How serious is Marcelo's injury?

When the new coach takes over, Rafa Benitez by all accounts, he's likely going to want an injury parade on his first morning. There have been a few players in and out of Valdebebas who are not yet fully fit including Karim Benzema, Sergio Ramos and Luka Modric.  Now Marcelo has been added to the summer list with lower back pain; this was recently announced by the Brazilian Football Confederation and clarified by Real Madrid as lower back pain presenting as acute sciatica.

Of all the injuries that can be sustained by the players, sciatic pain can strike anybody; as I am sure most readers will know!  It's possibly one of the most painful and annoying injuries or conditions that anyone can suffer and often the cause is unknown.  The pain is usually felt as a constant, nagging, burning pain going down the back of the leg from the lower back, through the buttock and as far down as the foot and ankle.  Although most injuries in this category often tend to stop at the level of the knee, true sciatica extends right into the foot and ankle.  The pain can be debilitating.

Causes are variable and can result from poor lifting techniques, maybe straining to lift a weight in the gym perhaps, or by sustained postures like sitting on a long flight for example, or through repetitive mechanisms or impact-related activities like playing squash, distance running on hard surfaces like roads or treadmills as opposed to soft grass, or over-training.  Sometimes, though, sciatic pain just comes on without any single specific incident or triggering factor and often these can be the most difficult presentations to get rid of.

The sciatic nerve originates in the lower back and the pain usually results from pressure on the nerve in the back itself, often caused by a lumbar disc bulge, and frequently sustained through any of the means described above.  The pain then follows the course of the nerve as it passes through the buttock area and radiates down the leg; often giving the ‘burning' sensation earlier described.  It's a horrible pain for us ordinary people and just as bad for footballers like Marcelo.

In extreme cases, sciatic pain as a result of a lumbar disc bulge can be just as career-threatening as any other injury that may be likely to result in limited appearances and a lengthy absence from the team.  Training is impossible with sciatic nerve irritation since anything that involves any degree of impact will hurt, running is usually out of the question as a result.  Any exercise involving the ‘sit-up' action is extremely painful, not recommended and will only make things worse.

Treatment normally consists of mobilising the area of the spine where the injury originates from in order to release the tension in the leg.  Specific exercises are vital and it's important to do everything at the correct stages otherwise the injury will only become more painful.  It would be no good Marcelo going for a light run for example until the medical staff clear him to do so even if he feels well enough to do so.  Running is probably the worst thing Marcelo could do at the moment since the impact involved would only make things worse.  Once the injury begins to settle, and treatment helps to reduce the pressure on the nerve and the pain eases as a result, he won't be long in getting into the action once again.

The close season - such that it is nowadays - can either provide a welcome respite from training or it can become a chore if you are carrying an injury into the break.  Players hate being injured at any time but even more so after the season proper has ended since in most cases they will be required to attend for treatment until their injuries have resolved.  Of course they'll be given some time off to holiday with their families etc., but this will be at the discretion of the club if they're having treatment in Madrid or will be negotiable with whoever is treating them if outside of the club; such as in France or Vitoria or wherever.  Either way; the club will have the final say.

Together with Marcelo, Karim Benzema continues to recuperate from his thigh strain sustained after returning from a knee injury.  Sergio Ramos picked up a deep calf muscle strain in the defeat by Juventus and based on recovery times for this injury will be progressing by now; while Luka Modric will be hoping that the close season provides even more of an opportunity than he expected to prepare for next season in fully-fit mode.  In addition to wanting to get back into full training asap and be available for the official return on the first morning the squad assembles under the new head coach, there are also the pre-season fixtures to consider.

Every player will want to be fit and available to fully take part in the preparations for the new season and to impress the incoming head coach; and his accompanying staff as indicated in previous articles.  Part of this is being able to demonstrate that they're going to be fit and able to take part in all of the opening sessions and be available for the pre-season fixtures.  This applies with most management changes.  The new coach may or may not have pre-conceived ideas about whether the players currently injured are capable of returning to full fitness in time for the new season or not; or whether they are likely to be troubled with niggling injuries if they miss the pre-season period.

A lot of managers / coaches place a huge importance on the pre-season period, their thinking being that if players struggle for fitness during the first few weeks back in training then they are likely to struggle on and off with injury / fitness problems once the season proper gets underway.  At the risk of stating the obvious, whether Marcelo et al will be ready and fully fit for August or not will largely depend on how their injuries respond to input from the medical teams; but it's going to one of the first things on the new man's agenda on his opening morning.  The injured players will know this and that's never going to be far from their thoughts over the next 24 - 48 hrs.