Guest Post:
Michael J. Barr, PT, DPT, MSR
Sports Medicine Coordinator
MUSC Sports Medicine

Rolling around on the ground, holding an ankle or a knee, or usually both, and screaming in pain, is a common site during the 2014 Fifa World Cup; but did an injury really occur? In most cases the answer is "No", however in some cases the player really did have a serious injury. I can picture Jozy Altidore screaming in pain after tearing his hamstring in the US’s match versus Ghana, and of course the response and pain we saw when Brazil’s Neymar went down in their match last week versus Columbia.

According to the Wall Street Journal’s The Count, in the first 32 matches of the 2014 Fifa World Cup, there were 302 instances of players rolling around on the ground in pain, however after careful video critique of the “injury” and their return to play response, there were “293 cases of potential embellishment.” One professional soccer player, who asked me to not publicize his name, said that he will, at times, embellish a tackle or hit on the field for a variety of reasons which include showing the referees that a foul did occur. He also went on to say, that he will stay down on the field sometimes to give himself and his teammates a minute or two to rest and catch their breath, as well he has even used this tactic to change the speed and momentum of a game. In basketball a coach will often call a timeout to slow the game down and to break-up their opponent’s momentum, but there are not any timeouts in soccer, so some players resort to this tactic.

Arjen Robben from the Netherlands even admitted in multiple reports that he dove at the end of the game against Mexico to set up the free-kick. So many players are relying on this tactic to get a foul called; some of the biggest stars in the world cup have complained about the physical play and continual small fouls. I have watched almost every match this year, and you see teams taking the “hack-a-shaq” approach to defending players like Messi, Neymar, Muller, and James Rodriguez in order to break-up their game and slow their relentless attack.

Unfortunately, serious injuries do occur which we saw with Brazil’s Neymar who suffered an L3 vertebral fracture in the 88th minute of their match versus Columbia. Luckily, according to multiple reports, the fracture is stable and does not require surgical intervention. He will be treated with a combination of medications, physical therapy, rest and bracing. Without knowing the actual extent of his injury there is no way of knowing when he will be back on the pitch, however usually a stable third lumbar fracture takes 6-10 weeks to heal and for the athlete to return to play.

Even with the ever growing number of “flops, dives, and embellishments” and injuries to some of the biggest of stars, last week was truly an EPIC week. To the MUSC community, that may mean the system wide implementation of our “one patient, one chart” documentation system. However to the soccer community, I am talking about the outstanding play during the 2014 Fifa World Cup, including Tim Howard’s world cup record 16 saves, Argentina advancing to the semi-finals for the first time in 24 years and to having a potential European team win a World Cup on South American soil.

I, like all soccer fans, eagerly await seeing the remaining 4 matches of the 2014 Fifa World Cup; hopefully the quality of play and excitement of the games will fill the highlight films rather than injuries and boys crying wolf.