Improve Rugby Performance with Chiropractic
What you need to know
Preseason and Season Training in Rugby
Reductions in pre-season training loads reduce training injury rates in rugby league players and result in greater improvements in maximal aerobic power. The intermittent movement, collision, and skill components of rugby league match play require players to have a wide range of technical (e.g., passing, kicking, tackling) and physical (e.g., strength, speed, repeated effort ability) capacities Within each of the gym sessions, players completed on average an estimated volume of 279 repetitions of upper body and 263 repetitions of lower body exercises. On field, players averaged 4180 m of total distance, 516 of high-speed running, at a rate of 77.3·min, 10 tackles per session During Rugby matches, rugby league players are involved in an average of 0.68 collisions per minutes, while generally travelling 90-100 m per minute, 300-500 m of this at high-speed and completing an average number of accelerations 1.1 s 0.56 per minute During peak periods, elite rugby league players can be involved in up to 1.5 collisions per minute, travel 154-172 m per minute Rugby players completed 6–9 training sessions with an equal frequency distribution between gym and field. Weekly training time comprised of 324minutes (3–8 hours) of training per week Based on the collective findings following the pre-season, a greater increase in lower body strength was observed when players lifted predominantly heavier loads during resistance training sessions. The undulating pattern of strength (higher-load) and power (lower-load) training sessions appears to maintain upper body strength and power throughout a competitive season. Muscle damage and inflammation following a rugby match, potentially causing decrements in muscle performance, which may be problematic for developing or maintaining muscular strength and power During a typical match, played over the course of 60–80 minutes and depending on the level of play, players physically engage each other to compete for ball possession and territory As such, the ability to repeatedly engage in the tackle, whether as a ball carrier or tackler, is essential for team success and player performance. It is also the leading cause of injury, with over 90% of total injuries occurring during the tackle in some professional and amateur cohorts. The primary goal during pre-season resistance training in rugby league is often to stimulate muscle hypertrophy while increasing maximal muscular strength and power This why we are so passionate at Health Wise Chiropractic to educate check and adjust as many rugby players as possible to ensure proper muscle and spinal hygiene to achieve peak rugby performance
Rugby Injury Rates
Studies reported that 61% of all rugby injuries occur as a consequence of physical contact among players during tackling in professional rugby, while this percentage is lower (47.9%) in amateur rugby . Tackling is the most frequent contact situation during rugby, and it occurs on average 221 times in a professional rugby game Rugby players who had participated in less than 15 or more than 35 matches over the preceding 12-month period were found to be more prone to injury
What happens in a Rugby Game
What happens in a rugby game? Players are commonly split into two positional sub-groups (‘backs’ or ‘forwards’) or six sub-positions of front row (‘prop’, ‘hooker’), second row, back row (‘flanker’, ‘number eight’), scrum-half, inside backs (‘fly-half’, ‘inside centre’, ‘outside centre’) and outside backs (‘fullback’, ‘wing’). Typically, backs perform more running, whilst forwards undertake increased collision and contact activities Studies within senior rugby players have demonstrated that post-match fatigue may manifest as acute reductions in neuromuscular function , elevations in markers of muscle damage , alterations in immune and endocrine function] and negative changes in mood up to 60-hours post match-play. What are the different positions in Rugby: Forwards—Player numbers 1 to 8. The main role of forwards in rugby union is to win and retain possession of the ball Backs—Player numbers 9 to 15. The main role of the backs in rugby union is to attempt to gain field position and score points Scrum—A means of restarting play after minor infringements. The forwards from each team form together in three rows and close up with their opponents so that the heads of the front row players interlock. This creates a tunnel into which the ball is thrown. The front row players contest possession of the ball by hooking the ball back with their feet Tackle—When a ball carrier is held by one or more opponents and is brought to the ground. Following a tackle in rugby union, play continues Ruck—In rugby union, a ruck is a phase of play (often after a tackle) that occurs when the ball is on the ground. One or more players from each team, who are on their feet and are in physical contact, close around the ball and contest possession Maul—Similar to a ruck except that the ball is off the ground and is held by a player who is simultaneously held by one or more opponents and a team mate
All Injuries in Rugby
A major consideration for development of ACL problems are Lower hamstring to quadriceps muscle strength ratio and lower body weight as factors associated with noncontact anterior cruciate ligament injury in rugby players Several risk factors increase the likelihood of sustaining ACL injury. Intrinsic risk factors for male athletes include general joint laxity, bony anatomies decreased fatigue resistance, decreased hip abductor strength, and decreased hip external rotational strength. 57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury
