Sports and injuries go side by side. A player who does not
sustain injury is a virtual player. Football player sustain numerous injuries.
Most of the renowned players have undergone surgeries for their knees, ankles
and wrist. Ronaldo (BRAZIL) underwent 3
surgeries for his injured knee ligament. He was prone for knee injury as his
body was disproportionate. In spite of repeat injuries he could push himself
and compete with the world’s giants. The
other giant injured his ankle, Ronaldo (PORTUGAL). He had just recovered and
was dragging himself to represent his country for this world cup. In general
football players sustain lower limb injuries more than anything else. Toe
injuries, ankle twisting, knee twisting, hamstring pull, muscles tear are few
of the common injuries. Apart from these they have fair chances to sustain
upper limb injuries, like wrist ligament injuries, finger injuries and shoulder
elbow trauma while protecting themselves during landing. Back injuries are not that common as they
have good reflex to protect their back and they are trained to protect back
during fall and landing. Football player prioritize and try to prevent knee and
back injuries as they take longer to heal and require prolong rest and
surgeries many times. Trauma and rest for a football player is a huge loss. It
is a physical as well as a monitory loss for them. So they are trained such a way that they
pretend to fall and they hardly sustain injuries. They know how to protect
various body parts during fall. But not all the time it works, and they too
sustain real injuries. Let me concentrate to the injury that very few players
have sustained so far. Most unlucky was Neymar who sustained this injury last
night.
Spine injuries for the world rated player is a nightmare to
the doctor and the player as well. To
examine, opine and treat such demanding professionals is a herculean task. No
single surgeon or physician is ready to take up such challenges. That is the
reason a group of physicians and surgeons are appointed to treat such players.
The best in the globe are hired to treat the best in the world. But even for
the best It’s a heart pounding task to decide to operate or not to operate.
Neymar sustained a direct knee thumping over his back by
defender Juan Zuniga. Immediately he fell down.
This mode of direct thumping in the center of back results the fracture of spinous process of
the vertebra. The direct injury in the side (off center) may result fracture of transverse process of vertebra. But it requires more impact as transverse process is way deep and covered by muscles. It also results the hyperextension (backward bending) of the
spine resulting the opening up of the anterior column resulting injuries of the
ligaments of anterior column. This is what I feel Neymar has sustained. Other
possibility of injury is hyperextension injury of his back while landing. This
is high-energy trauma, which can cause more extensive injury than the previous
one. This can virtually cause trauma to all the column (anterior, middle and
posterior) of the vertebra. In that case his recovery will take a longer, as he
might need surgery as well.
There are very few posts regarding his injury. The team of
doctors first verifies these injuries and then they are circulated to the
media. So Far he has been evaluated with X-ray and CT scan. CT scan was
suggestive of fractures. This much was given to the media early morning. Few more details have been disclosed day time. The specific level of vertebra L3 is disclosed, the part that got
fracture is the transverse process of L3. The associated injuries of ureter and kidney is to be seen in such cases. Probably he will be evaluated through MRI again and the injury details will be officially disclosed. That is what I
believe the experts are planning. The
official doctor of the Brazilian team Rodrigo Lamsar says “ Unfortunately, he
is not going to be able to play. He is very, very sad. It’s not serious in the
sense that it doesnot need surgery, but he will need to immobilize it to
recover” and the expected recovery period is few weeks….
With his statements what I can presume is he has
suffered a fracture of transverse process of L3 and that is being treated conservatively
with rest and immobilization. This is moderately a painful condition. The movement in the hip and lower limb will increase pain as iliopsoas muscle is attached to the fractured tip and that muscle in attached to the part of femur in the LT below hip joint. So initial few days will be complete rest to manage pain. Spine immobilization will be done by lumbar brace. A minimum immobilization of 6 weeks is an optimal time for such
fractures to heal. Sometimes it takes a longer course and takes up to 12 weeks. In rare cases it fails to unite and stays ununited. But it does not require surgery. By this time the ligamentous injury also heal. But, Does this mean he will be
able to play after 6 weeks or 12 weeks in the worst case. The answer is a BIG
NO. The immobilization and rest will waste his back muscles; his thigh muscles
and entire fitness will be low. So he will take few more months to regain his
fitness. I feel a minimum of 3-5 months will take to bring his form back.
During this time he will miss couple of interesting games including the semi
and possibly the final too.
