'I'm going to need a knee replacement, probably in my late 30s': The shattering toll rugby has taken on Alex Rieder

Seven months after his sad injury-enforced retirement was officially confirmed, former Wasps back row Alex Rieder popped his head above the parapet in midweek on social media. A graduate of the rugby academy in Leeds, he found it disturbing that the RFU had just opted to shut it down rather than provide funding to keep it alive now that relegated Carnegie have disappeared into the National 1 backwaters.

Without his apprenticeship at Leeds, Rieder could be in an altogether more precarious position on the rugby scrapheap than he currently is at the age of 28. While earning his academy stripes, he used his downtime to bank the university degree he hopes will eventually be his salvation in the world of financial advising and business development whenever life gets back to some semblance of post-Covid normality in the months and years ahead.

Hand on heart, he will tell you the lockdown has been purgatory. That have been some positive distractions. Learning Spanish, reading leadership, motivational and fiction books, and being able to switch off after a 24/7 sports career where his eating, sleeping and downtime patterns were always rugby influenced.

Recruitment has dried up, putting a block on tentative plans to move back to Leeds or wherever work might have taken him after his fiancé's contract as a Coventry hospital doctor expires in August.

And while the stoppage of rugby has been useful in the sense he isn't mentally kicking himself every weekend that he is missing out on the action, restrictions caused by the pandemic have damagingly hurt. As someone struggling to walk free of pain, his Leamington Spa apartment hasn't been ideal for a dodgy knee that needs regular working out in a proper gym.

Rieder was no rugby star. He only ever started 14 Premiership games for Wasps, coming off the bench in another ten league matches along with three Champions Cup cameos that included the 2017 quarter-final defeat at Leinster's Aviva Stadium. But the story of his demise is a compelling insight into hardships inflicted by an increasingly physical sport - shattered limbs, dependence on painkillers and an onerous mental health battle that preyed on vulnerabilities.

Having caught the eye at Rotherham Titans, his selection in the 2015 Championship dream team was followed by transfer to Wasps and his career was on an upward trajectory until injuries wrecked it. A battered shoulder versus Harlequins in September 2017 was a bad enough layoff, but nothing compared to the misery of the devastating knee destruction suffered the following February against Exeter.

Nineteen months of gruelling rehab was needed and although he was a Premiership Cup try-scorer versus Saracens when he finally made it back on the field in September 2019, that heroic comeback was confirmation he was finished rather than the first indication he was back for good. He was crocked - and still is despite undergoing the knife again last December to improve his quality of life.

"No, it's not good, to be honest. I'm in quite a bit of pain," he told RugbyPass on Friday, a few hours before Leeds United's promotion back to football's Premier League for the first time since 2004 would have seen grimace temporarily replaced by a beaming smile. "I can walk, I can play a bit of golf but certain things, it gets quite painful, it gets sore on long walks. What hasn't helped is not being able to get treatment because of lockdown.

"That was a very pivotal part, being able to get treatment, being in the gym and building up strength. I have been doing stuff at home, a lot of balance-based stuff and that's fine, but you need to build up strength around it and I have not been able to do that.

"We're in an apartment so I can't bring weights into it because it crashes the floor. That hasn't helped but hopefully things [restrictions] are now lifting and I will be able to go out and improve. To be honest, that operation was more delaying a knee replacement. I'm going to need a knee replacement, probably in my late 30s, and this is just delaying that a bit more."

That's a shame given his torturous efforts to return to the pitch after being absent for over a year and a half. The hope was that getting picked by Dai Young was genuine cause for cheer but instead the restriction of knee movement which his return appearance highlighted and the subsequent swelling became the catalyst for the retirement decision agreed in late October and made public some six weeks later in December.

"I kind of knew going into the game I wasn't right," he admitted, looking back ten months ago to when he made his final Ricoh Arena appearance. "I was really fit, running linear, running straight lines, and was absolutely great, but the problem was any sidestepping or any movement that required really hard, aggressive force diagonally or through the knee.

The beginning of the end... Alex Rieder is stretchered off with his left knee injury (Photo by Adam Davy/PA Images via Getty Images)

"My leg just felt worse and it got to the point where I wasn't even doing it [sidestepping]. The style of rugby I used to play was very dynamic, sort of spinning through tackles, but I had effectively lost what I was able to do, so I knew going into the game it was the last throw of the dice.

"I did alright but it wasn't what I knew. I let myself down. I expect a lot more from myself. I always said I was never going to be that player who was just going to keep playing for the sake of it. I only wanted to play when I knew I was fulfilling my talent. I wanted to play to the point where I was doing myself and my teammates justice and I just knew I wasn't.

"I remember the review. I got called out for a few things I normally wouldn't do, but it didn't really affect me because I knew I was finished by that point. I left it a couple of weeks to see how everything was, but then I just started speaking to the physios and said, 'Look, this isn't right, this is the truth. I have hidden a lot of it from you, unfortunately'.

