Shoulder injuries are common in rugby: up to 15-20% of all rugby injuries involve this part of the body.
The most common shoulder injury is an acromio-clavicular (AC) subluxation (separation). This usually happens after falling on the shoulder after being tackled or due to a direct collision from an opponent. This sudden impact causes the scapula (shoulder blade) to push down which stretches the ligaments away from the clavicle (collar bone). The injury can vary from a simple sprain (grade 1) to grade 3, 4, or 5, with grade 3 being by far the most common.
These injuries are usually treated conservatively, with initial management by the physiotherapist using ice, ultrasound and other pain relieving methods. These torn ligaments heal within a short period of time (mostly within 3 to 4 weeks) and as long as these ligaments are not heavily loaded, activities can be allowed soon. Lack of tenderness over the area the AC joint can be regarded as a sign for safe return.
An AC joint injury should not be confused with a shoulder dislocation where the head of the humerus is displaced from the shoulder socket.
Symptoms and signs include a visibly deformed shoulder, swelling and bruising accompanied by excruciating pain, an inability to move the shoulder joint and sometimes numbness or a lingering sensation from the neck which can radiate to the arm.
The shoulder dislocation should be reduced as soon as possible to decrease the chance of a chronic instability of the shoulder.
Rotator cuff injuries also occur fairly frequent in rugby players. Think back a few years to when Stormer player Jean De Villiers had a torn rotator cuff injury. The rotator cuff is a group of four muscles that performs the movement of the shoulder. Tears of these muscles or inflammation of the tendons that connects these muscles to the shoulder are the most common problems.
A fractured clavicle occurs when a player falls onto an outstretched hand or due to a hard tackle directed towards the shoulder. This causes severe pain and the immediate reaction of the player will be to hold the arm in pain. It is usually easy to detect a broken collar bone. Most fractures heal on their own and surgery is rarely needed.