{"id":11394,"date":"2025-07-04T08:46:17","date_gmt":"2025-07-04T07:46:17","guid":{"rendered":"https:\/\/www.goonerholicsforever.com\/?p=11394"},"modified":"2025-07-07T15:12:09","modified_gmt":"2025-07-07T14:12:09","slug":"arsenal-injuries-1","status":"publish","type":"post","link":"https:\/\/www.goonerholicsforever.com\/?p=11394","title":{"rendered":"Injury, Injury! They\u2019ve ALL Got An Injury!"},"content":{"rendered":"\n
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Firstly, apologies (not) for the parody of Mr Kenneth Williams. It will be interesting this summer to see if our various ins and outs involve the medical \/ conditioning team at all. Obviously they will be conducting medicals for ALL our incoming player at least, but what I mean is will any of those staff be moved out and new people brought in.<\/p>\n\n\n\n


To be clear, I\u2019m not pointing fingers at anyone – I couldn\u2019t even name anyone on the team – and we all saw the reaction of Bukayo Saka when he scored on his return to the team. He was thrilled and immediately ran in gratitude to the physio who had guided him back to fitness. To be fair, he has played regularly since his return, if not yet up to his best level, has taken a bump here and there with no lasting effect, and everything is crossed that he doesn\u2019t suffer a recurrence. <\/p>\n\n\n\n


But our injury list has seen us make an unwelcome return to the top of the Infirmary League this season though, and it\u2019s not unreasonable to think that a thorough review of training, conditioning and monitoring procedures will be taking place.<\/p>\n\n\n\n


So just how bad was our injury situation ?<\/strong>
According to Premier Injuries, the football injury statistics resource founded by Ben Dinnery, Arsenal suffered 36 separate \u201ctime loss\u201d injuries last season and lost 1,297 days to them – the fourth highest on the Premier League behind Ipswich, Tottenham and Brighton. Our relative success despite our injuries is a huge credit to Arteta and the coaching staff.
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We have, as we all know only too well, suffered an uncanny number of long term and season ending injuries that required surgeries. The great majority of them have involved hamstrings and knees, closely linked of course, and unsurprisingly really for footballers. I can only think, off the top of my head, of Martin \u00d8degaard (ankle) and Mikel Merino (shoulder) who have suffered much else. Riccardo Calafiori has been plagued by calf strains, also closely linked to knees, and he arrived at the club having already suffered an extremely serious knee injury and reconstruction in Italy. Jurrien Timber had apparently only suffered to a minor extent this season, thankfully, but it now transpires that he too has had to succumb again to the surgeon\u2019s – or robot\u2019s** – knife, although this time requiring ankle surgery. 
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With so much stress being placed on anyone who has remained fit, there has maybe been a surprising absence of back and groin strains by comparison. White, Gabriel, Saka, Jesus, Havertz and Tomiyasu have all been on the operating table with knee and hamstring issues, while William Saliba came off at half time against Newcastle towards the end of the season with similar problems but thankfully did not require surgery. It is a worry, in the present context, that even Reiss Nelson suffered serious hamstring injuries in both legs which severely hampered his efforts to make an impact on loan at Fulham. It\u2019s reasonable to ask whether his preparation at Arsenal could have made him more susceptible to those injuries.<\/p>\n\n\n\n