Shoulder Pain In Rugby
Shoulder instability is a commonly diagnosed condition in young contact athletes. A diagnosis of instability can be detrimental to a competitive athlete’s future, as it can negatively affect performance attributed to pain, weakness, and/or recurrent instability Most of the studies into shoulder injuries in athletes report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears
How Chiropractors help Rugby Performance
How Chiropractic is essential for Rugby Players Altered lower extremity mechanics due to the effects of proximal lower extremity muscle weakness have been significantly correlated with lower extremity pathologies such as iliotibial band syndrome, patellofemoral pain syndrome, and ankle sprains Chiropractors work on ensuring proper muscle and spinal hygiene exist to allow for proper posture and limiting poor form when participating in Rugby Individuals that display inter-limb differences of ∼15% in knee flexor strength, or hip extensor flexibility may be at greater risk of injury than those with less asymmetry So seeing a Chiropractor should be essential in proper hip alignment to improve performance
Return to play suggestions for Rugby Injuries
Some key criteria to take as advice: The single leg bridge and single leg squat are other excellent assessments for core stability and appropriate gluteal musculature function and strength. Weakness in the core and hip muscle groups have been identified as risk factors for lower extremity injury risk Absence of swelling or joint effusion Full, pain-free PROM and AROM symmetrical to contralateral extremity Adequate baseline extremity and core strength ≥ 4/5 strength of affected area via MMT or HHD Appropriate functional tests (select those applicable to appropriate area) 1 minute 8 inch box heel tap comparison 1 minute 8 inch box step up comparison 1 minute calf raise comparison The injured lower extremity should be within 85% of the uninvolved limb Running tolerance Able to run > 20 minutes without symptom provocation or effusion 1 minute single leg squats to depth of 40-60 ° of knee flexion No presence of valgus collapse Appropriate posterior chain recruitment Sufficient trunk control and balance 5 single leg bridges with a 10 second isometric hold performed at the top of the movement No presence of trunk rotation or hamstring substitution Safe technique ideas based on Rugby Smart Eyes focused on target area Chin up, eyes open Low body position Keep back flat Shoulders above hips Use legs to drive powerfully into contact
Does sleep change in pre or competitive season of rugby?
Do you sleep more in pre OR competitive season of rugby league? Research looked into this important topic and found no differences were seen when considering the amount of time in bed, sleep duration or sleep efficiency obtained between the pre- and competitive seasons Early morning training sessions scheduled during pre-season advances wake time in elite rugby league. However, both players and staff can aim to avoid reductions in sleep duration and sleep efficiency with subsequent adjustment of night time sleep patterns.
Different Types of Rugby Injuries
01
The Tackler Injury
This occurs most commonly when the player tackles an opponent travelling towards them.
The arm is held abducted to ninety degrees. A posteriorly directed force results from contact with the ball carrier. The tacklers’ arm extends behind the player in the plane of abduction, exerting a levering force on the glenohumeral joint.
Anterior dislocation is most common in tacklers, with a high incidence of anterior–inferior labral tears, SLAP tears and Hill–Sachs lesions. Humeral avulsions of the anterior band of the inferior glenohumeral ligament (HAGL) tend to be more common in tackling injuries.
03
The Direct Impact Injury
The ball carrier may impact directly with the ground or another player, sustaining a large impact to the lateral aspect of the shoulder.
The arm is held flexed below ninety degrees or neutral, with internal rotation, such as when carrying a ball by the side.
A medially directed compressive force caused by direct impact to the shoulder results in injury.
Due to the variability of the exact impact vector, multiple complex injuries are sustained. This includes a combination of bony glenoid lesions, complex labral tears, scapula fractures and acromio-clavicular joint (ACJ) injuries.
02
Try Scorer Injury
This mechanism occurs whilst diving and reaching the ball-carrying hand forward to score a try. The mechanism involves the injured arm in extreme overhead flexion above 90°.
A posterior force drives the arm backwards and exerts leverage on the glenohumeral joint with the arm either remaining in fixed flexion by contact with the ground or forced into further hyper-flexion.
This may be compounded by opposing players falling on top of the injured player, increasing the leverage on the glenohumeral joint.
The glenohumeral joint may subluxate or dislocate, resulting in Bankart tears, Hill–Sachs lesions and rotator cuff tears. This mechanism has a higher incidence of significant rotator cuff tears than the others
04
Flexed Fall Injury
In rugby league, increasingly in modern rugby union, the ball carrier is tackled and lifted from behind.
The ball-carrying elbow makes the first impact with the ground, with the elbow and shoulder joints flexed whilst holding the ball.
This results in a large posterior directed force through the glenohumeral joint, causing injury and disruption to the posterior shoulder structures.
