Tyrone Mings

[Deano & Dalian's Umbrella]

16 minutes ago, YLN said:

Do you think it could be PCL then? 

I would say almost certainly not as you would normally only injure that by a severe blow to the tibia or a severe hyperextension.

But what can be more common with ACL injury is:

 

meniscal tear (not the end of the world)

"bone bruise" - microfractures of bone under the cartilage - not a big deal in the short-term.

an osteochondral fracture (piece of bone and cartilage comes away)  - - bigger deal but possibly not the end of the world.

Injury to the structures at sides of the knee which prevent rotatory instability - collectively called things like the "posterolateral corner" and "posteromedial corner" (this includes the medial ligament - MCL) . Now you have a knee which is not just unstable from front to back (the sagittal plane) because of the ACL rupture,  but you now have one that is unstable in multiple directions.

You have to also reconstruct these structures or otherwise the ACL reconstruction will fail due to the additional rotatory forces on it.

Rehab from these reconstructions is a lot slower and a lot more fiddly because there are lots of things you can't do for a while to avoid strain on these structures.

This is where MRI comes into its own.

As you can see, it is not that difficult to diagnose an ACl injury from your armchair watching sky sports - these other structures are more difficult to assess with any certainity.

 

Edited August 14, 2023 by Deano & Dalian's Umbrella

[Demitri_C]

Tys going through a tough one

based on his insta deleted everything 

Poor guy

[Tayls]

So with possibly over a year out and considering his age, I’m assuming he has played his last game for us then? All after 30mins or so, and chasing an offside. 

[one_ian_taylor]

2 hours ago, lapal_fan said:

Just look at that knee joint

Phwoaarr! Could have used a ruthless killer robot in out midfield on Saturday 

[allani]

1 hour ago, Deano & Dalian's Umbrella said:

Although about 15 years ago people were messing about with getting people back in 4 months, it seems to have gone back to more what it was before then which is 6-8 months.

I am a bit cautious so would be aiming for back to training at 6 months and playing at 8 but people have got back in 6.

However, I was surprised by how much pain Mings was in, which could suggest he has done more than his ACL.  If other ligaments have been badly injured, it is going to be longer than that.

I would like to know how quickly his pain settled down because ACL injuries normally hurt when you do them but can settle relatively  quickly because the ligament is completely ruptured and there is nothing to "pull" when you move. . Okore is an example of many who go back on and try to continue.

The final thing is that the irony is that there are professional athletes who have coped without an ACL and didn't need surgery and came back much quicker.

In the past, there were tales of New Zealand all blacks with no ACLs and I heard from someone at Wolves that one of our ex-players in the 80s/90s went in for a small knee operation only to find out he'd ruptured his ACL at Villa and never knew. And he was pacey and a dribbler.

The problem is you can't predict accurately who doesn't need surgery and clubs won't risk several months of rehab to then have a player need surgery anyway, so all pro athletes have ACL surgery now whether they need it or not.

I was wondering about this and whether he was just in pain or whether part of his reaction was also frustration / dismay that he knew that what should have been the biggest season of his life was pretty much over before it started.  I'm sure that the second time I did my knee it felt more painful - but that maybe some of that "pain" was actually my brain knowing that my knee had gone and remembering the pain of the recovery process.  The first time my brain was more "ow that hurts, but I might be alright in a couple of minutes" whereas second time it was like "ah shit not again, I've got to go back to that pyscho physio who will have me throwing up in the waste bin again".

[duke313]

4 minutes ago, Tayls said:

So with possibly over a year out and considering his age, I’m assuming he has played his last game for us then? All after 30mins or so, and chasing an offside. 

He'll be determined to come back stronger, but will he be the same player?  Look at VVD, hasn't looked the same after his injury.

[birdman]

8 minutes ago, Demitri_C said:

Tys going through a tough one

based on his insta deleted everything 

Poor guy

Think it's just mental preparation for recovery. Get rid of the past content and look to the future and getting back to playing. Start afresh that kind of thing.

[grantholtgolazo]

18 minutes ago, Tayls said:

So with possibly over a year out and considering his age, I’m assuming he has played his last game for us then? All after 30mins or so, and chasing an offside. 

not necessarily a safe assumption, but if youre getting something out of being both dramatic and pessimistic, have at it.

