Physical Therapy for Rugby Injuries
Rugby is a demanding high-intensity sport with a high risk of injury, combining the running and endurance of soccer with the contact and tackling of American football. Rugby players may develop overuse or traumatic injuries. Common injuries include concussions, jersey finger, muscle strains of the hamstrings or quadriceps, ACL or MCL tears, ankle sprains, shin splints, and shoulder joint injuries. Physical therapists can help rugby players prevent and manage sports-related injuries through a targeted strength and conditioning program.
Common Rugby Injuries
Rugby is a demanding high-intensity sport with a high risk of injury. Rugby combines the running and endurance of soccer with the contact and tackling of American football. The sport is characterized by repeated changes in exercise intensity, from low-speed activities like standing and walking to high-intensity bouts of sprints and tackles. Rugby players also tend to adopt an unbalanced posture posteriorly which can contribute to difficulty controlling foot stability and increase the likelihood of lower extremity injuries. Another factor that contributes to high levels of injury in rugby is that rugby unions prohibit hard-shell helmets and there is little to no body padding during competition.
Rugby players can develop overuse injuries like shin splints or knee and ankle tendinitis due to the repetitive running of the sport but are more likely to experience traumatic injuries from collisions with other players or the ground, leading to injuries like concussions, fractured bones, sprained ligaments, or strained tendons.
Research has shown that the lower extremity is the most common site of injury in rugby, with 41% to 55% of all injuries sustained in the lower limbs, such as a medial collateral ligament (MCL) or anterior cruciate ligament (ACL) strain or tear or a lateral ankle sprain. Upper body injuries include injury to the head (23.1%), half of which are concussions, the face (13.8%), and the shoulder (12.4%).
Common rugby injuries include:
Concussion: a mild traumatic brain injury caused by a blow to the head by a collision with other player or a fall to the ground.
Jersey finger: a flexor tendon injury that can occur when a player grabs another player’s jersey and the tendon is pulled off the bone of the finger.
Muscle strains of the hamstrings, quadriceps, calves, or groin muscles due to constant running and changes of direction.
Contusions, bruises, cuts, or fractures to the collarbone, arm, leg, nose, fingers, or facial bones due to collisions and contact with other players.
MCL and ACL ligament sprains or tears due to sudden changes in direction or direct blows to the knee.
Meniscal injuries to the knee from twisting and sudden direction changes that can tear the knee meniscus.
Lateral ankle sprains from uneven ground, collisions, and quick changes in direction that can cause the ankle ligaments to overstretch.
Shin splints and stress fractures due to the repetitive impact of running on the tibia and feet.
Hamstring strains are frequent due to rugby’s constant running, kicking, sprinting, and quick accelerations and decelerations during competition.
Groin strains or pulls due to rapid lateral movements.
Shoulder joint injuries like shoulder impingement, rotator cuff injuries, or AC joint sprains can occur from collisions, falls, and heavy tackling.
Physical Therapy for Rugby Injuries
Physical therapists can help rugby players prevent and manage sports-related injuries through a targeted strength and conditioning program. Physical therapists customize the rehabilitation program to address the type and severity of the injury. For example, for a concussion, physical therapists follow a specific protocol of gradual exercise exposure to help manage symptoms and safely restore the athlete’s physical activity tolerance without exacerbating symptoms. For soft tissue injuries like an ACL tear, meniscal injury, or hamstring strain, the therapist designs a progressive strengthening program to restore mobility and function in the injured joint and ligaments.
Physical therapy treatment can include pain management with ice and heat, manual therapy to restore range of motion, targeted strengthening and aerobic exercise to increase endurance, strength, and mobility, agility and plyometric training, neuromuscular re-education, and sport-specific drills, including a progressive return to running and return to sport program.
During rehabilitation after a rugby injury, physical therapists focus on improving neck, shoulder, hip, and core strength as well as flexibility of the hamstrings and hip flexors for overall conditioning and to prevent the risk of a secondary injury upon return to sport. The therapist often begins with unilateral balance and strength training as early as possible to ensure normal movement, progressing the athlete to circuit training to improve power endurance capacity as tolerated. Neuromuscular re-education training is also done to help restore normal functional movement and minimize future injuries.
Once the athlete has regained sufficient strength, he is then progressed to practice loading, landing, and deceleration mechanics, utilizing drills like lunges, single limb squats, small bounding hops, and drop box landings to promote neuromuscular control.
The therapist then begins a gradual return to sport progression, beginning with a progressive running tolerance program on a level surface. Return to sport testing can include tests like the Y Balance tests, single leg bridge, and squats. The therapist will also incorporate plyometric and agility drills to prepare the athlete for the demands of rugby.
Have you experienced a rugby injury? Work with a physical therapist today!
