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The Untold injury records – 10. We’re not yet down on our knees

By Walter Broeckx

After the introduction part 1   and part 2   and part 3   and part 4    and part 5  and part 6 and part 7  and part 8  and part 9 we continue to have a further look at some of the injuries in detail. And remember this is based on the injuries since 2002.

11. Knee injuries

An injury type that happens rather a lot. In fact this is the second highest injury type behind ankle/foot injuries. So those are the parts of the body that suffer most from playing football. And/Or being kicked in those parts.

Of course you can twist your knees without contact. But I think we will all admit that a lot of the knee injuries happen because of being fouled. A tackle that clamps your leg and drags you down and then the knee giving in under the impact. Or because of the clamping around the legs tackle the knee cannot bend in a natural way. I think we all have seen it happening. So in our attempt to be correct we have judged that 50% of the knee injuries has been a result of contact and the other half not.

But now let us take a look at this injury type and see what the numbers are saying us about one of the most common types of injuries.

 

Knee injuries Injuries Coefficient risk
Arsenal 89 96.04 %
Aston villa 95 102.52 %
Chelsea 96 103.60 %
Everton 112 120.86 %
Fulham 52 56.12 %
Liverpool 76 82.01 %
Man City 107 115.47 %
Man United 95 102.52 %
Newcastle 80 86.33 %
Tottenham 121 130.58 %
League average without Arsenal 92.67
Total injuries 923

And as this is an injury type that we look at with assuming that 50% of those injuries might have happened because of bad contact then we see that Arsenal is having a better record compared to the league average! This is the first time I noticed this so far in the series. Our risk coefficient is lower than the league average. Only Fulham, Liverpool and Newcastle do better on this type of injury.

The worst off in this type of injuries are Tottenham, Everton and Manchester City.  Now of course after the first euphoria about this good record for Arsenal we return to the ground and see that we are almost level with the league average. So no need to start a big party neither. But it sure feels nice to have the chance to write for once that we haven’t been hit as hard as other teams.

And that for an injury type that happens a lot.

We will stay on our knees for a little while yet and look at another type of injury.

12. ACL Knee injury

And ACL stands for anterior cruciate ligament. An injury that needs surgery to be repaired and leads to a long time outside the field for the player who has suffered from this.

Just as with the other knee injuries we have decided that we will use the 50/50 way of looking at it in the grand scheme of things. It can be caused by fouls but also just by having bad luck that your foot and knee don’t go in the same direction at the same time.

So how does this injury table looks like?

ACL Knee injury Injuries Coefficient risk
Arsenal 6 125.58 %
Aston villa 2 41.86 %
Chelsea 6 125.58 %
Everton 7 146.51 %
Fulham 1 20.93 %
Liverpool 7 146.51 %
Man City 1 20.93 %
Man United 9 188.37 %
Newcastle 6 125.58 %
Tottenham 4 83.72 %
League average without Arsenal 4.78
Total injuries 49

Luckily it doesn’t happen that much. Because it is painful and as said takes a long recovery. So the league average is rather low. But unfortunately we see that Arsenal once again has more than the league average.

But we aren’t the worst victims of such injuries. Because it is Manchester United that has suffered most of this type of injury. Again I like to point at the fact that contrary to most non contact injuries we have a big difference in risk coefficient between the different teams.  From ridiculously low scores like Fulham and Manchester City to ridiculously high scores with Manchester United, Liverpool and Everton.

Arsenal well above the league average but in numbers they are only in 4th place. So not a complete disaster. Keep it that way.

The next injury is again a knee injury.

13. MCL Knee ligament injury

And the MCL stands for medial collateral ligament.  Another of those ligaments in the knee that can tear suddenly.  And as for the other knee injuries we have decided that we look at it to be an injury that can be provoked for 50% by contact. And the other 50% are down to bad luck. So this table looks like this:


MCL Knee ligament injury Injuries Coefficient risk
Arsenal 17 201.32 %
Aston villa 5 59.21 %
Chelsea 7 82.89 %
Everton 12 142.11 %
Fulham 10 118.42 %
Liverpool 10 118.42 %
Man City 6 71.05 %
Man United 6 71.05 %
Newcastle 12 142.11 %
Tottenham 8 94.74 %
League average without Arsenal 8.44
Total injuries 93

So we mention the word ‘contact injury’ even only for half of the injuries and as a result we see that Arsenal has much more injuries than with non contact injuries. Way on top of this table. More than the double of injuries than the league average. Not looking good at all.

