Round 4 casualty ward: Dylan Napa out for up to six week

Tom Trbojevic out long-term, another major setback for Cronulla, Canterbury lose a second NRL star to injury in as many weeks while the hits keep coming for St George Illawarra.

Tom Trbojevic of the Sea Eagles runs the ball during the Round 4 NRL match between the Manly Sea Eagles and South Sydney Rabbitohs at Lottoland in Sydney, Saturday, April 6, 2019. (AAP Image/Brendon Thorne) NO ARCHIVING, EDITORIAL USE ONLY

Brisbane-based physiotherapist Brien Seeney, aka NRL Physio, gives his expert analysis of all the Round 4 injuries.

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Cronulla have suffered another major injury setback with Test prop Aaron Woods set to miss the next three months.

In a massive blow, Woods is booked for surgery after suffering a fractured foot against Parramatta last Saturday night.

The official diagnosis is a ‘Jones fracture’ to Woods’ foot which will leave him out of action for between 10 to 12 weeks.

It’s a devastating hit for rookie coach John Morris ahead of the Sharks’ clash with reigning premiers the Roosters on Saturday night at PointsBet Stadium.

The Sharks are already without co-captain Wade Graham (knee) and Matt Moylan (hamstring) while Paul Gallen (ribs) and Shaun Johnson (quad) are rated only 50-50 chances of playing this weekend.

— David Riccio

Aaron Woods faces a long stint on the sidelines. Picture: Getty Images

Tom Trbojevic’s NSW State of Origin hopes are hanging by a thread after the Manly superstar was ruled out for up to nine weeks with a serious hamstring injury.

Less than two months out from the the June 5 series opener in Brisbane, the Sea Eagles confirmed on Monday Trbojevic would miss between six and nine weeks as a result of the blow.

It means the speedster’s earliest possible return will be if he misses just six games and comes back against the Gold Coast on May 24, just three days before teams for game one are announced.

Manly would also be expected to take a cautious approach with their biggest attacking weapon, given he was only in his second game back from a similar injury on the same hamstring when he went down against South Sydney on Saturday.

Confirmation from Manly that Tom Trbojevic is expected to miss 6-9 weeks with a hamstring strain suffered this past weekend. Likely recurrence of hamstring strain from the preseason, which almost always results in an extended recovery time.

— NRL PHYSIO (@nrlphysio) April 8, 2019

Canterbury have lost a second NRL star to injury in as many weeks after prop Dylan Napa was ruled out for up to six weeks with an ankle issue.

Scans on Monday revealed Napa suffered a grade two syndesmosis to his right ankle during Sunday’s NRL loss to Melbourne.

It is the same injury that ruled out five-eighth Kieran Foran for three months last week, leaving the Bulldogs devoid of experience for Sunday’s match against St George Illawarra.

Dylan Napa to miss 5-6 weeks with a grade 2 sydesmosis injury (high ankle sprain). Most in the NRL require 4-8 weeks recovery, can be quite variable. Good news is he will not require surgery

— NRL PHYSIO (@nrlphysio) April 8, 2019

Korbin Sims has been ruled out for up to eight weeks after suffering a broken arm in the Dragons’ NRL win over Newcastle.

Sims copped the injury on a routine carry not long after coming on midway through the first half at McDonald Jones Stadium on Sunday.

The 27-year-old bravely played through the pain for the remainder of the first half before club doctors ruled him out of action at half-time.

The injury comes in just his second game for the Dragons after completing a two-game suspension incurred while playing for Brisbane last year.

“Korbin will undergo surgery on Monday afternoon to stabilise the fracture,” Dragons head of athletic performance Nathan Pickworth said on Monday.

“His return to play will be approximately six to eight weeks.”

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Korbin Sims suffered a fractured left forearm during this hit up & stayed on the field for a further 15 minutes. He will now require surgery, with an expected recovery of 6-8 weeks pic.twitter.com/CHvT3uN47x

— NRL PHYSIO (@nrlphysio) April 8, 2019

Korbin Sims will spend time on the sideline after injuring his arm. Picture: Getty

Shaun Johnson was ruled out very late in the pre-game for the Sharks after suffering some quad tightness while goal kicking. Johnson wanted to play, but the medical staff decided the risk was too high for further injury to occur. A moderate strain of the quad can keep players out for a month, so it is a relief that Johnson appears to have avoided this. Hopefully his injury is just restricted to tightness and he is able to return next week.

James Roberts was ruled out of Round 4 due to a re-aggravation of an Achilles tendon issue he has been battling for the past 15 months. Unfortunately this is not a problem that has a set ‘X week’ recovery period. It is an injury that can linger for months, but can usually be managed quite well with rehab exercises and training load modification. Roberts could go the rest of the season with no issues, yet could also have an acute aggravation at any stage and require a week or two on the sidelines. It’s looking likely the Broncos will give him at least a couple of weeks off to allow the pain and inflammation to settle.

Dylan Brown is dealing with bruising on his spine, that is not yet a fracture, but showing up as “hot spots” on scans. Hot spots in these cases often indicate inflammation or injury in a certain bone. It is also possible Brown is dealing with stress reactions in his lower back, which is usually caused by overuse and repeated activity that puts pressure on the spine. A stress reaction involves the structure of the bone becoming weaker, but a fracture is not yet present. It is an injury that is much more commonly seen in cricket fast bowlers, with the repetitive forces from bowling placing excessive strain on their spine. Treatment usually involves rest from high impact/repetitive activities to allow the bones time to heal, along with a comprehensive rehab program. This is another injury that does not have a concrete recovery time, so it is an accurate use of “indefinite” by the Eels. Brown’s symptoms will likely be monitored very closely along with follow up scans to ensure the bruising is going down. Recovery is usually measured in weeks rather than months, but with Brown still so young full recovery will no doubt be the top priority.

