Bring on the rugby (world cup)!

We are in heaven. 6 weeks of uninterrupted, game after game of rugby. Yes, that’s right folks it rugby world cup time! Massive high fives all around.

To get even more into the rugby mood, let’s talk about it. Rugby injuries seem like a good place to start 😀. It makes sense that a contact sport like rugby has a high number of injuries. Thankfully the majority of injuries are minor and do not require major or urgent treatment. Tackling, or being tackled, causes approximately half of all rugby injuries.

What are the top 5 rugby injuries and why do these occur?

1. Concussion
Concussion is a brain injury that can range from mild to severe. It is the result of the brain being banged against the skull. Around 1 in 5 of all rugby match injuries are concussion based. Concussion is serious, and you should not play again until you have been cleared by a medical expert. The major signs of concussion are headaches, memory disturbance, dizziness and balance problems. Tackling is the main cause of concussion.

2. Sprains and strains
Sprains and strains are caused when muscles or ligaments become overstretched. It often happens when you stop or start suddenly, change direction, fall or land hard. These are all movements common on a rugby field. Physiotherapy is a great option to aid recovery from sprains and strains as it rebuilds strength and mobility in overstretched ligaments and muscles. If the trauma injury is particularly bad surgery might be required.

3. Shoulder dislocation/AC joint related injuries
Tackling in rugby also causes a high percentage of shoulder injuries. The AC joint (acromioclavicular joint) lies between the outer end of the collar bone (clavicle) and the shoulder blade – think where a bra strap would go. It can take from 12 to 16 weeks to be fully recovered from a should injury.

4. Overuse injuries
Common overuse injuries seen in rugby are bursitis and tendinitis. Bursitis is when your joints become painful, tender and swollen. It happens when the fluid-filled sacs (bursa) that cushion your joints become inflamed. Bursitis can affect any joint, but is most common in the shoulders, hips, elbows or knees. Tendinitis is inflammation or irritation of a tendon (the thick fibrous cords that attach muscle to bone). It causes pain and tenderness just outside a joint. While tendinitis can occur in any of your tendons, it’s most common around your shoulders, elbows, wrists, knees and heels.Overuse injuries are generally not as serious as trauma injuries, BUT if left without any intervention from a doctor or physiotherapist they could turn in serious and cause you a lot of pain.

5. Disc related injury
Contact sports have high recurrences of both neck and back injuries (es. disc bulges). Repeated stress, especially from tackling, gradually breaks down the connective tissue around the discs. Without this tissue swelling can occur and put pressure on the nerve endings. This means pain!

No matter what level you play at, injuries (unfortunately) are an inevitable part of rugby, but there must be ways to reduce the risk? Yes, there are – keep reading :).

What can rugby players do to reduce the chances of getting injured?

Below are a few ways that leading rugby and sports organisations are trying to reduce the number of injures:

  • The EPG (English Professional Game) and World Rugby are continually working together to review injury risks on an ongoing basis. There is a specific focus on reducing the incidents of concussion in tackles and a view to reduce the current legal height of the tackle.

  • The PGB Scientific Advisory and Scientific Advisory Group are woking together to provide advice on optimal training and work load, as well as the size and composition of the team to advise on customised player management.

  • Two studies are on the go: A Cardiff Metropolitan University study (began Sept 17) is examining the psychological load in rugby; and the University of Bath is exploring the associations between training and injury risk.

Another great way to reduce the chance of injury is to think ‘PREHAB’ 👇.


The idea of’ pre-hab is to prevent common injuries before they occur. Due to the dynamic and ‘tough’ nature of rugby there will always be injuries, regardless of how well prepared the players are but performing pre-hab can help reduce the risk. Many of the injuries occur because the demands of rugby, both playing and training, exceed the body’s ability to cope. But, if you can increase that coping ability, those demands become less severe. For example, strong neck muscles could help reduce the risk of injury caused by a collapsing scrum. Some parts of the body need stretching to reduce injury risk while other regions of the body need strengthening and stabilising.

Pre-hab training might not be as exciting as tackling practice or big deadlifts in the gym, but it’s almost as essential. A recent study from health researchers at the University of Bath and England Rugby found that the introduction of a simple injury prevention exercise programme has significant impacts in reducing rugby injuries. In fact it found that it could reduce concussion injuries by up to 60% and lower-limb injuries by up to 40%.

This study went on to form the foundations of “Activate” which is the RFU’s Injury Prevention Exercise Programme. Activate is an injury prevention exercise programme that can be integrated into training and pre-match sessions. Exercises are designed to improve functional and core strength, balance and agility, helping players with the game’s physical demands. Activate is a progressive programme where each phase of the exercises should be carried out for 4-6 weeks in order to achieve the most effective results. Consistency is key! It’s important to have an external support for this program (such as a physiotherapist 😀) in order to assess the right execution of the exercises and avoid overload on one group of muscles over another. A physiotherapist can also help to identify any weaknesses and focus on an individual’s demands, according to their body type, role in the game, previous injuries, etc.


Warm Up

Based on the the above study “Activate” here are a few different exercises that would work well as part of a rugby warm up and that are designed specifically to prevent injuries (check out England Rugby’s website for more information):

  • Snake run

  • Squat stand with rotation

  • Heel to toe walk with knee raise

  • Single leg balance with partner push to balance

  • Static shoulder isometric exercises against resistance (see below)

  • Arabesque with aeroplane (also known as a single leg deadlift) – see below


  • Mountain climber

  • Hop and stick forwards

  • “Pop” press up (see below)

  • Jogging High Jump (view from the side)

  • ​Diagonal Skip to Sway Lunge

  • Shoulder workout (in pairs)

  • Static neck contractions

For more advice on how to perform these exercises just ask us when you book your prehab session 😀.


The often forgotten and neglected cool down is very important too and these are the reasons why:

  • Gives the body a chance to recover after an intense match.

  • Helps your heart rate and breathing to return towards resting levels gradually.

  • Prevents fainting or dizziness, which can be caused by blood pooling in the leg muscles after vigorous activity is suddenly stopped.

  • Aids joints and muscles in returning to their normal length and function, which will quicken the recovery process.

  • Can reduce the risk of injury in future exercise or games by preparing your muscles and increasing their flexibility.

Here are some examples of what you can incorporate in a cool down:

  • A 5 minute light jog or walk.

  • Deep breathing.

  • Upper body drills, such as low impact arm swings and shoulder circles.

  • Walking lunges.

Stretching should include:

  • Hamstring

  • Quad

  • Calf

  • Hip

  • Glutes

  • Triceps

  • Back (the cat stretch is good).

  • Shoulders

10-12 minutes in enough time for the entire cool-down.

Injury prevention, pre-hab, warm ups and cool downs are important for ALL rugby players, regardless of the level you play. We can’t really iterate this enough! Please do come and see us and put yourself in the best position to remain injury free this season. And, most importantly (nearly), enjoy the World Cup!


British Journal of Sport Medicine


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