Tom Dearden ruled out, Blues hopeful Jordan McLean sidelined

Queensland lose big-hitting debutant for Perth clash, while rookie Brisbane halfback set for a sideline stint — NRL Physio provides expert analysis of all the latest injury news.

Our man in the know, Brisbane-based physiotherapist Brien Seeney aka @nrlphysio, provides expert analysis of all the latest injury news in the game.

Brisbane halfback Tom Dearden is facing several weeks on the sidelines following confirmation he will need surgery on his injured ankle.

The 18-year-old limped off in the opening minutes of Sunday’s 26-18 loss to NRL rivals Gold Coast at Suncorp Stadium, and scans have confirmed a syndesmosis injury.

Dearden will have surgery on Tuesday, and Broncos head of performance Paul Devlin said a cautious approach will be taken with the youngster’s recovery.

“It is a fairly sensible rehab time of five weeks plus, but he is an 18-year-old player so we will take maximum caution with that,” Devlin said.

“Daly Cherry-Evans got it down to five and-a-half weeks, which is pretty impressive.

“But he is a young player so we won’t be putting any pressure on him in that regard and we will do what is best for him.”

Brisbane has received good news on representative prop Joe Ofahengaue’s knee.

The 23-year-old suffered a bad cut to his knee during his State of Origin debut for Queensland last week, which required surgery.

Ofahengaue visited his surgeon on Monday and, with the wound showing no signs of infection, it’s hoped he’ll be fit to return for the Broncos following the bye against Newcastle on June 29.

Ofahengaue will be a loss for Queensland. Image: AAP Image/Dave Hunt

Titans forward Kevin Proctor will be sidelined for up to three weeks with a fractured eye socket.

Newcastle and NSW prop David Klemmer is expected to miss at least four weeks of football after fracturing his wrist in Origin I last Wednesday night.

Such was Klemmer’s toughness he didn’t notice any soreness in his wrist until the next day, with scans unfortunately showing a fracture.

A minimum of four weeks is usually required to allow for adequate bone healing, and with Klemmer able to avoid surgery the usual recovery range is four to six weeks. This would rule him out of Origin 2 in two weeks.

David Klemmer faces up to six weeks out with a fractured wrist. Picture: Getty Images

It is worth noting there have been isolated cases of NRL players and other contact sport athletes playing through minor wrist/hand fractures, often with the assistance of a brace.

However this is only appropriate in rare occasions, with most requiring at least a month on the sideline for recovery and bone healing to reduce the risk of further fracture or long term damage.

With 5.5 weeks until Origin 3 Klemmer may still play a further part in the series.

In a further blow to both the Cowboys and NSW forward stocks, Jordan McLean came from the field late in the game on Saturday night with a hamstring injury.

The unfortunate news for McLean is his injury appeared to be a “stretch” strain high up on the hamstring, which occurred when he was placed in an awkward position during a tackle causing his hamstring to overstretch.

Hamstring strains of this type often take longer to recover because of the location of the injury, potential involvement of the hamstring tendon, and limited blood supply to the tendon.

The more common “sprinting” strains seen due to loading of the hamstring muscle during running often occur lower down in the hamstring, and while these can feel more severe to the player they often result in a shorter recovery time than stretch strains of similar severity.

A general recovery guide for hamstring strains (with stretch strains usually at the upper end of each estimated time frame):

Grade 1: 2-4 weeks

Grade 2: 4-6 weeks

Grade 3: 6-10 weeks

Jordan McLean faces time out with a hamstring injury. Picture: Getty Images

Rabbitohs back-rower Sam Burgess on Saturday had surgery on a shoulder injury he had reportedly been carrying for the past month. A scan showed loose bodies within his shoulder joint which needed to be “cleaned out”. These can be small pieces of bone or cartilage which can cause pain, inflammation and restrict function of the shoulder. This procedure usually involves arthroscopic (keyhole) surgery, and with no significant repair or reconstruction to be performed recovery is usually short. Burgess’ rehab will focus on building up the strength in his shoulder as quickly as possible, and he is hoping to return in five weeks for the Rabbitohs’ Round 17 game.

Sam Burgess had surgery to repair a shoulder injury. Picture: AAP

Fellow South Sydney forward Tom Burgess will likely be joining his brother on the sidelines after scans showed some loose bodies of cartilage in his ankle. Tom Burgess finished the Rabbitohs Round 13 game with some ankle soreness, and will now visit a surgeon early next week with the expectation he will require some form or surgery. There are a few surgical options that could be appropriate depending on the severity and location of the damage, but if Burgess only requires a similar “clean-out” procedure to his brother he will likely be looking at a three- to six-week recovery period.

