Born just over a year apart, developed alongside one another at Arsenal’s Hale End academy and given their first-team debuts within 10 weeks of each other, Bukayo Saka and Emile Smith Rowe were often viewed as two sides of the same coin in the early stages of their professional careers. But a few months after those debuts, their careers diverged.
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While Smith Rowe went out on loan, first to Bundesliga side RB Leipzig and then to Huddersfield Town in the Championship (returning to the Arsenal squad for the first half of the 2019-20 season in between), Saka remained in north London and gradually established himself as a regular starter in the first team.
The 2020-21 campaign brought a lasting reunion, though. After a successful loan spell in Yorkshire, Smith Rowe returned to London full of optimism about the impact he could have on an Arsenal midfield needing a spark. It took until December for him to make an appearance in the league, though a shoulder injury in training meant he was out of action for the early months.
By the time he returned to fitness, Arsenal were knee-deep in their worst start to a league season since 1974-75, with 14 points from as many games.
On December 26, Arsenal manager Mikel Arteta turned to the then-20-year-old, giving him his first league start of the season (his second in total) in a huge Boxing Day derby against London rivals Chelsea at the Emirates. Back alongside Saka (who had started all but three of Arsenal’s league games to that point), Smith Rowe dazzled.
By the end of that season, Smith Rowe had made 33 appearances in all competitions. That rose to 37 the following year, when his goal tally (10 in the league) saw him become the first Arsenal academy graduate to reach double figures in a season since Cesc Fabregas hit 19 in 2009-10 (although Saka replicated the feat a couple of months later, and went one better to finish the season with 11 Premier League goals).
Excitement abounded. Two academy products delivering in the biggest moments for Arsenal? It was the stuff of dreams for the players and the fans. A new chant was created, sung to the tune of Status Quo’s 1977 hit Rockin’ All Over The World:
“And I like it, I like it, I like it, I like it; I la-la-like it, la-la, like it; Here we go, oh! Saka and Emile Smith Rowe.”
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The duo even perfected an iconic celebration, seen after Smith Rowe scored a clinching late second in a 2-0 home win against London rivals West Ham United in December 2021.
Emile Smith Rowe & Bukayo Saka’s celebration after Arsenal’s second goal against West Ham. [BT]
Picture perfect. 😂❤️
— afcstuff (@afcstuff) December 15, 2021
But the pair’s on-field connection has since become frayed, their paths diverging once more.
While Saka has remained a core member of Arteta’s starting XI, Smith Rowe has moved increasingly to the fringes at Arsenal. Initially, that could be put down to personnel issues, such as the emergence of Gabriel Martinelli as a regular starter on the left side of the attack, and Smith Rowe’s proficiency off the bench.
But by the start of last season, physical issues started to play a role.
Hampered by what the club later called “discomfort in his groin”, Smith Rowe had played just over a half’s worth of football in four appearances by mid-September. By the end of that month, he had undergone surgery to repair a damaged tendon in his groin.
Fast forward a year, and Smith Rowe was making his first Arsenal start in 499 days, in an all-London Carabao Cup tie away against Brentford (which Arteta’s side won 1-0).
In the period between those two starts (the other coming against Newcastle United at St James’ Park on May 16 last year), Saka had started 51 games (all competitions) for the club. His durability has been a recurring theme, with Arteta often quizzed on where the limits are for a young player who has made 40-plus club appearances in each of the past three seasons (not to mention the demands also placed on him as an England regular).
The contrast in consistency between the two is stark.
Saka has started all but one of Arsenal’s 12 Premier League games this season, while Smith Rowe has started just one. Since that day (the 5-0 home victory against Sheffield United on October 28), he has been out with a knee injury Arteta described as a “big worry” — although The Athletic’s David Ornstein has since reported the issue is not “overly severe” and relates to a knock suffered in that game, rather than anything more serious or related to previous injuries.
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Even so, a quick glance at the appearance records of the two players over the past three and a bit seasons tells its own story. And it’s one that raises an age-old question: why is it some players seem able to rack up the games year after year, missing nothing more than the odd game here and there, while others seem to collect one injury after another, spending big chunks of their career rehabilitating and rebuilding instead of being able to consistently perform at their peak?
