How do Saints help to ensure their players come back from a long-term injury?

IT is easy to take an injured play­er’s prog­no­sis as gospel and dis­card them from our thoughts until that dead­line comes.

For the play­er in ques­tion, the injury can mean a long, frus­trat­ing and painful per­son­al jour­ney with — cru­cial­ly — noth­ing guar­an­teed. 

Seri­ous injuries can dis­rupt devel­op­ment, dam­age con­fi­dence or — in the most extreme cas­es — even destroy a career. 

Tim­ing can mean the impli­ca­tions of an injury to a foot­baller can be the dif­fer­ence between the next con­tract and uncer­tain­ty. 

Saints defend­er Dynel Simeu knew that surgery on his rup­tured Achilles ten­don in August would make play­ing again this sea­son unlike­ly. 

“My first con­cern was that it was dur­ing the trans­fer win­dow and I am in the last year of my con­tract,” he told the Dai­ly Echo

Daily Echo: Dynel Simeu made a Premier League bench three times for Saints but was never awarded his senior debutDynel Simeu made a Pre­mier League bench three times for Saints but was nev­er award­ed his senior debut (Image: Southamp­ton FC)

“I knew I need­ed to be play­ing to either impress here or else­where. My first thought was that this was the wrong tim­ing. 

“After a few weeks, I realised there is nev­er a good time for an injury — you’re nev­er pre­pared to get injured,” Simeu con­tin­ued. 

“So I had to look at the pos­i­tives. I am a Southamp­ton boy and I could do my rehab at home with my fam­i­ly and sup­port sys­tem around me. 

“But at first, I was ask­ing ‘What is it? What is it? I thought it was some­thing dif­fer­ent, I thought I had just been kicked in the calf.” 

The man there to answer that ques­tion for Simeu was Chris Onoufriou, Southamp­ton’s cur­rent lead phys­io­ther­a­pist for the under-21s. 

Onoufriou, for­mer­ly a beach soc­cer play­er for East­leigh, grad­u­at­ed from phys­io­ther­a­py at the Uni­ver­si­ty of Southamp­ton in 2017. 

“You’re a part-time psy­chol­o­gist and part-time physio at the same time,” Onoufriou explained, hav­ing invit­ed us to join him for a group ses­sion. 

Daily Echo: What a session looks like as Chris Onoufriou orchestrates in the academy physio centre at StaplewoodWhat a ses­sion looks like as Chris Onoufriou orches­trates in the acad­e­my physio cen­tre at Sta­ple­wood (Image: Alfie House)

“It’s all about build­ing rela­tion­ships with the play­ers because we are the front line with them and they will offload to us. 

“With­out them trust­ing you, you have got no chance. You don’t want them to hide stuff and you want to be able to man­age expec­ta­tions. 

“The oth­er half is the play­ers them­selves as you’ll get some who go all-in right from the start to get back but oth­ers will strug­gle. 

“The hard­est bit is when a play­er does­n’t meet the rough plan you’ve set out and they ques­tion why it’s not sev­en months like you’ve told them.” 

So what actu­al­ly hap­pens when a play­er is injured? Saints med­ical staff have spent years curat­ing their play­er reha­bil­i­ta­tion path­way. 

Injured play­ers will sit with the head of med­ical, doc­tors, phys­io­ther­a­pists, psy­chol­o­gists and some­times coach­es to deter­mine rough­ly how long rehab will be.

If surgery is involved, the sur­geon will strict­ly always be includ­ed in these dis­cus­sions and they will be the case man­ag­er.

They look to work play­ers through five phas­es; recal­i­brate, reload, regain, rein­te­grate and return to per­for­mance. 

Daily Echo: Chris Onoufriou in action on an under-21s matchdayChris Onoufriou in action on an under-21s match­day (Image: Southamp­ton FC)

The ear­ly ini­tial man­age­ment phase might be focused on under­stand­ing and nutri­tion, includ­ing the pre­scrip­tion of vit­a­mins and Col­la­gen for recov­ery. 

