Physio Room Blog: Everton Pre-Season Uncovered

Wigan's manager, Roberto Martínez

Everton’s players return to pre season training this week to be put through their paces by Dave Billows and his sports science team as the infamously gruelling pre season programme commences. To gauge what’s involved in the  process, EB spoke with Ross from @UKPhysiotherapy to get some more detail on what this entails and how it will potentially change under new boss Roberto Martinez, who himself is a qualified physiotherapist.

1. Generally, in terms of performance, how crucial an edge can pre season give both in the short term and in the latter stages of the season?

The closed season and pre-season are crucial to players, not just in terms of making a good start like we did at home to Man U but in terms of longevity and not suffering injuries or fatigue later on in the season.  There’s a lot more science and preparation involved now than just taking the teams to Wales for the week to run up and down sand-dunes.  Pre-season is the time players get their cardiovascular fitness levels back and also train to get the right amount of strength and conditioning in their muscles to cope with the demands of the fast paced Premier League games.

From a football point of view I think players get to know their teammates and the style of play if they’re allowed a full pre-season with each other.  It’s not just about learning the style of play though, it’s then allowing the medical team to monitor a player’s progress so a change or tweak can be made to training regimes of individual players to help them become more physically suited to that style of play.

I suppose an example of this is under Walter Smith, the centre halves thigh muscles needed a lot more strength work to deal with the amount of long balls they needed to hoof up the pitch all season long!  Under Moyes, as Mirallas found out, he needed to fill out a bit more and work on that extra bit of fitness so he could ‘track back’.  I hope under Martinez, our team keeps the same level of intensity but pre-season will focus on ball retention, skill and any fitness work is done with an attacking mindset.

It’s no coincidence that players who we’ve signed late in August or have suffered an injury forcing them out of pre-season don’t tend to last the season.  Players like Baines, Jagielka, Distin (even at his age), Howard, Osman and Pienaar played a lot of games for us last year and all managed a full pre-season.  None of them suffered long term injuries.

article-1310025086251-0CE3658600000578-76759_466x310

Water-Way to have a good time

2. injuries and fatigue was a constant issue for Mirallas last season, missing a chunk of the season due to knocks and he was withdrawn over 90% of the games he started. Can a full pre season help remedy his ailments?

It’s not just pre-season that’s important for Kev but the closed season as well.  I don’t think he was quite ready for the pace and physicality of the prem last year hence why he had time out with a recurring hamstring injury.  Although we’d seen his skill and pace in a few tasty You Tube clips, a lot more consistency was expected of him at Goodison and he also needed to fit in to Moyes’ work ethic and the defensive unit.  I don’t think his hamstrings could quite take it.  Hopefully over the closed season the medical staff have given him a comprehensive strength, balance and flexibility routine to make sure his hamstrings are strong. Then once he’s back in pre-season and he starts his trickery and puts more force through his knees again his hamstring problems won’t hamper him next season.  I think Mirallas is going to be our key man next year so getting his preparations right will be crucial to how successful we are.

‘Swansea only lost 6 players to muscular injuries in 2012/13, one of the lowest in the Premier League. However their average of 37 days recovery was one of the highest, second only to Everton (53 days)‘ Source: www.physioroom.com

3.In the past, players like Saha have been critical of the emphasis placed on fitness in our pre season sessions at the expense of ball work. Does he have a point and does this make players more susceptible to injury? 

I’m a big believer that training should be functional.  It used to be pre-season was some sadistic ritual to just make the players throw up maybe to enforce some kind of discipline.  Moyes was guilty of this with his installation of ‘the hill’ at Finch Farm and taking them off to Austria for hill running where the oxygen levels are lower.  I’d understand this method of training if you wanted your players to be good hill runners but we need them to be good at football.  Martinez, himself has a physio degree (I’m reliably informed) so I think he will take a more scientific approach to pre-season than Moyes.  It’s well known the fitter you are the better your touch is on the ball so surely getting fitter whilst practising on the ball will give you better results?  I still think Moyes took an old school approach to pre-season and I’m sure Unsworth once said they were worn out heading into the start of the season.

