Evolution of football injuries…

[Rozay]

Perhaps it’s just me, but I’m having to recalibrate what the recovery is for common football injuries more and more today. Growing up watching the PL, I feel like a cruciate was always ‘out for a year’, and now players are coming back in half that. Perhaps that makes more sense with medical advancement, but on the flip side, a hamstring was always ‘two weeks’. Now a hamstring seems to mean 3 months. Kai Havertz is out for the season with a hamstring injury. Luke Shaw’s hamstring injuries are automatic 3 month lay-offs, as are Mason Mount’s.

Is it just me, but did hamstring and thigh strains not used to always be 2-4 weeks max back in the day? They both seem to take so much longer these days, and tbh, it seems there are barely any injuries at all, aside from head injuries maybe, that keep players out for two weeks anymore.

 

[Oranges038]

No proof, but I'd imagine sports science means recovery periods are now designed to be longer.

 

[Vanrouge]

Not in any way a medically trained person, but from personal experience, I know that hamstring injuries, at least, come in grades. The less severe can be just three weeks. Also, there are other types of cruciate ligaments than the anterior, and injuries to those (the MCL, for example) can be less severe. That's it. That's all I know, and it's mostly anecdotal.

 

[Rozay]

On a side note, footballers are being sidelined with far less groin strains than they were in earlier PL years. Can’t recall the last time a player was out with a groin strain. Probably one of Shaw and Mount’s many injuries I guess.

 

[Rozay]

Not in any way a medically trained person, but from personal experience, I know that hamstring injuries, at least, come in grades. The less severe can be just three weeks. Also, there are other types of cruciate ligaments than the anterior, and injuries to those (the MCL, for example) can be less severe. That's it. That's all I know, and it's mostly anecdotal.

Yea I’m aware of the different grades with hamstrings, but I still don’t recall anyone missing several months with a hamstring injury back in the day. Giggs used to get them all the time, and I don’t remember them being so long term like they are now.

 

[DJ Jeff]

Yea I’m aware of the different grades with hamstrings, but I still don’t recall anyone missing several months with a hamstring injury back in the day. Giggs used to get them all the time, and I don’t remember them being so long term like they are now.

I kind of remember Giggsy getting a hamstring tear and being out for 3 months in around 05? Could be wrong on that but yeah his was a severe tear as I assume Shaw's and Havertz' have been.

 

[Vanrouge]

Yea I’m aware of the different grades with hamstrings, but I still don’t recall anyone missing several months with a hamstring injury back in the day. Giggs used to get them all the time, and I don’t remember them being so long term like they are now.

You wrote "a hamstring was always ‘two weeks’," which didn't indicate you knew about the grades (grade 1 – a mild muscle pull or strain; grade 2 – a partial muscle tear; grade 3 – a complete muscle tear). So in other words, you knew the answer to your own question?

From the NHS website, it's clear that grade 3 hamstring injuries can take months:

A minor muscle pull or strain (grade 1) may take a few days to heal, whereas it could take weeks or months to recover from a muscle tear (grade 2 or 3).

Giggs's hamstring injuries became longer term until he discovered yoga's benefits, from what I remember.

 

[Cutch]

The same thing has crossed my mind in recent times but I think Luke Shaw and Mason Mount are solely to blame for this. They can turn the most innocuous looking injury into a 4-5 month job. Agree on the hamstrings, they seem to be taking far longer these days so gone are the Grade 1s for whatever reason, and groins almost disappearing as an injury

 

[Mb194dc]

Lots more ACL than there used to be, even more in Women's football as well. Who's come back in 6 months? Still 12 pretty much.

Footballers are running 10km+ every game now. Tactics, much more pressing probably a big reason for more injuries. Pre 2010, it was different.

Combined with more games and travel. Imagine running 10km 2 or 3 times a week, for months on end.

