Exeter has confirmed that Luke Cowan-Dickie will be sidelined for the start of the upcoming Guinness Six Nations with England, as the hooker was meeting with a surgeon Tuesday to decide what treatment is needed for his latest injury. 

The 29-year-old's test career will come to an end later in 2023, when his post-World Cup move to Montpellier will leave him ineligible to be selected by Steve Borthwick.

However, hopes that he would wield a significant influence on the start of next month's Six Nations also have been dashed, after Exeter boss Rob Baxter provided an injury update from Pretoria ahead of this weekend's match against the Bulls in the Heineken Champions Cup.

Cowan-Dickie was the starting hooker for three of the four England matches in November, but last Saturday's ankle damage in the Exeter win over Northampton in the Gallagher Premiership will sideline him from the upcoming campaign, which begins Feb. 4 game versus Scotland at Twickenham.

"It looks relatively bad, possibly requiring an operation, and that is about as far as I can say," admitted Baxter during a virtually media briefing from the Exeter team hotel across the road from the Loftus Versfeld Stadium. "I believe he is seeing a surgeon today. The surgeon will then give an indication of exactly what happens, but at this stage, we have got to say it is relatively bad.

"I don't want to be kind of flippant and say it's going to be 10 weeks, 12 weeks, eight weeks. We are assessing, that but you are not going to see him running around in the next three or four weeks."

Reflecting on how the injury happened in the second half last Saturday at Sandy Park, Baxter continued: "If you look at the mechanism of the injury, it's pretty awkward. He ends up kind of half-breaking through a tackle, and someone is doing that classic falling on the back of his legs, and it kind of ends up with his ankles crossed, and one foot twists underneath him. It's just one of those typical syndesmotic injuries."

How has Cowan-Dickie reacted to this latest injury setback? 

"He was very, very annoyed on Saturday evening as you can imagine," added the Exeter Director of Rugby. "I sat with him in the physio room with the medical staff, his ankle was swelling. Obviously, he was massively looking forward to coming over here, to experience being over here (in South Africa) with the club.

"He was really looking forward to getting involved in a big game - the Heineken Cup means a lot to him. The truth is, he is a really good guy who wants to have a big impact at the end of this season, with it being the season where he is now leaving. A lot of that really bothered him, but having said that, if there is a guy who can come back on time from an injury, it does tend to be Luke.

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"Don't get me wrong, there is still a lot of the season left for him, but immediately now, we have got to get things done very quickly, so we can get that rehab down significantly, and so he doesn't miss too much more of this season."

Scotland full-back Stuart Hogg also was left behind in England to tend to the heel injury that has sidelined him from the Exeter XV since Dec. 24. 

"Because we had to announce the group and wanted to make sure with the limited numbers we were as strong as we could be when we came over here, he did a fitness test on Saturday pre-game and still couldn't run at speed or couldn't put any distance, as his heel was still too sore," Baxter explained.

 "He will be doing a kind of rehab program this week while we are away, and as soon as his heel feels comfortable enough, he will be declared fit to play again. If you watched the last game he played, he carried and stumbled and banged his heel. It was as simple as that. It's not like a ligament thing, not like it requires an operation. It's just a big bang."