Tackling Rugby injuries part two

Unfortunately, at any level injuries are inevitable. However, if you work hard on your fitness, improve your technique during contact, and consult your Physiotherapist before any niggles develop, you will perform better on the pitch and reduce your chances of sustaining injuries.

Lower back pain, knee ligament and cartilage issues, rotator cuff and ankle ligament tears are some of the most prevalent injuries reported at my clinic. In matches and in training, unexpected and heavy contact, or quick changes of direction can cause these, but if you work hard on your prehab you can help limit your chances of injury.

It is extremely frustrating to incur injuries. However, if you think positively and use your time away from the field to return fitter and stronger, you will be in better condition than your opposite number who hasn't had the time to recover properly and work on his/her prehab during the week. It is worth spending some time with your Physiotherapist and completing a 'mini pre-season'.

Here are four common rugby injuries and some advice on exercises to help prevent them:

1) Lower Back Pain

This is common in both Forwards and Backs, but normally for different reasons. Obviously both playing positions are open to contact related contusions and more severe injury, but in general the Forwards will have large axial loads enforced on their spinal discs and joints through scrummaging, rucking and mauling. Backs on the other hand are more likely to 'jar' their lower back through high speed changes of direction and half breaks at pace. In order to minimise the effects of these position specific risks, it is essential to have great core strength, protecting the spine with increased dynamic stabilisation which helps if you jump in the line out and jackal.

2) Knee Ligament Injury

Knee injuries generally relate to a twisting injury which most likely damages the cartilage, or a forced motion either sideways or backwards during contact which damages the collateral or cruciate ligaments respectively. In fact, it is impossible to prevent injuries that occur through heavy contact, or the joint having force imposed on it whilst being in an awkward position. But you can condition the muscles around your knee to deal with these adverse loads.

Strengthening your quadriceps and hamstrings is essential to protecting your knees. This should be done with functional exercise as well as static lifts, to ensure the smaller stabilising muscles around the back of the knee are well conditioned. Olympic lifts including Squats, Deadlifts, and Power Cleans can help you gain the dynamic leg strength required in rugby. It is vital not to neglect the more precise exercises as advised by your Physiotherapist for both prehab and rehab from knee injury.

3) Shoulder Injury - Rotator Cuff

Shoulder injury is very prevalent in rugby for the obvious reason that it is a main point of contact in attack, defence, set piece and broken play. Shoulder injuries can be fractures or dislocations, labral tears (the cup of cartilage that deepens the ball and socket joint) and more commonly, rotator cuff damage. The rotator cuff is a group of four small muscles that hold the ball (humeral head) into the socket (glenoid fossa), starting at the rear of the shoulder and passing through under the collar bone attaching to the top of the arm.

These can develop impingement syndromes with repetitive actions, and in rugby, traumatic tears due to impact. These tears can be managed conservatively by your Physiotherapist. However, in some instances they do need surgical intervention. It is essential for rugby players to have well-conditioned and responsive rotator cuff muscles to help prevent impact injury, and to provide the foundation for completion of the larger upper limb lifts, thus preventing overtraining and over reaching. Rotator cuff exercises should be completed for both shoulder prehab and rehab.

4) Ankle Ligament Injuries

Ankle function is paramount for Backs to perform at full pace, and for Forwards to be able to adopt the correct body positions at set piece and the collision zone in broken play. The lateral ligaments on the outside of the ankle are the most commonly damaged structures due to inversion injury from 'rolling' or 'going over on your ankle' whilst sprinting, jumping, or during a collision.

The natural recovery of these ligaments can sometimes be them healing by sticking to the bone at the side of the ankle where they shouldn't. This will reduce the amount ankle movement possible, thereby reducing performance and increasing the risk of further injury. This healing abnormality can be controlled by an experienced Physiotherapist throughout the progressive phases of healing. The rehab exercises you do to recover from this lateral ligament injury are also used to train the neural pathways and muscles required to minimise the risk of inversion injury in the first place.

Rugby player? Looking to rehabilitate, recover, prevent injury or even improve performance? Get in touch with us today and we would be happy to tell you more about the services we can provide. Call us now at our Nottingham Physiotherapy Practice on 07866 464 385 or email us at tripti@triptigyan.com