"I just wanted to give it everything - I didn't want to walk away without playing a (comeback) game. I wanted to have a first-team game for my mental health just to say I have walked off the Ricoh and then also to know that it definitely wasn't right and I couldn't look back and say, 'Well, it might have been'. I know it wasn't.

"There were a lot of conversations. They tried different things, a lot more aggressive strapping or took me out of a lot of training to do other things. The club really tried to help but it was just never going to work. We went to see the surgeon and he literally was showing how my knee was dislocating quite a lot, it could pop out pretty easily which isn't good at all. This was the end of October. After that I didn't train again... and that was that."

Rieder won't let the darkness pass without mention, the diet of painkillers to soothe constant aches and the monotonous mental trauma of grinding injury rehab. But even though scars will be apparent for many years to come due to the catastrophic extent of his knee damage, he'd incredibly do it all again as rugby meant that much to him.

"Rugby was my identity and when it started getting taken away from you, you start doing irrational things," he said, initially addressing the medicinal issue. "Look, I wasn't horrendous by any stretch of the imagination. Rugby is such a violent sport, so painful, so you do have painkillers and pain management. That, unfortunately, is the nature of a lot of sport.

"It's naive to say you can get through it by taking an ice bath or whatever. The game is so physical that sometimes painkillers are the only thing that can numb it, especially with a serious injury where you're pushing your body to repair itself, and sometimes you overdo it.

"It was important to get through it but it's not something that ever really controlled my life, it was just something that assisted it. I'm not saying everyone needs to take painkillers or anything like that. It's something you need to have advice on and be transparent with, but equally it's not something that should carry the stigma it sometimes does.

"Some people might have a problem that needs to be addressed, but I know players who have taken painkillers and it was in a very managed state. It was important to get through it because sometimes your body is in a lot of pain and there is nothing that can subside it. You need sleep, you need to get up for training the next day and there is really no other solution," he explained before moving on to the topic of mental health.

"I'd say probably 75 per cent of injury rehab is mental because it's like groundhog day. You're turning up and it's such small margins. Some days you're going backwards, one or two steps back and it's a real battle. It's about having physios around you and other injured teammates, it's about supporting each other because you can have days where you're really struggling or just not really in a good place and it's understanding that.

"When you're injured and doing the same thing day to day it just starts eating you up. It's a really dark period but David Breen, my physio who's a Limerick lad, was fantastic, a really good confidante with a lot of stuff. That is a huge aspect of physiotherapy, the mental side as well as the physical because if your brain is not in there you can't really do much about it.

"I know some people might look at it and say we're in a very privileged position, you get paid very well, how could you ever be upset... but you have got this weight bearing down on you and you feel like your body is giving up on you. It's a real battle and I did struggle.

"I let myself down on quite a few occasions, probably didn't step up or spoke out when I should. I let it eat me up and control me in a negative way... but look it's an irrational frame of mind that you're in when you're feeling down and low and depressed and unfortunately injury and depression go hand in hand. There's no escaping it. You're suddenly taken away from your training and your mates, you're on your own and your body is sore. It's a real tough period."

One that ultimately ended in Rieder's retirement. "When it happens you curse everything and anyone. You have the emotional outburst about it but I wouldn't change it. Well, I would change maybe passing the ball instead of carrying it and doing my knee, but looking back I don't regret anything.

"I didn't regret I got dealt this hand. I had some of the most amazing memories of my life playing sport. It gave me great friends and instilled discipline and skills I can take with me further in life. I have met people, superstars if you like. George Smith, (Danny) Cipriani, Jimmy Gopperth, Hask (James Haskell), they were some of the best players that played the game.

"I have been in rooms and have met celebrities, I have lived a life I thought I would never lead and it has been absolutely amazing. I'm gutted I don't know how far I would have got with rugby. The year I got injured I became Wasps' first choice six, worked hard to get to that position and it then ended.

"But life happens and you have got to move on. I look back with nothing but the fondest of memories. Despite knowing the dangers, if I had children I would never stop them playing it. I would never prevent anyone from playing the sport. I'm nothing but an advocate for it because it is absolutely amazing... I walk away with nothing but happy memories.

"I loved after a real tough game being in the changing room and having a beer with your mates, singing the songs and everyone is cheering. I was very lucky we won a lot of games which was nice. You have cuts, you're bleeding everywhere, you have got a broken nose or something, but everyone is just happy and it's just such a great feeling to share, something I will never forget. Without a doubt, that's my highlight."

His traumatic, career-ending experiences, though, mean he is a voice that should be listened to in the realm of player injury welfare. Wasps were fantastic, paying out the length of his contract. The RPA, too, whom Rieder was a club rep for, were also of excellent assistance. But he still feels the game as a whole owes a debt to its most prized assets - its players. His belief is they can't be neglected if they are suffering rugby-related issues long after they have retired.

