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Aug 8, 2014

European injury report

Bayern Munich midfielder Bastian Schweinsteiger doubts he'll appear in the German Super Cup final against Dortmund.

Join us for regular injury updates every Friday throughout the season with physioroom.com (@physioroom), starting with who might struggle to be fit for the new campaign.

Xavi Hernandez, Barcelona
Injury:Calf strain
Fitness chance for season start: 80 percent
Background: Training ground

Barcelona's veteran midfielder, who is rumoured to be leaving soon for new MLS side New York City FC, sustained a slight calf injury as the start of the club's preseason training. Nevertheless, chances are still good that the former Spain international can feature in the club's opener.

Expert view: Earlier this week, Barcelona confirmed Hernandez was being assessed by club doctors following a calf problem during preseason training. Although the full extent of the injury is not yet known, the early indications are positive, with only a slight feeling of pain and tightness noted by the player; a clear indication the damage is only minor. Xavi will have an MRI to confirm the diagnosis with a Grade 1 tear -- which signifies damage to only a few muscle fibres -- typically requiring up to 21 days to ensure full recovery. However, after a short period of rest -- around five to 10 days -- Xavi should be able to resume light training -- Sports injury expert Ben Dinnery

A calf injury has kept Xavi on the sidelines during Barcelona's preseason.
A calf injury has kept Xavi on the sidelines during Barcelona's preseason.

Nuri Sahin, Borussia Dortmund
Injury: Patellar tendinitis
Fitness chance for season start: 50 percent

Background: Training

Borussia Dortmund will need the Turkish international back in the fold as soon as possible should Juergen Klopp's men wish to make a run at last year's champions, Bayern Munich. Sahin appeared in 31 Bundesliga matches last season for Dortmund, but that number could be lower in 2014-15 should his knee problem persist.

The injury bug has once again bitten Borussia Dortmund's Nuri Sahin.
The injury bug has once again bitten Borussia Dortmund's Nuri Sahin.

Expert view: Sahin has emerged as a doubt for the start of this year's Bundesliga after the midfielder was forced to leave his club's training camp in Switzerland to undergo tests on a persistent knee problem. On examination, analysis indicated an inflamed tendon brought on by increased activities causing microscopic tears to fibres that make up the patella tendon just below the kneecap. Because of the amount of stress placed through the tendon by repetitive running, jumping and landing drills, the problem is exacerbated and symptoms gradually increase discomfort. Generally, it is advised to refrain from this type action while alternative exercises may be incorporated during a player's rehabilitation to help maintain cardiovascular fitness. Sahin is expected to miss around three weeks in the first instance. -BD

Alvaro Morata, Juventus
Injury: Left MCL injury
Fitness chance for season start: 30 percent
Background: Broke down on the first day of training

After scoring nine goals for Real Madrid in 2013-14, Morata hoped for better things when he moved to Juventus, but an MCL injury has put the brakes on any visions of grandeur thus far in Turin, Italy.

Expert view: Eager to impress on his first day at a new club, Morata suffered a medial ligament sprain just weeks after signing from Real Madrid, a problem which is likely to keep the attacker out until September. The medial, or inner, ligament acts as a stabiliser for the knee, and a scan confirmed extensive damage -- a Grade 2 tear -- although the ligament did remain intact. Normally, this type of injury is caused by either an external force -- player collision -- or by a player's studs being caught in the turf when trying to turn. The expected duration for rehabilitation is six to eight weeks; with the knee being immobilised, this can help to support, protect and reduce swelling. Light training activities -- such as biking -- will be incorporated into a phased recovery program as pain permits, combined with proprioception exercises -- the body's ability to sense movement -- to help protect against injury recurrence and improve coordination. A return to full activity within 56 days is realistic, although minor stiffness and soreness can persist for up to six months. -BD

Cristiano Ronaldo, Real Madrid
Injury: Left knee injury
Fitness chance for season start: 95 percent
Background:Ongoing

Never one to be held back, Ronaldo made his first Real Madrid appearance in last weekend's friendly defeat to Manchester United in front of a packed house at the University of Michigan stadium. Still, a nagging knee injury could become a major concern for Los Blancos in 2014-15.

Expert view:Ronaldo has overcome a variety of muscular problems this year, but hampering his return to full fitness and form has been the Portuguese attacker's ongoing battle against tendinitis, a condition which underlined his disappointing World Cup and one which threatens to cause problems for the remainder of 2014. Rest is paramount in the management of this overuse injury, but, despite advice from his club's medics, Ronaldo seems determined to decide when he is fit for duties, potentially placing his long-term health and well-being at risk. As the condition progresses, symptoms gradually become worse, and if they persist, surgical intervention might need to be considered, although only as a last resort, as its success cannot be guaranteed. Ronaldo has trained ahead of Monday's Super Cup game against Atletico Madrid, but expect concerns regarding his fitness to rumble on. -BD

There are sure to be concerns over Cristiano Ronaldo's knee this season at the Bernabeu.
There are sure to be concerns over Cristiano Ronaldo's knee this season at the Bernabeu.

Bastian Schweinsteiger, Bayern Munich
Injury: Ankle
Fitness chance for season start: 90 percent
Background: Preseason friendly

Schweinsteiger has likely received warmer welcomes, as the German World Cup star had his ankle injured in a tackle during Bayern's 2-1 defeat to the MLS All-Stars. Thankfully for the German champions, it does not look to be a serious one for the veteran midfielder.

Expert view: Wednesday night's MLS All-Star game in Portland, Oregon, was meant to serve as the perfect preseason preparation for Bayern Munich, who begin their defence of the Bundesliga title in two weeks' time. However, what Bayern boss Pep Guardiola didn't account for was a pumped-up team out to prove a point, which resulted in German international Schweinsteiger being withdrawn minutes before full-time after he was on the receiving end of an over-exuberant challenge during his brief cameo. Postmatch reports suggest the midfielder suffered only heavy bruising with no ligament damage, although Schweinsteiger will have a scan and X-ray to ensure there is no fracture. Small vessels under the skin tear and blood leeks into the tissue causing a discolouration; in terms of treatment, the area may be immobilised in the first instance to help protect and fix the joint, while compression and cold therapy will help to reduce swelling. -BD

Gianluca Pegolo, Sassuolo
Injury: Broken leg
Fitness chance for season start: Zero
Background: Collision in training

Pegolo's 2014-15 season is over before it even began after a training-ground clash resulted in a broken leg that will force the netminder to wait until 2015-16 before seeing any further action.

Expert view: Serie A side Sassuolo will be without goalkeeper Pegolo for a minimum of two months after a collision in training left the player with a fractured tibia. Treatment options depend on the type of fracture; if the two bones remain in relatively close proximity, as in this instance, then the surgeon may decide to move the two fragments together under general anaesthetic and fit a cast to immobilise the site. More severe fractures require additional support to fix the bone; options include a screw-and-plate technique, a nail down the bone or using an external fixator. These methods allow for an earlier and more active rehabilitation. In addition, the patient is less likely to suffer from muscle atrophy (wastage) and from joint stiffness. Rehabilitation can begin once the fracture site has healed, which for mid-shaft injuries is approximately three to four months. -BD

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