There was a club I worked at once that used to take the players running up and down sand-dunes in Wales as part of pre-season. Three crucial 1st team players ended up missing the start of the season because of hernias caused by hill running.  It never makes sense to me to get players to do hill running to get fit when you play a game all season on a flat pitch.

Although I’m not sure what the best thing with Saha was because it didn’t matter what sort of training you did with him.  The rumour why Ferguson binned him at Man U was because he only ever declared himself at most as 80% fit.

efc__1364916245_gibbomm

Gordon Brittas would have been proud of this facility

 4. Last year’s pre season was heralded as a contributory factor in us bucking the trend of starting the season slowly. One of the differentials was not travelling to the states as we had done in previous seasons. This year we are going back to the US for the ICC trophy. Does travelling such long distances have a negative impact on a performance athlete’s body short term? Or is this a load of guff?!

Total guff I reckon.  We’ve seen plenty of players around the world all perform well despite travelling.  Man U often spend pre-season on the other side of the globe yet they seem to keep winning trophies. It’s hard to say but I think the reason we started better was because after the Euros and summer internationals, a lot of our better players missed that gruelling fitness camp running up hills in Austria.  They weren’t already knackered heading in to the new season.  Don’t get me wrong, fitness is very important but having watched so many crap starts to the season, I think Moyes’ way of doing it left a lot to be desired.

‘Wigan lost 1281 days to injuries in 12/13, the second most in the league behind Newcastle (1745). In contrast, Everton (714) lost the 5th fewest days, with Stoke (496)losing the fewest’    Source: www.physioroom.com

5. Pundits often talk of players needing to ‘get a good pre season under their belt’ but does it have any impact if you are, say Gibson who breaks down in game 3 like he did vs WBA last season? Does this in essence mean you are back to square one fitness wise?

Gibson is a bit different because I think his thigh problem is going to be one of those things that’s going to plague him throughout his career.  I think the medical staff at Man U must have suspected this hence why they gave us such a talented player on the cheap.  There may be something that can be sorted over the closed season and pre-season but he had a full pre-season last year and still broke down.  The good thing from a physio’s point of view is you do get a lot of time in pre-season to work with players and make sure they get fit.  Often during the season you don’t get that luxury, all you’re doing is patching them up to make sure they can play the next game.

 6. On the subject of Gibson, his long standing injuries are a real concern. How does this impact his performance and recovery? His portly midriff indicates he finds it hard to train between games?

I hate players who can’t keep themselves fit.  If any of us were in such a privileged position as Gibson then 90% of us would at least stay in peak shape.  I remember watching James Beattie blowing out of his arse at home to Charlton after 20 minutes and I’ve never forgiven him for that.  There are other ways of training with an injury and watching your diet to make sure once you’re injury free you come back quicker.  Ricky Hatton is a classic example.  If he’d have looked after himself more in between fights, he’d have found it easier to train for fights and maybe he’d have prolonged his career.

I don’t think there’s a sure fire way to get players and teams ready for the new season.  If I could crack that I’d be a multi-millionaire.  It seems you can think you’ve got it sorted because you win your first few games but then after Christmas the players are all knackered.  Apart from last season, I’ve always thought we looked lacidasical and our decision making and even touch on the ball was lacking.  Maybe Moyes did more ball work with them last year.  But Man U have been renowned for poor starts so even Ferguson didn’t know his best way of preparing his team.  I suppose even though we might hope Martinez might apply a more scientific approach and get the best out of his players, his Wigan sides have been shocking at the start of each season so who knows what we can expect!

Ross is a an avid evertonian and resident physiotherapist for UK Physiotherapy. You can follow him on Twitter here

For any grassroots players or coaches embarking on pre season in the coming weeks there is a highly recommended six week pre season diet and fitness schedule available to download from the coaching zone of the blog.

EB

Advertisements

Physio Room Blog: Mirallas set to miss Stoke trip

New Picture (101)

Like every other Evertonian inside Goodison, my heart sank to see Mirallas pull up and grasp the back of his thigh just before half time last Sunday.  Having watched in awe Gibson’s pin point passing, the out ball, to our flying winger, I knew we were in for a tough second half once Mirallas didn’t emerge for the second half.