 

[Rozay]

You wrote "a hamstring was always ‘two weeks’," which didn't indicate you knew about the grades (grade 1 – a mild muscle pull or strain; grade 2 – a partial muscle tear; grade 3 – a complete muscle tear). So in other words, you knew the answer to your own question?

From the NHS website, it's clear that grade 3 hamstring injuries can take months:



Giggs's hamstring injuries became longer term until he discovered yoga's benefits, from what I remember.

I know the difference between grades, but my presumption was that different grades also existed 20-25 years ago too when hamstring injuries didn’t take so long. And conversely, I don’t recall anyone being our for two weeks with a hamstring injury in recent years, again - regardless of grade.

 

[Rozay]

Lots more ACL than there used to be, even more in Women's football as well. Who's come back in 6 months? Still 12 pretty much.

Footballers are running 10km+ every game now. Tactics, much more pressing probably a big reason for more injuries. Pre 2010, it was different.

Combined with more games and travel. Imagine running 10km 2 or 3 times a week, for months on end.

Rojo and Ibrahimovic both did their ACLs in the same game for us, and it was back end of the season and I feel like they were back well before 12 months. Falcao did his ACL in December I think and started the season with us.

And more recently, Rodri did his in what, October? City expect him to play again this season. Oscar Bobb did his in the Community Shield and he’s back already. That Barcelona doctor seems to be turning them round in 6 months now.

 

[Vanrouge]

I know the difference between grades, but my presumption was that different grades also existed 20-25 years ago too when hamstring injuries didn’t take so long. And conversely, I don’t recall anyone being our for two weeks with a hamstring injury in recent years, again - regardless of grade.

Okay, I think I get where you're coming from. I just don't have the expertise to answer it beyond my personal experience and observations. Hopefully someone else will.

 

[simonhch]

Perhaps it’s just me, but I’m having to recalibrate what the recovery is for common football injuries more and more today. Growing up watching the PL, I feel like a cruciate was always ‘out for a year’, and now players are coming back in half that. Perhaps that makes more sense with medical advancement, but on the flip side, a hamstring was always ‘two weeks’. Now a hamstring seems to mean 3 months. Kai Havertz is out for the season with a hamstring injury. Luke Shaw’s hamstring injuries are automatic 3 month lay-offs, as are Mason Mount’s.

Is it just me, but did hamstring and thigh strains not used to always be 2-4 weeks max back in the day? They both seem to take so much longer these days, and tbh, it seems there are barely any injuries at all, aside from head injuries maybe, that keep players out for two weeks anymore.

Fergie used to say that a hamstring was automatically a minimum of two weeks. That was just for the most basic of strains. I think two things have happened here, (1) the evolution of medicine and sports science means that rehabilitation times for serious injuries are significantly shorter than they used to be, with better outcomes than ever, and (2) so much more information is disseminated into the public domain that it ever was in the past. A hamstring injury for example is like saying "I have a cut". That could range from a paper cut to a gaping stab wound. The same with hamstring injuries, which can be everything from a strain to grade 3 full tear which requires surgery. Now, I know you know this, but it seems that you seem to believe that hamstring injuries have suddenly gotten worse in recent times, with extended recovery times.

I would contend that this is just a symptom of how information is reported, with us now able to access much more detailed information from clubs. I will also suggest that it is possible that due to advances in scanning technology, as well as improved access to scanners for clubs, they are more accurately able to determine the extent of soft tissue injuries and subsequently keep players sidelines for the appropriate amount of time. It may have been the case in the past that players were returning to playing status much sooner than they were supposed to, due to the absence of detailed scans of their injury. This may have contributed to players, 2-3 decades ago, having more recurrent injuries that were avoidable. On the flipside, I remember Giggs missing 4-6 weeks with a lot of his hamstring injuries, which seems pretty standard - even today. A three month hamstring absence is for a fairly serious tear, and think that is just as rare today as it was before. We just know about it more now. Anecdotally, I also remember players like ALvaro Recoba being out for several months for a hamstring strain, and then a quadriceps strain.

