Real Madrid prepare for Liverpool without Lucas Vázquez

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Saturday night’s bruising Clásico may have set the scene for Real Madrid’s second leg of the Champions League quarter-final in Liverpool, but it didn’t help with the injury situation.  

As we all know now, Lucas Vázquez’s injury turned out to be a tear of the posterior cruciate ligament (PCL) of the left knee, sustained in a heavy challenge which is typical of the injury mechanisms for knee injuries of this nature.  

There will no doubt be ongoing discussions over the next few days regarding the forward management of Lucas’ injury, since PCL surgery can be complicated and the club will want to ensure the correct pathway is followed.

The reason for mentioning this is that not all PCL injuries go down the surgical route. 

The tricky nature of the operation often means that many surgeons will go for the physiotherapy and rehabilitation option instead, and although this can turn out to be the correct decision, the choice of which pathway to follow needs careful consideration.

It’s important to get this right at the assessment stage, and although the option to operate is one that can always be taken up at a later date, any delay in going to surgery will invariably affect the outcome in terms of returning to play.

Such is the importance of making the correct decision, it might even be later in the week before that decision is taken.

With the game not being played until Wednesday, Zinedine Zidane will at least have an extra day to assess the injury situation in general. Real’s players went through a rest and recovery session on Sunday morning and trained on Monday behind closed doors with several players still feeling the effects of Saturday’s game.

Fede Valverde was replaced by Marco Asensio after an hour against Barça and was also clearly struggling at time up. Having only returned to full training 48 hours before the first leg against Liverpool he did well to compete for that hour against Barça.  

Being replaced by Marco Asensio on Saturday night was a reversal of the roles against Liverpool when Fede made his entry from the bench, and it just shows how incredibly difficult coming back from injury can be.  

Being able to ease himself back into playing mode with some game time in the last week will have helped, but Fede will likely be only one of several players Zidane et al will have been assessing in the past 48 hours.

He didn’t take part in Real’s training on Monday morning and will continue to have treatment over the next 24 hours.  

Although none of Zidane’s triple substitutions appeared to have been made for injury reasons, it will probably be late in the day before there is some clarity over who is likely to be fit for Anfield and who isn’t.

Taking into account the weather conditions in Madrid on Saturday night, the Barça game was always going to be a test of players’ fitness.   Every time there was a stoppage the players could be seen desperately trying to keep warm until play resumed. All this takes its toll on the players and of course, there will be no let-up.  

Zidane’s rotation system is currently being tested to its limit and now that Lucas Vázquez has joined Sergio Ramos and Dani Carvajal on the sidelines it’s just another challenge for Zidane and his staff to address. 

As everyone knows, Real are unlikely to be given a warm welcome on Wednesday night as a result of the fall-out from the final in Kyiv three years ago, but it was extremely disappointing to see Jürgen Klopp fan the flames before the first leg with his comments about the Alfredo de Stéfano.  

Zidane refused to be drawn and in doing so treated the criticism of the de Stéfano with the contempt he felt it deserved, but others were not so diplomatic.

Real’s former Sporting Director Jorge Valdano didn’t waste any time in taking the bait with his response about the current stadium developments at the Bernabéu and was less than flattering about Liverpool’s Anfield Stadium in response.  

Even Barça coach Ronald Koeman admirably came out in support of Real’s current use of the Castilla stadium, a facility many clubs in La Liga (and elsewhere) would be glad to be able to avail themselves of.

The fact that Koeman felt strongly enough about Klopp’s comment to respond as he did speaks volumes about the standard of Real’s facilities. It seems to be just another example of the post-Kyiv reaction that has been simmering since the draw was made.  

Injuries apart, Real need to rise above all of this and focus on getting a result at Anfield.  

12th April, 2021

Although tactics and teamwork have featured highly in the discussions about who will play in Real Madrid's Champions League quarter-final game against Liverpool, the talk among the Liverpool support had been about Mohammed Salah coming up against Sergio Ramos once again.

But the calf muscle injury sustained in Spain’s midweek match against Kosovo has all but ruled Sergio out of both legs of the Champions League quarter-finals,   

El Clásico, and in all probability, a couple of league matches after that.

We all know how injuries can influence a team’s performance, but that’s never been an excuse used by Zidane. On Merseyside, though, they still hold Real Madrid’s captain responsible for the Egyptian striker’s shoulder injury in the Kyiv final three years ago when Real took the trophy for the third successive time.

It’s hardly surprising then that the prospect of the reds gaining revenge by dumping Real out of the Champions League had been the main talking point for many Liverpool fans until last Wednesday.

