One more look at 'Hilly'

Saturday November 15 2003

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) has one more look at everyone's favourite injury case - Richard Hill - while he also discusses how injured players are put through their paces by management.

We're down to the last four now of RWC 2003 and England are still in it, despite their efforts to go about things 'the hard way' on game day.

Nice to see 'Hilly' back in the starting line-up. Very good of him to comply with my explanation of his situation as well! I couldn't help but notice there was some confusion in the message board about just what his status was after that column. Knowing what an intelligent bunch Planet Rugby readers are it was really about explaining the why rather than a straight "Hill will be back on such and such a date".

I hope I didn't lose too many of you along the way. Have had some good feedback about the growing number of armchair hamstring experts out there at least!

This time I'll try and keep things brief & I've been asked to round up on current injuries within the English camp and things have finally gone a little quieter on that front. That doesn't leave me much to work with. (The sponsor ProSport is English-based and so I must curb my desire to write about things Kiwi!)

But my loss is Clive's gain, and I'm sure he's pretty chuffed with the timing of his first-choice line-up's resurrection in front of what will without a doubt be their biggest challenge yet in this RWC.

"This is our strongest team and it's the first time we've been able to pick from all 30 since the first game," he's quoted as saying earlier this week. It's good that the game will come down to form then and not a case of "what if we had player X ...".  Balshaw is back to sit on the bench, but it's the return of Hill and Lewsey to the starting line-up that will draw most attention.

Hill, in particular, would have been working hard to maintain his fitness while unable to train fully with the squad. Hang on though ... surely injury downtime is a bit of a holiday, a chance to hit the beach or down a few Latte's? Play a bit of X-Box maybe?

No such luck. Being injured in the current professional environment is a player's worst nightmare. The coaching staff will expect you to be at all team-orientated team sessions to keep in touch with team tactics and calls. Then on top of this, there's strength and power training, flexibility, core strength and cardio-vascular (CV) fitness all to be maintained. Sadistic fitness trainers are on hand to beast you with horrible alternatives to running in multiple sessions during the day.

You can't run for CV work? Too bad, it's yaughting style grinder sessions, pool freestyle sprints not kicking with a float between your legs, or upperbody circuit training as alternatives. Normal weights sessions are modified to keep working the non-injured body parts. And you have to fit in at least two physio treatment sessions and specific rehab exercise sessions.

But, after all this, nothing quite works you the same as actual game time, the holy-grail called match fitness. Clive recognises this and says: "Richard's a little bit short of match practice but after seeing him running around I think he'll get through it on passion and adrenaline."

Nothing like playing the French to bring out that in an Englishman!

But the England management must be sensible too. Clive will want 'Hilly' on the field for as long as possible, but don't be surprised if 'Hilly' is subbed mid second-half, maybe even earlier. Why? Because as he fatigues generally, his rehabbed hamstring, now four weeks on from having last been pushed to the limit, becomes high risk for a break down. We know this for a fact from data collected by the RFU through detailed injury audit within the UK premiership.

Just how long you leave a rehabbed hamstring on the field is one of the most difficult calls for a medical team to make. It's the larger part science now days, but there is still an element of calculated risk. Add to this the fact that any player in this situation, playing a vital World Cup semi-final, is hardly likely to make a rational decision about coming off without being injured. And for all the importance of this game, it is not the Final. If England make it through, the need for a fit Richard Hill will be even more crucial.

Aren't you glad that you don't have to make these kinds of decisions? You just have to watch. And that's going to be nerve-wracking enough for most of us.

Chat soon
Nigel

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

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