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Selected Sporting Injuries - Part 2 by Bryan Rhodes

Dave Mackay’s Shinbone

Sadly, in 2015 we lost one of football’s greatest players with the death of Dave Mackay. Generally, soft tissue injuries (muscle, tendon, and ligament) are much more likely to end the career of a football player than injuries involving broken bones. This is because bones heal better – they heal with a slow process that involves the formation of new bone whereas soft tissue healing involves scar formation that can leave the player prone to further injury.

Mackay was particularly unlucky because he broke the same bone twice in quick succession. I have recently read his excellent book - The Real Mackay – and (pardon the pun) these are the bones of the story.

Mackay was the tigerish midfield maestro and one of the stars of the double winning Spurs team on the 1960/61 team. Still at the height of his powers, he broke his leg in a tackle at Old Trafford in December 1963. His book says very little about the injury or his treatment but I believe that he broke his left shinbone (tibia) and that he was treated in the traditional way with a plaster of paris cast. He states that he was in the cast until the end of the season so around 5 months. The summer months would have been spent rehabilitating and training. He returned to competitive football in the reserve team and was playing a match in Shrewsbury in September 1964. Imagine how he must have felt when he broke the very same bone in another tackle in this match! He was treated for a second time in a plaster cast and didn’t return to competitive football until the start of the 1965/66 season. Understandably, he remained sensitive about his left shin and the famous photo of him grabbing Billy Bremner came at the start of the 1966/67 season after he thought Bremner had deliberately kicked him on the left shin.  Lesser players would have struggled to come back after these injuries but Mackay went on to further success with Spurs and with Derby.  Nowadays such injuries would usually be treated by an operation to insert a metal rod inside the bone from just below the knee joint. When Aaron Ramsey suffered a similar injury to Mackay in 2010, he was treated in this way. It still took 9 months before he could return to competitive play.

 Dave Mackay is carried from the pitch after the double misfortune of breaking his leg a second time

From Cumbria to Umbria

I once had a patient who decided to cycle from Cumbria to Umbria! He then realised that it is a long way! Still he went to the cycle shop and looked for equipment to help him succeed. He chose to buy some German handlebar attachments that were described as being specially designed to reduce the risk of nerve injuries in the hand. Nerves are sensitive structures prone to injury from persistent pressure. The patient was travelling across France when he started to get tingling and weakness in his hands. He did try to adjust his new handlebar attachments but decided to continue his journey. By the time he had returned to England he had evidence of a severe nerve injury in one hand and a moderate injury in the other hand.  Fortunately, both his hands subsequently recovered. I did write to the German company to suggest they modify the design of their product but I didn’t get a reply!

The Jockey’s Collarbone

I don’t think that there can be any doubt that currently the most dangerous sport is National Hunt horse racing.  One study found that National Hunt jockeys had sustained 800 broken bones over a 9-year period. Jockeys develop the ability to roll away from danger when they fall from a horse but inevitably suffer injuries from falling whilst travelling at high speed. The collarbone is particularly vulnerable to such injuries and jockeys with long careers can often accumulate large numbers of fractures (broken bones). According to the Telegraph, British jockey Robert ‘Choc’ Thornton suffered over 40 serious injuries in his long career including a broken arm and torn ligaments and tendons in his right knee. Over the years, he has broken every one of his 24 ribs, broken his left collarbone three times and his right collarbone 6 times! He has broken three teeth, lost two in the same fall, and suffered three fractured vertebrae (spinal bones) after a fall at Leicester races. Sadly, Robert had to retire this year (2015) after his injury at Chepstow in 2014, which involved a further injury to his spine. I would like to wish Robert a happy and injury free retirement!

1916 - The most dangerous game of football ever?

July 1st 1916 has gone down in history as the worst day for casualties in the history of the British army. Martin Middlebrook describes the events vividly in his excellent book ‘The First day of the Somme’.

B Company of the 8th Battalion Royal East Surrey Regiment were stationed in their trenches at Carnoy opposite the German positions 300 yards away and were scheduled to be in the first wave of the attack. Their commanding officer Captain Wilfred ‘Billie’ Nevill was concerned about how his men would perform so whilst on leave he had purchased some footballs.  Middlebrook suggests that four footballs were used but other sources state that there were just two.  Nevill offered a prize for the platoon that was first in kicking their football onto the German lines. Private L. S. Price saw one of the balls being kicked “As the gunfire died away I saw an infantryman climb onto the parapet into No-man’s land, beckoning others to follow. As he did so, he kicked off a football; a good kick, the ball rose and travelled well towards the German line. That seemed to be the signal to advance”.

Sadly, Captain Nevill was killed close to the German lines but one of his footballs is still on display at the Princess of Wales’ Royal Regiment Museum at Dover Castle.

The Most Dangerous Sport of all

Some years ago, my wife and I enjoyed a holiday in Cancun, Mexico. We had the opportunity to visit the Mayan site at Chichen Itza and it was definitely a highlight of our holiday. The site features the largest and best-preserved Mayan stadium where an ancient ballgame was played (called ōllamaliztli in the local language). The rules of this game are not known but stone carvings indicate that the losing team or captain paid a heavy price for failure!  It appears that one or more players from the losing team were sacrificed at the end of the match. There is a modern version of the game called Ulama played with a rubber ball that is bounced from the side of a players hip (see YouTube video below) but I’m pleased to say that the human sacrifice has been phased out!

The Great Ballcourt at Chichen Itza (see photo below) measures 96.5 metres by 30 metres so close to the smallest football pitch size (90 x 45 metres).  One of the intriguing features of the stadium is a stone circle high up on the side of the playing area (see photo below). Perhaps this was used in the event of a draw and the players had to throw the ball through the centre of the circle to determine which team was victorious.

Ulama, the modern day version of the ancient ballgame

The Great Ballcourt at Chichen Itza

The mysterious stone circle high up on the side of the playing area

References

Dave Mackay and Martin Knight – The Real Mackay – Mainstream  2004

Martin Middlebrook – The First Day of the Somme – Penguin books 1971

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