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It's all about the shoulders

What's happening with the shoulders of Real's players?

Denis Doyle/Getty Images

James Rodriguez became the third Real Madrid first team player to suffer with a shoulder injury; having had to come to the side of the pitch for attention during the Roma game.  Apparently, James had dislocated his shoulder and Dr Ximo Mas relocated this on the spot.  The little Colombian went straight back on to the field and played as if nothing had happened according to the report in Marca on Thursday.

It's all about shoulders at the moment and the word dislocation is being used a lot right now at Real Madrid.  If James really did dislocate his shoulder on the night it's certainly less painful to relocate it as soon as possible.  It's a bit like stitching a head wound; the sooner it's done the better.  However, we're talking about three players now having had shoulder dislocations and the fact that all three are outfield players shows how easily these injuries can happen after what often looks like a simple fall.  Viewed individually, the only real similarity between the three is the fact that although the recovery periods will all vary, the likelihood of recurrence will be high.

James appeared to have sustained a dislocation although we still haven't had a formal medical report from Madrid as yet.  It may be that James suffered what's known as a subluxation; which is when the joint literally "pops out" but is easily re-located.  Players in other contact sports such as rugby league, union, and American football frequently sublux their shoulders due to the constant mechanisms of hitting the ground after being tackled or when making a tackle.  Many players in these other codes of football have a long history of shoulder injury and to them, these injuries are commonplace.  Some players even become adept at relocating their own shoulders although due to the risk of sustaining nerve damage this method of treatment is not formally advised!

Repeated shoulder subluxations or dislocations can lead to longer term damage to the ligaments and also to a structure known as the glenoid labrum.  This is a strong band of fibrous tissue which helps to reinforce the shoulder and acts as a strong restraining structure, which blends with the shoulder ligaments to provide additional stability.  Repeated shoulder subluxations or dislocations can lead to longer term damage to the labrum as well as to the shoulder ligaments.  When the joint "pops out" as in subluxations, the ligaments supporting the shoulder joint become stretched or torn.  Continual stretching or tearing of the shoulder ligaments leads to a loss of their elasticity and consequently they become less able to hold the shoulder in place.  The labrum can also be torn in the event of a single or first-time dislocation of the shoulder.  This is a common complication of shoulder dislocations since associated injuries to the glenoid labrum frequently require surgical intervention.

James looked in pain after his shoulder injury in Rome.  In many ways it just wasn't his night.  Taking a blow to the ear is never pleasant but the shoulder dislocation would have hurt a lot more.  Although he seemed to recover quickly enough he would have been in a lot of pain afterwards and even more so the next day.  Players often refer to adrenaline carrying them through in situations like these and judging by the way he took the hits on the night James certainly released plenty of that.  Everybody will be saying what a brave guy he is to carry on in spite of the injury but it remains to be seen how he responds between now and Sunday's visit to Malaga.

Zinedine Zidane said he would only pick Marcelo for the starting line-up in Rome if the Brazilian was 100% fit and in the lead up to the game there was nothing to suggest that he was ever going to leave Marcelo out.   Pictures of the squad training in Rome on the day before the match showed Marcelo laughing and joking; and in one image he's pointing his arms at the camera in true Usain Bolt style so he certainly appeared relaxed enough beforehand.  It looks as though Marcelo's injury wasn't as bad as everyone feared on the night in Granada; but in the early stages you can never really tell and it's always better to be safe than sorry.

Marcelo's injury was similar to Sergio Ramos' in the sense that the injury was to the acromio-clavicular joint (ACJ) as opposed to being a dislocation of the shoulder proper.  Time has passed in Sergio's case and it's looking as though he's managed to avoid surgery; with "conservative treatment" as they say being sufficient for now.

Although the level of severity would have been much less for Marcelo in order for him to have been given such a realistic chance of playing so soon after the injury was sustained, there's always the chance that the true extent of the damage could have been underestimated.  Players will often be quite liberal with the truth when owning up to how serious their injuries actually are; and in reality, Marcelo will have been desperate to play in Rome.  Let's hope he hasn't done any lasting damage to the shoulder that could potentially come back and bite him in the weeks to come.

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