There has almost been an overwhelming feeling of disappointment among the Liverpool support that Sergio Ramos won’t play in either of the two legs thanks to the injury sustained on duty with Luis Enrique’s side last week.

Well, rest assured that it’s an even bigger disappointment in Madrid. Real’s skipper is known for being a big-game player, and the fact that he’s going to be missing on Tuesday night is just another setback for Zinedine Zidane to deal with in a season where injuries have never been far from his mind.

The absence of Real’s inspirational captain will be felt a lot more by Zidane et al than by Jürgen Klopp. And, of course, it takes away any distraction that could potentially have crept into Liverpool’s game had Sergio Ramos been on the field.

Seriously, we need to question the wisdom of playing two international games in the week leading up to such an important stage in the European calendar.

We’ve known about the Qatari World Cup for years now, so surely it wouldn’t have taken an awful lot of forward-thinking for the planners to tweak the fixture lists to accommodate this.

It all adds to the argument that football was rushed back last June without a lot of thought given to the clubs and particularly to the players.

Zinedine Zidane alluded to this himself recently when asked about Real’s injuries, stating that there was no pre-season and that the games were coming thick and fast.

It’s an undisputed fact that clubs were asked, or rather told, to play on through the pandemic. Now the effects are becoming obvious for all to see.

Ever the optimist, Zidane was still hopeful after the Eibar game on Saturday that there was a chance of Eden Hazard and Fede Valverde being in contention for the forthcoming games against Liverpool and Barça.

Without committing himself to giving a definitive answer about either player, the coach simply said that he would assess Real’s squad in the lead-up to the Champions League game on Tuesday and that he would make a decision on the fitness of both players nearer the time.

Whether this was an answer designed to appease the media or not I don’t know, but at least it deflected the usual questions about Eden Hazard’s fitness.

It’s a no-win situation for Zidane when it comes to talking about the Belgian attacker. If the coach includes him in the squad then he’s bringing him back too early. If he doesn’t, then in the eyes of the media it’s just a case of Eden Hazard being injured yet again.

At that stage, the usual criticisms will inevitably be rolled out about Sanitas, the training methods, and the fitness regime.

At least Zidane was quick to react about the intonations that Sergio Ramos wasn’t fit to go away with the Spanish squad and acknowledge that the injury just happened without looking for someone to blame, but as with all players who return injured from the internationals, it’s the clubs who suffer.

In all honesty, I don’t think I will be the only one for won’t be expecting to see Eden Hazard in Real’s squad for either the Liverpool game or the Classico that follows.

Muscular injuries are simple to address in theory but not so easy in practice, and it’s probably too early to expect Eden (or Fede) to turn out this week. As always, though, we’ll have to wait and see.

5th April, 2021

The return game with Atlético at the Wanda last weekend seems to have been the turning point for Real Madrid as far as injuries are concerned.

It's a brighter picture all around for Zinedine Zidane.  The stats don't lie, and the number of players returning to fitness has increased since then.  

The coach included both Eden Hazard and Sergio Ramos in the squad against Elche yesterday, leaving Mariano Díaz and Dani Carvajal as the only two players currently unavailable through injury.

It's a far cry from the situation a month ago when Real Madrid had Nacho, Rodrygo, Fede Valverde, Álvaro Odriozola, Marcelo, Eder Militão and Dani Carvajal all out with various injuries in addition to Sergio Ramos and Eden Hazard.

Apart from Sergio Ramos making a welcome return to the team against Elche, another bonus for Real Madrid was Eden Hazard making an appearance from the bench in the 75th minute. 

To say he's not had the best of seasons would be the understatement of the year, but even though he's taken a battering in the media, support from Zinedine Zidane and particularly the Belgian national team coach Roberto Martínez has been unwavering.   

That says a lot in itself.  Coaches can be quick to criticise players' injury records, yet that's never been the case where Zidane is concerned.  The coach has always been a model of patience whenever discussions centred on Eden Hazard.

Occasions when Zidane's frustrations have surfaced in the past have been notably few and far between.  Likewise, Roberto Martínez has never been one to hesitate in saying his piece about Eden Hazard's injury problems.  

As a physiotherapist himself, Roberto knows more than most about the challenges that players face.  Accordingly, he is also well aware that there is a constant demand for players to return to the team at the earliest opportunity.

It would have been easy for Zidane to take the approach favoured by several other high-profile coaches when asked about injuries.  

Some coaches don't appear to think twice about targeting their frustrations towards the medical teams or even the players themselves in an attempt to justify poor performances or results on the field. 

There's no doubt that injuries have been a significant issue at the club this season, and a classic example of this is the number of injuries that affect certain players more than others. 

