Not the Bees Knees

A father takes his young daughter to the footy:

"What's wrong with him dad?"

"He's getting absolutely smashed."

"Why's that dad?"

"They can see where he's running from a mile away honey."

"But why daddy? Why can't he do one of them side step thingys like Freddy? Why daddy?"

"He's got a bung knee love."

"Will they have to put him down like we did when mum backed over Spo... Oh look daddy, he's got the b..."

"He's gone straight through them! GO SON! GO YOU GOOD THING! GO..."

"How's he going to get around..."

A collective grown emanates from the crowd as the player with the bung knee goes down in a world of hurt, his season over, and possibly his career.

Knee injuries are a major problem in rugby league and have been responsible for prematurely ending a number of careers, especially prior to advancements in modern medicine. On April 18, 2002, a report in the Daily Telegraph detailing 14 NRL players already ruled out for the season with knee injuries, prompted leading surgeon and NRL board member Dr Merv Cross to blame gang tackles. Certainly, many knee injuries can be caused by knees twisting too far in tackles or being bent in ways they are just not supposed to bend, so gang tackling could be targeted for review.

Some knee injuries however, occur without another player within cooee of them, eg. Knights fullback Seage vs Parramatta. There have been suggestions that the ground may have something to do with it, as per the "Sandcorp" accusations of 2003, but this was officially ruled out as a cause. So what else can be done to take precautions against all these knee injuries? If they are not already doing it, NRL clubs are likely to soon be including a 15 minute "Prevent injury, Enhance Performance" (PEP) program as part of their training. This program was developed by a team of physicians, physical therapists, athletic trainers and coaches in the USA, with the aim of improving balance and neuromuscular conditioning, in order to help prevent knee injuries in athletes.

An ideal NRL world would be one where all precautions have been taken, all tackles were made according to the textbook and no injuries occur, but even the most optimistic fan could never expect that to actually happen. In the real NRL, there are injuries, and one of the most feared is the Anterior Cruciate Ligament (ACL) knee injury, see illustration. This is the one that sidelines players for 6-12 months, usually requiring a knee reconstruction (there were 20 ACL knee reconstructions in 2002 and 14 in 2003). This is the one that brings a lifetime of increased risk of further problems to the affected knee and also the other knee. Nobody knows this better than Nik Kosef, who has had two knee reconstructions on each knee. That's not one, not two, not three, but FOUR knee reconstructions. This increased risk surely has a negative impact on the player's price in the market, thereby affecting their livelihood as well. Now, the term "bees knees" is synonymous with excellence, so there must be something pretty damn magnificent about bees' knees. Injured knees are certainly not the bees knees. Just ask Nik.

The news isn't all bad however. Players can still function, even go for a run, without a fully functional ACL. Their knee joint will probably collapse if they try to change direction too quickly, but they can still go to the park and play with their kids. Interestingly enough, some forwards play on with dodgy ACL's as their role is mainly just to go forward, straight and hard, without too much need for lateral movement. Matt Adamson was known to have played for the Panthers in that condition.

Now that I have painted a bit of a portrait of ACL injuries, please head a few words of wisdom. Please learn from the mistakes of an idiot who has been there and done that. If your mate goes down with what appears to be a serious knee injury during a match, but after resting for a while, he seems to be walking okay, DO NOT do the following. Even if it does happen to be his birthday, DO NOT proceed to get him pissed that night and go club hopping. The alcohol will act as a pain killer, allowing him to turn what was probably just a minor tear into a full blown knee injury requiring a reconstruction.

References: Middleton, D - Rugby League 2003 http://www.injuryupdate.com.au http://sportsmedicine.about.com/cs/knee_injuries/a/aa021902a.htm

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