We caught up with our physio John Gripper, on all things Rugby related…..
What injuries do you see most often from this sport?
You get a fair bit of everything in rugby. Shoulder problems are common – things like dislocations and AC Joint sprains (the highest point of the shoulder blade is called the acromion. Strong tissues called ligaments connect the acromion to the collarbone, forming the AC joint. An AC joint sprain occurs when an injury damages the ligaments in the AC joint). Knee and ankle ligament tears. Muscle tears. ‘Stingers’ of the neck…. a stinger most commonly occurs when the head is forced sideways and away from the shoulder or pushed backward.
As a physio, how do you treat them?
For the shoulder injuries… less severe AC Joint sprains can be managed conservatively with physio, often involving PRICE (Protection, Rest, Ice, Compression, Elevation) when acute, strength and mobility exercises, manual therapy and commonly taping can be useful to help offload the joint. More severe sprains can require surgical intervention before requiring a physiotherapy rehabilitation program.
People who experience dislocated shoulders are more commonly the younger population who want to return to sport and high levels of activity. Generally these injuries will require surgery to stabilise the shoulder.
Ultimately whether undergoing surgery or not, the goals of physiotherapy are to:
- Restore range of motion. We do this using exercises and hands on treatment
- Strengthening the shoulder using a graded strength program
- Increasing proprioception of the shoulder (your awareness of shoulder joint and muscles position), using exercises
- It’s important to ensure the rest of the system is working well. Identifying weaknesses elsewhere in the body and working on those can also help reduce stress and injury to the shoulder. Deficits in strength and range of motion as far away as the ankle have been shown to place increased stress on the shoulder!
The latter stages of rehabilitation are more sport specific. They include phasing back to rugby training and lastly contact drills; things like tackling, hitting rucks and scrummaging – all the fun stuff.
What’s the one piece of advice you would give your best mate if they were taking part in this sport and wanted to avoid an injury?
The best advice I could give would be to get strong and fit. Engaging in a strength and conditioning program is invaluable and something I wish I’d done when at school. The game places big demands on the entire body. Having a good foundation of leg strength and trunk stability, as well as shoulder and neck strength are essential in avoiding rugby injuries. I’d suggest touching base with a physio if you have any concerns about your movement or strength, or even just for a MOT to check everything is in working order and you are good to go get stuck in. Rugby is a collision sport so the nature of the game is there are going to be some decent injuries. It’s a trade off because obviously rugby injuries are not ideal, but the collisions are what make it such a lot of fun to play and watch.
How to reduce the likelihood of shoulder injury:
- Shoulder Strength and proprioception program
- Get strong from the ground up, i.e. don’t underestimate the importance of leg and core strength in supporting your shoulder
- Good technique with tackling and rucking etc.
- Good Range of motion and posture
- Supported cuff work with a dumbbell: it is invaluable when done properly, progressed gradually and done over a sustained period. It targets the fine stability muscles at the back of the shoulder required to stabilise and rotate the shoulder.
- Upper back and shoulder strength work
- Single leg strength work in your program, like a Bulgarian split squat and single leg calf raise.