Dani Carvajal has suffered in this respect because players are often most at risk of injury when they have been out for a while, and like Eden Hazard, it is becoming a season for Dani to forget.  

His recent injury, sustained in the Valencia game, has kept Dani on the side-lines since February.   As discussed on previous occasions, the more this happens, the more difficult it becomes for players to return with the confidence that the same thing won't happen again.

People often say that a team is at its most vulnerable defensively immediately after they've scored, and the same can apply to players returning from injury.

Making that transition from full-scale practice matches on the training ground can be a difficult gap to bridge when you take into account the differences in intensity between training games and proper league or cup fixtures.

The two may not seem to differ much with the empty stadiums and lack of atmosphere, but playing against outside opposition results in a higher intensity of competition than taking part in games against your teammates ever will.

However hard players may appear to be competing, there's always the likelihood that they won't go in for challenges in training in the same way they would do in a competitive fixture, either for fear of inflicting an injury on a colleague or even themselves.  

The latter happens when people are in their final stages of training before making a return to competitive play and may be hesitant about making full-blooded challenges, either subconsciously or otherwise. Either way, the real test of fitness comes when the game starts.   

Moving forward, Zinedine Zidane will likely spend his Sunday by assessing the progress of those who returned against Elche with Tuesday's game against Atalanta in mind.

Neither Marcelo or Álvaro Odriozola were in the squad for Elche, so on that basis, it will be interesting to see who Zidane includes to face the Italian club on Tuesday.  

His main worry at the moment will be whether anyone has picked up minor injuries on Saturday.  If so, the question will be if these are likely to respond to treatment in the next 48 hours.  

14th March, 2021

Analysing injuries at Real Madrid (past or present) has always been topical, and as usual the media have a lot to say about the potential reasons for this.  Not surprisingly, the debate has reignited as a result of the current situation.  

But as we have mentioned in previous articles on this theme, Real Madrid are no worse than other clubs in this sense.  

The incidence and nature of injuries at clubs across La Liga varies, with previous experience indicating that those who have recently returned to fitness are likely to be replaced by colleagues who are currently fully fit.

That was never more evident than before the Eibar game in December when Real Madrid went from having a fully fit squad on a Friday morning to three players down in the space of 36 hours, well before a ball had even been kicked.

Zinedine Zidane will be bit happier this weekend because the injury list has trimmed down a little with the return of Dani Carvajal and Lucas Vázquez.  

Despite their return, several players remain unavailable, with the majority of these due to muscular injuries. 

Muscle injuries, though, are generally regarded as an accepted part of football life.  The statistics will support that. In football, muscular injuries to the lower limbs (hamstrings, thighs, adductors and calf muscles) significantly outnumber those of the upper regions (arms, shoulders, wrist and hand).

Muscular injuries also occur in the lumbar spine and the neck muscles, but these are less frequent, although they do exist.  Isco, for example, recently missed some time due to a back injury, and Marcelo is another who has suffered from back problems on previous occasions. 

The problem arises when those who have recently returned to fitness find themselves back in the treatment room after only playing a handful of games before suffering unfortunate recurrences of their previous injuries.

We talk about players being injury-prone, but for the medical staff, nothing compares with having to deal with recurrent injuries regularly, and there lies the difference.

A recurrence of a previous injury is the worst possible scenario for any player, and the same applies to the staff.  Most medical teams would happily settle for dealing with three times as many new injuries, even if meant a dramatic increase in the daily workload.

The reason?  Recurrent or repeated injuries lead to a loss of confidence in the medical unit if players are declared fit to play but find themselves back in the treatment room before they have had the chance to establish themselves in the team again.

Repeat or recurrent injuries also provide the media with the opportunity to unfairly target players struggling with injuries.  That can negatively influence their returns, forcing them to bow to indirect pressure by attempting a return to the team well before they are ready to do so.

Eden Hazard, who has suffered from a succession of injuries since coming to Spain, is a classic example of this, having been labelled as injury-prone by some sections of the media.  Most of his current problems can be traced back to when he had surgery in the USA, but Eden has struggled to regain full fitness.  

By his own admission, media criticism has affected him, and consequently he's tried to come back too quickly in the past to avoid being seen as letting his teammates down.  

Not surprisingly, all this does is destroy someone's confidence. When the next injury comes along, and they find themselves back in that dreaded routine again of going through rehab, they start asking themselves how long they are going to be out for this time. 

The current injury list at Real Madrid shows that Rodrygo, Eden Hazard, Fede Valverde, Álvaro Odriozola, and Marcelo are all out of the team with muscular injuries.  

