Are Real Madrid’s injury problems caused by repetitive actions?

Although having a fully fit squad would do Zinedine Zidane the world of good at the moment, it’s a no-brainer to say that the real issue lies in keeping them injury-free once they all return.

Putting aside the Valencia match for the time being, Zinedine Zidane took a barrage of criticism after Real Madrid lost to Leganés in the Copa del Rey, and will likely do so again if it’s a negative result at Levante.

The obvious conclusion for most people to come up with is that the Leganés result would never have happened if he had everyone available.

But while that might be stating the obvious on paper, in reality it’s not that simple. Having a fully fit squad doesn’t always translate into results but it helps if everyone is available for selection.

It won’t be too long before the current crop of players under treatment for various injuries recover, but the problem then lies in keeping them on the field.

There doesn’t appear to be anything too out of the ordinary in terms of the injuries sustained at the moment by Real Madrid’s players. It’s just the frequency of these that is the problem.

Most people accept that this is always going to be an issue for Real Madrid though. The fixture calendar usually means playing two games a week, so the injury-risk is heightened despite Zidane’s rotational policy being used almost the full.

Injury prevention is something that is continually being looked at; but it’s not as easy as it looks.

It’s been notable in the last couple of seasons how the medical people have tried to analyse and implement various strategies including the introduction of lifestyle adaptations for those players who seem to suffer with recurrent or repetitive injuries.

Gareth Bale in particular has probably sustained more injuries in this category than anyone else at the club and has made several positive lifestyle changes in recent times.

When he first signed for Real Madrid, Gareth was renowned for his love of low, fast cars and for playing golf; neither of which might have raised an eyebrow when he played for Tottenham but he quickly found that in Madrid his lifestyle came under far more scrutiny than it ever did in either London or Cardiff.

Suffering in the early days in Spain with hip problems and then the protracted soleus muscle injuries that caused him to miss so many matches led Gareth to introduce several lifestyle adaptations to help him minimise the risk of picking up further injuries.

He stopped driving the low-seated fast cars when it was suggested that as a footballer he wasn’t used to sitting in driving positions which although fine for those who are in the habit of doing so, might not have been suitable for Gareth.

Although no concrete evidence was ever produced, the thinking at the time was this might have affected his back and consequently may have been a contributing factor to his hip and thigh injuries.

To exclude the possibility that driving while in seat positions not normally associated with everyday commuting could well have potentially aggravated any pre-existing injuries or conditions, Gareth reluctantly put this interest to one side.

His golfing activities were also curtailed; and he now plays far less than he did when he first came to Spain.

Still, with having had so many injuries since joining Real Madrid, Zidane prefers to take no chances and affords Gareth whatever protection he can - often setting himself up for criticism over his own team selection in the process!

It’s a fact that external factors are known to contribute to internal muscle and joint injuries.

Intrinsic muscle injuries, to give them their proper term are often the by-product of extrinsic – or external – factors. This is perhaps one area of injury treatment and management which appears blatantly obvious but equally can be one of the most difficult to address.

When James Rodriguez played for Real Madrid before moving to Bayern Munich, he too suffered with injury problems - attributed at one stage by the former Colombian team doctor Hector Fábio Cruz to James’ choice of boots.

Dr Cruz’s concern was that the particular type of footwear favoured by James at that time was unsuitable for his body type; even though the boots in question were perfectly good in terms of durability and are worn by many professionals the world over.

It’s a theory that’s perfectly plausible. Your boots need to suit your body and blend in with the contours of your feet. If your feet aren’t in the right position while running then it’s only natural that other areas of the body will be taking excess strains where they shouldn’t.

So instead of the knees for example spreading the load evenly through the joints then perhaps one side or the other is taking a greater impact through the joint it than it should be.

Some people are said to be naturally flat-footed with slender calf muscles while others have high arches with larger and well-developed muscles in the calf and lower leg.

Both types are equally prone to injury through the biomechanical differences present, but for different reasons as each will have a foot strike specific to their own body type.

This can often result in biomechanical overload; and in turn often leads to repetitive injuries for which unless the underlying reasons are addressed are only likely to result in more of the same.

So with Real Madrid’s medical staff currently rehabilitating Jesús Vallejo and Dani Ceballos, and with Sergio Ramos also having been side-lined recently due to a soleus muscle injury, it’s certainly food for thought.

Not so much with Dani, which looks like a straightforward ankle ligamentous sprain; but more with Sergio and Jesús since they’ve both suffered with injuries of a repetitive nature in the past.

This could also apply to others in the current Real Madrid squad including Raphaël Varane and Karim Benzema who have both been troubled with hamstring muscle injuries.

If biomechanics have a big part to play in the management of repeated and recurrent injuries, then although that’s something that sounds simple in theory its actually very difficult in practice.

Sometimes there’s just no easy answer; but it’s one more avenue which the Real Madrid medical team will be fully aware of as they seek to reduce the effect of injuries on Zinedine Zidane’s current squad.