Chelsea defender, Kurt Zouma, last week became the ninth player to be plagued by the most feared injury in football history, anterior cruciate ligament (ACL).
Zouma, 21, who has been a revelation thus far for the Blues, joined the list of afflicted players this season and will be sidelined for six months after hyper-extending his right leg against Manchester United.
Others sidelined include Callum Wilson, Tyrone Mings, Max Gradel, Tim Krul, Joe Gomez, Danny Ings, Carl Jenkinson and Jordan Amavi.
So what exactly is ACL?
ACL is one of the four major ligaments in the knee and attaches the femur (thigh) to the tibia (shin). It stops the tibia from over-extending excessively beyond the femur and prevents excessive rotation.
The stats
According to research done by Premierinjuries, this season could be set to see the highest number of ACL injuries.
At this point in the last five seasons, we’ve recorded six (2014/15), seven (2013/14), eight (2012/13), six (2011/12) and four (2010/11) cases compared to this season’s nine.
Possible causes
Just like in the case of Zouma, ACL is majorly caused by poor landing from a jump without necessarily any contact from another player. Suddenly slowing down and changing direction (cutting), pivoting with your foot firmly planted and receiving a direct tackle to the knee or collision are other causes.
The comeback
In relative terms, Zouma is lucky. ACL reconstructions have been going on for roughly half a century but the recent strides have been significant. Paul Gascoigne, for instance, was out of the game for 16 months after rupturing his ACL in the 1991 FA Cup final.
Rehabilitation process
After surgery, a physical therapy programme will help regain knee strength by returning motion to the joint and surrounding muscles. This is followed by a strengthening program designed to protect the new ligament. This strengthening gradually increases the stress across the ligament. The final phase of rehabilitation is aimed at a functional return tailored for the athlete’s sport.
The blame game
Experts and coaches vary on the possible causes of ACL. While some think the new style of the pitch is to blame, others are of the view that the modern training methods and football boot designs are the cause.
“It would be interesting to see some research into modern pitches and also footwear, which, on a lot of occasions, leave a lot to be desired,” Hull City coach, Steve Bruce stated.
Mark Leather, head of performance and medicine, Bolton Wanderer said: “A lot has been said about pitches. Firstly, I would say the new pitches are better, but they might be part of the problem, though that is a big “might”.”
Dr Ajeya Adhikari, leading orthopaedic consultant formerly of Crystal Palace, believes the boots are the major factor.
“Aside from the traumas you would expect from collisions and falls in sport, the boots are one factor.
“The focus on greater support to the arches and increased flexibility help with some aspects of foot and ankle problems but can increase the load on the knee.”
New training methods should be held responsible according to former Arsenal physio, David Wales.
He said: “Another interesting factor is about how the players move, particularly if they are trying a new method in training.
“There is the difference in movement that comes with the new routines and also the psychology of possibly trying harder for the new manager.”
