West Ham Post Match Injury Update

Despite the physical nature of the Bournemouth match, West Ham United look to have reported a clean bill of health after the game. Of course, that could all change in the next day or two as injuries that didn't appear to be an issue at the time come to the fore; but in that respect we'll just need to wait and see if anything develops.

Substitute Robert Snodgrass did take a heavy tumble at one stage and ended up on the gravel but appeared to recover quickly enough. There were initial concerns over goal scorer Michail Antonio, returning to the side after suspension, who also took a heavy fall and landed on his shoulder. Winston Reid, who had to be subbed against Chelsea suffering from cramp, managed the whole ninety minutes.

In the 48 hours leading up to the Bournemouth game, a potential doubt over Portuguese defender José Fonte dominated Hammers’ media sources. José was reported to have picked up an injury against Chelsea which hadn’t been mentioned in the press until the Thursday; but Slaven Bilić didn’t appear to have any real concerns over José’s fitness for the trip to Dean Court aka the Vitality Stadium. Specific details about the injury weren’t released at the time but will no doubt come to light in the week ahead.

We already knew that both Andy Carroll and Robert Snodgrass needed stitches as a result of lacerations sustained in the Chelsea game but the regular update provided by Stijn Vandenbroucke on the club’s official website in midweek explained that neither player would be a concern for the Bournemouth trip.

Photo by Bryn Lennon/Getty Images

After all, football is a physical game and it’s only to be expected that players are going to take knocks. Stitches on their own aren’t usually a problem for any player but often it’s trying to stem the blood that can be the main issue for the medical staff.

There’s nothing worse than trying to get someone back on the field as quickly as possible; only to be delayed by the difficulties in closing the wound. Additionally, the stitches themselves need to be inserted in such a way that the wound is safely – and cleanly – closed in order to prevent infection.

As if that isn’t enough, the problem of further injury is always present since Murphy’s Law says that if you’re going to take another knock then the chances are that it’s going to be in the exact same area and right over the original wound!

Both Andy and Robert played on Saturday as we all know; but until Thursday there had been no mention of José Fonte’s injury. That’s hardly surprising since it doesn’t do any good to give away too much in the immediate 48 hours before a game. The key as always lies in how well people perform in the Friday training session, since that’s usually when any final decisions on players’ fitness or otherwise are likely to be made.

Going back to Winston Reid for a moment, though, West Ham’s New Zealand international defender has had a few injuries himself over the past season. Who will ever forget that injury sustained earlier in the season when he took an elbow from an opponent? In more recent times, Winston’s also had a hamstring muscle injury (sustained against Everton in November) but reports after the Chelsea game on Monday night indicated that a ‘severe cramp’ was the reason for the Kiwi’s withdrawal.

He didn’t appear to be suffering from any adverse effects against Bournemouth, though, and Winston made his presence felt on a number of occasions in the physical sense.

Photo by Stu Forster/Getty Images

Although cramp as an entity can hit any of the muscles in the body, with footballers and runners etc. this is usually found in the calf group. Once it occurs, cramp is difficult to shake off and can be a worry in that it can easily recur; a fact which Winston will no doubt have been aware of in the lead-up to Bournemouth. Cramp, however, can often lead to further problems if not addressed.

The worry for the medical people in cases of recurrent cramp is whether the initial presenting symptoms could be masking the early stages of a deeper injury.

The calf group consists of the muscles of the gastrocnemius; which is the larger, bulkier muscle that gives the calf it’s characteristic shape, and the deeper soleus muscle which lies deeper and lower than the gastrocnemius, originating behind it’s lower fibres. These muscles then merge to form the Achilles tendon along with a third muscle (plantaris) although academics agree that the latter is less-frequently injured in footballers than the other muscles of the calf (Armfield et al, 2006).

However, it’s important to remember that injuries to the calf muscles can also affect the Achilles tendon and vice-versa.

Calf muscles tend to be the most susceptible to cramp; particularly the larger and more superficial gastrocnemius muscle. However, deep strains of the soleus muscle often present as cramp in the early stages. So if a player comes off with cramp or cramp-like symptoms, it’s well worthwhile keeping an eye on how the muscles respond.

Soft-tissue muscular injuries in general are common in football; with Ekstrand et al, (2011) reporting that 92% of all muscular injuries in football are known to affect the four major muscle groups of the lower limb. Of those, 13% are to the calf muscles; with higher percentages recorded for the hamstrings (37%), adductors (23%) and quadriceps (19%).

Of those players currently returning to full fitness, Álvaro Arbeloa has also suffered with a calf muscle injury that kept him out of action for several weeks. Álvaro was injured in December and as the January transfer window approached, there were concerns that he might have moved on at that stage. He hasn’t really appeared to have figured in Slaven Bilić’s plans since joining West Ham from Real Madrid last summer and the calf injury only complicated matters further.

Photo by Charlie Crowhurst/Getty Images

Along with his Spanish colleague and former Real Betis goalkeeper Adrián San Miguel, both are still battling away in training and hoping for a return to the first-team at the earliest opportunity. Adrián’s also had a calf injury if you remember; missing game time at the end of last season; as has Welsh defender James Collins.

Back to the present, however; and preparations will already be under way for the Hammers’ next game; a difficult-looking home fixture against Leicester City on Saturday. This will be the last game for the East Enders before the international break and providing no further injuries are reported in the next couple of days Slaven will be happy.

Players, however, have a habit of showing up with injuries when least expected but I’m sure that Stijn and the medical team will be prepared for anything that comes in over the next 48 hours or so!

References:

Armfield DR, Kim DH, Towers JD, Bradley JP, Robertson DD (2006). Sports-related muscle injury in the lower extremity. Clinics in Sports Medicine. Vol. 25; 803 – 842.

Ekstrand J, Hagglund M, Walde M (2011). Epidemiology of muscle injuries in professional football (soccer). American Journal of Sports Medicine. Vol 39; 1226 -1232.