Shoulder injuries in rugby

An increase in the frequency and severity of shoulder injuries in rugby has been noted and this realisation has prompted guidelines such as this one to be drawn up as a guide for the coaches, physiotherapists and sport physicians caring for the players on the field. Of equal importance is that younger players are playing more competitively and aggressively and the specific injury patterns in these players with immature skeletal structures should be realised.

Why have a “manual” on shoulder injuries in rugby, and not simply use the standard references on shoulder injuries? The reasons are that certain injury patterns occur in rugby specific to the sport and that the players have different requirements as far as rehabilitation and return to this high contact activity within a relative short period.

The most relevant structures of the shoulder to recognise as far as injuries are concerned are:

Superficial Anatomy

Trapezius muscle
The trapezius is the large muscle running from the neck to the shoulder and back

Acromio-clavicular (AC) joint
This is the junction between the collar bone and shoulder bone

Deltoid muscle
The large muscle at the upper and outer aspect of the arm which is the main muscle used to lift the arm

Rotator cuff tendon
This is also an important muscle and tendon to lift the arm and is situated deep to the deltoid

Sterno-clavicular (SC) joint
The junction between the breast bone and collar bone on the upper front part of the chest

Brachial plexus
The large set of nerves above the collar bone, which run from the neck to the shoulder and arm

Shoulder joint (Gleno-humeral joint)
This is the main ball and socket of the shoulder

Pectoralis major (Pec Major)
The large muscle on the chest which draws the arm towards the body

Clavicle (collar bone)
The collar bone supports the shoulder and can easily be felt under the skin