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USMNT injuries and what they mean for the rest of the World Cup

One of the biggest victories in recent United States soccer history did not come without a price.

One of the biggest victories in recent United States soccer history did not come without a price.

Last evening's match with Ghana saw United States Men's National Team (USMNT) striker Jozy Altidore leave the game with what appeared to be a significant hamstring injury. In interviews, Altidore described the injury as 'the worst feeling' and said he was "crushed"—emotions not typically associated with a quick return to action.

Later in the game, USMNT center back Matt Besler left the game with a hamstring injury of his own. While Besler's injury did not appear to be as serious, he was unable to continue after halftime, leaving his status for the game against Portugal this Sunday in doubt.

"Comparing the two, [Altidore] pulled up in the middle of the field, whereas Besler sort of grabbed his hamstring and kept playing," says Justin Shaginaw, M.P.T., A.T.C., who works with US Soccer and traveled to the 2010 World Cup with the USMNT. "That's not always a true indication of severity, but if it is a serious injury, you're looking at a 3-6 week recovery."

The MRI results for both players will likely be available later today. Clint Dempsey, who scored the USMNT's first goal seconds into the match, broke his nose later in the game. The injury is unlikely to keep Dempsey out of action; but could potentially affect him in the humid climate Sunday.

"If they need to re-set the nose, the swelling and occlusion are things that can affect his performance to a degree," says Shaginaw. "But I expect he'll play through the injury."

Of particular note was the comment by ESPN's Taylor Twellman, who said last night's match was the first time he remembered seeing a United States team that didn't look fit. If the Americans are known for one thing in world soccer, it's top-of-the-line fitness. Is there anything to Twellman's observation?

"There are two main reasons why muscle injuries occur," observes Shaginaw. "One is not being out of shape, and the other is fatigue from being overworked."

"But there is a third factor, and that's plain old bad luck."

When two starting players sustain similar injuries in the first half of the first game, there's definitely an element of misfortune. Sunday's match in Manaus—located right in the middle of the Amazon rainforest—will be the most physically demanding of the entire tournament for the USMNT, and will tell us once and for all just how prepared this team is.

Read more Sports Doc for Sports Medicine and Fitness.