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We've all heard the horror stories of Dan Smith's over-the-top challenge on Abou Diaby in injury time of a match Arsenal were winning at a comfortable 3-0 trot.
Something was immediately the matter with Diaby as he attempted to get up from the challenge. He would enlist the aid of the Arsenal medical staff to limp off the field, with his ankle turned out at a grotesque angle.
Tom Goom, a physiotherapist, attempted to diagnose the extent of that initial injury, which has obviously provided Diaby with relentless others in the six years since.
The official diagnosis of the injury, which Goom reported, was a fractured dislocation of the ankle. "It is common in these injuries for both [the] tibia and fibula to break, sometimes in several areas," Goom said.
While he noted that the club did not release the exact details of the grisly injury as per patient confidentiality rules, Goom noted that when an ankle dislocates, "there is trauma to the surrounding ligaments as well as the bone and ankle joint."
Diaby had three surgeries to help repair his ankle, and was out of football for almost a year.
Goom noted the reason for Diaby's lengthy convalescence, and a potential reason for the bevy of injuries he's suffered since.
"The nature of the trauma causes a lot of swelling and stiffness in the ankle joint," Goom said. "It is quite rare for a patient to recover 100 percent range of movement in the ankle, even with intensive treatment. The fact that Diaby was able to return to action nine months later is a great credit to Arsenal’s excellent medical team."
Goom then cited a frightening statistic. From the initial 2006 injury, to his problems as of December, 2011, Diaby had 29 injuries, most of which were muscle-based and stemmed from the ankle area.
There is a possible reason for this. As Goom says, one of the most important movements of the ankle ligament is dorsiflexion, which is required for any activity that involves absorbing impact—ie. running, jumping.
It is very difficult to restore dorsiflexion to the level seen before an injury such as Diaby sustained, Goom says.
The problem that arises, then, is that the body, in order to make up for its decreased balance, places more stress on the knees or muscles surrounding the ankle.
Hence, the myriad ligament and muscle injuries (knee, hamstring, calf) we've seen Diaby suffer since. The ankle can also become stiff from football-related actions (kicking, running), and thus become more prone to subsequent injury.