Rugby World Cup means more attention on rugby injuries

The drama and spectacle of the opening ceremony, the relief of England opening the competition with a win against Fiji, the shock and awe of Japan’s showing against the mighty Springboks; this World Cup looks set to be a fantastic display of world-class rugby and it’s a good time to take a look at rugby injuries for both the professional and weekend warrior.

Since the game turned professional in 1995, players at every level have had to adapt to a more demanding game to avoid injury; many studies have pinpointed the increase in injuries, the higher the standard of play.

Rugby is a full-on contact sport, so there are a number of potential injuries that can be incurred during a match, from the thigh, hamstring, head, neck and the knee. Although the knee is not necessarily the most common injury in rugby it is certainly among the most serious in terms of time out of the game. We’re going to focus on injuries to the knee.

What are the most common knee injuries incurred during rugby?

The most common knee injuries are damage to the ACL, the Anterior Cruciate Ligament, and the MCL or Medial Collateral Ligament. Both of these injuries result in lengthy time out periods from play or even force full-time retirement from the game.

The ACL is the main ligament that connects the thigh bone to the shin and the MCL is found on the inside of the knee. These ligaments work together to stabilise the knee, particularly from abrupt side-to-side motions. Injuries to the ACL and MCL are usually a result of falling awkwardly in a tackle as the knee moves in an ‘unnatural way’. The ligament becomes overstretched and ruptures – often players report a loud popping noise.

The knee will usually start to swell as blood vessels have also ruptured, but once the swelling has gone down the knee may feel relatively normal but as soon as it is put under pressure, as in a game scenario, it will often feel unstable and ‘give’.

How do we grade ligament injuries?

When players present for assessment of the knee ligaments we grade them depending on our physical assessment and their reporting of side effects.

• Grade one; the player will report mild tenderness in the knee area, but there is usually very little swelling. This means there has just been a minor tear in the ligament fibres.
• Grade two; the knee joint feels less stable when it is rotated and there may be more tenderness all around the knee and swelling present. There is more extensive damage to the ligament fibres.
• Grade three; the knee is very unstable, there is a lot of pain rather than tenderness or discomfort and a large degree of swelling. This points to a complete rupture of the knee ligaments.

If the player has a grade three ligament injury then there are a number of treatment options including ACL reconstruction surgery. For more information on knee treatment options, get in touch to book a consultation at either Mr Jonathan Webb’s Bristol or London clinics.