The most common rugby injuries, recovery time, treatment and tips
You take the pass and move up the (probably a bit muddy) pitch, the try line within sight! But in comes the tackle. You hit the ground and feel something give. But what? Don’t worry, we’re not going for have-you-been-injured-in-an-accident-that-wasn’t-your-fault vibes. Instead, we’re going to talk about the most common rugby injuries, their treatment and how to give yourself the best chance of making it through a match relatively unscathed.
So let’s rundown the main ones, likely causes, and some top tips on how to recover from them. We’ve grouped them into certain areas and then more general ones towards the end.
Before we get started, the main thing to remember throughout all of these is that if there’s a chance you’ve been injured then you should stop playing and see a doctor as soon as possible; many of these injuries can cause long-term issues if they go untreated.
- To ice or not to ice
- Shoulder injuries
- Knee injuries
- Ankle and foot injuries
- Head injuries
- Hand injuries
- Sprains, strains, breaks
- How recovery helps avoid injuries
To ice or not to ice
If you’ve ever twisted your ankle, then you’ve probably applied ice packs, or trusty frozen peas, to it to reduce swelling and pain. This has long been a central part of injury treatment, but there are some studies that suggest it could negatively impact some elements of the healing process.
By limiting blood flow to an area and numbing it, cold reduces swelling and pain, but this can also delay the body from beginning healing.
We’ll be honest with you here, the jury is still out on whether ice should be completely abandoned because although some inflammation is needed, too much swelling (which is linked to inflammation) is definitely bad and ice can limit that.
Bearing all this in mind, the best thing you can do is consult a doctor and see what they say. In the meantime, protect any injuries and rest until you receive expert advice. If you are going to apply something cold, do so immediately and over the first 24-72 hours for up to 20 minutes at a time.
Electrotherapy is another effective way to manage pain, swelling and inflammation and one that can be used just as easily as cold packs or frozen veg wrapped in a tea towel. It can even promote blood flow to the area, which can optimise recovery, and we’ll talk about this in more detail later.
Now, on to the injuries!
Common rugby shoulder injuries
If you’ve played rugby, and probably even if you haven’t, you’ll know that your shoulders are one of the main points of contact with other players, whether in the ruck, scrum or tackles - and have a tendency to fall onto them when tackled! It should come as no surprise then that they are one of the most commonly injured body parts in rugby.
What it is
A powerful impact, such as a tackle or fall, can cause the ball of the upper arm bone (humerus) to “pop” out of its socket. This is bad enough in itself, but the main problem is the extra damage that is caused to the surrounding cartilage, nerves, blood vessels, muscles, tendons and ligaments that make up the shoulder joint, keep the arm in place and help it move normally. Because of the physical nature of the game, this is one of the most common rugby injuries.
Fortunately, the humerus can be pushed back into place, although don’t try this yourself because there is a high chance of causing more damage if you do. A doctor can do it without surgery, but sometimes surgery may be necessary, usually if there is particular damage to the surrounding area.
Once your shoulder is back in place, it’s going to stay there for a while. Your doctor will put your arm in a sling for at least a week to give it time to begin healing without more disruption.
After the sling comes off, it’s time for rehab. Exactly what this involves will vary, but the aim is to help your shoulder regain strength and flexibility in a safe way - your doctor or physiotherapist will advise what’s suitable for you.
The other main focus of this shoulder dislocation recovery and treatment is strengthening the joint so that you don’t dislocate it again because it becomes more likely after the first time. Just think of your first trip out as a teenager and how the heady taste of freedom left you wanting more. That’s how your humerus now feels.
Recovery time for a dislocated shoulder can take roughly 12-16 weeks if you didn’t need surgery, but if surgery was needed then it can take up to 6 months.
