The analysis of Dr. Paolo Torneri, physiotherapist in San Martino Buon Albergo, founder of FisioScience and expert in rehabilitation and prevention of musculoskeletal injuries
The diagnosis that arrived the day after Real Madrid’s home defeat against Getafe leaves no margins: for Rodrygo rupture of the anterior cruciate ligament and external meniscus of the right knee. The Brazilian came on as a substitute in the 65th minute, falling on the sideline a few minutes after coming on and touching his knee. The tests the next morning clarified what everyone feared and we asked the Dr. Paolo Torneri, sports physiotherapist and founder of PhysioScienceto explain to us what such an injury really entails.
Dr. Torneri, what is the role of the anterior cruciate and why is its rupture so disabling for a footballer?
“The anterior cruciate ligament is one of the main elements of stability of the knee, controlling the anterior translation of the tibia and internal rotation. Following injury it can compromise the dynamic stability of the knee, which for a professional footballer who changes direction, brakes and jumps hundreds of times per match, means compromising the ability to sustain a match.”
How does the associated meniscal lesion change the picture?
“It complicates it, but everything depends on the type and degree of injury. The lateral meniscus distributes the load, absorbs impacts and contributes to joint stability. The surgeon will choose, based on the conditions in which the meniscus will be at the time of the operation, whether to proceed with a suture (more conservative, but taking longer) or with a menischetomy (removing a segment of the meniscus). Each option has different implications on rehabilitation and future prognosis.”
Rodrygo finished the match despite the injury. How is this possible?
“It’s a well-documented phenomenon. In the immediate future, adrenaline and pain modulation mechanisms can attenuate the perception of the trauma. Strong muscles partially make up for the loss of stability. Many athletes with a complete ACL rupture remember thinking, at the time, that it was nothing serious. Then comes swelling and a sense of failure, and the picture becomes clearer.”
Does recovery time exclude the World Cup?
“The evidence says that an ACL reconstruction requires between 9 and twelve months for a safe return to a high level and with the World Cup starting in June the numbers don’t add up. It’s not being pessimistic, but it’s looking at the risk of recurrence and the time needed for functional recovery.”
How is rehabilitation structured?
“The macro structuring divides the rehabilitation periods into 3. In the first acute post-surgery phase, we work on articulation, swelling and muscle activation. In the second, strength and neuromuscular control are recovered and the foundations are laid to safely reach phase 3. In the third, running, changes of direction and technical gestures are reintroduced, but only after having passed objective criteria of strength and stability”.
