'The outcomes from this surgery are generally very good'
John Gloster, India's new physio, gives us the latest medical bulletin on Sachin Tendulkar's elbow
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With a problem like this you can never really say for certain what is going to happen. But he got through the Pakistan series really well. He was very good with the protocol we set for him, but before that series we had told him we couldn't guarantee that he would be pain-free or would not have discomfort from it. But he battled through, and surprisingly for the majority of the time he was pretty good.
Overall he was pretty good. He had off days but they were certainly not as bad as they had been in the past.
During the break he was going to London and while he was there we felt that he should consult the specialists who had carried out the operation last September. We compared the sets of scans they had then along with the latest ones, and there were changes in the scans. The surgeon reviewed the scans along with myself and Sachin together, and felt that there were some degenerative changes occurring in the extensor tendons of the elbow, and these changes looked to be progressive. So with that mind he basically put the situation to Sachin, and said that once he started playing again they couldn't guarantee that he wouldn't require treatment. The option was given to him to have surgery.
The outcomes from this type of surgery are generally very good. I know the surgeon Dr Andrew Wallace, who is originally from Sydney and has been regarded as one of the top specialists in the United Kingdom for a long while. So after having had a couple of meetings with him and weighing up the entire situation - worst-case scenario, Sachin's level of activity, etc - we came to the conclusion that surgery was an option. Obviously, Sachin was made aware of all this and he gave the go-ahead. If he was going to play for only one more year then surgery might not have been indicated but we all agree that he has got a number of years ahead, and with those long-term prospects we felt that surgery would help that.
It's a worn tissue. Because it doesn't have a good blood supply it becomes poor, and there is micro-tearing. By doing the surgery then you are artificially healing it - you are making it stronger and more durable.
There is no guarantee. But with the results that Wallace has had, he reports that he has never had a case that has come back - the worst-case scenario was that the condition was still the same as what it was pre-operatively. But the percentage of success rate is extremely high.
He'll not be able to tell that for a while. It will be very uncomfortable for the initial week or ten days, because he has had an open surgery. He was in good spirits and very confident, though a bit drowsy.
Yes, that's about right. We will give it the best possible chance of full recovery, and then start a graded return to strength training and then a graded return to batting.
Certainly. There are other things [we could have done], like we could just keep going and hope that day by day we would get him past each match. But Sachin is a perfectionist and an elite athlete, and for the players that belong to this category it only needs very, very minor change to upset them - to upset their rhythm, to upset their technique, to upset their concentration ... and a 1 or 2% change in the pain-level for Sachin might perhaps be enough to distract him to the point where it is upsetting his game. So we are trying to give him every opportunity to not get distracted.
For the intial four to six weeks, yes, as the tendon tissue requires that minimum period to heal. Then it's a gradual recovery to get back. Unfortunately he is left-handed, but he is confident.
Nagraj Gollapudi is sub-editor of Wisden Asia Cricket