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IT'S amazing how injuries in sport, like buses, often come along in clusters.

Chris Sutton has only recently recovered from a hamstring injury at Celtic as Alan Thompson starts rehabilitation from his while youngsters Shaun Maloney and John Kennedy are both recovering from knee ligament injuries.

It's the same south of the border. Liverpool's Steven Gerrard has just had surgery on a broken metatarsal, a fortnight after England team-mate Wayne Rooney scored a hat-trick on his Manchester United debut following a prolonged period out with a similar complaint. Gerrard's injury happened when he caught his studs in the Old Trafford turf last month and even though he's had a screw inserted into his foot to hold the bone in place and facilitate healing, the midfielder can still expect to be out of action for six more weeks.

David Beckham, Danny Murphy and Garry Neville are other England stars to have broken metatarsals in recent years while Hibs and Scotland Under-21 striker Gary O'Connor has broken one in either foot.

So what are metatarsal injuries and why are they so common?

The metatarsals are the five long bones in the foot. Injury normally results from a direct blow, such as a tackle or someone stamping on the foot. They can also result when the bone is weakened. The main symptoms are pain, swelling and tenderness and the symptoms will be aggravated by weight bearing such as running. Runners struggle when the second metatarsal is broken as this is critical in weight bearing.

These fractures are often compared to the ones boxers break in the hand, known as the metacarpals. Boxers break them when they punch and footballers when they kick or are kicked. It normally takes between six to eight weeks to recover. Some players wear special boots to protect the area and surgery may be needed to hold the bone in place during the healing process. The best treatment is rest and non-weight-bearing activity to maintain fitness.

Think back to just before the 2000 World Cup when Beckham fractured his metatarsal. How would he recover in time - unable to run or kick a ball? The answer was Hydrotherapy. David worked in the pool up to three sessions each day to maintain cardiovascular fitness.

The result? He returned to full training earlier than expected and played in the World Cup.

Whether it is after a frustrating game of golf, a session at the gym or just a hard day at work, we all understand the pleasure of a long soak in a warm bath - with or without a glass of wine. But did you know that the relief of pain, stiffness and muscle spasm by water therapy or Hydrotherapy has been around for more than 2000 years?

Hydrotherapy spas were introduced by the Roman Empire and still exist today in Bath and other towns.

Modern day Hydrotherapy dates back to the mid-1800s with the belief that the waters would dissolve and remove diseased matter and strengthen the body by restoring cleansed blood to the tissues and maximising circulation. The Hydros, such as those at Crieff and Peebles, were originally set up for this purpose. In addition to the baths, water with a particular mineral content was taken internally. Even today colonic or bowel irrigation has survived as a treatment favoured by some.

So what is Hydrotherapy? It is basically physiotherapy in heated water and its benefits come from two main factors - the high water temperature (and resultant humid air) and the buoyancy or relative reduction in body weight. It is also fun, which encourages and maintains motivation - helping psychologically in the recovery from injury or illness.

The benefits of Hydrotherapy include relief of pain and muscle spasm (like aching stiff backs), strengthening weak muscles and improving balance, co-ordination and posture. It can be used on children with muscle or joint problems and older patients where arthritis or reduced strength limit land-based physiotherapy.

Scott Harrison, Scotland's world boxing champion, injured his arm in preparation for a title defence against William Abelyan. He could not punch without suffering pain and making the injury worse. Sparring and punch bag work, vital in Scott's preparation, were impossible so he came for treatment at the Sports Injury Clinic at Hampden and underwent sessions in the Hydrotherapy pool. It meant Scott could improve his fitness and work his arms to simulate punching.

Hydrotherapy helps maintain cardiovascular fitness during injury rehab and can be used as part of the treatment of specific injuries, especially to the lower limbs. It will allow Gerrard to return in peak physical condition. When Barry Ferguson leads out the Scotland team tonight against Moldova his mind may drift back to his hydro sessions as he battled back from a fractured kneecap. His recovery should inspire Kennedy and Maloney, who will use Hydrotherapy, working to their maximum intensity in the pool to build up muscle strength and improve fitness until they are able to run on dry land.

Remember Gerrard et al the next time you reach out for another glass of wine as you soak away in that warm, relaxing bath.


POOR OLD STEVIE: Gerrard has missed out on international action because of foot injury and he's not the first
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Title Annotation:Sport
Publication:Daily Record (Glasgow, Scotland)
Date:Oct 13, 2004
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