A blow to Wilkinson’s abdomen smashed his kidney into a rib, but damage can also occur if a player on the ground has a kidney compressed by another player landing on them. Kidney trauma takes several forms. Lesser blows bruise the edge of the kidney, forming a collection of blood; more violent collisions can cause bleeding within the organ, and if the kidney has been significantly moved by an impact, its wall may tear.
The worst-case scenario is that blood vessels supplying the kidney are ruptured. This requires surgery, but fortunately it rarely happens in sport.
The most striking indication of kidney damage is blood-red urine. However, even normal-looking urine can contain microscopic particles of blood, indicating damage. If pain in the kidney region persists for two or three hours following an impact, or if it worsens, it’s worth getting medical advice.
There is no guaranteed way to avoid this kind of bad-luck injury, but the stronger your abdominal muscles, the more force they can resist (see exercises). Following a kidney bruise or tear, the best plan of action is to keep the region stable by resting, and drinking plenty of clear fluids to help flush any blood clots out of the kidney. Gradually returning to gentle exercise is better than inactivity. Try walking short distances, but stop if you feel any pain. Crucially, resist the temptation to return to sport too early, since you are likely to re-injure the same area. You need to give the injury proper time to heal.
“Even after major damage, the kidney heals itself very well, as long as it is allowed to settle,” says David Cranston, consultant urological surgeon and medical adviser to Kidney Research UK. Slight damage can heal within a couple of weeks, but it could be two or three months before Wilkinson is back playing. Whether he will ever regain his form is another matter.
www.kidneyresearchuk.org The Kidney Research UK website has information on keeping your kidneys healthy and the conditions that can affect them
www.urologyhealth.org Type “kidney trauma” into the search on the American Urological Association’s website for more information on this kind of injury
www.timesonline.co.uk/section/0,,7994,00.html News on Jonny’s injury, straight from the horse’s mouth, on his monthly weblog