Fraser Brown and Cameron Henderson share their ACL rehab story of tears, setbacks and hopes for the future

Both players are on the road back from the same serious knee injury – a ruptured anterior cruciate ligament. The ACL is the injury all professional sportspeople dread. The worst case scenario is it can end careers. Thankfully, medical advances mean most come back from it but the rehabilitation is long and arduous.

Brown, the 61-times capped Scotland hooker, ruptured his ACL at the end of last season while playing for the invitation World XV against the Barbarians at Twickenham. His recovery has been tough and he was forced undergo a new operation this week due to instability in his knee and a build-up of scar tissue. It has set him back a few weeks and Brown admits that at 34 he has a big decision to make when his Glasgow Warriors contract expires in June.

Henderson is ten years younger but suffered the second ACL rupture of his career last month while playing for Leicester Tigers against Stormers in the European Champions Cup. The lock, who won his first Scotland cap in the summer, was in a rich vein of form with his club and should have been vying for a place in Gregor Townsend’s squad for the Six Nations. Instead, he is in the early stages of rehab having undergone an operation to repair the ligament before Christmas.

The pair got together with The Scotsman’s Graham Bean to discuss their shared experiences in the first instalment of tracking their rehab progress.

Cameron Henderson: Tell us about your operation on Thursday?

Fraser Brown: I had what they call a Cyclops lesion, which is a ball of scar tissue which forms on the top of your graft. So they had to go in and cut that out and they found other bits and pieces to clean out, then scraped a bit of bone out. It wasn’t actually too bad – I was in and out in about an hour and a half. And it was an excuse to have a lie-in this morning!

Graham Bean: Is it painful?

FB: No, it’s fine. It’s funny because when you get major surgery, like an ACL, the amount of anaesthesia you get knocks you out for what feels like days. When I came round from mine I slept on and off for about 12 hours and then the next day I felt really groggy. But on Thursday I went into surgery at five, was back in my room at 6.30, had a little power nap while watching the football and then I was up and out my bed by eight o’clock, and home by nine. I feel fine today, no pain. But they weren’t doing anything dramatic. It’s not like an ACL op where they drill through your bone. I don’t know if you’ve ever seen videos of it, but they are pretty aggressive when they are in there. Most of the pain from the ACL is from the surgeons doing the work.

GB: Talking of ACL injuries, tell us what happened to you Cammy?

CH: It was non-contact and quite innocuous, actually, just a change of direction. A kick went through and we were all in a chase line and one of the Stormers players made a late step and I made a late step as well to try to tackle him and I felt my knee pop. I knew straight away that it was my ACL because I’d done the other one. But it felt very different. The first one was done in contact and I actually felt all right after it whereas this one was really sore. So I knew it wasn’t great as soon as it happened. Because of the time you spend rehabbing you learn all the mechanics of it, what it’s meant to be like, what’s really bad, so I knew straight away. And I think that means it’s been slightly easier, mentally. I knew what was coming, what the recovery process was.

GB: Is the fact that it’s a different knee good news?

CH: The last time I did it was against Worcester a couple of seasons ago. I suppose it’s a slight positive in that if you start messing with the same knee it’s going to be a lot more difficult to get back. It’s not an ideal situation but I’m going to try to make the best of it. You can look at it and say I’m going to end up with two super-strong knees.

FB: You will basically have two new knees. When was your surgery?

CH: It was on December 20. They got me in about nine to ten days after it happened which was quite lucky because they’d said that if I hadn’t get the swelling down I wouldn’t have had the operation until this week. So I basically lived in ice and got the swelling down.

FB: Was it just the ACL?

CH: No, it was lateral and medial meniscus as well. So I’ve had those repaired and I’ve done three days of rehab now and I’m very much on the road back.

GB: What has early rehab involved?

CH: Because they’ve operated on the meniscus you can’t bear weight for three weeks so it’s very basic. It’s focusing on strengthening the quad, hamstring and calf, just basic stuff which would have been easy had I been fully fit but is now a lot more difficult. It will start to progress and next week I’ll get on to partial weight-bearing and then the week after it will be full weight-bearing and the fun can really start.

GB: Do the circumstances of Cam’s injury sound similar to yours, Fraser?

FB: Mine was completely non-contact as well. I’d never done my ACL before but I knew. I’d seen enough of them. It’s hard to describe. Your knee wobbles from side to side, you feel a crunching and it’s as if an elastic band has gone ping at the same time. You feel this massive instability when you put your foot down. The bottom half below the knee stays completely still but the top half shifts from side to side. I fully ruptured it so there was nothing left but it wasn’t sore at all. The medics came on and I told them I’d done my ACL because I knew straight away. It was strange circumstances because I was playing for the World XV against the Barbarians at Twickenham. They only had one knee brace which was too small to fit around my leg and so they ended up strapping my knee with lineout tape and sent me off into London for the Baa-Baas dinner! I flew up to Glasgow the next day and was sent for a scan. As I say, I was certain I had done my ACL and had made peace with that fact that my whole season was pretty much gone but when the doc, Johnny Hanson, called me to tell me I burst into tears as soon as I got off the phone. That moment of confirmation really hit me. It felt like a big thing because it’s such a long rehab. I’ve had neck surgeries and prolapsed discs which meant five or six months out but this was different. With most injuries you are given a timescale and I always had a competition with myself to try to beat that. So if they say you’re out for 14 weeks I try to come back in 12. But with an ACL it’s at least nine months and it seems so long.