Sergio Ramos is still in post-operative rehab following surgery to a meniscus in his left knee, and Eder Militão also missed training in the week due to a recent adductor muscle injury.

Breaking that down a stage further, none of them are out with an injury that does not fit in with the usual pattern of football injuries.  

Hamstring, thigh, and calf injuries occur regularly, and that will account for most muscle injuries at the club.  Even Sergio Ramos' meniscus operation is a common football injury that used to be referred to in the old days as a torn cartilage.  

Zidane's main worry will be if players are missing games with recurrences of previous injuries instead of new injuries.

There’s a big difference between one or two players suffering from recurrences of previous injuries and several new injuries of the same type being picked up by different players throughout the club.  

A spate of injuries of a similar nature can be annoying, but often a link can be identified to a series of particularly hard or physical matches played within a short space of time between each, ground and weather conditions, footwear, or a change in training intensity.

We know Zidane likes to train at a high intensity and perhaps some players have found this difficult to adapt to, but that doesn't necessarily mean that they are injury prone, nor that the injuries are the fault of the fitness staff.

Injuries occur for several reasons, with a player's age and past medical history including the severity and nature of previous injuries contributing more and more to the likelihood of sustaining further injuries as they get older.  

Injuries are known to occur through a complex interaction of multiple risk factors and events (Bahr and Holme, 2003), but it is the interaction of these risk factors that leads to players sustaining injuries in given situations (Bahr and Krosshaug, 2010).

The timing of an injury is unpredictable, and for that reason it is impossible to say that anyone who is regularly training and playing will not pick up an injury at some stage in their careers, but for some players, the interaction referred to above happens more often than others.

References:

Bahr R, Holme I (2003).  Risk factors for sports injuries  - a methodological approach.  British Journal of Sports Medicine.  Vol. 37 (5), 384 – 392.

Bahr R, Krosshaug T (2010). Understanding injury mechanisms: A key component of preventing injuries in sport.  British Journal of Sports Medicine.  Vol. 39 (6), 324 – 329.

13th February, 2021.

Real Madrid returned to training on Sunday with a closed-door session in Valdebebas, and immediately the focus turned to the Copa del Rey match this Wednesday against Alcoyano.

Sunday’s training was behind closed doors, and you can always tell that Zinedine Zidane means business when this happens. There’s training, and then there’s training. But when the sessions are in private, this is usually a sign that the coach has a pressing agenda that he wants to keep within the camp for the time being.

Travel issues over the Osasuna game last weekend and the defeat by Athletic are still fresh in mind. There’s also the injuries that will affect Zidane’s options for the up-and-coming games with Alcoyano in midweek and another trip to the north next Saturday to face Alavés.

Everyone was disappointed at losing to Athletic Club in midweek, and the Copa del Rey game provides a chance to move on from that and get the focus back on the league campaign in the weeks that follow. 

With the Champions League about to resume again in late February, there will be plenty to concentrate on in the coming weeks.

Not least, Zidane will have spent some time over the weekend liaising with the medical staff for updates and progress reports on Sergio Ramos, Dani Carvajal, Rodrygo, and Raphaël Varane. 

Now that Luka Jović has moved on loan to Eintracht Frankfurt we’ll find out shortly how Zidane intends to approach the midweek cup game and which players are likely to figure in his thoughts.

While people are understandably lamenting the quick exit from the Supercopa, at least the team didn’t have to travel outside of Spain this time. Travel is still a sore point for Zidane though, bearing in mind the appalling situation this time last week when Real had to travel to Osasuna in terrible conditions.

There were accusations that Zidane was looking for excuses after Real dropped two points with the draw in Pamplona. But looking at the situation around travelling as opposed to the actual game itself, suggestions that Real should have travelled on the day of the game instead of the night before just weren’t practical from a logistical aspect.

Real Madrid were not the only club affected by the weather either. While Real were sitting on a plane in Madrid Barajas airport waiting for the all-clear for take-off on the Friday, Rayo’s squad had set off by road from Madrid for their game against Mirandés, before having to turn back due to the appalling and dangerous weather conditions.

Some of Rayo’s players were even pictured helping other motorists to dig their stranded vehicles out of the snow. If both games had been scheduled for Friday night instead of Saturday, travelling on the day certainly wouldn’t have been the best of ideas under the circumstances.

In a week when Madrid had its heaviest snowfall in almost fifty years, surely there must be a case for making decisions about these fixtures a lot sooner and taking people’s safety into account when doing so.

