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What does Theo Walcott’s ACL and Ligament injury mean for him?

Arsenal and England got bad news on Monday after scans showed that Theo Walcott, the speedy star winger for club and country, has sprained knee ligaments, including his ACL, and will require reconstructive surgery, according to Arsenal’s official website.

The club announced the injury on Monday after Walcott was hurt in Saturday’s FA Cup game against Tottenham Hotspur.

Walcott’s injury resulted from a tackle by the Spurs’ Danny Rose. Initial testing showed a ligament issue and, given the accuracy of manual testing, the scans were likely for confirmation. While Arsenal announced that Walcott would be out for “at least six months,” the normal recovery time for this type of injury can be significantly longer.

If Walcott has only ruptured the ACL, he could return at the low end of estimates. In most cases, there is associated damage to other ligaments and to cartilage, but there have been no reports of this. A “clean” ACL tear requires less rehab and results in fewer stability problems in the early stages of recovery.

Long term, Walcott should have no real issues returning. While his speed will be compromised slightly in the first 18 months post-injury, it is not straight-line speed that is normally problematic. Instead, it will be the quick stops and pivots that will cause the lingering effects.

The anterior cruciate ligament itself is designed to keep the bones of the leg—the femur above the knee and tibia below—in line. When stopping, the ACL is one of the primary stabilizers, though secondary stabilizers such as the bone structure quadriceps muscles are very involved.

When the ligament is stressed and twisted, as it was with Walcott as he was tackled, the ligament can fail.

Surgery is very straightforward. As shown in the video to the right, the normal procedure is to reconstruct the ligament using a section of the patellar tendon. The surgeon harvests the section, drills holes to thread the replacement through and then anchors it in place. Over the next few years, the body actually turns the tendon into a ligament, a period known as “ligamentization.”

With Nicolas Bendtner also out, Arsenal will be hurting up front. This could lead Arsene Wenger to look for replacements during the January transfer window.

Several other Premier League players are dealing with similar problems, seven players are currently out recovering from ACL injuries. In American football, 2013 was a record year for ACL injuries, with more than 50 occurring during the season.

It is unlikely that Walcott will have any chance of returning for the World Cup, though it could be close. Watch to see when Walcott begins running and cutting, with the latter being the biggest test.

Arsenal will closely guard their young winger, so Walcott will likely have to wait for Russia 2018 before he gets another chance on the World Cup stage.

Contact Sports Therapy Scotland for the assessment and treatment of all knee conditions.