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“The cruciate ligament of the knee was cut” … a phrase that the soccer player does not want to hear from the beginning of his career until the suspension of his shoes, since it is a “nightmare” for the players.
In its sense, the sentence entails “hostility” towards athletes in general and soccer players in particular, since the matter does not depend solely on the performance of a surgical operation, but on the period of rehabilitation and physical preparation that it will entail, as well as on the will and patience of the player not to run back.
The cruciate ligament, or cruciate ligament, is one of the stabilizers of the knee bone during movement and is one of the main ligaments of the knee.
The cruciate ligament is of two types: the anterior cruciate ligament and the posterior cruciate ligament that cross in the shape of the letter X and meet at one point, and the cruciate ligament connects the thigh bone with the shin to prevent it from slipping.
There are two types of cruciate injuries, either an anterior cruciate ligament tear or a posterior cruciate ligament tear. The anterior cruciate ligament is more common among athletes, and it can be a complete or partial cut, and it occurs when a player receives a severe blow to the knee, or when they run fast and then suddenly stop to change direction.
When the injury occurs, the injured player hears a “popping” sound, and a lump may occur in the affected area hours after the injury, as well as pain in the joint area and the inability to stabilize when attempting to load the knee .
During this season in the Egyptian League, more than one player suffered a cut in the cruciate ligament, some returned quickly at 6-9 months (usual period), while others were late, such as Mohamed Mahmoud, the Al- Ahly, whose absence approached a full year.
Mohamed Mahmoud, the Al-Ahly player, is the most prominent player who suffered a cruciate ligament injury twice in a row and his absence lasted much longer than usual. To the stadiums?
The Al-Ahly player suffered the first injury on January 8, 2019 during his second participation with Al-Ahly in the Smouha League match, being absent from the stadiums until the beginning of October of the same year (the period of absence here was 9 months, which is the normal rate).
As soon as the player returned to the stadiums, after he began to regain his physical form, Mahmoud suffered another injury during training on October 24, 2019, to be absent from that moment until the date of publication of the investigation. (The period of absence is close to one year)
In the same period of time due to Mohamed Mahmoud’s injury (several weeks before or after), more than one player suffered a cruciate ligament injury as Mohamed Toni, the Egyptian player by the clearing (he performed surgery at the end of September 2019 ), Ahmed Abdel Aziz, Enppi’s player (he was injured on October 19), but they took part in official matches again and Mohamed Mahmoud is still absent.
During Yallakora’s research, for reasons and factors that help the player to return quickly to participate in matches, we found that the recovery phase of a cruciate ligament injury goes through several stages: the preoperative period, the first week after surgery and after surgery, which is called the rehabilitation period, which is the most important period. In periods of injury.
Preoperatively
Yallakora went to speak with Wael Raafat, the physical trainer of the Egyptian club’s coaching staff, to tell him: “The cruciate ligament injury is a defect in the muscular proportions between the anterior and posterior muscles, which causes heaviness in one than in the another, which leads to the appearance of injuries “.
Raafat adds: “A similar (snap) occurs as a result of cutting the ligament that connects the group to the knee. The player feels that he cannot control his gait and there is a common term ‘my legs betray me.’
Regarding the causes of the injury, Raafat said: “Al-Sulaibi’s injury occurs as a result of various reasons, including poor stadiums, poor shoes or an error in pre-match warm-up operations.”
And when asked about the best time for surgery, he replied: “It is better for the player to perform the surgery immediately after confirming the injury, and in case of postponement exercises are performed to strengthen the muscles.”
He adds: “If the operation is not performed within a day or two at most, then muscle strengthening exercises should be performed, and these exercises benefit the player in the postoperative phase.”
Tariq Soliman, a former doctor from Zamalek and Egypt, supported Rafat’s talk about the preoperative period.
Suleiman said Laila Koura: It is preferable that the player does not wait long before performing the surgery (no more than a week or 10 days), and at that time the player should perform exercises in the gym to strengthen the muscle.
For his part, Mohamed Al-Najjar, rehabilitation specialist of the current Al-Ahly Club’s first team, highlighted the importance of the preoperative phase, highlighting that the main objectives of the preoperative rehabilitation program are to measure the range of motion of the other leg , minimal muscle swelling, adequate latency, and neuromuscular control.
