by Pool and Darts »
01 Feb 2007 22:26
Royalupnorth RoyalBlue Royalupnorth you didn't answer my question!
What does our resident sports physio make of this news?
I find it absolutely incredible that Sonko apparently managed to play on, after he first went down, with his cartilage damage and his cruciate ligaments b*ggered up.
Or did one of those happen as a consequence of him deciding/being allowed to play on?
Be interested in your professional view now the full extent of the injury has been declared.
Its a rare phenomenon, but I mentioned it as a possibility at the time.
In rare cases a ruptured ACL can cause a spasm in the muscles that stabilise the knee (popliteus and parts of the hamstrings) This can allow people to carry on, until the spasm eases (usually due to fatigue) and the leg gives way.
It is impossible to assess a knee in this state as it would appear normal.
It is also impossible to say whether the cartilage was damaged during the initial injury or the subsequent giving way.
The one thing that shocks me is that if the ACL was healthy (and there is no reason why it shouldn't be) it would have a healthy blood supply. And when you rupture the ligament, you should be able to see swelling immediately as the knee fills with blood.
I have stuck up for the medical team throughout this, but I am amazed at the way the swelling wasn't obviously being managed on the sidelines. With immediate swelling, I would have had his knee in ice when he came back out of the tunnel, and he would have been wearing some form of compression support.
If they missed this - tut tut. If he didn't swell - he had a serious problem with his circulation and had a ticking timebomb in his knee.
Haemarthrosis doesn't always balloon up straight away, even in an injury as serious as this. I can take up to 24 hrs. So maybe the swelling wasn't that obvious when Fearny was checking him on the pitch.
The one thing that does cause me to think, is that if he ruptured the ACL on the first occasion he went down, then I know that JF was smart enough to be able to spot/carry out a positive anterior draw test - even if the hamstrings are spasming and providing active stability to the joint.
(have worked briefly with John Fearn - outstanding physio. always very impressed).
Or maybe Sonks did enough to convince him that he was OK the first time, and proper f***ed it the second. hmmm.
Either that, or he bluffed JF first time, then while running across the pitch before going down second time, was un-nerved by the instability in his knee that he was now obviously feeling when he was running.
Dunno.
Agree about the acute injury care though - ice and compression would have been a good idea!