🏴󠁧󠁢󠁥󠁮󠁧󠁿 10. Cole Palmer

[bigbluewillie 1,946]

Chelsea manager Enzo Maresca says Cole Palmer's ongoing groin injury makes no "sense" - and hopes it does not prove to be a season-long problem.

[Vesper 30,589]

7 hours ago, bigbluewillie said:

Chelsea manager Enzo Maresca says Cole Palmer's ongoing groin injury makes no "sense" - and hopes it does not prove to be a season-long problem.

We are so fucked atm.

Grrrrrrrr

[Vesper 30,589]

Palmer made the FIFA Best XI for 2025

https://www.fifa.com/en/the-best-fifa-football-awards/2025/articles/mens-11-revealed-2025

The Best FIFA Men’s 11 

• Goalkeeper: Gianluigi Donnarumma

• Defenders: Achraf Hakimi, Willian Pacho, Virgil van Dijk, Nuno Mendes

• Midfielders: Cole Palmer, Vitinha, Pedri, Jude Bellingham

• Forwards: Ousmane Dembele, Lamine Yamal

[Vesper 30,589]

What is pubalgia, the chronic groin condition afflicting Lamine Yamal, Cole Palmer, Franco Mastantuono, and Nico Williams?

https://www.nytimes.com/athletic/6866405/2025/12/09/what-is-pubalgia-the-chronic-groin-condition-afflicting-yamal-palmer-and-williams/

Pop quiz, hotshot: What two things do Barcelona’s Lamine Yamal, Real Madrid’s Franco Mastantuono, Athletic Club’s Nico Williams and Chelsea’s Cole Palmer all have in common?

All are wingers and, in recent months, all four have been diagnosed with an injury called ‘pubalgia’, a chronic groin injury causing pain in the lower abdomen and groin, and which has previously affected Lionel Messi.

The injuries have been disruptive to both the players and their clubs’ campaigns. Palmer has made just six appearances for Chelsea this season, completing 90 minutes only twice, and is being rested for the Champions League game against Atalanta tonight as the club aim to manage his workload. Williams, meanwhile, has missed seven games for Athletic Club.

Yamal has only been ruled out of five matches but Barcelona and Spain have clashed over the handling of his condition. The Catalans had accused the national team of not “taking care” of the player when he aggravated his groin while on international duty in September, while Spain expressed “surprise and displeasure” at Yamal being withdrawn from their squad by Barcelona for their November fixtures.

Here, The Athletic digs deeper into pubalgia, what causes it, why certain players are affected more than others and what can be done about it.

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What is pubalgia?

Pubalgia is actually an umbrella term that can include a number of different issues in the same area, says former Manchester United physiotherapist David Binningsley. “It’s a generic term that encompasses pain around the groin referred from structures such as tendon, joint, fascia and nerve pathology,” says Binningsley.

“The groin includes the adductor muscles, which flow into the muscles of the abdomen and they’re all linked across the pubic symphysis (a joint located at the front of the pelvis where the left and right pubic bones are joined). The general term for any pain around that area will be classed as pubalgia.”

That means that all four of the players mentioned above could actually be suffering from different injuries, such as an adductor tear, abdominal strain or a hernia-related problem.

Cole Palmer has spent much of this season on the sidelines Crystal Pix/MB Media/Getty Images

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Are wingers more susceptible to these injuries?

It is probably not a coincidence that Yamal, Mastantuono, Williams and Palmer all operate in wide positions, according to Geoff Scott, a high-performance specialist who worked in the Premier League for 20 years, most recently as head of medicine and sports science at Tottenham Hotspur.

“Wingers and wide players are particularly vulnerable to groin problems because their game demands repeated high-speed running, rapid changes of direction, and explosive acceleration and decelerations,” he says. “These movements place a significant load on the adductor complex, especially when sprint volumes increase sharply.”

Binningsley also points to the unilateral nature of the position, stressing that the wider players will be using one foot a lot of the time. “In terms of the high accelerations and decelerations, you will probably find that a winger is favouring one side compared to a player who is more central,” he says.

He highlights a recent research paper which concluded that when players execute a maximal deceleration from a sprint, almost 14 times their bodyweight goes through the hip joint.

It’s an injury that players can develop on both sides, explains Binningsley, usually concurrently because they will rehab the problem on one side and overlook the other.

