When Steve Borthwick was named England head coach in December 2022 – nine months before the World Cup – he had a lengthy to-do list.

On it was having a look at a promising flanker in Newcastle who had been recommended to him by a World Cup-winning former team-mate.

“As soon as I took this job, Richard Hill spoke to me about Guy Pepper,” Borthwick told BBC Sport.

“I went up to Newcastle to meet him in 2023 and watched him play. He only played 30 minutes, but in that time he was incredible.”

Pepper quickly established himself as Newcastle’s starting open-side flanker in the 2023-24 season, having made his debut as a 19-year-old in the previous campaign.

He moved to Bath in the summer of 2024 and helped them become league champions with a series of impressive displays – fighting off tough competition in the back row to win player of the match in the semi-final, and again in the final.

His form led Bath head of rugby Johann van Graan to compare him to New Zealand great Richie McCaw, and on Saturday he will start for England against Australia.

But while his rise may seem linear, the truth is different.

Pepper had to stop playing for a year at the age of six because of arthritis, is still under treatment and has injections every two weeks, external after an issue with his right ankle when he was 14.

“It was a shock to us all and a bit of a bump in the road for him,” his father Martin told BBC Sport.

“We didn’t really know as a family what was going on but he got some great, immediate help from doctors and nurses, particularly at the Royal Victoria Infirmary in Newcastle.

“He was well looked-after, and it is something that has been part of his life since he was five or six.

“He treasures that he is able to play, as he had times where he has not been able to do stuff which when you’re young is frustrating and confusing.

“He manages it, and appreciates every minute he gets on the field now.”