TO SOME RUGBY players they are a badge of honour, to others, an unsightly reminder of some of the less appealing aspects of the sport. Hematoma auris, or cauliflower ears to you and me, are as much part of the game of rugby as deck shoes and scrums.
Essentially, they are formed by repeated blows to the ears as well as friction caused by hitting against opponents. This friction leads to clots developing under the skin in ears, which blocks the flow of blood to the cartilage.
Over time, it can cause ears to lose their shape, appearing in some cases as bloated or puffy in players such as former English international Graham Rowntree. Increasingly, participants in mixed martial arts sports are also experiencing the condition.
There is some evidence that if untreated, long-term hearing problems may result, but generally, apart from cosmetic concerns, there is no major long term health issue arising from the injury.
Former Munster player Frankie Sheahan says that timing was everything when it came to effectively treating the injury.
“If you got it at the end of the season you were okay,” Sheahan says. “It is one of those things that takes maybe three weeks to clear up. So while it is clearing up, you do your best to stay out of contact.
“All it took was another belt and it would flare up again. If you get it mid-season, you are in trouble. You just had to drain it and then it would fill again, and you’d repeat the process.”
The manner in which players treat the condition is quite simple and involves draining the build up of fluid with a syringe and compressing the affected area afterwards. This can be done by a GP, and some players choose to wear scrum caps and bandages to help either prevent injury or to suppress an existing one.
Dr Tadhg O’Sullivan, team doctor to the Munster rugby team, says that the injury is part of the modern game. “It’s an issue with the second rows and front rows, and also probably the back rows get it a bit too.
“It results from trauma to the cartilage of the ear. Vaseline is used as protection from the friction so that area slides along in contrast to getting repeatedly hit.”
After their careers end, some players can have cosmetic surgery on the affected areas, particularly if the deformations are unsightly.
The procedures are relatively straightforward and can restore the normal shape of the ear in the majority of cases.
“It can be treated by a plastic surgeon after playing. It is like when you have debris in your knees, and they can do it under general anaesthetic,” says O’Sullivan. “You can do under a local , but it is pretty sore. I had it done myself after playing and it is fine.”
O’Sullivan says that players see cauliflower ears less as a badge of honour these days and the majority do take time to care for affected areas and wear protective headgear.
“It is a treatment process you have to repeat. Most players don’t want their ears deformed these days. I don’t know about the past, but all the modern lads, especially the younger guys, are aware of the long-term implications of not getting it treated.”
For Sheahan, sometimes that treatment was less clinical and more DIY, and he says that players simply accept the condition and get on with their jobs.
“At one stage my brother had access to some syringes and it wasn’t that practical to get a doctor every time. So he would treat it in the kitchen after training!
“Some ears can look okay, but in fairness, they can look very ugly. You get a fright alright the first time it happens. Some lads think they’re ruined for life and that females will never look at them.”
