When Arsenal football club announced new signing Jurrien Timber faced a lengthy spell on the sidelines due to a serious knee injury sustained on his Premier League debut, sports fans questioned why so many top professionals have been struck down with the same injury in recent weeks.
The Dutch defender, who signed for the North London club only last month, faces lengthy rehabilitation and a similar recovery programme to Real Madrid stars Thibaut Courtois and Eder Militao, who also damaged their anterior cruciate knee ligaments (ACL) during pre-season training.
And they are not the only ones.
Christopher Nkunku, one of Chelsea’s many star summer signings, has a similar injury, while teammate Wesley Fofana had surgery on his ACL last month.
Aston Villa defender Tyrone Mings was another who crumpled to the floor on the opening day of the Premier League season after sustaining a serious ACL injury.
Stem cell therapy accelerates the early recovery and delays the further degeneration of the affected tissues
Dr Ashok Kumar,
orthopaedic surgeon
The Women’s World Cup in Australia and New Zealand, which draws to a close on Sunday, has been without 30 top players because of ACL tears, including England stars Leah Williamson and Beth Mead.
This year's Rugby World Cup will be without one of its biggest stars – France fly-half Romain Ntamack – who has been ruled out with a ruptured ACL.
This may seem like a mini-pandemic in the world of top-level sport, but experts say there is little evidence to suggest the injury is becoming more common.
“The incidence of these type of injuries has not changed, but we may see them more commonly because more people are active and involved in collision-type sports,” said Dr Erik Hohmann, an orthopaedic surgeon who has worked with Australian professional rugby teams and FC Bayern Munich.
“Football is big and the injury has a high incidence but the absolute number of ACL injuries per hours played has not changed.”
The ACL in the knee connects the shin bone to the thigh bone and is vital for pivoting, jumping and landing.
Women more at risk
While a series of high-profile ACL injuries may be a freak occurrence this summer, studies have shown the injury is becoming more common in young people, while women are also more susceptible.
Research by the University of Minnesota Medical School showed ACL tears in people aged six-18 have increased by 2.3 per cent a year over the past two decades.
Data showed girls reported higher rates of ACL tears, peaking at age 16 with 392 injuries per 100,000 people per year.
In the male population, ACL injuries peaked at age 17, with 422 injuries per 100,000.
There are on average 200,000 reported ACL tears per year in the US.
“Females in general are more vulnerable, maybe as much as eight times, due to a couple of factors,” said Dr Hohmann, who now works at Burjeel Hospital for Advanced Surgery in Dubai.
“Men have more testosterone and women have more oestrogen that makes the tissue more elastic and [leads to] a higher risk of injury.
“If we look at the hormonal cycle of women, as soon as there is a high oestrogen push and they are ovulating, they are at more risk of an ACL injury.
“When they perform jumping sports like handball or basketball, women have different landing patterns.
“They are landing with knock-knees so are extending their knees more and they are not bending as much [as men].
“These are risk factors, whereas men are more bow-legged and bend their knees more, with more muscle strength per square cm, so it is a hormonal, anatomical and biomechanical problem.”
While that could explain the high number of injuries at the Women’s World Cup, there are still questions over the recent spate of injuries in men’s football.
When a player has to undergo surgery to repair a damaged ACL, doctors will often look at several options.
Repairs can be made with tendons extracted from the hamstring or patella or even with a synthetic alternative.
Each option has different properties and recovery times, said Dr Hohmann.
“The patella tendon is generally stiffer and heals faster, which is why we take this option with professional athletes,” he said.
“In recreational athletes, we tend to use hamstrings and recovery is slow.”
Surgical alternatives
While some professional players may return to top-level sport after about six months, they are more at risk of developing osteoarthritis in later life.
The advice for most people, without the commercial pressures of professional sport, is usually a slower recovery of about 15 months.
One of those is Andrei Comsa, 30, a physiotherapist in Dubai, who had surgery in 2018 after first suffering a meniscus and ACL tear while playing football seven years earlier.
“It happened on a synthetic pitch while I was taking a shot, and my standing leg just gave way,” said Mr Comsa, who played semi-professionally for Metalul Aiud in the third tier of Romanian football as a right-sided defender.
“I had no issues while playing on a full-size grass pitch, but it was a problem on the artificial surface.
“I went through a period of rehabilitation and continued to play until 2018 when my meniscus had gradually deteriorated and I required an operation.
“I was able to walk without sticks after a few months and since then it has been perfect.
“The only way you could tell I had an operation is the scars around my knee.”
