2017-09-20 08:32:02
The Lonely Road Back From a Very Public Injury

08:32, September 20 56 0

MANCHESTER, England — From the other side of the wall, the muffled sounds of halftime drifted through to Ilkay Gundogan. He could hear the skitter of studs on the floor, the murmuring voices of his Manchester City teammates exchanging notes, and then his manager, Pep Guardiola, starting to speak.

Gundogan had been with them only a few minutes earlier, joining in the celebrations as they took the lead against Watford, on the way to City’s first Premier League home win in three months. Not long after the goal, he had tried to snatch a loose ball from Watford’s Nordin Amrabat. The two collided. Gundogan fell to the ground, and raised a plaintive arm to summon medical attention.

Initially, he was sure it was “not too serious.” There had been a strange sensation, coming from the outside of his right knee. “The same feeling as when you click your fingers, but without the noise,” he said. Aided by Max Sala, City’s team doctor, Gundogan got to his feet. He could stand. He could walk to the side of the field.

Sala thought it better if his game ended there, but Gundogan insisted he felt O.K. Despite the doctor’s doubts, Gundogan persuaded Sala he should be allowed to continue and trotted back into the game. The first few touches, the first few passes, went fine, but as soon as Gundogan tried to turn, he felt the sensation again.

“I thought something was wrong,” he said. “I knew I had to come out.”

A few minutes later, in the treatment area that sits on the other side of the wall from the first-team changing room at City’s Etihad Stadium, Sala’s on-field suspicion — a ruptured anterior cruciate ligament — was confirmed with a few cursory tests.

Many athletes fear a torn A.C.L. more than any other injury. It is not as visibly painful, or as gruesome, as a broken bone, but it is much more menacing. Not so long ago, it was more often than not the end of a career; even now, many who suffer it find they are never quite the same.

Deep down, as Gundogan watched the second half of that December game against Watford on a laptop in silence, his knee packed in ice, he knew what was coming. He tried to be optimistic.

“People know what to do now,” he thought. “They know how to operate, how to do rehab, how long you are out.”

He had steeled himself for the worst. Now he just had to face it.

What he was facing, though, was intimidating. There would be the delicate hours of surgery, the endless days of rest, the long, slow weeks and months that would teach him first to walk, then to run, and finally to play again.

It would be painful, repetitive, exhausting. He would struggle to stave off the shadow of loneliness, to keep at bay the dread that in his absence from the team, from the spotlight, he would be forgotten. Most of all, he would have to learn to handle it all not as one of the team, but on his own, trapped on the other side of the wall.

Dr. Ramon Cugat knows how to put players, in deep distress and full of fear, at ease. For years, his clinic at Barcelona’s Quiron Hospital has been the first port of call for high-profile victims of knee injuries. Cugat’s expertise has restored David Villa, Fernando Torres, Andres Iniesta and a host of others to their former glories; his manner, as much as his success, has convinced others to follow in their wake.

Gundogan (pronounced GOON-doh-wahn) had worked with Cugat before he spoke to him in the days after the injury; Cugat had carried out an unrelated operation on Gundogan’s kneecap a few months earlier. He had been inclined to return to Cugat anyway. What clinched it was the story Cugat told him when they talked.

“He said that he had also operated on Xavi Hernández,” Gundogan said. “He said that after he had the operation, Xavi won every competition: the Spanish title, the Champions League, the World Cup, everything.”

That was enough. As soon as the swelling on his knee had subsided, Gundogan flew to Barcelona. On Friday, Dec. 23, nine days after his season ended and two before Christmas, he entered the hospital.

For such a major operation, the reconstruction of a cruciate ligament is surprisingly quick: just a couple of hours in theater, no general anesthetic. Gundogan’s whole lower body was numb, but, aside from the first few minutes, he was awake throughout. Cugat instructed his assistants to turn the video screen toward Gundogan, so that he could follow the process: two small incisions above and below the knee; the insertion of a tiny camera probe; the removal of part of his patella tendon, which was then fixed in place as a substitute for the A.C.L., completely torn and unrepairable.

“A lot of it was too complicated for me,” Gundogan said of the procedure. “I didn’t watch all the time, but they wanted me to watch. I still don’t know if that was a good thing. The most interesting thing was the camera coming out of the knee: I could see the screw.”

He stayed in the hospital for three days. It was 48 hours before he was allowed to stand up, but when he did, the pain was so intense he had to sit down immediately. The rehab work, though, began right away. His leg was packed in ice, as it had been in the hours after the injury, or blasted with cold air; he was put through a series of gentle movements to start to extend his range of motion. Gundogan referred to it as his “work.” This was his job now.