**The improving success of surgery<\/strong>
It\u2019s very early days yet but one possible cause for hope to come from our spate of surgeries is that the likelihood of recurrence seems to be reducing. Technology is making surgery more accurate which in turn is leading to less damage to both bone and soft tissue, reduced bleeding and infection risk and, therefore, quicker healing times. Many orthopaedic surgeries are now guided by robot, albeit with a consultant surgeon still in control! A CT scan (computerised tomography – like a 4D x-ray) is taken of the area to be operated on and aligned by laser with the patient on the operating table. The robot then guides cutting precisely according to the scan, thus improving the accuracy.
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Methods of testing for potential fatigue and overuse injuries <\/strong>
We are all familiar with the \u201cred zone\u201d players are said to be in when they are running a high risk of overuse and fatigue injuries. To avoid such injuries at Premier League level clubs there are many and varied ways of regularly testing the condition of players.
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Firstly, to start with the bleeding obvious, good old fashioned communication between player and coaches. The old adage that \u201cplayers always want to play\u201d is true enough but it is vital that they are honest about how they feel. 
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Players are now fitted with GPS tracking systems in all matches and training sessions to monitor the distances a player is running. They can also be used to assess when the number and speed of sprints and recovery runs begins to drop, which are also indicators of fatigue and the need for rest or substitution. That information is constantly relayed to coaches, so when you see Albert Stuivenberg and Mikel Arteta studying the iPads during a match, they are not always only fuming at the latest refereeing bungle.
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Fatigue has become a major concern as players are asked to play more and more club and international matches. Far flung club tours are a requirement to raise revenue and international tournaments are invented to fill every possible space in the calendar – the latest of them as a means to boost the ego and bank accounts of some high ranking officials and to subvert the normal competitive process of winning the rights to host a World Cup.
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Electronic Methods Of Testing.<\/strong>
Muscle fatigue can be tested electronically using various methods, including assessing force output of muscles; using electromyography (EMG) to measure electrical activity in muscles; analyzing blood samples for biomarkers of stress and fatigue; maximal voluntary contraction (MVC) tests; twitch force measurements in muscle fibres; and electrical stimulation of nerves or muscles. 
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Maximal Voluntary Contraction (MVC) tests<\/em>: these tests assess the force or power a muscle can produce during a voluntary effort, which is a key indicator of fatigue. 
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Electromyography (EMG)<\/em>: this measures the electrical activity within muscles. Surface EMG (sEMG) is a non-invasive technique that can detect changes in muscle activity associated with fatigue.
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Twitch Force Measurements<\/em>: these involves measuring the force generated by a single twitch contraction of a muscle, often using electrical stimulation. Changes in twitch force can indicate fatigue.
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Blood Analysis<\/em>: blood tests can reveal levels of lactate – lactic acid – creatine kinase (CK) an enzyme produced by effort in the muscles, and other biomarkers that may indicate muscle fatigue or damage. The lactate stress test is a standard way of assessing the levels of lactic acid produced during a heavy workload.
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Mechanomyography (MMG)<\/em>: this non-invasive technique measures muscle micro-oscillations that are related to force production.
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Twitch Interpolation<\/em>: this technique involves stimulating a muscle with a small twitch during a maximal voluntary contraction, again to assess the degree of fatigue.<\/p>\n\n\n\n


Muscle Biopsy<\/em>: in some cases, a muscle biopsy may be performed to examine the muscle tissue under a microscope, which can reveal signs of muscle damage or changes associated with fatigue. 
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Nerve Function Tests<\/em>: these tests evaluate the electrical activity in nerves, which can be relevant in understanding muscle fatigue or weakness.<\/p>\n\n\n\n


Manual Methods Of Testing<\/strong>
There are various manual methods of testing muscle strength and fitness, from Observational Tests, Repetitive Movement Tests and operator (eg physio) resistance to player (patient) effort. These are pretty obvious tests like observing players walking on heels or toes, rising from a chair, climbing stairs, and balance tests following long injuries to assess proprioception.<\/p>\n\n\n\n


Medical Research Council (MRC) Scale<\/em> – also known as the Oxford Scale<\/em>: this is a standardised test using a scale from O to 5 to grade muscle strength against resistance. It measures range of movement, from very impaired to full, against degrees of resistance, again from nil to maximum, as applied by the operator (physio). <\/p>\n\n\n\n


In terms of Premier League footballers, these manual tests and observations will really only apply to players returning from injury or surgery, otherwise all these levels of ability will be constantly mechanically recorded. There is though always the ultimate \u201ceye test\u201d of a returning player – how does he look in training – and the player\u2019s hopefully honest assessment of how he feels.<\/p>\n\n\n\n