A shoulder dislocation is going to stop you playing rugby for a while, but you can reduce how long. Professional rugby player Olly Butterworth suffered this very injury and although it put him out for a whole season of play, he managed to cut months off his recovery time by incorporating our technology into his recovery routine. Read about it in our interview with him. Spoiler: his doctor thought he’d been recovering for 3 months when it was really only 7 weeks!
AC joint separation
What it is
Also known as shoulder separation, or acromioclavicular joint separation if you’d prefer to use the full name, it’s an injury to the joint between the shoulder blade and the collarbone. This injury involves damage to the ligaments that support the AC joint and comes in six grades, with grade 1 being the least serious - often just a sprain - and grade 6 being the worst. That said, grades 4, 5, 6, and sometimes 3 all commonly require surgery to repair.
When the ligaments actually rupture or tear, rather than just a sprain, then it’s possible for the collarbone and shoulder blade to move around and become misaligned. If this is not corrected properly then it can lead to permanent deformity and loss of mobility in the arm.
As before, you need to rest the injury and protect it to avoid further damage.
If the injury is not bad enough to need surgery - remember to see a doctor to find out - then the next steps are usually keeping the arm immobilised with a sling and resting it. It’s then on to exercises to gradually get the joint used to moving again. Remember to always take these slowly and not push yourself too hard, otherwise you might just make the injury worse.
Grade 1 and 2 AC joint separations can take 2-6 weeks to heal and regain the full range of motion. Grades 3-6, however, can take much longer. A grade 3 without surgery may require 6-12 weeks, while surgery for all four grades can require up to 6 months for recovery time.
Once you do get back to playing, we’d recommend wearing some kind of brace to give your shoulder as much support as possible to lessen the chance of re-injury.
Common rugby knee injuries
Ah, the knees. A blowout here can put paid to the most promising of careers either immediately or over the long term as the result of chronic conditions like arthritis that start after an injury. The most common rugby knee injuries are of the three main ligaments - anterior cruciate ligament (ACL), medial collateral ligament (MCL), lateral collateral ligament (LCL) - and of the meniscus (the little rubbery, shock-absorbing disc in the knee).
The ACL, MCL and LCL have three grades of injury. Grade 1 is only mild damage and it can still function and heal by itself (but still protect it). Grade 2 is a partial tear that will still provide some function but will need more intervention, while grade 3 means the ligament has torn completely in half and is very serious.
What it is
The ACL - and MCL and LCL - are all vital for keeping the knee working as it should and preventing it from moving too far in any one direction. The ACL’s job is, essentially, to prevent the knee rotating too much, as well as to hold the shin in place.
Injuring the ACL is extremely common and is usually the result of a sudden impact, although it doesn’t have to just be colliding with someone. A study found that 57% of ACL injuries in rugby players were the result of contact with another player, while the majority of non-contact causes came from side-stepping. A sudden change of direction can put the leg under a lot of stress, which can cause harm.
Even if the ACL doesn’t immediately tear, damage can build up over time until it finally gives. And what’s more, grade 2 tears of the ACL are rare, it usually tears completely.
Regardless of the cause, once the ACL tears, your range of motion will be greatly reduced and it’ll be extremely difficult to do several everyday activities.
Aside from rest, immobilising the joint, managing the pain and swelling, the next big decision is whether to have surgery or not. For a grade 1 ACL injury, you don’t need to have surgery, just rehab and rest.
For grades 2 and 3, the chance of regaining full function is much higher if you have surgery, and this is obviously essential for professional athletes. If you don’t have surgery after an ACL tear, then your knee will likely remain unstable and there is a risk of further injuries.
Before surgery, you need to wait for any swelling to go down so that you have the full range of movement back and to strengthen your thigh muscles as much as possible. This will increase the chances of an easy recovery.
Both before and after surgery there will be a range of exercises that you can do - you’ll normally be referred to a physiotherapist who can help you with these.
Once you’ve had surgery, you’ll be on crutches for a couple of weeks. During this time, your knee will be painful and swollen, but there are ways to manage the pain and inflammation. You can take painkillers or use our technology to instantly tackle the pain and reduce the chances of inflammation getting out of control.