“I’ve got an interesting case at the minute,” says Binningsley, who has set up his own clinic since leaving United. “He’s had groin pain on one side and you come in and measure him and he’s 35 per cent down (in strength) on that side. I said, ‘What have you done?’ He went, ‘Well, I’ve just rehabbed the other side,’ but he’s focused on functional movement strengthening, not isolated muscle rehab.”

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Is age also a factor?

Yamal and Mastantuono are 18, while Williams and Palmer are both 23, and Scott says that age can play a role in susceptibility to injuries around the groin.

“We see this even more frequently in younger players making the transition into first-team football: the sudden jump in training intensity, match tempo, and high-speed running can create dramatic changes in load that the groin simply isn’t conditioned for yet,” he says. “Without careful management of these situations, the risk of adductor injuries can rise considerably.”

Dr Sean Cumming is a professor in paediatric exercise science at the University of Bath and internationally recognised as a leading expert on growth and maturation in sports. He explains that there are certain parts of the skeleton that, in an average male, are not fully developed until the age of 21 or 22.

“These are areas called the apophyses,” says Cumming. “These are little bony sites where the tendon attaches from the muscle through to the bone, and those sites are on the hip and pelvis.”

Franco Mastantuono joined Real Madrid in the summer Angel Martinez/Getty Images

Cumming stresses the importance of not overloading these players, as does Binningsley, who points to the “growing demands of the game.” Palmer and Mastantuono played in FIFA’s revamped Club World Cup over the summer; they are also, along with Yamal and Williams, full internationals with all the travel and playing demands that involve.

“This is the concern that everyone in football has got: that guys are getting 10 days off maximum before they’re back in for pre-season,” Binningsley says.

Once the season has started, there is little opportunity for respite for those who are playing internationally, too. “The players who are not internationals can get around 10 days off each international break, which helps them to settle injuries down,” Binningsley adds. “Then you’ve got the ones who have been selected (for their country) who have the game demands of playing in Europe and playing Premier League or La Liga every week.”

Game density is the most-used term among most backroom teams these days, looking at the number of games a player has had in a certain amount of time.

“If you look at a seven-day load in terms of training and games, then you look at a 28-day chronic load, these guys are constantly at the top in terms of minutes, metres per minute, distance covered, sprint distance,” says Binningsley. “And it’s all an overuse thing.”

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How are they treated and prevented?

In terms of the approach to dealing with these injuries, Binningsley says it will be similar no matter what the exact issue.

He explains that most are tendon-based problems which will be best treated with isometric exercises (a form of static strength training where muscles are contracted and held in place without changing their length or the angle of the joint — these can include squeezing a small ball between the knees for increasing durations), shockwave therapy (a treatment that uses high-energy sound waves to treat the injured area) and radio frequency treatment which involves using high-frequency waves to stimulate the production of collagen and elastin.

Platelet-rich plasma injections, whereby a sample of the patient’s own blood is taken, spun in a centrifuge to concentrate the platelets and growth factors and injected into the injured body part to promote a healing response, have also been used — though the evidence on its efficacy is less convincing.

“Whatever modality you treat it with, a tendon is going to take six to eight weeks to fully heal,” says Binningsley, although he adds that players can return from smaller tendon injuries after four or five weeks “because the rest of the tendon can take up the slack.” More serious tendon issues can leave a player on the sidelines for up to 12 weeks.

Nico Williams is another who has suffered with groin problems Ozan Kose/AFP via Getty Images

But what about prevention: could more be done to guard against these injuries occurring? For a physiotherapist, the answer to that is always going to be a resounding ‘yes,’ especially in an environment where the time available for strength work is minimal once a season is underway.

“We say, ‘We’ll microdose this and we’ll microdose that,’ so you get a little hit of adductors or hamstrings post one game. Then a little bit after the next game to hit quads and abductors. But how many clubs are doing it?” asks Binningsley. “How many players do it? Are we standing over them, watching them do every single set and repetition? Probably not.”

It doesn’t help much that the isometric exercises, which are most beneficial for strengthening the groin area, are not the most exciting. But in terms of injury prevention, the squeezes and holds are effective, and don’t leave players with any muscle soreness because there is no eccentric component to them.

“They’re basically telling the muscle, ‘You need to work and this is going to have to switch on,’” says Binningsley. “It’s about neuromuscular facilitation; the brain knows and the body knows it’s going to have to work and this is what we’re activating it with.

“It’s not the sexy side of training that you see on Instagram. But this is more beneficial for you.”