Photo: Earl Gardner

Let’s start with a quick introduction. I am a physical therapist working in the Philadelphia area out on the Main Line.  I grew up in South Jersey playing club soccer and played for four years at Arcadia University.  I later attended physical therapy school at Arcadia as well.  I currently play locally in the Casa League for South Philly United and at Starfinder in Manayunk. I have been a Union fan since inception and thought that I could combine my training and my love of soccer to help share some info on injuries and rehabilitation as it relates to the Union and sport in general.

The Union’s starting left back, Kai Wagner, has been off the grid since an injury suffered in the preseason around January 27  Since then, Wagner has not been seen training and no timetable for the young German to return has been given.  As of Wednesday, manager Jim Curtin said that he hoped that Wagner could start running by the end of this week.

The front office’s tight-lipped approach as to what injury Wagner suffered has been frustrating for fans who understand his importance to giving the Union width and service from the left side.  While Matt Real’s performance against Dallas was adequate, the German as regarded as a top level left back in MLS and potential best XI player (if MLS didn’t have a back 3 in their best XI).  So what is going on?

What we do know

About five weeks ago we were told Wagner suffered a lower leg injury in training and would need some time to recover. More recently it has been called a calf injury. At the time, most thought it was proper to not rush him back and make sure he was ready for the start of the season.  Since then, we have gotten little information on his progress.  Even in the days leading up to the opening match in Dallas, Jim Curtin was non-committal on whether Wagner would play or not, and he’s since been ruled out of this weekend’s match.

But what does it all mean Basil?

I will clarify before saying all this that I do not have any non-public information on where Wagner is in his return to sport rehab or any other inside information.

If we take the front office at their word, Kai Wagner is dealing with a calf injury. What that injury is remains the question.

The injury could be a muscle strain of the gastrocnemius muscle, or simply the more explosive of your calf muscles. The severity of muscle strains is graded from I-III and are determined based on the severity of tearing of the muscle.  Grade I is more of a “tweak” and would keep an athlete out two to four weeks. The tearing in Grade I is microscopic and would not show up very visibly on an MRI.  Grade II is more serious and would keep an athlete out six to 10 weeks typically. This type of tearing is more macroscopic and is visible on MRI. Grade III tears are full tears requiring surgery to repair the offended muscle requiring at minimum 12 weeks recovery.

Another possibility would be some sort of overuse injury such as a tendonopathy.  These can occur in several tendons of the lower leg including achilles, posterior tibialis, and peroneal muscles.  Again, to put it simply, there are several muscles around the ankle that perform a similar motion with different secondary muscle actions that could be involved. Also, the term tendonopathy is the preferred term over tendonitis because –itis indicates active inflammation, which would not be present in a long-term overuse injury.  This would fit more with the lack of true timeline and lack of definitive information on Wagner’s injury.  These overuse injuries require rest and gradual reloading based on symptom tolerance which is different in each case.  For anyone who has dealt with this type of tendon issue, you know they can be nagging and last for weeks into months in many cases.

Since we have no indication of any surgical intervention a Grade III tear is unlikely, compared to a Grade II. However, usually at this point in recovery an athlete would be back to light training and working towards full contact with a Grade II strain.  This would be barring any setbacks that may occur.  My thoughts based on the information given is that it is some sort of overuse injury that is nagging and preventing Wagner from progressing through a normal rehab protocol.  Unfortunately, given what we know right now, the Union will likely be without their starting left back for a few more weeks at least.

But don’t worry everyone: with my luck my predictions will be totally off base and Wagner will be back in the starting XI next Saturday…