Rugby is a popular game being played in over 100 countries. As there is physical contact, injuries inevitably occur. One of the major issues faced in rugby union is the risk of cervical spine injury, which has received growing worldwide attention because of their often catastrophic nature.
Rugby, a High-Risk Contact Sport
Rugby is a full contact team sport that has gained popularity around the globe. Unfortunately, participation in this sport carries a high risk of injury to the cervical spine that in worse cases results in tetraplegia, quadriplegia or even death. Tetraplegic or quadriplegic points to the same condition, by which a person has suffered a spinal cord injury to the neck area, resulting in a paralysis of the arms, legs, and trunk of the body below the level of an associated injury to the spinal cord.
Rugby has four main phases of play – tackle, ruck and maul, set pieces (scrum and lineout), and open play. A tackle in rugby is the same as in American football, where being brought to the ground by opposing player. A ruck is when the ball is on the ground and players from the opposing team fight to obtain the ball. Maul is when a ball carrier is being held by players from opposing team while others are joining the tackle. Scrums occur after penalties and are an organised way for teams to form opposing tunnels. During scrum, the ball is placed in the formed tunnel and the teams push each other to obtain the ball. A lineout happens when the ball has left the field of play and players are lifted in the air in an attempt to catch the ball.
How Rugby Causes Cervical Spine Injuries
Injury is an inevitable consequence of participation in contact sports including rugby and a spinal cord injury is one of the most devastating a player can sustain.
The cervical spine is particularly at high risk to injury due to its anatomical and mechanical structure. It is essentially a movable column that carries the weight of the head. Compared to the rest of the spine, it has greater mobility, smaller vertebral bodies, oblique articular facets, and weaker muscle protection.
Extreme neck flexion is the most common cause of cervical spine injury in rugby. Neck flexion generally happens during the scrum, where a front-row player can have forces of up to 1.5 tons or about 3,300 lbs exerted in their flexed cervical spine when engaged with the opposing team. This force is far greater than which is required to cause compression failure or ligamentous injury to the cervical spine.
A study has shown an increasing proportion of spinal cord injuries that occur during tackle. These injuries are sustained early within the season, often secondary to players with insufficient practice and physical conditioning. Front line players suffer the greatest amount of cervical spine trauma. The grounds tend to be harder earlier in the season, and players are lacking both practice and physical conditioning for the physical contact phases of the sport.
In addition, professional players are also getting bigger, faster, and stronger, causing greater impacts against players of the opposing team, provided that they have less favorable physique.
The Role of Physiotherapy
Physiotherapy is composed of treatments that will build strength and vigor in the neck muscles to increase stability and restore range of motion. Treatment may vary depending on the type of injury. Your physiotherapist may prescribe strengthening, stretching, and range of motion exercises to help with neck stability and pressure relief on the spine. Acupuncture and dry needling can help reduce pain and swelling at the site of the injury. Your physiotherapist may also recommend wearing appropriate protective gears and staying in correct fitness levels to reduce injury risk.
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