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NRL casualty ward ward Round 22

GRAPHIC CONTENT: “One part went north and the other part went south.” Warriors centre Gerard Beale has suffered one of the most sickening injuries seen on a rugby league field.

Brien SeeneyNRL Physio
10 min read
August 20, 2019 - 12:26PM
Sam Burgess, Tom Burgess and Braidon Burns all picked up injuries for the Rabbitohs.
Sam Burgess, Tom Burgess and Braidon Burns all picked up injuries for the Rabbitohs.

Gerard Beale’s 2019 season is over, and the beginning of his 2020 campaign is in doubt after suffering a traumatic knee injury on a Sunday afternoon.

What was initially reported as a patella tendon rupture was later revealed to be a suspected displaced patella fracture by Warriors coach Stephen Kearney. In simple terms; Beale’s kneecap had fractured in 2 after a direct blow to the front of his knee, with the top half of his kneecap ending up sitting in his thigh.

“One part went north and the other part went south,” coach Stephen Kearney said.

Gerard Beale down with a patella injury.
Gerard Beale down with a patella injury.

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If this is confirmed surgery will be required to wire the two pieces of fractured bone back together, but is actually somewhat of a positive outcome in regards to prognosis compared to a patella tendon rupture.

Gerard Beale’s season is over. Picture: AAP
Gerard Beale’s season is over. Picture: AAP

Rehab for surgery on a patella tendon rupture is considered even more challenging than that for an ACL reconstruction, with a very wide return to play range of 6-12 months.

However Beale is likely “only” facing 4-8 months on the sideline with the news he suffered a patella fracture. James Tedesco suffered the same injury in June of 2014, and whilst he missed the rest of the season his initial return to play estimate was set at 12 weeks.

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Matt Moylan left the field with a hamstring issue, having only just returned after missing Round 19 with a similar injury. Moylan, like Burns, has an extensive history with hamstring strains. Even minor damage to his hamstring will likely cost him 1-2 weeks on the sideline, whilst anything more significant could be a season-ender for the Sharks fullback.

Matt Moylan faces more time out of the game. Picture: Brett Costello
Matt Moylan faces more time out of the game. Picture: Brett Costello

Brisbane’s playmaking stocks have hit crisis point with halfback Tom Dearden ruled out for the season in the lead-up to the Broncos’ grudge match against Wayne Bennett’s Souths on Friday night.

Just 24 hours after Tevita Pangai Jr and Jake Turpin were charged by the NRL, The Courier-Mail can reveal that Dearden will not return this year in another blow to Brisbane’s finals charge.

Full story by Peter Badel

Broncos halfback Tom Dearden is out for the season.
Broncos halfback Tom Dearden is out for the season.

Sydney Roosters playmaker Cooper Cronk has been cleared to play this week asthe NRL defending champions continue their push to lock up a top-two finish. Cronk failed to complete the Roosters’ 42-6 flogging of the Warriors on Sunday after copping a late hit by Jazz Tevaga and experiencing increasing pain and stiffness in his left shoulder.

However, the Roosters said on Monday their medical staff have cleared him of injury and he is available to take on St George Illawarra on Saturday. That’s a relief for Roosters fans who would have vivid memories of Cronk defying pain from a fractured scapula in the same shoulder to play last year’s grand final before undergoing surgery.

Cooper Cronk after being hit late.
Cooper Cronk after being hit late.

There are fears Braidon Burns’ season could be over after he left the field with a recurrence of a hamstring injury that has already caused him to miss much of the season.

The Rabbitohs centre motioned for the trainer immediately after going down in a tackle, and later looked dejected in the sheds with an ice pack strapped to the back of his thigh.

After suffering a hamstring injury in Round 3, Burns was initially expected to return in Round 8, however multiple setbacks during his rehab meant he did not see NRL game time until Round 15. Despite a successful run of games over the next month, in the week leading up to Round 21 Burns suffered some “hamstring awareness” and was ruled out of last weeks’ clash against the Storm.

Sam Burgess, Tom Burgess and Braidon Burns all picked up injuries for the Rabbitohs.
Sam Burgess, Tom Burgess and Braidon Burns all picked up injuries for the Rabbitohs.

