Heung-Min Son speared by “The Spanish Archer”

Wednesday, February 19 2020

 

Heung-Min Son speared by “The Spanish Archer”

 

On form, on Son…..

Six in his last 5, the Champions League quarter-finals just around the corner, Kane hamstrung and no centre-forward signing during the January window, then all of a sudden, Spurs UNDROPPABLE man has been speared by the deadly “Spanish Archer” and given the “El-bow”.


The Perfect Storm:

  • 32 games already this season
  • Previous Elbow Injury
  • Contact with an opponent
  • Fall on an outstretched hand

Surely this is a schoolboy error by Mourinho???

They said he had it all: speed, power, technical attributes and an unerring ability to be in the right place at the right time. And they were right: he is an exceptional player, some would say one of the best in the world. But he’s not Superman. With Kane injured, Jose Mourinho placed all his eggs in one South Korean basket, and under his tutelage, he started every game when not suspended. So there you go, high game load, previous injury and the correct mechanism to inflict a proximal radial fracture. I’m surprised your surprised he got injured!!! Why not plan for the worst and hope for the best? Why did Mourinho not sign a proven goalscorer in the January window? Is this amateurish? I’ll cover this in The Late Fitness Test Podcast with my cohosts Ben and Stel.


How bad is this injury?

Radial fractures are the most common fracture at the elbow. This type of injury was first reported over 80 years ago in the New England Journal of Medicine; it is still a topic for debate on how to best manage this injury. The radius is an extremely important bone of the forearm. If injured it pretty much renders the rest of the arm useless. It provides vital stability and movement at the elbow and governs function at the wrist and hand. Suffice to say, an injury to it can be quite debilitating. An important note to also bear in mind is that radial fractures are often associated with other injuries including ligament and cartilage damage as well as damage to the other bones around the elbow joint. More trauma may lead to a delay in return to play is what I am getting at.


The Surgeon

Mr Alun Yewlett, a recognised expert in the field of shoulder and elbow surgery, reports that an operation is usually required if the bone has been displaced. In an interesting conversation around this type of injury and the need to go under the knife, Alun believes that the key to a successful surgery is to “restore stability at the joint”. Alun also forecasts that “when surgery is involved” and depending on which repair option was chosen, these cases are more likely to need “between 10-12 weeks before returning to play”.

https://www.108harleystreet.co.uk/consultant-list/the-london-sports-orthopaedic-clinic/alun-yewlett/


Where is the proximal radius?

The proximal (closest to the head) part of the radius can be found at the elbow. The radial bone runs the length of the forearm down to the wrist on the side of the thumb and forms two joints at the elbow and one further down at the wrist. The other bone of the forearm is the ulna.


When will he return to play?

Six weeks might be a best-case scenario while some people can take up to three months to recover from such an injury. Obviously, a lot depends on how severe the initial trauma was. The more trauma, the more likely it will take longer to recover.

According to injury analyst Ben Dinnery, Heung-min Son suffered a similar injury (same arm) in the summer of 2017. He returned to play nine weeks later (61 days exactly). Further interrogation of the data by Ben reveals that he is the only attacker to have suffered this injury in the Premier League in the last ten years. Over 63% of players to incur this type of injury or similar were goalkeepers and defenders. And of note his teammate Hugo Lloris recently spent 109 days on the sidelines due to an elbow dislocation.


Premier Injuries

If like me, you love your injury stats, then check this out for size:

  • Arm/Elbow account for Five of the Top Six time-loss injuries for the Upper Body
  • On average Goalkeepers spend 75% longer (vs Outfield) on the sidelines after suffering an Upper Body injury.
  • Overall Upper Body injuries count for 12% of those reported by Premier Injuries.


Rehab Like A Pro:

The key to quick and safe recovery is to get the arm moving as soon as possible to limit stiffness, reduce stiffness and minimise muscle loss. The rehab around the elbow itself will focus on:

  • Minimise infection risk
  • Protect the surgical site from re-injury
  • Optimise Bone remodelling
  • Pain reduction
  • Range of Motion - https://youtu.be/CYQmLzEp9ik
  • Grip strength
  • Functional strength

If the fracture site is deemed stable, and surgery is relatively unremarkable, the likelihood is that Son’s elbow will not be placed in a cast, and instead, be placed in a removable splint which will enable early gentle movement to begin as soon as possible. When he returns to train and play, the medical team will need to come up with an innovative solution to not only protect the elbow from future injury but to also ensure that it will not endanger the safety of the other players.

