Why is Ryan Papenhuyzen the latest NRL star to seek out the specialist who treats knee injuries like a brain injury?

Melbourne Storm talisman Ryan Papenhuyzen followed in the footsteps of two other elite NRL fullbacks, who have recently suffered long-term or persistent injury issues, by travelling to Philadelphia this week to work with the world-renowned Bill Knowles.

The American has gained a reputation for helping to guide athletes back to full fitness through his unique methods, although Papenhuyzen admitted he still had a long, uncertain road ahead of him as he flew out to complete a program under the guidance of the reconditioning specialist.

Why has Ryan Papenhuyzen gone to America to seek treatment?

The Storm flyer has been plagued by injuries over the past few years having missed a two-month chunk of the 2021 campaign due to lingering concussion symptoms before enduring a hamstring tear and then a fractured kneecap late last season.

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Papenhuyzen’s rehabilitation from that gruesome accident, where he shattered his patella into 10 pieces while attempting to wrangle a rampaging Jack Wighton, has taken longer than initially expected to recover from.

“It’s just an opportunity to progress in my rehab and get some different eyes and see if I’m going in the right direction,” the 24-year-old said after divulging how he had yet to start running six months on from the incident.  

“I went into it knowing it’s not an easy injury to get over, but I didn’t really have a timeline, so whether it’s a setback or it’s just taking a bit longer than what I initially thought I had in my head, I’m not too sure yet.

“I’m still doing heaps of gym, but I still can’t squat or anything like that. It’s just trying to find what’s comfortable for me.”

However, Knowles’ approach to treating injuries, he commonly refers to as ‘insults’, doesn’t necessarily coincide with restricting movements within his training activities. Rather, he narrows in on the deficiencies.

“It’s not about being focused on the hamstring,” Knowles told The Sydney Morning Herald after helping Latrell Mitchell in his recovery from a hamstring injury last year.

“Have I rehabbed a lot of hamstrings? Yes. A lot of knees? Yes. A lot of calves and Achilles and surgeries? Yes.

“In this case we look at it that the hamstring is not a solo, it’s in a symphony.

“What I’m saying is you pull their athlete out of their injury. If you focus on the solo player, you forget about the quality of the whole symphony.

“I make sure everyone is playing at the right time, the orchestra is going really well. When that happens, the hamstring is less loaded, it’s more part of the process and it decreases their risk [of reinjury].”

Papenhuyzen expects ‘intense’ sessions in Philadelphia

Knowles discussed how he and his team fuse science and art together to craft programs which focuses on teaching athletes rather than therapeutically treating them.

“So much of what we do is a blend of the art and science,” he told MovementWise. “We use science and we parallel it with lots of other experiences that can achieve the same result.”

Mitchell benefited greatly from the time he spent at Knowles Athletic after suffering his second serious hamstring injury in as many years, while Tom Trbojevic has also made the trip after he broke down at pre-season training before Christmas. 

“It’s very often that athletes get caught up in that they have had this injury, the focus is on the injury, the attention, the scans, the rehab protocol – everything is about the injury,” Knowles said.

“I have a tendency to forget about the injury and focus on the movements and think of an athlete as a whole.”

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Yet while Mitchell received impressive results after his work with Knowles, returning to South Sydney and powering them to a fifth-straight preliminary finals appearance, Papenhuyzen is refusing to get too carried away.

“Latrell had great results from it and I’m sure other athletes have had great results from it too, but for me I don’t want to go into it with any expectations,” he insisted.

“They’re going to be pretty jam-packed days. It’s two sessions a day for the 14 days that I’m over there. It’ll be pretty intense.

“I’ve jumped at the opportunity. I like to do these types of things that are a little bit different.” 

‘I started looking at knee injuries as a brain injury’

Papenhuyzen, who will be accompanied by Melbourne’s physiotherapist Liam Robinson, will be the third star fullback in the NRL to seek consultation with Knowles, although he will be the first one looking to mend a knee injury.

“Many years ago, I started looking at [knee] injuries as a brain injury and it had a lot to do from a sport psychology perspective,” Knowles said.

“Lack of confidence or motivation from an athlete who is doing something every day who then gets hurt and stops doing that- it’s a pretty traumatic change for them. So, we looked at it like a brain injury.

“I looked at it from the angle of balance and coordination and because they’re in a brace or on crutches, or whatever it may be, they have to regain all those types of abilities again.”

Papenhuyzen noted how due to the restrictive nature of his injury, he had been reduced to work in the pool and a few bits of training which focused on land-based mobility.

Time spent in the gym doing leg work has been kept to a minimal and as a result the Storm No.1 has felt disheartened by his lack of progression during the pre-season.

“Science is really helping us with brain plasticity and how much what we do influences that. So, all injuries are brain injuries,” Knowles explained.

“We look at them as physiological and neurophysiological insult that manifest into a peripheral disruption as well. So, an ankle injury has as much brain insult as on a ligament.

“The wiring that needs to take place to reverse those facts- it’s pretty complex.

“We have to understand the more we treat the body moving as a whole naturally and normally and the faster we do it- the faster the reset to normal is for an individual.”

Many athletes are ‘deficient’ in basic physical education principles

Knowles has acknowledged it is impossible to forecast how long it will take to fully recover from a serious injury, while discounting the theory that he can guarantee a clean bill of health for an athlete for the rest of their career after working with him.

Although he pointed out the importance of establishing correct patterns of movement in the chain of command from the brain to muscle function in rectifying problems which can contribute to injury.

“One of the approaches that I take in this performance-based model, which is re-conditioning, is the restoration or improvement of an athlete’s physical literacy or their movement vocabulary,” Knowles said.

“This is basic physical education. The development of these essential movement patterns; running, jumping, skipping, hopping, pulling, pushing and rolling.

“These things need to be taught at younger ages and physical education, basically world-wide, is failing at that. 

“We’re seeing a lack of or a deficient vocabulary on a regular basis. Part of our injury prevention strategy is to improve this physical literacy.”

Meanwhile, Melbourne’s CEO Justin Rodski highlighted Knowles’ glowing reputation as a reason for cautious optimism. 

“Bill Knowles comes highly recommended following the work he has done with a number of sporting stars across many sports who have been in a similar situation to Paps,” he said.
 
“This rehab work will be an important next step in his recovery. We know Paps will leave no stone unturned to get his body right and we are confident he will be back out on the field as soon as possible.”

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