I think the concern is this may be a recurrent problem for Mirallas, for this season anyway.  I had hoped after the good news of Mirallas’ scan that it was a niggle that would go away.  We’ve seen it time and time again though with young fast players (not so much at Everton as we’ve not had a flying winger since Kanchelskis) being prone to suffering these hamstring strains.  Ryan Giggs springs to mind and Michael Owen is another that has been plagued by hamstring and groin injuries.  Gareth Bale thankfully was missing against us because of a hamstring injury.

Reasons the hamstrings tear

Generally speaking the hamstrings are very stretchy especially in youngsters.  They don’t tend to tear from overstretching during running unless you’re a bit older.  The thing that struck me about Mirallas on Sunday is his hamstrings didn’t ‘pull’ whilst he was running full pelt so I doubt the injury reoccurred purely from just overstretching the hamstrings.  The other reason the hamstrings tend to tighten up is to protect the knee.  Every person with a knee injury I’ve ever assessed has always had increased tightness or spasm in the hamstrings behind the knee. Mirallas gripped the back of his thigh after a jinking run from the right wing area to the left side of the Spurs penalty area.  He was running but I suspect the hamstring tightness came on as a result of the twisting and turning occurring in the knee joint.  As the knee twists, the force of the body weight through the joint is transmitted through the 4 main ligaments, which resist this force to stop the knee collapsing.  The knee ligaments are packed with nerve endings that constantly fire messages to the brain and spinal cord telling our body what position the knee is in and to contract the muscles to change the position of the joint.  Sometimes the force through the ligaments causes them stretch to a point that a pain signal is triggered.  The body perceives pain as harm so the muscles around the knee, especially the hamstrings, tighten up around the joint to protect it from harm. For Mirallas, bearing down on goal, he carried on running and that’s when the hamstring tear may have occurred as he stretched against the body’s protective tightening of the muscle.

What can be done about it?

I talked in my last blog about how the hamstring tear can be treated but Mirallas will now have to embark on rehab training to prevent this injury becoming a persistent problem.  This involves specific strength work, not just to bulk up the muscle but also to gain better control through the muscles around the knee to improve balance and fine movements and better resist twisting movements.  This however takes time and is why Mirallas might not be free of this problem just yet.

Improving proprioception

Proprioception is a fancy word given to your balance reactions.  It’s a bit more than that though.  It’s your ability to know what position your joints are in and what force is required to perform a certain movement.  An example of this is to close your eyes, point your finger out to the side then place your finger on your nose.  Providing you’re not drunk and you managed to do it, how did you know what position your arm and hand were in order to touch your nose?  How did you know not to slam your hand into your face and break your own nose?  That’s the proprioceptive reaction.

New Picture (13)

If you transfer this to running, your proprioception is the reaction that controls the fine movements of your leg.  The better your proprioception, the better control you have of your joints and therefore the less chance you have of injury.  Another example of this is to stand on one leg and keep your balance.  Now close your eyes and keep your balance.  How long did you manage?

Your proprioception can be trained to improve.  If you spend time standing on one leg with your eyes closed, you will find the more you practice the longer you can stand without falling over.

This is low-level stuff but is your basic starting point to improving your proprioception.  For Mirallas, rehab should be progressed to involve different types of balance exercises, practicing twisting movements and fine control of the knee joints through the range of movement.  On top of this, more traditional strength sessions in the gym to bulk up the hamstrings will no doubt take place.  For now, Mirallas should recover quickly from the current hamstrings pull and Moyes said he took him off as a precaution but expect Mirallas to be in and out of the side this season because of his hamstrings.

Expected return: 1-2 weeks.  West Ham away.

By Ross @UKPhysiotherapy

Physio Room Blog: Will Baines & Mirallas make Man City?

New Picture (107)

Since the last blog, we’ve seen ‘Hibbo’ and ‘Gibbo’ return to action against Arsenal.  Mirallas is still missing but pictures of him running around with a smile on his face from todays open training session seem encouraging.  However, in the same way other teams are struck down by a cold or flu virus, our team seem to be coming down with hamstring strains as though they’re catching.  The latest news is that Baines may have now injured his and could miss Saturday’s game at Man City.

