Physio Room Blog: Assessing Neville injury / Mirallas + Gibson Update

With only a squad of 19 first team players, my hope with this blog is that I won’t be called upon too often to write about Everton’s injuries.  I, like many other blues, breathed a huge sigh of relief when our international contingent returned unscathed.  I’m not sure many of us are that forgiving if one of our players is injured playing for their country.

Since the last blog none of our injured players have returned to action and another one has fallen.  Our skipper has his critics but is still an important member of the squad being able to cover so many positions.  I think another impact of Gibson being out for so long is missing ‘Fizzer’ from the defence.  At least once Neville and Gibson are back it’ll be like having 2 new signings!

Phil Neville

INJURY: Knee surgery

So far all we know about Neville is he’s had knee surgery and is likely to be out for 6 to 8 weeks.  I’m speculating but it’s likely, judging from the length of recovery time after knee surgery, that Neville has suffered a cartilage tear.  I may be wrong but there’s not much else it could be that would require urgent surgery but you can expect to be back playing in 6 weeks.  Ligament or tendon tears take a lot longer after surgery.

The Knee Cartilage

The cartilage is basically a protective coating over the ends of the bones to allow the bones to slide over each other when they move.  In the knee joint there is some extra thick horse-shoe shaped cartilage that rests on top of the tibia (the shin bone) called the meniscus (menisci plural).

The Tear

There are 2 main reasons the cartilage tears:

  1. Sudden trauma.  This occurs as a one off, for instance in a tackle where the knee is twisted and force from the incoming player is transmitted through the knee joint.  As the force passes through the joint, the cartilage tears.
  2. Repetitive trauma.  Through over use or repetitive actions of the knee the cartilage starts to wear.  This is normally age related (Neville’s not getting any younger).  Small bits of trauma in the joint that occur over the years cause small tears in the cartilage that go unnoticed.  Like a ladder in a pair of tights, one of these small tears can easily develop into a larger tear.

The Symptoms

The main symptoms include ‘locking’ of the knee joint where the torn piece of cartilage catches between the thigh bone and shin bone as the knee bends and stop the knee from straightening.  Sometimes this also causes the knee to give way, especially when twisting or changing direction.

The Cure

With most things in the body, a good blood supply is needed for it to heal.  Unfortunately the meniscus cartilage doesn’t have one.  Surgery is therefore required to basically chop out the offending piece of cartilage.  Physio rehab is crucial to restore movement, strength and control in the injured knee joint.  This usually takes 6 weeks.  Rushing back too soon could lead to further injury.

Expected return: 6 to 8 weeks, if Neville has indeed had surgery to correct a torn meniscus.

Update on other players

Darron Gibson: With Fellaini now suspended for our next game, Gibson’s return could never be more vital.  As predicted in the last blog, Gibson is on course to return against Norwich having lined up for Everton’s under-21 side against Reading.

Kevin Mirallas: After the Reading result, if ever we missed a player it was Super Kev.  It’s vital we have him back for the Norwich game.  As predicted in the last blog, Mirallas should only be out for 2 weeks after the scan showed very little in the way of damage.

Tony Hibbert: The club have given us very little info on Hibbert’s injury.  I suppose my worry is this is because they’re not sure how long it’s going to take.  If it’s straight forward, Tony should be back in the next week or two but if it’s one of those niggling injuries, it may take a lot longer.  I know Coleman’s struggled at times and I’d love to see Hibbo back in to add a bit more stability to the defence.

By Ross Whiteside.

Follow Ross on Twitter @UKPhysiotherapy

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One thought on “Physio Room Blog: Assessing Neville injury / Mirallas + Gibson Update

  1. Hi Ross,

    2 years ago I had an operation to repair a damaged Meniscus, I still get discomfort from it and a recent MRI said the ligament is less than 50% of it’s original size and basically I have to live with it. Are there any specific exercises I could do to try and get some strengh in to the knee.

    Thanks

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