Mr Comsa underwent knee reconstruction, with surgeons using extracts from his patella to create new ligaments.
Since then he has retrained as a physiotherapist and personal trainer and he moved to Dubai 12 months ago, working at J-Club Emirates Towers.
Many of his clients are recovering from similar knee injuries.
“It is an area I have an interest in, particularly as it is something that I have also been through,” said Mr Comsa, who is from Cluj in Romania.
“Most of my clients have been women, as they seem to be more vulnerable to these kind of injuries, due to their hip structure and anatomy.
“But the rehabilitation they must go through is the same as men, it can be a long process.”
Stem cell injections
Techniques to rebuild and repair knee injuries have remained unchanged in recent years, although the development of stem cell therapy could offer a more robust alternative.
Stem cells reset the joint environment, promote healing by reducing pain and swelling and improve the range of motions and quality of life.
Stem cell therapy also helps patients undecided about surgery or those medically unfit for a full knee replacement.
While there is little scientific data to support the therapy in professional sport, experts at Abu Dhabi Stem Cells Centre (ADSCC) said it could be used more widely in the general population.
“Studies have shown that such procedures usually take long recovery time and the patient might have residual painful knee due to incomplete healing,” said Dr Ashok Kumar, an orthopaedic surgeon at ADSCC.
“Surgical augmentation with stem cell injections enhances the strength of repaired or reconstructed tissues.
“It promotes early recovery and delays the ligament and cartilage degenerations in the knee joint.”
Stem cells have the unique ability of self-renewal and promote accelerated healing by replacing the damaged local tissue.
They are harvested from the bone marrow at the time of surgery or taken from patients' own stored stem cell and injected into the desired site.
"Combining stem cells with conventional knee surgery provides better tissue at the site of repair or reconstruction,” said Dr Kumar.
“It accelerates the early recovery and delays the further degeneration of the affected tissues. We proudly perform these procedures at ADSCC.”
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
The specs: 2019 Mercedes-Benz C200 Coupe
Price, base: Dh201,153
Engine: 2.0-litre turbocharged four-cylinder
Transmission: Nine-speed automatic
Power: 204hp @ 5,800rpm
Torque: 300Nm @ 1,600rpm
Fuel economy, combined: 6.7L / 100km
Roll%20of%20Honour%2C%20men%E2%80%99s%20domestic%20rugby%20season
%3Cp%3E%3Cstrong%3EWest%20Asia%20Premiership%3C%2Fstrong%3E%0D%3Cbr%3EChampions%3A%20Dubai%20Tigers%0D%3Cbr%3ERunners%20up%3A%20Bahrain%0D%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EUAE%20Premiership%3C%2Fstrong%3E%0D%3Cbr%3EChampions%3A%20Jebel%20Ali%20Dragons%0D%3Cbr%3ERunners%20up%3A%20Dubai%20Hurricanes%0D%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EUAE%20Division%201%3C%2Fstrong%3E%0D%3Cbr%3EChampions%3A%20Dubai%20Sharks%0D%3Cbr%3ERunners%20up%3A%20Abu%20Dhabi%20Harlequins%20II%0D%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EUAE%20Division%202%3C%2Fstrong%3E%0D%3Cbr%3EChampions%3A%20Dubai%20Tigers%20III%0D%3Cbr%3ERunners%20up%3A%20Dubai%20Sharks%20II%0D%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EDubai%20Sevens%3C%2Fstrong%3E%0D%3Cbr%3EChampions%3A%20Dubai%20Tigers%0D%3Cbr%3ERunners%20up%3A%20Dubai%20Hurricanes%3C%2Fp%3E%0A
Roger Federer's 2018 record
Australian Open Champion
Rotterdam Champion
Indian Wells Runner-up
Miami Second round
Stuttgart Champion
Halle Runner-up
