Pat Bamford’s feet: TSB investigates - The Square Ball 30/3/22

FLOORBANGER TECHNIQUE

Written by: Moxcowhite • Daniel Chapman

It is not for me to wonder why Leeds United chose to pile Pat Bamford’s ruptured hoof upon my reasons for dreading last weekend’s end, when I was already miserable and disoriented enough from the clocks going forward and the sun staying in the sky at night. Instead, after they issued their ‘Injury Update’ on Sunday evening, all I could wonder about were Bamford’s feet and their various aches and injuries.

Pazza Bamfs has, head of medicine and performance Rob Price says, “played with a plantar fascia injury for the last twelve months, and despite treatment and a prolonged period of rehabilitation, the injury has progressed from a partial tear to a full rupture.

“Patrick has been incredibly unlucky this year,” Rob went on. “His game time has been limited by different injuries including an ankle injury sustained at Newcastle and hamstring and quad injuries once back in training and matchday squads. What he needs is a period of rest and rehabilitation to allow his body to fully recover.”

Don’t we all. Injuries have been a hot topic at Leeds this season, which is an understated way of saying they have ruined the whole campaign and robbed us of Marcelo Bielsa’s presence in our city. So news like this prompts a lot of thoughts. First among them is, wasn’t Jesse Marsch going to solve it all? At his first press conference, Marsch said:

“There’s been a little bit of a cycle here where guys have been fighting through injuries, and often playing with injuries, and it means they’ve sometimes picked up other injuries and put themselves more in danger of missing minutes. What I need to do is help guys recover as quickly as possible but not overload or endanger them.”

Since then, he’s put Bamford on the bench at Leicester when he was only fit for ten minutes if needed, from where he watched Tyler Roberts limping himself out of the rest of the season. Then Bamford was on the pitch for the last half hour against Aston Villa, and the first forty-five minutes against Norwich — he had hoped for an hour, said Marsch, but at half-time it was obvious Pat was done. Then he started against Wolves and his plantar fascia ruptured inside 25 minutes. Next time I’m transporting some priceless porcelain, I’m not calling Jesse Marsch.

Bamford’s bad paw has a much longer history, though, so we should wonder about the eleven months leading up to this. That means learning about the plantar fascia and how it tears and ruptures. Which means googling it. I am not a doctor, nor an anatomical expert, but they let Gabby Agbonlahor on the radio to talk about stuff he doesn’t know anything about, so I feel on safe ground saying literally anything I like about sport. And feet. It won’t really matter. So here goes.

The plantar fascia is a ligament that stretches from the heel, along the bottom of the foot, to the toes. It’s very important! It stabilises the arch, works like a shock absorber meeting the ground, and its rigid structure is important to propulsive motion i.e. running and jumping. Athletes use this thing a lot and as such it gets a lot of wear and tear and then it hurts. It sounds like this is what has afflicted Pazza Bamfs (and Rodrigo): the plantar fascia can degenerate and weaken over time, and become painful, but isn’t a game-ender until it gets really bad.

Ordinary wear on a plantar fascia can turn into tearing — the condition is called plantar fasciitis — but a number of factors can speed that process up. Do any apply to Patrick? Obesity and old age, no. Intense, repetitive training and overwork? Ah, now we can point a finger at Bielsa. But it might also be Bamford’s fault: worn out boots can be a problem, or boots that don’t provide proper support, or wearing high heels, and we did see him going to get some orthotic shoes fitted the other week, suggesting he needed better footwear. Equally, he might just have naturally wonky feet — the way some tootsies are built can mean forces on the plantar fascia will cause problems in the end. Another possible factor that interested me was training on hard surfaces, when I remembered lots of Leeds’ first team activity moved indoors during the pandemic and stayed there. Their strength work is done inside, playlists blasting, on the hard floors of The Barn at Thorp Arch.

Ultimately, it’s really hard to identify one reason why a person might wind up suffering from plantar fasciitis. They might not even notice they have it, which doesn’t help. It manifests itself first in painful heels in the morning, and what footballer doesn’t wake up every day with aching dogs? We forget sometimes how much time elite athletes spend just, like, in pain. Footballers or track athletes or tennis players will laugh at the idea of 100 per cent fitness. As Rob Price said, this season Bamford has been out with an injured ankle, then his hamstring, then his quad. How are you going to differentiate between types of pain and say this hurt is being caused by the ankle, and another is coming from the sole? Those twelve months of plantar fasciitis could have been masked by either assuming what was hurting was ordinary ache and pain, or thinking it was being caused by another injury, until all the other injuries subsided and the cause of the remaining pain revealed itself.

