Rugby is one of the highest-risk sports for shoulder injuries. 20% of rugby injuries affect the shoulder. Recurrent injury is affects over a third of players, and an injury on one side are increases the risk of injuring the other side. The tackle is responsible for the majority of all shoulder injuries in rugby, but direct impact onto the shoulder (fall onto it with arm at side, or collision) and overreaching injuries (try scoring and diving tackles) can also cause injury.
Labral Tears and Instability
Those injured in a tackle are more likely to have anterior labral tears and bony Bankart lesions. Players injured from a direct impact on their shoulder are prone to complex labral tears (posterior and superior labral tears). Try scoring or diving caused anterior labral tears, rotator cuff injury and capsular injuries.
Shoulder dislocations in rugby players often involve considerable force and the anatomical damage from even a single dislocation can be very severe. Dislocations from rugby are more likely to involve bony socket (glenoid) fractures and have more extensive labral and capsular tears than dislocations outside of collision sport. Recurrent instability in rugby players is a big problem. Even after arthroscopic stabilisation, some players will suffer repeated dislocation if they continue to play. Factors such as your age, your level of play and whether or not you have bone damage affect your risk of re-dislocation after keyhole surgery. For some players requiring surgery to stabilise their shoulder, a bony (Latarjet) procedure will provide a more reliable result, although this is a more invasive operation and does not restore normal anatomy in the same way that keyhole surgery does.
The labrum is a cartilage rim that lines your shoulder socket (glenoid). It normally requires a dislocation, a traction injury or an impact, to rip this from the bone of your socket. Rugby players with shoulder pain may well have a labral tear, even though their shoulder has never fully come out of joint. Posterior labral tears, which are generally uncommon, may exist in up to half of elite rugby players with shoulder instability, and especially in those with a history of a direct impact to their shoulder. Labral tears may require surgical repair to allow you to return to full function. This is done by keyhole surgery.
Acromioclavicular Joint Problems
A direct blow to the top of your shoulder is the most common mechanism of injury to the acromio-clavicular joint (AC joint). These are very common in rugby players because of the collision nature of the sport. Not every AC joint dislocation requires surgery, but some injuries are more likely to do poorly without stabilisation.
Rugby players are also prone to more chronic AC joint pain. They are lifting heavy weights and sustain repeated shoulder impacts. Over time this can cause damage to the cartilage inside the AC joint or it can cause the bone of the lateral end of the clavicle to resorb (osteolysis). Patients with AC joint pain will have pain at the end of range that is exacerbated by play. Normally players with a painful, but stable AC joint can continue to play, but it is painful. These patients do well with arthroscopic excision of the distal clavicle and can expect to retun to play within 6-8 weeks.
Rotator Cuff Injury
Your rotator cuff is subjected to large forces as you perform ripping and forward-play manoeuvres. Partial tears to an otherwise healthy rotator cuff are not uncommon and may occur at the same time as dislocation or labral injury in your shoulder. Sometimes they require surgical repair as part of your keyhole surgery.
- Limiting access to the ‘vulnerable shoulder position’ for dislocation - 90% of shoulder dislocations come out forwards: the vulnerable position for anterior dislocation is with you arm raised up away from the body and with your forearm pointing skywards. These braces restrict the forearm rotation and therefore claim to reduce the likelihood of a dislocation. Two example braces are shown below, but several companies offer similar products
If you have injured your shoulder whilst playing rugby, or if you have concerns about returning to play, do get in touch via the contact section, or book an appointment.
The return to sport rate after shoulder surgery is high. The time taken for competitive return varies between studies, but generally ranges between 4 - 7 months. Some injuries tend to take longer to rehabilitate from and these are often the more complex injury patterns.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
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