You are the greatest mauler in the team. No one else has your cunning, your strength, your ferocity, your commitment. Once the opposition see you holding the ball in a rolling maul they know a try is inevitable. They see you coming into the breakdown and they know there is going to be a turnover ball.

But if the maul is down one end of the pitch and you are at the other, you are a waste of a jersey. You’ve worked on your skills, you’ve done the sit-ups and pushups, but you hate running. So you’ve missed the leg work. After 30 minutes you are blown. The coach dare not substitute as the team will say why have you taken off our best player?

The most important skill in most team sports is being there. The right place at the right time. No good being the best player on the pitch if you are too winded to keep up with the ball.

Familiar? See it all the time. A lot of players hate running. So they work on everything else, have the best 6 pack in the bar, but no-one notices they are a few seconds late to every breakdown.

But that is not the only problem with failing to do the leg work.

Fit people don’t get injured as often.

Rugby is not a dangerous game. Not many international players are seriously injured when you consider how often they play. When they are, it is often due to bad refereeing. You’ll see more hamstring injuries in international sprinters then in rugby, more knee injuries in football players. Most injuries occur in the lower levels, in the third division, in the amateur. Because they are not fit.

Ligaments, tendons and joint capsules tear. Bones break. Joints dislocate. The human body is built to take a few knocks, and if you understand how the body works you can do a lot to prevent injuries.

This month I want to look at an injury that most contact sports people fear. Knee ligaments

There are 4 ligaments in the knee that hold the knee together. The joint capsule itself is also tough stuff and helps keep the joint in place. It is tempting to think of all the different structures as separate, like in the pretty diagrams in the books. Ugandans know better, as they see joints in the butchers every day! The tendons of the muscles and the ligaments enter the joint capsule and sort of merge into it and then sort of thicken up a bit and come out the other side as tendon again. You cannot dissect out the tendons and ligaments and leave an intact capsule behind. You will also have seen how incredibly tough these things are. It’s difficult enough to tear apart a chicken’s knee joint when it is raw, never mind a goat or a cow. (Alright, I know, you never have any trouble making the chicks go weak at the knees; knock it off this is a serious article)

The knee is meant to bend in only one plane, it does not bend forward, nor sideways, nor rotate, unlike a hip or a shoulder that can move in all 3 planes. What stops it rotating is the ligaments. What stops it bending sideways is the ligaments, what stops it bending forwards is the ligaments. Easy isn’t it? You want to rupture those ligaments, just try and rotate the knee or bend it side ways. Take a knock head on with the knee bent a bit the right way, and you can stop an elephant. Twist it sideways and you can stuff up your cruciates playing football with a toddler. That is why footballers do their ligaments, they dance around twisting sideways. Rugby players soon learn that if you take a hit full on you don’t get injured. Get a small hit from the side and you can be off for the season. Remember JPR? The first full back to join the line and run. His specialty was picking a ball from a kick deep in his own half and running straight into the opposing scrum. Ok he was a doctor so he wasn’t very clever, but he knew his anatomy! Take a hit full on and you don’t get injured. And he never was. Well, a few stud marks, but he was ugly already .

If you are going to take a hit, take it head on, not sideways

There are 4 ligaments in the knee. Two on the sides called the lateral and medial ligament, and 2 in the middle of the joint. They cross over, so they are called the cruciates. One crosses in front and is called the anterior cruciate, and the other crosses… oh work it out for yourself.

Take a tackle from the side, as you often do in football, and your knee on the opposite side tries to bend sideways. Your weight takes you on, and the tackle stops your foot from joining you. So it breaks the lateral ligament. There is immediate severe pain, your knee flops inwards, and it swells up like a football. If someone takes your foot in one hand and holds your leg above the knee with the other, he will be able to bend your knee inwards, as there is now no lateral ligament to stop it. If there is no swelling and the knee does not bend sideways, then the ligament is not torn. You’re a whingeing git so get up and get on with the game. Well you might have torn the capsule. That feels pretty bad when it happens. I did it dancing with the reverent Coulson's wife at the St George’s ball. Trying to show off.

Tearing the capsule and partial tears of the ligaments will make your knee pretty painful and stiff for a month, you will need to rest for a couple of weeks and your wife will have to climb on top.

The medial ligament is injured more often. This is the most common knee ligament injury It can be a twisting injury but more likely a knock from the side or a trip or a fall at speed. If you are knocked or swerve sideways when your foot is held on the ground, or you are going straight on and your foot slips sideways, you put force on the medial ligament. Your knee swells up, but not usually so much as the other ligament injuries. When you hold the lower leg with one hand and the upper leg with the other it bends outwards. If you are lucky it is only the medial ligament that is torn. Unlucky and the cruciates are torn as well.

Partial tears of the lateral and medial ligaments do not require surgery. Early mobilization and exercise is the key. Complete tears of the medial ligament usually do well with surgical repair. It can be simply sown back together, or even join up again on it’s own with rest and crutches. However physio is crucial. Strengthen the muscles and the tendons will do the ligaments job. Now if you can treat the injury with exercise, can you see what I mean about being fit prevents injuries? If you have good leg muscles, the muscles aren’t stiff and you are more able to dodge out of the way, you have les chance of injuring your knees. JPR never had an injury

The cruciates are probably a bit nastier. They tear with a twisting injury or a forced extension. That means someone tries to bend it backwards. They can also tear when the medial ligament is torn. Again pretty painful and immediate swelling. Most of the cruciates I’ve seen have been from motor bike accidents. T o find out if your cruciates are torn, if someone gets hold of your leg above the knee with one hand and the leg below with the other and tries to slide the knee forwards, it does. It’s a really weird feeling! If you are rich and under 25 someone may offer to operate. Some people have carbon fibre repair, or reroute a muscle tendon. Maybe I’m a cynic but I reckon it seldom restores full stability for long. The rest of us have to rely on physio: and most of us do just as well.

Do you remember Sean Mann? He stuffed his cruciates. Went down to SA and was told to have physio to strengthen the muscles. He came back and was the Heathens top scorer for about the next 3 seasons wasn’t he? I know a lot of people have had their playing career cut short by cruciate tears, but most people can carry on with their sport after good physio to strengthen up the muscles. If it is a complete tear of both then you will have a pretty unstable knee whatever exercise you do. But I know a lot of runners who have no problem on a fairly flat surface, play quite a bit of sport and yet when you examine the knee you can slide the lower leg forward on the knee with no resistance. Absolute proof they have a complete tear of the anterior cruciate, yet it hardly bothers them.

One last thing about strapping and knee supports. Have another look at the goat in the butcher’s shop. (no, not the butchers wife!) Those ligaments, tendons and capsules are pretty tough. Try and wrench that joint apart and you’ll never do it without a crow bar and a sledgehammer. Compare that sort of strength to a piece of cotton bandage wrapped round your knee. Pathetic, isn’t it? If your kid had a toy and it broke the wires holding the joints together, would you mend it with a piece of cotton bandage wrapped round the joint? It would fall apart under gravity! If you want to mend that toy, you’d use a piece of string between the bones, wouldn’t you? Like a ligament.

Strapping may make you feel better. It tells the opposition that you’ve got a knee injury. But it is not going to prevent further damage, nor hold your knee together. Your skin is probably stronger than the bandage. Strengthen the muscles! Don’t rely on a knee support.

Bottom line.

Do the leg work and you will have a far better chance of avoiding injuries.

Fit players get injured less often

Take hits head on: twisting does the most damage

Most people with knee injuries can keep on playing their sport after good physio.