Everton and Newcastle also have suffered much more than the league average. The most lucky team in this table is Aston Villa who only had 5 of these type of injuries in the last 10 seasons.

So when we look at the knee injuries in this article we see that Arsenal has been hit by a few certainly MCL injuries but in the big scheme of things we didn’t do too badly. But I can imagine any Arsenal player being out with and ACL/MCL for the moment will think about that in a different way.

In the next article we will have a look at two more types of injuries.  But we don’t stop even then.  For then we will have another look at what he have found and add some data that can show some more information about the injuries. Not sure what the impact of that data will be at the moment. And that is something extra to look forward too.

26 comments to The Untold injury records – 10. We’re not yet down on our knees

  • Walter I wonder if the knee injuries really are 50/50. I have no knowledge of medical matters at all, nor how injuries are caused on the pitch (as my playing days were at a very low level indeed), but I do know that with jiving, just about the biggest level of injury on the dance floor is the knee injury.

    Now since jive isn’t a contact sport by and large, these injuries come from the physical activity itself, and I wonder if there are more knee injuries in football from the activity of running and turning quickly, rather than a foul.

    I don’t know either way, but it could just be that this would explain why our position in the injury league table is so different.

  • Gord

    As I understand things, the reason for FIFA mandating action for tackles from behind, is to lower the incidence of career ending ACL injuries. These were almost all due to contact, but the ACL can be injured in due course from non-contact. I think you need to get some information on the severity of ACL injuries in order to make sense of this. Also, these type of injuries also happen to be in the territory of that ligament which was only discovered a year or so ago.

    MCL injuries are contact injuries. The knee is meant to pivot on a specifically oriented hinge (even though it isn’t a hinge joint). The MCL injury occurs because some force is trying to have the knee bend at 90 degrees to the hinge.

    I think someone might be able to injure their MCL on purpose without contact, I think it highly unlikely.

  • WalterBroeckx

    Thanks Gord for your additional medical information. I should have asked it to you as I should have remembered you have some knowledge about sports injuries yourself before deciding what are contact or non contact injuries.

  • Mike T

    @Walter
    I am not a great fan of the Daily Mail but have you seen this?

    http://www.dailymail.co.uk/sport/football/article-2589756/Arsene-Wenger-spin-doctor-Aaron-Ramsey-latest-star-misdiagnosed-Arsenal-boss.html

    Does pose some interesting questions in terms of estimated time out due on injuries

  • Mandy Dodd

    Yes did see that Mike T, and I agree, these delays,are,far too commonplace for my liking. It is possible wenger is deliberately underestimating,these injuries so as not to put pressure on the team, or spread negativity.
    It is also possible the medics are getting things wrong, or the physios are not doing recovery properly. It is also possible these things just happen.
    But, as a wenger supporter, one who agrees with the excellent work of Walter that the kicking we get is a major part of the injury problem, but as someone who also believes something more may be going on, I hope these recovery times and delays are a starting point of our much talked about injury review. If there really is something wrong, I hope they do whatever required to put it right, and quickly, no matter whose nose may be put out of joint. This is too important and costly to ignore. Have a strong feeling the Ramsey situation may have prompted wenger and the club to look a little further into this

  • WalterBroeckx

    In a way it is interesting that they seem to look at Wenger as a medical person. Now when Wenger is asked how long will player X be out I would assume that he has spoken to his medical staff about it and that it is their prediction that he just passes on to the media.
    Why would Wenger make it better. Nobody is winning anything by saying only 4 weeks out when it is 6.