After the swelling has gone, get ready for more exercises and gradually increasing your activity levels! Cycling and swimming are both good ways to still get moving as they don’t involve twisting of the knee.
Grade 1 takes about 2-4 weeks to recover from. Grades 2 and 3 take roughly 6 months, but there is a great degree of variation in how much improvement you experience during this time, and it can take longer to get back to full fitness.
What it is
Like the ACL, the MCL is responsible for keeping your knee stable and controlling the sideways movement of your knee. The main ways of injuring it are by twisting your knee or if it gets pushed inwards, towards your other leg, which can happen when tackled or in a collision with another player.
Again, repeated stress can lead to an MCL injury later on. Fortunately (well, fortunately-ish), an MCL injury is not as severe as one to the ACL, thanks to it being not as important as the ACL and the MCL being on the outside of the knee rather than the inside.
One of the things to note is that an injury to your knee may well have injured multiple ligaments, so it’s not uncommon for the ACL to be hurt as well.
Because MCL injuries aren’t usually as damaging as ACL ones, it can heal faster and without as much intervention. Surgery may still be required, but often only in the case of a complete tear (grade 3).
Grade 1 and 2 injuries to the MCL can be managed with rest and physiotherapy later on. Even so, if you play professionally then you might want surgery even for a partial tear (grade 2) as you’ll be putting more pressure on it when back on the pitch.
As ever, if you do have surgery then it will require physio exercises before and after and a longer rehabilitation process. Whether you have surgery or not, wearing a knee brace wouldn’t be a bad idea as it will support you when you’re moving around, and you might want to use crutches for the first few days or weeks to keep weight off it.
If the ACL is hurt as well, this will make things more complicated and probably require surgery.
A grade 1 MCL tear can heal by itself in about 1-3 weeks, a grade 2 can take 2-4 weeks, while a grade 3 will take longer due to the need for surgery, so usually 6 months.
What it is
Not so much to say here. The LCL is really very similar to the MCL, just that it’s on the outside of your knee rather than the inside. The LCL is injured less frequently than the MCL but, when it is injured, it’s often along with other structures in the knee because the outside edge is more complex.
The main way for the LCL to be injured is if your knee is pushed outwards, so the opposite of the MCL. Moving the knee this way is much less common, as most impacts in rugby (and life in general) are going to be hitting from the outside and pushing the knee in.
Pretty much the same as treatment for MCL injuries. If other bits of the knee have been damaged as well, then surgery may be needed even if the LCL wasn’t too badly damaged.
A grade 1 LCL tear can heal in about 3-4 weeks, grades 2 and 3 can take 8-12 weeks, but if you have surgery then it will take around 6 months.
What it is
The meniscus sits between the bones of the thigh and the bones of the lower leg and acts as a shock absorber. Each knee actually has two menisci, one on the inward side and one on the outward side.
Meniscus tears have the same three grades as the ligament injuries above - consistency makes all these injuries much easier to discuss - and most commonly occur when the knee suddenly twists while the foot is planted in the ground. Beware your studs getting stuck in a muddy pitch!
As before, grades 1 and 2 are a sprain and a partial tear respectively, while grade 3 is a complete tear.
Grade 1 and grade 2 meniscus tears can heal without surgery, so long as the injury is not too severe, so that means the usual regime of rest, protecting your knee (keep weight off!), inflammation control, and physiotherapy.
Grade 3, however, will generally require surgery. There are three main options when it comes to surgery for a meniscus tear: repair, removing part of the meniscus (partial meniscectomy), removing all of the meniscus (total meniscectomy).
And then after surgery you will need to rest and recuperate as well! Your physio and doctor will give you exercises to do that will strengthen and support your ankle and the muscles around it, but remember not to be too vigorous and take it slow.
Surgery does give a lower chance of injury occurring again and may be a preferred choice in younger patients where keeping as much function of the meniscus as possible is important.
