Jude Bellingham wouldn’t get up. But surely, he had to. Jude Bellingham always gets up. Still, he didn’t. Bellingham lay slumped on the Bernabeu turf. The speculation started immediately. ACL? Broken ankle? Concussion? Muscle tear of some description? What could possibly keep the man down?

The answer was none of the above. Bellingham had, in fact, dislocated his left shoulder. A bit of strapping around the injury, and he was able to play on. He laboured through the rest of the fixture, visibly uneasy and seldom involved — by his standards, at least — as Los Blancos settled for a 0-0 draw with mid-table Rayo Vallecano.

That was six weeks ago, and Bellingham has played consistently since. But it emerged a fortnight ago that La Liga’s top scorer might need surgery, an operation that could see his season grind to a halt, hinder Real Madrid’s title chances, and potentially rule him out for Euro 2024. England’s fate rests on Bellingham’s shoulders, and one of them might not quite work properly.

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  How the injury happened

  Bellingham’s fall looked rather innocuous. But he landed awkwardly on his left shoulder, and the joint momentarily popped out. He needed extensive treatment, heavy strapping and a few minutes of recovery, but was soon ushered back onto the pitch.

  The midfielder was slightly subdued for the remainder of the contest. Although he clipped the bar at the end of the first half, he cut a frustrated figure as he lunged all over the pitch. By the end of the contest, he was picking verbal fights with seemingly every Rayo opponent possible.

  After the match, Ancelotti admitted that his star man might need an assessment. But a few days later, ahead of Madrid’s clash with Braga, the manager insisted that he would be ready to play

  “He hasn’t done all of the training, to avoid blows, but he’s felt good in his movements,” Ancelotti told reporters. “He’ll probably play tomorrow but I’ll evaluate it with him tomorrow.”

  Late evaluations ruled Bellingham out, and he was worryingly absent against Valencia the week after. And then, it all got complicated. Bellingham, despite being unable to play for Madrid, was summoned to the England squad. He was pictured arriving at his national team’s training ground, much to the indignation of Ancelotti.

  “If he didn’t play today, he can’t play with England. He has to do specific work to strengthen his shoulder and he will do that in the coming weeks. After the international break I think he will be able to play again,” the Madrid manager said.

  And he was right. Bellingham left the Three Lions’ setup, returned to the pitch — albeit with heavy strapping — and found form immediately. Watch him now, and everything seems normal.

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  The argument for surgery

  But that doesn’t mean all is well. Dislocated shoulders are complex injuries. Isolated incidents are usually treated with heavy strapping and physical therapy — the kind of “specific work” Ancelotti mentioned in describing Bellingham’s return. Still, these things never quite heal properly on their own. One dislocation is likely to lead to another — isolated incidents can add up.

  Ancelotti knows this. Speaking to The Athletic, multiple Madrid sources have admitted that surgery has been considered to fix the injury in earnest.

  It’s something that has already happened in the footballing world this season. Liverpool’s Andy Robertson — an admittedly less crucial player — suffered a more severe dislocation on Scotland duty in October. He went under the knife almost immediately and will be on the sidelines until early February.

  Bellingham isn’t quite in that territory. He has only dislocated his shoulder once, and was able to play through the injury. By all indications, he is responding well to treatment. There is no glaring need for a major operation here — not yet, at least. However, surgery would radically decrease the likelihood of re-injury. He won’t be risk free – no footballer ever really is – but with a successful surgery, this problem would be put to bed for the time being.

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  The argument against it

  Right now, though, the midfielder can’t undergo such a procedure. It would require a three-month recovery period. Even if he is quick to return to the pitch — and immensely lucky for his body to heal so well — Bellingham would be sidelined for two months. An operation now would see him miss the first round of Champions League knockouts. An operation later would see him miss the crucial final few months of the season. An operation in May would see him miss Euro 2024 — a loss that could see England’s best chance to win a trophy in years go up in smoke.

  His team-mate Brahim Diaz has already made a decision. He injured his shoulder in late September, and has reportedly opted to delay his procedure until the end of the season. With little chance of representing Spain at next summer’s Euros, the midfielder can afford to have his operation over the summer — and return in time for the start of the 2023-24 season.

  Bellingham doesn’t have that luxury. He cannot sacrifice time with his club and still serve his country. Similarly, he cannot simply wait until the end of the Euros without missing the start of the season with his club. There aren’t eight free weeks in the footballing calendar — especially for a player so vital to his team.

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  The worst-case scenario

  And what if this goes horribly wrong? What if Bellingham lands awkwardly in Madrid’s matchup with Villarreal on Sunday? What if he gets pulled to the ground by an Alaves midfielder the week after? What if he bumps into Antonio Rudiger in Madrid training? Two dislocations, just months apart, would leave Madrid’s doctors with no choice. They would have to operate on the Englishman or risk potential long-term injury. He would be a dislocation waiting to happen.

  Madrid could perhaps cope without him. There is enough attacking talent here to make things work. Brahim, Vinicius Jr and Rodrygo are not like-for-like replacements, but if Ancelotti manages their minutes, and gets Vinicius back on time from his own ailment, then he could see out the season. Champions League glory, though, might go out of the window, especially if Los Blancos get an unfriendly draw in the knockout stages.

  For England, the consequences could be dire. Bellingham has been the fulcrum of this side for a year now. Southgate hadn’t really given the midfielder a starring role until the 2022 World Cup in Qatar, even though he had arguably been ready to step into the fold for some time. But once he snagged a spot in that team, he never let go.

  All of the good things that happened in that tournament — and the Euro 2024 qualifying wins since — have come from Bellingham’s brilliance in midfield. He makes Phil Foden look like the Andres Iniesta regen that Pep Guardiola once infamously referenced. He makes Harry Kane look even better. Even Jordan Henderson looks passable in central midfield alongside him.

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  Avoiding the bumps

  So, it comes down to hope. But it doesn’t look good. Opposing defenders have repeatedly targeted Bellingham’s shoulder in La Liga. Meanwhile, the midfielder has occasionally pulled out of duels, or adjusted his landing when his upper body might be in danger. There is always the chance that something else gets hurt here — another injury brought about by protecting his current one.

  Still, Bellingham has shown no signs of slowing down. He is still scoring at a frightening rate, averaging a goal contribution per game, despite now being the centre of attention for opposing teams. Even a shoulder-damaged, man-marked Bellingham is finding ways to be a match-winner.

  The risk will always remain. An awkward bump, random fall, or unexpected jolt could see his season thrown into jeopardy. There is a chance he could escape an operation if this happens again. But it’s not to be counted on — especially given Bellingham’s age (20) and potential (immense.) There will be other games, other seasons, and, in all likelihood, other trophies.

  For now, he will continue to go about his business. There will be goals, assists, tackles, and highlight-worthy tricks, flicks, and stepovers. But every time he goes down, Southgate, Ancelotti, England fans and Madridistas will hold their breath. Bellingham might not get up next time.