When he left the hospital, he repaired not to a hotel but to an apartment on Passeig de Gracia, found through a friend of the Barcelona midfielder Arda Turan. Gundogan stayed for a month. He felt less isolated here, more a part of things, looking out from his windows onto one of the city’s most stylish boulevards.

Gundogan, 26, is not especially loud or notably garrulous. Born to Turkish parents in the industrial German town of Gelsenkirchen, he jokes occasionally about his “Southern” nature — a passion and emotion rooted in his ancestry. But he is, in many ways, typically Teutonic. He is soft-spoken, calm, happy to blend into the background. Often, he sinks into his own thoughts, contented in his introversion.

He is most at ease, though, when he has company. He spends little time alone. His cousin Ilkan is often by his side — part companion, part assistant — and his friends and family visit regularly.

It was the same in Barcelona. Gundogan received a steady stream of guests, some social, some professional: as well as parents and brothers and cousins, he brought in his osteopath, his fitness coach and his private chef.

The tight group ventured outside when they could, for a meal at Nuba or Da Greco, his two favorite restaurants in the city, and once to Camp Nou, to watch Barcelona play. But for most of his waking hours, Gundogan’s work demanded that he was alone, or as close as possible to it.

He spent two hours of every day at the hospital, with only a member of Cugat’s staff for company, and two more in the apartment, under the watchful eye of Arthur Jankowski, his fitness coach, gently exercising his knee, flexing and dipping and lifting and stretching. Every evening there was 45 minutes more on the sofa, his knee placed in a Game Ready cryotherapy unit or undergoing light therapy. He drank gallons of the ginger green tea that Jankowski brewed and then forced on him, praising its anti-inflammatory properties.

After a few days, most of the work was conducted in silence. It was just Gundogan, on his own, in his own mind.

He had not done much to decorate the apartment, to introduce any personal touches. Maybe that was deliberate. This was not a place to be enjoyed, but endured; there was no point getting too comfortable. He had brought only one photograph with him, and it rested, framed, beneath a giant flat-screen television. It was of him and Ilkan, and had been taken by Jankowski.

On a day off, a few weeks before the injury, Jankowski had persuaded them to climb Scafell Pike, the highest peak in England. Jankowski is a big believer in fresh air, for its mental and physical benefits, and he has tried to convert Gundogan, too.

In the photo, Ilkan looks decidedly unimpressed, but Ilkay is smiling broadly, happily.

Like a man who has just climbed a mountain.

For months, the best part of the day was the first part. Every morning after he returned from Barcelona at the end of January, Gundogan had arrived at Manchester City’s training facility — in the shadow of the Etihad — at the same time as the rest of the squad.

At first, his teammates made a point of fussing over him, welcoming him back, asking how long it would be until he would be playing again. “After the second, third and fourth day, it is less and less attention,” Gundogan said. He preferred it that way, being just another face in the crowd.

Gundogan had been in this situation before. In August 2013, only a few weeks after he scored for Borussia Dortmund in the Champions League final, he had sustained a back injury that would, eventually, prevent him playing for a full year. Three years later, Manchester City signed him while he was sidelined with a patella injury, so keen was Guardiola, the club’s new manager, to work with him.

As Gundogan walked the long path to fitness once more, he could not only make light of his past — “I am quite good at sitting on the couch now,” he joked one night in Barcelona — he could draw hope from it.

On the day Gundogan tore his ligament, he had cried on Guardiola’s shoulder, his despair overwhelming him. Less than 24 hours later, he had reconciled himself to his situation. The A.C.L. is a more common injury than his back problem; there was a clear road map to follow.

But another long stretch out troubled him, too. His injuries might have been unrelated, but he knew what the cumulative effect would be. Soccer has a short memory. There is always someone ready to take your place in the coach’s plans, in the team’s roster, in the fans’ affections.

Gundogan appreciated the sympathy, but he exists in a brutal world. He did what little he could to mediate its effects. He posted regular images on Instagram, and made sure he was present on Twitter. He enjoyed the interaction and, in particular, the photography, but pleasure was just a byproduct.

“I do not want people to forget me,” he said in February.

That kept him going as his recovery started in earnest — that desire not to be forgotten, not to be written off.

His schedule was physically exacting, his life mapped out for him by Cugat, Sala and City’s medical staff. Monday and Friday were for conditioning; Tuesday, Thursday and Saturday were for strength; Wednesday was cardio work. On Sunday, he rested.

