It would have been great to start 2020 with a clear injury list

Good news this week for Zinedine Zidane with both Marcelo and Lucas Vázquez are partially back in training and hopefully in line for a return to the team in the near future following their respective injuries.

At this stage it would be unrealistic to try to predict anything more accurately than that since there's always the need to assess the response to the session first thing tomorrow morning to check for any reaction.

Provided all is well then both will be able to step up the intensity of their work and help the rehab and fitness staff to be more specific in targeting a date for their return.

Both players have injuries that have the potential to relapse if they try to come back too soon; and although that could be said of most injuries, the unique problems associated with fractures of any kind in the foot and soleus muscle strains in particular demand careful management.

An essential aspect of this will be recognition by the players themselves that any apparently minor symptoms shouldn't just be shrugged off. Marcelo, of course, picked up a left soleus muscle injury in early December while Lucas had a broken toe in his left foot.

Fans of Real Madrid will be quite familiar with soleus muscle injuries by now. This injury has plagued Gareth Bale in the past and Sergio Ramos has also suffered of late with this part of the calf muscle group.

The soleus muscle is an important muscle for ankle strength and also acts as a postural muscle. It therefore has an influence on lower limb biomechanics and gait; but injuries to the soleus can be difficult to diagnose accurately due to it’s location.

Often a full MRI scan is required to provide the most accurate images of the damaged tissue (Balius et al, 2014) but since MRI is performed with the muscle at rest this can be a disadvantage if the symptoms of injury are relatively minor.

Ultrasound scanning can be adapted to provide a moving image of an injured muscle which can be viewed in real time, but with the soleus muscle not all areas can be seen with enough clarity to provide a true diagnosis.

Additionally, the early symptoms of soleus injury often mimic cramp or general muscle tightness which is easy to dismiss in the absence of the player feeling a sharp pull or tear.

Dixon (2009) stated that that the true extent of the tissue damage cannot always be visualised when scanning a soleus injury and as result injuries to the soleus muscle can often be underestimated.

In the case of Lucas Vázquez’s toe fracture, although he likely feels well enough in himself the toe is likely to be highly sensitive round the fracture site, but this should reduce proportionally with the amount of training he is able to do.

Provided he’s able to run without any problems then he should be fine. Mind you, he’ll soon know all about it if some clumsy defender decides to stand on his toes albeit accidently!

Seriously though, it’s great to see all the injuries responding and this is by no means intended to be a negative post - just cautionary as always.

Lucas Navarette asked the question in an earlier article this week in Managing Madrid about whether Marco Asensio would be back in time for the end of the season.

More specifically the discussion was about whether it would be wise for Real Madrid to bring him back for the final stages of this campaign and it started quite a debate.

Marco has posted some updated videos of his rehab on his twitter account lately and as he seems to be doing well, he could be available for the latter part of the season.

The question though is whether Zinedine Zidane would want to take a chance on him if there’s still a question over his fitness at that stage; bearing in mind that although Marco’s rehab is going well at the moment he still has the functional, football-related stage to pass through before he’s ready to make a return to the team.

That leaves Eden Hazard; still working away after an ankle injury that isn’t all that uncommon but nevertheless troublesome enough due to the tiny microfracture that is associated with it; identified through deeper investigations initiated by Real Madrid’s medical team.

But like the others, Eden will in time work his way back to full fitness and he’ll certainly be welcomed back, as will Marco Asensio.

For sure, the situation could be a lot worse. It would certainly be the ideal scenario if Zidane could have started 2020 with a fully fit squad but it was never going to happen.

Let’s just hope that things settle as well as they are doing at the moment and that the injuries are kept to a minimum for the foreseeable future.

References:

Balius R, Rodas G, Pedret C, Capdevila L, Alomar X, Bong DA (2014). Soleus muscle injury: sensitivity of ultrasound patterns. Skeletal Radiology. Vol. 43; 805 – 812.

Dixon BJ (2009). Gastrocnemius v Soleus strain: how to differentiate and deal with calf muscle injuries. Current Reviews in Musculoskeletal Medicine. Vol. 2 (2): 74 – 77.