The injuries kept coming for the Rabbitohs with Adam Reynolds failing to play this week after discovering he suffered a fracture in his back during last week’s game. Thankfully for Reynolds the fracture is to his transverse process, a bony prominence that extends off each vertebrae in the spine. Thankfully these fractures pose little to no threat of injury to the spinal cord or nerves. While it is known as an extremely painful injury, it’s not as structurally debilitating as a fracture to the body of the vertebrae. A fracture of this nature will often be referred to as pain tolerance issue, and coach Wayne Bennett has said Reynolds will be able to return once the pain in his back settles. While this can be quite varied from person to person, the usual recovery range is three to six weeks.

Adam Reynolds is out with a back fracture. Picture: Getty Images

Broncos and Queensland forward Joe Ofahengaue is expected to miss the next two to four weeks after suffering a laceration (cut) to his patella tendon during Origin 1.

The injury was severe enough that he was unable to return to the game after leaving, and required a surgical clean-out late on Wednesday night. The patella tendon (tendon below the kneecap) plays a very important role in the strength and function of the knee.

The main concern for Ofahengaue at this stage is infection of the wound, as this could greatly extend his recovery time. If he is able to avoid this the healing process usually is quite short (one to two weeks), and from here Ofahengaue will need to make sure the function and strength of his knee is restored.

Winger Corey Oates will also miss Sunday’s game for the Broncos with a hip pointer (cork) injury. This occurred while scoring a try in Origin I on Wednesday night. Oates came down hard on his hip after leaping to put the ball down. While players are often able to finish the game with a hip pointer injury, the key is keeping the area warm and mobile. Once the body cools down post game the injury can become much more painful and stiff. Thankfully the recovery is usually quite fast, with most able to return to play in 7-10 days.

Corey Oates was injured while scoring this try for the Maroons. Picture: Getty Images

There has been significant concern for Titans fullback Michael Gordon this week as it was revealed a blood clot was discovered in his leg. If the clot travels through the blood stream and reaches the heart or lungs there can be significant, and sometimes life-threatening, consequences, so thankfully the Titans medical team were able to identify this early while the clot was still located in Gordon’s leg.

He will not require surgery and will remain on blood-thinning medication over the next month. The clot will be constantly monitored, and if everything goes as planned Gordon is hoping to return to the NRL in the next four to six weeks.

Wests Tigers failed to finish the game with 17 fit players in their clash with Canberra on Friday night.

Benji Marshall did not return after half time due to an eye injury, which was suffered after copping an stray elbow. He will require scans to assess the severity and potential structures involved, but coach Michael Maguire was hopeful Marshall would be fit for next week. Winger Mahe Fonua is set to undego surgery for a foot injury and will be sidelined for an extended period.

Warriors centre Patrick Herbert was ruled out late in the week after failing to overcome a minor quadriceps strain he suffered on Tuesday. He was able to train on Thursday but the Warriors played it safe and did not want to risk him. He would expected to be fit for next week provided there are no setbacks.

Cowboys utility Mitchell Dunn suffered a suspected shoulder dislocation on Saturday night. If this is confirmed a thorough assessment of his shoulder stability will be undertaken by the Cowboys medical staff, and scans will be performed to check the severity of damage to the shoulder joint. Recovery time is then heavily based on the level of stability and severity of damage. If the joint appears stable and there is minimal structural damage, a strengthening rehab can be performed for three to six weeks before trialling a return to sport. Surgery is often still required, but can be delayed to the off-season in these cases if the strengthening rehab program is successful in reducing the risk of re-dislocation.

Unfortunately if there is significant instability and structural damage to the shoulder, this often results in a high risk of re-dislocation and further/long-term damage to the shoulder joint. In these cases shoulder reconstruction surgery is performed, which usually requires three to six months of recovery.

A few updates on expected return times for injured players:

* Raiders hooker Josh Hodgson is aiming for a Round 15 return from a broken thumb. This would be a five-week return to play after suffering the injury in Round 11, which is within the usual recovery range of four to eight weeks.

* Roosters coach Trent Robinson confirmed Luke Keary was looking at approximately six weeks on the sideline after his latest concussion, which would have him returning in Round 17.

* Winger Nene MacDonald is aiming to return in just five weeks for the Cowboys, and is back running already. This would be a 13-week return to play after he suffered an ankle fracture dislocation earlier this season, which would be a very impressive rehab effort.

