[OC] Arsenal’s Pablo Mari Injured & Out for the Season with Ligament/Tendon Injury : Gunners

Hi everyone,

On the premier league opening day, Arsenal lost 3-0 to Man City in a one sided battle in this league affair. What’s worst for Arsenal however is the fact that they lost 2 players due to injury, one being Granit Xhaka (the former club captain) and Pablo Mari’s. I’m made a separate video on Xhaka’s ankle injury (check my profile/channel), this one is going to be on Pablo Mari. Before we start, if you don’t know me already, my name is Matthew Feyissa and I am a medical student from London interested in sports medicine. As always I have attached part of the transcript below, but I encourage you to watch the video version as it comes with step by step analysis of my initial thoughts of the injury prior to any official reports coming out. It would be great if you enjoy the content to subscribe also, the channel is nearly at 300 subs now thanks to the readers here who have shown their support and admiration for my content.

Channel: Matthew Feyissa

Video Link: https://youtu.be/YhRTBnw9uRU

Transcript:

If we look at the footage and some pictures we can see Pablo Mari pulled up whilst chasing the ball in his own penalty box. At first it appeared to look like he had pulled his hamstring, however on looking further and seeing him clutching his heel I’m starting to think its more likely to be an Achilles tendon injury which unfortunately is usually a worse injury to sustain.

The Achilles tendon injury can be devastating to any professional athlete with notable players recently like Marcos Asensio from Real Madrid, Kevin Durant in basketball, and a few years back Santi Cazorla. It is noted however Cazorla’s injury however was made way worst due to an infection which caused gangrene and dead tissue formation nearly ending his career and requiring an amputation.

To see the effects of an injury such as this, I am going to compare it to basketball players. In the NBA, research carried out by Basketball reference.com alongside ESPN used a stat called VORP, the Value over replacement player which indicated that out of 22 players to get the injury, 5 had to retire because of it and out of the 17 who continued playing only 2 players returned to their normal ways.

The extent of an injury such as this though is dependent on how bad the anatomy was affected. If it was in fact a hamstring, then the injury can be simply managed with RICE, rest, ice, compress and elevate to help with the initial rehab process. However if it was in fact an achilles injury then more meticulous methods need to be adopted.

The achilles tendon itself is a structure that connects the calf muscle to the heel bone which is called the calcaneus. The function of this tendon is that it brings the foot closer to the calf muscle behind the leg and is usually in action when we are walking and running. To first investigate what is wrong, ultrasound would be used to examine the muscle and tendon fibres and clinical examination would be used. For tendon injuries, palpation which is a fancy word for feel and examine using your hands, would be used to see whether there the region is tender and sensitive to touch. Also, there may be a reduced plantar flexion reflex of the calf, you can test that on yourself by relaxing your leg and squeezing your calf. This causes your foot flex down away from your shin.

If we assume it’s an Achilles injury there a treatment method which can be adopted prior to surgical intervention. Eccentric exercises which lengthen the tendon can be adopted for 3 months with fifa advising 90-180 reps per day, which is then paired with… (for more information on treatments and management methods see video link above; benefits of cryotherapy, hydrokinesia- underwater treadmills and isometric holds)

If you liked this video, I would appreciate if you could subscribe to the channel so you can join the community and also not miss out on future videos I make. I don’t make any money from this, I just love sports and want to incorporate that as much as possible with my everyday medical teaching. I suspect there will be a lot of videos made in the next few weeks considering that project restart has happened, and players are not match fit increasing the likelihood of injuries occurring. Thanks for watching and I’ll see you guys next time.

Video on Leno coming Wednesday/Thursday.