Over the coming few weeks, I will detail the type of rehab that he will undertake in our Rehab Pro Series and you can check out all the exercises he is likely going to do on our YouTube Page: https://www.youtube.com/channel/UCB1DrMOViNEvMATXnUDfBpw


Hope you enjoyed the piece guys. Love to hear your feedback.

Best wishes

 

Johnny Wilson

Clinical Director

108 Harley Street

www.108sem.co.uk


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View from the Boot Room | Week Twenty-five

Friday, January 31 2020

 

It’s a stressful time of year…

Big money changing hands. Fraudulent claims made. Unnecessary risks taken. And the underlying feeling that it could all go horribly wrong…

I’m not talking about Transfer Deadline day. It’s self-assessment income tax declaration time for us freelancers. But the frenzied levels of administrative activity are similar. With many hurriedly drawn up forms, sketchily calculated columns of numbers and 11th hour faxes exchanged.

(Note: For any millennials reading, a fax is like an old fashioned and slightly faded/ smudged email)

Followed by silent prayers that it all works out for the best. Makes this FPL lark seem like a breeze.

I’ll take a look at the Deadline Day movers and shakers next week. But for now, we’re turning the spotlight on the best performing Bonus Points players this season.

The standout heroes that rake in additional points for being their teams’ top man…

 

Player

Club

Price (m)

Selection %

Foster

WAT

£4.9

5%

D

E

F

 

Alexander-Arnold

LIV

£7.6

42.6%

Digne

EVE

£5.8

13.1%

Robertson

LIV

£7.0

20.8%

M

I

D

 

De Bruyne

MCI

£10.7

52.7%

Salah

LIV

£12.6

36.8%

Grealish

AVL

£6.7

21.1%

Willian

CHE

£7.2

5.7%

A

T

T

 

Ings

SOU

£7.0

28.8%

Vardy

LEI

£9.9

41.7%

Aubameyang

ARS

£10.7

15%

S

U

B

 

Pope

BUR

£4.6

13.7%

Maddison

LEI

£7.6

23.9%

Fleck

SHU

£5.0

5.6%

Jimenez

WOL

£7.6

22.3%

Pukki

NOR

£6.5

13.6%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G-men

The latest obsession with playing one-twos with the keeper in your own six-yard box has led to the demise of the clean sheet. Making the area of FPL goalkeepers a bargain bucket.

Foster and Pope are two fine sub-£5m examples. Only Sheffield United’s Henderson has performed better this season (by just a couple of points). But if it’s BPs you want, they’re your men.

D-men

Nothing to say about AA. Most of you are already members. And a fair chunk have invested on his opposite flank too. But if you keep going in that direction – right across Stanley Park, dodging the scallies on the way. You arrive at Everton’s Digne, who is only just outside the Top Ten Defenders this season and worth a £5.8m look.

Middle-men

No point preaching about De Bruyne and Salah either. Around 90% of you are already converted. But there are some (slightly) less likely midfield Bonus Point heroes worthy of note.

Villa’s Grealish scores high on price appeal (a mere £6.7m) and FPL pts. Rubbing shoulders with the much more exotically valued Maddison, Richarlison and Mahrez. And only one big game away from reeling in Raheem. Bostin’.

Willian is another low-balling BP merchant. But perhaps pricey at £7.2m.

The men

For that, you could get Ings and change. Danny is tearing up at St Mary's – with 10 in his last 13. Doing a lot of the heavy lifting that has dragged Southampton out of the mire that look stuck in. He is an essential 3rd, perhaps even 2nd choice Attacker.

Vardy and Aubameyang are more expensive options. Rat Boy has gone off the boil a bit, and Pierre-Emerick has a certain Arsenalness about him that makes me wonder sometimes. But Bonus Points are Bonus Points and he makes the Top Ten. So, who am I to quibble?

