Injuries hit the England camp

Nigel Roe

ProSport is the Number One range of sports support in the UK - helping people relieve, prevent and protect them from the risk of high-impact and potential injuries.

This week, in his exclusive column for ProSport and Planet Rugby, Saracens physiotherapist Nigel Roe (pictured) writes about the injuries in the England squad, most notably those to the scrum-halves Kyran Bracken and Matt Dawson.

We're more than used to seeing Kyran Bracken and Matt Dawson battling it out for selection of the England No.9 jersey, and on more than one occasion in recent times one has done the other the favour of getting crocked to make it a one-horse race. Brack's historically seems to have the edge on Dawson for self-destructing at key times, but it seems now they may have outdone each other in the gentlemanly pursuit of standing down through injury, with both battling injuries concurrently. There is even talk of a replacement, with Bath's Martyn Wood flying in as back-up should medicals later this week turn out for the worst.

But let's think positive. I know Brack's back pretty well having helped put him back together on numerous occasions over the past six years. Obviously I can't say too much, but as long as he hasn't done anything drastically new, I'm sure he will bounce back. He has historically had minor back pain episodes since his disc injury and surgery that ended his 1999 World Cup before it began, but the Georgia game is the first he's missed in four years as a result of his back, and I'm sure it was more precautionary than anything. He may not be every England rugby journalist's favourite for the position (What has he done to earn Stephen Jones eternal disdain? - Parked in his spot at Twickenham?!), but he has worked so hard to make this World Cup that it just doesn't bear thinking about him missing out again through a return of last tournament's injury demon.

Dawson's injury may be another matter though, and Clive's measures to fly in cover make good sense. The specifics of the injury are understandably hard to get hold of, but a hamstring twinge has been mentioned. That's not really much help in deciding what the actual injury is, and that's no doubt about as much as Clive Woodward would want anyone to know, for obvious tactical reasons.

Muscle injuries are graded medically into three grades: a grade one is a strain with no muscle fibre disruption: a grade two is a partial tear of a muscle belly: a grade three is a complete tear. Grade one is one-two weeks recovery, grade two is two-four weeks recovery; grade three is usually four-six weeks plus. Recovery time is influenced by the site of the injury. A tear within the muscle belly generally heals faster than a tear between the muscle/tendon junction.

From the time-frame suggested by England's management for Dawson's return, we can speculate he has a grade one or a lesser grade two injury. They will have been able to assess the extent of the injury by ultrasound scan, and whether or not rehabilitation in a reasonable time frame is viable. Much will depend now on the careful rehabilitation from England physio's Barney Kenny and Phil Pask.

Allow me to digress for a moment on this theme. Don't expect management teams to be telling you much about their players' injuries unless a player is clearly out (as will be Tana Umaga's unfortunate case if he does have a complete rupture of his posterior cruciate ligament, but that's another story).

It's cloak and dagger stuff, and my job to tell you how long players are out for will be made all the more difficult by the standard generic injury descriptions of "joint or muscle strain/twinge/knock" etc. A knee twinge could be a meniscal cartilage tear needing surgery and two to four weeks recovery, a ligament strain or tear needing one to six weeks dependant on site and severity, or just a slight aggravation of an old injury requiring just a few days to bounce back.

All I can offer is an educated guess from the information that does get out or is obvious from television footage. A pack of tarot cards may come in handy as well!

Back to Mr Dawson. Those of you who did watch England's first game will have seen that he walked off unassisted. No stretcher or massive limp, which would seem positive, and yet the press reported Woodward as saying he's only 50/50 for the South African showdown. This one may remain a mystery until Thursday, when Clive has stated decisions will be made pending medical review.

Nobody would wish a solo journey home on anyone at this point of the competition. Let's hope its a clean bill of health for both these age-old rivals so that their performance, not their injuries, determines who gets the nod for the No.9 England jersey.

Cheers
Nigel

Click here to view a table on all the RWC injuries!

ProSport is available at all good UK pharmacies.