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Össur investigates Stoke City’s injury woes (and performance)

We may only be 4 games into the new season but already there are some surprises given the amount of money spent in the summer and the performances we saw last season.

Leicester have started with a stumble and thrashing at the hands of Liverpool, whilst West Ham find themselves with just 3 points despite new stadium and a huge outlay on players. I am not sure many people would have expected Stoke City to be propping up the table and with such an inferior goal difference given they have only scored twice in 4 games yet conceded 10.

The question we have to ask is whether league position is related to player injuries.

Do injuries correlate with league position?

For some of the larger clubs there can be 2 world class players for every position on the pitch, so if one is injured it’s not great but you have someone with world class talents to step straight in and do the job. Arsenal currently have 6 players out of action to Liverpool 5 but the former sit in 6th place and the latter in 5th.

If you’re a smaller club then if you’re key player is out of action then that’s not good news, but if a few of the first team take of residence in the treatment room and they might end up raiding the development squad for extras. Sunderland have 6 players sitting in the treatment room and are level points with Stoke City, but a superior goal difference.

On the other hand there are teams that completely buck the trend. Just look at Hull City who, despite a really chaotic summer in losing a manager and having barely 11 players to field in the first game, currently sit in 7th place with 7 points.

What has happened at Stoke City?

Currently Stoke City have the highest number of any Premier League casualties with 7 players out of action, two of which are long term, one medium term and (luckily for them) 4 players who are due back in action by the end of the month.

A quick glance down the list and those who are injured were pivotal members of the 2015/16 campaign so to lose 1 or 2 is pretty bad but to lose so many key players may be one of the reasons why they currently reside at the bottom of the league with Stephen Ireland, Jack Butland, Mame Biram Diouf and Xherdan Shaqiri (to name but a few) all out of action.

So given the issues faced at Stoke we thought we would take a look at some of the key injuries the team has faced and a little bit about how to manage these conditions effectively in case you are unfortunate enough to injure yourself in the future.

Ibrahim Afellay - Anterior Cruciate Ligament Injury

Potential date of return: 25/02/2017

The ACL is one of four ligaments within the knee and is located at the front. It is responsible for stability and effectively preventing your shin bone from moving forward beyond the knee joint, check out the below video.

If you’re trying to run, jump, turn on the pitch then you need a stable knee and if you have one like on the above video then you won’t make training, let alone the big game.

We are seeing more and more acl injuries in football and this is because the technology is getting more advanced than the body. Blades are designed to offer increased grip so a player can pivot quickly, the downside is that the body isn’t designed for that so where the knee twists at an angle there is an increased likelihood of damaging the acl (just look at Michael Owen).

If you do damage you’re acl then you’re looking at missing an entire season, depending on the severity of the injury. A grade 1 will see you on the sidelines for a couple of weeks, a grade two a few months and if like Afellay, you’re on the sidelines for a while.

For a grade two surgery can be used to repair the tear but most of the time it can be treated conservatively with the latest knee braces which work to maintain the right amount of force on the ligament during movement i.e. keeping the tear stuck together so that it can heal.

For a complete rupture surgery is normally the only way to manage it, by taking a graft from the hamstring or groin but new techniques are always being proposed for this common injury, check out this video. Once you’ve recovered from surgery the main focus is on building strength in the joint once again before a player can return to action. You can also use a knee support post injury to help offer a little more stabilisation.

Not to put a bigger cloud on the injury but if you have suffered an acl injury then you are more likely to suffer from osteoarthritis of the knee at a later stage in life and more likely to need a knee replacement.

Stephen Ireland – Double Leg Fracture

Potential date of return: 04/02/2017

We can all feel for Ireland following his double leg fracture sustained on May 10th, especially when you see he is not expected to be back in action until early February 2017. It is one of the most severe injuries a footballer can encounter and could potentially have been career ending, given it creates an inherent weakness in the bone and may not heal to the same levels as before, therefore increasing the risk of it happening again.

Surgery is the only way to manage the injury initially (along with a lot of gas and air) and as like Jack Butland’s ankle fracture the surgeons will need to pin the bones back in place before a period of immobilisation. The leg is immobilised as movement could undo all the hard work as well as minimising the risk of it happening again and would normally be put in a cast. During the initial stages of recovery a leg may need to come out of and be recast several times as they keep checking on the progress of the bones healing through x-rays.

Once you’ve been in a cast for 8 weeks your range of motion will be compromised (your ability to move your leg) so as this is pretty important that will be the main focus of your physio sessions. Swimming is a great way to rebuild strength in your legs without putting too much stress through the newly healed bone.

Jack Butland – Fractured Ankle

Potential date of return: 05/11/2017

Butland has endured a horrid few months, having initially fractured his ankle in March which stopped him from going to France and more recently having to undergo surgery again to remedy a further issue and ruling him out for a further 6-10 weeks

The lower leg is constructed from two bones in the tibia and fibula and a fracture occurs where there is an uneven break in the bone which apart from being extremely painful, will result in a total loss of stability (especially if it is the fibula).

Following this type of injury surgery is often the only option, as with a clean break you could simply cast the joint and allow it to heal naturally. Surgeons will need to reposition the bone and may even need to pin it in place before it is put in a cast or a walker boot.

Once the initial injury has healed then you’ll need to start working on strengthening the joint and increasing your range of motion, as you’ll have not moved your ankle in a few weeks. Once you can put weight on your ankle and are mobile once again you can start to build yourself up to light training.

Glen Johnson – Quadriceps strain

Potential date of return: 18/09/2016

Quadriceps are the muscles located in your thighs and are the source of the power when running, jumping etc.

Muscle strains are diagnosed by the grading of their severity, the same as with ligament injuries. A grade 1 is a minor tear and whilst it can be painful with some inflammation it will heal naturally and you’ll be back in action after a week or so. A grade 2 is where there is a partial tear in the muscle. Again this is self-limiting (will heal naturally) but will take a few weeks and you may need physio to help strengthen the muscle once healed. A grade 3 is a complete rupture and requires surgery to stitch it back together before a longer period of recovery.

Treatment depends on the severity of the injury but the RICE principles should be followed in rest, ice, compression and elevation. Grade 1 and 2 are largely self-limiting so rest is required to give the body time to recover, with ice and compression being used to manage any inflammation. Compression can be offered in the form of compression shorts which are also worn to reduce muscle vibrations when mobile. Elevation of the affected region is also used to reduce blood flow to the affect area to manage inflammation.

The injury was first reported on 27th July so given the return date is not expected to be until 18th September we can assume it was a grade 2 injury.

Stoke City may have a number of high profile injuries at present but luckily for them 4 players will be back in action within the next couple of weeks so they will be hoping it will enable them to kick start their season and propel them off the bottom.

Injury information available from premierinjuries.com