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Meet the ‘Rehab Guy’


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Just as Madonna and Paris Hilton have their own celebrity trainers, the rugby glitterati seem to be becoming ever more reliant on the skills of American knee guru Bill Knowles to keep creaking players on the field of play.

With a star-studded list of rugby clients such as Richard Hill, Dan Ward-Smith, Charlie Hodgson, Austin Healey, Jason White, Ollie Smith, Lewis Moody, Seru Rabini, Henry Tuilagi, Leicester Tigers, and from other sports: David Boston (Tampa Bay Buccaneers), Hannah Teter (2006 Gold Medal Snowboard), Michael Owen (Soccer), and many Olympic skiers, Knowles is fast building a reputation on both sides of the Atlantic as the world’s foremost rehab specialist for severe knee issues and in Anterior Cruciate Ligament injuries in particular.

James Griffith paid Bill a cyber-visit to his clinic high in the snow-capped Vermont Hills to find out why ACL injuries seem to be contagious and what is causing the epidemic…

JG: Hi Bill, good to meet you. So with all these star players dropping like flies, what is it about our game of Rugby Union that is causing so many high profile ACL injuries?

BK: Rugby is a collision sport that has inherent risks, just like American football. The strong, the weak, the fast, the slow… they are all at an equal risk once you step on the field. Are the higher profile players taking additional risks to increase their chance of injury? This is a good question. The adage – “bigger, faster, stronger” has its pros and cons. The bigger you are, the faster you run. The harder you hit, the quicker you rotate at the knee joint. Across all sports and levels within the sport, athletes are injuring their knees. The frequency is no higher in rugby than in American football.

JG: Yes, but the number of recent cases seems to be rising…

BK: The injury rate is often just bad luck. Athletes often have no chance to walk away from certain situations. But then again, we must also look at fatigue factors…both mental and physical. How many games are being played…is there enough recovery, etc. Good luck is rarely considered the main reason for a winning season. Likewise, bad luck should never be weighted too heavy when evaluating an injury-prone season. We may find no compelling evidence that points to poor preparation, but a program should always evaluate itself critically each season.

JG: How does the game demands differ to the other sports you’re involved with? Where are the ‘pressure points’ in your opinion?

BK: As far as rehab and reconditioning goes, ground based sports are fairly similar. The goal is to get their strength up quickly and then allow them to express their inherent athletic ability through “movement” training. Sounds simple, but the trick is in managing when to advance the workouts and when to hold back. This is the “pressure point”. Too often when the athlete begins to make quality progress they are pushed too hard and setbacks (physical and mental) can occur. Likewise, holding the athlete back too long can be a problem.

JG: So you think professionalism and the match workload is placing greater strains on the players’ bodies and also their performance expectations than before?

BK: Quite simply, ‘more’ is most times not better. Unless it is recovery from competition when ‘more’ could be very beneficial! The Premiership rugby season is very long compared to other collision sports. Then add in the internationals and it is easy to see how some players may be subject to injury. Regardless, it is impossible to prevent injury in rugby… you just try to decrease the incidence within your team. There is no doubt that pro players are expected to perform week in, week out, even if not fully recovered. This is the nature of pro sports. Those teams that manage this situation the best have a tendency to have a healthier team. Once again though, injury happens eve

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