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Rugby injuries to the shoulder

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Rugby injuries

The shoulder is prone to injury in rugby, this occurs in several situations

  • Direct impact
  • Fall onto point of shoulder
  • Fall with arm out to the side.

Direct impacts may cause injury to the muscles such as deltoid, pectoralis major and trapezius, localised bruising may occur and recovery will be quick. In more severe injuries the internal structures of the shoulder may be damaged. Over half these injuries result in dislocations of the shoulder. There are several different things that can be damaged such as:

  • Anterior or posterior labral tears
  • SLAP lesions
  • Bone injuries
  • Rotator cuff tears

The picture shows a torn anterior labrum

In a fall onto the point of the shoulder the AC joint is at risk. This can be sprained or actually dislocated.

In a fall with the arm out to the side the risk of labral injury is high and if force is sufficient then the shoulder will dislocate. The player will complain of severe pain and difficulty moving in the arm, the shoulder will looked squared off as the numeral head sits anteriorly.

In contact athletes there are higher rates of co-existing injuries such as Rotator cuff injury; Boney bankart lesion and Neurological lesions.

In adolescent rugby players there is a higher rate of clavicle fractures and proximal humeral fractures. Localised pain an crepitus should be assessed and X-rays performed.

Pectoralis major muscle rupture.

This is a rare occurrence but should not be overlooked. Mechanisms can occur with eccentric muscle contraction or when the arm is forcible ripped away from the body as could happen in a contact situation. Localised bruising on the chest wall with bunching of the muscle and bruising tracking down the upper inner arm are the hallmarks of this injury. Diagnosis and exact location of the injury ie tendon insertion or muscle belly rupture are confirmed with MRI scanning.

Should the tendon insertion on the humerus be damaged then consideration is given to early surgery.

Andrew Brooksbank

Febuary 2012

 

 

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