 

[Rozay]

Fergie used to say that a hamstring was automatically a minimum of two weeks. That was just for the most basic of strains. I think two things have happened here, (1) the evolution of medicine and sports science means that rehabilitation times for serious injuries are significantly shorter than they used to be, with better outcomes than ever, and (2) so much more information is disseminated into the public domain that it ever was in the past. A hamstring injury for example is like saying "I have a cut". That could range from a paper cut to a gaping stab wound. The same with hamstring injuries, which can be everything from a strain to grade 3 full tear which requires surgery. Now, I know you know this, but it seems that you seem to believe that hamstring injuries have suddenly gotten worse in recent times, with extended recovery times.

I would contend that this is just a symptom of how information is reported, with us now able to access much more detailed information from clubs. I will also suggest that it is possible that due to advances in scanning technology, as well as improved access to scanners for clubs, they are more accurately able to determine the extent of soft tissue injuries and subsequently keep players sidelines for the appropriate amount of time. It may have been the case in the past that players were returning to playing status much sooner than they were supposed to, due to the absence of detailed scans of their injury. This may have contributed to players, 2-3 decades ago, having more recurrent injuries that were avoidable. On the flipside, I remember Giggs missing 4-6 weeks with a lot of his hamstring injuries, which seems pretty standard - even today. A three month hamstring absence is for a fairly serious tear, and think that is just as rare today as it was before. We just know about it more now. Anecdotally, I also remember players like ALvaro Recoba being out for several months for a hamstring strain, and then a quadriceps strain.

Thanks, I think there’s a lot of truth in that response.

 

[Rozay]

There’s also Tyrell Malacia. He got a ‘leg injury’ and was out for 18 months. That’s the longest I’ve ever seen a player injured for. Pretty sure David Brooks went off and fought Hodgkins and came back sooner, as did Fletch with his life threatening illness. Same for David Haller.

 

[Mb194dc]

Rojo and Ibrahimovic both did their ACLs in the same game for us, and it was back end of the season and I feel like they were back well before 12 months. Falcao did his ACL in December I think and started the season with us.

And more recently, Rodri did his in what, October? City expect him to play again this season. Oscar Bobb did his in the Community Shield and he’s back already. That Barcelona doctor seems to be turning them round in 6 months now.

Had a look on transfer mkt injuries data (accurate?). Rojo was 217 days, couldn't see Ibra.

They estimate Rodri will be back 30th April, which would also be 220 days ish. Falcao had a cruciate in 13/14 which out for 190.

Interestingly I checked Shearers from back in the day, that was 232.

I think you're right though, that there's better surgery available now and recuperation can be quicker.

 

[rimaldo]

must be a change in the curriculum. i coach one of my son’s team, and a lot of the rest and recovery periods are focused on injuries to the penis. it’s a coaching manual put together by the bbc from the 1970s. they state 72% of football related injuries happen to the penis.

 

[DannyCAFC]

As mentioned there are obviously different grades of tear so we might be comparing apples to oranges a bit here, but I do wonder if we are seeing a greater severity of these types of injuries because of the way the game's gone physically.

50-60 game seasons for a lot of players these days, running 10-11km on average per 90 plus the degree with which players are expected to get around the pitch now probably means a lot more short interval sprints than back in the day.

 

[sullydnl]

There’s also Tyrell Malacia. He got a ‘leg injury’ and was out for 18 months. That’s the longest I’ve ever seen a player injured for. Pretty sure David Brooks went off and fought Hodgkins and came back sooner, as did Fletch with his life threatening illness. Same for David Haller.

That had a pretty straightforward primary explanation though, which is that his initial surgery was botched. As per The Athletic:

United proposed a surgeon in London but Malacia wished to undergo treatment in the Netherlands with his own choice of surgeon. United agreed to that request and Malacia travelled home for the operation, which was conducted outside of the club’s oversight.

Yet scans on the affected knee had revealed that small fragments of cartilage remained around the meniscus.

