Pogba: It’s undoubtedly a Duck

Tuesday, October 22 2019

 

An insight into his rehab journey: Manchester → Dubai → Manchester

The Media Myth

There are several reports circulating that Paul Pogba has a “cracked toe”. Let’s put THIS speculative media claim to the test:

  1. If Pogba had a “cracked toe” then he certainly wouldn’t have a cast over his ankle and have nothing to protect his “cracked toe”.
  2. The fact that Pogba has heavy protection over his ankle would indicate that he does have an ankle injury.
  3. The fact that United themselves have stated that it is an ankle injury would lead to the conclusion that it is an ankle injury. Why would they lie? This would cause significant problems in the long run, and there is no advantage gained by disguising an ankle injury as a toe injury.

If it waddles like a duck

If it quacks like a duck

If it looks like a duck

Then its most probably a… *see blog title*


Weight-bearing Status

The current advice for injuries to the ankle is to weight-bear as tolerated (pain) as soon as possible to maintain strength and function of the foot and ankle as much as possible. It is only in very serious cases where the player would be advised to immobilise and rest the ankle completely (fracture-dislocation etc.)

Partial Weight Bearing

Pogba is currently “partial weight-bearing” which basically means that he is putting as much weight as he can tolerate through his ankle. As his pain levels decrease and his function and confidence in the ankle improve, he will quickly progress to full weight-bearing. It stands to reason and is common sense that he needs to be able to take all his body weight through this ankle before he can progress to more dynamic movements such as running, jumping, changing direction and kicking a ball (discussed later).


Off-Feet Conditioning Phase

Looking at Pogba’s Instagram posts, his rehab tasks have been focused around “off-feet conditioning”. This is where the player is carrying out his rehab in either a sitting or lying down or partial weight-bearing position so that he is not bearing the full weight of his body through his ankle. An in all fairness to Pogba he is maximising every opportunity during this phase to improve his aerobic fitness levels (general fitness - bike work), anaerobic fitness levels (ability to carry out multiple sprints during a game(rope work)) and power (medicine ball throwdowns). He is also most definitely working on his overall leg, core and upper body strength and power qualities during this phase too.

Warm weather conditioning

Why not? As long as the works gets nailed, then does it really matter where he does it?

Next stop: On-feet Conditioning

Once everything goes to plan, and he has no setbacks in his rehab journey then he can progress to activities which require him to weight-bear through his ankle, for example, lower limb gym strengthening exercises (squats/lunges/calf raises/jumping/hopping). If he does not react to these activities, then he can quickly progress to grass-based rehab. He will also most likely continue his off-feet conditioning to keep on improving his fitness levels.


Grass-based Rehab

This includes activities like jogging, running, sprinting, ball work etc. As a rule of thumb, two weeks is advised at the very least to cover this type of conditioning. Essentially, the team at United will be trying to gradually expose Pogba to running volumes, intensities, game-related activities and scenarios which he will be faced with when he returns to full squad training. Sometimes this period can take a little longer and occasionally the player will request to return to squad training earlier than advised. It’s a dark art rather than a fine science!!

Time to return to train

This is the period when Pogba will transition from 1 to 1 sessions with the fitness staff to training with the squad. Some managers like the player to be fed in gradually to the squad sessions while other managers prefer to wait until the player can participate fully - so this will come down to Ole’s preference here. Again, as a physio I always like to see players complete 2 weeks of full training before transitioning back to play, however, this is usually not dictated by the medical staff and is rather decided upon by the player and coaching staff following a risk analysis from the sports medicine team about the risks of re-injury when returning a player to competition. It’s important to recognise here that the risk of re-injury never goes away, it’s merely tempered through strategies which might help to reduce the ugly head of re-injury appearing again. It’s a very tough time for all involved, and no matter how long or rigorous the rehab is, there is always something lurking under the bed!! Proceed with caution.


Time to return to play

Given the above timeline, social media pictures, stage of his rehab, his weight-bearing status, it would be reasonable to suggest that Pogba is still several weeks away from playing for United again. However, rather than basing his return to play solely on time as the ultimate criterion, it will more likely be based on his ability to complete high-intensity football-specific tasks.

I hope this snapshot helps. 


Johnny

Fantasy Physio

Ben Dinnery

Ben Dinnery

@BenDinnery

Ben is football’s leading injury specialist. The ‘go-to’ guru for big hitters like Sky Sports, ESPN and NBC Sports when they need data. Or the BBC, talkSPORT and the broadsheets when a quote is required. His unique insight has helped provide a better understanding of what is really happening in the treatment rooms.


Johnny Wilson

Johnny Wilson

@johnny_wilson5

Johnny is a respected physiotherapist and sports scientist, specialising in football injuries and rehab. Johnny has headed up the medical departments at Chesterfield, Scunthorpe and Notts County. Overseeing everything from player-specific training loads to pre-signing medicals. He has a proven record working with elite athletes in Private Practice and is regularly called upon throughout Europe to deliver presentations on the latest rehab innovations.


Matt Nesbitt

Matt Nesbitt On TipTV

@MattNesbitt16

Matt's short, unremarkable football career was ended by his own bad driving. His long, distinguished career as a football tipster was ended by his own good advice. Because bookmakers don’t like a winner. First, they closed his accounts. Then his members’ accounts. Then his tipping service. And now they employ him as a consultant. Funny old game.


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