As with other knee injuries, a really bad one might mean that you have damaged more than just the meniscus, so surgery to fix multiple areas may be required.
If you didn’t have surgery, then recovery time for a meniscus tear can be around 6-8 weeks. If you go down the surgery route then there is some variation.
Interestingly, it takes longer for a meniscus repair to heal (up to 3 months but sometimes longer) than partial or total removal (around 6 weeks plus rehab time).
Common rugby ankles and feet injuries
Moving down the leg, we get to the ankles and feet.
Peroneal tendon injuries
What it is
You have two peroneal tendons in each foot. They go behind the ankle then one attaches to the bottom of the foot, the other to the upper outer part. Their main purpose is to provide support when bearing weight to prevent strains. But in doing so, they can become injured themselves! As with everything in the human body, it’s a balancing act.
There’s a range of injuries that the peroneal tendons can suffer from and in rugby these will often result from inversion ankle sprains, which is when your foot rolls inwards. If you’re sitting down while reading this, you can probably gently try to put the outside edge of your foot flat on the ground to imagine how painful this is. But you can also just take our word for it. In rugby, an ankle sprain like this could easily happen while you’re running and the pitch is a bit uneven (who hasn’t played on an uneven pitch at some point?).
The main types here are: tendonitis (inflammation of one or both tendons, causing pain and swelling); the tendon tearing; or something called subluxation, where the tendons move out of place, which is very much not good as it prevents you from raising your foot.
For tendonitis, all you can really do is rest and avoid putting any weight on the foot and let it heal by itself - although that doesn’t mean you shouldn’t use something for the pain or swelling.
If a peroneal tendon tears, then it could be partial or complete. If it’s partial, then it will likely heal with rest and physiotherapy - still see a doctor, obviously - but if the tear is a complete one then surgery will be needed to repair it.
Subluxation cannot heal on its own! It will need some kind of intervention from a doctor, and although there are situations where a special regime of exercises can do the trick, this is rare. The majority of cases will require surgery. After that, just follow the normal procedures for recovering from surgery: rest and the recommended exercises and motions.
In all cases, an ankle brace is a great way of keeping your foot immobilised and protecting it. But remember to take it off before bed and that, if it doesn’t hurt too much (and your doctor says it’s ok to do so) then you should regularly try to move the joint around a bit to prevent it getting stiff.
Peroneal tendonitis takes about 6-8 weeks to heal. A peroneal tear can take around 3-4 months to recover enough to start using it again, but it is possible for it to take much longer and, as ever, any surgery will add to that. Speaking of surgery, subluxation full recovery will take about 6 months, but rehab will begin after approximately 6 weeks.
Achilles tendon injuries
What it is
The Achilles tendon - named for the ancient Greek hero of the Trojan Wars - is the strongest in the human body and is part of what gives us power when we walk, jump or run. As it is a tendon like the peroneal tendon, the injuries it can suffer are similar, primarily tendonitis and tearing.
Overuse or repetitive motions can bring on tendonitis, along with trying to do too much of a type of exercise too soon. This means that if you’re just getting into rugby, don’t push yourself too hard early on, but instead build up the intensity of your activity. It also makes proper training and warm up more important to get your body used to these motions. As for overuse, sadly there isn’t much that can be done to prevent it other than properly recovering.
Tearing can be partial or complete, as in the other cases we have looked at, and these require more intense treatment.
All you can really do for tendonitis is to rest, try not to use the affected area, and then gradually resume exercises once it is not as painful and the swelling has gone down. Exercises that strengthen your calf muscles can help reduce the pressure on your Achilles tendon, but those may need to come later. Low-impact forms of exercise like swimming and cycling are also a good idea to keep active without putting too much strain on it.
For a partially torn Achilles tendon, you may not need surgery, but a fully torn one likely will. If you do have surgery, you will then need to take part in physiotherapy to strengthen your leg and ankle to help with the recovery.