A decision was taken to proceed with corrective surgery. The operation was carried out in November by the same surgeon responsible for the first, with representatives from United overseeing it.

Things like that happen, any injury can be extended indefinitely.

 

[Rozay]

That had a pretty straightforward primary explanation though, which is that his initial surgery was botched. As per The Athletic:



Things like that happen, any injury can be extended indefinitely.

Ah thanks, didn’t recall that at the time of posting.

 

[Sandikan]

Yea I’m aware of the different grades with hamstrings, but I still don’t recall anyone missing several months with a hamstring injury back in the day. Giggs used to get them all the time, and I don’t remember them being so long term like they are now.

Giggs had a few 6-8 week spells out.
At one point they reckoned it was due to changing gears at high speeds in his flash cars!

But I think he mitigated his injuries by not going to full pace on runs after a certain age.

But he never ruptured a hamstring which is your proper max severity

 

[Rozay]

Just read that Saka is set to miss another 8 weeks with a hamstring injury tbh at has already kept him out for about 5/6 weeks.

 

[Dave Smith]

I think two things have happened with hamstring injuries:

1) They are better understood/are being treated differently than before with extended periods of recovery.
2) The modern game, with a high proportion of sprints and longer distances being covered mean higher grade tears are more common.

As for ACL's I have a feeling a lot of that is to do with point 2 and also the boots worn today, where lightness has been overly prioritised. This is 100% me guessing however.

 

[Red in STL]

Had a look on transfer mkt injuries data (accurate?). Rojo was 217 days, couldn't see Ibra.

They estimate Rodri will be back 30th April, which would also be 220 days ish. Falcao had a cruciate in 13/14 which out for 190.

Interestingly I checked Shearers from back in the day, that was 232.

I think you're right though, that there's better surgery available now and recuperation can be quicker.

Keyhole surgery plays a large part in it, once upon a time your career was over with ACL type injuries

 

[Red in STL]

Giggs had a few 6-8 week spells out.
At one point they reckoned it was due to changing gears at high speeds in his flash cars!

But I think he mitigated his injuries by not going to full pace on runs after a certain age.

But he never ruptured a hamstring which is your proper max severity

That's apparently what Havertz has done hence his seasons done or so they say

 

[noodlehair]

Hamstring inuries have never really had a time frame as far as I'm aware. If it's precautionary it's 2-3 weeks maybe. As soon as there's a tear it could be anything as the resilience of the muscle once it's repaired, and how/if the body can build that back up is a factor.

Other injuries I've always had the impression some players tend to just mend quicker than others. Probably part how well they look after themselves, and part genetics/luck.

Still remember Valencia coming back from having his leg/ankle basucalky shattered to pieces in what seemed like freakishly quick time, and then on his return mowing Arsenal to pieces. Found that quite bizarre at the time. A lot of players just don't fully recover from those types of injury..

 

[Big Andy]

Giggs had a few 6-8 week spells out.
At one point they reckoned it was due to changing gears at high speeds in his flash cars!

But I think he mitigated his injuries by not going to full pace on runs after a certain age.

But he never ruptured a hamstring which is your proper max severity

Giggs took up yoga, and that seemed to stop his hamstring injuries.

 

[Rozay]

Leg breaks seem to be significantly reduced too, although that’s probably inevitable in that tough tackling has become practically outlawed. That said, two of the leg breaks I remember from yesterday were Djibril Cisse and Henrik Larsson, and neither of those were the result of impact if I remember correctly. They were just running and fell over with a broken leg. Alan Smith’s leg was once broken by a football (John Arne Riise shot I think).


A lot of little things have changed. On a side note, players don’t get straight red cards for an elbow like they used to either. And the elbows haven’t stopped either, they are just deemed as not deliberate now and given yellows. Back in the day in the PL, I there were many straight reds for violent conduct. Now a VC red is generally just a high tackle.