Hamstring awareness usually indicates a player is experiencing symptoms in the hamstring (tightness/soreness etc) without any actual injury to the muscle itself. This is still concerning and usually indicates the player is at increased risk of injury. Unfortunately for Burns his latest setback is a textbook example of the frustrating nature of hamstring injuries and their high recurrence rates (up to 30%).

Whilst low grade hamstring strains can allow a return in as little as two weeks, the early word from the Rabbitohs indicated there was concern for more significant damage. Rehab is often more complex for a hamstring strain re-injury, which extends the usual return to play time. If scans confirm a grade 2+ hamstring strain Burns could easily be looking at 4+ weeks on the sideline.

There was another re-injury for the Rabbitohs with Sam Burgess hobbling through the final minutes with a suspected aggravation of his quadriceps strain. After only missing one week, Burgess came into the game with a heavy wrap around his quad, and made it through much of the game unscathed.

However just prior to full time he was forced to hit top speed in chasing a runaway Bulldogs player, and looked to be “shot by a sniper” as he pulled up mid-chase.

Whilst the severity of his injury is yet to be determined, as with Burns muscle strain re-injuries often present more complex and lengthy recovery periods. The Rabbitohs captain is likely looking at a few weeks on the sideline in a best-case scenario.

And in a third blow for the Rabbitohs, Tom Burgess suffered a concussion and must pass protocol before next week’s clash against the Broncos.

Horrible news for Jacob Liddle this weekend with the Tigers’ hooker suffering an ACL injury in his side’s loss to the Sea Eagles.

Jacob Liddle suffered a serious knee injury on Thursday.
Jacob Liddle suffered a serious knee injury on Thursday.

Liddle went down in severe pain after some friendly fire, with one of his own teammates landing on his lower leg causing his knee to violently collapse inward.

This is a mechanism of great concern for both an ACL and MCL injury, and after assessment in the sheds the Tigers indicated there was concern for injury to the ACL, MCL and PCL. Scans on Friday confirmed the worst, with some reports there was also further damage to the knee other than just an ACL rupture. Damage to the MCL or PCL secondary to an ACL rupture will often result in a longer return to play time, with Liddle reportedly facing 9-12 months on the sideline.

This is due to the instability in multiple directions with a multi-ligament knee injury, meaning rehab has to be more comprehensive in correcting these deficits. After undergoing double shoulder reconstruction surgery at the end of the 2017 season and finally looking like getting his shot at a full time starting role with Robbie Farah’s retirement, this is especially devastating for Liddle. We wish him the very best with his upcoming surgery and recovery.

Robbie Farah is said to be hopeful of returning for the Tigers’ Round 25 game at Leichhardt Oval, just four weeks after suffering a tibia fracture. After he was initially suspected to have suffered an MCL sprain, scans revealed Farah actually fractured the top of his tibia (tibial plateau). When the knee collapses inward like Farah’s did, the structures on the medial side (MCL) of the knee can be stretched, whilst the surfaces on the lateral side can be compressed (meniscus/tibial plateau).

A tibial plateau fracture isn’t just considered a pain tolerance issue as it involves a critical weight bearing area within the knee. Even the most minor of tibial plateau fractures usually require six weeks recovery time to allow for adequate bone healing.

If Farah returns too soon one of the significant risks that often exists with a tibial plateau fracture, if it hasn’t already, is the fracture can extend into knee joint surface or articular cartilage.

Robbie Farah down with a fractured tibia.
Robbie Farah down with a fractured tibia.

If the already weakened bone absorbs a second impact, further fracture or joint surface collapse can occur. Injury to the joint surface/articular cartilage brings concern for long term damage and issues in life post football. If the fracture gets worse surgery can also be required to minimise long term risks.

The odds are certainly stacked against Farah to withstand the rigours of the NRL just four weeks after suffering the injury. Both Farah and the Tigers have to hope the fracture is extremely minor to reduce any risk of further or long term injury.

Whilst his ability to play on after initially suffering the fracture supports this hope, Farah’s pain tolerance levels can’t be underestimated. The importance of a farewell game will obviously play a role, but Farah’s short and long term health will be the No.1 priority.

