We didn't know it, but the Rugby World cup game against France was to be Paul O'Connell's last act of duty in an Irish jersey. A hamstring tear brought about his demise and any athlete who is familiar with this injury, will say that it's a minor ailment that heals within a few weeks.
But it's more complex than that. Hamstring injuries are segregated into grades. A grade one strain involves some mild discomfort and a recovery time of one to three weeks. Grade two sufferers will be limping and will be out of action for up to eight weeks.
But those in the grade three bracket, which very much includes O'Connell, have vastly bigger problems. This is a severe injury in which half or all of the hamstring is torn away from the bone.
O'Connell suffered a proximal hamstring avulsion and if you're scratching your head contemplating what this injury entails, just cast your mind back to those disheartening images of a normally pain-resistant Ireland captain in visible distress as he was transported from the pitch.
That should help you deduce just how excruciating this injury is and Richard Mack of the University of West England has explained the severity of it.
While hamstring injuries are common in sport, a proximal hamstring avulsion is a rare but serious injury. The proximal hamstrings attach to the pelvis via the proximal hamstring tendon. If you sit on your hands you will be able to feel the bony tuberosity where the tendon attaches. In an avulsion the tendon pulls from this bone and if not diagnosed correctly this can lead to poor outcome.
Mack goes on to describe O'Connell's movements which led to this traumatic injury.
The position that O’Connell got into while competing at the breakdown, in effect the splits with knees straight and hips flexed puts an enormous amount of stress on the hamstring tendon. The tendon, which attaches the hamstring muscle group to the pelvis, can literally pull off the bone causing significant pain and a loss of function.
Patients cursed with this injury will normally hear a 'pop' followed by extreme pain at the back of the thigh as well as extensive bruising and swelling. An MRI and ultrasound is later conducted to confirm the diagnosis.
But the major aspect of O'Connell's recovery will involve surgery to avoid long-term complications. And Mack enthuses that this will give the former Munster man the best chance of recovery.
O’Connell has the benefit of immediate access to an experienced medical team and is without doubt in the right environment to have the best chance of a return to action after his significant hamstring injury . A rehabilitation period of 6 to 9 months following surgery is normally needed before returning to sport after sustaining a proximal hamstring avulsion.
That 6 to 9 month period could be key. With a two year Toulon contract awaiting him, it's quite possible that O'Connell won't see any Top 14 action this season which finishes in June. However, being the character that he is, you'd have to be hopeful that at 35, there's still one more year left in the big man when he does get over this setback.
[Vivomed]
