Central Health's top rugby tips for injury prevention and rehabilitation
Due to the physical demands of rugby injuries are common.
Common injuries include:
• Hamstring Strains
• Ankle ligament sprains
• Shoulder/ A-C joint dislocations
• Thumb dislocations
• Rib fractures
• Knee cartilage and ligament injuries
• Stingers (a traction type injury to the brachial plexus nerve complex that runs from the neck to the arm, often sustained in the process of tackling. The symptoms can include weakness and burning down the arm.)
Let's look at two of the most common of these injuries, ankle sprains and hamstring injuries.
Ankle Sprain
Soft tissue 'sprains' of the ankle joint are common. They frequently occur due to the foot rolling inwards. This causes the ligaments which help to support the outside of the joint to be over stretched or 'sprained'.
Good post injury care will help recovery and reduce the risk of further sprains.
P.R.I.C.E
P.R.I.C.E should be used for the first 3 days after injury to minimise pain and swelling of the ankle and help to ensure a rapid return to fitness. (For more detailed information please see the separate 'P.R.I.C.E' leaflet.)
Protection
Avoid all activities which make your pain worse. This may mean you require crutches for walking, or a brace around your ankle.
Rest
Rest your leg but don't be afraid to practice small range movements of your foot and ankle that are comfortable.
Ice
Place a plastic bag with crushed ice wrapped in a thin towel on your ankle for 10-20 mins. Your skin will turn pink, but do not let your skin turn red as this may lead to an ice burn. Repeat 3-5 times daily for the first 3 days. Leave the ice off for at least 2 hours between applications. If you have poor sensation in your skin only apply ice with great care as there is an increased risk of suffering a cold burn.
Compression
Wrap a tubigrip or elastic bandage from the toes to just below the knee, using even pressure. Loosen the wrap if your toes start to feel cold.
Elevation
Elevate the ankle on a stool when sitting or by using pillows when lying.
This helps to decrease the swelling. When elevating the ankle the compression should be removed.
Exercises to Encourage Movement
Once the initial effects of the injury have settled the aim is to return the ankle to normal. Below are some exercises that you may find helpful.
Perform these at least 3 times a day.
1. Move the foot up and down.
Repeat 5 times
2. With your foot on the floor, turn your ankle so you alternately raise the inner edge of our foot (and big toe) and then the outer edge (little toe). Repeat 5 times
Stretching Exercises
Attempt these when comfortable, approximately 10-14 days post injury. Hold each stretch for 30 seconds. Repeat twice. Do not “bounce” the stretch.
1. Calf Stretch
Standing, place the injured foot behind the other with your toes pointing forwards.
Keep your heels down and back leg straight.
Slowly bend your front knee until you feel the calf stretch in the back leg.
For more information on Ankle sprains and suggested rehabilitation exercises please see our Ankle Sprain information leaflet.
Hamstring Injuries
A hamstring injury is the most common reason for absenteeism from training and match games in sport. It is the third most prevalent injury in rugby and the primary injury in soccer.
Hamstring Injuries, like all muscle injuries can be divided into 3 categories:
Grade 1 strain – a very minor injury, with most people returning to sport within a few weeks. It involves an over stretching rather than tearing of fibres and therefore has less swelling, bruising and tenderness involved with it than more serious hamstring tears. There is good evidence to suggest that a lot of the symptoms coming from a Grade 1 hamstring injury are associated to the low back and the nerve supply to the hamstring, it is advisable to see your physiotherapist for a proper evaluation of these areas to ensure that you receive complete treatment and future prevention advice.
Grade 2 strain – a more serious hamstring injury, the athlete will often be unable to weight bear without significant discomfort in the hamstring. It involves actual tearing of the hamstring fibres and therefore is much more tender to the touch, a grade 2 strain will often result in significant bruising and swelling.
Return to sport at around 6 – 8 weeks.
As re-injury rates can be high it is important the muscle is given enough time to heal, and that proper rehabilitation is performed; the more times the muscle is re-injured, the more scar tissue will be formed, making it more prone to further injury.
Grade 3 strain – a very serious but fortunately rare injury. Players often report a sudden stabbing pain in the hamstring. It is associated with immense pain, swelling and bruising, an inability to walk on the effected leg and a palpable depression where the muscle has torn. It often requires surgery and most players are out for around 3 months.
For all hamstring injuries the initial principles of P.R.I.C.E. should be undertaken and then followed by assessment and treatment from a skilled practitioner.