Rugby: Braid's days of shouldering burden over

Luke Braid will be on the Blues bench tonight after spending the back half of last year recuperating from double shoulder surgery. Photo / Getty Images

Dynamic Blues flanker raring to go after off-season surgery a success.

Pain has been a constant companion for Blues loose forward Luke Braid for much of the past two seasons.

Not the unbearable kind, he says, just constant soreness - a sharp ache that refused to die. His right shoulder had been giving him problems for a couple of years. Then, last season, the other one started playing up as well. It had got to the point where he was unable to take part in any of the Blues contact sessions during the week if he wanted to be in any sort of shape at the weekend.

Once on the field he'd launch himself into the clear-outs, exact punishing tackles and run at the defensive line at full speed. With every impact his shoulders took, the cartilage that keeps the joint together was wearing away. He'd walk off the field barely able to raise his arms above his head. Then he'd spend the week resting up; and repeat.

Approaching the end of the Blues campaign last year, it was clear Braid's shoulder problems were becoming unmanageable; the only option left was surgery. He had his right shoulder repaired in July, then the left six weeks later. Seven months on, the 26-year-old has been named on the bench for tonight's opening round clash against the Chiefs.

Shoulder injuries are ubiquitous in rugby. At a quick count Blues physio Mark Plummer says around 10 members of the squad have had shoulder stabilisation surgery, including All Black prop Tony Woodcock, who like Braid will return to the field for the first time tonight following rehabilitation in the off-season. We barely bat an eyelid now when hearing of players going in to get their shoulders "done". And yet most of us know very little about why these injuries occur and how they are repaired.

It is also unclear how some players can go their entire careers without any issues, while others are dogged by problems. There is research suggesting Polynesian players may be more susceptible to this type of injury due to ligament laxity, but Plummer said there doesn't appear to be a factor that puts certain athletes at risk.

"It's a bit of a lottery - I don't think bulk tends to make a huge difference, we've got big strong boys that have suffered dislocations," he said.

The problem is the anatomy itself. Shoulders aren't really built for the forces and high-speed collisions of rugby. It is essentially a ball and socket joint, but the socket is extremely shallow with only the labrum - a cartilaginous skirt that surrounds the humeral head - keeping everything where it should be.

"The stability of the joint is not really there to begin with, and when you add in the sorts of forces that these boys get you can see why it happens so often," Plummer said.

Studies have shown the most common way for this injury to occur is when making a tackle, a direct blow to the shoulder or falling on to an outstretched arm (yes, even scoring a try is a fraught business). The loads and repetitious trauma the shoulder joint is subjected to can cause tears to that skirt, loosening the part of the joint which keeps it tight in a way that does not allow it to heal.

"Once the labrum is damaged or torn that leads to constant instability, so the joint shifts as opposed to fully popping out," Plummer said. "It's painful and generally doesn't settle down with ongoing trauma, so it gets to the stage where the only option left is shoulder stabilisation surgery."

There was a time when the only way to repair these types of injuries was to open the shoulder up. In recent years a less-invasive arthroscopic technique has been developed. Through a tiny incision the arthroscope is inserted, shining a light - literally - on the interwoven anatomy of ligaments, tendons, bone and cartilage. Two other small incisions are made to reattach and tighten the torn labrum and ligaments of the shoulder, using sutures and small bone anchors.

"It's amazing what they can do these days - I've got three little scars on both shoulders from having really big surgery," Braid says.

Braid elected to get his shoulders done within six weeks of each other so he'd have one functioning arm.

Braid says he's not worried that at 26 he is playing with two patched up shoulders. He figures in his position he's only got a shelf-life of about 32, so he's done pretty well to make it to the halfway point before requiring any major surgery. Nor is he worried about developing any issues that might impact on his contract at French club Bordeaux, where he is bound for at the end of the season. "You've just got to put your head down and play."