Here we are again, it’s February and the Six nations is upon us.
As a proud Englishman it pains me to say it, but I think the Irish are the team to beat. A well-oiled outfit, with most of their players playing in a dominant Leinster side, alongside a sprinkling of stardust from the other corners of the green Island.
They also have very few injuries, stemming from a club system that allows their rockstars to be fit and firing for international duty, however the next 2 months or so will be gruelling, so let’s consider some of the injuries that we may see.
This is a very topical area of the game at the moment, with some former players moving to sue the games authorities for brain damage, after suffering from early-stage dementia following head collisions. Rugby seems to be doing all it can to stem these incidents, with law changes and head injury assessments being commonplace.
It will however, be very tricky to eliminate these head collisions altogether, as the game is played at such a ferocious pace. This gives players very little time to make decisions and get their bodies into the correct positions to avoid head contacts, and therefore some concussions seem to be inevitable.
It’s not about taking risks or pretending that bravery is admirable with this type of injury. If it does happen, it’s time to get you off the pitch, into the changing room and working with the Sport, Exercise & Musculoskeletal Consultants to assess whether it’s safe to continue.
The frustrating short-term outcome of concussion is that it can be two weeks before a player is fit to return and, in a tournament, this could be 3 – 4 games out.
Stock imagery: canva.com
Rugby is a collision sport, and almost all of the collisions involve the shoulders, so this one is obvious really. Players are coached to hit the soft spots of the opposition’s bodies, (thighs, bottoms and bellies), but when you are in the depths of battle you will get it wrong occasionally.
Injuries can range from dislocations, to muscular injuries and everything else in between, and unless you are Alyn Wyn Jones and can rise like a phoenix from the ashes, it usually takes some time to get back up to scratch.
2. Hallam Amos suffered a shoulder injury against England. Photograph: Andrew Couldridge/Reuters. Source: https://www.irishtimes.com/spo…
Although this doesn’t sound like much, it really is painful, and continues to be painful for a long time. Consider that every time you breathe, walk, rotate and reach the ribcage moves, and every movement has the distinct possibility of causing a pain sharp enough to take your breath away.
The other issue is, you are generally passed ‘fit to play’ before the injury has fully healed, so the first few games can be an absolute nightmare.
3. Bidwell, H. (2016) Hurricanes coaches unable to confirm severity of Dane Coles’ rib injury.
This is more likely for the gazelles out in the wide channels, but can certainly get the big lads as well.
You can generally tell if its a bad one when the players look like they have been hit by a sniper in the back of the thigh mid sprint. There is a huge amount of research into hamstring injuries but the injury rate doesn’t seem to be improving, with a bad strain taking on average 6 – 12 weeks to resolve.
Due to the players becoming bigger and faster each year, the hamstring and surrounding structures need to be unbelievably robust. It seems the best way to prevent hamstring injuries, is to never get one in the first place, as the biggest predictor of injury is if it has been injured before.
To avoid these, try to stay hydrated with plenty of fluid and electrolytes, jump in an ice-bath post-match (like a Game Ready ice machine) and keep gentle but continuous movement in the days following.
Right now I’m sure any England fans will be hoping that the Sale Sharks Medical Team are hamstring experts, so we can get Manu Tuilagi back from his latest ‘twinge’, and bulk up our midfield somewhat.
4. Stafford, I, (2008). Jason Robinson: I played in the World Cup final despite the pain from my secret injury.
Saving the worst for last, the last thing that a rugby player wants to hear is they have ruptured their ACL. Any player that has done their ACL will know just how painful this injury can be.
This injury can take 9 – 12 months to recover from, and has a pretty high reoccurrence rate. There are a number of recovery options, from surgery to conservative management, however the recovery time is very long for either option.
The early phases of ACL rehab are all about restoring range, reducing swelling and controlling pain but the big milestones are, returning to running, change of direction and progressing back to contact; if people don’t incorporate change of direction into their training in general, they’re more likely to be injured.
For clinicians it’s about slowing the athlete down and keeping them motivated and positive during a long period of rehabilitation.
If this happens to you, look on the bright side, you have plenty of time to focus on the upper body, so at least you’ll look good on the beach during the offseason.
4. Hansen (2019) Steve Hansen stated on Sport 24 that “He could be out for eight to nine months”
Here at Pure Sports Medicine you don’t have to look far to find rugby expertise at anyone of our practices. Whether you want a Consultant in Sport, Exercise & Musculoskeletal Medicine, Dr James Thing (Matchday Doctor for Harlequins) to ultra sound a painful tendon, a Strength & Conditioning coach such as myself, (Head of S&C at PSM and formerly of Rosslyn Park RFC) to plan your pre-season preparation, Jo Kelly a Soft Tissue Therapist of ours (Twickenham RFC) to soothe a sore hamstring or Dr Simon Lack, Physiotherapist (Otago rugby 7’s) to approximate your bad shoulder — we’ve got it covered!
Many of our team can help with returning injured patients to play, by creating rehabilitation programmes that delve into fixing movement-based anxieties; so feel free to get in touch to aid your rugby needs.