It does seem I’ve been a little too optimistic with my predictions so far about when our players will be able to play again.  I was disappointed not to see Gibson or Mirallas feature against Norwich.  Without disrespecting Norwich too much, if we’ve any designs on finishing in the top 4, this was a must win game.  Gibson had managed 64 minutes a week earlier with no reaction to his thigh injury and the noises from Everton about Mirallas following a positive scan result suggested he’d be back within 2 weeks.

Mirallas – to play or not to play?

INJURY: Hamstring strain

Unfortunately, the decision about when a player is fit enough to play is not an easy one. From the sounds of it, the scan on Mirallas’ hamstring didn’t show much damage so the decision about whether to play him, will have been based on how his leg felt when running.  If Mirallas reported any tightness Moyes will have then been faced with the dilemma about whether to risk him.  Sometimes, tightness in a muscle is just that and with a few stretches you can run it off.  Tightness can be a warning though, a precursor to a more significant injury.  So do you risk your star player in one game in the hope he has no reaction to his injury but a flare up could see him missing the next 6 games? Many a physio and manager have fallen out in football clubs over the years about when a player is fit to return.  Benitez’s over reliance on Torres at Liverpool is a good example of where I’m sure the medical team will have wanted to give the player more recovery time but the manager knew not playing him greatly reduced their goal threat.

Lets hope the caution shown by Moyes and the extra week’s rest will see Mirallas now go on an extended run in the team and we can get back to winning ways again.

Predicted return: Saturday (Man City away)

Baines

INJURY: Hamstring strain

The Everton site is saying Baines has suffered a slight hamstring injury.  Baines managed to finish the game last night so hopefully this is certainly no more than a grade 1 tear.  If it’s just a bit of tightness then a few days rest and some physio treatment should see him return to action in the next game.  A tough call again for Moyes with the busy Christmas schedule approaching.

Predicted return: Saturday (Man City away)

Neville

INJURY: Knee surgery

Predicted return: 4 to 5 weeks (Swansea home)

Anichebe

INJURY: Hamstring strain

Predicted return: 1 week (Tottenham home)

How to rehab a hamstring strain


New Picture (107)

This is just a bit of general advice on how the hamstring strain is managed and treated.  The extent of treatment depends on how bad the strain is.

1-2 days:  When any muscle or soft tissue is torn, there’s an initial acute inflammatory reaction, which lasts about 48 hours.  During this time there’ll be pain, swelling and bruising around the injury site.  Bending the knee will also be very painful.  Initial treatment is following the RICE principal – Rest, Ice, Compression, Elevation.

1-2 weeks:  At a football club, a scan will be done to assess the extent of any damage.  If the damage is minimal, some massage will be done on the hamstring to help reduce the tightness.  Maintaining strength and flexibility is important to protect against further injury so it’s likely the player will perform low resistance non-weightbearing exercises such as the exercise bike or swimming or running in the pool.  If there’s no reaction to this, the player can start to run on dry land in straight lines.  Again if there’s no reaction to this the player can then return to ball work and twisting and turning in normal training.

If a scan shows more significant damage, it’s likely the player will still have to apply the RICE principle during this time and will be given crutches to avoid putting too much weight through the injured leg.

3-4 weeks:  Hopefully if a player has suffered a grade 1 tear, they’ll return to playing in this time. Extra strength work will be done in the gym and regular massage and ultrasound therapy will help limit any scarring in the muscle.

If it’s a grade 2 tear, they can ditch the crutches and start some light rehab in the pool.  Specific physio treatment will include regular massage, ultrasound therapy, hamstring stretches and specific hamstrings strengthening exercises.  It’s important that the muscle length is maintained and scar tissue is limited to prevent further injury.

4-6weeks:  Grade 1 tears should have resolved by this point.  Players with a grade 2 tear will step up their work in the gym to build up strength in the damaged muscle.  Gradually the player can progress from low loading exercises such as the exercise bike and swimming to light jogging.  The physio will monitor the player closely to see whether there’s signs of any further damage or inflammation.  Massage and stretching will continue on a regular basis.

6-8 weeks:  The player can return to running and then normal training.  There is a risk of tearing again as there will be weakness in the muscle at the site of the original tear.  If the hamstrings have been kept strong and flexible during the period of the rehab then the risk is greatly reduced.

Follow Ross @UKPhysiotherapy

New on the blog today: Scout Report – Moyes Tactical Blueprint for Man City

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

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