Tendonitis of the Achilles tendon can take a long time to heal - up to 6 months. You should avoid using it as much as possible during the first 8-12 weeks, after which point physiotherapy exercises can begin.
Recovery for an Achilles tendon tear is equally lengthy. You might be back on light activities in around 4-6 months, but returning to high-impact activities like rugby could take longer and it might be a year before you are at the same level as you were.
What it is
Challenging to pronounce, that’s what it is (should sound something like “fash-ee-i-tis”). Phonetics aside, plantar fasciitis happens when a large piece of tough tissue on the bottom of your foot becomes inflamed. This tissue, the plantar fascia, connects your heel bone to your toes and is important during walking.
There are several things that can lead to this issue, including shoes without the right support, overuse, foot structure, and the surfaces that you walk on. The plantar fascia takes pressure when you’re standing or walking, and over time can lose its elasticity and become tense, which causes the pain.
The good news is that surgery is rarely needed, although can be an option in very severe cases. Otherwise, the best treatment involves stretching and other exercises, along with pain management and anti-inflammatory treatments. You should also be resting your foot and trying to keep pressure off it - you might want to consider shoes with more support.
There are also certain rugby boots and insoles that can give your feet more support and reduce the chance of plantar fasciitis.
For most people, plantar fasciitis will heal by about 6 months, but for some it can take as much as a year to fully recover.
Common rugby head injuries
There’s just one main injury here (though broken noses are another frequent rugby injury).
What it is
One of the most common head injuries in rugby - occurring roughly once in every two or three games for professionals - a concussion is usually caused by an impact to the head. This doesn’t necessarily damage the structures of the brain, but does cause problems with how it functions, which can include problems with balance and memory, headaches, and confusion. These can last for days or weeks and normally should get gradually better.
Unhelpfully, there is not a great deal that you can do for a concussion. Obviously, if there is a chance you have suffered one while playing rugby then you should stop playing immediately and see a doctor. They will be able to diagnose you and advise on what to do.
You will likely be advised to rest for the first 48 hours, both physically and mentally. You shouldn’t spend your whole time in a dark room doing nothing as that won’t help your recovery, but limiting the amount of time you spend doing things that require lots of concentration or action is good. This means limiting video games, watching TV, reading, etc., particularly if they start to cause you pain.
Otherwise you just have to wait and gradually increase the amount of activity as you feel able to and take pain relief.
Most concussions get better in 7-14 days. If it takes longer, see a doctor again.
Common rugby hand injuries
Throwing the ball, catching the ball, hitting the ground, fending off tackles, holding onto your teammates (or the opposition) in the scrum - just some of your hand’s duties during a rugby match. Sadly, injuries are partly inevitable.
What it is
You go to tackle that guy or girl and grab onto their top (or jersey - you can probably see where this is going). But then they break free of your tackle!
As they break away, their jersey slips out of your grip and your fingers rapidly extend, pinging backwards. Your fingers might bend slightly backwards due to the sudden release and this can cause the tendon along the underneath of the finger, connecting the muscle to the fingertip to detach (or the tendon stays on but some of the bone breaks off instead…).
Hence the name, jersey finger.
Curiously, it most commonly occurs in the ring finger. If you’re wearing a ring on the affected finger, take it off as it can make any swelling worse.
This is not a pleasant injury, and usually needs surgery to repair - unless you were lucky and the tendon didn’t tear - otherwise you won’t be able to bend the finger properly anymore. This should be within around 10 days of the injury occurring for the best chances of recovery.
After surgery, your finger will be in a splint for about 6 weeks, during which time you can gently move the finger but should not try to straighten it completely as this can cause the tendon to detach again.
If there was no tear or it was only partial, then rehabilitation with exercises and managing pain and swelling may be enough.
It’ll be about 3 months until you’re back doing any kind of contact sport but it can be longer than this, depending on your doctor’s advice.
