Three years of debilitating back pain and a heavy reliance on medication led All Blacks prop Karl Tu'inukuafe to the brink of retirement.
Tu'inukuafe's issues first arose after rising to prominence, as one of New Zealand's best scrummagers, from outside the Chiefs squad to playing the first of his 25tests in 2018.
The rapid change in training load required to be an international front-rower took its toll. At the start of the following season, he started experiencing regular tightness in his glutes.
That pain only got worse. By the end of 2020, following the Tri-Nations tournament in Australia, shooting pains down his legs to both ankles caused constant discomfort.
Getting out of the car would take forever. He couldn't bend over without spasming as the bulging discs in his back pressured the sciatica nerve.
"I was barely able to touch my knees without feeling shooting pains down my legs. I didn't really tell anyone but after the 2020 All Blacks year I was close to retiring," Tu'inukuafe tells the Herald after his comeback off the bench for the Blues last week.
"I didn't want to play because my back pains were really bad. When we were on tour I would wait for everyone to jump off the plane so no one would see me limping off the flight."
All Blacks prop Karl Tu'inukuafe in action against Tonga last year. Photo / Photosport
Tu'inukuafe initially began taking Voltaren to alleviate the pain and inflammation but his reliance on those led to stomach aches and even bleeding.
"When I went off those Voltaren I couldn't train, but I didn't want to train with them because I would mess up all my insides. That's when they came up with the new meds to help out with the nerves in my back. It held up until I had surgery in December."
Last year Tu'inukuafe first revealed the seriousness of his back pain to Blues doctor Noah Whitehead, who prescribed a series of pills to get him through the season.
"I told him I was done, that I needed surgery or I was going to stop playing. I couldn't train; couldn't bend over because I was in too much pain.
"There's a lot of everyday, blue-collar people who suffer from it but if you're trying to work at this intense level of professional rugby you can't do it. That's why I told the doc I was done.
"He had me on this concoction of pills and it eventually started to help me. He said it wasn't for long term – just until we could find the time for surgery. After a couple of weeks I was able to touch my toes again.
"I was on five, six pills a day for 18 months straight until I had surgery. I was like an old man. I had the Monday to Sunday pill cases. The boys would always mock me but if I ever missed a dose I would feel the shooting pains down my legs so I had to make sure I was on top of it."
Karl Tu'inukuafe says he is well on his way to recovery after years of pain. Photo / Photosport
A programme, devised by All Blacks physio Pete Gallagher, of progressive standing Swiss ball exercises proved a game-changer in strengthening Tu'inukuafe's back. He did those until one week before surgery when a final scan revealed the bulging discs had started to heal.
Surgery originally planned to shave the discs – a major procedure that would have ruled Tu'inukuafe out for the majority of the Blues campaign – but with the Swiss ball exercises improving the pressure, cavities were instead created to allow the nerves to flow more freely.
"I kept it pretty low key I didn't even tell my parents until I came out from hospital. They asked where I was and I said 'I'm in bed I can't do anything for a few months'."
Four months on from surgery, and the 29-year-old is working his way back to full match-fitness after two appearances off the bench for the Blues.
"I wasn't keen to carry on in that position. Taking five, six pills a day is not ideal for anyone.
"I've watched a lot of people end their careers because of concussion or injuries. When you feel like you're about to get there and you get another chance it makes you very grateful.
"It's changed my perspective on everything I'm doing. Health wise I'm really happy with where I'm at.
"I feel the difference. I used to struggle on scrum days now I can go all day. My back is still stiff in the morning but it's not the same as before surgery. I can jump out of the car and walk straight into the changing rooms. My main focus now is winning Super Rugby Pacific with the Blues."
Standing Swiss ball exercises remain a staple of Tu'inukuafe's daily routine and he's keen to impart their benefits on emerging props so they avoid his near premature retirement.
"The boys ask me for exercises now because I'm standing on it with weights. I want to get the young guys into it because it strengthens muscles you don't condition until scrum time."