So how can injury be prevented ?<\/strong>
The first thing I would do to help prevent knee injuries is impose a complete ban on the knee slide goal celebration. The most certain way of tearing or weakening an ACL (anterior cruciate ligament) is to force the head of the femur over the head of the tibia, that is, exactly the action of a knee slide. I accept that none of our current crop has been incurred in that way, but if I was an insurance company the knee slide would be top of my exclusions list. 
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Watching the videos online of Arsenal training sessions, I was surprised to see players going through their warm up jogs and lazily kicking a bent leg across the body. Of course an individual exercise needs context but I was absolutely left wondering what this is supposed to achieve, especially under the gaze of someone as intense as Mikel Arteta. Dynamic stretches of some sort, maybe? Sorry, but not at this level of engagement. It made me wonder what the quality of stretching really is at first team level. In particular, I wondered whether a great Arsene Wenger innovation is still used at the training ground – that of the Plastic Stretch.
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When Arsene Wenger arrived at Arsenal the famous back four \/ five he inherited were all of an age where they would normally have been approaching the ends of their careers. I remember them being amazed at two hour sessions when they did nothing but stretching exercises. The result was that they played for probably an extra five years – and I don\u2019t ever remember an injury crisis in Arsene\u2019s time that came close to the one we have just experienced. (That is apart from when all the young players like Walcott, Wilshere, Ramsey, Oxlade-Chamberlain, Jenkinson, were suffering recurrences of connective tissue problems associated with immature bodies.)
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So, what is plastic stretching? There are three basic types of stretching:<\/p>\n\n\n\n

1 – Ballistic stretching<\/em>: This is the typical Sunday morning footballer\u2019s 10-15 second bouncing stretch to touch toes. The bouncing, or ballistic stretch does not actually stretch at all, but causes muscles to contract. It\u2019s the sort of thing you see sprinters or skiers doing in the start blocks to prepare muscles to fire into action when the start gun goes off.<\/p>\n\n\n\n


2 – Viscous stretching<\/em>: This is the 30-40 second stretch before an activity begins. It will generally last for the duration of the activity and then everything reverts to normal.<\/p>\n\n\n\n


3 – Plastic stretching<\/em>: This is a series of long, slowly progressing, passive stretches where the target muscle is not active during the stretch. Typically, it will involve gently stretching the muscle for around 3 minutes, carefully extending the stretch with breathing as it becomes possible. There will then be a 1 minute rest. The whole thing will be repeated 3 or 4 times before moving on to the next muscle group. So anywhere between 10-15 minutes to stretch a single muscle group. Nothing I have seen or read suggests that this kind of thing still happens. I would be pleased to be corrected if anyone knows better.<\/p>\n\n\n\n


Another way of avoiding stress and fatigue injuries is obviously to rotate players more regularly in order to reduce the number of hours \/ minutes they are playing for. That, of course, requires a bigger squad of more even quality. Last season we incurred injuries at such a pace that there simply weren\u2019t enough fit players left to choose from.<\/p>\n\n\n\n

So Why Did So Many Injuries Occur ?<\/strong>
With so many ways of monitoring, testing and, therefore, avoiding injuries, the obvious question is how did we finish up with so many. We were very unlucky last season to be hit by a number of freak injuries. Knocks and impact injuries can reasonably be put down to bad luck and can happen at any time. Martin \u00d8degaard was unfortunate to pick up a serious ankle ligament injury caused by a tackle in an international match. Mikel Merino was landed on by Gabriel in his very first training session after his transfer from Real Sociedad, which resulted in a broken shoulder. Riccardo Calafiori was also unlucky to be hit by a low flying Frenchman in an international match, which resulted in a serious calf muscle tear.
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But we suffered so many serious muscle and ligament tears and ruptures that pure bad luck does not seem a likely explanation for these. Again, I would be happy to be proved wrong if anyone in the know is reading, but it seems that either our preparation and conditioning was inadequate, warning signs were being ignored or a sufficient level of testing was not being carried out.
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Due to our squad size and composition maybe we were ignoring warnings of necessity – there simply weren\u2019t enough fit players to draft in, but the basic question remains – how did so many players become affected ? <\/p>\n\n\n\n

If anyone has the answers \u2026.. the Drinks beckon \u2026..<\/p>\n","protected":false},"excerpt":{"rendered":"

Firstly, apologies (not) for the parody of Mr Kenneth Williams. It will be interesting this summer to see if our various ins and outs involve the medical \/ conditioning team at all. Obviously they will be conducting medicals for ALL our incoming player at least, but what I mean is will any of those staff be […]<\/p>\n","protected":false},"author":15,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[33],"tags":[],"_links":{"self":[{"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/posts\/11394"}],"collection":[{"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11394"}],"version-history":[{"count":9,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/posts\/11394\/revisions"}],"predecessor-version":[{"id":11409,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=\/wp\/v2\/posts\/11394\/revisions\/11409"}],"wp:attachment":[{"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11394"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=11394"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.goonerholicsforever.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=11394"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}