Sometimes in football you get away with carrying minor injuries into games and at other times you don’t.
For West Ham United’s Mark Noble it was a case of the latter. The midfielder was forced to withdraw late in the first half with hamstring pain during last Saturday's 3 - 0 win over Stoke City at the Britannia Stadium.
Mark admitted to the media that he had felt some discomfort in the hamstring muscles last week in the league game against Arsenal. Mark will now miss the second match against the Gunners, which this time will be the League Cup tie at the Emirates Stadium on Tuesday evening, plus other games as appropriate.
It’s always a disappointment when a player has to come off with an injury; but sometimes it’s better to be safe than sorry. Clearly Mark was feeling this on Saturday and sometimes that’s just how it goes.
In an ideal world every player in the league would turn out for the games only if absolutely 100% fully fit and without risk of repeat or recurrent injury. In the real world, though, it just doesn’t work like that.
Most people in football accept that players are rarely - if ever - 100% fit when they return from injury. But that doesn’t always mean that they are returning to play too soon.
There’s a big difference between attempting a come-back when it’s blatantly obvious that they’re nowhere near ready and someone like Mark who has maybe felt a niggle a few days ago but has come through several training sessions unscathed since.
In addition to Mark, both Pablo Zabaleta and Marco Arnautović picked up soft-tissue injuries against the Potters.
Marco is reported to have sustained a calf muscle strain; while Pablo Zabaleta is reported to have played for the majority of the game with a bruised thigh muscle - aka the ‘dead leg’.
David Moyes also mentioned in his lunch-time press conference that Andy Carroll has been struggling with some back pain but will be considered for the Arsenal game; with a decision likely to be made over Andy’s fitness on the day of the match.
There’s no need for David Moyes to make any decisions before then; either about Andy Carroll or any of the other players who are said to be carrying injuries.
His main concern will be over whether he should take any risks with anyone who might not be at the level of fitness he would have liked, or who may have picked up an injury in the Stoke City game.
Marco and Pablo immediately spring to mind. In the knowledge that players are always keen to play even when carrying an injury that they perceive to be minor, any decisions of that nature will be left to the medical team.
Even though the input from the players involved will obviously be heard, nobody wants to take any chances at this stage so managing the risks of aggravating any underlying injuries will be high on the list of priorities.
So as Mark Noble is forced to sit out of the game at the Emirates, he becomes yet another victim of football’s most frequent muscle injury; and one which has affected many of his colleagues in recent times.
Chicharito, James Collins, Michail Antonio, Cheikhou Kouyaté, and Winston Reid have all suffered with hamstring injuries; and as mentioned last week, this is a problem in football that is not solely confined to West Ham United.
The statistics say that this is the most common lower limb muscle injury in the game (Ekstrand et al, 2011; Ueblacker et al, 2015); and it would be hard to find any manager, coach or medical person to argue with this, not to mention the players themselves.
Various solutions have been suggested, particularly with regards to preventing recurrences of these injuries, and many of these focus on introducing specific types of exercises in the later stages of rehabilitation.
Other suggestions include continuing these exercises for some time even after the injured players have actually returned to the team.
The thinking behind this is that there’s a tendency to think that the minute you are back playing, then the problem has been resolved; and its fair to say that in the majority of cases it has.
But we all know that making such sweeping statements can be dangerous; and when dealing with injuries there’s nothing more likely to bring you back down to earth with a bang than assuming everything will be fine.
So its fair to say that David and the medical team will be exercising the utmost caution in the weeks to come; particularly with the difficult fixture list that lies ahead.
Ekstrand J, Hagglund M, Walden M (2011). Injury incidence and injury patterns in professional football - the UEFA injury study. British Journal of Sports Medicine. Vol 45 (7); 553 – 558.
Ueblacker P, Mueller-Wohlfahrt, Ekstrand J (2015). Epidemiological and clinical outcome comparison of indirect (strain) versus direct (contusion) anterior and posterior thigh muscle injuries in elite male football players: UEFA Elite League study of 2287 thigh injuries (2001 – 2013). British Journal of Sports Medicine. Bjsports - 2014-094285 Published Online First: 9 March 2015.