Kicking rugby players’ knee injuries into touch
According to the Professional Rugby Injury Surveillance Project, there were 447 match injuries that led to time lost from training and/or match play in the 2015-16 English professional rugby season. Encouragingly, there was a fall in match injury incidences but it remains a dangerous sport, with injuries to the knee – specifically Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL) injuries – still some of the most common, only exceeded by concussions. Just recently, Rhys Webb was ruled out of Wales’ Six Nations team with a knee injury.
Unfortunately, knee ligament injuries in rugby are extremely common, and pretty much everyone involved in the sport will know someone who’s had some kind of knee ligament injury or knee surgery. The key factor in ensuring a successful recovery is to take the appropriate time out to rest and ensure players receive the right treatment for them.
It’s the nature of the game — high energy, full contact, hard impact. Part of the problem nowadays is that players are so big and so strong, and the speed of the game is so fast, that players are literally smashing themselves to bits. They’re effectively storing up huge problems for themselves for when they get older, with a terribly high rate of neck arthritis and major knee problems.
There are a number of different types of knee ligament injury that can be sustained from rugby, ranging from small things like a minor sprain of the MCL to major injuries such as an ACL tear. With higher energy injuries it’s actually possible to tear multiple ligaments and even dislocate the whole knee joint, which can be catastrophic.
Most knee ligament injuries occur unexpectedly, from someone landing on a player’s leg in a ruck whilst their leg’s in an awkward bent position, or from tackles from the side where the tackler’s shoulder impacts on the side of the player’s leg, where the forces involved can be huge.
In these situations, there’s pretty much nothing you can do to prevent a ligament snapping, as the forces can be like being hit by a car! However, to minimise the overall risk of any kind of injury, the most important thing is to train sufficiently in order to ensure that you’re as fit and strong as possible before you go onto a pitch. The stronger the muscles are and the faster your reflexes, combined with having good posture and good biomechanics, the less likely you are to sustain an injury.
In terms of what to do once you sustain a knee injury, the most important thing is to take knee injuries seriously! Fundamentally, with any significant injury, you should get it looked at properly, and if there’s any concern about anything potentially serious then the best thing is to be seen by a specialist (an experienced physiotherapist or a specialist knee surgeon) and to have a high-res high quality MRI scan (a 3T MRI) — to see exactly what the potential damage actually is.
If you’ve damaged your knee, you also need to consider very carefully the timing of when to return to play after injury. You should listen carefully to your knees, be gentle with your joints and avoid anything that hurts or aggravates your symptoms in any way.