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SPORTS: CRICKET
Foot Fault
Sachin Tendulkar, who has missed out on his first Test
in 12 years, will not return to cricket until the end of September
By Sandeep Unnithan
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NAILED:
Tendulkar's rare injury can also affect ballet dancers and high
jumpers
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If there's a body
part more obsessed over than the prime minister's knee, it must be Sachin
Tendulkar's toe. Already foreheads are furrowed as India's most popular
athlete has gone missing from action, a fractured toe taking him out of
the three-Test series against Sri Lanka. Injuries to athletes are part
of their job profile but every time Tendulkar winces, it would seem all
of India feels the pain.
As the team began its first Test tour in 12
years without the 28-year-old Mumbai batsman, he appeared on television
asking for all Indians to "pray" for him, little knowing that
cricket-crazy citizens are already halfway through their Hail Marys. It
has been a worrying few weeks for Tendulkar and his doctor Anant Joshi,
with the clamour for information growing: what exactly is the injury,
how long will it take to heal, will he be the same player again? "Sachin
is just another human being. Your fracture and mine take six weeks to
heal. So will his," Joshi wearily says.
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"He
would have risked further injury had he played the Tests."
Dr Anant Joshi, Sports Medicine Specialist
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BREAK POINT
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But Tendulkar's injury is not any routine fracture,
not only because it has affected the cricketer. The problem began on July
4, during the last league match of the tri-series in Zimbabwe. When Tendulkar
struck the ball and set off for a run, he heard a "click" in
his right toe and felt a pain. It was forgotten quickly and he scored
an unbeaten 122, leading India to a six-wicket victory.
Later that day Tendulkar had the foot X-rayed,
but the results showed nothing. He was then cleared to play the final,
which India lost. On his return to Mumbai, when the pain persisted, Tendulkar
went to sports medicine specialist Joshi. On July 17, Joshi took the player
for an isotope bone scan of his foot at Hinduja Hospital. The scan detects
fractured bones by showing them as "hot spots".
Tendulkar's bone scan lit up an area the size
of a 25 paise coin on his toe-and a ct scan of the foot revealed a horizontal
crack in the medial sesamoid bone, a tiny structure around the size of
the nail of the little finger. The bone, embedded inside the muscle tendons
at the base of the great toe, acts like a lever arm for the tendons to
flex the toe.
The fracture took place when Tendulkar heard
the "click"-the sound, most likely, was the tiny bone snapping.
Tendulkar himself suspects there could have been more pressure on the
area due to the spike-studded sole of his custom-made Adidas shoes. One
of the seven spikes in the shoe is located directly below the sesamoid
bone of the great toe. The pressure from the take-off for the run, which
experts reckon puts between three to five times the body weight on one
foot, could have been centered on the tiny bone and fractured it.
The sesamoid bones, strictly speaking, are not
even bones. Made up of thick cartilaginous tissue, sesamoid bones are
mostly found in the lower limbs and are not included among the 206 bones
of the human body. Injuries to these bones are rare and given only a passing
mention in medical tomes-even the best podiatrists and orthopaedic surgeons
come across only four or five cases. Injuries usually occur after an activity
where tremendous pressure is placed on the feet and toes-ballet dancers
and athletes like high jumpers and basketballers are more prone. What
has puzzled many people is the time taken between the first sign of trouble
and the first scan-nearly two weeks. Says Dr P.S.M. Chandran, director
of sports medicine, Sports Authority of India: "A negative X-ray
is not an indication that all is well. You shouldn't leave anything to
chance with a top-class sportsman."
Tendulkar's doctors, suspecting sesamoiditis
(the inflammation of the sesamoid), decided to give the injury three more
weeks to heal before delivering a verdict. The hope was that the foot
would have healed enough to give Tendulkar the chance to play the Test
series. "I don't mind missing the one-dayers, but please ensure I
can make it for the Test series," he told Dr B.A. Krishna, chief
of nuclear medicine at Hinduja Hospital.
The second round of scans, however, showed an
inflammation around the affected area with little sign of healing. Moreover,
Tendulkar winced in pain when Joshi probed the area near the toe. The
verdict was out. "Sachin could have played the Test series only at
the risk of further injury. And even then he wouldn't have been able to
give a hundred per cent," says Joshi. For India's most prolific run-getter
in both forms of the game, the injury now means completely resting the
toe for between six to eight weeks, to allow the bone to heal completely.
"He won't be playing cricket at least until the end of September,"
says Joshi. Surgery, the final option, isn't being thought of just yet.
Tendulkar now has to wear cushioned sandals
and can walk and drive his Mercedes without pain. Experts in the US are
being consulted for designing rigid-soled orthotic footwear. All his footwear-from
sneakers to ordinary slippers-will be retrofitted with these devices,
most of them fitted internally to lift the injured area off the floor.
He will have to wear this special footwear for at least six months after
he resumes playing. Joshi has also devised an "active rest"
exercise regimen, for every part of his body, excluding the lower limbs.
"Sportsmen like him cannot afford to rest completely for so long,"
Joshi says. The good news, he says, is that once the fracture heals, chances
of a recurrence are slim.
In recent weeks, Tendulkar was surrounded by
plenty of conspiracy theories about a difficult relationship with current
captain Sourav Ganguly and his wish to regain the captaincy. They have
all been driven underground and rendered unimportant for the time being
as the only current cricketer in Sir Donald Bradman's all-time World XI
begins his fight for fitness and the chance to return to the field to
do what he did best: go out and bat for India.
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