Sale director of rugby Alex Sanderson is “frustrated” that Manu Tuilagi could be facing a significant spell out with the hamstring injury sustained on England duty.

A scan has revealed that Tuilagi suffered a grade three tear while scoring the opening try in Saturday’s 27-26 victory over South Africa and he will see a specialist in the coming days to determine if he needs an operation.

If surgery can be avoided the 30-year-old powerhouse will be out for six to eight weeks, but the alternative is a lay-off lasting eight to 12 weeks that would affect his availability for the Six Nations.

Muddying the waters is that his right leg was bandaged before kick-off, indicating a pre-existing problem that was exacerbated when he accelerated and then dived over the line.

Manu Tuilagi limped off after six minutes of England's victory over South Africa
Manu Tuilagi limped off after six minutes of England’s victory over South Africa (Adam Davy/PA)

Sanderson has revealed that the medical teams of Sale and England were in contact in the build up to the final Test of the autumn and refuses to blame the international set-up, while stressing the need to take a risk-free approach to Tuilagi’s fitness.

“Apparently the scan showed a grade zero hamstring tear and I believe we’ve been shown evidence of that prior to the game,” Sanderson said.

“I’m sure they wouldn’t have pushed him through training if anything had shown up on that scan. They’ve gone off the scan as a grade zero.

“You’d love someone to blame in this circumstance. You’d love to point the finger at someone and say ‘it’s your fault’.

“Manu is injury prone as we all know. Regardless of where he’s at in terms of what the scan has said is wrong with his hamstring, you have to pre-empt injury with Manu. That’s my understanding of him.

Manu Tuilagi ran in the first of England's three tries against South Africa
Manu Tuilagi ran in the first of England’s three tries against South Africa (Adam Davy/PA)

“That’s the tactic we’ve used and that’s why we’ve rested him as much as we did. If you overplay him, regardless of how he’s feeling, he’s going to get an injury.

“I’m frustrated, of course I’m frustrated, but I can’t say it’s England’s fault because all the medical advice would suggest this is a one-off.

“I’m really gutted. I’m gutted for him and gutted because we were managing him well and then something like that happens.

“There are still ongoing discussions between their physios and ours. The communication between them is wide open and transparent.

“We know exactly how much loading he does on a weekly basis, what the plan is for him, the metres he runs.

“I can’t dictate or assume over a group of people who have 100 years of medical experience.

“I can’t say this how we should manage him, I’ve got to lean into their advice and experience.”

Tuilagi’s career has been stalked by a series of significant injuries, the most recent of which was a torn Achilles that contributed to an 18-month hiatus to his England career that ended this autumn.

“It would be tough if he was 24 or 25 and that was his further break into the international scene. But he’s taken it pretty much in his stride,” Sanderson said.

“It’s happened and it’s not a career-defining or even a season-defining injury for him. It shouldn’t affect the back end of the season, which will be big for him, big for us and big for England. He should recover pretty strong. He’s a fast healer.”