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NRL casualty ward Round 20: Full injury report from weekend

Paul Vaughan proved his toughness on Sunday when he pulled off the tackle of the season with a badly dislocated finger.

Brien Seeney and NRL Physio
8 min read
August 5, 2019 - 5:05PM

Paul Vaughan proved his toughness on Sunday when he pulled off the tackle of the season with a badly dislocated finger.

The NSW and Dragons prop was attempting to get medical attention in backfield when Parramatta’s Clint Gutherson made a break.

But in a courageous last-gasp effort, Vaughan reached out his left (good) hand and somehow dragged Gutherson down to complete the potential trysaver (watch video above)

Vaughan immediately came from the field after the tackle and didn’t return. However, reports suggest he won’t miss any games with the injury.

Parramatta forward Nathan Brown came from the field late against the Dragons with a knee/ankle issue.

His injury is not considered serious and he’s expected to be named for next week’s clash against the Knights.

EARLY MAIL: Predicted team changes

There was devastating news on Saturday with confirmation from the Storm that Christian Welch suffered an ACL rupture in his right knee.

The front row forward was only able to play 27 minutes before a simple change of direction saw his knee collapse inwards. He limped from the field and indicated he “felt a pop” in his knee.

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This coupled with the usual characteristics of an ACL rupture (non contact/change of direction/inwards collapse of the knee) did not provide a positive early outlook, and the prognosis only became worse with the indication post-match of a suspected ACL injury.

This was after the Storm medical staff had the opportunity to perform manual hands on tests to assess the integrity of his ACL, which are highly accurate in identifying a ruptured ACL.

Christian Welch has done another ACL.
Christian Welch has done another ACL.

Worst fears were confirmed on Saturday when scan results showed an ACL rupture, with Welch to undergo reconstruction surgery and the usual 6-9 month recovery period.

Welch has a history of ACL injury, rupturing his left ACL in 2017. Athletes who suffer an ACL injury are at increased risk to suffer a second one, with an ACL rupture often described as a single leg injury but a double leg problem. This is particularly devastating for Welch considering the emotional roller-coaster he endured through a misdiagnosed ACL rupture earlier this season.

Despite his history of knee and ACL injuries the good news is a return to full fitness is very achievable for Welch, especially considering his style of game as a forward does not have a heavy reliance on explosive direction change. Whilst players often don’t return to their best until the second season back from an ACL reconstruction, at just 25 years of age Welch has time on his side as he looks to continue his already successful NRL career.

Andrew McCullough came from the field on Friday night clutching his right shoulder after tackling Melbourne’s mountain front row forward Nelson Asofa-Solomona. Word quickly came through from the Broncos medical staff that the starting hooker suffered a significant burner and was unlikely to return.

A burner occurs when the nerves that run from the neck to the shoulder and arm are suddenly stretched or compressed, which can cause weakness, numbness and pins and needles down the arm. These symptoms usually settle quickly and we often see players shake off these injuries and finish the game.

However in significant cases where the neurological symptoms (weakness etc) linger it is important to come from the field for further evaluation. Despite McCullough suffering a significant burner he would still be very unlikely to face an extended recovery time, with most allowing a return within 1-3 weeks.

Andrew McCullough has a shoulder issue.
Andrew McCullough has a shoulder issue.

Even if McCullough were to miss time, it looks unlikely the Broncos will have rookie half Tom Dearden to call upon after he suffered what appeared to be a severe lower leg injury in his return to the field. Dearden had missed the previous seven weeks after undergoing surgery on a high grade syndesmosis injury, with coach Anthony Seibold opting to ease him back to game play through the Intrust Super Cup.

The immediate concern was a re-injury of his right ankle, and the signs weren’t good with the mechanism of injury suggesting his syndesmosis may have been put under significant stress again. Unable to put weight through his right leg, Dearden was helped from the field with no indication from the Broncos as yet on the nature or severity of the injury.

Another who has been unlucky with ankle injuries, Kodi Nikorima, was unable to finish the Warriors Round 20 game after suffering an injury almost identical to the one that caused him to miss last week. On both occasions Nikorima had a tackler fall on his lower leg from behind, causing his foot to roll out significantly.