    Blaming Wenger for the longer recovery of an injured player is completely off the mark. It is the job of the medical staff to bring those players back so that they can resume full training. Is someone not doing his job properly? Or not competent enough?

    The Ramsey situation is starting to get worrying to be honest. Starting to remind me of the Rosicky injury a few years ago. Rosicky who at the end lost almost 2 years with what looked a small injury at first and later was a bad kind of knee injury….or was it a complete muscle tear just above the knee?

  • Tom

    Mike T
    Those Wenger quotes you gave the link to are nothing new to any Arsenal fan who has followed Arsenal’s injury crises over the years.
    Clearly there’s a problem with diagnosing injuries properly or treating them so. One or two cases would be normal but this is just way too many to be purely coincidental .

  • Mandy Dodd

    If you are right and wenger is just relaying info from,the medics, then someone,is,getting,things seriously wrong on a regular basis. For Ramsey, read Poldi, theo at various times, Ox, as you say, TR, TV RVP and Jack to name but a few
    I do not expect to see Ramsey again this season , but you can hope for a pleasant surprise.
    Wenger cannot be blamed for things to do with the medics, but if there really is something wrong…..and let’s face it….of it looks like a duck , and walks like a duck…..well I am surprised the club have not done something sooner, this is an annual event going back years. If there is something amiss, or someone just not up to it….maybe protected by loyalty….or pulling the wool over people’s eyes?
    Whatever it is, investigate, leave no stone unturned, and fix it once and for all. These injuries could seriously derail a very promising season if we do not get these players back. Wenger seems concerned, he said he will look into everything

  • Tom

    Walter
    I totally agree. There’s no way Wenger is saying anything other than what he was told by his medics.

    This is your number one reason for our collapse this season . It was like a perfect storm .
    First we loose Ox and Poldi at the beginning of the season . Soon after we loose Cazorla so Wenger is unable to properly rotate his mid. Then we loose Walcott for a while and after he comes back for a handful of games , we loose him for the season. Then we loose our player of the year candidate in Ramsey for what was suppose to be a short absence which now might turn into a season ending injury. Our signing of the year Ozil , looses his two primary targets for showcasing his talents , begins to struggle , gets injured himself and then we loose Wilshere.
    The only way this could only ever get worse is if Arsenal team bus drove off a fucking cliff.
    We can scream for more quality players to be brought in and I have, but you can only bring so many. You can’t sustain a title challenge with five first team players missing for almost half the season.
    This is not to absolve Wenger of any blame mind you. There are players in Arsenal squad who have been passengers and if Wenger doesn’t trust them then he should loan them out or move them on .
    Giroud started the season pretty well but he was forced to run himself dead because our other striking options are a player who has never scored a goal in any top flight and was himself injured , and the other one who is a head case and likes to drop his pants to show off his underwear and piss on taxis.
    Considering all our injuries ,if Wenger can deliver the FA cup and a CL place, we would have to consider this a really good season but Arsenal’s entire fitness and med department needs to be looked at and changes must be implemented.

  • Tom

    You said it Mandy !
    If it looks like a duck and walks like a duck , then it’s a motherfucking duck !
    Pardon my French Mandy.

  • Mandy Dodd

    Can only agree with a lot of your post Tom. The question, if there are problems, why have we taken so long for this review? Has wenger been protecting someone, or maybe not his area, maybe someone else has been covering things up. Think I remember reading the contracts for wengers staff are up at the same time as the man himself. If there is anything wrong, and some cite a degree of malaise, the club need to root it out.
    Have a feeling a lot will change behind the scenes this summer. I know these issues have been used by some to bash wenger, certainly not my intention, but after reading about problems with the academy set up which had significantly deteriorated to the point of very nearly losing elite status,I hope many aspects of running the club are looked at..do we have the best physios, medics, GK coaches or tea ladies, because frankly, if we do not,,we should have. This summer could be a good time to look at anything that needs looking at…preferably with us as cup winners, in the CL and with wenger in charge

  • Mike T

    Mandy

    Either Wenger is telling porkies(which I don’t think is the case)or he`s getting bad info through incompetence

    I have been scratching my head and trying to think when a PL manager got it so wrong so often.

