New and Improved EPS Watch/Player Form Thread

[Oakboy]

WT, does the op still involve some sort of binding (carbon fibre?)?

[Which Tyler]

WT, does the op still involve some sort of binding (carbon fibre?)?

By definition, yes.
The what and the reasoning behind choosing which option is too far outside of my wheelhouse to comment on. As an observation, glue seems to be becoming more and more common.

TBH, most of the above is outside my wheelhouse as a chiro - I see patients for other things whilst they're undergoing all of that, so my job there is to encourage the patient actually do their fucking rehab! (patients are lazy, and they often lie, probably to themselves as well - NB "I have an alarm in my phone reminding me to do my exercises 3 times a day" =/= "I do my exercises 3 times a day")

[Oakboy]

WT, does the op still involve some sort of binding (carbon fibre?)?

By definition, yes.
The what and the reasoning behind choosing which option is too far outside of my wheelhouse to comment on. As an observation, glue seems to be becoming more and more common.

TBH, most of the above is outside my wheelhouse as a chiro - I see patients for other things whilst they're undergoing all of that, so my job there is to encourage the patient actually do their fucking rehab! (patients are lazy, and they often lie, probably to themselves as well - NB "I have an alarm in my phone reminding me to do my exercises 3 times a day" =/= "I do my exercises 3 times a day")

I can relate to the lying bit! My chiro is a cracking young lad and I like to encourage him. I'm sure he sees through me but is too polite to say, "You lying old scrote!"

[Banquo]

Pretty similar - immobilise in full plantar-flexion (toes pointed). Massage of the calf to encourage the ends to meet (carefully, you're going against the venous valves), consider acupuncture or some form of electrotherapy to encourage healing. Intensive rehab to maximally regain function.
NHS protocols would be the same, but ditching the massage and acupuncture / electrotherapy and 3-4 physio sessions and trusting to do your homework, probably no-one actually touching you post-surgery.

But Ollie's a professional sportsman, so he'd have been in surgery ASAP - higher risk, but higher reward - probably rescanning it weekly, potentially even more frequently, and tailoring the rehab based on the results of each scan.


IMO: NHS option is fine for your office worker couch potato who wants to walk unaffected (hilly hiking will likely hurt and fatigue), and maybe jog once in a while.
Gold standard conservative is fine for the vast majority of low-mid level amateurs doing sport for fitness.
Your pro.s, high level amateurs (depending on sport) and those who go from 0 to full-on are going to want the surgery, but risks all the complications of cutting someone open with a sharp knife.

Which doesn't mean that a pro wouldn't be fine with gold standard, or a mid level amateur with NHS; but the more you're going to challenge and rely on it, the more certainty you want that it's a solid repair, and the more risk you're willing to take to get it.


Out of academic interest - is the acceleration gone because the repair isn't solid, because it hurts, or because you don't actually trust it, and therefore hold back?
In theory, if the ends are held together properly, then acceleration shouldn't be affected. If they're held together with shitty undifferentiated scar tissue, then there may be too much elasticity in there (and usually means the rehab wasn't completed, or attempted properly [can be "I'm young and invincible" "I didn't know / can't be arsed to do my rehab on the other 13 days between my fortnightly physio" or "my physio didn't even try to push me"]); but either one shouldn't give you much warning before snapping again. Pain and fear of reinjury would be major depressors of acceleration though, and worth addressing on a more psychological level

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!
Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

[Which Tyler]

Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

Kirwan was a little while ago, and things have moved on since then.
Pros will automatically go the surgical route with stupidly intensive rehab, which more-or-less guarantees good healing - there's still the risk of surgical error (snipping a nerve) but most holdbacks are likely to be not trusting the body / fearing a re-injury - which is a long and hard road to get over; and a delicate balancing act against being too desperate to challenge it again, and re-injuring it from doing too much too soon.

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!

Yeah, if it's inelastic mending, then sorry, you're buggered. Once it's been a couple of years, then remodelling that scar tissue is really tough.
It still shouldn't particularly hurt though - that's far more likely (not 100%) to be neuroplastic pain, rather than nociceptive pain - essentially phantom limb type pain without losing the limb. Which is complicated, requires buy-in from the patient, and a willingness to put in the (mental) effort. It's also fascinating stuff, and conversations I have with patients... probably a couple of times a month - and get the most dramatic results for (as in my star patient, told they wouldn't walk unaided again after multiple disc injuries, got them doing dog agility and running half-marathons with a couple of years of hard work on their behalf).