The principal target, as explained by James Baldwin, the City physiotherapist overseeing his recovery, was “to restore the mechanics of the knee.” Baldwin talked about “gait re-education,” and proprioception, making sure all the disparate parts of the body are working in unison. In simpler terms, Gundogan was learning to walk again.

The exercises were simple, but demanding: a series of stretches and flexes, lifts and dips, followed by an arduous series of crabwalks. As the weeks passed and Gundogan’s knee improved, the exercises were made incrementally harder: resistance bands were introduced, or a Bosu ball, or an unstable surface. Baldwin said the idea was to “replicate the elements of human movement.”

All of City’s state-of-the-art facilities were available to Gundogan. His cardio work took place in a heat chamber. A couple of afternoons a week were spent in the pool area, walking against rapids to build up resistance, using underwater treadmills, donning one of a dozen buoyancy suits that hang on the walls. There were regular cupping sessions, to “stimulate the lymphatic system and clear effusions in the knee,” Baldwin explained early in the spring.

The days were long and tiring, but it was not the physical demands that were most punishing. It was the mental strain, the sense of being apart, adrift, incomplete, surrounded by those constant, early-morning reminders of what he used to be, and where he wanted to be. “The general feeling,” Gundogan said, “is of loneliness.”

“The worst thing for me is seeing the other players,” he added. “I see them on the training field, when they are in the locker room, when they go up to the meeting before training. I see how they work in the gym, and I am not able to do the same. You know that you are not able to be a full part of the group.

“That is the most difficult thing: to feel that you are useless, not worth as much as before, not worth as much as the others.”

Every day, for nine months, Gundogan waited for the pain. He woke up every morning knowing that was what the day would bring, what it must bring, if he was to ever have a day without pain again. Everything he did, every exercise in the gym with Baldwin, every session in the heat chamber or the pool, was designed to take him to the point of pain. The pain was not a punishment, but a reward. The pain was progress.

“You need to go until the pain starts,” he said. “You always go to the pain. The pain is a sign that this is new.”

That was true in the gym in the dead of winter, and it was true in spring and summer, when Gundogan was back out on the field, getting closer and closer to his goal. The newer exercises were tough — sprinting, passing, dancing through cones, turning, sprinting, passing — and the sense of relief he was, perhaps, anticipating was absent.

“It is a start,” he said in June. “But it is not comparable to being with the team, playing games.”

The pain reminded him of that. His knee still ached; there were still sensations to interpret; everything was fragile. Turning and jumping, in particular, were a challenge. It took a toll.

“To go to that point, and then do the same the next day, and the next day again, and again and again,” Gundogan said. “That is bad for the brain. Rehab is always up and down for the mind and for the body. And there have been points where my mind has said: ‘O.K. I have to go now.’ ”

The pain is an answer, but it is also a question. “You feel it, come home, and you do think about it,” he said. “You ask if it was good or bad pain. Even if the doctors and physios convince you it was fine, everything is O.K., you still think about it.”

Gundogan knew — and all those around him knew — that he had to be distracted, that thinking about the pain, floating in melancholy, was dangerous. Manchester City helped him to change his backdrop: a trip to Abu Dhabi in February, and another to New York, with a brief vacation tacked on to the end, at the end of March. He relished walking through Manhattan, wrapped up against the biting cold, cloaked by relative anonymity.

He took on other projects, too. He commissioned a director to film his recovery, though he is not quite sure yet what he will do with the footage. It may become a personal memento of these 10 months of his life; it may turn into a documentary. It almost became nothing at all: when some of the equipment was left on a corner in Times Square during his visit to New York, the N.Y.P.D. nearly seized it.

Most of all, though, Gundogan surrounded himself with his friends, the half-dozen close companions who have been with him since adolescence, the group he refers to as “the seven.”

During his recovery, they served as a bulwark against boredom and loneliness. He is well aware how easy it is for him to make new friends, as a pro athlete, but too wary to fall for it. He prefers to get to know people his cousin Ilkan has met, if he must; better still to lean on those who have always been there.

Members of the seven visit Gundogan often, in ones and twos. In April, Christian Kijanka and his mother came to Manchester for a few days. They have known Gundogan since he was 6 or so; Gundogan can still recite Kijanka’s childhood telephone number by heart. Together they watched Manchester City beat Hull City from a private box.

“I don’t think there are many footballers who would invite their friend’s mother to watch a game,” Kijanka said. “Ilkay never changed.”

After the Hull game, together with Ilkan and Ilkay’s uncle and agent, Ilhan, the group headed back into central Manchester, found a place for coffee, and sat among the skateboarders and the stoners in the spring sunshine in a park a few minutes from Gundogan’s apartment.

