Typical Injuries seen in a Redcliffe Dolphins season – Megan Kelly, Physiotherapist
Working as a physiotherapist for the Redcliffe Dolphins I often get asked by patients about the most common player injuries we see in the clinic. It’s a welcome question and gets me thinking about rugby league injuries, how they differ throughout the season and past injuries I’ve seen which stick vividly in my memory!
I have worked with the Redcliffe Dolphins for the past 5 seasons and James Handyside for 11 seasons and counting. With the Dolphins 2015 season fast approaching and the boys half way through their pre-season training I thought it would be appropriate to discuss common league injuries and give you an insight in to what we see in this area of physiotherapy.
Players return to pre-season training at the start of November, often a few kilos heavier either from an enjoyable few weeks off, or, from trying to bulk up with weights. Many are not physically ready for the amount of running they are about to endure, 3-4 times a week.
Pre-season training is focused on regaining fitness and strength. Game situation skills come later. With the combination of high running load and extra weight gain we see a lot of low back pain creeping in to the clinic. This responds well to manual therapy, a good stretching program & close monitoring of their running program.
During this time we can also see an injury called Osteitis Pubis (inflammation of the pubic symphysis). Causes include
- Recommencing exercise or increasing exercise intensity too quickly
- Exercising on hard or uneven surfaces
- Faulty foot and body biomechanics
- Tight muscles in the hips, groin and buttocks
- Muscle strength imbalances
Treatment of this condition includes
- Identifying the cause(s) for the inflammation
- Addressing these with appropriate treatment
- Decreasing their running load then slowly increasing it again as they are able. All of this involves a
lot of communication back and forward between the physiotherapists and the training staff at the Dolphins.
The off & early pre-season is a popular time for players requiring shoulder reconstructive surgeries to have these done. A strict rehabilitation schedule ensures that they are back out on the field as soon possible to train and prepare for the season ahead. Following surgery, when restricted to no running or upper body weights, they will be placed in a rehab group. Bike, rower, boxing, swimming and altered gym programs keep them moving until given the all clear to start running and upper body weights again.
As New Year arrives, so does an increase in contact training involving more tackling drills and physicality than in previous weeks. This often results in sore necks. Along with physiotherapy treatment, training and coaching staff are responsible for checking players technique and making necessary changes.
During the season we see a large array of musculoskeletal injuries. Being on the sideline for games allows us to assess injuries as soon as they come off the field. This can be crucial in making a correct diagnosis.
We usually see one or two of dreaded ACL (Anterior Cruciate Ligament) ruptures in a season. For anyone who has suffered this injury they know that it can be quite a tough prospect to swallow to realise your season is over and surgery is a necessity to keep playing in the future. Knee reconstruction surgery takes place fairly quickly and players begin their 6-9 month rehabilitation as soon as they come out of hospital.
Early treatment includes regaining full range of movement and quad strengthening exercises. As time progresses exercises become more functional & dynamic and running is slowly reintroduced once the graft has bonded strongly inside the knee.
Other injuries we see during the season include shoulder joint dislocations (both glenohumeral and acromioclavicular dislocations), concussion, elbow joint injuries (including dislocations), thumb sprains and fractures, hamstring tears, knee ligament strains and tears, meniscus tears and calf tears.
A Horror day!
One of the first games of the season in 2013 playing the Seagulls in Wynnum really sticks in my memory. On arrival I bumped into a guy from reserve grade who had just re-ruptured his ACL in his first game back after his reconstruction and 9 month rehabilitation. Needless to say he wasn’t feeling in the highest of spirits.
During the Queensland cup game a player fell and dislocated his elbow within the first quarter. Three of us (doctor, myself and James) relocated his elbow in the Doctors room before he was driven to the hospital for x-rays. 10 minutes later another of our players dislocated his elbow in a tackle and split his head open whilst falling to the ground, complicating his injury. Again we relocated his elbow and an ambulance was called for the head-injury he’d suffered. Some may go their whole career never seeing a dislocated elbow, and we had two in one game!
Only bumps and bruises?
Bumps and bruises need to be closely assessed to ensure that’s all they are. In a game at Dolphin oval one of our players walked off after being kicked in the shin. He complained of soreness and the trainer, assuming it was a hematoma (cork), wrapped it in ice and left him to sit out the game on the bench. With the team back in the sheds after the game I removed the ice and, palpating up the fibula bone on the outside of his lower leg, I felt the bone disappear! When I pushed on his leg with the palm of my hand I felt his whole bone move under my pressure. As he wasn’t in much pain and could walk everyone thought I was a bit crazy sending him to hospital for an x-ray. An hour later we got a call to say he had a clean fracture through the fibula. You can never be too careful in this game!
The Season Wears On
At this time we start to see overuse injuries rear their ugly head such as tendonitis to the Achilles and Patella tendons. These injuries need to be closely managed from all treating and training staff to ensure that the player can continue to play without disrupting the end of their season and possible finals campaign. As players can have faulty biomechanics, often our podiatrist colleagues at My Foot Dr are asked to assess. Video analysis of them walking and running is used so we can look at their styles in slow motion to create the best rehabilitation plan for them.
As finals approach in late September (which hopefully we are involved in!) we breathe a sigh of relief as the season ends for another year. Only four to six weeks rest and we start all over again!
Let’s hope that this year is a successful one for the Redcliffe Dolphins! We continue to love our involvement with such a great sporting club.