Are all muscular injuries, muscular injuries?

By Walter Broeckx

I have been writing in the past about injuries. I even wrote a whole series in which we looked at the different types of injuries that Arsenal players had suffered.

One of the debating points was of course when an injury is caused by contact or not. I remember some not agreeing with some of our interpretation of the numbers in some cases. And of course we had to make some arbitrary decisions on some injuries and assuming that it was 50/50 or 30/70 to count them as contact or non contact injuries.

In this article in particular  I talked about the hamstring injuries.  And nobody really challenged the fact that I said that hamstring injuries are almost certainly always caused by non contact issues. Now I must say that at the time I had my doubts when we talked about that type of injuries. I am not saying that all hamstring injuries come from non contact but I am also very sure that a lot of those hamstring injuries come from contact.

And sometimes even small contacts that seem unimportant at the time of the contact can turn out to be important.  A kick at the wrong time on the wrong part of a muscle can cause some small damage that will get bigger later on. And that is exactly what happened with Alexis.  In the match against Dinamo Zagreb he got a kick on his hamstring early on in the match. In fact the Dinamo Zagreb player knew he had made a bad tackle and immediately apologised to Alexis and urged his team mates to play the ball outside the field.

Needless to say that referee Kassai who hates Arsenal as much as Dean I think, didn’t see the foul and didn’t give a free kick. So a lot of people will have missed that foul and kick. But that is the moment the damage was done that cause his hamstring to give way in the Norwich match.

Ask any doctor and he will confirm that a kick on the muscle that is in full tension can cause the muscle to retract even more and even to have it go in to a kind of cramp. Alexis surely felt the impact at the time and hobbled on for a few more minutes. But he ran it off, as they say. That is possible when your muscle has been hit but something. Then you can run it off and make it supple again. As long as the muscle is kept warm and busy this can happen.

If you pull up in a sprint etc, this is impossible in 99.9% of the cases. Then the injury comes from inside and then it is match over. But after a kick a player can continue to play as if the muscle is still fine. However the damage might have been done already.

But athletes are people who usually have a high pain border. Remember how “soft” Theo Walcott was on the stretcher but sitting upright smiling and indicating the score when in fact he should have been screaming from the pain inside his knee…? The adrenaline and all the things in your blood when playing a match can block a big part of the pain. So players like Alexis will feel the pain but will continue unless they really pull up like he did in the match against Norwich.

At that moment the internal damage from a kick becomes visible. But as the injury then occurred people will classify it as a muscular injury and put the blame at the door of Wenger. I expect a Dutch physio somewhere in the newspapers in the UK this week to say this. Maybe it is already there.

But they completely ignore the kicks that cause the initial damage to the muscle. And so will most statistics do.

And now this is with a hamstring injury but the same can be said about calf injuries. I remember my brother having a serious calf injury once from a small kick on his calf during a match. But when you talk about calf incidents people will consider them as non-contact injuries. They might be, but the chance is much bigger that a few kicks left and right on the calf could have caused the injury to come above water.

And also injuries can come from the match before. A good massage after the match can release the tension for a big part in the muscle and give both players and staff a false feeling of everything being fine. And so they continue and carry on but the suddenly in the next match they muscle pulls up without any visible contact. And sometimes of course we cannot even see the contact. It needed a close up from another angle to reveal the contact against Alexis in the Dinamo Zagreb match. So players might get kicks without it being visible inside the stadium or on TV.

So I have always been very careful about pointing at the manager or the medical staff in case of a muscular injury. In a way a fractured bone is easier to see and treat than a kick on a muscle. And even then they can miss hairline fractures from time to time.

The biggest problem for me with muscular injuries is that it usually is a building up of different incidents that causes such injuries. Of course hamstrings do pull up with no apparent reason from kicks. But that doesn’t mean that they cannot come from kicks. Only when an incident can be seen on TV in replays you can see the impact on the muscle. But in most cases we can’t and then the blame the manager game can start.