Here's a brief primer:


Here's a YouTube, sorry - but Lorimer IS an acknowledged expert, probably THE biggest name in the field - which probably explains the relatively low viewing figure:


Here's someone creating phantom limb pain in people with all of their limbs - note, he's REALLY good at the buy-in stuff; and whilst claiming that it's not real, it really is, it's just about psychology, not physiology:


If anyone's still interested, I have plenty more - to link or to say; but let's not spam this thread any further.

[Banquo]

Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

Kirwan was a little while ago, and things have moved on since then.
Pros will automatically go the surgical route with stupidly intensive rehab, which more-or-less guarantees good healing - there's still the risk of surgical error (snipping a nerve) but most holdbacks are likely to be not trusting the body / fearing a re-injury - which is a long and hard road to get over; and a delicate balancing act against being too desperate to challenge it again, and re-injuring it from doing too much too soon.

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!

Yeah, if it's inelastic mending, then sorry, you're buggered. Once it's been a couple of years, then remodelling that scar tissue is really tough.
It still shouldn't particularly hurt though - that's far more likely (not 100%) to be neuroplastic pain, rather than nociceptive pain - essentially phantom limb type pain without losing the limb. Which is complicated, requires buy-in from the patient, and a willingness to put in the (mental) effort. It's also fascinating stuff, and conversations I have with patients... probably a couple of times a month - and get the most dramatic results for (as in my star patient, told they wouldn't walk unaided again after multiple disc injuries, got them doing dog agility and running half-marathons with a couple of years of hard work on their behalf).

Here's a brief primer:


Here's a YouTube, sorry - but Lorimer IS an acknowledged expert, probably THE biggest name in the field - which probably explains the relatively low viewing figure:


Here's someone creating phantom limb pain in people with all of their limbs - note, he's REALLY good at the buy-in stuff; and whilst claiming that it's not real, it really is, it's just about psychology, not physiology:


If anyone's still interested, I have plenty more - to link or to say; but let's not spam this thread any further.

[Danno]

Worth a thread of its own imo

[Which Tyler]

Worth a thread of its own imo

Happy to do more / answer questions, if Puja wants to split off (better than splitting the semi final thread!)

[Danno]

Worth a thread of its own imo

(better than splitting the semi final thread!)

[Puja]

AOF called up to train with the Lions while Stuart/Furlong are in finals and Fagerson's injured, and in the box seat for a game against Argentina. Great learning opportunity for him, although I hope that's all he's called up for - wouldn't be keen on him going on the tour proper

George also likely to be there.

Puja

[fivepointer]

Yep, I want AOF with England rather than on the jamboree.

[FKAS]

He'd have probably been better off with a couple of rest weeks before the summer tour. Looked absolutely done in before half time at the weekend and didn't last long into the second half. He's played quite a lot of rugby this season. This is a great experience for him but I wouldn't be adverse to him getting the summer off.

[Oakboy]

He'd have probably been better off with a couple of rest weeks before the summer tour. Looked absolutely done in before half time at the weekend and didn't last long into the second half. He's played quite a lot of rugby this season. This is a great experience for him but I wouldn't be adverse to him getting the summer off.

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

[Which Tyler]

Yep, I want AOF with England rather than on the jamboree.

I want him sat on a beach, drinking something with an umbrella stuck in the top.
Of my licked-finger-in-the-air estimate of how much game time I think is "enough but not too much" for a prop of his age - AOF has already exceeded double that for this season.

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

You'd have to say the same for summer international tours, and end-of-season pay-offs as well.
Or you take a second, and make the match / gametime limit on a rolling 12-month basis, not August to August.

[FKAS]

He'd have probably been better off with a couple of rest weeks before the summer tour. Looked absolutely done in before half time at the weekend and didn't last long into the second half. He's played quite a lot of rugby this season. This is a great experience for him but I wouldn't be adverse to him getting the summer off.

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

He's a 20 year old tighthead who's got 25 appearances with 20 starts and over 1200mins. That's a lot for young player still physically developing in a demanding position.

[fivepointer]

He'd have probably been better off with a couple of rest weeks before the summer tour. Looked absolutely done in before half time at the weekend and didn't last long into the second half. He's played quite a lot of rugby this season. This is a great experience for him but I wouldn't be adverse to him getting the summer off.

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

He's a 20 year old tighthead who's got 25 appearances with 20 starts and over 1200mins. That's a lot for young player still physically developing in a demanding position.

Thats quite a workload. I didnt think he played that much as he was injured earlier in the season.

[FKAS]

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

He's a 20 year old tighthead who's got 25 appearances with 20 starts and over 1200mins. That's a lot for young player still physically developing in a demanding position.

Thats quite a workload. I didnt think he played that much as he was injured earlier in the season.

Was he? I remember Fasogbon picking up an injury but thought AOF had a pretty consistent season.

The playing stats is a pure steal from AllRugby as per usual.