The play­er then moves through the path­way with spe­cif­ic move­ment re-train­ing, regain­ing strength and re-intro­duc­ing foot­ball work, re-intro­duc­tion to team train­ing or match­days and final­ly con­tin­ued mon­i­tor­ing of progress after their full return. 

It is a bal­ance of sci­ence and art, Onoufriou insists; you can empir­i­cal­ly mea­sure so much but progress through phas­es comes down to feel­ing.

Under-21s star Dom Bal­lard also required surgery for a major Patel­la ten­don injury, anoth­er with a long lay-off, this sea­son. 

“Achilles and Patel­la ten­don are prob­a­bly the longest rehabs you can have — ACL is long but they’re even longer,” Onoufriou admit­ted. 

“With Dynel, he is super focused. He knows what he wants to achieve and is deter­mined to get there. 

“He has been on it every sin­gle day and from that point of view, he is a dream to work with — because of that men­tal­i­ty, he will be fine.”

Simeu’s ear­ly phase was about giv­ing the ten­don time to heal but had to be bal­anced with not allow­ing it to become stiff and risk reduced range. 

He worked on move­ment deficits he had before his injury before being able to work on func­tion­al move­ments.  

Run­ning on grass came six months into his rehab, with a cou­ple of days on the pitch and then a cou­ple off for ten­don regen­er­a­tion. 

“My recov­ery has been good. At the start, there was a lot of progress, and then you hit some road­blocks along the way,” Simeu said. 

Daily Echo: Dynel Simeu and Diamond Edwards in a session with Chris OnoufriouDynel Simeu and Dia­mond Edwards in a ses­sion with Chris Onoufriou (Image: Alfie House)

“I got back on the pitch but start­ed to feel not as great so we had to go back to the draw­ing board and cater the plan to my needs. 

“I am in a good place so hope­ful­ly there is not long left. It is my first injury and it is a long one so that is hard to deal with.” 

Although the light at the end of the tun­nel can be dim, there is one tried and test­ed method to get foot­ballers to pro­duce a smile. 

“Even when they are in the gym doing a bal­ance ses­sion, we will try and get the balls out as much as pos­si­ble,” Onoufriou said. 

“How long can you stand on one leg for? Bor­ing. How long can you stand on one leg while doing a cou­ple of head­ers? Bril­liant. 

“Then every time the ball touch­es the floor, you give them five press-ups. Any chal­lenge like that makes it engag­ing.” 

Rather than keep the play­ers stir­ring with­in the same four walls, Saints encour­age oppor­tu­ni­ties to get away from Sta­ple­wood. 

The club have mem­ber­ships for the local David Lloyd gym and a gym­nas­tics cen­tre to mix up their sur­round­ings. 

Bal­lard was giv­en time to hol­i­day in the sun while Simeu vis­it­ed Cameroon for 10 days to attend a fam­i­ly wed­ding. 

They will be armed with a plan to keep their recov­ery tick­ing over but it will be no more than an hour of work a day. 

A big focus is put on goals away from recov­ery.

Through the rehab’s five phas­es, foot­ball analy­sis is pushed to build an under­stand­ing of Southamp­ton’s phi­los­o­phy and oppo­si­tion. 

Play­ers will study online video clips or even senior team ses­sions before giv­ing pre­sen­ta­tions to coach­es on what they have learned.

They may also be giv­ing some­thing away from foot­ball to focus on. This could be learn­ing a lan­guage or even DJ lessons. 

Onoufriou insist­ed: ‘It allows them to unwind and get away from it, they work so hard when they’re in rehab.


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“We gave Dynel options but he already speaks anoth­er lan­guage and he wants to be out on the dance­floor — not behind the decks.” 

Asked about his choice, Simeu revealed: “We go swim­ming every week, I could­n’t swim at all before but I am alright at it now. 

“My goal is to be able to jump off a boat. I think it’s the scari­est thing.

“I don’t know when that will hap­pen, but that is my future aim. Once I have con­quered that, I’ll be good!” 

It is not only a cliche man­ager’s response that injured play­ers can improve cer­tain aspects as a play­er despite being side­lined.

If a play­er is skin­ny, they will be made to smash the gym — some­thing there is no time for in a typ­i­cal play­ing sched­ule. 

