We have had a productive week in the medical department with Sean Perry, Dan Ward Smith and Nathan Budgett all returning to full training.

It is always satisfying to see players return to full fitness after injury and it is important to look back to see if you would do anything different next time.

This is what we call reflective practice and because sports science and medicine is a rapidly changing field it is vital we continue to move with the times.

One of the most important parts of the player's injury management is the initial diagnosis. The word diagnosis is Greek in origin and means a distinguishing  between two possibilities. Diagnosis is when we put a name to the injury based on the players signs and symptoms.

A sign is objective evidence of an injury, something that can be seen or felt such as swelling and heat. A symptom is subjective evidence of an injury, something that is described by the player such as pain.

As well as signs and symptoms to help us with the diagnosis we often need to get investigations. Common investigations include x-rays, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT).

Also at Bristol Rugby we have some excellent local Consultant Surgeons and Specialists who help us with the initial diagnosis and injury management.

The first few days after injury are therefore busy trying to diagnose the injury and giving the player and coaches our opinion medical opinion on the likely prognosis.

The Greek word prognosis literally means fore-knowing and in the medical context it means the prediction of how a patient’s disease or injury will progress.

The prognosis is based both on the typical outcome of that diagnosed injury, the player, their position and the medical teams experience and expertise.

As you can see it is often difficult to give an accurate diagnosis and prognosis immediately after the injury before we have time to fully investigate all factors.

Enjoy the game.

Richard Mack