Answers by midnight tonight by fax, please.


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Rashford: This is just the tip of the Iceberg

Monday, January 20 2020

 

A new Era for the Type of Injuries Seen in the Premier League

Not so long ago the expectation on professional footballers was to be able to “play week in week out” now it's every three days. The rising intensity of the physical demands of the sport and the frequency of games are toxic ingredients when combined. The outcome of this venom could signal the onset of a new era for the type of injury seen in the Premier League. A Pars stress fracture (spondylolysis) is an injury to the vertebrae in the spine. It is thought to be an overuse injury in which the lumbar spine is exposed to repetitive stresses which over time exceed its physiological limits and cause the bones of the spine to fracture, and, in extreme cases can cause a segment of the spine to slip from its position and significantly increase the chance of suffering from degenerative back conditions, disc herniations, and nerve impingement.


A Strange Occurrence

This type of injury is traditionally seen in youth athletes in and around their pubertal years when they undergo rapid increases in height when their bones have not fully developed to tolerate the demands of playing so much football at such a volatile age for growth and development. However, Rashford is far from pubertal. At 22 years of age, he is a young man, commanding a first-team position at Manchester United. He has started every game this season and is undeniably integral to United’s success. So how could this happen to him?


Practice makes perfect, but it can also fracture

I won’t bore you with the details of how a Pars Stress Fractures occur in general; you can google it. But I will speculate on how it might have reared its venomous head for Marcus Rashford. It is well documented in the media and by Rashford himself that he has had a longstanding history of low back pain, dating right back to his early teen years. Rashford is an explosive athlete, who week after week, month after month and year upon year, since the age of 13, has been making the same repetitive runs into the box to hone his craft of scoring goals for one of the greatest teams on the planet: Manchester United. Practice makes perfect they say, but it can also lead to a stress fracture of the lumbar spine. The repetitive action of turning, sprinting, kicking, jumping and landing hundreds of thousands of times during training and playing can cause a stress reaction in one of the vertebrae of the spine, usually the lowest lumbar segment, commonly known as L5.


The stealth-like qualities of a Pars Stress Fracture

This stress reaction has James Bond-like qualities; it can develop for months on end without being detected. It is stealth in its infancy. As Rashford continued to pursue his dream of playing for United and rise from prospect to hero, so too did his stress reaction; it fractured. And just like Rashford learned how to make clever raiding runs into the opponent's box to fracture their defence by attacking areas where they were most vulnerable, so too did the stress reaction: it learned where best it could become a fracture. It learned to strike the part of the spinal segment where it is most vulnerable: the pars interarticularis (pars for short), a known weak spot.


Where now for Rashford?

Now that the spy-like stress fracture has been detected and diagnosed, the return to play stopwatch has already begun. Twelve weeks is a general rule of thumb to allow pain to subside, the bone to heal, physical activity to be resumed and progressed to a standard where he can start banging them in for club and country again. The rehab journey is by no means a simple walk in the park, setbacks can be potentially pretty serious and, in some instances, may require surgery. Along his rehab travels, Rashford is likely to undertake work on the Wattbike, engage in hydrotherapy and aim to restore function on an anti-gravity treadmill to ensure he returns to play as quickly and as safely as possible. Core strength, endurance and control play a significant role in the recovery process, and his rehab progress will be based on his ability to carry out tasks in a pain-free manner. If he reports pain on a particular task, let's say jogging for example, then the rehab journey will not progress to running until he is able to jog pain-free.


Who’s to blame?

I’ve read all the speculation in relation to the performance of the Manchester United Sports Medicine Team on social media; however, he is in fact in the very best of hands. From the outside looking in, it is very easy to criticise and let’s face it everyone has a PHD in “hindsight”. Not knowing all the facts pertaining to this specific case, I do not doubt that the medical team at United always acted in the best interests of the player. Injuries happen and if one were to lay blame anywhere, then the rising nature of fixture overload would be a reasonable place to start.


I hope you enjoyed this short piece. I will write a more in-depth review on the rehab process for this type of injury over the coming few weeks.

 

Johnny Wilson


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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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