Rugby injury? – It’s a POLICE matter.

In the build up to the Rugby World Cup and start of the 2015/16 rugby season around the corner we thought we’d offer a rugby themed post this month.

While the post focuses around rugby, there are some key take-home messages for other sports, regardless of the level of participation.

With the contact nature of rugby there’s a fair chance that at some point in the season an individual is likely to pick up some form of injury. Whether it’s big or small, here are some pointers as to how to best manage it in the initial stages so as to optimize your recovery.

How to manage an injury?

The foremost principle in injury management is to avoid them! By this, I don’t mean leaping out of the way of the opposition’s mammoth-sized No 8 rocketing through the air to fold you in half with a bone crunching tackle; but to regularly do some key exercises that activate certain muscle groups that will not only minimize your risk of injury, but also assist to enhance your performance. I’ll talk more about these later…

Traditionally the acronym PRICE (Protect, Rest, Ice and Elevate) has been central to the advice in managing acute injuries, however a more contemporary evidence base suggests a shift towards more modern acronym: POLICE (Protect, Optimally Load, Ice, Compress and Elevate). The key behind this change in advice is that while rest is important, it should only be for a limited period of time after injury and that resting for too long can actually inhibit recovery.

So what is it to POLICE an injury?

Protect

If moving or loading (putting weight through the affected area) causes excess pain it is advisable that immediately after the injury you should unload (by taking the weight off of it) and/or prevent movement of the affected area. The duration for this is variable depending on the severity of the injury, but usually it is expected to require up to 24 – 48hrs post-injury.

Optimally Load

Once again, depending on the severity, gradually start to introduce gentle movement and load as tolerated.

For example: If you injured your ankle and for the first few hours it hurt to move the ankle and to put your weight through it when walking, then don’t do it. However, it then started to feel more comfortable to move and put some weight through it again, you could start to do so again (as long as it doesn’t begin to cause more pain again).

Ice

Whilst the jury’s out and there are arguments for and against the use of ice following an injury, applying an ice pack wrapped in a damp towel (to prevent an ice burn to the skin) to the affected area for 10 minutes every 2 hours over the first 24 – 48 hours can assist in pain relief and reducing excess swelling which can impede recovery.

Tip: Wrap the ice pack around the injury with cling film to keep it in place for application.

With regards to pain relief, if necessary, it is advisable to take an analgesic, such as Paracetamol. However do not take an anti-inflammatory (such as Ibuprofen) within the first 72 hours following injury as this has been shown to impede longer-term healing if used in the initial stages of healing. Consult with a pharmacist or doctor if you are unsure about taking these medications.

Compress

Apply a compression bandage/ garment around the affected area to again help to reduce excess swelling.

Elevate

Keep the affected area elevated (ideally above heart height) to reduce swelling and maintain good circulation around the area.

Prevention exercises:

Here are a couple of exercises that can help you minimize your risk of injury and enhance your performance if you can do them on a regular basis – they won’t make you more skillful at what you do, but they may help you move better to perform your skill with greater speed/ control and/or precision. Please also bear in mind that each and every person is different and has different injury prevention needs, which can only be identified with a one to one assessment. These exercises below are ones I give in relation common rugby injuries:

Drawing the sword:

One for Rotator cuff (shoulder stabilizing muscles). Using a resistance band, hold the band in your hand with your arm across the body and thumb pointing down. Pull the band up and outwards (keeping your arm straight), rotating the arm through the movement so that your thumb now points behind you.

15 reps for 3 sets:

Side plank:

45 secs for 3 sets each side:

Lunges:

Aim to keep your hip, knee and foot controlled in alignment throughout the movement. Introduce weight if you can complete all reps and sets with control.

15 reps each side for 3 sets:

Hop and stick:

Hop (in different directions) controlling your landing by trying to stick on the one foot. Aim to keep your hip, knee and foot controlled in alignment on landing.

5 hops on each side for 3 sets:

A special mention on concussion

The topic of concussion is red hot in sport at the moment and is unfortunately too complicated to go into detail about in this blog post. However, I’d like to highlight it here as the importance of identifying and treating concussion appropriately cannot be stressed enough.

The RFU and World Rugby have put a lot of work into providing guidelines for rugby players, and I’d highly recommend following the link to have a look and take part in the interactive learning module for the general public (http://playerwelfare.worldrugby.org/concussion).

What next?

Once you’ve started to look after your injury the right way, it may start to settle down naturally or it may persist. If you sustain an injury you feel would benefit from having one of the physiotherapists at Complete Physios have a look at it, then please do not hesitate to get in touch and book an appointment.

Best of luck this season!

Paul

Paul is a top Rugby physiotherapist who splits his time between professional rugby at Wasps RFC and at Complete Physio. You can find him at our Angel clinic (www.complete-physio.co.uk/clinics/angel). To make an appointment, call 020 7482 3875 or email paul@complete-physio.co.uk.