“It’s complex,” says Luke Anthony, the clinical director at sports-injury centre GoPerform who has vast experience working in professional football with clubs including Watford, Reading and Norwich City, holding the title of injury prevention specialist with the latter.
“When we talk about players being injury-prone, there are several factors. I worked with (long-time Reading defender) Chris Gunter, who held the record number of Welsh caps (before Gareth Bale overtook him), for about five seasons. He played every week, plus internationals — 50 to 60 games a season, year after year. And he never missed training.
“Then you have other guys in the same position or team and they might play 25 to 30 games. They don’t necessarily have big injuries but they’ll just have one little thing after another and you’re thinking, ‘What is the difference between them?’.”
It’s an area Anthony has spent a lot of time researching, and he breaks down the factors involved into four (often interrelated) areas…
1) Genetics
Anthony says: “There are some physical attributes that play a role, and some of those come down to genetics.
“For example, there is a condition called hypermobility. Everyone has a degree of natural flexibility. Some people who are more extreme in their flexibility have a degree of hypermobility and we know that people who have a degree of hypermobility have a higher injury risk, because the collagen that makes up the tissue of their muscles, ligaments and tendons is slightly weaker than someone who has ‘normal’ mobility. That means there’s slightly more instability at the joint and slightly less tensile strength in the soft tissue.
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“Often, those people get filtered out; they don’t make the grade (as a professional footballer) because they get injured as a young player and are not robust enough to have a professional career. But some of them come through and there is good data to show that they have a higher injury risk in terms of both soft-tissue and joint-based injury.
“Also, what we know about certain injuries — anterior cruciate ligament (ACL) knee injuries, for example — is that there seems to be a certain predisposition for people to have that type of injury. The research is very strong that if a player has a non-contact isolated ACL injury, there is a higher risk of that person having a future injury, either on the injured or non-injured knee. If you add hypermobility to that, then there’s a five times greater risk.
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“Why is there an increased risk to the non-injured knee? You could say it’s because you’ve injured one knee and put more pressure on the other one. But that argument doesn’t hold as much merit as the probability that there’s something in your makeup — and that can be your genetics or the way that your brain processes information about your movement at the joints when you’re challenged (on the pitch) — that is predisposing you to that injury.
“There is also some evidence that there are certain genetic types that predispose you to a tendon injury. So we know that someone with an Achilles tendon injury is more likely to also have a (knee) patellar tendon injury or other tendon problems. So there probably is a genetic trait that would indicate that.
“So, there is a sort of baseline in terms of what you’re born with. And there is a natural screening process players go through over the years that means if their body is not robust to a certain level, they’ll stop playing in their teenage years or just won’t make it to a professional level. But even in those who do make it to a professional level, there is a variety of levels of genetic robustness to withstand injury or predispose to injury.”
2) Injury history
“If you pick up a hamstring injury early in your career, you are more likely to have hamstring injuries down the line. Is that because you were born more injury-prone or is that because you develop an injury history and that injury history is the thing that predisposes you to further injury?
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“There’s good evidence that injury history is a big determinant of your future playing robustness. So if you pick up injuries in the early part of your career, whether it be to a hamstring, knee or something else, that injury might heal well, but you carry an injury risk going forward. If you have picked up two injuries as a 20-year-old —for example, a hamstring and a knee — then your risk profile is higher for those two common injuries compared to a person who hasn’t had those injuries.
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“When we’re looking at signing a player, the first thing we look at before we look at the player (as a footballer) is their injury history. If he’s played 50 games a year over the last three seasons then you almost don’t even need to do the medical because you think, ‘Well, as long as he’s fit now, he’s shown his body is robust to the demands of the professional sport’.
“At a tissue level, that means strong tendons, strong muscles, the ability to run at fast speeds repetitively, strong connective tissue in your body — muscle tissue, tendon tissue, bone, ligament, et cetera. All those things underpin that ability to tolerate load. Muscular strength is obviously something you can develop, but some players also have it more naturally.”
3) Human aspects
“There’s not a right or wrong to this, but you’ll have some players who will play with an injury and some players who won’t. Putting it down to pain tolerance is probably a bit too basic, there are lots of factors.
“One of those is injury history. If you’ve had a hamstring injury and six months later you have hamstring tightness, you’re less likely to play through it than someone who thinks, ‘Actually it’s just tightness because I’ve played three games in seven days so I’ll get on with it and come through it’.
