Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Tackles and Tinnies Presents: Physio Corner: Ep 1 - R21 recap— Jahrome Hughes & the Shoulder Saga
11 Plays4 months ago
Welcome to the very first episode of Physio Corner, the Tackles and Tinnies injury breakdown show where we swap banter for bandages and stats for scans.
Joining us is our resident physio and co-host Gary, who’s here to break down the biggest injuries around the NRL — what they mean for your SuperCoach side and your team’s season.
This week, we dive deep into the injury sending shockwaves through Melbourne: Jahrome Hughes and that dislocated shoulder.
🩺 In this episode:
🔍 What actually IS a shoulder dislocation?
– Gary breaks down the physio lingo in plain English
– What happens anatomically when the shoulder pops out
– Common causes in footy & how it impacts performance
⏱️ Recovery & Risk
– Timeline for return
– Strength, range, and re-dislocation risk
– Why it's not just about pain, but function
⚡ What it means for the Storm
– Can the spine survive without Hughes?
– What it does to playmaking structure and momentum
– Fantasy fallout: should you hold, trade, or panic?
🎧 Whether you're a SuperCoach tragic, injury nerd, or just love footy from all angles — Physio Corner is where sport meets science (and a little salt).
Recommended
Transcript
Introduction and Professional Background
00:00:00
Tackles and Tinnies
Hello, hello, hello. Welcome, Tackles and Tinnies listeners. This is very odd. It's your boy, Gary, recording podcast by himself, but I'm doing Physio Corner and breaking down Jerome Hughes's injury.
00:00:16
Tackles and Tinnies
For those who haven't met or who are new to this show, name's Gary. I am a sports and musculoskeletal physiotherapist, and I work at Burley in Back in Motion.
Jerome Hughes's Shoulder Injury
00:00:29
Tackles and Tinnies
Today we're going to break down, i think most of you would have heard, Jerome Hughes injured his left shoulder. He sustained a shoulder dislocation about two weeks ago. yeah, we're just going to break down a little bit about the mechanism of action, kind of what's involved, what's the rehab and and and the return to play strategy.
00:00:52
Tackles and Tinnies
So what happened? So a bit of a summary, and i'm going to pull up a play-by-play at the moment and just kind of describe for those that are listening what happened, but it was the roosters verse...
00:01:07
Tackles and Tinnies
The Roosters versus Melbourne Storm and Jerome Hughes, he was going for a tackle. He missed James Tedesco as he kind of Jimmy the Jet just ran through. But going for a tackle, his left arm landed really awkwardly. So it's oftentimes that mechanism, that but full outstretched hand and landing on it.
00:01:28
Tackles and Tinnies
And for Jerome, I don't think he's previously had, I mean, I could be wrong, but I don't think he's previously had this left shoulder
Understanding Anterior Shoulder Dislocation
00:01:36
Tackles and Tinnies
injury. So just a force of that typically can cause an anterior shoulder dislocation.
00:01:42
Tackles and Tinnies
And I believe that's what Jerome Hughes sustained. So an anterior dislocation for those who are interested or not aware is the most common type of shoulder dislocation.
00:01:55
Tackles and Tinnies
So it's where the upper head of the arm bone, so your humerus, it's displaced forward. So it usually goes forward of the shoulder socket.
00:02:07
Tackles and Tinnies
Oftentimes, qua ah or I wouldn't say super common in in rugby, but more of that traumatic event. So like sustaining something like what Jerome Hughes did.
00:02:17
Tackles and Tinnies
Oftentimes, footy players, might you might see it going for a try or trying to score and they've just had their arms outstretched. and then someone's may have just gone over the back.
00:02:30
Tackles and Tinnies
It's quite sore, very intense pain. You can see that the shoulder socket's usually out. And yeah, limited very limited mobility and swelling. So usually like Jerome just didn't really wanna move his arm. He just left it kind of in that neutral position.
00:02:48
Tackles and Tinnies
But yeah, interestingly, I have sustained one on my right shoulder.
Joint Stability and Shoulder Mobility
00:02:53
Tackles and Tinnies
That was not a fun time, but as a physio, I think it was interesting to rehab my own shoulder. So, yeah.
00:03:04
Tackles and Tinnies
Covering the mechanism of injury. So, yeah, being forced into that. So, physio speak, but abduction. So, bringing your arm out and then into that external rotation oftentimes is the most, I guess, important.
00:03:18
Tackles and Tinnies
your arms ah and your shoulder is the least strong in that position. A bit of a review in and and in terms of anatomy, usually that glenohumeral joint, it's very mobile, so you can move through full range of motion, but it's not very stable in terms of the most stable joint in there.
Clinical Assessment of Shoulder Injuries
00:03:38
Tackles and Tinnies
it's The hip is a very or much more mobile and stable hip compared to the um shoulder.
00:03:46
Tackles and Tinnies
But some key structures getting into anatomy, but it might be the anterior capsule. It could be the labrum in the shoulder that could be injured and possibly any rotator cuff strains or tears is quite common.
