Rugby Shoulder Injuries

Cameron Hatrick

Many of us will experience shoulder pain at some point in our lives, but for rugby players, a shoulder injury can stop them playing the game they love. Shoulder specialist Cameron Hatrick from Spring Orthopaedics explains more.

The problem with shoulders is that they are vulnerable to damage from heavy impact. The joint consists of a large ball on a shallow, relatively small socket which allows for a great degree of movement but makes it unstable.

The joint is stabilised as far as possible by the capsule and ligaments, which surround the ball and socket, the labrum (a rim of gristle which deepens the socket and to which the capsule and ligaments are attached) and the muscles around the joint (known as the rotator cuff) which work to balance and counteract the forces on the joint.

How do injuries occur?

Overhead sports which involve continuously reaching up with your arms, can damage the shoulder joint through repetitive small injuries resulting in ‘wear and tear’. Shoulder injuries in rugby, however, are usually caused by a violent event, either by a fall on an outstretched arm or a direct blow to the side of the joint such as during a tackle. In fact, about 50% of shoulder injuries occur during a tackle.

What treatment is available?

Treatment will vary considerably for different problems so the most important step in treating your shoulder pain is to get the right diagnosis.

If your pain follows a relatively minor injury or comes on gradually, then you should see your GP or a local physiotherapist. For milder injuries, they will give you advice about modifying your activities and show you exercises to address your problem. Occasionally they will give you a steroid injection which can reduce pain caused by inflammation.

For a structural tear of the labrum or the shoulder tendons, surgery is normally required. Keyhole surgery under general anesthetic can be performed unless the injury is severe enough to require open surgery. Occasionally there is some damage to the bone of the joint, requiring a ‘bony’ procedure to augment the repair. This is more common if the joint has completely dislocated a number of times.

What is the recovery?

Following surgery, patients will undergo a programme of physiotherapy to restore stability and strength to the joint. It can take up to six months before they can return to contact sports whilst they regain power and range of motion in their shoulder.

Unfortunately, rugby players will always be at risk of shoulder injuries despite their best efforts. Building the muscle around the joint or even wearing pads combined with good technique is their best bet for avoiding serious damage; or they could always take up golf!