Shoulder injuries suggest size matters
Wayne Smith | October 26, 2009
Article from: The Australian
SHOULDERS are becoming the new knees in rugby, causing Wallabies coach Robbie Deans to ponder how much longer the game can remain faithful to its charter of being suitable to players of all shapes and sizes.
Knee injuries have long been the most common in rugby but research conducted by England's Rugby Football Union over the past seven years of injuries sustained in the club premiership season and in national elite squads has established that shoulders are becoming the new hot spot.
According to London's The Sunday Times, of the 1000 injuries reported by the premiership clubs and the various England squads each season, one-fifth are to the shoulder. While there is a slightly greater incidence of knee injuries, shoulder dislocations now account for more playing days lost than any other injury.
Phillip Duke, the orthopaedic surgeon of choice for the Wallabies and the Queensland Reds, said the number of shoulder operations he is performing on rugby players has doubled in the past five years.
"It's not just the number of operations that has doubled, the problem itself has doubled," Duke said. "More players are having surgery but that is not necessarily because we are getting better technically, but because players, coaches and medical staff are now more aware that shoulder injuries just keep getting worse. In the olden days, you'd end up with an arthritic shoulder.
"But now if you're a player with a shoulder injury, you might as well face up to it and get it fixed, even though that means six months out of the game with a full reconstruction."
But, really, professional players have no option but to submit themselves to surgery. With many coaches setting their players hefty benchpress targets to ensure they boost their strength, any contracted footballer whose injuries regularly prevent him from working out in the gym will soon find himself forced to seek new employment.
Yet even those players who comply with their coach's instructions can quickly come to grief, with Duke nominating a Wallabies centre of fairly recent vintage who suffered a severe injury when he followed orders to increase his benchpress weight load from 95kg to 125kg. "When I asked him why on earth he had done that, the player replied 'Coach (name withheld) told me to'," Duke said.
Deans - not the coach involved - was not surprised by the England statistics but he wasted no sympathy for his England counterpart Martin Johnson who has lost prop Andy Sheridan, fullback Delon Armitage, centres Riki Flutey and Jordan Turner-Hall and flanker Tom Rees for the November 7 Twickenham Test against Australia, all because of shoulder injuries.
"Well, we lost four second-rowers for the spring tour, Nathan Sharpe, Sam Wykes, Tom Hockings and Peter Kimlin, because of shoulder injuries," Deans said.
It is not just the tall, gangly players who are most at risk, however. Reds Test winger Digby Ioane, the strongest player in the Queensland squad, has missed all nine Tests so far this season while recuperating from a shoulder injury that he initially ignored.
Deans is unsure how rugby might combat the rising incidence of shoulder injuries.
"Players are 10-15kg heavier than they were just a few years ago," he said. "They're fitter and stronger and, as a result, the collisions are much harder.
"It's part of the evolution of the game. If you look at Test match rugby, there are not many gaps to run into these days. There are still some in Super rugby but almost all the time at Test level, players are taking the ball up into heavy traffic."
Certainly this season, any Wallaby who was tackled by a solitary defender got off lightly. The RFU statistics reveal that slightly more than half the tackles in top-flight club matches involve more than one defender, so the expectation is that the percentage would be even higher in Tests.
While rugby at least bans shoulder charges - as much for the protection of the tackler as for the target - the hits are still ferocious, so much so that Deans has begun to question how much longer smaller players can survive at international level.
"Part of the charter of the game is that whatever size you are, there is a position for you," he said.
But with players in every position - even halfback - getting bigger and stronger, there could come a time when the Matt Giteaus, James O'Connors and Will Genias of the game simply find themselves too small to survive at the top level.
Law changes relating to the scrum engagement might have reduced the incidence of neck and spinal injuries but it is difficult to envisage how any tweaking of the existing laws could make shoulders - essentially ball-and-socket joints - less vulnerable because once position-specific roles have become interchangeable in the modern game, with all players expected to make themselves useful at the breakdown.
The RFU is pioneering the use of global positioning system units on players in training to accurately measure the force of collisions to see what, if anything, can be done to reduce the risk of shoulder injuries.
Hopefully, the Australian Rugby Union, which is planning to use 40 such units on Wallaby squad members next year to monitor the volume of training they are doing with their home provinces, will tap into the English research to see if there is any way players of the quality of Ioane and Sharpe might sidestep the scalpel.
http://www.theaustralian.news.com.au...015651,00.html