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Anniversaries

30 November 1997: Arsenal 0 Liverpool 1 left Arsenal with only two wins in eight league games.  This was the fifth game in six in consecutive matches in which Arsenal failed to score – which didn’t make it seem like league game 16 of the 2nd Double Season.   The second double: part 1, part 2, part 3.

30 November 2002 Arsenal 3 Aston Villa 0.  The last game of the sequence of Arsenal games without failing to score.  Pires and Henry (2) gave Arsenal the goals.

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The campaigns

 

 

27 Replies to “Are all muscular injuries, muscular injuries?”

  1. Didn’t Sanchez first feel that muscle when climbing out of the TV camera pit sometime earlier?

  2. I posted a link to an estimate of contusion injury rates.

    http://untold-arsenal.com/archives/48385#comment-861780

    The study is from Cincinnati, Ohio (metro population 2.1 million). I think it should be a reasonable study for English purposes, as ice hockey also tends to bring in this referee nonsense of “be a man” and not penalize illegal play to keep the game flowing.

    In looking for hamstring injury rates, most studies don’t even mention impact. One study said they were specifically ignoring impact. None mention how often impact is the cause of injury.

    While this one particular study found a rate of 31%, I am going to say that impact (contusions) is a “minor” cause of muscle injury. The reason is that 31% is less than 50%. It is entirely possible that it is the largest single cause of injuries.

    I would suggest the medical community still doesn’t have a handle on impact as a source of injuries. My biggest reason is that in paper I just looked at, they said that hamstring impact injury only occurs when the muscle gets crushed against the femur. Sorry, this is nonsense. The femur need not be stressed significantly in order to see the hamstring get damaged from impact.

    Another point in defence of the medical community not understanding impact, is the martial arts. In particular, the “karate chop”. Does the person applying the chop relax the muscles of the hand, so that the impact is delivered by bones of the hand? No! The muscles of the hand are at near full contraction, to put the bones highly in compression. Impact is first handled by the muscles along the edge of the hand.

    Does the muscle get injured, when the chop lands? Not very often seems to be the answer.

    Wenger did not run out on the field and injure Koscielny, Cazorla or Alexis. In large part, their injuries can be attributed to referees not making the pitch a safe environment for the players.

    Opposing managers know that Mike Riley 😈 managed referees will not usually call fouls when Arsenal players are fouled. Those managers could tell their players to hold and push Arsenal, but not to do things which can cause injury. That isn’t happening. Fouls which have the capacity of severely injuring an Arsenal player are still happening.

  3. Following up on something:

    > Fouls which have the capacity of severely injuring an Arsenal player are still happening.

    A NIOSH (USA) study into workplace fatalities, seems to have death rates around 1 per 100,000 workers per year. By around, I mean it could be 2 or 3 or 0.5. The fraction of fatalities which come from a worker falling into a hole is about 4.8%.

    There are maybe 10,000 “football workers” in England, so we would expect about 1 death every 10 years for jobsite conditions. And about 1 death every 200 years for a football worker falling into a hole. Note, you can multiply or divide those numbers by about 3 or 4 to get a range of rates.

    How would Moss feel, if Alexis would have been the first? All because he had been instructed to not call fouls against Arsenal and to allow fouls by the opposing teams.

    Of course, it is possible I am mis-interpretting some of the information in this 300+ page report, which I just skimmed over.