Wimbledon Quarter-finals
Cincinnati Runner-up
US Open Fourth round
Shanghai Semi-finals
Basel Champion
Paris Masters Semi-finals
The specs: 2017 Dodge Viper SRT
Price, base / as tested Dh460,000
Engine 8.4L V10
Transmission Six-speed manual
Power 645hp @ 6,200rpm
Torque 813Nm @ 5,000rpm
Fuel economy, combined 16.8L / 100km
Tour de France
When: July 7-29
UAE Team Emirates:
Dan Martin, Alexander Kristoff, Darwin Atapuma, Marco Marcato, Kristijan Durasek, Oliviero Troia, Roberto Ferrari and Rory Sutherland
THE%20SPECS
%3Cp%3EBattery%3A%2060kW%20lithium-ion%20phosphate%3Cbr%3EPower%3A%20Up%20to%20201bhp%3Cbr%3E0%20to%20100kph%3A%207.3%20seconds%3Cbr%3ERange%3A%20418km%3Cbr%3EPrice%3A%20From%20Dh149%2C900%3Cbr%3EAvailable%3A%20Now%3C%2Fp%3E%0A
The Vile
Starring: Bdoor Mohammad, Jasem Alkharraz, Iman Tarik, Sarah Taibah
Director: Majid Al Ansari
Rating: 4/5
BRAZIL%20SQUAD
%3Cp%3EGoalkeepers%3A%20Alisson%2C%20Ederson%2C%20Weverton%3Cbr%3E%3Cbr%3EDefenders%3A%20Dani%20Alves%2C%20Marquinhos%2C%20Thiago%20Silva%2C%20Eder%20Militao%20%2C%20Danilo%2C%20Alex%20Sandro%2C%20Alex%20Telles%2C%20Bremer.%3Cbr%3E%3Cbr%3EMidfielders%3A%20Casemiro%2C%20Fred%2C%20Fabinho%2C%20Bruno%20Guimaraes%2C%20Lucas%20Paqueta%2C%20Everton%20Ribeiro.%3Cbr%3E%3Cbr%3EForwards%3A%20Neymar%2C%20Vinicius%20Junior%2C%20Richarlison%2C%20Raphinha%2C%20Antony%2C%20Gabriel%20Jesus%2C%20Gabriel%20Martinelli%2C%20Pedro%2C%20Rodrygo%3C%2Fp%3E%0A
COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3ECompany%3A%20%3C%2Fstrong%3EEducatly%3Cbr%3E%3Cstrong%3EStarted%3A%20%3C%2Fstrong%3E2020%3Cbr%3E%3Cstrong%3EBased%3A%20%3C%2Fstrong%3EUAE%3Cbr%3E%3Cstrong%3EFounders%3A%20%3C%2Fstrong%3EMohmmed%20El%20Sonbaty%2C%20Joan%20Manuel%20and%20Abdelrahman%20Ayman%3Cbr%3E%3Cstrong%3EIndustry%3A%20%3C%2Fstrong%3EEducation%20technology%3Cbr%3E%3Cstrong%3EFunding%20size%3A%20%3C%2Fstrong%3E%242%20million%3Cbr%3E%3Cstrong%3EInvestors%3A%20%3C%2Fstrong%3EEnterprise%20Ireland%2C%20Egypt%20venture%2C%20Plus%20VC%2C%20HBAN%2C%20Falak%20Startups%3C%2Fp%3E%0A
Mohammed bin Zayed Majlis
Vikram%20Vedha
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Groom and Two Brides
Director: Elie Semaan
Starring: Abdullah Boushehri, Laila Abdallah, Lulwa Almulla
Rating: 3/5
The biog
Marital status: Separated with two young daughters
Education: Master's degree from American Univeristy of Cairo
Favourite book: That Is How They Defeat Despair by Salwa Aladian
Favourite Motto: Their happiness is your happiness
Goal: For Nefsy to become his legacy long after he is gon
UAE currency: the story behind the money in your pockets
INDIA SQUADS
India squad for third Test against Sri Lanka
Virat Kohli (capt), Murali Vijay, Lokesh Rahul, Shikhar Dhawan, Cheteshwar Pujara, Ajinkya Rahane, Rohit Sharma, Wriddhiman Saha, Ravichandran Ashwin, Ravindra Jadeja, Kuldeep Yadav, Mohammed Shami, Umesh Yadav, Ishant Sharma, Vijay Shankar
India squad for ODI series against Sri Lanka
Rohit Sharma (capt), Shikhar Dhawan, Ajinkya Rahane, Shreyas Iyer, Manish Pandey, Kedar Jadhav, Dinesh Karthik, Mahendra Singh Dhoni, Hardik Pandya, Axar Patel, Kuldeep Yadav, Yuzvendra Chahal, Jasprit Bumrah, Bhuvneshwar Kumar, Siddarth Kaul
LILO & STITCH
Starring: Sydney Elizebeth Agudong, Maia Kealoha, Chris Sanders
Director: Dean Fleischer Camp
Rating: 4.5/5
Coffee: black death or elixir of life?
It is among the greatest health debates of our time; splashed across newspapers with contradicting headlines - is coffee good for you or not?
Depending on what you read, it is either a cancer-causing, sleep-depriving, stomach ulcer-inducing black death or the secret to long life, cutting the chance of stroke, diabetes and cancer.
