Ayman Benarous’ season is over as the Bristol City midfielder has suffered a second hamstring injury of the campaign in his bid to recover from back-to-back ACLs.
Benarous hasn’t played for the Robins since April 2022 after sustaining his first ACL in training, with a second following seven months later as he neared a first-team return.
His rehab looked to be trending in the right direction last summer as he worked with the senior squad during pre-season and featured for the Under-21s in August only to then to be set back by a hamstring issue.
The 21-year-old returned to training around the start of the year and, after making two appearances for the U21s against Coventry City and Sheffield Wednesday, there was hope he may even be included in the matchday squad towards the end of this season.
But after not being selected for the Young Robins against Barnsley on Tuesday, head coach Liam Manning has confirmed it was due to injury, albeit another minor one in terms of expected recovery.
“Ayman’s going to be out for the rest of the season, unfortunately,” Manning said. “It’s in a completely different spot, really high up. Nothing major, it’s a four-week injury.
“I find it incredible how level he stays; he’s an extremely intelligent, mature lad and given what he’s had in the last couple of years and how he copes with it, I can’t commend him enough with how consistent his attitude is, and his emotions in terms of some people would be really struggling - he obviously hates the fact he’s injured - but he channels it into work, so I commend him for that.
“He’s now got a couple of months where it’s about getting ready for day one of pre-season and making sure the programme he has in the off-season allows him to be in the best shape possible.”
Benarous’ hamstring injuries, coupled with complications around Rob Atkinson’s attempts to return from his own ACL, and other players experiencing similar period of absence with soft tissue problems, means Manning plans to fully review and potentially restructure City’s training methods over the summer.
It’s a delicate balance because the demands of a Championship are such that staff must maintain and often regularly enhance fitness levels and overall output of the players, but that can come at a price given the additional and constant wear and tear on their bodies.
“It’s a common thing, we do really have to look at it in the summer in terms of what we do, how we operate and how we work,” Manning said. “I’ve had some real initial conversations with Brian (Tinnion, technical director) around what does that look like and where do we go? Because it’s across the game. So I think we need to assess and be brave and go in the direction we believe is going to help us.
“It’s the whole thing across the programme, I wouldn’t say it’s any one thing in isolation; if someone could put their finger on it, you’d be a multi-millionaire because every club is facing the same challenge.
“There has been such a huge boom in strength and conditioning and that side of it. We have to assess and look at how we train and the correlation between the gym and the training - what does that look like?
“Everything has to be geared around Saturday, so how functional is the gym work? How well do we treat the players so injury prevention helps them stay on the pitch? How good is the football in the training programme to make sure it replicates what they need?
“You have to find that sweet spot of not over-cooking them and not under-cooking them. In a 55-game relentless Championship season how do you pitch it? They’re the bits where we have to be brave and look at us, and how we operate.”
Hamstring injuries have been on the rise over the last two decades, as revealed in the the UEFA Elite Club Injury Study which reviewed 54 teams in 20 different countries across a 20-year period. In 2001, hamstring injuries represented 12 per cent of all total injuries but by 2022 had jumped to 24 per cent, while the total days of absence increased from 10 to 20 per cent.
Manning subscribes to the theory that the demand for more football, and the regularity at which games are being played is having a detrimental impact on players’ health. But, at the same time, it remains the landscape he has to work in so the key is finding the best possible path for each individual.
Sam Bell, Mark Sykes, Tommy Conway and Kal Naismith have all experienced hamstring issues over the last 12 months, while Joe Williams’ problems at the start of his City career were well documented, something the midfielder appears to be over.
With the end of the season less than three weeks away, and thoughts turning to the summer and getting the squad in optimum shape, not just for the kick-off to 2024/25 but deep into the season where advantages can be gained, it makes for a tricky balancing act.
“I think so,” Manning added, when asked if the game has a problem. “Knighty and Sykesy have a quick break after the season and then they’re away with Ireland. When you look at the outputs, December, January, February, a game every three-and-a-half days.
“When you ramp it up then the quality of the product suffers because the physical demands are only getting higher and what you then get with that are the psychological demands, hence maybe a tiny bit at the weekend we were sloppy, because we haven’t been like that for quite a while.
“Maybe a little bit, mentally, the volume of games that we’ve recently had. The first thing that gets tired is your brain. I know I’m not the first person that’ll speak about it and I’m sure I won’t be the last but when there’s such a demand for it, it’ll never change.”
City are set to welcome back Rob Dickie for Saturday’s trip to Norwich City as the 28-year-old has missed their last three games with a calf problem. Dickie has trained at the High Performance Centre this week and although Manning has been careful not to categorically state he can play, it looks likely at this stage.
There is also an outside chance of centre-back partner Zak Vyner joining him with the defender missing the weekend draw against Huddersfield Town after a knock to his knee.
“Rob’s very, very close, he’s been in training so it’s just a case of seeing how he responds to that,” Manning said. “Zak’s been out on the grass with the medical staff so there’s a slim chance he’s available for Saturday as well so hopefully we’ll have the two, if not, definitely hopeful for one of them.”
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