A back injury has sidelined Eels young gun Dylan Brown indefinitely. Picture: AAP

Gareth Widdop had shoulder reconstruction surgery earlier this week after dislocating his shoulder for the third time in seven months. Widdop had what is known as a latarjet shoulder reconstruction, which involves a bone graft being placed at the front of the shoulder joint to provide extra stability. The good news for Widdop is this procedure has a great success rate; only 1-2% of people suffer a re-dislocation after having a latarjet reconstruction. The Dragons expect Widdop to require 4-5 months recovery, and this is the average return time for shoulder reconstructions in the NRL. This recovery timeline would have Widdop aiming for a return from around 20 onwards. Despite his recent issues it will be worth keeping an eye on Widdop for a possible early return. In the AFL players will commonly come back from a latarjet shoulder reconstruction in 12-14 weeks, with one player even accelerating their rehab and returning after 8 weeks! Each case is different and no doubt the Dragons will be looking to take a conservative approach to Widdop’s rehab and return to play, but it looks like he has not played his last game in the Red V jersey just yet.

Kieran Foran underwent surgery on a syndesmosis injury (high ankle sprain) earlier this week. This is usually required when the damage to the joint is too severe that the ankle becomes unstable, and risk of further injury is too high. The Bulldogs are expecting a 10-12 week recovery period for Foran, with most in the NRL returning in the 8-12 week range from similar surgery.

Frank Winterstein faces up to six weeks out after suffering a grade two MCL injury.

Frank Winterstein suffered a grade 2 MCL injury & will be out for up to 6 weeks. Most grade 2 MCL sprains require 3-6 weeks recovery. Past examples in the NRL below: pic.twitter.com/ByQh4Hk8NM

— NRL PHYSIO (@nrlphysio) April 7, 2019

FULL NRL CASUALTY WARD

BRONCOS

James Roberts (Achilles, Indefinite)

Payne Haas (Disciplinary, Round 5)

Tevita Pangai Jr (Suspension, Round 7)

David Fifita (Concussion, TBC)

BULLDOGS

Dylan Napa (Syndesmosis, Round 9-11)

Kieran Foran (Ankle, Round 16)

Renouf To’omaga (Hamstring, Round 5)

Brandon Wakeham (Ankle, indefinite)

COWBOYS

Jason Taumalolo (Knee, Round 8-12)

Kyle Feldt (Groin, Round 5-7)

Scott Bolton (Suspension, Round 6)

DRAGONS

Korbin Sims (Arm, TBC)

Jacob Host (Ankle, TBC)

Gareth Widdop (Shoulder, Indefinite)

Jack de Belin (Stood down, Indefinite)

Tyson Frizell (Testicle, Round 4-5)

Darren Nicholls (Scapula, Round 7)

EELS

Dylan Brown (Back, indefinite)

Nathan Brown (Pectoral, Round 14)

Will Smith (Broken arm, Round 8)

Kaysa Pritchard (Personal leave, Indefinite)

Manu Ma’u (Knee, Round 6)

KNIGHTS

Connor Watson (Knee, Round 5)

Slade Griffin (Knee, Indefinite)

Nathan Ross (Finger, Round 5)

Jacob Saifiti (Leg, Indefinite)

Daniel Saifiti (Knee/foot, Round 6)

Pasami Saulo (Hand, Round 5)

PANTHERS

Sam McKendry (Knee, Indefinite)

Tyrone May (Stood Down, Indefinite)

Frank Winterstein (Knee, TBC)

RABBITOHS

Greg Inglis (Shoulder, Round 5)

Adam Doueihi (Knee, Round 4-5)

George Burgess (Suspension, Round 4)

Liam Knight (Suspension, Round 5)

Braidon Burns (Hamstring, Round 8)

RAIDERS

Aidan Sezer (Oblique, TBC)

Joseph Tapine (Thumb, Round 5)

Michael Oldfield (Groin, Round 5)

ROOSTERS

Jake Friend (Shoulder, Round 6)

Isaac Liu (concussion, TBC)

Jared Waerea-Hargreaves (Rib, TBC)

Brett Morris (Knee, Round 5-6)

Cooper Cronk (Hamstring, Round 4)

Ryan Hall (Knee, Round 8)

Lindsay Collins (Concussion, Round 4)

SHARKS

Shaun Johnson (quad, TBC)

Aaron Woods (Foot, TBC)

Matt Moylan (Hamstring, Round 10)

Paul Gallen (Rib, TBC)

Wade Graham (Knee, Round 9-12)

Ava Seumanufagai (PCL, Round 4)

SEA EAGLES

Dylan Walker (Stood down, Indefininte)

Tom Trbjocevic (Hamstring, Round 10)

STORM

Scott Drinkwater (Pectoral, Round 8-12)

Tom Eisenhuth (Throat, Indefinite)

Joe Stimson (Back, Round 4)

TIGERS

Benji Marshall (Hamstring, TBC)

Luke Garner (Shoulder, TBC)

Chris Lawrence (Broken jaw, TBC)

David Nofaluma (Shoulder, Round 4)

Jacob Liddle (Ankle, Round 6)

TITANS

Nathan Peats (Pectoral, TBC)

WARRIORS

Issac Luke (Hamstring, TBC)

Nathaniel Roache (Calf, Round 4)