Jason Taumalolo was ruled out for the Cowboys after suffering a foot injury during the week. Whilst the Cowboys are hopeful of having him back for next week’s clash against the Panthers, they are unsure at this stage the length of recovery time that will be required. Coach Paul Green said: “It can either be short term or out for a while”, so this will be one to watch as training progresses over the next week.

Mystery surrounds Jason Taumalolo’s foot injury.
Mystery surrounds Jason Taumalolo’s foot injury.

Joseph Tapine failed to finish for the Raiders after aggravating a rib injury he carried into the match. After initially suffering the injury last week, Tapine required multiple pain killing injections pre-game in order to play.

Rib injuries are known as one of the most painful as they can cause severe pain with simple tasks such as breathing and twisting. Thankfully the risk for long term/permanent damage is often very minimal, and thus are often considered pain tolerance issues rather than an injury that requires time on the sideline for adequate healing. If Tapine has avoided a fracture most players are able to return in 1-3 weeks, often with the assistance of pain killing injections or a chest guard.

Connor Watson failed to return to the field after suffering a suspected minor MCL sprain. After leaving the field and heading up the tunnel for further assessment, Watson was strapped up and on the exercise bike in an attempt to return to the field.

However the Knights thought it best to hold him out for the remainder of the game. Minor (grade 1) MCL sprains usually allow a return within 1-3 weeks, so if this is confirmed the Knights hooker would still be a chance to return next week.

Connor Watson (jacket) on the bench with a knee injury.
Connor Watson (jacket) on the bench with a knee injury.

Expected to make his return on Sunday after missing three weeks with a calf strain, Boyd Cordner is now facing at least a further two weeks on the sideline with a quadriceps strain. Thankfully with that recovery estimate it is likely only a minor strain, but still poses a concern with finals just four weeks away.

Lower limb muscle strains can occur due to compensatory patterns, and with Cordner recovering from a calf strain it is certainly possible this contributed to his latest injury setback.

Jordan Kahu may have re-injured his eye socket with scans to assess the injury in the coming days. The Cowboys centre initially suffered the injury prior to half time, but in a brave effort battled it out until the full time siren. If Kahu has re-fractured his eye socket he would be likely looking at a further 3-6 weeks on the sideline, and with the Cowboys out of the finals hunt this would end his season.

Jordan Kahu may have re-injured his eye socket. Picture: Alix Sweeney
Jordan Kahu may have re-injured his eye socket. Picture: Alix Sweeney

Junior Paulo was held out by the Eels mostly as a precaution after suffering a minor ankle sprain. He is expected back on deck for them next week.

Warriors centre Gerard Beale suffered a ruptured patella tendon against the Roosters and is out long term.

ALSO INJURED IN ROUND 22

Stephen Crichton (Pre-game, TBC)

Brent Naden (Concussion, TBC)

JUDICIARY REPORT

Brisbane livewire Tevita Pangai’s season could be over after he was stung with a grade two dangerous contact charge following his side’s Friday night win.

The Broncos had the game won when Pangai was sin-binned in the final minute of their crucial 24-12 home victory for his crusher tackle on James Maloney, who was already sitting on the ground.

The Broncos will challenge the charge at the judiciary, with Pangai to miss five weeks if he loses or one week if he wins.

Tevita Pangai Junior is facing suspension.
Tevita Pangai Junior is facing suspension.

Teammate Jake Turpin has taken the early guilty plea for a swinging arm on Penrith’s Dylan Edwards and will miss two weeks.

Cameron Munster (dangerous contact) can escape suspension with an early guilty plea for a hit on Iosia Soliola.

Aiden Tolman (dangerous) is free to play regardless of plea.

Luke Brooks and Joseph Tapine (contrary conduct), Michael Jennings and Anthony Milford (both tripping) will escape with a fine.

