Rugby is a fun, fast-paced sport that is as exciting to play as it is to watch. But, the price of competing in such a high impact contact sport is that rugby players are at particularly high risk of injury. In fact, rugby has the highest risk of injury per player per hour of any sport. We regularly treat upper limb injuries sustained during rugby here at Thames Shoulder and Elbow.
Risk factors in rugby
A study published in the British Journal of Sports Medicine in April 2013 considered upper limb injuries in rugby, which account for between 14 and 28% of all injuries in the sport. Researchers looked at the injuries occurring in 1,475 adult male rugby players in Colts, Grade and Elite competitions. Their research covered five rugby seasons from 2004 to 2008. They considered every upper limb injury that resulted in a player missing a game.
Out of a total of 61,598 games a total of 606 upper limb injuries were recorded. Two thirds of these (66%) affected the shoulder. The higher the level of play, the fewer the number of upper limb injuries – with 10.74 per 1000 games in Colts compared to 6.07 per 1000 games in Elite players. Researchers concluded that age, level of skill and playing experience may all be risk factors for upper limb injuries. There is also a correlation between the position played and certain types of injuries.
Common shoulder injuries in rugby
Around 20% of all rugby injuries affect the shoulder. It is the most commonly injured joint after the knee. Shoulders may become injured through falling onto the joint or as the result of a direct impact.
If a player sustains a shoulder injury, he is more likely to injure it again and there is also an increased risk of injury to the other shoulder.
Shoulder injuries are most likely to occur during a tackle. This could be the result of a direct impact or forced wrenching of the arm during contact with another player or with the ground.Incredibly, scoring a try is another common cause of shoulder injuries as the arm is outstretched in hyperflexion!
Among the most common types of shoulder problems linked to rugby injuries are:
- Shoulder dislocations – this is a very common rugby injury where the ball of joint slips out of the socket. Sometimes the ball immediately returns back to the socket, but very often the joint stays dislocated until it is put back in place, either at pitchside or in hospital. Commonly the labrum is torn as a result. The labrum is a ring of cartilage that attaches to the rim of the shoulder socket, helping to keep the ball centred in the socket. Very often it does not heal and can result in the shoulder recurrently dislocating when you move it in a particular way. You may have an anterior tear, a posterior tear or a SLAP (superior labral anterior to posterior) tear.
- Collar bone fractures or dislocations–usually result from a direct impact onto the collar point or the point of the shoulder.
- Rotator cuff tears– these may be partial or total tears. They are more common in senior and veteran players. In fact any player aged 40 or over who has a dislocation should have a precautionary scan to make sure there is no tear.
Common elbow injuries in rugby
Rugby players are also prone to elbow injuries, although these are less common than shoulder injuries. Elbow injuries may be the result of overuse – such as in tendinopathy (tennis elbow or golfer’s elbow) or dislocations which may also be accompanied by an elbow fracture.
Distal biceps ruptures can be caused by sudden force or contraction of the distal biceps tendon. The result is weakness in the elbow flexion and forearm rotation, accompanied by pain and swelling. This type of injury will normally require surgery if the player wishes to return to full strength.
Diagnosis of rugby injuries
Depending on the type and severity of the injury you may require different types of imaging scans to obtain an accurate diagnosis. Initially a simple x-ray will be done to assess for a fracture or dislocation. An ultrasound or MRI scan may be used to identify problems with the rotator cuff. In order to assess for a labral tear after a dislocation the most accurate scan is an MRI arthrogram. This is where sterile dye is injected into the shoulder just before the scan.
Once you have an accurate diagnosis, your surgeon will recommend a treatment plan. This will be affected by the severity and type of injury, your level of play, and stage of the season. For elite players decisions are made in conjunction with the club medical and coaching team.
Orthopaedic Consultant & Surgeon | London
If you sustain an injury, or are nursing an old injury, it is important to seek professional help. An orthopaedic surgeon can provide an accurate diagnosis and recommend the most effective type of treatment, which may include surgery.
Contact us to speak to a shoulder and elbow specialist and get back to playing the game you love.
Telephone: 020 376 15987