CH: I was similar. I thought it was most likely my ACL and the physios thought that too but there was that little glimmer of hope that it might be something else. Unfortunately, that wasn’t the case and it is a shattering feeling when you get the news and have to get your head around it. To be fair, the first time I did it, in 2021, I was able to play again after seven months.

FB: That’s because you’re young!

CH: For me, there’s no rush now. The season finishes in May-June and I’m not going to get back in time so it’s about being ready for September and the new season, and making sure it’s right, making sure the knee’s really strong. I’ll have a full pre-season and won’t have the pressure of trying to get fit for a particular game.

FB: That’s a good point. Ollie Smith, my Glasgow team-mate, did his in the game with Bayonne recently and he was gutted but at the same time he knows he’s not going to be fit for the rest of the season so it takes the pressure off a bit. He’ll be back running towards the end of May so he’ll have four months of running and pre-season before he has to play a game again. He’ll be at the same level as everyone else.

GB: Does it help to talk with other players who have been through this injury?

CH: I think so. Last time I reached out to people within the club and it’s surprising how many people have done it. I found it helpful to speak to them and find out what their experience was like. I worked with a psychologist last time as well and things like that help you mentally.

FB: It’s funny, I think I started a spate of ACL injuries at Glasgow because we hadn’t had one at the club for six or seven years. Then I did mine, JP du Preez did his at the end of August and now Ollie’s done his too. Hené Branders, our new physio at Glasgow, who’s South African, is the only one who has rehabbed an ACL in the last five years. She had three at her last post with the Lions in Joburg but no-one else at Glasgow has done one recently and then we have three in the space of six months. Of the guys who are still kicking about, Pete Horne did his in 2013, Ali Price did his and Alex Dunbar did his in 2015 as well. So these guys all did it in their early to mid-20s and it’s good to talk to them but I’m at the other end of the scale. I’ll be 35 before I play another game of rugby so I’m at a completely different stage of my career. They all had loads of rugby ahead of them. I was working it out the other day that this is my 11th surgery and it’s a different pressure this time because I’m out of contract in June, and I’m probably not going to play rugby before then because of the little issues I’ve had post-surgery. So while it was useful talking to those other guys, I am in a different place.

GB: So neither of you think you will play again this season?

CH: The earliest I could possibly play is June and I think there are only one or two fixtures scheduled for then so I don’t think it’s going to happen but I’m at peace with that.

FB: My original return date was April 17 but I’ve had issues around instability and been in a lot of pain and that’s why I had surgery on Thursday. Without wishing to get too technical, your knee is a hinge joint but when you fully lock out there is a bit of rotation, and you need full stability for that. And because of that little lesion on top of my ACL I couldn’t get into full extension and get that little bit of rotation that locks your knee in place which is why I had so much instability. It means I’ve lost two months in terms of my return schedule. I was meant to be pitch running at the end of November but I probably won’t be able to do it until February. So before Thursday, my return date had gone from April 17 to June 17 and the first game I could have played would have been the URC final! The latest surgery has put it back another five weeks but because my strength markers are way ahead of where they should be I will hopefully be able to catch up time but it’ll depend on how much the pain settles. Playing again this season would probably be unlikely at the minute.

GB: Cammy, you made your Scotland breakthrough in the summer and had started all Leicester’s games this season and probably had high hopes for the Six Nations. Has Gregor Townsend been in touch?

CH: Yes, Gregor’s been in touch, as have the other Scotland coaches, John Dalziel and Steve Tandy. They were letting me know how pleased they were with how I was going and how gutted they were that I wouldn’t have a chance of being involved in the Six Nations. They were very positive about the future. I turn 24 next week so I’ve got a lot of time ahead of me and hopefully lots more opportunities.

GB: You’ve more time to concentrate on your studies at Loughborough University now?

CH: I’ve split my final year and this is the second part of it so it means I’m able to knuckle down. I’ve got six modules left and then I’ll graduate in June in finance and management. The plan now is to try to push to get as good an honours degree as possible. I’ve got no excuses now so I’m aiming for a 2:1 or even a First.

GB: You are also planning to document your rehab?

CH: I’m going to try to do it through my Instagram and keep people involved with how it progresses. The last time I did my ACL I did something on YouTube but this time I’m hoping to make it personal and give people more of an insight so they can follow the process all the way through. I think people want to see the intricacies of what goes on, the different stages of the recovery.

FB: The more you can open up in terms of the media the better. I think we need to try to normalise what life is like for professional rugby players. People need to see how basic it is at the start, and how hard it is just to lift your leg off a physio bed, for example. Muscles in your body, like in your quads, are still asleep. You spend ages trying to extend your range and I was in tears on the physio bed going through extension and flex ranges because it was so, so hard. Sports people are sometimes portrayed as superhuman so it’s nice to strip it back sometimes and show the pain they had to go through to get there. And I’m looking forward to catching up with Cammy in a few months time when we’re both further down the rehab road.