Deano & Dalian's Umbrella

I'll never forget seeing an article in the Daily Mail saying that Dennis Bergkamp was flying in to the UK that day to sign for us - done deal.  The next day, it was announced that he'd signed for Arsenal.

4 minutes ago, TheAuthority said:

Can you PM? My usual doesn't have it listed.

and could you pm me when he pms you please!

11 minutes ago, Brumstopdogs said:

 

I went up and touched it because I couldn't believe it was painted on the brick and not just stuck on.

53 minutes ago, AndyM3000 said:

The atmosphere was poor but the music before the game does my head in. Turn it off 10-15 mins before KO and let the atmosphere build, it's insanely loud you can barely hear the person next to you. 

I remember back in the MON days we'd get a chant going for each player in the 3-4 mins before KO and they'd clap the Holte, surprised if they can even hear it now.

 

They even blasted us with it at half-time too  - no chance to discuss the game with my dad.

(Also, I thought the atmosphere was pretty poor today).

4 minutes ago, lexicon said:

Thanks for the info 

 

You're welcome.

Just carrying on from the question about the player in Greeec:

I just found a (translated) article which says:

 "He underwent stitches to the medial meniscus in his left knee, while it was decided to undergo an invasive procedure for the posterior cruciate ligament at the same time, with estimates – at the time – talking about his absence from the courts for 4-5 months.

On the one hand, this suggests he did have PCL surgery but on the other hand, it makes it sound like the meniscal surgery was the main procedure and then whatever was done to the  PCL was a secondary procedure, which doesn't make sense as a PCL reconstruction would be the much bigger deal.

57 minutes ago, lexicon said:

@Deano & Dalian's Umbrella There was a case here of a player here in Greece, Sergio Araujo, who ruptured (I believe) his PCL but managed to come back after only 111 days. How unusual is it to recover that quickly, if you don't mind me asking. 

Normally, return to play from PCL surgery is not dissimilar to the time for ACL surgery, so around 6 months plus. So that would be unusual.

For PCL injuries managed conservatively (without surgery), return to play is more like 4 months but I just googled and that player did have surgery and there are articles saying he had a "cruciate" injury but I can't find anything more than that or details of the surgery.

Given that PCL injuries often don't require surgery, I'm wondering whether the surgery he had was to deal with a lesser, associated injury like a meniscal tear and the PCL tear was left alone.

Otherwise, and I hope you don't mind me saying this as I'm part Greek myself, the crazy Greeks just let him go back too quickly and hoped for the best.

This is complete guesswork but we now have Wilson happy to say that Mings has an ACL injury but not happy to disclose (other?) details which means that Wilson is either worse than me at keeping secrets or there are additional details he isn't saying.

Combined with the official site saying it will require "lengthy rehabilitation" whereas for Buendia, it said 6-8 months which is the standard thing the physio and doctor would tell the manager for an ACL, this makes me suspect that Mings has injured additional structures which need reconstructing.

The most likely candidate would be a collection of structures known as "the posterolateral corner".

If someone has this and the ACL reconstructed together, return to play could be more like 1 year.

29 minutes ago, MrBlack said:

and we don't know the severity of the ACL injury.

 

Just on that bit - about 80% of ACL injuries are complete ruptures with about 20% being partial (that's just off the top of my head)

It doesn't tend to be like other ligament injuries where you rate them on a 3 grade scale (1-microscopic tearing, 2-macroscopic tearing / incomplete rupture, 3- complete rupture).

The fact that we saw the knee sublux (move out of place) and the fact that he needs surgery  both mean it is a complete rupture.

18 minutes ago, YLN said:

I posted this before, but Mings' looked like Owen's. Maybe less severe. The unhappy triad. It's the injury I got skiing and my knee went over like Owen's. I also had a segond fracture. 

During my rehab I watched this video of Owen over and over and it made my stomach turn. Like licking a pizza burn on the roof of your mouth 

 

You are right that this is similar - you can also see the "pivot shift" mechanism here.

When you rupture the ACL, the femur (thigh bone) moves out of place on the tibia (shin bone) but the bones suddenly clunk back into place.

With Owen, his foot is still on the floor so his femur clunks forwards.

With Mings, his foot was coming off the floor so his tibia clunks backwards.

