Will U.S. star Christian Pulisic play in Saturday’s World Cup game? How team doctors will evaluate his injury.
"I did not, like, get hit in the balls," team USA's star said in a press conference Thursday.
Christian Pulisic wants you to know that he did not “get hit in the balls.”
The Hershey native sustained a blow to his crotch when he scored the winning goal in his team’s 1-0 victory against Iran on Tuesday that sent the U.S. to the Round of 16 of the World Cup in Qatar. Pulisic had to leave the field after the goal. At the hospital, he was diagnosed with a “pelvic contusion.”
In a news conference Thursday, Pulisic said the injury “was very painful,” but he is “getting better.”
It is still unclear if Pulisic will play in Saturday’s game against the Netherlands. But Captain America, as he is known, said he is “doing everything in my power to be able to be out there on the field.”
The Inquirer spoke to two sports medicine physicians to learn more about this type of injury, and how Team USA’s doctors may decide if Pulisic is cleared to play.
What is a pelvic contusion?
“A contusion is basically a fancy word to describe a bruise,” said John Vasudevan, a Penn Sports Medicine physician.
A bruise occurs when force — in this case, the blow of Iran’s goalkeeper’s knee to Pulisic’s groin ― creates microscopic damage inside the body. The bruise could be on the bone itself or the soft tissue around it, causing inflammation and pain.
Imaging, such as MRI, can help diagnose a contusion and ensure that any organs behind the pelvis bone weren’t harmed from the blow.
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What is the treatment for this injury?
The contusion heals by itself, usually with rest, patience, and perhaps some treatment for pain management.
How long does it take to recover from a pelvic contusion?
It can take between one and three weeks for the pelvic tissue to heal and the inflammation to go away, Vasudevan said.
How is someone like Pulisic treated?
Most people with similar injuries aren’t the star player of a soccer team ahead of a decisive World Cup game. The inflammation experienced by Pulisic is part of the body’s natural healing process — but it also causes the pain that can limit an athlete’s ability to perform.
An athlete like Pulisic will have access to treatments to calm the tissue and reduce discomfort, said Steven Cohen, an orthopedic surgeon at Thomas Jefferson University Hospital and the head team physician for the Phillies. Those could include light stretching, applying heat or ice to the affected area or using pulsed magnetic waves that reduce inflammation.
Anti-inflammatory medications may also be prescribed.
How will doctors decide if he is ready to play?
The decision to play on Saturday comes down to Pulisic and the team doctors.
“It really is based on his comfort,” Cohen said.
Trainers may see whether he can run, change directions, kick the ball, and do all the movements involving the pelvis in a soccer match of that level.
As a the Phillies team physician, Cohen said he’d worry about putting Pulisic at risk for further injury. When players aren’t at 100%, they could compensate for a weakness, creating higher risk of another injury, he said.
Then if the pain is tolerable — and Pulisic demonstrates that he has the flexibility, strength, and agility — he likely would be cleared to play.
“If the risk [for another injury] is lower, and he’s comfortable, you let him play,” he said.
Even if Pulisic is only performing at 80% or 90%, and he is comfortable, it could be worth having him play because, Cohen noted, at that level Pulisic is still “better than the majority of people in the world.”
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