That is already set to full screen.....
Worked it out though, well kinda, found the problem anyway:
It turned out to be the following lines in XF86Config
# This loads the miscellaneous extensions module, and disables
# initialisation of the XFree86-DGA extension within that module.
# SubSection "extmod"
# Option "omit xfree86-dga" # don't initialise the DGA extension
# EndSubSection
Disabled as they are above RTCW runs much faster and smoother but in a window, even when set to full screen....
# This loads the miscellaneous extensions module, and disables
# initialisation of the XFree86-DGA extension within that module.
SubSection "extmod"
Option "omit xfree86-dga" # don't initialise the DGA extension
EndSubSection
Enabled as above RTCW will work correctly in full screen as I would expect but the graphics look like they're struggling, shuddering from time to time....