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What's happening with Bale's injuries?

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Zinedine Zidane has confirmed what we already suspected, and that is that Gareth Bale aggravated a previous soleus muscle injury against Bayern.  

Real Madrid CF v Deportivo Alaves - La Liga Photo by Gonzalo Arroyo Moreno/Getty Images

Having been withdrawn with a muscular injury purely as a precaution on the night, it remains to be seen how long Gareth will be absent for.

Zidane himself has only referred to Gareth ‘tweaking a muscle’ and that he was taken off against Bayern as a precaution. Although all the reports appear to indicate that Gareth will miss the second leg against Bayern together with the ‘Clásico’; it makes sense to wait and see what the official club statement is regarding the full extent of Gareth’s injury.

Although he’s travelling to Asturias for the Sporting match, Gareth is unlikely to play. Soleus injuries are notoriously difficult to treat and the likelihood as that the medical people will want to make sure that Gareth’s recovery is as near to 100% as possible before he attempts to train with the team again.

That last paragraph might seem like stating the obvious but professional players are rarely (if ever) 100% fit. In most cases, as soon as they are able to run they’re trying to be allowed back into training and often if they suffer from recurrent injuries that they become cautious about returning.

If you try to come back to play too soon then you are simply increasing your chances of sustaining a similar injury in the future (Orchard et al, 2005).

Although the research on recurrent injuries applies to all injuries, this is particularly true in the case of muscle damage. Healing needs to be complete in order for the injured tissue to be strong enough to withstand the demands placed on the body.

Football places a high demand on the muscle tissues due to the requirements of the game, therefore in the later stage of injury treatment the emphasis changes to active exercise with a focus on strengthening and stretching.

Gareth’s injury will be in the acute stage at the moment. Even if the injury is of a very low level, any attempt to stress this by running or trying to sprint will only result in aggravating it further. It’s better therefore to leave things as they are and look towards minimising the damage bearing in mind the fixtures that lie ahead.

Having suffered with soleus injuries in the past, Raphaël Varane will be thinking along the same lines. Side-lined with a hamstring injury at the moment, Raphaël’s current lesion is a recurrence of a previous injury and his return to the team against Alavés a fortnight ago lasted only ten minutes before the symptoms became evident again. As a precaution, Raphaël was taken off immediately before he made things worse but the initial damage had already been done.

Since having knee surgery in 2013 Raphaël has often emphasised that he’s played in pain. It’s a fact that the hamstrings take a lot of the strain that is placed through the knee as a joint and that can lead to overload in the muscles; particularly with the amount of forces that go through the joints in an average La Liga game.

The knee is vulnerable to twisting and turning and the hamstrings are affected by sprinting and changing pace. That combination will almost certainly lead to an increased risk of repeat or recurrent injury based on the stresses individually.

One of the main reasons for the hamstring muscle’s prevalence to injury is it’s role in acceleration and deceleration. Footballers rely on being able to change pace and the hamstring muscles provide the ability to do this. It’s not only changing pace to go past an opponent or to sprint after a long ball that is required either; slowing down after a sprint is equally important.

Research by Greig (2009) showed that the hamstring muscles are particularly vulnerable in the deceleration stage and that the ability to ‘slow down quickly’ has to be factored into the rehabilitation process to avoid the risk of repeat or recurrent injury.

Recurrent hamstring injuries are a problem in football, as we all know. Previous research has indicated that muscle weakness is a potential risk factor for recurrent injury (Aranson et al, 2004) but both Raphaël Varane and Gareth Bale will have had that factored into their respective rehabilitation programmes.

Based on the current situation, it seems highly unlikely that Gareth Bale will play although he is travelling to Asturias as mentioned earlier. It makes more sense for Zidane to leave Gareth to concentrate on regaining fitness for the games to come instead of taking any chances at a time when alternatives are available.

Based on current events, though, these alternatives might not be available in a week’s time!

References:

Aranson A, Sigurdssom S, Gudmundsson A, Holme I, Engebretsen L, Bahr R (2004). Risk factors for injury in football. American Journal of Sports Medicine. S – 16S

Greig M (2009). Soccer-specific fatigue and eccentric hamstring muscle strength. Journal of Athletic Training. Vol. 44 (2); 180 – 184.

Orchard J, Best TM, Verrall GM (2005). Return to play following muscle strains. Clinical Journal of Sports Medicine Vol. 15, 436 – 44.