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Yes, it cannot be denied that the EPL is the league with the tightest competition and the most competitors from top big clubs. So, every club is obliged to perform well and excel in whatever conditions. However, on the other hand, injuries to first line players at a religious club is a challenge in itself. For this reason, the coach must have the ability to change strategies as best as possible in times of urgency and choose the most suitable replacement. Even though they may not be as strong as the first line players, at least the club will not be so devastated when a main player is injured.
Regarding Tottenham, and other clubs too, when a player has just been injured, especially a fairly serious and long injury, of course this will not be good. Because after all, usually after injury, the performance may not be as good and strong as before. So there may have to be a little more adjustment, unless it's not a major or vital injury.
Undeniably, you are right. Injuries to important players tend to make it difficult for coaches to find suitable players to replace those players in the line up. Pep Guardiola had difficulty finding the right player to replace the injured De Bruyne, so he often rotated one player with another for the same purpose.
Tottenham has at least 7 players struggling with injury problems. The team's performance has generally fallen, although as a result Ange Postecoglou has been able to give other players opportunities. Tottenham only have 22 players out of 29 in their squad at the moment, but some of them are likely to recover as scheduled and this will certainly help team improve form.