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England lock Courtney Lawes has offered an insight into the resilience required to play at the highest level by revealing that for six months almost every tackle and carry he made resulted in a 'stinger' injury.
For a period of the 2014-15 season, Lawes found the ferocious tackling that is the hallmark of his game impaired by the knowledge that any contact was virtually certain to end in searing nerve pain shooting down his right arm.
With only three second rows in Northampton's squad, there was no respite for the 26-year-old who was forced to endure the acute discomfort until it was healed during the build-up to last autumn's World Cup.
Lawes has been a first-choice lock for much of a Test career entering its seventh year despite an alarming list of injuries, and on Sunday he will make his return to England's starting XV in the RBS 6 Nations clash with Italy.
"It was really tough because I was as fit as I could be, but I couldn't do what I would normally do," Lawes said.
"It was quite hard mentally to put your body on the line knowing you are going to hurt yourself.
"There was no risk of dislocations - I don't have that kind of scarring in my shoulders - but pretty much during every tackle I'd get a stinger.
"You get different kinds of pain with a stinger. You can't use your arm for a couple of seconds after you have made a tackle, it is quite a painful experience. It shuts off your arm.
"Pretty much my whole game is my physicality and what I can bring in that area with carrying and tackling. That is pretty much my game.
"I'm a decent line-out forward and I have worked on other areas, but physicality is my point of difference. It was a tough time, but I did what I could - that is all you can do.
"The shoulders weren't bad enough to say 'don't play, get them fixed', but they were not good enough to do what I wanted to do which was the toughest thing.
"It is resolved now. I knew that the end of that season I had get myself right and fortunately I was able to do that."
The stingers predominantly affected Lawes' right shoulder, but the joints on both sides of his body require careful management and will do until he eventually retires.
One of them will never be fully functional and may yet require surgery once the season has been completed.
And in the last six months alone, Lawes has damaged both knees and a hamstring, the latter setback affecting his preparation for last weekend's 15-9 victory over Scotland in which he produced a forceful second-half cameo off the bench.
"English players and the stuff they have to go through, especially this season when it's week-in, week-out Premiership, it's tough," Lawes said.
"It's hard but it's what you get paid to do. You have got to be professional, do your rehab and your prehab and do everything you can to stay on that field for the season.
"I'm always going to have a problem with one of my shoulders. It may need some work, but it's the middle of the season.
"My shoulders now feel as good as they have done and I can put myself about a lot more than I was able to do that season before the World Cup, which is a very good thing. I'm a lot more confident.
"Not a lot of players are 100 per cent fit. I have been playing professionally since I was 20.
"I started young and you pick things up during your career, you have just got to learn to manage them. That is what I am doing and I have become pretty good at it."