The common pathologies are posterior labral tears, reverse bony Bankart lesions, reverse HAGL tears and posterior rotator cuff injuries
Different Types of Rugby Injuries
01
Injuries in Amateur Rugby
Studies reported that 61% of all rugby injuries occur as a consequence of physical contact among players during tackling in professional rugby, while this percentage is lower (47.9%) in amateur rugby .
Tackling is the most frequent contact situation during rugby, and it occurs on average 221 times in a professional rugby game
study; players who had participated in less than 15 or more than 35 matches over the preceding 12-month period were found to be more prone to injury
02
Knee Injuries in Rugby
Extensor mechanism injuries in rugby athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries
Critical to the stability of the patella and the extensor mechanism as a whole is the trochlear groove.
The trochlear groove is a concave sulcus at the distal-most aspect of the femur, the trochlear groove provides an articular surface along which the patella can glide as the knee is cycled through flexion and extension while also providing the medial and lateral stability necessary for the patella to act as an anchor for both the patellar and quadriceps tendons.
Knee extensor mechanism injuries, whether bony or primarily involving the soft tissues, most commonly occur secondary to an acute, forced flexion of the knee.
Although less common, these injuries may also result from direct trauma to 1 or more of the components of the extensor mechanism as may occur during participation in contact sports
03
Injuries in Youth Rugby
The most common injury type was ligament sprain (males) and concussion (females). The tackle was the most common event associated with injury in matches (55% male, 71% females).
Median time loss was 21 days for males and 17 days for females. Twenty-three risk factors were reported. The risk factors with the strongest evidence were higher levels of play and increasing age.
In a study looking into the ACTIVATE injury prevention exercise program a 72% reduction in overall match injuries and a 59% reduction in concussions were reported in teams maintaining full compliance through a season (≥3 times per week
The head, shoulder, knee, and ankle were the most common injured body regions; however, forwards sustained significantly more head and shoulder injuries than backs.
The tackle was responsible for the majority of injuries in both groups. The highest proportion of injuries occurred during the third quarter.
Studies into youth rugby found a higher injury incidence rate in schoolboy rugby as compared with the adult amateur and professional game. Shoulder injuries were responsible for more days lost than any other injury, and shoulder dislocations were the most severe
04
Low Back Pain in Rugby
A common cause of pain for athletes is a Pars Interarticularis defect
Pars interarticularis defects relate to spondylolysis and/or spondylolisthesis of the spinal vertebra. The pars interarticularis is the segment of bone bounded by the lamina, pedicle, inferior articular process, and superior articular process of each vertebra
Complete fractures of the pars interarticularis may lead to anterolisthesis of the affected vertebra relative to the vertebra immediately inferior to it (spondylolisthesis), at which point neurological symptomatology may occur
The patient with lumbar spondylolysis typically complains of progressive back pain in the lumbar region, exacerbated by extension or twisting of the spine.
Radicular pain and urinary disturbances are uncommon unless nerve root compression has occurred as a result of spondylolisthesis
The incidence of pars interarticularis defects was found to be highest in diving (35.38%), cricket (31.97%), baseball/softball (26.91%), rugby (22.22%), weightlifting (19.49%), sailing (17.18%), table tennis (15.63%), and wrestling (14.74%)
Spondylolysis causing back pain in Rugby Spondylolysis is most commonly bilateralpossibly because unilateral spondylolysis increases stress on the contralateral pedicle.
The majority of spondylolysis occurs in L5, followed by L4, then combined L4-L5 involvement. Furthermore, the severity of spondylolysis varies with location.
Sixty-three percent of L5 spondylolysis exhibits terminal-stage defects despite young skeletal age, while most L3/L4 spondylolysis exhibits early-stage defects.
The incidence of spondylolysis has been shown to be 6% in the general adult population. The incidence is significantly higher in the athletic population, with studies showing as many as 52% of athletes with low back pain suffering spondylolysis and 60% with low back pain suffering a pars interarticularis defect of any grade.
Rugby Union players who sustained lumbo-pelvic-hip injury can expect to lose on
average 61 days when the injury occurs during training compared to 83 days
when it occurs during competition.
Exercise programs look at hip adductor strength and hip adductor to adductor ratio may result in decreased muscle capacity , muscle imbalance and increased risk of groin injury from side stepping, cutting, sudden acceleration or deceleration and change of direction mechanisms
How Chiropractors assess Lumbo pelvic hip complex:
Isometric adductor squeeze - adductor Magnus and gracilis ( at 0 degree)
At 60degree is adductor longus
Isometric adductor squeeze at 90 90 degree are pectineus and adductor brevis
Side lying hip adduction are adductor Magnus, gracilis, adductor longus , pectineus and adductor brevus
Side lying hip abduction are glut med, min and TFL
Prone hip extension are glut max, adductor mag and hamstrings