From the Physio – Gameweek 7

In this week’s “From the Physio”, I focus on Dimitar Berbatov’s flexed hip which, according to the player himself, has him undergoing a bout of Hyperbaric Oxygen therapy (HBOT) as the Bulgarian goes all out to be fit for the weekend visit to Southampton…

Reports from Craven Cottage late last week left many a Fantasy manager looking for the nearest cat to kick, as Martin Jol revealed Dimitar Berbatov would be missing for two weeks after sustaining an injury from a kicking action at the end of Thursday’s training session. Jol elaborated further, to suggest that Berbatov sustained an injury in the region of his hip and thigh, but that no tear was evident.

“He was a number nine but he played in a number 10 role so for us it was quite good that he was there, but he is injured now and can’t play tomorrow so that is a big disappointing thing. He will be out for the next two weeks. Berbatov looked good in the training session as usual and then the final shot [of the session] he felt something and he had to go in and stop training. It appears he has not got a tear but a problem with his hip, upper thigh so we couldn’t take the risk to involve him tomorrow.”

From the clues offered, we may infer that Dimitar has a problem with the “Hip Flexor” muscle group. This group of at least five muscles attaches to the hip and upper thigh region. Further analysis supports this view as the latter part of any kicking motion precipitates a latent “whip” like action from the Hip Flexors. In addition, it is not uncommon for injuries to occur towards the end of physical activity as the muscles and connective tissues become fatigued and increasingly lax.

Due to the mechanisms and general nature of the injury, my first impressions, purely from anecdote, were that the injury, barring complications, wouldn’t be too serious and recent updates from Berbatov’s Facebook page shines a further light, as photographs reveal the Bulgarian breathing pure Oxygen whilst ensconced in an Hyperbaric Chamber.

Hyperbaric oxygen therapy (HBOT) is breathing 100% oxygen while under increased atmospheric pressure. The effects of HBOT are based on the gas laws, and the physiological and biochemical effects of hyperoxia. When a patient is given 100% oxygen under pressure the blood can be hyper-oxygenated by dissolving increased amounts of oxygen within the blood plasma.

In theory, this amplifies oxygen gradients promoting collagen matrix formation (scar tissue) and new blood vessel synthesis, prompting a speedier healing process. In essence, this has the potential to reduce inflammation and speed up tissue repair increasing recovery times.

In summary, my overall impression is that Berbatov has sustained a minor grade 1 Hip Flexor strain that would heal naturally within one to two weeks from the date of injury. Personally, I feel that this is a fervent attempt by Fulham to get a player integral to their success fit for the weekend and by using HBOT they think he has a chance. It obviously depends on his response to treatment but with the International break looming, if any latent deficits persist, he won’t be chanced. This tempers my optimism just slightly, even so, I still feel there is a good 60-70% chance that the mercurial Bulgarian will grace St. Mary’s this weekend.