England captain Sarah Hunter admitted she questioned whether she would ever wear the white jersey again after a neural neck issue left her unable to even tie her own shoelaces.
The 35-year-old returns to the Red Roses starting line-up this weekend to face Italy in what will be her first international match for 13 months following a lengthy injury lay-off.
While a hamstring issue saw Hunter miss England's Grand Slam decider with the same opponents last year, she has also struggled with a neural injury which impacted her day-to-day life.
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Despite undergoing numerous tests and seeing specialist after specialist, the problem initially remained undiagnosed and left Hunter unable to do the simplest of daily tasks.
And on the cusp of her 124th cap, Hunter described the period as "the hardest 12 months" and revealed she did wonder whether she would ever represent her country again.
"The question did come up about whether I would be able to get back," she said.
"It was pretty difficult as the injury that kept me out of the Six Nations in terms of my hamstring was pretty straightforward but, as has been widely reported, I had this neck neural issue.
"That was probably the toughest injury I've ever had based on the fact that no one knew what it was, I went to see different specialists, had numerous MRIs, numerous tests.
"I had electric tests, neurologists, all sorts of different things and you would go to an appointment hoping to get an answer and there was no answer.
"They then stop looking at you as a rugby player and start looking at you as a person as I lost power in my hand and it was affecting day-to-day stuff, doing my shoelaces, holding things.
"Eating, going to my car, all the things you need to do day to day so they start to begin to have conversations with you around you long-term day-to-day life, which is quite right.
"As a rugby player that becomes quite worrying because you then think, what happens if I don't get to play rugby? That was pretty tough but our England medical team have been brilliant.
"They have got me to see the best people, given me the best programmes and I've been supported so well that we did get the bottom of it and it took five months to do so.
"It's now allowed me to be back where I am and back in a white shirt, which is everything my day-to-day life is to strive for and what I get up to do.
"I work hard in the gym, the pitch, everything around it and I can't wait to pull that white shirt on as there have been a lot of difficult moments and moments people don't see.
"It does make it all worth it that Saturday will finally come when at times you don't think it's going to, you think that might have been the last time you will pull on that white shirt."
Hunter acknowledged that she would need to manage her schedule more carefully in future, accepting she will not be able to play every game as reaches the twilight of her career.
But she remains determined to represent England at next year's Rugby World Cup and said being selective about which games she plays is a sacrifice she is willing to make to achieve her goal.
She also explained how she was not always completely forthcoming with her family when discussing her injury as she tried to avoid the question about hanging up her boots.
"At times I probably didn't give them all the information that I was getting until I found answers out as I knew they'd worry but they were fully supportive of me," she said.
"Again they saw at it from more of a person point of view than a rugby player but just the thought of not being able to play made me even more determined to try and play.
"It's strange but I just thought I'll just get back, do my rehab and it will be fine and it has worked out that way but your loved ones around you have more serious conversations with you.
"I think I was a bit blase at times and saying I'll just give it a go and see. I'll try and rehab and do this and if it doesn't work then we'll have a conversation about if I need to hang the boots up."
Hunter's inclusion is one of ten changes made by Simon Middleton to the England team that started the 52-10 victory over Scotland at Castle Park on the opening weekend.
Victory against Italy would seal top spot for England in Pool A and a chance to defend their title but despite the high stakes, Middleton said it was an easy decision to pick his skipper.
"We've missed Sarah massively in terms of what she brings, first and foremost as a player and then as a leader in terms of match days and through training weeks," said Middleton.
"She's been doing a lot of her recovery at Loughborough and away from camp so to have her back in on a consistent basis has been a great shot in the arm for us all.
"It wasn't a difficult decision albeit there are some players playing outstandingly well and Sarah knows that. She knows she's got great competition, but we're delighted to have her back."
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