    Ok I know some will say Arsenal get more injuries but the these players are mulit million pound assets and other clubs quite simply don’t get it wrong when expressing the date of return or indeed more to the point he extent of the injury

  • Mandy Dodd

    Ultimately, I don’t think he is telling porkies either, perhaps negating bad news at times…but not out and out lies as I say,wonder if Ramsey may be the catalyst for some sort of change.
    Whatever the causes of injuries ….a subject currently under much debate, the treatment and recovery seems a concern, and possibly leading to further concerns over something as fundamental as diagnosis even? How can they get it so wrong so many times?

  • Tom

    Mandy
    I don’t think Wenger is protecting any one but rather this might be a case of Arsen simply being loyal to his people. After all this has always been his trademark character trait.

    Pat Rice was Wenger’s long serving assistant manager for 16 years and had he not retired in 2012 ,he still would’ve been Wenger’s Nr 2 .
    Compare that with another long serving PL manager , since retired SAF ,who in his 27 years had 8 assistant managers. That’s about 1 assistant manager for every 3.5 years.

    We always thought Diaby’s case was unique and we kind a got over it but Ramsey’s injury and subsequent possibility of mishandling it , might be the straw that broke the camel’s back.

  • Mandy Dodd

    Could be right Tom, remember Paddy V saying Wengers greatest strength, and his greatest weakness was the loyalty…..of which you speak…

  • andy1886

    Here’s a theory that may hold some water – please note that this is not aimed to blame any individual but to offer a possible explanation.

    One thing that we’ve noticed is that Arsenal players often suffer setbacks – that is we announce an expected return date and something happens and it gets put back. I suggest that maybe it’s that we try to rush players back too quickly and they either have a relapse (if they are well into recovery) or exacibate the problem if they start the recovery programme too early leading to a longer than is necessary layoff. That means that the original diagnosis may be correct but poor planning makes the problem worse.

    This would explain the ones where there seems to be no return date offered (started recovery too early, exacebate the problem, it drags on) and also the repeated relapses (announced date then a revised date because they get rushed through recovery and injured again).

    The small squad would explain why we might rush someone back, but the results suggest that this is counter productive. Just a thought.

  • WalterBroeckx

    I think that it is only a doctor that can say when a player can start training again and at what level. If a doctor tells Wenger player X can start running again from today then when he turns up on the training field to run he should be able to run. If Wenger then tells him to run and he has a relapse then who is to blame?
    For me it is clear that in such a case (that happens too much to my liking) it is/are the doctors who are responsible. If it is too soon they should tell Wenger: no, not yet, wait longer before he can start running again.
    In such a case the doctor is the boss and not Wenger.
    Or do you really think that for instance with a player in plaster that it will be Wenger who tells when the plaster will be removed? I think no doctor will ever allow a non-medical educated person to decide such things.

    I wouldn’t be surprised if the medical department will see a big change this summer. We could do with some Wohlfart 😉

  • andy1886

    Walter, as you can see I stated clearly from the start that my theory wasn’t intended to blame anyone, just offer a possible explanation. It’s a problem for the whole club and needs to addressed by everyone who has any input into the situation.

  • Mandy Dodd

    Out there conspiracy theory. I believe the majority of wengers back room staff will have their deals renewed….or not when or if wenger signs.
    Last year, there was a cull of playing staff. Maybe , this year, a look into the back room staff …..wenger having to agree to this as part of signing a new deal? We have already had an overhaul of the academy….a new director, from what I have been told by someone who really follows that set up, not before time.
    Is it possible that this summer, there will be a cull ….of at least some of the back room staff, they are just not being told yet so some of them don’t just down tools before the season ends. Of wenger signs now, would they have to either be signed up….of let go at a vital stage of the season? Only a theory!!
    I do not know enough to even suggest anyone on the backroom staff is doing anything wrong, but we need , and can afford the very very best

  • Gord

    At the end of the day, recovery takes as long as it takes. And that can sometimes be a long time.

