Brentford ace is still only 25, and has been a key factor in the Bees' success of late. In the 38 top-flight games he played last season, he provided a phenomenal 10 assists. Two goals could be improved upon, but in the right team, that's entirely possible.
Frank knows what makes the player tick; however, it could be the toughest of negotiations with the West Londoners, particularly after Brentford have already seen Bryan Mbuemo, Christian Norgaard and keeper Mark Flekken depart.