“Patrick Bamford, we believe, is not too bad,” Marsch said in his post-match press conference at Wolves, surprising everyone who had seen him pulling up in agony on the pitch and crying on Liam Cooper’s shoulder on the bench. “I think that with his plantar fasciitis it’s just been sensitive over the last couple of weeks as he’s trying to get himself back, obviously he was very disappointed, and then the reaction can look like it’s a bad injury. But I don’t think it is, I think he was just really disappointed to have to come off the pitch.”

Funny how it turned out, Jesse! A tear becoming a rupture was not inevitable, but it was possible. The internet tells me there is some debate about how a rupture can be caused. They can tend to come after a course of painkilling corticosteroid injections aimed at helping an athlete manage the pain, meaning those injections are thought by some to be the cause of ruptures; other studies deem corticosteroid to be safe, and a rupture just a result of keeping working on something that is already tearing. If plantar fasciitis is chronic — and twelve months sounds pretty chronic — it can weaken the ligament so much it’s gonna go altogether at some point. See: Bamford, Patrick J.

This is not, though, necessarily a bad thing. There are three options for action with plantar fasciitis. First is rest, until the ligament repairs the tears and restores itself to full strength. This can be a slow process, though, as there isn’t a lot of blood flowing to this thing. Secondly, plantar fascia release surgery, which involves a ‘precise and systematic’ cutting of the plantar fascia to release the tension in the ligament, ease the inflammation, stop the pain, and start a process of healing that will make it good as new. The third option is for a rupture to happen, like it did to Bambo, which is basically an uncontrolled version of option two.

Option three is such a good idea, in theory anyway, that some athletes have taken the process upon themselves. I’m indebted to TSBer Eamon Bower who got in touch from Down Under to tell us about Aussie Rules player Rob Harvey, and his (as Eamon put it) “ridgy didge no worries she’ll be bloody right” ‘Harvey Floorbanger’ approach to rupturing his own torn and painful plantar fascia. Harvey explains it in this video, or, from a report in The Australian newspaper:

Driven to despair by a partial tear in his plantar fascia — the tissue that runs from the heel bone along the foot to attach under the arch — Harvey famously jumped repeatedly off his kitchen table to fully rupture the band in order to allow it to heal and him to return to the field. While hardly scientific, it proved an effective remedy…

Can anyone picture Pat Bamford repeatedly jumping from his kitchen table to bang his foot off the stone tiling until his ligament snaps? And them with a new baby in the house, too. It doesn’t seem likely. Another Aussie Rules player, Josh Kennedy, was inspired by the Floorbanger technique but took a different tack: he got a painkilling injection and set off doing sprints at the team training centre until his plantar fascia snapped. Which sort of seems like what Bamford ended up doing anyway. It’s not strictly advised by medical practitioners. In the video, Harvey mentions a player who jumped off a fence and, “fixed his plantar fascia, broke his ankle.” Those words ‘precise and systematic’ are used to describe the surgery for a reason, and an uncontrolled rupture carries problems of bruising and swelling, and the risk of only half-rupturing it without doing the full job. One physio said:

“If you do rupture it, it means once the pain goes away, you won’t have trouble with it. If you half rupture it, it’s worse in the sense that you’ve now got a half ligament that gets sore because it’s working too hard in the future. That’s the only upside of a complete rupture — once it’s ruptured and the pain goes away, you can’t rupture it any more.”

And that, hopefully, is the good news for Bamford. United’s injury update said he won’t require an operation, and this should be why — he was basically self-administering his own surgery on the pitch at Wolves. No wonder he had tears in his eyes. But whether under the doctor’s knife or lying on the grass at Molineux, a rupture releases the tension that causes the pain and starts the repair work the foot needs to be good as new, so Bamford is fast on the way to pain-free feet in the future.

Admittedly, option one — rest until it gets better — might also have worked. It’s what Bielsa was aiming for. When discussing Rodrigo and Bamford’s heels, he said they were waiting until they were pain-free enough to train. Marsch’s method seems to have been patching Bamford up to get as much as he could out of him to save our season, hoping any rupturing would wait until the team was safe. “What I need to do is help guys recover as quickly as possible but not overload or endanger them,” he said when he arrived, and in the sense that even though it ruptured, Bamford’s plantar fascia is now on the mend, that could still be true. But Premier League safety is taking priority until the summer, when all these hurt bodies can rest, and for now we have to hope what we got from Bamford in March was enough.