As Autumn Internationals kick off, England’s run of injuries raises concerns

As England’s Autumn internationals get underway when they meet South Africa at Twickenham on Saturday, some of our best players will be watching from the sidelines because it’s already been a brutal season for some of the leading figures in the game.

Maro-Itoje-rugby-knee-injurySam Jones was unfortunate enough to break his leg during a judo session, which will delay his national debut for some time, and Anthony Watson broke his jaw in a training session. James Haskell’s already-dodgy toe gave out in the test series against Australia, and is spending the start of the season in a protective boot. Manu Tuilagi’s groin injury has flared up again. And right before the beginning of the Four Nations, Maro Itoje fractured his hand in a Saracens game and has been ruled out for all four tests. And, at the time of writing, it appears that Courtney Lawes’ place in the squad may be in doubt after suffering a swollen knee during a training session.

It goes without saying that rugby is a very physically demanding sport, and injury is part of the game – but is there something else happening here? A recent article in the Guardian certainly seems to think so, drawing comparisons between the demands of the professional game on today’s players and what top-flight footballers have been experiencing for years: an increased workload brought about by international tournaments, conflicts between club rugby and the national associations, and an off-season that’s getting shorter and shorter. The Lions squad, for example, won’t be booking their holidays until July next year and then going straight into pre-season training.

Putting aside random events like getting on the wrong side of a judoka, what’s the main injury in rugby? For one of the most gruelling contact sports in the world, the answer may surprise you: a study conducted by the American Journal of Sports Medicine came to the conclusion that knee injuries accounted for the highest number of missed days in the rugby world.

Rugby and knee injuries

Out of all knee-related maladies covered in the study – conducted amongst twelve English clubs over the course of two seasons – anterior cruciate ligament accounted for the greatest proportion of days missed, followed by medial collateral ligament injuries. Most of the severe injuries happened during contact – mostly in the tackle – and flared up more frequently in the final quarter of a game more than at any other time.

Players in the back position suffered more than anyone else. Sixteen per cent of knee injuries occurred during training, and each club in the study suffered an average of ten knee injuries per season, clocking up a total of 353 missing days, and 1 in 20 of a club squad being out of action at any one time due to knee injuries.

While the more gruesome rugby injuries are always going to grab the headlines, knee problems are the chief cause of missed play. An orthopaedic surgeon such as Mr Jonathan Webb that specialises in the knee works with rugby players at all levels, aiming to return them to play as quickly as possible.