This brings concern for a syndesmosis injury or medial ankle sprain. In minor cases, with minimal ligament damage, a quick return is possible once the pain and swelling settles. This was obviously the case with Nikorima’s Round 18 ankle injury, but there is concern this time more significant damage occurred. If a syndesmosis injury is confirmed, a general recovery guide:

Grade 1: 1-4 weeks

Grade 2: 4-8 weeks

Grade 3: 8-10 weeks

Kodi Nikorima down with an ankle injury.
Kodi Nikorima down with an ankle injury.

Karl Lawton looks set for another stint on the sideline, and possible surgery, after re-injuring his left shoulder on Friday night. Lawton missed the previous three games with a shoulder injury, and admitted he pushed to come back early after the Warriors lost regular starting hooker Issac Luke to suspension.

Lawton has a history of injury in his left shoulder, undergoing shoulder reconstruction surgery at the end of the 2018 season. Scans will be performed in the coming days, but it appears certain he will require some form of surgery come the offseason. Lawton hopes to see how the injury settles over the next week or two, but after suffering such a quick re-injury surgery may even be indicated before the end of the regular season.

Jarome Luai lasted just six minutes for the Panthers after copping an accidental poke in the eye from Dylan Napa. Coach Ivan Cleary indicated the Panthers utility was unable to see out of the eye after it closed over due to swelling, with some associated bruising already present post-game. Whilst the severity is yet to be determined, provided the swelling settles there is optimism Luai will be available next week. The most common worst case scenario for these injury types is a corneal abrasion, which a day or two with an eye patch will usually settle.

Kurt Mann hobbled off in the closing stages of the Knights loss to the Sea Eagles after suffering a knee injury. Mann lost his footing as he tried to change direction in defence, causing his left knee to buckle inwards as he fell to the ground. After initially being strapped up for what appeared to be medial knee instability (which brings concern for an MCL injury), the Knights winger was forced to come from the field after just one set. Knights coach Nathan Brown was unsure of the injury severity post-game.

There was plenty of concern amongst Rabbitohs fans, and no doubt thousands of SuperCoaches, when Damien Cook reeled out of a tackle clutching at his elbow. Thankfully he was able to finish the game after only suffering an ulnar nerve contusion, more commonly known as “hitting your funny bone”. Often called the “burner” of the elbow, a blow to the ulnar nerve can be extremely uncomfortable in the short term and even cause some pins and needles, numbness or weakness. However it almost always settles quickly, and in Cook’s case there will be no ongoing concerns.

Damien Cook has been cleared of serious injury.
Damien Cook has been cleared of serious injury.

The 2019 season may be over for Tohu Harris, who has a review with a foot specialist at the end of Round 22 to determine if he will play again this year. The Warriors forward was initially ruled out for six weeks after undergoing surgery to treat a stress fracture in his foot.

A six week recovery would have allowed for a return this week, however he is progressing slower than expected. This is still within the normal recovery range for stress fractures of the foot, with most requiring 8-12 weeks for adequate bone healing and reduced risk of re-fracture. There are some bones in the foot with a particularly poor blood supply, which extends healing times. Add to this the significant forces that are transmitted through the foot in a return to full training and NRL games — this is not an injury to be rushed back from before the stress fracture has healed.

Kieran Foran was expected to return from a hamstring injury for the Bulldogs this weekend. Unfortunately as he was completing the final stages of rehab he suffered a calf strain, which is thought to be directly related to the hamstring strain he was recovering from. The calf and the hamstring are two muscle groups that are very closely related — they pass each other as they cross the back side of the knee.

Strains in these muscles have a high recurrence rate (up to 30 per cent) and calf strains particularly tend to be more prevalent in older NRL players. Foran also has a history of lower back issues that have been associated with his past hamstring strains. All of this presents a complex rehab scenario for Foran and the Bulldogs. Whilst the expectation at this stage is a return in the next 1-2 weeks for Foran, he will no doubt be one to watch with the likelihood for re-injury, or further injury, higher than usual.

Kieran Foran has a long injury history.
Kieran Foran has a long injury history.

Titans’ front row forward Shannon Boyd will miss the rest of the 2019 season after news he will require a shoulder reconstruction. This surgery is usually required due to shoulder instability and joint/ligament damage as a result of a shoulder subluxation or dislocation. Boyd last played for the Titans in Round 17, a game he left twice struggling with his right shoulder. It is likely Boyd attempted to strengthen the shoulder with rehab over the past three weeks. Unfortunately his shoulder will now require surgical reconstruction, which comes with a 4-6 month recovery period in the NRL.

