Tottenham utility man opens up on the perforated appendix that laid him low for months and left him in a downward spiral

Eric Dier and the Tottenham medical team had tried to explain it away as a stomach bug. A number of the club’s players had gone down with it and Dier’s symptoms sounded similar. Except they were not. It was something far more sinister and it would be the beginning of a nightmare period for Dier, one that would see him lose his status as a regular Spurs starter and mainstay of the England squad – and from which he is still battling to recover.

It was mid-December last year, Spurs were about to play Burnley at home in the Premier League and Dier reported feeling unwell. He would be stood down from selection and on match day he was overwhelmed by a crippling abdominal pain. His appendix was perforated and infected – a dangerous situation – and he needed an emergency surgery.

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Dier, who started at centre-half in the 4-0 Champions League win at Red Star Belgrade on Wednesday, has not spoken previously about the details of the illness. When he opens up about the long-term consequences, he provides a context to his on-field struggles.

“It was quite serious,” Dier says. “At the time, there were a few players at the club with a stomach ache, so we just presumed it was that, which is no fault of the medical staff at all. They treated me fantastically. I was at home and I had to be rushed to hospital and I had the procedure straight away. I was very fortunate like that but it was just very difficult afterwards. I kept on getting ill.

“My immune system just really struggled with the medicine after the appendix and I kept on getting ill. People said I was injured but I was never injured. I just kept on falling ill because of it [the appendix], which was very frustrating.”

Dier was unavailable for five weeks after the operation but, when he returned, he did not feel right. He appeared to be trapped in a negative spiral. With his body run down, he would feel knocks and struggle to recover from them or fail to give himself sufficient time to recover fully.

Facebook Twitter Pinterest Dier has needed to bide his time in his attempt to get back to full fitness. Photograph: Michael Zemanek/BPI/REX/Shutterstock

To Dier’s mind he was never injured; rather laid low, primarily, by the after-effects of the appendix issue. He would be unavailable for further spells until the end of the season and then, when he addressed what he hoped would be a full pre-season in a non-tournament summer, he was forced to have further surgery. No information about this “procedure” has ever been made public.

There remain elements of mystery to Dier’s most recent career chapter, a feeling that more facts have yet to emerge, and there is the broader sense that fans tend to be less understanding when players are ill as opposed to injured. Witness the reaction when Arsenal’s Mesut Özil falls sick. Some consider it abnormal for an elite athlete to be poorly.

“What I went through wasn’t a normal thing for anyone,” Dier says. “It was a very strange experience but something that hopefully I will be better for. So it is what it is. It’s gone. I’m just looking forward now.”

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Dier could feel positive after the Red Star game, having been a part of a defence who were solid on a hostile occasion. With doubts over whether Toby Alderweireld and Jan Vertonghen will remain at the club next season – both are approaching the end of their contracts – could Dier see his Spurs future at centre-half? He has indicated previously that he wants to be viewed as a defensive midfielder.

It was only Dier’s third start of the season in all competitions and the previous two had been disasters. First came the Carabao Cup penalty shootout defeat at League Two Colchester and then the Premier League defeat at Brighton, when Dier endured a torrid first half in midfield. He is keen to look at Belgrade as a turning point, a step back in the right direction.

“I’ve felt for a while that I’m on my way back,” Dier says. “It’s just been unfortunate circumstances – my appendix and then coming back pre-season and having to have another procedure. But since then I feel very good.”

On Thursday Gareth Southgate named his England squad for the Euro 2020 qualifiers against Montenegro and Kosovo and it felt like a sign of the times that Dier had not even been in the conversation. He has been overlooked for each of the squads this season.

Yet at 25 Dier has youth on his side and it is probably worth remembering that in October 2018 – just before he was taken ill – he was starring in England’s 3-2 win over Spain in Seville. The talent has not gone away, merely the health and playing rhythm that support it.