FULL NRL CASUALTY WARD

BRONCOS

Tom Dearden (Ankle, Season)

Tevita Pangai (Facing suspension, TBC)

Jake Turpin (Suspension, Round 25)

Alex Glenn (Knee, Round 23)

Matt Gillett (Groin/back, Indefinite)

Richie Kennar (Shoulder, Season)

Jack Bird (ACL, Season)

BULLDOGS

Marcelo Montoya (Knee, Season)

Sauaso Sue (ACL, Season)

Christian Crichton (Ankle, Finals)

COWBOYS

Jason Taumalolo (Foot, TBC)

Jordan Kahu (Eye socket, TBC)

Josh McGuire (Suspension, Round 25)

Kurt Baptiste (ACL, Season)

Ben Hampton (Biceps, Round 23-25)

Justin O’Neill (Spleen, Indefinite)

Mitch Dunn (Shoulder, Season)

Te Marie Martin (Bleed on brain, Season)

DRAGONS

Tariq Sims (Groin, Season)

Jack de Belin (Stood down, Indefinite)

Jordan Pereira (Neck/head, Indefinite)

EELS

Junior Paulo (Ankle, Round 23)

Josh Hoffman (Shoulder, Indefinite)

Blake Ferguson (Infection, Indefinite)

Kaysa Pritchard (Retired)

Ray Stone (Ankle, Round 24)

KNIGHTS

Connor Watson (Knee, TBC)

Tim Glasby (Concussion, Round 23)

James Gavet (Hamstring, Round 23)

Edrick Lee (Broken arm, Round 25)

Slade Griffin (Knee, Indefinite)

Nathan Ross (Foot, Retired)

PANTHERS

Stephen Crichton (TBC)

Brent Naden (Concussion, TBC)

Jarome Luai (Eye, Indefinite)

Wayde Egan (Shoulder, Indefinite)

Tyrone May (Stood Down, Indefinite)

Tim Grant (Pectoral, Season)

Jack Hetherington (Sternum, Indefinite)

Caleb Aekins (Foot, Season)

Jed Cartwright (Shoulder, Season)

RABBITOHS

Sam Burgess (Quad, TBC)

Tom Burgess (Concussion, TBC)

Braidon Burns (Hamstring, TBC)

Alex Johnston (Knee, Indefinite)

George Burgess (Suspension, Finals)

Greg Inglis (Shoulder, Retired)

RAIDERS

Joe Tapine (Ribs, TBC)

Brad Abbey (Knee, Season)

ROOSTERS

Cooper Cronk (Shoulder, Round 23)

Ryan Hall (Knee, Round 23)

Sio Siua Taukeiaho (Calf, Round 23-24)

Boyd Cordner (Calf/quad, Round 23)

Jake Friend (Fractured forearm, Round 25)

SHARKS

Matt Moylan (Hamstring, TBC)

Andrew Fifita (Knee, Round 23)

SEA EAGLES

Brad Parker (Knee, Round 23-24)

Curtis Sironen (Hamstring, Round 23-24)

Toafofoa Sipley (Knee, Round 23-24)

Albert Hopoate (ACL, Season)

STORM

Brandon Smith (Ankle, Finals)

Christian Welch (ACL, Season)

Albert Vete (Shoulder, Indefinite)

TIGERS

Jacob Liddle (ACL, Season)

Luke Garner (Suspension, Round 23)

Josh Aloiai (Hand, Indefinite)

Moses Mbye (Hip, Round 23)

Robbie Farah (Knee, Indefinite)

Mahe Fonua (Foot, Indefinite)

Ben Matulino (Knee, Indefinite)

TITANS

Keegan Hipgrave (Concussion, Season)

Shannon Boyd (Shoulder, Season)

Dale Copley (Hamstring, Indefinite)

Ryan James (ACL, Season)

WARRIORS

Gerard Beale (Patella, TBC)

Karl Lawton (Shoulder, Round 23-24)

Issac Luke (Suspension, Round 23)

David Fusitu’a (Hamstring, Round 23)

Nathaniel Roache (ACL, Season)

Tohu Harris (Knee, Season)

Originally published as NRL casualty ward ward Round 22

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Original URL: https://www.couriermail.com.au/sport/nrl/supercoach-news/nrl-casualty-ward-ward-round-22/news-story/097a3cd43edead32162c34273b04b0ec