Preventing Rugby Injuries of the Lower Extremity

Rugby is a field-based contact sport which has increasing participation rates in over 100 countries worldwide. At various levels of competition, there can be around 7-15 players on two opposing sides, depending on the league and country.

A high level of physical contact is involved between competing teams in an attempt to either score or regain possession of the ball and prevent it from advancing towards the other team’s goal line; this could entail high-intensity running, sharp changes in direction or multiple collisions with opponents.

The combative nature of the sport makes it necessary to identify the mechanics responsible for common rugby injuries of the lower extremity and to develop effective injury-prevention programmes accordingly.

An injury surveillance of the Welsh National Team was conducted to assess the incidence, severity, nature and causes of match and training injuries sustained during different international tournaments over a period of three years.

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The primary definition of injury used in this study was, “Any physical complaint sustained by a player during an international match or training session that prevented the player from taking a full part in all training activities or match play for more than 1 day following the day of injury, irrespective of whether match or training sessions were actually scheduled”.

Muscle and tendon injuries were found to have the highest incidence during matches, followed by joint and ligament injuries; the severity of joint, ligament, muscle, and tendon injuries was observed to be at its peak during autumn tournaments.

The authors advocate a better understanding of the physical demands of match play to prevent contact injuries especially within tackles; a video analysis of such tackle events should be useful in directing improvements in technique or rule amendments to aid injury prevention.

Anterior cruciate ligament (ACL) injuries contributed to the greatest time lost for the forward positions in 5 Australian Super Rugby teams during the 2014 Super Rugby Union tournament; this was attributed to the severity of ACL injuries rather than the injury count.

Injuries to the lower extremity were determined to be significantly higher during the tournament, largely because of the high rate of knee and thigh injuries. Other severe match-play injuries included ankle, tibia and fibula injuries which occurred either while being tackled, tackling or collision.

The role of fatigue in contributing to the development of injuries is evident from the fact that the highest injury incidence occurred in the second half of English community rugby matches; there is a hindrance in the activation of lower limb muscles in stabilising the joint as a response to destabilising events during fatigue.

Preventative and rehabilitative strategies can only be successful if they’re employed in conjunction with regulated safety measures, improved coaching standards and revision of rules especially with regard to tackles and collisions.

As described by Hislop et al., injury may be the result of tissues being acutely exposed to a force in excess of its normal tolerance or a repetitive exposure to forces that result in submaximal load becoming injurious.

For this purpose, the authors recommend exercise training interventions to reduce harmful tissue loading patterns by decreasing the external forces acting through a tissue, altering posture and kinematics, and enhancing a specific tissue’s ability to withstand load.

The inclusion of MASS4D® foot orthotics in such an exercise intervention can help in addressing any underlying biomechanical discrepancies to prevent mechanical stresses on the lower limbs and to minimise postural misalignment caused as a result of aberrant foot kinematics.

By correcting foot postural disparities, MASS4D® enhances the player’s ability to reach peak performance while reducing their predisposition to injuries of the lower extremity during the game.

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