  4. We get Madley for Sunderland

    Saturday 5 December 2015
    K.O. _MATCHES _ _ _ _ REFEREE _ _ _ ASST. REF. 1 _ _ASST. REF. 2 _ _4TH OFFICIAL
    15:00 Arsenal – Sunderland _ _ _Robert Madley _ _M Perry _ _ P Kirkup _J Simpson
    17:30 Chelsea – Bournemouth _ _ Mike Jones _ _ _ R West _ _ _A Garratt C Pawson
    15:00 Man Utd – West Ham _ _ _ _Mark Clattenburg S Beck _ _ _J Collin _S Attwell
    15:00 Southampton – Aston Villa Anthony Taylor _ S Burt _ _ _G Beswick K A Woolmer
    12:45 Stoke – Man City _ _ _ _ _Martin Atkinson _M Mullarkey S Child _ R East
    15:00 Swansea – Leicester _ _ _ Michael Oliver _ M McDonough S Long _ _A Madley
    15:00 Watford – Norwich _ _ _ _ Mike Dean _ _ _ _J Brooks _ _H Lennard D England
    15:00 West Brom – Spurs _ _ _ _ Jonathan Moss _ _S Bennett _ D Bryan _ L Mason
    Sunday 6 December 2015
    K.O. _MATCHES _ _ _ _ REFEREE _ _ _ _ ASST. REF. 1 _ _ASST. REF. 2 _ _4TH OFFICIAL
    16:00 Newcastle – Liverpool _ _ Andre Marriner _ S Ledger _ _D Cann _ _K Friend
    Monday 7 December 2015
    K.O. _ _MATCHES _ _ _ _ REFEREE _ _ _ _ ASST. REF. 1 _ _ASST. REF. 2 _ _4TH OFFICIAL
    20:00 Everton – Crystal Palace _Craig Pawson _ _ M Salisbury E Smart _ L Mason

  5. Why do professional football players seem to suffer different and more sustained injuries by comparison with amateur club players?
    They are obviously better performers on the field of play, but why (say) so many hamstring injuries?
    For instance, it’s not unknown for some injuries to occur during the pre-match warm-up. This would never happen to a club player who, in my day, never warmed up apart from a few soft passes and kicks. 😉

  6. If you look at sprinters (100m), you see the same thing.

    Nominally, they are running so close to the limit of their own performance, that the probability of going past (and hurting something) becomes quite high.

  7. Technically speaking, hamstrings are 3 tendons that support the thigh muscle.

    Two of these tendons are susceptible to injury, and, as they are attached to the thigh muscle, the injury is mostly caused by exceptional high activity in that area. So you shouldn’t get a hammie by walking for example.

    With regards to Alexis Sanchez, because he is mostly expending high energy levels in that area (thigh), it’s easy to think that he should be constantly wracked by injury to the tendon. However, the fact that he is “high energy” probably saves him to a certain degree, as the injury is more likely to happen during sudden bursts of speed. (Reference Rambo pulling up sharply last season).

    Therefore, I’m with Wenger on this – it’s impossible to guess when that sort of injury will happen, especially with someone like Alexis.

  8. If you get kicked it is possible that your running motion could become altered or destabilized for a period of time. The ‘running off’ period as it is called. Would the hamstrings have more stress put on them as a result of running awkwardly because your body is out of alignment due to being kicked?

  9. Infact in the Norwich game the first play when carzola dribble past a couple of Norwich player’s he was shoved away only for him to stretch hard and pass it to the wing and moss was watching

  10. Norman14, you need more technical in your technically speaking.

    Mick, the short answer is yes. Not only is the body subject to unexpected forces at the moment of impact, but the body may have to respond differently shortly after impact as well.

  11. I Noticed that Tony said in a recent post last week that the 4 players we would rather not lose and would be highly unlikely to lose all at once are santi, Sanchez, kosielny and ozil….. What are the odds on ozil being next..

  12. Indiesight is correct.

    Between the uncalled foul and HT Sanchez could not run after climbing out if the pit. He wasn’t sure where to be. He was angry. His teammates unsettled. Norwich score an equaliser.

    Koscielny an unecessary knock on his back which I’ll be generous on and say it was not a foul was the cause of his injury, like Alexis, like any professional athlete, he tried to carry on but eventually had to come off.

    Alexis was having quite a good game. Up until the two handed push in the back (as in cowardly cheating otherwise known as a “foul” since about oh I dunno 1860? Alexis was disgusted and we all know, at least those of not suffering from bigotry, we all know Chilean football loves a bit of argy bargy).

