Hector Bellerin’s return to first team action does not necessarily mean he is over his ACL injury

AT this point, it’s fair to say Hector Bellerín has not looked his old self since returning from a complex ACL injury earlier this season. Physically, he looks to be a shadow of the player he was before his knee exploded in an innocuous collision with a Chelsea player last January. Rupturing the anterior cruciate ligament was considered a career threatening injury until relatively recently. Advances in sports science and medical treatment have changed that.

However, they have not yet entirely eradicated the long-term impact of the injury. Understanding of the medium-term impact is, in my view, still low. I think a lot of fans give a recovering player a grace period of a handful of games before the injury becomes less immediate in their minds and the ramifications fade in significance for them. That isn’t the case for the player, however.

Through covering women’s football, I have spoken to a few players who have recently recovered from the injury (female footballers are somewhere between 6-8 times more likely to rupture their ACLs than their male counterparts). Arsenal Women midfielder Jordan Nobbs ruptured her ACL in November 2018, two months before Bellerín. I quizzed her on her recovery recently, five months after her comeback.

No agenda against him but we have to talk about Bellerín’s form. Before his ACL he was superb, back to his best. Since he returned from his injury he isn’t the same: touch, runs, recoveries, pace and physical. Looks like it’s a very long process for him to be 100% fit.

— Foxey (@foxseabirds) February 28, 2020

“I’m still not at the level I was before the injury,” she admitted. “When you come back you feel like you haven’t played football for a really long time. If you’re out for three weeks you lose the rhythm of games. When you’re out for ten months it takes a long time to get back.” Last year I spoke to Arsenal Women forward Danielle Carter three games after her return last March. Naively, I asked her if she was happy to be out of the rehab stage.

“My rehab isn’t over because I am playing again,” she corrected me. “I will still have a different pre-season to everyone else.” Tragically, she very much did. She ruptured her ACL again during a pre-season friendly in July. In investigating the impact of ACL recovery, I also interviewed knee surgeon Pete Gallacher last summer.

He explained that recovery from the ACL reconstruction surgery results in several weeks of almost total immobility for the player. During that time, they lose a great deal of the muscle and explosiveness they build up through constant fitness and conditioning. The muscles in their legs can drop from ‘elite athlete’ levels down to zero very quickly and that takes time to build back up again.

So if Hector Bellerín doesn’t quite look up to speed at the moment, there are good reasons for that. Rob Holding ruptured his ACL a month earlier than Bellerín and Holding is currently considered fit enough only for the U-23s. Recovery from such injuries is a long road and getting back into the team is not the end of the journey.

Seen some criticism of Bellerin. I’m not sure he’s 100% fit & flying yet. He does look a yard short of pace, which is weird, but I think he’ll come good. We need to be patient with him.

— FK ☕️ (@fkhanage) February 23, 2020

Of course, there is no guarantee that Bellerín will totally rediscover his explosiveness, but that judgement ought to be postponed for some time yet. The only way is through and players only rediscover their rhythm is by playing games, it’s not ideal but we don’t live in a perfect world. There are also tactical reasons for Bellerín’s rustiness, in my view.

He is being asked to play the right-back role in a slightly different way under Arteta. He is asked not to provide as much of an overlap as Saka does on the left hand-side- which is probably for the best anyway considering his physical condition. Under Arteta, the right-back tucks infield to guard against the counter-attack and that’s new for Bellerín.

He is playing behind Nicolas Pepe, who is undergoing his own tactical struggle in this Arsenal team. The Ivorian is not the most fastidious defender either. When teams break on Arsenal, Hector is often left with a choice between covering the half space and engaging with the wide player. He still hasn’t got total command of his bearings in transition situations.

Richarlison capitalised on this confusion time and again in the recent victory over Everton. I was surprised Arsenal left their right flank so bereft given the Brazilian’s qualities attacking teams from that side of the pitch. Ultimately, with Bellerín, Holding and indeed any player returning from a long-term knee injury, patience is required – playing again represents a milestone, but not the conclusion of the journey.