The miracle of Nowlan Park? Not quite

EIGHT thousand people saw it, so it must have happened. Henry Shefflin, ruled out of the All-Ireland final after rupturing the anterior cruciate ligament in his left knee in the semi-final win over Cork, took a full part in training with Kilkenny on Wednesday in Nowlan Park and is in line for a sensational appearance on September 5 as the Cats seek a fifth All-Ireland in a row.

However, Shefflin may not need to change his name by deed poll to Lazarus just yet, says Tom McCarthy, orthopaedic surgeon at the Sports Surgery Clinic in Dublin.

“Unusual,” says McCarthy of Shefflin’s return to action, “but not miraculous. I wouldn’t even say ‘rare’, it would probably be more accurate to say ‘uncommon’.”

McCarthy explains the dual nature of the mysterious cruciate ligament.

“There are two bundles in the cruciate. One controls forward and backwards motion, and the other controls pivoting motions. It connects the shinbone to the femur. There are degrees of tear, and sometimes the tears may involve the other ligaments in the knee – there are three other ligaments there. If you damage a bone or cartilage as well, then that complicates matters further, so there are a number of variables involved regarding the seriousness of a cruciate tear.

“At one end, if a player tore the bundle in the ligament which covers backwards and forwards motion then he could compensate for that. We’d have seen patients with cruciate injuries who’d have gone back to play games afterwards, but there are other factors at play – the quality of rehab, the player’s musculature, even the time of the season, for instance.”

Although playing on with a cruciate knee tear involves risk, McCarthy says Shefflin might never need an operation to repair the damage.

“The injury’s painful when you tear it first, but not afterwards. It controls the stability of the knee. Someone like Henry Shefflin wouldn’t have their entire knee give way getting into the car, for instance, and he could play on forever and never have any problems with it. But it could also give way in a training session or game: you’re not exactly getting into the lap of the gods territory, there’s a science behind this, but you are venturing into the unknown.

“We would certainly have seen patients who would have played on in games with cruciate tears, and who would have gone on and played complete games after the one in which they tore the ligament in the first place.”

Another doctor with years of experience in sports medicine confirms that sports people continued to play on with torn cruciates many years ago: “Players were continuing to play with cruciate ligament tears for years when doctors couldn’t diagnose those specific injuries.

“One assumes that Henry has a clean tear of the cruciate and that his rehabilitation is going well. In addition, he’s obviously a very fit man from his years of training, with strong leg muscles surrounding the knee, and that’s clearly going to be an advantage – he’s starting off from a much stronger base than an ordinary person who tears that muscle.”

The Kilkenny management face a conundrum regarding Shefflin’s preparation for the final clash with Tipperary, according to the same medic.

“In all probability he’ll need to have an operation, but the fact that he had a similar knee injury would not have had a bearing on this injury.

“You could keep him on ice until the final and then put him on to see how long he can play, but that’s a matter for team management. They may want him to keep training with the team, though that clearly carries more of a risk that the knee will give way.

“While he may be able to take the training sessions leading up to the All-Ireland final, and the game itself, the danger that his knee may go suggest to me it would be more practical to have him start the All-Ireland final rather than bringing him on.

“He might last the game or his knee might give way, but as a substitute there’s a risk of that happening if you bring him on anyway.”

Tom McCarthy concedes that the Ballyhale man has made an unusually quick return to action but dismisses hints of the miraculous.

“It’s surprising to see someone come back so soon. It’s not the norm, it’s not the most common occurrence, but a miracle? No.”