Neymar da Silva Santos Júnior was lying prone on the trainer’s table, a faceless man kneading his hamstrings, when he learned he’d been cut from Brazil’s national team. Four friendlies remained on the team’s schedule in March—enough time for the thirty-four-year-old to prove he still had it before the 2026 World Cup. But the odds of a call-up had always been slim after he injured his meniscus last December. That was his second meniscus injury in two years; his first, in October 2023, was compounded by a nasty tear to his anterior cruciate ligament, or ACL.
“I’m sad, obviously,” he said in a video he posted to YouTube titled “48 Hours With Me (unrestricted access).” “Before, I knew I was going to be called no matter what.” Neymar was arguably football’s first “golden boy” of the social media age, but he soon came to represent the rot of influencer culture within the beautiful game. His diva-ish behavior on and off the pitch never gave traditional—and particularly international—media much reason to like him, and despite surpassing Pelé himself in goals scored for the Seleção, he never reached the heights others dreamed for him. No Ballon d’Or, no Copa América—when he returned to Santos FC in early 2025, he was dubbed “the prince who never became king.”
But the disappointment in March didn’t stop him, like Napoleon in Elba, from immediately planning his triumphant return. “Now, it’s time to keep working, keep improving in everything,” he said, “and if there’s an opportunity, be prepared.” Even by today’s most generous estimates, selection for the World Cup seemed improbable: Before Christmas, he underwent arthroscopic surgery, which would mean he had roughly four months of recovery before he could start training with the Seleção. Neymar’s father-slash-agent admitted that his son had considered retiring after his latest injury. But after tapping world-famous physio Eduardo “Dr. Miracle” Santos, a physical therapist who boasted a ten-day rehabilitation for Brazilian David Luiz’s hamstring injury back in 2015, he might just wring a couple more months from his knees to represent Brazil one last time.
More than a dozen pro players will miss the World Cup due to leg (mostly knee) injuries, around the same number as those who missed the Women’s World Cup in 2023. At every level of the game, the most common serious injury by far is the torn ACL, a roughly three centimeter-long collagen band nested deep in the center of the knee, cinching femur to shin. If it tears, it rarely repairs itself. Surgeons must graft tissue to the place the ACL used to be. Although the graft will heal in a matter of weeks, the severed nerve endings in the original ACL cannot regenerate, and the nerve control takes months to reconnect: players must essentially relearn how playing soccer feels. Growing up, footballers hear that tearing one all but preordains tearing the other (due to muscle imbalances after surgery, or some presumed predisposition to the injury), and that no one is quite the same after tearing one. To think, snapping a band no thicker than a pencil eraser can spell the end of one’s multimillion-dollar career. Such outsized consequences demand an industrial complex of like kind.
It used to be that players had little choice but to go with the town surgeon and in-house trainer for recovery. Today, the pros’ healthcare has all but consolidated around a handful of boutique firms.
Neymar’s “Dr. Miracle” is among the highest-paid medical staffers in the soccer world. In 2016, after hopping from St. Petersburg’s FC Zenit to Shanghai’s Port FC, he reportedly commanded a seven-figure salary. (Currently he’s medical director of physiotherapy at Al-Duhail SC in Qatar, going where the money takes him.) He’s not to be confused with surgeons like Kylian Mbappe’s so-called “miracle doctor”—the renowned knee surgeon Bertrand Sonnery-Cottet—or another physio, “Dr. Miracles” (plural), a.k.a. Paulo Araújo, a “master in Chinese medicine” who in 2022 helped AC Milan’s Rafael Leão return to the pitch seven days after the winger ruptured his abductor. (Leão missed this spring’s international friendlies due to recurring adductor issues.) While their methods—and medical backgrounds—differ, their collective goal, like their tabloid-christened nicknames, is basically the same: to defy nature, no matter the cost.
At least, that’s the great hope of players and their agents, who are often at odds with their clubs—and their doctors—regarding treatment. It used to be that players had little choice but to go with the town surgeon and in-house trainer for recovery. Today, the pros’ healthcare has all but consolidated around a handful of boutique firms, with surgeons and physios whose acclaim spreads by word-of-mouth among athletes and their entourages. One high-profile case with a shorter-than-average recovery time can make a doctor’s career. The sports medicine industry rewards extremes: It’s become hyperspecialized and susceptible to the kind of competitive pressures that produce false positives, correlations without causations, and unreplicable “miracle cures” for serious injuries. It reinforces the kind of hubris athletes thrive on, given the heights to which their superhuman bodies have taken them—that is, until they fall. And it increasingly flushes with the so-called “longevity” industry, where money often goes to the best salesmen, not the best doctors.
Aside from the aforementioned miracle purveyors, there’s Ramón Cugat in Barcelona, who pioneered a procedure that involves injecting the player’s own platelet-rich plasma into the injured area to promote healing; the silver-haired Pier Paolo Mariani in Rome, who recently co-wrote a study that states, unequivocally, that a return to the pitch in fewer than six months after ACL surgery effectively guarantees a shorter and worse career (he has a habit of publicly weighing in on when players should and shouldn’t return); Andy Williams in London, who has served seventeen of the twenty English Premier League teams—the exceptions are “Sunderland, Fulham (“though I do see their players sometimes”), and Manchester City (“though I take care of their women and [the] Man City Group”)— and published widely on the results of ACL surgery in pro-athletes (he even edited the 2005 edition of Gray’s Anatomy); and Neal ElAttrache in Los Angeles, who has framed photos and notes from star-studded patients lining his office walls (“Can’t thank you enough for my new knee,” writes Leonardo DiCaprio).