Injured play­ers spend many more hours at the train­ing ground than their fit coun­ter­parts and have plen­ty of time to build.

It is up to them to max­imise — they can only be giv­en the tools by club staff, although Saints do boast an impres­sive med­ical cen­tre.

Daily Echo: The old first team gym at Staplewood has been turned into a fitness centre for injured playersThe old first team gym at Sta­ple­wood has been turned into a fit­ness cen­tre for injured play­ers (Image: Alfie House)

Saints play­ers have access to an anti-grav­i­ty tread­mill, a hyper­bar­ic cham­ber to pro­vide 100 per cent oxy­gen and blow-up igloos that can be heat­ed to sim­u­late warm weath­er inside. 

Daily Echo: Anti-gravity treadmill - a bubble-like attachment over the legs typically allows users to run with as little as 20 per cent of their body weightAnti-grav­i­ty tread­mill — a bub­ble-like attach­ment over the legs typ­i­cal­ly allows users to run with as lit­tle as 20 per cent of their body weight (Image: Alfie House)

They have freez­ing-cold cryother­a­py, elec­trother­a­py and Tecar machines — an ultra­sound-like ther­a­py to reduce pain and stim­u­late tis­sue repair. 

Daily Echo: These igloos can be blown up and heated to simulate warm weatherThese igloos can be blown up and heat­ed to sim­u­late warm weath­er (Image: Alfie House)

Even down to the under-18s, the first age group in the pro­fes­sion­al devel­op­ment phase, play­ers will get one-to-one physio time. 

Daily Echo: 'Recovery Zone' - space for players to use compression boots and massage guns. Not an unusual place for a player to fall asleep‘Recov­ery Zone’ — space for play­ers to use com­pres­sion boots and mas­sage guns. Not an unusu­al place for a play­er to fall asleep (Image: Alfie House)

The club brings in a breath­ing expert, man­u­fac­tur­ers of spe­cial­ist beds and uses sleep­ing sprays for relax­ation dur­ing trav­el.

Daily Echo: Gym guidelines on the wall at StaplewoodGym guide­lines on the wall at Sta­ple­wood (Image: Alfie House)

The day after every game, play­ers will be giv­en an ‘MOT’ by med­ical staff. 

“At Saints, we’re real­ly lucky because all the staff are dri­ven to be for­ward-think­ing,” Onoufriou insist­ed. 

“Noth­ing is com­ing in in the future that is going to change every­thing but as a col­lec­tive, we’re always look­ing at an extra per cent.” 

Simeu added: “I knew I had a club well-equipped with good peo­ple around me so that all changed my mind­set quick­ly.

“For a while after my surgery, I could not move from my bed as I had to keep my leg ele­vat­ed. 

“I was very grate­ful to be at home. My mum looked after me and cooked me great meals and my dad was always around to give me advice — whether I want­ed to hear it or not!” 

Simeu now has to hope that a man­ag­er some­where in the Foot­ball League will put their trust in him this sum­mer. 

Daily Echo: Dynel Simeu, 22, has banked 50 appearances between League One and TwoDynel Simeu, 22, has banked 50 appear­ances between League One and Two (Image: PA)

The Southamp­ton-local, for­mer Chelsea lad has already impressed in loans at the likes of Carlisle, Tran­mere and More­cambe. 

He may have to rely on that bank of expe­ri­ence already built if he is cru­el­ly denied the chance to play again this term. 

Simeu is not the first play­er to be injured in such cir­cum­stances and will not be the last — you want all of them to have their come­back. 

“My con­tract end is com­ing up and I know that I will be leav­ing at the end of the sea­son,” he said. 

“The worst thing with injury is know­ing you can’t affect what comes next, every­thing you have done is in the past. 

“I could­n’t turn down the oppor­tu­ni­ty to play for this club, loads of my friends are Southamp­ton sup­port­ers and it has been an hon­our. 

“I have already got over 50 games in the Foot­ball League so I believe I should be good. I go with faith every day. 

“I believe every­thing hap­pens for a rea­son and I have that tat­tooed on my skin. I believe I will come back stronger, wher­ev­er I belong.”