News that Owen Hargreaves has returned to Dr. Richard Steadman’s Denver clinic has once again put the England international midfielder’s career in doubt. After just 25 starts in three years for United talk ofÂ retirementÂ is now a serious consideration with Sir Alex Ferguson refusing to set a date for the 29-year-old’s return to first team action.
Hargreaves has undergone two operations to cure persistent patellar tendinitis, also known as Jumpers’ Knee, which has forced the combative midfielder to stay on the sidelines for the best part of the last two years. Indeed, the former Bayern Munich star played less than 30 seconds, against Sunderland, last season and just four games the campaign before as injury forced the midfielder under the surgeon’s knife.
The problem has left a long-term hole in United’s midfield, but what is patellar tendinitis and why could it cause Hargreaves’ premature retirement? Rant takes a look.
The patellar tendon attaches the quadriceps muscle group to the tibia, the larger and stronger of the two bones in the leg below the knee. These make up what is known as the ‘extensor mechanism’ of the knee, including the patellar or knee cap.
Patellar tendonitis is the common condition that arises when the patellar tendon and the tissues that surround it become irritated and inflamed, normally due to overuse. Jumping – hence the nickname – acceleration, deceleration, and landing cause a large amount of stress on this mechanism, with the healing process stopped until rest is taken.
The condition usually causes pain directly over the patellar tendon and in more serious cases swelling around the tendon itself.
When Hargreaves broke his leg playing for Bayern Munich against Arminia Bielefeld in September 2006 the player returned just four months later, appearing during the last two months of the Germans’ campaign. The rapid return ultimately proved disastrous though, although neither player nor club knew it at the time.
When Hargreaves moved to United in summer 2007 there was little sign of the problems to come but now the player blames his speedy return to action and poor injury management by Bayern for the stress placed on both knees.
Initially United treated the problem with rest and injections – Hargreaves appeared in just 34 gamesÂ in all competitions during the 2007/8 campaign, scoring a vital penalty against Chelsea during the Champions League final shoot-out that season.
But Hargreaves appeared in just three games the following season before the pain in his knees forced the player out and eventually into the hands of the surgeon.
In most cases the micro-tears in the tendon associated with the condition will repair with significant rest and recuperation, ice, compression and injected anti-inflammatory drugs.
More serious cases may require eccentric loading, a form of physiotherapy that aims to strengthen muscle groups around the affected area to reduce stress on the joint and tendon itself. The worst forms of tendonitis can be treated with autologous blood injections – the injection of platelet rich plasma into the affected area.
Then there is Hargreaves, whose knees were “the worst ever seen” by Steadman in 25 years operating on injured sportsmen. The Canadian-born player required Steaman to clean up both tendons after significant portions were shown as degenerative on an MRI.
The player underwent surgery on his right knee on 10 November 2008 and received a similar operation on his left knee in January 2009. While neither operation required a graft, Steadman removed lengths of damaged tendon, accessed by drilling holes through Hargreaves’ knee-cap.
Six months of rest followed before Hargreaves began a very long programme of training with the reserve and first team squads. Not only is it important for the knee to settle down after the operation but Hargeaves also had to rebuild muscle around each knee.
Yet the player was no closer to a return, despite initially being named in Ferguson’s Champions League squad for the 2009/10 campaign. It proved a false dawn, with the Scot appearing to lay the blame for Hargreaves’ delayed return on a lack of confidence as the Scot removed the midfielder from United’s squad for the knock-out rounds.
The midfielder did finally return though, playing 27 seconds of United’s match at the Stadium of Light in March. Such was the optimism generated by the player’s comeback that England manager Fabio Capello even asked Ferguson if the 29-year-old would be able to take part in the World Cup this summer.
Then the potentially career ending blow – a further injury to Hargeaves’ knee in pre-season training and a return to Steadman’s Colorado clinic.
Hargeaves’ 38 appearances for United have come at considerable cost to the club. Quite apart from the Â£20.2 million fee paid to Bayern Munich after more than a year of negotiation, Hargreaves has also earned around Â£70,000 per week during his three years at Old Trafford.
That total investment in the player of Â£31.26 million, or Â£822,632 per appearance, hardly represents value in the market. The real cost, however, is to the player’s career which now lies in tatters, and to United’s squad structure that still lacks a player of the midfielder’s ilk.
Whether Hargreaves will play again before he turns 30 next January, if at all, is now in serious doubt.