Friday April 6 2012
Caring for Pato

As Alexandre Pato suffers yet another muscle injury this week, David Swan offers one explanation for the player’s recurring nightmare.

“Milan communicates that today Alexandre Pato underwent an MRI scan. The examination has shown an injury, between grade one and grade two, to the biceps femoris muscle of the left leg.”

It is a statement so frequently posted on Milan's official website that all they need do is copy and paste the last one, and change the minor details such as the leg affected.

How frequently is it posted? La Gazzetta dello Sport reckon Pato's injury against Barcelona was his 14th since January 2010, although only half of them were identified as hamstring injuries, with another two simply labelled as muscle strains in his right and left leg respectively.

Although La Gazzetta use January 2010 as a cut-off, Pato had suffered hamstring injuries before this point, yet more than two years later, now approaching three, the club are no closer to solving the problem.

In December 2010 they sent Pato to the USA to seek opinion from Dr William Garrett, a specialist in orthopaedics at Duke University. He conducted a variety of gait analyses using video and force plates, and concluded the problem was postural - Pato's running style means he leans too far forward during sprints, creating a muscle imbalance that loads the hamstrings.

Former sprinter Stefano Tilli also believes Pato’s issues stem from posture, although he identified a problem in the lower half of the body in Thursday’s  Gazzetta: “When the foot leaves the ground, the pelvis is too far forward, and the foot is parallel to the floor, instead of at a 90 degree angle to the rest of the leg. It places too much pressure on the hamstrings.”

Either MilanLab were not listening to Garrett’s opinions or they ignored his advice altogether, because the problems have not subsided. They may even think that Garrett is wrong, and certainly the change in direction this year seems to suggest MilanLab believe there is a different cause for the injuries.

From an orthopaedic specialist in 2010, Milan - under the guidance of Jean-Pierre Meersseman - took him to a chiropractic neurologist, Dr Frederick Carrick, only last week. After assessing Pato’s brain activity, he amusingly gave him a clean bill of health on the Friday, only to see the Brazilian injured the following Tuesday.

What has flown under the radar throughout this two-and-a-half year period, and indeed Carlo Ancelotti’s final season where injuries were also rife, is the constant changing of staff at MilanLab.

The last four seasons have seen four different individuals as director of medicine at the club – Massimiliano Sala in 2008-09, Massimo Manara in 2009-10, Gianluca Melegati in 2010-11 and now Rodolfo Tavana, who took over last May, and was previously at the club from 1987-2003. Each has brought one or two of their own doctors with them, and as is the way in medicine, each has their own specialty and ideas for injury prevention and management.

This position belonged to Meersseman before the flurry of changes, but he has taken an increasingly marginal role since 2008 at his own request. He was credited as one of the driving forces behind the MilanLab set-up, and the fact that each of the four seasons since he vacated the post has seen the squad decimated by injuries augments his reputation.

It is telling that the club turned to him to solve Pato’s problems, and it also explains the massive difference in approach from 2010 to now. Melegati, an expert in rehabilitation and injury prevention, took Pato to an orthopaedic specialist, Meersseman, a chiropractor, took him to see a colleague in his same field.

Both approaches have failed, though given the decent injury record during his time at the club, you would fancy Meersseman to get to the bottom of it. He had a sly dig at the length of time he had been given when speaking of Pato’s latest setback: “I have not solved something in three weeks that has not been resolved in two years.” Perhaps he should have focused on the real problem hurting the No 7 right now, the continuity of care, or lack thereof.

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Have your say...
milan lab probably the greatest medic centre in sport!!!! When u got players like nesta and seedorf still going strong at there age.......
im prettty sure pato will be back,and at 22 still got time to be a legend
on the 10th April, 2012 at 3:56pm
The person who said he's 21 and doesn't heal as fast as when 18, please be quiet. It's not an additional three years of biological age that's hindering him, it the compounding injuries. Fact is that scar tissue developed from strain and needs a proper amount of time with exercise rehab progression to become functional. These guys are often rushed back too soon while the scar has not yet become functional enough to adapt to the high loads placed on them an re-injury occurs. More later...
on the 10th April, 2012 at 9:32am
i nthink the first doctor was right - but what can milan lab do about his running style? if he needs to improve that, they need an athletics coach!
on the 10th April, 2012 at 8:21am
I think Pato's biological age is actually around 38 ish which is why his muscles have deterioated so rapidly. The poor lad is finished, his body is a wreck. Time to do a Van Basten and retire I think.
on the 9th April, 2012 at 2:09pm
anonymous i would sell pato and reinvest that money into tevez as he brings something to the table that not many other strikers can, consistency and hard work. tevez has proved himself but pato hasnt.
on the 7th April, 2012 at 6:33pm
Should have sold him in January when one of those Arab owned clubs wanted him...
What a waste of time and money. Don't get me wrong he's great but the kids getting worse and worse. Milan need players that can play a whole game not 11 players that last 30mins and then passout!
How are we ever going to be great again when every season the excuse of 'half a team injured' keeps being said..
on the 7th April, 2012 at 5:56pm
Interesting piece of information. But i was also thinking about the coach and his training setup. I have never seen milan have so many injured before. Not just this seasson but also the year before, where many was injured. I personally belive that Pato needs to adapt to new type of training, just look at ledly king of totenham. Also look at pirlo, unuder allegri he was injured alot, and now with juve and conte, he havn't been injured and looks more fit then ever.
people agree? :o
on the 7th April, 2012 at 5:35pm
Such a shame. He could turn out the be one the Greats that never was.
on the 7th April, 2012 at 3:57am
@Boss: Who would buy him at this point? Surely everyone is aware of his problems, and only an ignorant fool would pay anything near what Tevez costs.
on the 6th April, 2012 at 11:20pm
Well i know that when i was 18 i never knew what a muscle injury could possible be, your body just recovers so incredibly quickly. Now that pato is 21 possibly bigger and stronger he is putting more strain on the hamstring. Ontop of that even though he is still young at 21 your body just doesnt recover like it does at 18.
on the 6th April, 2012 at 10:41pm
Ever heard the syaing "y fix it if it aint broke". well pato is broken, sell him and get tevez, thats how you fix this.

He's only there cuz he's getting cosy with Berlusconi's daughter.
on the 6th April, 2012 at 5:46pm
Chiropatrics is unscientific and classed as CAM. Milan has done the right thing by adopting orthopaedics. The recent injury crisis of the last few seasons involves many newer players who could be injury prone. The veterans are also older, and thus are as expected more frequently injured. Then there’s tactics, which are more taxing than before and may trigger injuries. Some have had medical problems that can’t really be classed as injuries and it would be unfair to blame these on the doctors.
on the 6th April, 2012 at 4:11pm

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