Other days were spent following Jankowski’s advice to get out into the open air, to change his scenery, to lose himself a little. Gundogan tends to drag Ilkan along with him wherever he goes — into a local park, or to taste the sweeping beauty of the Peak District, southeast of Manchester.

“Arthur taught me to enjoy the nature, the fresh air, just being outside,” Gundogan said. “We all have so much stuff to do now: the work, the phone. We forget to forget everything.”

That became the most precious thing, the thing that kept him going: to forget. To forget the pain that he felt today, and the pain that he must feel tomorrow, and the day after that.

Over the course of 10 months, in countless conversations in his apartment in Manchester, his pied-à-terre in Barcelona, the gym and the pool at City’s training facility and on the streets of New York, Gundogan returned to one trope again and again. It came up so often it became a running joke. He would treat his recovery, he said constantly, “day by day.”

He knew it was a cliché, of course, and he knew that players were famous for speaking in clichés. But he meant it, too. All along, he knew that identifying artificial targets, imposing an imagined time frame, would lead only to disappointment. For his own sanity, he had to focus only on today.

Throughout his recovery, that belief proved his salvation. In April, just as he was getting used to being outside, he endured three bouts of fever in quick succession. It set him back by a month, more or less, and was solved only when he decided to have his tonsils removed.

He had spoken earlier, vaguely, about perhaps playing on Manchester City’s preseason tour of the United States in July. That lost month ensured a return then was impossible. He would have to wait. That is the problem with targets, if you miss them.

It was in the final weeks, though, as he inched closer and closer to the field, that he saw the true value of the day-by-day approach. By August, Gundogan believed he was ready. He had returned to Manchester at the end of June after a three-week vacation — a house in Los Angeles with the seven, a few days in Las Vegas, a trip to Turkey to see his parents and grandparents. On the flight home, he said, he felt “relaxed, something inside me bubbling up, a new motivation, a new energy.”

At first, he was alone again — the bulk of Guardiola’s squad would not return from the summer break until July — but the solitude did not feel oppressive. When his teammates did come back, Gundogan would be following much the same program as them.

“It is brave to say it,” he said then, “but I feel as though my rehabilitation is over.”

Having gone through all that he had, those final few weeks — the finish line in sight — should have been torture. He not only had to watch as City added $300 million of talent in the transfer market, but he also had to cope with the loss of control, too.

Gundogan had always had a degree of agency over his recovery: he governed its pace, slowing down if he felt a twinge, speeding up if he felt ready. But now he was caught in that Catch 22 — he needed games to be truly ready, but he needed to be truly ready to get games — and he was at the mercy of Guardiola. Only he could know for certain when Gundogan would get the call.

City’s preseason tour came and went; Gundogan did not play. He was given a few minutes in a friendly game against Girona on Aug. 15, but by the end of the month, he had still not featured in a competitive match. He was named as a substitute in City’s first two games of September — at home to Liverpool in the Premier League, away at Feyenoord of Rotterdam in the Champions League — but was still only a spectator.

He did not lose his patience, though, or drift into despair. As he had said all those months ago, he is “good” at rehab now; he knows its rhythms, its challenges. Gundogan has always by nature been calm, not given to “being too happy or too sad,” he said. But the last 10 months, lived under the mantra of day by day, on the other side of the wall, had taught him something, too.

He was afraid, at the start, that he might be forgotten while he was away. He was daunted by the prospect not just of the pain, but the loneliness he would have to endure, the uncertainty of everything, that unspoken worry that perhaps he would never be quite the same again.

As he waited, though, he noticed a change. As the months wore on, he worried less.

“It sounds sarcastic, but if I had to stop now, I would say, ‘O.K., I have to stop,’ ” Gundogan said. “It would not be the end of the world. I will stop and do something else. When I had my back injury, I was down. I was nearly dead, or felt like it.

“But now I am more relaxed. I feel quite O.K., maybe more like an adult. It has affected me. It has made me more mature. Maybe this was an experience I had to have.”

His wait lasted until Saturday: 276 days after he had left the field, and disappeared into the silence and the shadows, Gundogan emerged into the light again. With 66 minutes gone in a Premier League game against Watford, Guardiola turned to him and asked if he was ready. “Of course,” Gundogan replied.

He was nervous, more so than usual. He was aware of the curious poetry of coincidence, that he should make his return against Watford.

“Maybe it had to be that way,” he said.

Most of all, though, he was just glad to be back on the other side of the wall. His studs skittered on the floor. He walked out to the edge of the field, and the noise of the crowd hit him.