Thibault Courtois has also drawn criticism over his comments about being made to travel to Pamplona. Bearing in mind that the goalkeeper has a habit of speaking out it seems highly unlikely that he would have held his tongue even if Real had taken all three points on the night.

We need to try to separate results from logistics in discussions of this nature, and Thibault certainly has a valid argument if we look at this purely from the safety aspect. Although several matches were off at the weekend, others went ahead anyway despite the frozen conditions.

There’s no doubt that in almost all cases the groundstaff work their socks off trying to get pitches playable, often aided by an army of loyal supporters who happily turn up armed with a shovel to help clear the snow away. Yet there are occasions where the conditions underfoot are just too dangerous for play to be allowed.

That’s a different matter though from making a journey (of any distance) in dangerous conditions. As mentioned earlier, I think we need to prioritise the risks instead of focussing on the results.

With the benefit of hindsight, it’s easy to say you should have gone this way or that way or on a different day or time. But it’s also easy to overlook the dangers that accompany travelling in adverse conditions by allowing results to influence what should be an objective judgement.

17th January, 2021.

Real Madrid trained in the snow in Friday’s build-up to the Osasuna game this weekend and for once there were few absences in Zinedine Zidane’s squad.

Dani Carvajal trained separately once again and so too did Rodrygo. Both players are carrying injuries and on this occasion, kept themselves to themselves while working away at their fitness.

However, Luka Jović sustained a muscle injury in training just before the squad finished their Friday morning session before setting off to the airport for the flight to Pamplona.  So the two injuries quickly became three.

We’ve come to expect more than a couple of absences in recent weeks so it’s been heartening to see the injury list gradually reducing, albeit not to the point where it doesn’t exist though.

Football has a habit of kicking you in the teeth as soon as you start to become complacent about anything at all, and boasting about having an injury-free squad is usually asking for trouble!

If we go back a few weeks, we had the situation where Real were technically injury-free on the Thursday night and then were minus three players twenty-four hours later.

Of course, on that occasion all the injuries were minor. Isco took a knock to his ankle in training, Vinicius rang in with gastroenteritis, and Zidane decided not to risk the recovering Eden Hazard against Eibar on the Sunday.

That said, it’s a little bit different this time. Rodrygo had to be substituted against Granada in the last match before Christmas with a hamstring injury, but instead of being out for a couple of weeks, it looks as if he will be out of action for a considerable length of time.

Real Madrid’s medical team were quick to confirm that Rodrigo’s injury was to the biceps femoris muscle of his right thigh, which is one of the more frequently injured of the hamstring muscles.

There’s been plenty of stats quoted over the last year about how common these injuries are in football, both in this column and elsewhere, but the majority of the injuries referred to tend to involve the fleshy, muscular part of the hamstrings.

Rodrygo’s injury is reported to be in the tendinous part of the muscle, which generally indicates a longer recovery time due mainly to the differences in structure between muscles and tendons relative to the blood supply which drives the healing process.

The larger, bulky part of the hamstrings contain lots of muscle fibres and these respond quicker to treatment due to the increased availability of oxygen in the blood. Tendons, which have a relatively poorer blood supply by comparison, generally take longer to heal.

The function of a tendon is to join the muscle to the bone but the area where the muscle becomes tendinous, known as the musculotendinous junction, is also the weakest part of a muscle and highly susceptible to injury.

It may be that Rodrygo will take a little bit longer than expected to make his return to the squad, depending on the actual severity and nature of his injury.

Dani Carvajal is, as we know, suspended and therefore unable to be considered for the Osasuna game, but he also picked up a minor injury last week against Celta Vigo in addition to the yellow card that excludes him from making the trip to Pamplona.

Minor injuries can be tricky though and without knowing the exact extent of Dani’s injury it’s impossible to comment on his progress at this stage, but for obvious reasons it doesn’t make any sense whatsoever to push him to make an early return given the intense fixture list for the remainder of January.

Both teams put in their final training sessions today and the weather is likely to turn colder over the weekend with temperatures set to drop. The evening kick-off will only add to the risk of conditions deteriorating as the starting time approaches.

Snow isn’t as much of a problem nowadays as it used to be, at least not at elite level anyway. Matches tend to be postponed with the safety of spectators in mind rather than for any other reason. Hard, icy pitches present their problems though and sometimes a top-covering of light snow can actually be helpful.

The problem is often that the conditions underfoot can vary from one side of the field to the other, and if there is an area of the pitch that is constantly in the shade and never gets direct sunlight because of the stands, then that in itself can be an injury risk.

The priority for Real in Pamplona, apart from the obvious emphasis on taking another three points, of course, will be to come back to Madrid afterwards without any further injuries.

8th January, 2021