Cost, analysis, and new perspectives on injuries and absences.
Since Ousmane Dembele joined the Barcelona FC squad, he has suffered at least 9 injuries. In the last 4 years, he has been inactive 39% of the time: 514 days absent due to injuries (1.41 years) and 63 days due to suspensions and/or commitments outside the club (0.17 years). In total it represents 88.52 million/Euros in non-productive spending for the club. Considering only 2019, Dembele has been absent 49% of the days, representing 27.46 million/Euros spent in non-productive time.
This case is very significant since all the actors involved try to disassociate themselves from any responsibility. For example, the club refers to the player's misconduct and lack of professional commitment. At the same time, teammates are demanding answers in perhaps the wrong places. Luis Suarez asks the doctors to find solutions.
Let's examine some objective facts: 1) The initial medical examination at Barcelona FC indicates that Dembele was "healthy" and "ready" for competition. 2) The 9 injuries occurred in a relatively short period of time, beginning immediately after joining the club. 3) The injuries are recurrent in both legs, mainly in the hamstring region. 4) The injuries have been severe enough to require reparative surgeries. 5) Surgeries were necessary after successive discomforts and injuries that indicated possible long-term work overload.
I present new interpretations that could explain what happened and thus help change the direction of the training process:
1) During the initial medical examination, he has been physiologically evaluated, but apparently the characteristics of his running mechanics are not noted. In the video of the article we can already see mechanical aspects that can lead to various musculoskeletal pathologies. (See photos taken from the video)
2) The times between injuries are significantly short, which may indicate that the rehabilitation processes have been incomplete and/or inadequate.
3) Injuries in the hamstring region of the type Dembele suffered in both legs, are usually associated with high-intensity training loads with incomplete recoveries and/or with inefficient sports mechanics.
Although the injuries occurred in apparently simple and low-intensity actions (such as during the landing after a jump or a "taquito"), they can generate rupture tensions of the muscular material if the tissue's lactate load is at that moment elevated. This can occur due to lack of lactate removal capacity (decreased aerobic training); or by lactic acid accumulation not removed due to high-intensity training with incomplete recoveries; or by lactic acid accumulations due to inefficient movement mechanics. In the case that we are studying all the explanations are possible. Clearly, an inefficient running technique is present (see photos and videos above).
4) To get to repeat successively the same injury, with the severity suffered by Dembele (and in both legs!), we can consider that there has been probably a lack of criteria to analyze the player's process since joining Barcelona FC. In cases like Dembele's, there are usually a large number of signs and signals that can be identified before the athlete suffers an injury. Even if the player engages in inappropriate and risky behaviors as the club suggests.
For example, if nutrition was inadequate, there are tools to be used to assess it long before the injuries happen and thus modify it. If the athlete has not rested enough, during warm-up many variables can be evaluated that could indicate if the athlete's capacity at that time is inadequate for the planned work and thus prevent training before it causes damage. There are even possible physiological evaluations to be carried out to measure the energy reserves and/or muscle fatigue (for example, residual accumulation of lactate, glucose and glycogen levels, urea levels, etc.).
5) The periods of inactivity reported due to injuries (Transfermarket) are indirect indicators of the severity of the injuries suffered and whether the recovery time was adequate or not to heal the damaged tissue. Soft tissue injuries and/or tissue damage after reparative surgery require months of recovery before being able to tolerate safely the intensity and physicality of competition. The musculoskeletal system's materials (bone, muscle, tendon, and ligament among the most common to be injured in sport) must go through various phases of healing and rehabilitation before being prepared for the loads to which they are subjected in competition. If the recovery time and quality are inadequate, the risk of new injuries in the same region increases.
With this new perspective presented here, we can expect that if the working models applied to this player are not modified, the injuries might still be recurring. Permanent monitoring and data collection are essential to identify problems in the training and rehabilitation processes. Without the use of objective control tools it is almost impossible to identify the risk of injury that can be caused by training and competition loads.