Author LizWorsley

Author LizWorsley

Reds call on blue tape to cure van Persie’s ills

Liz Worsley January 20, 2013 Tags: Opinion 7 comments

Rather than wrap him in cotton wool, it seems Manchester United may need to cover Robin van Persie in blue tape to keep the Dutchman injury-free this season. The striker, who has become both vital and loved at United, was seen wearing the recognisable blue Kinesio Tape on his hamstrings at the back of both thighs during the game against Liverpool last weekend.

United fans hope, of course, that the Kinesio Tape (KT) was simply being used as a prophylactic, although many will be forgiven for thinking that van Persie may already be carrying a slight twinge and that it is only a matter of time before the striker is sidelined.

van Persie was notorious for being injury prone during his time at Arsenal; enough to earn the nickname “glass ankles” following persistent difficulties with both ankles. In addition, van Persie has also suffered hip, thigh, groin, hamstring, calf and metatarsal injuries throughout his career.

Although there is relatively little evidence to support KT, it has become increasingly popular with élite athletes and was particularly noticeable during Euro 2012 last year. A meta-analysis of KT’s effects (* Williams et al. 2012) suggests the tape may be beneficial for improving muscle strength and range of motion, however these results were not proven to be clinically significant, and with too few studies more research is still needed to be sure of its efficacy.

Despite this, many high-profile athletes have found KT to be useful, including Novak Djokovic, Mario Balotelli and Dwain Chambers. And although there is a lack of strong scientific evidence, anecdotal evidence from athletes is not being ignored by medical teams, often working under intense competitive and financial pressure to keep their stellar players in action.

van Persie is no stranger to experimentation with radical alternative therapies to stay fit. In summer 2009 he opted to have troublesome wisdom teeth removed, believing they could be linked to his recurrent injury problems. van Persie attended a clinic in Paris for the procedure and was seemingly injury free for several months afterwards.

“My osteopaths think there may be a connection between my teeth and the muscle injuries I suffer,” said the Dutchman. “Something like that is very difficult to prove. But if the operation makes just one per cent difference it’ll be worth it.”

However, in November 2009 the Dutch playmaker suffered yet another ankle injury in Holland’s friendly against Italy. He traveled to Serbia to try horse-placenta treatment, by having placental fluid massaged into his sprained ankle. Although little is known about how placenta therapy may work, the theory is that it by applying the fluid it will improve the healing processes by enhancing transport of nutrients to the injured area.

Manchester City’s Pablo Zabaleta and Vincent Kompany have both allegedly visited the same clinic for treatment.

“It cannot hurt. And if it helps, it helps” said van Persie, no doubt frustrated with persistent ankle trouble and willing to try an unproven treatment.

Initially expected to be out for six weeks, scans revealed that van Persie had actually torn rather than sprained the ankle ligaments and missed a further five months of the 2009-2010 season. The placenta therapy appeared to be fruitless when advice was sought from a leading ankle specialist, Niek van Dijk, who confirmed that more extensive damage had been suffered than was first diagnosed. van Persie required surgery on the damaged ligaments.

After being plagued by so many sprains, strains and tears, van Persie’s lengthy injury trouble appeared to ease in the 2011-2012 season in which the striker won PFA player of the year. His tenure with Arsenal ended and he joined United in August 2012 with many believing it a good deal for the Gunners, given van Persie’s age and injury record. £24 million for a 29-year-old prone to so many injuries seemed like good business at the time for Arsène Wenger.

Yet, van Persie’s transfer has so far appeared to be Sir Alex Ferguson’s bargain not Arsenal’s. The striker’s contribution has been spectacular, with 22 goals to date including a number of last-minute winners and equalisers, and an important goal against Tottenham Hotspur in difficult weather conditions on Sunday.

It is possible that the striker may have picked up a minor hamstring muscle strain during the busy festive period, and taping was being used to try and prevent a serious muscle strain from occurring. If van Persie feels even the slightest hint of an injury, Rob Swire and the United medical team will no doubt be trying everything possible to ensure van Persie stays fit for the title run-in and coming European campaign. Even if it means wrapping the Dutchman in blue tape.

Robin van Persie’s injury record whilst at Arsenal:

