Sports Injuries

Updated 16 October 2015

Rugby upper leg injuries

Rugby kickers are particularly vulnerable to an injury to the quadriceps as these are used extensively when kicking the ball. Backs are also at risk due to sudden sprinting.

Between 5 and 10% of all rugby injuries are leg injuries. Rugby kickers are particularly vulnerable to an injury to the quadriceps as these are used extensively when kicking the ball. Backs are also more at risk due to sudden sprinting.

The legs have powerful muscles.

They can be organised into four main groups:

- Quadriceps femoris and sartorius in the middle of your upper front leg – you use them to straighten your knee, and to lift your upper leg to your stomach. All four parts of the quadriceps are used in running, jumping, climbing and rising from a chair.

- The adductor group of six muscles on the inside of the thigh – you use them to close your legs

- The hamstring group of three muscles lies on the back of the thigh – you use them to bend your knee and to pull your upper leg backwards.

- The abductor muscles on the outside of the thigh – you use them to open your legs.

Injuries to the quads include contusions (bruising) and tears with varying degrees of severity. A grade one tear may only be felt after the game and can feel like a cramp.

A grade two tear will be felt right away and walking is painful. It throbs when the muscle is stretched or contracted.

A grade three tear involves the complete rupture of the muscle with excruciating pain. The player cannot walk and a depression in the thigh and a lump above that depression may be felt. Large bruising occurs.

Pulled hamstrings – you’ll feel it in your bum – are common sports injuries for sprinters. Grading of the injury is similar to those of the quadriceps.    

Iliotibial band syndrome is inflammation of the band of strong tissue that originates from the outside of the pelvis and attaches to the outer part of the knee. It is typically an overtraining injury and occurs towards the end of a season.

Running in circles places considerable pressure on the iliotibial band. Pain or tenderness on the outside of the knee is the presenting symptom. and studies show a higher incidence in athletes

An associated condition is trochanteric bursitis which is inflammation of the sack of fluid (bursa) at the outside (lateral) point of the hip known as the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. This is a common cause of hip pain.

Symptoms of trochanteric bursitis typically are pain on the outside of the hip and thigh or in the buttock, pain when lying on the affected side, pain that gets worse during activities such as getting up from a deep chair, getting out of a car or when walking upstairs. There is tenderness on the outside of the hip.

If a bad muscle strain or contusion is neglected, or due to repeated injury, the player may be unlucky enough to develop calcification of the injured muscle called myositis ossificans. This is a complication due to blunt trauma of the leg muscles and happens in about 10% of cases.

Bleeding occurs within the muscle which can sometimes calcify.Bone will grow within the muscle two to four weeks after the injury and become mature bone within three to six months.

Causes are not clearly understood but seem to be when not applying cold therapy and compression immediately after the injury, having intensive physiotherapy or massage too soon after the injury or returning too soon to training after exercise.

Symptoms of myositis ossificans include pain when using the muscle and a restricted range of movement. A hard lump can sometimes be felt in the muscle.


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Sports Injuries Expert

Adrian Rotunno is a medical doctor in the Sports & Exercise Medicine fellowship at the Sports Science Institute of South Africa, and qualified physiotherapist. Team physician for Dimension Data pro-cycling, and Boland Rugby. Special interests include endurance sport, in particular cycling, as well as contact sports.

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