Recent ankle surgery is likely to keep José Fonte out of action for some time

With David Moyes taking over from Slaven Bilić and the ongoing debate about how well he’s going to fit in at West Ham United, media coverage from East London has certainly been high-profile of late.

And this is all before David has even taken charge of the team on a match day yet!

There seems to have been so much discussion and debate over his appointment that the injury situation David inherited has largely been forgotten.

Although the new manager has promised that everyone will start with a clean slate, that’s assuming that everyone is fit enough to do so.

David takes over a squad who have been missing some key players for some time and he’s going to be keen to get everyone back in training and (obviously) playing as soon as he can.

The international week that’s just finished isn’t going to have helped matters with so many West Ham United players being away on duty with their home countries.

Chicharito is already reported to have sustained a hamstring muscle injury; the full extent of which we will shortly know.

Hammers Head of Sports Medicine Gary Lewin recently referred to the “international break” as being nothing like a break and this time around will have been no different either.

On the injured list when Slaven Bilić was dismissed were José Fonte, Michail Antonio and San Byram. James Collins had only just returned to training several days beforehand.

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Most prominent of the absentees from training at the moment will undoubtedly be José Fonte; who underwent surgery to repair an ankle injury sustained at Selhurst Park against Crystal Palace.

With defenders in short supply for Slaven’s last game in charge against Liverpool, the Portuguese stopper’s presence was sorely missed and his return isn’t anticipated to be for some time yet.

When you consider that José is facing a period in a walking boot once he comes out of plaster and that will be followed by wearing an ankle brace, progressions from one protective modality to the next can only be made at the appropriate time.

The protocol of cast to boot to brace is the standard following ankle surgery and transition between one to the other cannot be measured in days or weeks; only by the quality of the healing process.

Repair of damaged tissue can’t be “speeded up” as people like to think; but the key to successful ankle rehab often lies in allowing the tissue damage to heal properly whilst at the same time facilitating movements and regaining strength and flexibility.

Since you can’t facilitate the actual movements until the ankle comes out of the cast, patience is called for in the early days until the cast comes off and rehab proper can begin.

This is when the early movement and initial strengthening and flexibility work will then come in and an indication of how long the recovery period is likely to take can be given.

The initial estimate of early in the New Year is unlikely to be far off based on the fact that all this takes time.

Since the success or failure of rehabilitation from any injury or operation is generally the result of how well the condition is managed in the early days whether post-injury or post-surgery, you can guarantee that Gary Lewin et al. aren’t going to rush things.

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It’s quite a common occurrence for a player to sustain an ankle injury and then try to play on as José did.

He mentioned that he did try to continue, but he felt a sharp pain and clicking in his ankle every time he moved. Clicking and clunking is usually synonymous with instability; and often surgery is required to correct this.

Once the decision has been taken to operate, the whole process then has to take its course.

It becomes a matter of following the correct procedure, progressing the rehabilitation at the appropriate stages, and giving nature a helping hand by not doing anything to make matters worse like trying to come back into the team too early.

David Moyes will be desperate to get off to a good start this weekend. If he can manage to get West Ham United playing in such a way that the club begins to climb slowly but steadily up the league table, then everyone will be a lot happier.

That always makes it easier to manage the absence of anyone with a longer-term injury.

So by the time José Fonte is fully fit and ready to play again, he could well find himself coming back into a team who are in a far more positive situation than they were at the time his injury occurred.