Physio Room Blog: When will Gibson & Mirallas be fit?

Welcome to a new EB feature brought to you by Ross from UK Physiotherapy which focuses on our players currently on the treatment table and when we may next see them back in action. Over to Ross….

Basically, I’ll try and explain a bit more about the injuries suffered, why and how it occurs and most importantly how long you can expect the injured player to be out for. This is infinitely easier now Saha is no longer on Everton’s books!

I’d like to add something of a disclaimer though. I am not an ITK. I have no links to the medical team inside Goodison and no access to any of Everton’s players’ medical records or scan results. Anything I write in terms of recovery is an estimate based on the length of time you may expect someone with that type of injury to be out for. I’ll try and amend anything if I’ve called it wrong. Sometimes it’s just useful to know what part of the body is involved when you hear “ACL tear” or “hamstring strain”.

For any possible medics or other physios who read this, if you think I’ve explained something badly, I welcome any constructive feedback.

Kevin Mirallas

INJURY: Hamstring strain

Having established himself as our main attacking threat this season, this is probably the injury we’re all sweating the most on in terms of wanting to know how long our flying Belgian winger is out for. I’m hoping from Moyes’ recent comments, it won’t be too long.

The Hamstring
The hamstrings are a set of 3 long muscles that run down the back of your leg. They start from your saddle bone and the top of the leg and run down to insert below the back of your knee. Their action is to move your hip backwards and bend the knee. They help generate a lot of power to help propel you forward when running.

What is a ‘strain’?

Often when referring to any muscle injuries, you’ll hear the word ‘strain’ or ‘pull’. These words effectively mean a small tear in the muscle or some damage to the muscle fibres. As a reaction to this damage, the muscle goes into spasm and tightens up hence the feeling of a ‘pull’. The damage to the muscle usually occurs when running at full speed and the leg is at full stretch. The force going through the muscle to then bend the knee from the outstretched position can sometimes be enough to cause the strain.

There are 3 different grades of strain or tear:

• Grade 1 – very small tear. Usually pain local to the tear is felt and some tightening of the hamstrings. Straightening the knee can be sore but achievable and a resisted knee bend can also be painful. The player should still be able to walk. In some cases a player can stretch the hamstrings and carry on playing.
Expected recovery time: 2 -3 weeks

• Grade 2 – a more severe tear. Pain is felt immediately and the player appears to ‘pull up’ while running. The player is unable to carry on playing. Often a bruise at the back of the leg becomes visible and the leg can also become swollen. The player will find it very difficult to fully straighten the knee and walking will be very difficult to start with.
Expected recovery time: 6 weeks

• Grade 3 – a large section of the muscles tears. Similarly to a grade 2, pain is felt immediately. In this instance, it is likely the player will be unable to weightbear and will have to be stretchered off. The symptoms are the same as a grade 2 tear but more severe. Walking is very difficult and the player would usually have to use crutches for 1 or 2 weeks.
Expected recovery time: 6 – 12 weeks

Judging by the way Mirallas was able to walk off the pitch, my hope is Moyes took him off as a precaution to prevent a grade 1 tear becoming a grade 2 or 3. Also as Moyes stated “It looks as if (Kevin) has maybe got a slight hamstring injury. I don`t think it`s too bad but until it`s been scanned we wouldn`t be able to say what it was.”

Expected return: The scan may show something but everything points towards this not being too serious so I’d hope Mirallas will be back within 2 weeks in time for the Norwich game.
Darron Gibson

INJURY: Thigh strain

This one has me slightly puzzled. In September, Everton stated Gibson should be back within 4 to 5 weeks so I’d have expected Darron to be back by now. Gibson also tweeted 3 weeks ago that he’d be back soon after a scan, yet he’s only just started training again.

Thigh Strain

A thigh strain is an injury to the quadriceps muscles on the front of the leg above the knee. The quadriceps (or quads) are a group of 4 muscles that bend the hip and straighten the knee. The quads are the main group of muscles responsible for kicking a ball.

Similar to a hamstring strain, a strain to the quads is a tear to the muscles. The tear often happens where the muscles form a tendon just above the kneecap. As this is a muscle tear, the grading of tear is the same as talked about for the MIrallas injury – grades 1, 2 and 3.

From all the noises coming out of Goodison at the time, everything pointed to Gibson’s injury being a grade 2 tear, yet it seems to have taken an eternity for him to get back. Either the scan showed a more significant tear than first thought or Gibson’s suffered a setback whilst training. It’s quite common that some extra inflammation can set in around the site of the tear, which can be stubborn to get rid of. This’ll slow recovery down. My worry for Gibson is he has spent a bit of time on the treatment table since being at Everton.

Expected return: Hopefully at this stage Gibson will be back within the next week or 2. Reading is a possibility, Norwich should be more or a certainty.
Tony Hibbert

INJURY: Calf strain

You’ll start to notice a common theme to these muscle injuries. Once you’ve mastered the grading system of tear from 1 to 3, there’s not much more to it. Similarly to Gibson’s injury, I’d have hoped Hibbert would be back by now. Tony’s no spring chicken now though so maybe age is catching up with him and his recovery is slower because of it!

The Calf

The calf muscle is actually a group of 2 muscles – the gastrocnemius muscle and the soleus muscle. They can be felt as the bulky bit of tissue on the back of the leg between the knee and the ankle. These 2 muscles form the Achilles tendon at the back of the ankle. The calf muscles act to stabilise the ankle and foot and help with the ‘push-off’ movement from the toes and foot when walking or running.

The calf strain
A strain or tear to the calf muscle often occurs at the point where the muscle becomes the Achilles tendon. If you want to impress your mates, this is called the ‘musculotendinous junction’. The grading of tear is the same as mentioned in the description of Mirallas’ hamstring injury, grade 1,2 or 3. Injury to the calf will prevent you from running or planting your foot to kick the ball. Standing on your tiptoes is also very difficult if you’ve suffered this injury.

There’s not been too much news out of Goodison about Hibbert’s injury other than he’s listed as one of the walking wounded during Moyes’ Friday pre-match press conference so it’s difficult to predict Hibbert’s recovery time. Often, though, a grade 3 tear of the calf or Achilles is an 8 to 12 month recovery (remember Yakubu?).
Expected return: 2 to 3 weeks
Victor Anichebe

INJURY: Hamstring strain

Has Vic even suffered an injury? Those who like a good conspiracy theory would like to think not although Moyes’ comments after the Fulham game fuel speculation: “I just decided not to use him at the last minute. I won’t elaborate on it anymore.”

If Big Vic has suffered a hamstring strain then read through the Mirallas injury information again.
Expected recovery: As he’s a youngster, I’d expect Vic to be back within the next 1 to 2 weeks. I’m not sure mentally how long it’ll take Vic to get right though!

Ross Whiteside, UK Physiotherapy
http://www.ukphysiotherapy.com
Twitter: @ukphysiotherapy