FULL ROUND 13 NRL CASUALTY WARD

BRONCOS

Jack Bird (ACL, Season)

Corey Oates (Hip, TBC)

Joe Ofehangaue (Knee, Round 14-16)

Matt Gillett (Rested, Round 14)

Tom Dearden (Ankle, Round 18-20)

Alex Glenn (Knee, Round 15)

BULLDOGS

Jayden Okunbor (Foot, Round 15-17)

Kerrod Holland (Knee, Round 17)

COWBOYS

Ben Hampton (Biceps, Round 22-25)

Te Maire Martin (Bleed on brain, Indefinite)

Nene MacDonald (Ankle, Round 17-18)

Matt Scott (Shoulder, Round 15-17)

Gideon Gela-Mosby (Collarbone, Round 18-22)

Jordan Kahu (Shoulder, Round 18)

Justin O’Neill (Spleen, TBC)

Jordan McLean (Hamstring, TBC)

Mitch Dunn (Shoulder, TBC)

DRAGONS

Gareth Widdop (Shoulder, Round 20)

Jack de Belin (Stood down, Indefinite)

James Graham (Leg, Round 19-20)

Tim Lafai (Ankle, TBC)

EELS

Dylan Brown (Back, Indefinite)

Kaysa Pritchard (Personal leave, Indefinite)

Clint Gutherson (Concussion, Round 14)

KNIGHTS

Danny Levi (Ankle, Round 17-19)

Slade Griffin (Knee, Indefinite)

Aidan Guerra (Ankle, Round 20-23)

Nathan Ross (Foot, Retired)

David Klemmer (Wrist, Round 16-18)

Kalyn Ponga (Rested, Round 14)

PANTHERS

Dean Whare (Hamstring, Round 15-17)

Waqa Blake (Knee, Round 16-20)

Malakai Watene-Zelezniak (Rib cartilage, Round 14)

Tyrone May (Stood Down, Indefinite)

Jed Cartwright (Shoulder, Round 14)

Tim Grant (Pec, Season)

RABBITOHS

Greg Inglis (Shoulder, Retired)

Braidon Burns (Hamstring, Round 14-15)

Kyle Turner (Toe, Round 14-15)

Alex Johnston (Knee, Round 14)

Cory Denniss (Shoulder, round 20)

Kurt Dillon (Ankle, Indefinite)

Sam Burgess (Shoulder, Round 17)

Tom Burgess (Ankle, Round 17)

Adam Reynolds (Back, TBC)

Cody Walker (Rested, Round 14)

RAIDERS

Joey Leilua (Bulging disc, Season)

Josh Hodgson (Thumb, Round 15)

Brad Abbey (Knee, Season)

Luke Bateman (Knee, Round 14)

Hudson Young (Suspension, Round 19)

Corey Horsburgh (Elbow, Round 15-16)

ROOSTERS

Luke Keary (Concussion, Round 17-18)

Brett Morris (Knee, Round 14)

Jake Friend (Biceps, Round 19-22)

Lachlan Lam (Wrist, Round 14-16)

Jared Waerea-Hargreaves (Suspension, Round 15)

Latrell Mitchell (Rested, Round 14)

Angus Crichton (Rested, Round 14)

SHARKS

Aaron Woods (Foot, Round 16)

Shaun Johnson (Hamstring, Round 13)

Josh Morris (Rested, Round 14)

Jayden Brailey (Knee, Round 15)

SEA EAGLES

Lachlan Croker (Hamstring, Round 13)

Toafofoa Sipley (Knee, Season)

Albert Hopoate (ACL, Season)

Trent Hodkinson (Knee, Round 14)

Brad Parker (Broken jaw, Round 16-18)

STORM

Curtis Scott (Foot, Round 22)

Tom Eisenhuth (Throat, Indefinite)

TIGERS

Josh Reynolds (Knee, Round 14)

Benji Marshall (Eye, TBC)

Mahe Fonua (Foot, TBC)

TITANS

Philip Sami (Ankle, Indefinite)

Ryan James (ACL, season)

Michael Gordon (Blood clot, Round 16-18)

Ash Taylor (Personal leave, indefinite)

Kevin Proctor (Fractured eye socket, Round 15-16)

WARRIORS

Nathaniel Roache (Back, Round 13)

Ligi Sao (Suspension, Round 14)

Jazz Tevaga (Ankle, Round 16)

Patrick Herbert (Quad, TBC)