Journal of Orthopaedic Surgery and Research | |
Shoulder injuries in professional rugby: a retrospective analysis | |
Christer G Rolf3  Elizabeth M Fowler2  Ian G Horsley1  | |
[1] English Institute of Sport, Sports City, Gate 13, Rowsley Street, Manchester M11 3FF, UK;Centre for Rehabilitation and Human Performance Research, University of Salford, Fredrick Road, Salford M6 6PU, UK;Department of Orthopaedic Surgery, Clintec, Karolinska University Hospital, Karolinska Institutet, Stockholm 171 77, Sweden | |
关键词: Arthroscopy; Superior labrum; Shoulder; Rugby; | |
Others : 817771 DOI : 10.1186/1749-799X-8-9 |
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received in 2011-10-11, accepted in 2013-04-05, 发布年份 2013 | |
【 摘 要 】
Background
In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder.
Objective
The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest.
Method
This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome.
Results
The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort.
Conclusions
Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in this population in order to confirm treatable diagnosis on the painful shoulder and expedite a safe return to play.
【 授权许可】
2013 Horsley et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140711021718871.pdf | 359KB | download | |
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Figure 1. | 27KB | Image | download |
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【 参考文献 】
- [1]De Beer J, Bhatia DN: Shoulder injuries in rugby players. Int J Shoulder Surg 2009, 3(1):1-3.
- [2]Holtzhausen LJ: The epidemiology of injuries in professional rugby union. Int SportMed J 2001, 2(2):1-13.
- [3]Gissane C, Jennings D, Kerr K, White J: Injury rates in rugby league football: impact of change in playing season. The Am J Sports Med 2003, 31(6):954-958.
- [4]Headey J, Kemp S: The epidemiology of shoulder injuries in English professional rugby union. The Am J Sports Med 2007, 35:1537-1543.
- [5]Fowler EM, Horsley IG, Rolf CG: Clinical and arthroscopic findings in recreationally active patients. SMARTT 2010., 2(2) BioMed Central Full Text
- [6]O’Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB: The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med 1998, 26:610-613.
- [7]Jobe FW, Jobe CM: Painful athletic injuries of the shoulder. Clin Orthop 1983, 173:117-24.
- [8]Hawkins RJ, Kennedy JC: Impingement syndrome in athletes. Am J Sports Med 1980, 8:151-7.
- [9]Gilcreest EL: Dislocation and elongation of the long head of the biceps brachii. An analysis of 6 cases. Ann Surg 1936, 104:118-38.
- [10]Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ: SLAP lesions of the shoulder. Arthroscopy 1990, 6:274-279.
- [11]Rowe CR, Zarins B: Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am 1981, 63(6):863-872.
- [12]Sillman JF, Hawkins RJ: Clinical examination of the shoulder complex. In The Athlete’s Shoulder. Edited by Andrews JR, Wilks KE. New York: Churchill Livingstone; 1994.
- [13]Gerber C, Krushell RJ: Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br 1991, 73:389-94.
- [14]Neer CSI, Foster CR: Inferior capsular shift for Involuntary inferior and multidirectional instability of the shoulder. J Bone Joint Surg 1980, 62(A):897-908.
- [15]Webb J, Bannister G: Acromioclavicular disruption in first class rugby players. British J Sports Med 1992, 26(4):247-248.
- [16]Seward H, Orchard J, Hazard H, Collinson D: Football injuries in Australia at the elite level. The Med J Australia 1993, 159:298-301.
- [17]Gerrard DF, Walker AE, Bird YN: The New Zealand rugby injury and performance project II. Previous injury experience of a rugby-playing cohort. Br J Sport Med 1994, 28:229-233.
- [18]Brooks J, Fuller C, Kemp S, Reddin D: Epidemiology of injuries in English professional rugby union: part I match injuries. British J Sports Med 2005, 39:757-766.
- [19]Hughes DC, Fricker PA: A prospective survey of injuries to first-grade rugby union players. Clin J Sports Med 1994, 4:249-256.
- [20]Garraway WM, Lee AJ, Hutton SJ, Russell EBAW, Macleod DAD: Impact of professionalism on injuries in rugby union. British J Sports Med 2000, 34:348-351.
- [21]Bird YN, Waller AE, Marshall SW, Alsop JC, Chalmers DJ, Gerrard DF: The New Zealand rugby injury and performance project. V. Epidemiology of a season of rugby injury. British J Sports Med 1998, 32:319-325.
- [22]Sakoet I, Noakes TD: A high rate of injury during the 1995 Rugby World Cup. South African Medical J 1998, 88:45-47.
- [23]Wilson BD, Quarrie KL, Milburn PD, Chalmers DJ: The nature and circumstances of tackle injuries in rugby union. J Sci Med Sport 1999, 2(2):153-162.
- [24]Durie RM, Munroe AD: A prospective survey of injuries in a New Zealand schoolboy rugby population. NZ J Sports Med 2000, 28:84-90.
- [25]Garraway M, Macleod D: Epidemiology of rugby football injuries. Lancet 1995, 345:1485-1487.
- [26]Bathgate A, Best JP, Craig Jamieson M: A prospective study of injuries to the elite Australian rugby union players. British J Sports Med 2002, 36:265-269.
- [27]Gabbett T: Incidence of injury in semi-professional rugby league players. British J Sports Med 2003, 37:36-44.
- [28]Brooks JHM, Fuller CW, Kemp SPT, Reddin D: Epidemiology of injuries in English professional rugby union: part II match injuries. British J Sports Med 2005, 39(10):767-775.
- [29]Funk L, Snow M: SLAP tears of the glenoid labrum in contact athletes. Clin J Sports Med 2007, 17(1):1-4.
- [30]Winge S, Jorgenson U, Nielson AL: Epidemiology of injuries in Danish championship tennis. Int J Sports Med 1989, 10:368-371.
- [31]Sahrmann SA: Diagnosis and Treatment of Movement Impairment Syndromes. Missouri: Mosby; 2000.
- [32]Jull B, Barrett C, Magee R, Ho P: Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 1999, 19(3):179-185.
- [33]Comerford MJ, Mottram SL: Movement stability and dysfunction–contemporary developments. Man Ther 2001, 6(1):15-26.
- [34]Wilk KE, Reinold MM, Dugas JR, Arrigo CA, Moser MW, Andrews JR: Current concepts in the recognition and treatment of superior labral (SLAP) lesions. The J Orthopaedic and Sports Physical Therapy 2005, 35(5):273-291.