Common rugby injuries and how to prevent them

Brad Barritt showing just how bloody the sport can get
Brad Barritt showing just how bloody the sport can get

Andy Curtis, co-founder of UK Wide Physiotherapy service, and former professional rugby player for Bristol, gives TRU a breakdown of common rugby injuries and how to avoid them.

Unfortunately due to the nature of the game, injuries are common course for a player at any level. However, if you work on your conditioning, improve your technique and seek advice from medical physiotherapists before injuries have a chance to develop, you’ll perform better and reduce your likelihood of injury.

The most prevalent injuries I see involve lower back pain, knee ligament and cartilage issues, rotator cuff tears in the shoulder, and ankle ligament tears. Unexpected and heavy contact can be the cause of these, but you can limit the risks, and even ensure you return from injury quickly and in better shape.

You should always see an injury as an opportunity. It is easy to get frustrated with the fact that you have picked up and injury, but once you have, getting depressed about it won’t change a thing. Use the time away to back fitter and stronger than you were before your injury. The whole time you are taking advantage of intensive time with your Physiotherapist, and completing a ‘mini pre-season’, your opposite number is not able to, due to weekly playing commitments. When you come back and meet on the pitch you have the opportunity to be better conditioned and fresh, ready to get one over on him.

Four common rugby injuries and how to prevent them:
    •    Lower back pain:
This can be 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, while the backs 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 stabilisation, and allowing better performance in tasks such as lineout jumping and breaking tackles.
Supine leg pistons

  •    Knee Ligament Injury:
Knee injuries generally relate to a twisting injury, which is likely to damage the cartilage, or forced motion either sideways of backwards during contact, which is likely to damage the collateral or cruciate ligaments respectively. In truth, it is impossible to prevent injuries that occur through heavy contact, or the joint having force put through it while in an awkward position, but you improve the condition of the muscle around your knee to deal with these adverse loads. Strengthening your quads and hamstrings is essential to protect your knees, but 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. I would always advocate the large Olympic lifts such as Squats, Deadlifts, and Power Cleans to gain dynamic leg strength that is game specific, but it is vital not to neglect the more precise exercises detailed below for both prehab and rehab from knee injury.
Hamstring roll outs
Single leg deadlift
Single leg squat

    •    Shoulder Injury – Rotator cuff:
Shoulder Injury is very prevalent in rugby for the obvious reason that 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 most commonly, rotator cuff damage.
The rotator cuff is a group of four small muscles that hold the ball into the socket, 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 a physiotherapist; however in some instances they do need surgical intervention. It is essential for rugby players to have well conditioned rotator cuff muscles to help prevent impact injury, and to give the foundations for completion of the larger upper limb lifts, preventing overtraining and over reaching. Rotator cuff exercises should be completed for both shoulder prehab and rehab.
Rotator cuff with band
Swiss Ball roll outs

    •    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 collateral ligaments on the outside of the ankle are the most commonly damaged structures due to inversion injury from ‘going over on your ankle’ be it while sprinting / jumping, or during a collision. The natural recovery of these ligaments can sometimes see them healing by sticking to the bone on the side of the ankle where they shouldn’t. This will reduce the amount ankle movement achievable, and therefore reduce performance and increase the risk of further injury. This healing abnormality can be controlled by a clinician throughout the phases of healing. The rehab exercises you would do to recover from this collateral ligament injury are also used to train the neural pathways and muscles required to minimise the risk of inversion injury in the first place.
Theraband clock face
Heel raises
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