Williams likes to say that surgery only provides the “runway” for recovery, but if something—anything—goes wrong in the months after the procedure, the surgeon often receives the blame. (In 2022, Williams beat a lawsuit brought by former Wolverhampton center-back Roger Johnson, who alleged a botched surgery led to continued swelling and pain that prematurely ended his career.) Yet, “I’ve had to learn a lot about rehab, and had to help guide rehab,” Williams told me, “even though I’m not a rehab person.” In 2017, Williams nearly quit, but one club—“a family team, a team we follow”—refused to accept his resignation. After a heart-to-heart over dinner with the club doctor (“a lovely Spanish guy”), Williams reversed his decision.
When it comes to professionals and especially stars, surgery has to be perfect. If it’s not, it could jeopardize the player’s career. But recovery introduces a range of variables—the kind dependent on biology, environment, and mental constitution, but often interlaid with superstition. Athletes are, needless to say, unique; their bodies have “some of the most incredible structures I’ve ever seen,” Williams said. “The bone is harder when I drill a hole; if I cut the skin, it’s harder too.” Everything about them may be better, but that fact is itself a challenge: Athletes believe in their own excellence, and their hubris has medical implications. “They often talk themselves into things because they’re special. We almost can’t trust them”—because they push past where others might give up.
They also have the resources to access any number of treatments, with or without club approval.
For every miracle doctor like Williams and Sonnery-Cottet, there are others like Marijana Kovačević, a pharmacist known for using electric shocks and fluid from placenta in her treatments. In 2009, Arsenal striker Robin van Persie sought out Kovačević to heal his right ankle. After van Persie returned from Serbia, his ankle was still swollen and required surgery. But the striker’s high profile and Kovačević’s unique methods proved irresistible to British media, which labeled her the “horse placenta doctor.” (“I don’t know who thought of working with horse placenta,” she told the Serbian outlet Novosti, “maybe they think that in Serbia there are only wolves, cabbage, bacon, savages and horses.”)
In the years that followed, Frank Lampard, Vincent Kompany, and Diego Costa each paid her a visit, as did Luka Modric in mid-2023. (Lampard reportedly sat for treatment but left, unimpressed, before she finished.) At the time of van Persie’s injury, his coach, Arsène Wenger, had shrugged off the media frenzy, saying treatment is “sometimes psychological as well, for the players to feel that they can be helped.” More than a problem of physicality, “it can be a problem of confidence.” And what breeds confidence more than knowing you’re spending top dollar on care?
Whatever treatment professional athletes receive has a way of trickling down to the general public, Williams said, because pros are the perfect guinea pigs.
In 2022, while dealing with recurring hip injuries, Cristiano Ronaldo, then age thirty-six, purchased his own personal hyperbaric oxygen therapy machine—currently a favorite of LeBron James and Silicon Valley elites—for some fifteen thousand pounds. With his body naturally degrading each passing year, recovery became an ongoing process outlasting each discrete contusion, becoming a practice unto itself. (He’s also reportedly turned to stem cell treatment.) The chamber couldn’t hurt, Williams averred, but “I can remember Chelsea Football Club had one in the corner of the changing room in 1999. None of the players used it because they got claustrophobic.” Trends in medicine “come and go,” he said, but recovery has remained, for the most part, inelastic: six months-plus for full fitness.
Meanwhile, the grey market for recovery has only expanded. When news of Neymar’s “Dr. Miracle” hire broke, online speculation about the use of peptides—short chains of amino acids that reduce inflammation and accelerate recovery, the use of some of which is banned by the World Anti-Doping Agency—abounded, though there’s no real evidence suggesting this is the case. Whatever treatment professional athletes receive has a way of trickling down to the general public, Williams said, because pros are the perfect guinea pigs. In traditional medical studies, keeping track of patients over the long term is the hardest part, but with pros, “They can’t hide. We know what happens to their knees.”
In 2021, four years after I tore my right ACL, my left ACL snapped. It felt fateful, like my body telling me, after 21 years of playing soccer, now was the time to stop. About a week later, lying on the surgeon’s table, my leg was “exsanguinated”—a fancy way in the doctor’s notes to say the blood was forced from my limb—and an “80-mm graft was harvested” from my left quadricep. Using a motorized shaver and a drill, the doctor made space for the graft. The bony debris was “irrigated,” the suture was placed, and the nurses slowly loosened the tourniquet on my thigh over approximately sixty-seven minutes.
My recovery was slow; I lived in a walk-up. My swollen leg was for weeks tinted purplish and green, unrecognizable to me. Today, I still mistrust my knees. (“It may be that your neuromuscular control could be better,” Williams suggested during our conversation.) Embarrassed by my own self-pity, I quietly disposed of my cleats. Online, I found the pros’ rehab successes to be a source of envy and speculation. With pro healthcare balkanizing, a similar process has unfolded at the amateur level—and the rate of ACL tears, particularly among young players, has exploded, a trend that was probably not helped when, in 2017, FIFA nixed a youth-level injury-prevention warm-up regimen promoting exercises that were found to have reduced injuries by fifty to eighty percent. Meanwhile, in the US, hospitals often pay for the privilege to market themselves as the “official” care provider for local pro teams, luring amateurs with the promise of pro-level treatment, even as the pros shirk their purported medical sponsors for the likes of Williams or Neal ElAttrache.
And after surgery? Among the proles, homeopathics, supplements, subreddits, and advice forums rule the day, substituting for the full-time work of a “Dr. Miracle.”