"There does need to be a large amount of protection for players because the game is very brutal and these injuries do happen," he said. "I just want players to be protected. When I was injured I was lucky, the club looked after me, but I know there will be some players that won't be looked after that.

"If you're going to play this game, the game owes you a certain debt back and also you need to be looked after medically and emotionally... the problem is people have got so physically strong and powerful now that the human body can only take so much punishment.

"You look at the physicality of this game and we play upwards of 30 games a year whereas in NFL, where there is a huge media spotlight on the concussion aspect and the injuries and the severity of everything, they only play 16 games, maximum 20 if they make the Super Bowl through the wild card, and they are paid millions of dollars and realistically have much better training facilities.

"They have just got much better things on hand because of the money in the sport, but ours is probably just as physical if not more because you're playing attack, defence, everything - you're playing more games with an (annual) income that is probably what they get paid in a week.

Running man... Alex Rieder has a trademark carry halted (Photo by Tony Marshall/Getty Images)

"The game doesn't generate that money so you can't invest tens of millions into rehabilitation or things like that. To a huge extent, you sign the contract and you take the risk... but all players, regardless of status, should have the opportunity to experience the best medical care.

"I was very lucky. I saw the best surgeons for my shoulder and my knee. We had one of the best physios in the world, Bill Knowles, over from America. He saw us all and that was great. Jimmy Gopperth, there is a great ACL rehabilitation knee place in Ireland that they went over to and learned a lot from.

"But my concern is does that happen to a young 20-year-old who has been picked up from the Championship and has not played a game yet - are the club going to financially look after him as well as someone who is an established international player and so on? I don't know.

"Wasps were great with us but I do have a concern with how players are treated within the game. In the Championship medical care is a joke, there is none and you're still getting battered and bruised. You're going to have lifelong injuries yet you get no support. That needs to be addressed.

"Equally, Leeds academy getting shut down - where is the pathway for these young lads in Yorkshire? They will get picked up potentially by a Premiership club and thrown straight into the mix without having the progression or the transition of getting your body right mentally and strength-wise. You're just thrown into it, so they could get their bodies discarded by 25.

"The main thing that rugby needs to do is take ownership of the commodities which are the players. We play the part, they pay us well, look after us when we are doing it, but they need to take ownership that if we have been broken by the game they need to look after us in life after the game.

"There needs to be a certain element of supporting players in later life. I know money is not infinite but that is where investment needs to go more than anywhere else. It needs to go in looking after players both on and off the pitch, both in rugby and after rugby. No matter what calibre of player you are you should have the same level of care as the top player. That is where transparency needs to play a really important part."

If there is parting shot, it is Rieder's hope now as a fan that the shackles will in time be allowed to come off rugby and that its players can more often portray themselves exactly as they are behind closed doors rather than continuing with the politically correct exterior which he believes is robbing the game of its personalities.      

"Everyone loves sport. People love the emotional connection, that intangible attraction you have for sport. It's like no other thing. It just taps into the emotions and is just amazing. Unquestionably, rugby can tap into that because it is violent and people like watching the gladiatorial aspect. 

"What is a great aspect as well is a day out at a rugby game is very social. You're mixing with fans, there is great tailgating, you have drinks, there is a good family atmosphere, there is a lot going on. I'd say CVC coming in, they did wonders for Formula 1 so there are definite elements that can be improved.

"For me, they need to make it more star-powered for the armchair fans, make a bit more publicity with certain things, build up characters within the sport rather than have everyone toe the status quo of being politically correct in their answers. It's very mundane. We want to hear the truth, we want excitement.

"A bit like Tyson Fury in boxing, people are interested in personalities and the game needs to grow that. Unfortunately, we have some dinosaurs in the game that try and quell emotions and creativity when actually we need to let that flourish as that will be attractive and interesting. As anything over time people would become more aware of the sport and watch it more and more. 

"Rugby is growing in popularity and when it grows in America and grows with different leagues it will get more attention. The main thing they need to do is let people be characters and let people grow as individuals because there is nothing worse than this image of bog-standard politically correct answers to Q&As and things like that.

"People want to see the banter and the fun side of rugby because when you're playing it and the training ground side of rugby, it's great and people want to see that. Unfortunately, there are people within the game that don't like seeing the more outlandish characters but that is what the game needs. 

"The game needs to move away from the image of, 'Oh, this is for the faithful'. That is a small minority. If you want to grow the game and have money in to look after players, well it needs to be exciting. What is exciting? Big hits, tries, push for that. If anything it's things like scrums that can drag the game down. There will be a lot of people who don't agree with that but it's about making the game quick and exciting. That is what is going to entice fans in."

Alex Rieder in action during his Rotherham Titans days in 2014 (Photo by Jan Kruger/Getty Images)