00:03:59
Tackles and Tinnies
would have got an x-ray to clear his, any like Hill-Sax lesions or any bony lesions to the shoulder. to the the shoulder
00:04:11
Tackles and Tinnies
Let's dive into a little bit of it like a clinical insight and then like grading, the injury. So there's a thing like between first time and recurrent dislocations. Oftentimes if you're younger, let's say but between 18 to I think 25, 26, if it's your first time, the risk of re-injury is quite, well, is elevated. It's higher, especially because they found when studies found that during those age, uh,
00:04:40
Tackles and Tinnies
I guess the age category the time where most kids or most people are playing sports like rugby. So that can just increase your risk even higher. So once you've had a shoulder dislocation, the in the injury risk of redoing it because you know you're you're cleared for um play again and then you get into that position again and then re-injure.
Treatment Paths for Shoulder Injuries
00:05:04
Tackles and Tinnies
yeah, higher risk in young, high impact athletes. What we look for in the clinical assessment, typically the physio on field would have assessed Jerome's passive range. So looking at lifting his arm, how far can he lift it any apprehension tests. So it would be quite difficult as ah Jerome would be moving into that position. he wouldn't wouldn't wouldn't want to go any further.
00:05:31
Tackles and Tinnies
but he got X-rays and MRIs. I mentioned it before, but ruling out any bony bank art, so any lesions to the bone, any slap tears, so slap tear being your bicep anchored to the shoulder, um any any kind of cartilage can be pulled from that shoulder.
00:05:50
Tackles and Tinnies
And then any like rotator cuff involvement, so having a look at the muscles and any tears. So in terms of grading, you've got grade one, two, and three.
00:06:01
Tackles and Tinnies
So grade one's subluxation. So typically ah subluxation would be a very quick, you know, in and out kind of action. Not much is injured.
00:06:11
Tackles and Tinnies
So your structures are all pretty good. A grade two is a dislocation, but without significant tissue damage. Grade three is a dislocation with soft tissue or bony lesion.
00:06:24
Tackles and Tinnies
Some similar case studies. Let's have a look briefly, but Kalen Ponga in 2021 had multiple dislocations. He eventually opted for surgery and I believe it was the end of the year. He got his shoulder ah ah stabilized.
00:06:40
Tackles and Tinnies
Oftentimes with rehab, If it's the first time most medical professionals would like to try conservative rehab, you want to manage it with conservatively rather than going straight to surgery.
00:06:56
Tackles and Tinnies
And i believe that's what Kaelin Ponga did, went conservative first and then, correct me if I'm wrong, but may have redone, had multiple dislocations and then got the surgical stabilization.
00:07:12
Tackles and Tinnies
Cameron Munster in 2022 was another one. He played through minor dislocations during the final series and then had a bit of shoulder taping, that conservative management. So focusing on his rehab, getting that rotator cuff nice and strong, building the strength back.
00:07:30
Tackles and Tinnies
Cooper Cronk in 2018 fractured his scapula and had a bit of shoulder instability. So He managed it quite conservatively, which is great.
Conservative Management Advocacy
00:07:42
Tackles and Tinnies
then most recently, i remember Ola Kawatu from the Manly Sea Eagles. He suffered and last week actually re-aggravated his shoulder, so it popped out again. So most likely for Ola Kawatu, he's going to go under the knife and get shoulder stabilisation.
00:08:02
Tackles and Tinnies
But just some key learnings, I guess, just to reiterate, like conservative management is often attempted first. So you want to manage that. If you're in a position or if you knew someone that was in a position where they had a shoulder dislocation, likely ask them to see a physio, which is the first port of call and then attempt conservative management.
00:08:23
Tackles and Tinnies
Physio will go through a range of assessments looking at the passive range of motion, active range of motion, things like pain levels, and then begin a home exercise and strengthening program.
00:08:36
Tackles and Tinnies
If the person is young, you know, in their late you know teens or early 20s, there is a high reoccurrence rate of re-injury, typically because young kids want to return back to sport quite quickly.
00:08:51
Tackles and Tinnies
And then you return back to, let's say, rugby league, and then it's high contact, high impact. You sustain another blow or get into that aggravating position, and then there's a high reoccurrence rate.
00:09:07
Tackles and Tinnies
In that case, surgery is likely recommended, but oftentimes I'd see your physio first.
Rehabilitation Process and Timeline
00:09:14
Tackles and Tinnies
part So going into rehab principles. So Jerome Hughes, what's his return to play timeline? So initially, this is more textbook, but that four to six weeks.
00:09:26
Tackles and Tinnies
Typically, i personally would err between that five, six weeks and just to monitor before the return of play. but Acute management, so being in that neutral position, Jerome Hughes, for those that are listening, but arms close by to your belly at that 90 degrees, that's the most comfortable position.
00:09:44
Tackles and Tinnies
And it's oftentimes early immobilization. So being in a sling, Now, oftentimes they say about two to three weeks. So when I was at hospital, that's what the doctor said, but I started moving it a bit more. I took this thing off after a week because I just wanted to move it as much as I could.