    The only reasonable critique is that the physios didn’t spot and haul off both players. Perhaps they need a spotter physio in the stands or on the telly watching out for players who will predictably not be hauling themselves off? Makes sense to me.

    Anyone crying over the selection of Alexis should either have been

    A) crying non-stop since the Copa. Like me 🙂
    Or
    B) man-up, hehe, stop your bawling, your bleating against your manager and club and simply accept that as your eyes have been informing your good selves game after game year after year you that the reason AFC players get inured like this is not a result of voodoo juju or rocket science but by a lack of protection from the officials whose sole job it is (it’s why they are there) is to protect the players. Otherwise we’d all be watching players sorry I mean mules have five minute careers in a melee that resembles the game of Rugby.

    There’s a reason association football is more popular then rugby football.

  13. < Insideright

    My fingers suffer from an injury: illiteracy! Or perhaps it's just this dodgy dumb wannabe AI auto-correcting machine? A poor craftsman never blames his tools. Not me! Nope. Never.

  14. OT The honest Spanish press have reported that Arsenal may face a transfer ban similar to Barcelona for signing under age player’s…. They offer up no evidence me thinks it’s sour grapes because Real Madrid are next in line for child trafficking offences and the Spanish don’t like the way we take some of their young player’s (legally)

  15. The hamstring injury occurred right after a kick from the Norwich player. The foot of the Norwich player changed the normal motion of Alexis leg causing the strain in the hamstring. If one watches the replay of the incident it is very clear that the contact had an affect on the injury.

  16. This video here shows Alexis clutching his right thigh after the shove into the pit. That coupled with the kicks must have done the damage.

  17. I really hope Norwich get relegated, need to take their 19th century football out of the PL.

  18. Muscles are semi intelligent & remember (for a short periods). The hamstring injury is in fact the rear thigh muscle compacting & pulling against its sinues (the hamstring). Warming up softens the muscles (blood circulation) & allows them to be worked. If the muscles are not ‘warmed up’ they tend to compress (contract) & pull against the sinues when strained. Warmed up muscle has less chance of sudden compression (unless through physical contact). This sudden compression is what is referred to as the injury. Sometimes the muscle tears & sometimes it just needs time (days) to loosen & forget (memory).

    Impact on muscle causes compression & can at a later date (memory & blood clots) get injured or cause injury. The thigh muscle impacts on the femur (thigh bone) as it is the support that the muscle works for.

  19. Menace,

    Could it be that the temperature plays a part too? If I understand correctly, exposing the muscle to a cold source increases the risk of injury. Maybe it wasn’t only the impact with the pit wall, but also the fact that the wall was cold.

  20. Gnerally cold helps a warm muscle relax. So it is not an issue in this case. Impact with anything solid is an issue so the PGMO barsteward should have carded the offender who pushed the player & Health & Safety in Norwich should take action against the club for having a dangerous ungarded pit in the vacinity of a playing field. The FA should be sued by Arsenal for allowing a match to be played in such circumstances.

  21. Its a tricky one. I for one would not have played Alexis. I know the hamstring problem as I’ve had quite a few in my playing days. My approach would be that if I had even the slightest stiffness or twing, I would sit out a match or 2. If u play in that condition, 9 times out of 10, it will pop. Its better that being out for about 4/6 weeks. In my earlier playing days I would play through injuries and it often resulted in getting worse and being out for a longer duration. Now the CL match is going to be a tough one. But we have Rambo and then we have the ox. I only hope that we don’t fall short like the previous campaign, where we missed qualification by a goal.

  22. Walter

    You`re as bad a s Tony, you`re not criticising Wenger for Alex`s injury, don`t you know that everything that goes wrong with Arsenal is Wengers fault
    Most of the headlines said “Why did Wenger not rest Alex, now he has a bad injury and will be out for months !!”
    We now know that he might even be available midweek
    I have yet to see a retraction from these pratts
    Again, why is it that you and Tony write by far the best blogs ?
    Perhaps you only put facts (mostly) and most of those who respond to your blogs put adult informed and informing comments

    Thanks for maintaining my sanity

  23. Gord – I was just pointing out that a hamstring is a tendon, not a muscle

    Menace – Absolutely right. Why blame Wenger when we can blame PGMOB Agent Moss. (Just realised, he was also the agent in charge when Astronaut wrecked MDs career last season).

