Neymar injury explainer: Likely prognosis and Brazil’s options


Brazil fans worldwide are awaiting the prognosis: How badly injured is Neymar after he hobbled off the pitch in the second half of their 2-0 win over Serbia yesterday?

The Paris Saint-Germain forward was fouled nine times during the match and was ultimately withdrawn by manager Tite after Richarlison scored Brazil’s sublime second goal.

He seemed to sprain his ankle in the 66th minute after accidentally standing on Nikola Milenkovic’s foot, causing Neymar to bend his ankle awkwardly. Pictures later circulated of Neymar’s ankle looking swollen.

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Neymar’s ankle of being injured against Serbia (Photo: Giuseppe Cacace/AFP via Getty Images)

Also circulating were pictures of the forward appearing to be in tears on the substitutes’ bench. Ahead of Brazil’s report of his scan results, here is the latest on Neymar’s injury scare.

What have Brazil said?

Brazil’s national team doctor confirmed that Neymar had sustained a sprained ankle, although Tite said he believed the 30-year-old would play again in the World Cup in Qatar.

Brazil’s doctor said: “Neymar has a sprain on the right ankle. We started treatment immediately, but we need to wait 24 hours to have a better assessment.

“We have nothing else scheduled. Now we need to wait, and we cannot make any premature comments.”

Tite later added: “We are confident that Neymar will continue playing, that he will continue playing in the World Cup.”

How does an ankle work?

Dr Matt Stride, football medicine specialist at Isokinetic in London, says: “You won’t be surprised to know that the foot and ankle district is the most commonly injured district in football. It has always been the most vulnerable area, purely because of its location and the nature of the game of football.”

The ankle is made up of the tibia bone, fibula bone and talus. Ligaments connect those bones: three lateral ligaments on the outside, then a thicker ligament on the inside. The primary job of the ligaments is to stop excessive joint movement and allow a specific range of motion.

Consultant physiotherapist Nick Worth says: “The ankle has to be so flexible, whereas the knee, to a certain extent, is basically a hinge that goes backwards and forwards. The ankle does more than that. Being able to circle your ankle in all different directions means that it’s got to be strong and able to take pressure in all of those directions, and sometimes that’s difficult to do.”

How badly might Neymar’s ankle have been damaged?

Neymar’s seemed to go over on his ankle, probably spraining the ligaments.

When such an ankle injury occurs they are generally graded 1, 2 or 3. Grade 1, when the ligaments receive a minor strain, tend to keep a player out for three weeks. Grade 2, a partial tear, from six to eight weeks. And grade 3, a complete tear, can keep a player out for at least three months.

Even if Neymar has only a grade 1 ligament strain, he would face a rush to be fit for the final on December 18 if Brazil got that far.

Neymar’s history of suffering ankle injuries could complicate things. He has suffered six ankle injuries since joining Barcelona from Santos in 2013, including a sprained ankle in November 2021 that ruled him out for 12 matches for PSG.

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Neymar injuring his ankle in November 2021, which kept him out for two months (Photo: Marcio Machado via Getty Images)

Previous ankle injuries can make a player more susceptible to them in the future. However, there is also a scientific basis to suggest that previously injured ankles can become more robust.

“Some people are able to deal with it better than others,” explains consultant physiotherapist Nick Worth. “If your ankle is flexible, then to a certain extent, you’re able to take more pressure before there is damage on a ligament. On the flip side, if you had repeated ankle injuries, your ankle can go one of two ways: either it becomes a little bit tighter and doesn’t move as much, or, if you’ve got scar tissue in ligaments, sometimes they could be stretchier than they were before, more elastic, more flexible.”

What is the recovery process?

When recovering from an ankle ligament injury, the timespan tends to change at different levels of the football pyramid. Elite professional football has access to MRI and ultrasound scans, which has transformed clubs’ ability to understand an injury and act quickly. Lower down the pyramid, it can be challenging to establish how injured a player is.

“What happens particularly at the lower end of the game, particularly at amateur level, is that the ankle sprain is one of the most trivialised injuries,” says Dr Stride. “With fractures, there is an acceptance that it is either fractured or not. But at a lower level, once they have an X-ray and it’s not a fracture, just a sprain, then it is often left to its own devices.”

With Neymar’s history of suffering ankle injuries, the Brazilian doctors may advise against rushing him back quickly to protect his ankle’s long-term health, despite his status and importance to the team.

“There can be a lot of issues with the strength and stability of the ankle joint if it is not properly managed,” says Dr Stride. “And then going back to football too soon on an ankle that isn’t strong or stable enough, that cycle can happen again, and these microsprains just build up and up, and the ankle becomes weaker and more unstable.”

Where does this leave Brazil?

While Tite would prefer to have his star name available, the sheer number of attackers at his disposal means he has ample backup in Neymar’s free role. The strength in depth means there are several ways the manager can configure his midfield and attack in his absence. Lucas Paqueta, who started the match alongside Casemiro in a midfield pivot, may be asked to push forward, while Everton Ribeiro could be called upon as a natural No 10.

However, with the Brazil manager typically preferring a 4-3-3 formation, Manchester United midfielder Fred or Newcastle United’s Bruno Guimaraes will likely join Casemiro and Paqueta to make a flat midfield trio.

(Top photo: Visionhaus via Getty Images)


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