Howdy folks, Luke from Hunter Podiatry here talking NRL injuries. I have covered some injuries we often see in our clinics a few weeks ago, but I’ve decided to talk about some less common injuries in this blog. If you’re an NRL fan you may have already heard around the office about some of these injuries, but I’ll take some time to break down the mechanism of injury, typical recovery times and usual rehabilitation processes.
Addin Fonua Blake (New Zealand Warriors) + Albert Kelly (Brisbane Broncos)
This is known as the ACL of the foot, a really important ligament that connects the short bone (tarsal) to your long bone (metatarsals) of your first and second toes.This ligament provides internal support and is important for stability. The severity of this injury can vary from a sprain, partial tear, full tear, and even dislocation and fracture. Let’s look at the specifics of Addin and Albert’s injuries.
Mechanism of injury:
- Crushing mechanism with direct force to the heel bone, with the forefoot in a plantarflexed (toes facing down) position.
- This type of mechanism causes increased forefoot dorsiflexion compared to the rear foot – leading to excessive load through the Lisfranc ligament.
- Addin played on for a few minutes before being substituted without returning.
Typical recovery time:
- 3-6 weeks conservatively – this is the likely outcome for Addin in this particular case
- 3-6+ months post-surgical recovery, which is unfortunately the outcome for Albert.
- Non-surgical approaches may include a short period in a moon boot (1-3 weeks), followed by a progressive increase in load through the affected foot.
- Surgery typically requires plates and screws to be inserted into the affected foot to aid with increasing stability and recovery.
- This hardware can be removed at a later time – which is likely the case in Albert’s case to allow extra range of movement.
- As a Podiatrist, I would look at their footwear and likely prescribe foot orthoses to help with reducing high pressure areas at foot level.
Kurt Mann (Newcastle Knights)
Aneurysm of artery in the lateral ankle
This is an extremely rare injury that has only happened a handful of times in professional sport. An aneurysm is the ballooning of an artery, which may burst (see image to the right), as is the case with Kurt. There are typical signs that suggest an aneurysm, such as change of colour with the foot, increased warmth due to oxygenated blood pooling and swelling.
Mechanism of injury:
- Hard to say exactly in this case, but could be a result of previous ankle injury.
- This is likely to keep Kurt out for a few weeks, possibly around 4-5 weeks.
- With any vascular involvement there would be a colour duplex ultrasound and possibly MRI to confirm the diagnosis. Colour duplex ultrasounds are great for identifying any vascular pathology, which Podiatrists may refer for with any signs and symptoms of vascular occlusion.
- Kurt underwent a closed surgical procedure where a stent was guided from the artery in his groin to the affected area in the ankle to aid blood flow. There are also open surgeries where the lesion is treated directly. In this case a closed surgery allows a quicker return to play time.
- As always after a surgical procedure there is a rehabilitation time to ensure the stent is working correctly, but also general return to play rehabilitation guidelines, such as progression to running and general strength and conditioning.
I’ll continue to keep you up to date with any interesting injuries over the coming weeks! Stay tuned for a a great blog in the next fortnight where we’ll be talking about Fa’amanu Brown’s return from injury – this is one you won’t want to miss. Thanks to the NRL physio who provides in-depth and detailed information regarding most of the injuries in the current NRL season. Jump onto Facebook and Instagram and give him a follow!