[Puja]

The snag is that if you promote player welfare to the correct status the Lions concept cannot continue.

He's a 20 year old tighthead who's got 25 appearances with 20 starts and over 1200mins. That's a lot for young player still physically developing in a demanding position.

Thats quite a workload. I didnt think he played that much as he was injured earlier in the season.

Cross-posted from the transfers thread:

Fasogbon signs a new "multi-year" contract with Gloucester. I have to say it looks like they're handling his development very well - he's played 19 games this season (not including his England A game), with 12 starts, and has an average of 45 minutes per game, which seems like a decent balance for a 20 year old prop - enough to learn from, but not enough to break him. Admittedly some of that may be more luck than judgement, given he had an injury that kept him out for a bit and there's no post-season games for Glaws, but we'll still give them credit.

For comparison, AOF is 22 games, with 18 starts, and an average of 54 mins per match. That works out to an additional 351 minutes and it's probably safe to assume he'll have another 50-odd this coming weekend - that'll be a full 5 Maro Itoje international rest-weekends worth of rugby more than Fasogbon. Bit worried about him being overplayed, especially with him likely to go on tour as well.

Puja

[Scrumhead]

Just seen Jacob Umaga has been called up by Samoa. Funny to think he was once considered an England prospect.

With the exception of the Smiths a lot of the 10s we’ve had in that age bracket have had strange career trajectories. Umaga, Grayson, Manu Vunipola etc.

[Mikey Brown]

I notice a theme.

[Puja]

Just seen Jacob Umaga has been called up by Samoa. Funny to think he was once considered an England prospect.

With the exception of the Smiths a lot of the 10s we’ve had in that age bracket have had strange career trajectories. Umaga, Grayson, Manu Vunipola etc.

Good for him! An example of why World Rugby allowing change of nationality is a good thing - he deserves not to let his one England cap against the USA stop him from playing internationals and Samoa deserve to get use of a decent fly-half.

If Wasps hadn't imploded, then I think he probably still would be an England prospect - not in competition with Smith/Ford/Smith, but there'd be no question about our fourth choice if he was still around. Good get for Samoa and I hope he does well.

Puja

[Epaminondas Pules]

Just seen Jacob Umaga has been called up by Samoa. Funny to think he was once considered an England prospect.

With the exception of the Smiths a lot of the 10s we’ve had in that age bracket have had strange career trajectories. Umaga, Grayson, Manu Vunipola etc.

More of a standard thing for me, than anything. Same with Bailey and Atkinson. They were the same age group as Fin Smith and throughout age grade Smith was the one that stood out. I mean, you've got to be decent to play age grade and then onto Prem, but we've had quite a glut of decent prospects, but without the top two inches, and then the odd one who does. Smith, Smith. Benson maybe....

Davies and Linegar look like the next big prospects, while Bellamy and Coen look like squad filler or Championship players.

[Danno]

Just seen Jacob Umaga has been called up by Samoa. Funny to think he was once considered an England prospect.

With the exception of the Smiths a lot of the 10s we’ve had in that age bracket have had strange career trajectories. Umaga, Grayson, Manu Vunipola etc.

Good for him! An example of why World Rugby allowing change of nationality is a good thing - he deserves not to let his one England cap against the USA stop him from playing internationals and Samoa deserve to get use of a decent fly-half.

If Wasps hadn't imploded, then I think he probably still would be an England prospect - not in competition with Smith/Ford/Smith, but there'd be no question about our fourth choice if he was still around. Good get for Samoa and I hope he does well.

Puja

Bang on.

[Banquo]

Just seen Jacob Umaga has been called up by Samoa. Funny to think he was once considered an England prospect.

With the exception of the Smiths a lot of the 10s we’ve had in that age bracket have had strange career trajectories. Umaga, Grayson, Manu Vunipola etc.

Good for him! An example of why World Rugby allowing change of nationality is a good thing - he deserves not to let his one England cap against the USA stop him from playing internationals and Samoa deserve to get use of a decent fly-half.

If Wasps hadn't imploded, then I think he probably still would be an England prospect - not in competition with Smith/Ford/Smith, but there'd be no question about our fourth choice if he was still around. Good get for Samoa and I hope he does well.

Puja

Umaga was pretty terrible in the last season I saw him.

[Scrumhead]

At the time Umaga was capped he was a serious prospect. He just seemed to drop off quite considerably in his last season with Wasps and I’ve barely heard anything about him in the URC.

Perhaps he’s just flying under the radar but I doubt he’d have been mounting a particularly strong challenge for the full squad if he were still around in the Premiership.

When Wasps went under it looked as though Atkinson was their preferred 10 although I may be misremembering that.