 

[Gio]

I think two things have happened with hamstring injuries:

1) They are better understood/are being treated differently than before with extended periods of recovery.
2) The modern game, with a high proportion of sprints and longer distances being covered mean higher grade tears are more common.

As for ACL's I have a feeling a lot of that is to do with point 2 and also the boots worn today, where lightness has been overly prioritised. This is 100% me guessing however.

Agree with this.

Contributing as well are the pitches. The way the grass is woven, often using plastic, tightens the soil, locking your studs in, and means your knee has nowhere to go in a twisting scenario. The same bouncier surface also helps players run faster than they can on a basic grass pitch as there is more of an energy return. Higher speeds equals higher risk of injuries.

 

[Hughes35]

Keyhole surgery plays a large part in it, once upon a time your career was over with ACL type injuries

ACL isn't done by keyhole surgery.

There is just a greater understanding of the injury and the recovery. A few examples of this:

1. An ACL is usually fixed by taking a hamstring graft and building a new ACL from the graft. Not that long ago (90's & Even early 2000's), it was believed it was better to spread the trauma by taking the hammy graft from the uninjured leg. We now know that slowed down recovery as it just made people immobile, so now the graft is taken from the same leg that has the injury.

2. If you tore both your meniscus and ACL together (Very common). Most surgeons used to do the meniscus first, the patient would need to do 4-6 months rehab and then they would go in for the ACL opp. The top surgeons now do the two together which has shortened the recovery time for top sport massively....... A lot of NHS surgeons still do two separate preproduces.

I've said in another thread. I'm not convinced the boots is part of the ACL problem. I think the semi fake pitches play a part but I believe the fixture congestion means players are resting more and not putting as much time in to strength prehab.

From a very simple perspective, If you have games every Wednesday and Saturday with travel in between, when are you supposed to do a heavy leg strength training day?

 

[Zehner]

Perhaps it’s just me, but I’m having to recalibrate what the recovery is for common football injuries more and more today. Growing up watching the PL, I feel like a cruciate was always ‘out for a year’, and now players are coming back in half that. Perhaps that makes more sense with medical advancement, but on the flip side, a hamstring was always ‘two weeks’. Now a hamstring seems to mean 3 months. Kai Havertz is out for the season with a hamstring injury. Luke Shaw’s hamstring injuries are automatic 3 month lay-offs, as are Mason Mount’s.

Is it just me, but did hamstring and thigh strains not used to always be 2-4 weeks max back in the day? They both seem to take so much longer these days, and tbh, it seems there are barely any injuries at all, aside from head injuries maybe, that keep players out for two weeks anymore.

Tissue injuries generally take less time than bones and ligaments but there are various degrees. Robben used to be out for months with harmstring injuries and literally had holes in his muscles because they had to remove dead fibres. Maybe that's the case for Havertz as well.

In general, recovery times are getting faster. In many cases, today's pros are playing through pain these although players used to be sidelined in such cases because the MRI found that their injuries aren't structural.

 

[Rozay]

Tissue injuries generally take less time than bones and ligaments but there are various degrees. Robben used to be out for months with harmstring injuries and literally had holes in his muscles because they had to remove dead fibres. Maybe that's the case for Havertz as well.

In general, recovery times are getting faster. In many cases, today's pros are playing through pain these although players used to be sidelined in such cases because the MRI found that their injuries aren't structural.

I appreciate there are different degrees and grades, but whatever they are, it seems the proportion of the ones at the more serious end seem to be higher now.

WIlson Odobert made his first appearance since September yesterday. He was out with a ‘thigh injury!’. Mainoo apparently has a ‘muscle injury’ and his season is done. Whatever the variation with injuries, I feel like fewer players are out for two weeks with injury now. Any issue seems to be a month/six weeks minimum now.

Maybe players are just playing through the sort of things that would have kept you out for two weeks back in thr day now, as you said.

 

[Marwood]

Probably impossible to do this but the number of injuries now compared to twenty years ago would be interesting.