The term "pivot shift" is normally used to refer to a test that surgeons do to produce this clunk and diagnose ACL injury but the same clunk is what you are seeing here.

I'm probably going overboard here, but just in case anyone is interested, here is an article about what causes or stops a pivot shift.

https://link.springer.com/article/10.1007/s00167-011-1866-5

20 minutes ago, GREAT_BEARD_OF_ZEUS said:

Thanks D&DU much appreciated insight as others have said.

One last question if you permit… in your professional opinion, considering Tyrones physique and age, do you think he’ll come back at the same level he was performing to pre Saturday’s injury?

 

This is a really difficult one.

I'm always amazed when people who have ACL surgery and so long out do come back at such a high level.

If you just read the "abstract" (summary) of this study, you'll see that players often do not return at the same level as before , although a word of caution is that this involves data going back to the mid 90s.

https://www.sciencedirect.com/science/article/pii/S0968016018302187

Mings' physique and fitness is a definite plus.

His age is against him in terms of it then taking time once back to try and gradually get back to where he was.

But the biggest factor will be injuries to other major structures rather than just ACL - you are then entering Wesley territory.

1 minute ago, briny_ear said:

I’m disappointed that anyone might respond to information like this with sarcasm, and puzzled really as to what form such sarcasm could take. Thanks for the info anyway.

It has normally been comments inferring that I'm just someone on an internet forum  pretending I know what I'm talking about, to the tune of "it's amazing how many sports medicine experts we have on here".

I'm not asking people to take what I say as gospel but when you're just trying to answer someone's question, it can be a bit annoying to be accused of making it up.

Just now, Chicken Field said:

Great post

 

Quick question. I know no two injuries are the same and that there are 100's of factors involved in rehabilition and risk factor etc., but would the injury Carlos got mean he has a worse prognosis and increased risk at devolping similar injuries again, wheras Mings prognosis, once healed, should mean he is not at an increased risk of similar injury? (

Because there are predisposing factors to ACL injury, many of which you can do nothing about, it is not uncommon for someone who has done one ACL to do the other - so some people are just at more risk of ACL than others.  

I have seen a paper where people who had one achilles rupture were more likely to rupture the other one.  The theories put forwards for this were either genetic predisposition or the likelihood that if you have degeneration in one limb, you are likely to have it in the other one too:

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0838.2004.00344.x

So to answer your question, in both cases you are at increased risk of doing it again but tendon injury is more preventable with common sense about not doing too much too soon.

6 minutes ago, The Fun Factory said:

Apologies as is this a layman question but I thought the new £6 million pound sports performance centre at Bodymoor was supposed to do much more physical analysis of the players. Should they been aware of degeneration?  Since that has been built we have had 3 really bad injuries from senior players.

This is a difficult one because if you scan the tendons of most athletes, there will be some degree of degeneration and many will have no symptoms and no problems ever happen.

But if someone is complaining of tendon pain or discomfort, you definitely should investigate it and get an ultrasound scan  - then pain plus degeneration is a warning sign.

As a more preventative measure, you shouldn't hammer people in in pre-season or when they first come to the club and build up their training load gradually.  

From what I hear just as a fan, there seems to be lots of emphasis on managing training load these days, so hopefully Carlos was allowed to bed in gradually when he arrived.

1 minute ago, birdman said:

Excellent insight thankyou  

You're welcome and sorry for the defensive mini-rant either side of it.

8 minutes ago, bannedfromHandV said:

So what do we think? Bone break or ligaments? Kinda hoping the former 

It is 100% an anterior cruciate ligament injury.

You could clearly see what is called the "pivot shift" phenomenon where the thigh bone (femur) moves out of position on the shin bone (tibia) and then suddenly reduces (clunks back into place).

The only good news is that he and Emi can rehab together and encourage each other.

43 minutes ago, Xela said:

Defense?!

I thought the same but then realised that the OP is from the US and this is the correct spelling there.

On 18/07/2023 at 08:37, Zhan_Zhuang said:

One of the players I really disliked for his time at Villa.

Just out of his depth, promised so much.

Found his level at Rangers though.

He was a really nice guy.

1 minute ago, alreadyexists said:

“… in the cumming days…”

Sorry, I just saw the imminent bit. If he can still do that, that's fine.