Pieter-Steph’s comeback will have to wait at least one more week

There is no telling how great his already great rugby career would be if Pieter-Steph du Toit had enjoyed less bad luck with injuries. After a shoulder injury ruled him out of 10 of the Boks’ 13 Tests in 2021, Du Toit will miss Saturday’s first Test of 2022 against Wales in Pretoria. 

Not for the first time in his storied journey to the pinnacle of the sport, injury has held him back. Du Toit will miss the opportunity to earn his 59th Test cap at Loftus. A slightly slower than hoped return from shoulder surgery means he is not eligible this weekend.

Springbok coach Jacques Nienaber won’t consider the bruising flank for the match because Du Toit won’t be able to train until Thursday at the earliest.  

The Boks’ strict “don’t train on Monday, don’t play on Saturday” policy was enforced. There are no exceptions, even for a three-time SA Rugby Player of the Year and the 2019 World Player of the Year. 

The 29-year-old made his Test debut nine years ago and should have at least 75 caps by now, even allowing for some injuries. But Du Toit’s catalogue of blows reads like the script for a horror movie. 

He has had left- and right-ankle surgery, two knee operations, a cracked sternum and, perhaps most serious of all, acute compartment syndrome, which nearly cost him his left leg. Twice. That’s not even listing the usual rugby ailments of dislocated fingers, muscle tears and general battering.

That last injury, where amputation of the limb was a serious consideration during a critical few hours following what seemed a fairly innocuous blow to the leg during a Super Rugby match in February 2020, was enough to make his physiotherapist wife blanch.  

Only Du Toit’s previous experience of the same injury, sustained when he was a high school player, and the quick thinking of the Stormers’ doctor, Jason Suter, averted catastrophe at the time. 

Acute compartment syndrome is a potentially fatal condition that blocks blood supply from one area of the body to another as a result of an inflamed muscle compartment. Following trauma, the fascia — the connective tissue that keeps the muscle in place — cannot stretch and the resultant swelling causes a disruption in blood flow to nerves, capillaries and muscles. 

Du Toit was only the 43rd person in recorded medical history to have suffered this condition. When he alerted Suter that he had lost feeling in his leg after the match had ended, the physician immediately dispatched him to Vincent Pallotti Hospital. 

What followed was a series of surgeries and doubts. 

The initial operation saved Du Toit’s leg, but the wound was massive. A slice the length of his thigh (about 40cm) was left open for more than a week. The muscle in his thigh was so inflamed that doctors could not pull the skin over the gash to stitch it. 

Du Toit had a second operation to try to close the wound, but still the gaping chasm could not be sealed, leaving the doctors with no choice but to put on a vacuum dressing that kept the wound covered while the swelling reduced. 

After 12 days, doctors were able to stitch the wound, but by then Du Toit had lost nearly 10kg, much of it from the loss of muscle mass in his leg. 

A gradual rehabilitation process followed, with Du Toit making his return to the field 398 days after sustaining the leg injury. 

Springbok flank Pieter-Steph du Toit is tackled by Sam Underhill of England during the Rugby World Cup 2019 Final against England at International Stadium Yokohama in Japan on 2 November 2019. (Photo: Craig Mercer / MB Media / Getty Images )

Boks move on