We hear a lot about sports science but it feels like players get injured more than ever. Or at least at the same rate.

 

[jojojo]

Rojo and Ibrahimovic both did their ACLs in the same game for us, and it was back end of the season and I feel like they were back well before 12 months. Falcao did his ACL in December I think and started the season with us.

And more recently, Rodri did his in what, October? City expect him to play again this season. Oscar Bobb did his in the Community Shield and he’s back already. That Barcelona doctor seems to be turning them round in 6 months now.

Even among ACL injuries there are different degrees of damage and different combinations of surgery needed.

Basic rehab has improved - diminishing muscle loss during recovery. The 6 months point is a fast recovery, but even then it mostly refers to when they return to something that looks like normal football training. Some start playing again soon after that, but not by playing full matches. Injury risks are high when players first start playing again - you can train but it's not the same as a competitive match.

Very few look 100% before 12 months and even fewer are back as regular 90 minute sort of players. I think Oscar Bobb had a fracture, not ACL damage - and he's not actually back in the first team yet - unless I've missed something. Which Barca players said you thinking of?

Zlatan got injured mid April and came back as a sub mid-November, but he actually only made a handful of appearances as a starter that season. Rojo's timeline wasn't much different. Falcao is a harder one to judge because we saw him play, but we never saw the fully fit and match sharp version of him that were hoped to see, he was better the following season - but he wasn't with us, so it's hard to say how he'd have done.

 

[Rozay]

Probably impossible to do this but the number of injuries now compared to twenty years ago would be interesting.

We hear a lot about sports science but it feels like players get injured more than ever. Or at least at the same rate.

Would be hard to do it exactly, but top teams played at least as many games, typically with smaller squads than they do today. If you go back to our treble winning team, I’m pretty sure we played games two days apart at a point. We had Cup replays back then, and the core of our team played a huge amount of games. I don’t recall David Beckham really having any injuries of note, for example, and he’d just play game after game. Frank Lampard also went something like two+ years playing every single game for Chelsea at a point.

 

[SparcMac]

Lots more ACL than there used to be, even more in Women's football as well. Who's come back in 6 months? Still 12 pretty much.

Footballers are running 10km+ every game now. Tactics, much more pressing probably a big reason for more injuries. Pre 2010, it was different.

Combined with more games and travel. Imagine running 10km 2 or 3 times a week, for months on end.

We had a case in Estonian Football last year when we had significant amount of really good players out with ACL-s all 3 came back in 6-7 months. So it's very case by case - usually with ACL there's a case of extra damage, to other ligaments, so if they are also damaged that might lengthen the the recovery period.

 

[Rozay]

Even among ACL injuries there are different degrees of damage and different combinations of surgery needed.

Basic rehab has improved - diminishing muscle loss during recovery. The 6 months point is a fast recovery, but even then it mostly refers to when they return to something that looks like normal football training. Some start playing again soon after that, but not by playing full matches. Injury risks are high when players first start playing again - you can train but it's not the same as a competitive match.

Very few look 100% before 12 months and even fewer are back as regular 90 minute sort of players. I think Oscar Bobb had a fracture, not ACL damage - and he's not actually back in the first team yet - unless I've missed something. Which Barca players said you thinking of?

Zlatan got injured mid April and came back as a sub mid-November, but he actually only made a handful of appearances as a starter that season. Rojo's timeline wasn't much different. Falcao is a harder one to judge because we saw him play, but we never saw the fully fit and match sharp version of him that were hoped to see, he was better the following season - but he wasn't with us, so it's hard to say how he'd have done.

That’s true, coming back and back to full strength are different matters.

And regarding Barca, I mean Dr Cugat, who is a Barcelona-based Dr I believe that clubs from around Europe send players to get rehab.

It just seems like we’ve shaved a few months off traditional long-term injuries like ACLs and leg-breaks, but muscle injuries are taking longer these days. 3-6 month layoffs for muscle issues are becoming far more common now. At least it seems so.