Mechanisms of traumatic shoulder injury in elite rugby players

Abstract

BackgroundShoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce.Materials and methodsTwenty-four elite rugby players, referred to the senior author for diagnosis and management of shoulder injuries, were selected. Videos of the injuries were independently reviewed by rugby-medical experts to describe the mechanisms of injury. The mechanisms reported were collated and analysed to determine the level of agreement between reviewers and conclude an overall description of injury mechanisms.ResultsThe authors identified three mechanisms of shoulder injury from the video analysis. These are the ‘Try-Scorer’, characterised by hyperflexion of the outstretched arm such as when scoring a try; the ‘Tackler’, extension of the abducted arm behind the player while tackling; and the ‘Direct Impact’, a direct blow to the arm or shoulder when held by the side in neutral or slight adduction. The Try Scorer and Tackler mechanisms both involve a levering force on the glenohumeral joint (GHJ). These mechanisms predominantly cause GHJ dislocation, with Bankart, reverse Bankart and superior labrum anterior–posterior tears. The Try-Scorer Mechanism also caused the majority (83%) of rotator cuff tears. The Direct Hit mechanism resulted in GHJ dislocation and labral injury in 37.5% of players and was most likely to cause acromioclavicular joint dislocation and scapula fractures, injuries that were not seen with the other mechanisms.ConclusionGreater understanding of the mechanisms involved in rugby shoulder injury is useful in understanding the pathological injuries, guiding treatment and rehabilitation and aiding the development of injury-prevention methods.

Investigation of traumatic orthopedic injuries in rugby players of Maranhão.

“…The injury occurs during are also caused in the tackle. (10) In the present study, this information is highlighted as it was pointed out that the main cause of injury situation is the tackle.…”

“…Crichton et al (10) in a study with 24 players in the semi professional in a period of four years and revealed that the shoulder was the joint often affected with a prevalence of 7.7%. The analysis of muscle activity patterns and isokinetic strength of semi professional rugby done by Bolton et al (11) showed that shoulder injuries are the most serious in this sport, accounting for almost 20%…”

Prevention Strategies of Shoulder Injuries

“…The most common mechanisms of shoulder injuries in rugby players were defined by Crichton et al (2012) as the "try-scorer," "tackler," and "direct impact" mechanisms.…”

Desempenho muscular isocinético dos ombros em atletas de rúgbi

“…O tackle é responsável por 50 a 85% das lesões do ombro. Lacerações do manguito rotador, lesões de Bankart, SLAP (Superior Labrum Anterior to Posterior Lesion, ou seja, lesão do lábio superior de anterior para posterior) e luxações são as consequências mais comuns dessa manobra [13,[38][39][40]. Além disso, o MND é o mais atingido porque os atletas protegem-se com esse membro enquanto carregam a bola com o MD [34].…”