Why So Many Shoulder Injuries During Rugby?


As the team physio for Rangataua men’s premier and development teams, I am privy to the assessment and treatment of a multitude of injuries. Whilst we see a lot of lower limb injuries and concussions from rugby – we commonly get lots of shoulder injuries. Due to the nature of rugby being a contact sport with tackling it is fairly demanding on our player’s shoulders. It is also more difficult in the offseason to train for the specific demands required of your shoulders during trainings and games when compared to your legs.

Tackles are responsible for between 49-72% of shoulder injuries sustained from rugby trainings and games (Critchon, Jones & Funk, 2012) and you can imagine how many tackles are in a game.

Shoulder injuries sustained from rugby can be grouped into three main mechanisms:
1) The Try Scorer. This is when our players often get very excited about getting over the try line and complete the infamous rugby dive. They land on an outstretched arm to put the ball down. However, this can be quite a high force position for your body because often your shoulder is fully flexed overhead. Sometimes, for those unlucky few, we see another player (often from the opposing team) land on top of the try scorer’s outstretched arm which leads to further injury.

The most common injuries from this mechanism are shoulder dislocations, labral tears and rotator cuff tears (Critchon, Jones & Funk, 2012).

Shoulder dislocations are easy enough for us to identify on the field. The rotator cuff tears need more specific testing and may become more noticeable during the subsequent days/weeks. A labral tear is even more difficult to diagnose. We often need more imaging to help confirm a diagnosis.

2) The Tackler. Often we find players get injuries to themselves when they tackle with their arm lifted out to the side and the opposing player essentially tries to run through their arm. This again puts a lot of force through the tackler’s arm as it gets forced backward and can lead to significant injury.

The most common injuries from this mechanism are shoulder dislocations and labral tears (Critchon, Jones & Funk, 2012). I have also seen torn pectoral muscles (chest muscles) and stretched or irritated nerves as they come from the neck and down into the arm.

3) Direct Impact. This occurs when a player has a direct fall onto their shoulder either from being dropped in a line out or from a particularly nasty tackle.

The most common injuries from this mechanism are ACJ injury and scapular fractures (Critchon, Jones & Funk, 2012).

ACJ injuries are easy enough to identify. You will initially see swelling right on the point of your shoulder and it will be very tender. Especially as you take your arm across your body or try to lift it up high. As the swelling settles you will end up with a ‘step’ or a drop where the ligaments are not holding your joint so tightly. Scapula fractures are locally tender on the fracture site and can be confirmed by X-ray.

As rugby is a contact sport and the aim of the game is to score tries, some of these shoulder injuries can not always be prevented. However, there are a few ways to limit the likelihood of a shoulder injury.

  •  Try where possible to avoid diving with an outstretched arm when scoring your tries. I know it is boring and does not look as spectacular. But it might just save you a shoulder injury and mean you can play the following week.
  • Try not to tackle with a swinging arm. Aim to make the contact point of your tackles your shoulder and not the long lever of your arm. This way you will be more effective, have a stronger tackle and limit the wrenching forces through your shoulder.
  • Have a good offseason strengthening program in place. This will enable you to get a good strength base of not just your bigger, shoulder muscles but your back and deep shoulder stabilisers as well.
  • As you are getting closer to the season starting add in some more dynamic strength work. You will need your muscles both strong and reacting in the right timing for specific given tasks.

If you would like us to help you with a pre-season or off-season shoulder program, book into the clinic.

Maddison Taylor.

 

 

References:
Crichton, J., Jones, D., & Funk, L. (2012). Mechanisms of traumatic shoulder injury in elite rugby players. British Journal Of Sports Medicine, 46(7), 538-542. doi: 10.1136/bjsports-2011-090688

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