    Now if Wenger were to say that, he would be crucified. But it doesn’t matter what he says, people are looking for the opportunity to crucify him. Just think what would happen if purely be chance, every prediction in a season was correct, and then the next season there started to be differences between actual time and predicted time.

    Biological processes are complex, and open to lots of interfering factors. A good engineer can design an experiment in physics and easily get an R^2 for a linear experiment of 0.99. Most of chemistry can probably get high correlations as well.

    If we look at just response to a training program, not even recovery from an injury, we need to do the training in the correct manner in order to provide the stimulus for the response to strengthen the body. ATP can fuel a muscle cell for 2 seconds or so, and CP can be stored within muscle cells to regenerate ATP and allow fast access to energy for 20 seconds or so. Doing any exercise for longer than 20 seconds, is training the muscle in the endurance regime, as that is the only energy system that can maintain longer set times.

    In weightlifting, a person does at least one set to “failure”. You cannot do any repetition at all, or you cannot do it in good form. It is obvious that failure is of a variable nature. Some failures provide better stimulus than others. The act of weightlifting (and going to failure) actually damages the muscle, it is the recovery period afterwards where the muscle remodels itself to respond to the overload stimulus where it becomes stronger. How well it is able to do that, depends on blood flow to the area, it might depend on lymphatic drainage from that area, and it probably depends on all the nutrients needed in the remodeling. It may also depend on the general level of stress in your life. Take two workouts, one during tax season and one not, the tax workout probably doesn’t build as much strength.

    Doctors are not scientists. Medical science has made great strides in society. It produces two products: medical knowledge, and doctors. More often than not, the medical knowledge is generated by people who are not doctors.

    Doctors are also not statisticians. Recovery of any kinds, is going to follow some complicated probability density function. What number do you want? Mean? Median? Mode? 5 percentile? 95 percentile?

  • WalterBroeckx

    Thanks for the clarification Gord.
    Experience is important in predicting when a player can be in full training again. I don’t know if that is a lacking part at Arsenal

  • WalterBroeckx

    In the mean time believe it or not: next Tuesday Diaby will be in full training again at Arsenal. I almost fell of my chair reading it.

    Just imagine having a fit Diaby now… Even if only fit for 2 months….

  • Gord

    Another example, out of place. Sorry.

    Sprained ankles. Sprained ankle ligaments.

    Sprains happen to tendons and ligaments, strains happen to muscles. First degree is overstretched, 2nd degree is some
    tearing of tissue, 3rd degree is rupture.

    A ligament is composed of elastic tissue (which carries the mechanical load), blood vessels feeding the tissue, and nerve receptors.

    In a sprain, you almost always see some swelling, this is a result of blood vessels being torn, and blood leaking into the cavity around the ligament. Some of that blood may be carried away by the lymphatic system, a reasonable amount of the remainder goes into produce scar tissue on the ligament. Scar tissue is similar to an internal scab. It functions like scaffolding against a building on a construction site. At some point the reconstruction of the ligament is finished, and then a person wants to remove the scar tissue. But the act of breaking up scar tissue often results in the formation of new scar tissue.

    What you want is something like one step forward, half a step backward, repeated. But, sometimes you take half a step forwards and a big step backwards.

    Okay, the ligament has been remodeled to take larger forces, and the scar tissue is gone, everything is ready for return to action. Sorry, no it isn’t. When the ligament was overstretched, the nerve receptors got stretched. The body no longer has an accurate idea of the position of the foot in the brain. So you have to do balancing exercises, for the body to relearn the orientation of the foot in space. These exercises are often done at the same time as strengthening the muscles around the ankle.

    With respect to Diaby, I wish him well. I do hope that Wenger has some use for him.

  • Mandy Dodd

    Gord, said it before , but your club needs you!

  • Gord

    Thanks Mandy. Although I wish I would make fewer typing mistakes.

    Here’s hoping we do well tomorrow.

    COYG!

  • It’s so sad that in this league injuries can’t be avoided. I still do hope that Arsenal could lessen the numbers in the statistics of their injuries. I’m still one of the biggest fans though. Go go go!