Groin Strain – – 2012 February 29th
Ankle/Foot Injury – – 2011 August 7th
Knee Injury – – 2011 February 28th
Hamstring Injury – – 2011 February 22nd
Flu – – 2011 February 8th
Ankle/Foot Injury – – 2010 August 28th
Ankle/Foot Injury – – 2010 June 1st
Sprained Ankle – – 2009 November 14th
Knee Injury – – 2009 September 13th
Groin Strain – – 2009 April 18th
Groin Strain – – 2009 March 30th
Hamstring Injury – – 2008 October 6th
Ankle/Foot Injury – – 2008 August 31st
Thigh Muscle Strain – – 2008 May 2nd
Thigh Muscle Strain – – 2008 April 4th
Thigh Muscle Strain – – 2008 January 11th
Thigh Muscle Strain – – 2007 December 24th
Knee Injury – – 2007 October 18th
Metatarsal Fracture – – 2007 January 22nd
Ankle/Foot Injury – – 2006 November 19th
Hip/Thigh Injury – – 2006 September 14th
Ankle/Foot Injury – – 2006 February 10th
Ankle/Foot Injury – – 2005 December 22nd
Knee Injury – – 2005 October 17th
Ankle/Foot Injury – – 2005 February 5th
Sprained Ankle – – 2004 November 26th
Sprained Ankle – – 2004 August 27th

(physioroom.com)

* Williams S, Whatman C, Hulme P, Sheerin K. Kinesio Taping in Treatment and Prevention of Sports Injuries: A Meta-Analysis of the Evidence for its Effectiveness. Sports Medicine. 2012; 42(2): 153 – 164

Tentative Vidić poses defensive selection dilemma

Liz Worsley January 4, 2013 Tags: Opinion 10 comments

As the second half of the season gets underway, the once fearless Nemanja Vidić is now tentative about his return to full time action for the Reds. The Serbian defender has endured a frustrating time since originally injuring his right knee against FC Basel in December 2011 in what has proven to an an incredibly unlucky injury for player and club.

Back then the Serbian was caught in a tangle with Basel striker Marco Streller, and tore not only his anterior cruciate ligament (ACL), but also the medial and lateral collateral ligaments (MCL and LCL) too. To underline the defender’s poor luck, it is extremely rare for a player to tear the lateral and medial ligaments together due to the forces required to damage both structures at the same time.

Vidić then required further surgery early this season to repair damage to the meniscus after experiencing problems in training, thus completing ‘the unhappy triad’ of tears to the ACL, MCL and medial meniscus, three structures in the knee that are commonly damaged in professional athletes.

The defender’s surgery in September 2012 came shortly after the player had claimed that his knee was “in perfect condition” and that the partnership with Rio Ferdinand could once again be “the best in the Premier League”. Surgery proved to be huge blow to United, with manager Sir Alex Ferguson having become too familiar with defensive injury crises over the last four seasons.

Vidić returned on 15 December when the player made a late entry as a substitute against Sunderland, but is yet to pair up again with Ferdinand. The duo has created a formidable partnership over recent years, but injuries and age beg the question whether they will be able to regularly play together again in future?

After all, Vidić will now be wary of returning too early, with the consequences severe. United’s coaches already seem to be adapting the player’s first team involvement. The Serbian also says that he is now consulting with doctors before each game after suffering an adverse reaction following United’s match with Swansea City. In fact the player isn’t nearly as confident as he once was about his knee.

“The doctor is managing the games [I play],” said the Serbian. “Over the first two or three months I have to really look at the games I can play because sometimes I might have a reaction. This is a process I have to go through. I am glad I have managed to play after three months. It is nice to be on the pitch and playing games.”

Having been troubled for over a year, injury is now bound to have an impact not just physically, but psychologically on the tough 31-year-old defender, particularly after apparently being rushed back too soon last Autumn. Vidić will know that the risk of re-injury is a lot higher in players who have previously torn knee ligaments.

Furthermore, having been so unlucky in damaging the LCL, Vidić will be wary of his own personal fragility. It is debatable whether the player will ever regain the form of old.

To that point, a recent JUMP-ACL study looked at risk factors for ACL tears and provided some interesting findings, including the fact that certain body positions in relation to the ground, and postures such as hip flexion, are strongly associated with this damage.

This research is particularly interesting when you consider the stances adopted by players when engaged in defending – typically bent forward with knees and hips flexed to lower the centre of gravity in preparation to spring forward and intercept.

Vidić may also be wary of bending his damaged knee too far for fear of tearing the repaired meniscus again, and of sharp cutting maneuvers that can result in twisting the joint and threatening re-injury to the collateral ligaments.

The waterlogged pitch at Old Trafford against West Bromwich Albion on 29 December, which underwent a pitch inspection by officials, will no doubt have been a red flag for a player fearful of re-injuring old wounds. And over the Christmas period Sir Alex Ferguson rotated Vidić and Ferdinand by partnering one or the other with Jonny Evans.

During its peak, the reliable Vidić-Ferdinand partnership allowed one central defender to roam forward, knowing that the other would hold back and provide cover if an attack broke down.

However, with question marks hanging over the pace and agility of the ageing duo, it may now be sensible to play only one of them, along with Evans. The Reds are in a fortunate position to have all defenders back in contention while Vidić makes his gradual return to action.

But after a tumultuous first half of the season – defensively at least – Ferguson may also want consistency in his back four, posing interesting selection question in defence following two clean sheets on the run and with Real Madrid not too far off on the horizon.