“It’s just the way people are. Some people are a bit more risk-averse or more apprehensive about things. That’s human nature.
“Having been involved in successful seasons and unsuccessful seasons, I also know that when the team’s playing well and you’re winning games, people will push a bit harder (to play) than when form is not good. Some players might think, ‘Can I take a rest for a week or two and be out of the limelight for a bit?’.”
4) Club factors
“Saka and Smith Rowe had the same upbringing, effectively, at the same club, so this is not specific to them, but the training load within a club is important.
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“You can definitely overload players. Maybe a new manager comes in and puts in a system where he wants a lot more intensity in training and playing and pushes players beyond their levels, so they’ll pick up injuries as a result of overloading. There’s also the danger of underloading, where players don’t train as hard or intensively in the week and then they’re pushed harder in matches.
“There are also issues within squads — a small squad might mean more pressure on players to play with injury. There’s good evidence to show that if you have these low-level injuries, whether it be little contact injuries or micro-trauma to muscle, and you continue to play through those without sufficient recovery, you are more likely to develop more significant injuries.”
Other considerations
“The type of player is also important. The demand is different if you’re a flying winger who relies on top speed as your best asset versus a holding midfield player or central defender who is not required to run as fast as regularly. The tissue is under slightly less stress when you’re having to high-speed run versus when you’re having to top sprint. So the demands of the position, and what the player’s strength actually is, is going to be important.
“People always mention Michael Owen (whose pace up front helped make him a teenage star but whose career was marred by hamstring and other leg injuries). If you have someone who can create high forces by being high speed but they have less muscular strength, then they put more stress through their system and are more likely to have injuries. As we know, the problem is, once you’ve had one injury, it predisposes you to further injury.”
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Do biomechanics play a role?
“Biomechanics are important. We study these things, we look at players’ movement, do analyses.
“From an ACL point of view, if you have a tendency to land with what’s called a valgus knee, where your knee twists in, that is one predisposing factor for a knee injury, or an ACL. But most Premier League football players are top athletes, they generally get screened out of the most significant things.
“So we’re trying to look at more subtle aspects of what makes a player move well and prevent injury. We use things like force-plate testing, where players stand on a plate, jump and land, and you get data that tells you how high they jump, how much force they put through their feet when they land, and what angle their body is at when they land. There’s also something called a CODA (change of direction ability) analysis, where you put markers on different joints and move in front of a camera and it produces a CGI image of the person doing it.
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“I don’t think there’s enough good information there yet to be able to do a number of these tests and say, ‘This player is less likely to get injured than another player’. That’s not to say it won’t be there in years to come, though.”
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What can clubs do to help ‘higher risk’ players?
“If you have a player who’s had a history of hamstring injury, as an example, we know that if you put them through a certain strength-training programme focusing on eccentric muscle training (loading a muscle during movements, or phases of a movement that lengthen the muscle, such as lowering into a squat or the descending phase of a press up), it can help not only to strengthen the muscle, but it will also have a meaningful impact on future injury risk.
“To a lesser extent, we know that it works with adductor (inner thigh/groin) injuries and ankle sprains as well. So when someone’s sprained their ankle, if you put in place a training programme specifically to train the balance, proprioception (the body’s ability to sense movement, action and location) and strength of that ankle, you will reduce the risk of them reinjuring that ankle. And if they do reinjure, you’ll reduce the risk of a high-severity injury.
“We know that for hamstring, adductor and ankle injuries, and to a certain extent with ACL injuries as well, although the research in this case is mostly done with women’s football and junior football. You can’t solve the problem, but you can mitigate their risk of re-injury.
“With tendon injuries, the link is a bit more tenuous but if you work on tendon strength-type exercises like plyometrics, then you can improve their ability to absorb forces, which would reduce their risk of injury.
“The key is to find out the minimum amount of work they need to do to have an effect because they’ve got to play games. It’s not about doing stuff to prevent injury as number one, that’s a side part. I spent a lot of time researching, ‘What’s the minimum amount of eccentric training you can do to reduce someone’s risk of having a hamstring injury?’, because once you’ve got the minimum dose, you can work it into their programme, and people are compliant.”
(Top photos: Getty Images)