  24. Norman14

    Biceps femoris is every bit as much a muscle as any other. You might want to talk about the short head a little (it might be missing, more than one). Yes, semitendonosis and semimembranosis are largely tendon, which is why they have been “harvested” in the past for ACL reconstruction. I may have spelled some of these Latin names wrong.

    But, to be fair, a person should also talk a little about the iliotibial band, which is more tendon than either of the 2 unusual hamstring muscles.

  25. The reason Presstitutes talked about Alexis’s hamstring so much before the match is because they know he will be assaulted, as he and other Arsenal players are in each match, and it suits the narrative to make sure that any of the obviously effective players can be injured without resorting to punishment for the offenders, such is the hatred towards this club. (And you know that’s nothing new).

    Last season they talked about how Arsenal had better not be without Giroud, remember? This was the cue for opposition players to batter Olivier every time he tried to play the ball. (Nothing has changed there). And you’ll note that any complaint from OG12 is treated with derision, a yellow card, or it will have been preceded by the om famous “ghost foul” having been given to the opposition.

    In one match last season a player pushed Giroud into the goaly, and when he got up to confront that player, their hearts barely touched, the other player fell over, and Giroud was sent off! That’s what we’re dealing with.

    I meant to post the following last night – on the post Norwich thread by Walter:

    Thank you Walter.

    For weeks there has been talks about Alexis and the amount he has been played. These talks are never spoken about in the context of the brutality he receives in most matches. (The same goes for Jack Wilshere, and in his case the aaa and Presstitutes cling boldly to the claim that “he hangs on to the ball too long, when actually,the opposition simply kick his ankles”).

    During the pre match craptalk-fest, great emphasis was placed on the “Alexis hamstring conundrum”.

    Only Walter and Menace have (previously and currently) pointed out that Alexis is getting serious kicks, many of which go unpunished or even acknowledged. It’s not just Chelsea (esp. Gary Cahill) that set out to injure him.

    So many of these injuries come from (recent) historical deliberate assault “contacts”. The miracle is that Alexis has survived so long without being injured. An athlete with Sanchez’s conditioning/genes/whatever’s can survive all kinds of nonsense over a sustained period, but all will eventually succumb to limbs and joints being targeted in various ways.

    Cast your mind back to the FkCup semi final against Reading. One of Reading’s players stamped on Özil’s achilles. The ref ignored it. It was the same stamp performed by totty on Theo, which loosened him up for the later assault by Danny Rose. (Was there even any punishment for the coin throwing by the spuds?)
    So what did the Presstitutes highlight after the match: Theo holds up his fingers on a 2-0 sign!

    Walcott was out for over a year.

    Some of you have forgotten that Arsenal history shows that this club must not speak out about any assaults on its players. And don’t forget, if an Arsenal player assaults the opposition, they’ll be punished ten fold in comparison with other clubs. (Paul Davies got a 10 match ban. Wasn’t that during the ’80’s)?

    MOTD2 covered the Norwich Arsenal game. Whilst they showed Alexis being pushed into the pit – whilst showing the highlights, they didn’t show that incident again when they spent full five minutes blaming Wenger for Alexis’s injury. Oh no, this injury was nothing to do with Sanchez receiving a pre-planned blow to the thigh from Olympy player, or other not given fouls during that game, or indeed the many other non-fouls visited on him during that or other games.

    Having that enforced visit to the camera pit,obviously had no effect whatever on his following play, innit?

    There was a great one on Campbell – in the penalty area, near the end of the game,where the Norwich player, having failed to control the ball, followed through on Joel, at least causing him much pain. Still, if it puts him out of the game for a week or two – “Job done. Plucky Norwich”.

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