[PaulC]

23 minutes ago, duke313 said:

He'll be determined to come back stronger, but will he be the same player?  Look at VVD, hasn't looked the same after his injury.

Don't know last season vvd waw poor but the season before he was part of a team that nearly won the quadruple. So you never know. 

[HalfTimePost]

He can certainly come back and play for us again. Running Backs in NFL can come back from these injuries nowadays but it takes roughly 2 years for them to get a decent level of production.

Tys game isn't nearly as built on sprinting as those (obviously) so you'd hope he can get back to our level and in around a year. His aerial ability for example shouldn't be affected as long as he trusts his knees in the jumping and landing motions.

I'd say his ability to read a game will.mean he can come back.

But. He's probably going to need to be next to some fairly rapid defenders, either at CB or LB so they can help him against faster wingers as he's quite likely to lose half a yard of pace. That isn't a deal breaker. Many CBs deal with that. JT, Thiago Silva etc have played many years not at their fastest.

He can come back but we'll maybe need to scheme for him.

Edited August 14, 2023 by HalfTimePost

[CVByrne]

Really struggling to think about the club without him, and the strong possibility whatever happens with his recovery we have to move on from him being a cornerstone of the club. 

[MikeMcKenna]

Post on Linkedin by Tyrone Mings. He is being very positive!! 

[Zatman]

1 hour ago, Tayls said:

So with possibly over a year out and considering his age, I’m assuming he has played his last game for us then? All after 30mins or so, and chasing an offside. 

No. He will definitely play for us again

[The_Steve]

He will be back. One horrible injury and result won’t define our season nor will Ty want us thinking that. He will be back stronger for it. 

[Rolta]

2 hours ago, Tayls said:

So with possibly over a year out and considering his age, I’m assuming he has played his last game for us then? All after 30mins or so, and chasing an offside. 

Yesterday you were being crazy negative about Emery after one defeat, today Mings has played his last game—this is a lighthearted comment and not a dig, but do you consider yourself to be fairly negative when it comes to football?

[VillaJ100]

Remember that super knee surgeon Dr Richard Steadman. I looked to see if he was still going. He died in January

[Chine]

4 hours ago, Deano & Dalian's Umbrella said:

 

I swore I would never post on here about injuries again because I get so many sarcastic replies but when someone asks a question, I like to answer so:

99% of the time, this is a one-off acute injury that is not something waiting to happen.

The injury might look innocuous to you but the position that Mings' knee went in to - dynamic lower extremity valgus (knocked knee position) is the most common mechanism of injury for ACL injury.

And you can tell it is an ACL injury from how his knee joint moved out of place and then suddenly clunked back into position (called the pivot shift phenomenon)

The cases I know of where this injury was an accident waiting to happen is where people have gradually and repeatedly stretched the ACL out over time by hyperextending (over-straigthening) the knee. 

A famous case is Tiger Woods who used to purposely snap his knee into hyperextension when driving (a golf ball not a car) to get more distance and eventually it stretched out that much it was useless.

I also had a kickboxer patient who did the same on both knees.

Having said that, there are a number of proposed and not entirely well-understood risk factors that can make someone more predisposed to ACL injury (women in particular). These can involve anatomical variations and muscle imbalances and biomechanical variabilities.  

Given that FIFA have an exercise programme to try and reduce ACL injury risk that has been used with kids for years, I'm sure efforts would be made by the medical and coaching staff to minimise the risk of such injuries so I wouldn't put any blame there.

Finally, to ward off the usual sarcastic responses, I have degrees in physiotherapy and sports medicine, have worked as a physio at Villa and other clubs, and have published several papers on ACL injury in different journals including the British Journal of Sports Medicine.

I have not wanted to say this before but last time I posted about Carlos' injury and said tendon ruptures were, unlike ACL injuries, not one-off bad luck injuries but caused by overuse and degeneration, nobody would have any of it, so that is why I'm saying it now.

 

 

 

Thankyou

[Demitri_C]

There is no way this is the end. He is 30 not 37. 

[sharkyvilla]

VT really amazes me sometimes, cheers @Deano & Dalian's Umbrella for all the insight. 

[Tayls]

32 minutes ago, Demitri_C said:

There is no way this is the end. He is 30 not 37. 

But possibly out for 18 months (worst case scenario). Not being funny, but we’d have moved on by that point in terms of a starting 11. We can’t wait around for that long?