Al-Najjar, who previously worked at the Enppi, Petrojet, Vanguards of the Army and Misr Clearing House clubs in Egypt, as well as the Iraqi police, adds: “These factors make the recovery process after surgery better. and ideally, and it is important to maintain the level of functional status at the highest possible level in men other than The injured knee will also be used as a comparison to assess the progression of the affected knee.
The first week after surgery.
Raafat believes that immediately after the operation is performed, the treating doctor performs a test (Test) on the knee to ensure the success of the operation and, after a few days, the physiotherapy period begins, which lasts from 2 to 3 weeks.
Raafat says: “There is what is known as (painless natural therapy) and it is different from what is done in Egypt. In Europe, especially in Spain, the player begins the physiotherapy phase on the second day of surgery.”
For his part, Tariq Suleiman believes that the movement of the player immediately after the operation is important, since he uses crutches with a light load on the foot, with individual exercises and flexion of the knees (lying on the bed).
Suleiman advises the injured player to use a “knee” after the operation to preserve the patch that was installed, and it is monitored at each period according to the development of the injured player’s condition.
Qualification period
Al-Najjar believes that: “Traditional rehabilitation programs after ACL reconstruction were based on avoiding movement for a long time and not bearing weight. Now they are more powerful and require a quick return to sports activities that help to a good rehab. “
He continues: “The return of the player to the exercise of his own activity. She is judged after ensuring the stability of the reconstructed ligament, regaining confidence, postoperative times and the opinion of the medical team.”
Raafat (the Egyptian physical trainer) increases: “The rehabilitation phase takes 6 to 9 months, each month is divided into four stages (each stage lasts one week). In the first week, the player uses crutches to move and does not put your (injured) foot on the ground, and once the wound has healed hydrotherapy begins.
“During the second week, the player straightens and bends the knee in what is known as the knee range recovery phase, and after 45 days (6 weeks) the player enters another stage, which is to restore muscle volume to knee”.
He continues: “After 3 months, the player begins with regeneration exercises of brisk walking for 15 days, followed by joint stimulation exercises to test reflexes.”
Al-Masry’s physical team continues: “At the end of the fourth month of the injury, the player begins the process of straight running (in the forward direction) for two weeks, followed by a straight and multi-sided run (right and left. ) for another two weeks, and then he starts training with the ball. “
And he continues: “With the beginning of the sixth month, the injured player begins the stage of recovery of physical capacities (a mixture of running and training with the ball) before reaching the final stage of recovery of confidence in the field” .
After qualifying, Raafat advises players to continue doing “special” workouts in the gym to preserve muscle, as there are exercises to prevent injury.
Al-Najjar agreed with him, highlighting the need not to neglect the other man so as not to suffer another injury after the player returned to training, and stressed the importance of strengthening the muscles (rear – front – calves).
Yallakora led it by asking about the difference in one player’s ability to bounce back from another, and what are the reasons?
Wael Raafat says: “Certainly, the resilience of one player differs from another, as some need 6 to 9 months, and the other exceeds nine months, and this is due to several reasons, including: individual differences between players, poor qualification, urgency in the return of the player and not being well qualified, affecting the period of physical preparation, along with physical construction and muscular balance, which varies completely from one player to another.
As for Tariq Suleiman, he believes that the difference in the return of one player from another is due to several reasons: the success of the surgery, the will of the player, the capabilities of the rehabilitation center, the speed of the muscular response and the physical capabilities of the player.
Another question asked by Yallakora is, are there players who are more vulnerable to Al-Salibi than others and what are the reasons for the recurring injuries?
Al-Masry’s physical trainer says: “Yes, there are players who are more vulnerable to injury than others, unlike the physical structure that differs from one player to another, there are other factors that can cause an increase in the rate of A player’s injuries to his teammate, such as staying up late, poor nutrition, and lack of training.
Regarding the reappearance of the injury after a short period, Raafat believes that the lack of complete preparation for the player’s return to the games causes a repetition of the injury, as happened in the case of Mohamed Mahmoud, since the player did not I was 100% ready.
For his part, Suleiman, a former doctor for the Egyptian team, believes that the recurrence of the injury in the same foot is due to an error in the surgery, or the method of choosing the patch.
But if it is with another foot, it is likely that the incorrect qualification is one of the reasons for the return of the injury or neglecting the rehabilitation of the “healthy” foot, as is the case of Mohamed Mahmoud, the Al-Ahly player, in addition to the quality of some training sessions carried out by the players.
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