PRE-GAME WITHDRAWALS:

Matt Gillett (Groin)

Sosaia Feki (Niggling leg injury)

Issac Luke (Suspension)

Zac Lomax (Hamstring, Injured in warm-up)

JUDICIARY REPORT:

Sam Burgess (high tackle) is facing two weeks for a hit on Matt Moylan, reduced to one week if he pleads guilty — and Wayne Bennett isn’t happy with his star player’s discipline.

James Maloney (tripping) will be banned for one week regardless of plea. His only chance of playing next week to fight the charge and win at the judiciary.

Nelson Asofa-Solomona (dangerous contact) can escape a ban with an early guilty plea.

Sam Burgess is facing suspension.
Sam Burgess is facing suspension.

NRL CASUALTY WARD

BRONCOS

Andrew McCullough (Shoulder, TBC)

Matt Gillett (Groin/back, Indefinite)

Tevita Pangai (Suspension, Round 21)

Richie Kennar (Shoulder, Season)

Jack Bird (ACL, Season)

Tom Dearden (Ankle, Round 21)

BULLDOGS

Marcelo Montoya (Knee, Season)

Sauaso Sue (ACL, Season)

Kieran Foran (Calf, Indefinite)

COWBOYS

Jordan Kahu (Eye socket, Round 23)

Kurt Baptiste (ACL, Season)

Ben Hampton (Biceps, Round 22-25)

Justin O’Neill (Spleen, Indefinite)

Mitch Dunn (Shoulder, Season)

Te Marie Martin (Bleed on brain, Season)

DRAGONS

Paul Vaughan (Finger, Round 21)

Jack de Belin (Stood down, Indefinite)

Zac Lomax (Hamstring, Indefinite)

EELS

Nathan Brown (Ankle/knee, Round 21)

Blake Ferguson (Knee, Indefinite)

Kaysa Pritchard (Retired)

Ray Stone (Ankle, Round 24)

KNIGHTS

Kurt Mann (Knee, TBC)

Edrick Lee (Broken arm, Finals)

Slade Griffin (Knee, Indefinite)

Nathan Ross (Foot, Retired)

PANTHERS

James Maloney (Suspension, TBC)

Jarome Luai (Eye, TBC)

Viliame Kikau (Suspension, Round 21)

Tyrone May (Stood Down, Indefinite)

Tim Grant (Pectoral, Season)

Jack Hetherington (Sternum, Indefinite)

RABBITOHS

Damien Cook (Elbow, Round 21)

Alex Johnston (Knee, Round 23)

Sam Burgess (Facing suspension, TBC)

George Burgess (Suspension, Finals)

Greg Inglis (Shoulder, Retired)

RAIDERS

Nick Cotric (Suspension, Round 21)

Joey Leilua (Bulging disc, Round 21)

Brad Abbey (Knee, Season)

Ata Hingano (Thumb, Round 20-22)

Luke Bateman (Knee, Indefinite)

Brad Abbey (Knee, Season)

ROOSTERS

Jared Waerea-Hargreaves (Suspension, Round 21)

Ryan Hall (Knee, Round 21-22)

Sio Siua Taukeiaho (Calf, Round 21-22)

Boyd Cordner (Calf, Round 21-22)

Jake Friend (Fractured forearm, Finals)

SHARKS

Sosaia Feki (Leg, Indefinite)

SEA EAGLES

Toafofoa Sipley (Knee, Round 23-24)

Albert Hopoate (ACL, Season)

Jack Gosiewski (Groin, Indefinite)

STORM

Christian Welch (ACL, Season)

Albert Vete (Shoulder, Indefinite)

Curtis Scott (Foot, Round 22)

TIGERS

Mahe Fonua (Foot, Round 23)

Ben Matulino (Knee, Indefinite)

TITANS

Shannon Boyd (Shoulder, Season)

Dale Copley (Hamstring, Indefinite)

AJ Brimson (Hip, Indefinite)

Jai Arrow (Ankle, Round 21)

Ryan James (ACL, season)

WARRIORS

Karl Lawton (Shoulder, TBC)

Kodi Nikorima (Ankle, TBC)

Issac Luke (Suspension, Round 23)

David Fusitu’a (Hamstring, Round 21)

Nathaniel Roache (ACL, Season)

Tohu Harris (Knee, Season)

Patrick Herbert (Hamstring, Indefinite)

Originally published as NRL casualty ward Round 20: Full injury report from weekend

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