clock menu more-arrow no yes mobile

Filed under:

Reasons why Real Madrid should play it safe with their injured players

Gonzalo Arroyo Moreno/Getty Images

Things always appear worse when everything is going against you and the same can be said for injuries.  Despite winning at the weekend against Deportivo and the Champions League result in Germany against Schalke 04, the papers are still talking about the defeat to Atletico.  Ancelotti himself was beginning to show his annoyance with this through certain comments made before the Schalke game, insisting that Madrid have now turned a corner.  Much is still being made of the defeat to Atletico and associated events thereafter; but it seems that on the injury front at least, the outlook is all doom and gloom.  If you believe the press, Madrid's injury problems are going to lose them the League never mind the European challenge.

Sure Madrid have some injury problems; every club does.  Two hamstring injuries, a calf strain, a broken metatarsal and a long-term thigh muscle tear to name but a few.  None of these had any realistic chance of healing in time for the Schalke game although we had all hoped that Luka Modric would have met his target as indicated and been available for the first leg in Germany.  So on the night, Madrid travelled to Gelsenkirchen minus Sergio Ramos, Sami Khedira, Fabio Coentrao, and James Rodriguez in addition to the Croatian international.  The game in Germany provided a good indication of how the current Madrid squad will fare without such regulars on the field.

All football clubs have periods where key personnel are unavailable through injury; and as we have said before, this is just part and parcel of the game.  The drama is neither increased nor decreased according to who the next opponents are, and neither is the recovery time influenced by the impending opposition either.  Rushing players back for ‘a big game' has been proved over and over again to be a false economy and often results in what would have been a straight-forward three or four weeks injury turning into a seven or eight-week injury instead.  If players are rushed back because of who the next opponents are and the injury recurs, then the clock is immediately reset to allow for an even longer period than originally envisaged.  As for the ‘big game' theory, all games involving Real Madrid are big games.

With the two hamstring injuries, it is the very nature of these that gives reasonable cause for concern.  Sergio Ramos wasted no time whatsoever in coming off the pitch immediately after his injury was sustained.  That alone was an indicator that this wasn't going to be a 10-day injury and he didn't come off just as a ‘precaution'.  Hamstring muscle injuries are known for their slow healing properties, and although it could be argued that all muscles will heal at the same rate, the hamstrings functionally are designed to allow changes in pace and to increase or decrease speed; an essential attribute for a footballer to have.  With a mild hamstring injury normal jogging is usually possible, but any attempts to change speed or progress that jog into a half or even a three-quarter pace will be met with pain and stiffness which will eventually lead to protective muscle spasm at best or a recurrence of the original injury at worst.

Current evidence states that the single most identifiable risk factor for repeated or recurrent injury is having sustained an injury previously, and therefore rehabilitation planning needs to allow for this in the delivery of post-injury programmes and return to play fitness testing. I know I've mentioned this point before, but based on the currently available literature, this appears particularly true concerning soft-tissue injuries to the hamstring group.  Available evidence indicates that during running, the hamstring group is biomechanically most susceptible to injury in the deceleration stage and in the early push-off phase before the active leg actually leaves the ground. In other words, a right hamstring muscle will be at it's most susceptible at the moment your body weight rolls forward onto the ball of the foot before pushing off, and then when the leg is controlling the heel back to the ground as you slow down from a sprint.  Additionally, the sharp sudden reactionary movements which footballers are required to perform without having time to prepare for these all add up to an increased injury risk if proper muscle healing hasn't taken place.

More on Schalke vs Real Madrid

Although in theory it should be easy to test for complete recovery by going through all the football movements in training, in reality these often tend to be controlled movements and it's the uncontrolled or unexpected movements that really stress newly-healed injuries in match situations.  It's impossible to plan for a sharp, sudden deceleration for example, such a player running to keep the ball from going out of play; usually to prevent a goal-kick or a throw-in.  Although managing to keep the ball in play - usually by touching the foot on top of the ball - the resultant momentum which carries the player over the touchline can result in a recurrence of injury if the enforced ‘braking' is hard enough.   I've actually seen this happen when a ball-boy once anticipated the ball going out and stepped forward only for the onrushing player to have to pull-up sharply to avoid colliding with the lad and leading to a recurrence of injury.  On that occasion it would have better to have let it run!  The point, though, is that although players may seem right, and may feel right, often the healing process is nowhere near complete enough to safely enable a return to play; and this certainly can't be governed by who the next opposition are.

Sami Khedira is also out with a hamstring injury at the moment and we've mentioned before, these are the most common muscles injured in football so they need to be managed correctly.  The other muscle group frequently injured in football specifically are the quadriceps muscles; injured by Luka Modric and currently the topic of a semi-controversial treatment method, these straighten the knee and provide the kicking action.  There's not a lot more than can be done to enhance Luka Modric's recovery other than to continue working at the strength and flexibility aspects of the resolving tear and to prepare this functionally.  Since in Luka's case the injury is to the ‘kicking muscle', much of the rehab will be focussing on the act of physically kicking the football and again this comes in varying stages building up from kicking a rolling ball, to volleying, and finally to taking full-blooded shots (no pun intended) at goal since the muscle needs to be re-trained to deal with the varying loads of the different kicking actions involved.

Again, preparing for the unexpected is an essential part of returning to play preparation and at some point he's going to have to deal with someone attempting to block his kick while in the process of taking a shot.  It's usually when meeting the ball as in a mid-air volley that thigh muscles tear at the point of impact if an opponent blocks the follow through with a tackle and leads to a disruption of the newly-healed tissue if the healing process is not complete enough or if the new tissue is not strong enough.  When it comes to tissue repair, the body never heals like with like and so the resultant new tissue is always of a slightly inferior quality to that present before an injury is sustained, therefore regaining muscular strength is vital for that reason.  Players who sustain an injury will generally aim for the injured leg to be stronger than the unaffected opposite leg to counteract this.

Looking at the pre-Schalke injury list in more depth and putting Ramos and Modric aside, Sami Khedira has suffered a previous hamstring injury in the past together with a concussion and knee surgery, James Rodriguez has only recently returned from a calf strain, and Fabio Coentrao has also had a knee injury.  The point being is that while players are out injured it's also important to focus on working at any areas previously affected by injury while receiving treatment for the present condition, since it provides the opportunity to maintain recent gains in strength that may be affected by an enforced absence for something else.  Players in general are notorious for easing up on their specific exercises a week or two after returning to play and this is one of the areas where sports medicine has really advanced in recent years.  It used to be returning to play meant an end to rehab; but not anymore.

Although people will say, therefore, that this game or that is a bigger game than the other or that it is important that Sergio Ramos and co return in time for a particular weekend, if their injuries have not healed then they are unlikely to be risked.  If they do play, they then run the further risk of sustaining a quick recurrence leading to an even longer absence.  It's a fine balancing act, and often a difficult call to make for the medical team.   The players themselves will know deep down how they really are; and although they may be desperate to play in a particular game, it's important not to let the heart rule the head in these circumstances.  There is always the next game to think about.

Sign up for the newsletter Sign up for the Managing Madrid Daily Roundup newsletter!

A daily roundup of Real Madrid news from Managing Madrid