What it is
A bit like jersey finger, but on the other side. Where jersey finger damages the tendon on the underside, mallet finger damages the tendon along the top of the finger and makes it so that you can’t straighten your finger.
This might happen where something - ball, other player, ground - hits your fingertip while it is stretched out and suddenly bends the fingertip in towards your palm.
Mallet finger can often heal reasonably well with just applying a splint, you tend to only need surgery if the bone has broken as well. Sometimes you might not regain the full range of motion in your fingertip, but if the tendon fails to repair itself then you can wear a splint again. If it still refuses to heal, surgery may be an option.
6-8 weeks of wearing the splint should be enough but full function may not return until 3-4 months later. If surgery is needed then it will naturally take longer.
Other common rugby injuries - sprains, strains, and breaks
We’re bunching these all together in one category because, although they can happen in different parts of the body and having some variations in recovery time and severity, they all follow much the same principle. Although these are common rugby injuries, you’ve likely encountered them in other sports as well.
Sprains and strains
What they are
Sprains and strains are similar to things we’ve already talked about but the ones above are the main risk areas. Incidentally, a sprain is when the tissue connecting bones to each other is injured, but a strain is when the tissue connecting a muscle or its connection to a bone is injured.
The ACL tear is an example of a sprain. They come in three grades of severity depending on if they are stretched, partially torn, or completely torn.
Common ones include hamstring and ankle sprains.
Rest, protecting the injured area, and managing the swelling and pain are the main treatment options for sprains and strains. If the injury is grade 2 or 3 then it might require surgery. In both cases, rehabilitation exercises can help you get back on your feet (pun slightly intended) and strengthen the damaged area.
Usually 3 weeks - 3 months, depending on severity of injury. If surgery is needed then it can take up to 6 months.
Breaks and fractures
What they are
Actually, these are both the same thing, just different terms.
They both refer to the damage to your bones when injured, and can either be a complete break or “just” cracked. The collarbone is something that is commonly damaged in rugby as it connects to the shoulder and is in a position that undergoes several impacts and collisions, as well as being affected by damage to the shoulder itself.
Thumbs and ankles are other common sites of fracture.
As ever, you need to rest and protect the injury. Consulting a doctor is essential to understand the severity of the injury.
If the bone has broken completely, then treatment usually involves putting the bones back into the position they should be, which might need surgery and even pinning of the bones together, and then immobilising the area while they reknit. You may well get a plaster cast - friends and family signing it are optional - after which it is a case of waiting, unfortunately.
Once the cast comes off, rehabilitation exercises are likely going to be needed. These aren’t for the bone itself, so much as the muscles that will have also been doing less while the cast was on, and are therefore weaker.
A fracture may need a cast as well if serious, but sometimes just a splint or sling will be enough.
We’ve caused ourselves some problems by generalising this section because this can vary wildly based on which area is damaged. A minor fracture might take 6-8 weeks but a broken leg could take 5-6 months to heal.
Recovery and the power of (p)rehab
Avoiding injuries is not always possible. As Olly Butterworth says, you have to always give 100% on the pitch, which means that damage will sometimes occur. But if you have a good recovery and preparation (or prehab) routine, then you can make sure your body is in the best condition possible.
We’re sure you know the importance of stretching before and after a game, as well as regular training, staying hydrated and proper nutrition. You may even be working with a professional trainer - if you’re not, have a look and want to build your strength then have a look at these exercises to get some great results.
But one thing that you really should work into your routine is NuroKor Lifetech. Our technology optimises your recovery, which helps you recover more quickly and make bigger gains at the same time. If you read our interview with Olly Butterworth, you’ll also see that it can cut your recovery time from injury substantially, allowing you to get back to playing sooner.
We hope you’ve found this useful, but let us know if there’s anything else you’d like to know!
All the information provided in this article is for information purposes only and does not constitute medical advice. If there is a chance you have been injured then you should seek professional medical advice as soon as possible.