Zinedine Zidane shrugged off any doubts about Cristiano Ronaldo’s ankle injury in the first half at Barça on Sunday night by indicating that he wasn’t too worried; despite the impending UEFA Champions League final in less than three weeks’ time.
Cristiano injured himself while scoring Real’s first goal. He stretched to meet a ball set-up for him by Karim Benzema and on landing, sustained an inversion injury to his right ankle as he hit the ground.
There was also the suggestion that he had injured himself in the build-up to the goal; which Cristiano actually started by linking up with Toni Kroos, but after looking at replays it’s almost certain that the injury was sustained in the act of scoring itself.
It was the standard injury mechanism for a lateral ankle ligament sprain; but hopefully one that will respond reasonably quickly to treatment.
As with Isco in the first leg of the UCL quarter final against Bayern Munich, the fact that Cristiano was able to continue until half-time would suggest that the actual injury wasn’t thought to be too serious; and that he was withdrawn to avoid worsening the injury rather than for any other reason.
From the minute he stood up after scoring the goal and hobbled back towards the centre circle, CR7 was limping. He had some treatment from the medical staff on the field, but as he got to his feet again the ankle looked to give way as he took his weight on it.
Cristiano then came off and had some further treatment at the side of the pitch. When he re-joined the game a few minutes later, he was still limping but the ankle then seemed to loosen off and at that stage at least, all seemed to be well.
However, as we all know, Cristiano didn’t appear for the second half; being substituted by Marco Asensio. Hopefully, as Lucas pointed out earlier on managingmadrid.com, that was more with the Champions league final in mind than for anything else.
Lateral ankle ligamentous sprains like the injury Cristiano sustained on Sunday are normally sustained in one of two ways; either through direct contact with an opponent in a tackle or through non-contact mechanisms such as twisting or falling.
Some of the worst ankle injuries can actually occur in non-contact situations and often there isn’t an opponent or anyone else in the immediate vicinity.
On Sunday night, Cristiano’s injury was sustained in some ways as a combination of both. Although there was some physical contact made with Gerard Piqué in the act of scoring, it was as CR7 actually landed after touching the ball home that the injury looked to have occurred.
His own body weight and momentum carried the ankle into a forced inversion position, and he twisted awkwardly as a result; likely stretching the ankle ligaments on the outside - or the lateral aspect - of the joint,
The bones in the ankle complex are bound together by strong ligaments; of which the most frequently injured is the anterior talofibular ligament; or ATFL for short. This would be the most likely structure injured as a result of the way Cristiano landed.
The ATFL has been found to have the lowest tensile strength of all the ankle ligaments and is the weakest in comparison to all of the others (Pincivero et al, 1993); so if any ligament was going to be injured as a result of the way Cristiano landed on Sunday night then that was going to be the one.
The ankle joint is similar in many ways to the shoulder in terms of being a relatively flexible joint.
The main difference of course being that the ankle is a fully weight-bearing joint and as such is more vulnerable to injuries sustained as a result of either the running action or the twisting / turning / jumping movements that occur in football.
Due to the way the bones of the ankle interact with the bones of the foot, the combination of movements allowed as a result provides the ankle with its flexibility. However, as with any joint where flexibility is required, the risk for ligamentous injury is high.
The full extent of the damage sustained to Cristiano’s ankle on Sunday night will be assessed by an MRI scan and the appropriate treatment plan implemented without any delay.
Although CR7 can be quite open about the extent of his injuries on some occasions, at other times the reverse applies; such as after the knee injury he sustained in Euro 16 for example.
As a result, any information about the recovery process might be not be as forthcoming this time as we would otherwise expect.
Even with the postponed game against Sevilla due to be played on Wednesday night, Zinedine Zidane’s priorities will still lie in preparing for the Champions League final against Liverpool.
That’s not to say that he won’t be caring about the result at the Sanchez Pizjuán; but it’s going to be imperative that he doesn’t take any chances with players who may be carrying an injury or two, however minor, between now and the 26th May.
His caution might not only affect Cristiano Ronaldo in the weeks to come but could extend to others in the squad as well.
Pincivero et al., (1993). Ankle Injuries. In Football Traumatology, Current Concepts from Prevention to Treatment. Volpi V (2006), Milan, Springer.