The latest research - a study of 8,412 people across the UK who each underwent an MRI heart scan - is intended to put to bed (caffeine allowing) conflicting reports of the pros and cons of consumption.
The study, funded by the British Heart Foundation, contradicted previous findings that it stiffens arteries, putting pressure on the heart and increasing the likelihood of a heart attack or stroke, leading to warnings to cut down.
Numerous studies have recognised the benefits of coffee in cutting oral and esophageal cancer, the risk of a stroke and cirrhosis of the liver.
The benefits are often linked to biologically active compounds including caffeine, flavonoids, lignans, and other polyphenols, which benefit the body. These and othetr coffee compounds regulate genes involved in DNA repair, have anti-inflammatory properties and are associated with lower risk of insulin resistance, which is linked to type-2 diabetes.
But as doctors warn, too much of anything is inadvisable. The British Heart Foundation found the heaviest coffee drinkers in the study were most likely to be men who smoked and drank alcohol regularly.
Excessive amounts of coffee also unsettle the stomach causing or contributing to stomach ulcers. It also stains the teeth over time, hampers absorption of minerals and vitamins like zinc and iron.
It also raises blood pressure, which is largely problematic for people with existing conditions.
So the heaviest drinkers of the black stuff - some in the study had up to 25 cups per day - may want to rein it in.
Rory Reynolds
MATCH INFO
Euro 2020 qualifier
Norway v Spain, Saturday, 10.45pm, UAE
Gertrude Bell's life in focus
A feature film
At one point, two feature films were in the works, but only German director Werner Herzog’s project starring Nicole Kidman would be made. While there were high hopes he would do a worthy job of directing the biopic, when Queen of the Desert arrived in 2015 it was a disappointment. Critics panned the film, in which Herzog largely glossed over Bell’s political work in favour of her ill-fated romances.
A documentary
A project that did do justice to Bell arrived the next year: Sabine Krayenbuhl and Zeva Oelbaum’s Letters from Baghdad: The Extraordinary Life and Times of Gertrude Bell. Drawing on more than 1,000 pieces of archival footage, 1,700 documents and 1,600 letters, the filmmakers painstakingly pieced together a compelling narrative that managed to convey both the depth of Bell’s experience and her tortured love life.
Books, letters and archives
Two biographies have been written about Bell, and both are worth reading: Georgina Howell’s 2006 book Queen of the Desert and Janet Wallach’s 1996 effort Desert Queen. Bell published several books documenting her travels and there are also several volumes of her letters, although they are hard to find in print. Original documents are housed at the Gertrude Bell Archive at the University of Newcastle, which has an online catalogue.
Results
Male 51kg Round 1
Dias Karmanov (KAZ) beat Mabrook Rasea (YEM) by points 2-1.
Male 54kg Round 1
Yelaman Sayassatov (KAZ) beat Chen Huang (TPE) TKO Round 1; Huynh Hoang Phi (VIE) beat Fahad Anakkayi (IND) RSC Round 2; Qais Al Jamal (JOR) beat Man Long Ng (MAC) by points 3-0; Ayad Albadr (IRQ) beat Yashar Yazdani (IRI) by points 2-1.
Male 57kg Round 1
Natthawat Suzikong (THA) beat Abdallah Ondash (LBN) by points 3-0; Almaz Sarsembekov (KAZ) beat Ahmed Al Jubainawi (IRQ) by points 2-1; Hamed Almatari (YEM) beat Nasser Al Rugheeb (KUW) by points 3-0; Zakaria El Jamari (UAE) beat Yu Xi Chen (TPE) by points 3-0.
Men 86kg Round 1
Ahmad Bahman (UAE) beat Mohammad Al Khatib (PAL) by points 2-1
Men 63.5kg Round 1
Noureddin Samir (UAE) beat Polash Chakma (BAN) RSC Round 1.
Female 45kg quarter finals
Narges Mohammadpour (IRI) beat Yuen Wai Chan (HKG) by points.
Female 48kg quarter finals
Szi Ki Wong (HKG) beat Dimple Vaishnav (IND) RSC round 2; Thanawan Thongduang (THA) beat Nastaran Soori (IRI) by points; Shabnam Hussain Zada (AFG) beat Tzu Ching Lin (TPE) by points.
Female 57kg quarter finals
Nguyen Thi Nguyet (VIE) beat Anisha Shetty (IND) by points 2-1; Areeya Sahot (THA) beat Dana Al Mayyal (KUW) RSC Round 1; Sara Idriss (LBN) beat Ching Yee Tsang (HKG) by points 3-0.