00:10:02
Tackles and Tinnies
So early range of motion. It also depends on the type of injury. So we talked about the grades before. If it was a grade one, two, or three, it was grade three, you'd probably want to immobilize it a little bit longer.
00:10:14
Tackles and Tinnies
But yeah, for Jerome... I'm not sure what his scan says, but I'm pretty sure he's going for the conservative management. So likely that early immobilization, early ROM to get his shoulder motion back, and then some modalities.
00:10:35
Tackles and Tinnies
So TENS machines, if anyone's heard of TENS machines, you attach some electrodes to your muscles and then it kind of contracts that muscle and contract and relax, contract and relax, which can provide a bit of a analgesic effect.
00:10:51
Tackles and Tinnies
Phase two is often post two to three weeks. Are you looking around two to three weeks? Mobility and strengthening. So the pain and range of motion should be a lot better by two to three weeks. So then from there, you're focusing on isometrics or moving through range against resistance. So rotate a cuff strengthening elbow and across doing those types of exercises with bands or cables.
00:11:19
Tackles and Tinnies
um um And then a bit of closed chain kinetic exercises. Phase three, you're looking at more past that, you know, three, four weeks, but sports specific conditioning.
00:11:30
Tackles and Tinnies
Jerome Hughes using him as a case, but would be going back to passing and and kind of tackling. Tackling with a lot of strapping and then he'd be strapping the hell out of his shoulder and then probably putting him in a bit of brace at training.
00:11:45
Tackles and Tinnies
But yeah, some expected return to play. i know a lot of people like to know these weeks. So in if conservative, if it was that mild dislocation, it'd be about three to four weeks.
00:11:57
Tackles and Tinnies
If it was moderate, more moderate, so labral irritation, you're looking at more four to six weeks. If you were to get shoulder reconstruction or shoulder stabilization, you're looking at more that four to six months.
00:12:10
Tackles and Tinnies
And and I think Jerome Hughes, it was more of a mild dislocation. it could be wrong, but more of a mild dislocation. So they're looking more at the four-week mark.
Recurrence and Recovery Factors
00:12:19
Tackles and Tinnies
They're going to try and get him ready for the finals, which is great, you know, because Melbourne Storm, such a great team.
00:12:26
Tackles and Tinnies
They'll be hopefully or definitely in the finals. So you'll see Jerome Hughes pop up there, which is fantastic.
00:12:37
Tackles and Tinnies
So what are we thinking in terms of, so risk of recurrence and long-term outlook?
00:12:44
Tackles and Tinnies
So 90% of recurrence rates in young contact athletes without surgery. So it's not great in terms of re-injury.
00:12:55
Tackles and Tinnies
Jerome being probably in his later twenty early 30s, the risk of re-injury oftentimes lower.
00:13:07
Tackles and Tinnies
there was a study past the age of 30. If you were to have or return to contact, it's oftentimes less recurrent rate for those that are past 30. So that's good news for Jerome.
00:13:22
Tackles and Tinnies
it's oftentimes a return to sports. The decision making is based on the team. So especially in elite athletes and elite sports. So the team doctor is going to weigh in.
00:13:32
Tackles and Tinnies
at the final schedule is going to depend on Jerome's pain tolerance and the demands of the position. so Tyrone Wishart is playing there at the moment, covering number sevens.
00:13:45
Tackles and Tinnies
He's a great player too. Is he as good as Jerome Hughes? I don't think so, but you know as the position demands. Also, some decision-making.
00:13:58
Tackles and Tinnies
The medical staff, the physios will be thinking about the position-specific risk. So, halfbacks, they're having to tackle heaps and then passing left and right. It is a bit more of posing like a ah bit more risky for shoulders in terms of that instability.
Final Thoughts and Engagement
00:14:16
Tackles and Tinnies
But that's a wrap on our deep dive into Jerome Hughes's shoulder dislocation. But these injuries are quite common in rugby league, but every athlete's rehab journey is unique and slightly different.
00:14:27
Tackles and Tinnies
They're influenced by position, timing, the team needs, and individual tissue response. I'll definitely be keeping a keen eye with Hughes's progress.
00:14:37
Tackles and Tinnies
It will be good to check in and we might check in in a week or two, whether he opts for surgery or whether that team decides me medical staff decide shoulder stabilization or proceed with more that conservative rehab. That'll be an interesting point. then, yeah, bit a bit of outro, but if you have found this,
00:15:00
Tackles and Tinnies
episode helpful, don't forget to subscribe. So click that subscribe button, share with your physio networks or with your mates, if you found this interesting and then just check in on previous episodes. I know Ryan's been doing really great stuff with Chris and Adam and Jakey with all the podcasts, analyzing the super coach stuff.
00:15:20
Tackles and Tinnies
That's probably beyond my scope and expertise because those boys are weapons at it. But if you're more interested in these types of physio breakdowns, looking at injuries, us know.
00:15:32
Tackles and Tinnies
Put it in a comment as well. It gives a a lot of fan engagement. And yeah, really appreciate your support. But that is all done. We'll see you in the next one.