The TRL South Brisbane season is kicking off and Maximize Health is on board to make sure injuries aren’t keeping you away from the action. Rolled ankle? Pulled hammy? Or aches and pains that a good night’s sleep just won’t fix? Our physiotherapists have years of experience working with the likes of Souths Logan Magpies Rugby League and Sunnybank Rugby Union teams. We’ve now identified three of the most common injuries Touch Rugby League players will face and what you can do about them.
Lateral ankle sprain
Due to the nature of TRL, a common injury players present with is a lateral ankle sprain or “rolled ankle”. Lateral ligament injuries occur when the foot is turned inwards on landing, often with the toes pointed. This results in spraining of the outside ligaments of the ankle. In many instances, this will be the anterior talofibular ligament.
The excessive force creates tears in the ligament’s fibres. An ankle sprain can trigger immediate pain and may be accompanied by a clicking, cracking or tearing sound. Swelling, too, is often rapid, though may also take a few hours to come through.
Do I need an Xray?
If you present with ankle pain and one of the following, an ankle x-ray is required
- Bony tenderness along the bottom 6cm of the inside or outside ankle bones (tibia or fibula, respectively).
- Inability to walk 4 steps anytime post injury.
- Inability to move, or sensation changes in your toes.
For the first three days following the injury, it is important to rest, ice (every hour for 20 minutes), compress and elevate the ankle to reduce the swelling and pain. Gradually increasing weight through the ankle will help to reduce swelling, regain ankle movement, and speed up your rehabilitation.
A physiotherapist will use a range of joint and soft tissue techniques to assist:
- Reduction in pain and swelling
- Restoration of full range of motion
- Muscle conditioning
- Improved balance and reduction in risk of further ankle sprains
- Graduated return to sport
Preventing ankle sprains
- Thoroughly warming up prior to each game
- Wear supportive footy boots on the field
- If you have a history of sprains, ankle strapping can be effective
Muscle strain (hamstring/calf)
TRL puts lot of load on your leg muscles. The muscles need to contract quickly to provide explosive speed and agility. Sprinting is the classic activity that causes hamstring and calf strains during TRL. A sudden onset of stabbing pain in the back of the thigh or calf are the immediate signs of a strain.
Factors that can lead to muscle strains include:
- Not warming up thoroughly
- Having tight muscles prior to the game
- Previous muscular strains
- Irregular movement patterns
Muscular strains can be graded from 1-3 by your physiotherapist. Grade 1 strains involve a few muscle fibres being torn, causing pain. Grade 2 muscle strains involve around 50% of the muscle fibres, producing pain as well as weakness. Grade 3 strains or complete tears involve a complete rupture of the muscle, causing lasting (1 to 2 days) pain, excessive weakness and excessive bruising, often requiring surgery.
With any soft tissue injury, it is important to rest, ice (20 minutes every hour), compress and elevate during the first week to reduce pain and swelling. This should be followed by a detailed assessment by your physiotherapist. Stretching the affected muscle is not recommended in the early phases of rehabilitation as the muscle has already been “overstretched” to cause the tear.
Your physiotherapist will use a number of assessment methods to determine the location and severity of the muscle strain. They will also assess the entire lower limb for factors that may be contributing to your pain. Physiotherapy treatment of muscular strains will involve techniques and exercises to facilitate soft tissue release, build strong muscular fibres to replace those that are torn, and gradual return to play.
Preventing muscle strain
Dynamic warm ups increase muscle temperature, blood flow, contraction strength and reduce the risk of muscular strain. An example of a dynamic warm up could involve a 5 minute slow jog, 15 leg swings (back, forward, and side to side) of each leg, calf stretching, and short sprints at increasing levels of intensity to prepare the leg muscles for the demands of TRL. Stretching everyday will reduce muscular tightness and the likelihood of strains during games. Stretching a muscle for 30 seconds, 3 times a day has been shown to reduce muscle tightness, it’s that simple!
Achilles or patella tendinopathy
Tendons connect muscles and bones to help provide movement. Many TRL players won’t be engaged in much sprinting or agility training in the offseason. As a result, it is common for players to experience tendon overuse injuries when they get back into it. Over time, tendons adapt to an increase in load by stiffening. This helps the tendons to cope with the increased pull by the muscles. A sudden increase in force through our tendons activates a specific segment of tendon cells. These cells then cause thickening of the tendon and an abundance of water in the tendon. Common tendinopathies encountered by TRL players involve the knee cap (patella) tendon and heel (Achilles) tendon.
Common signs and symptoms of tendinopathies include:
- Pain the morning after or sometime later on that day.
- It can be painless at rest however becomes more painful with use.
- Ability to “run through” pain or pain reduces once you warm-up, only to return after exercise.
- Examination reveals local thickening and tenderness of the tendon.
Players may be able to continue their training or playing routine in the early stages of the condition. With tendon overuse injuries it is important to reduce the amount of exercise or load through the tendons to prevent tendon failure and eventual surgery.
Your physiotherapist will use a number of assessment and treatment techniques to:
- Identify contributing factors ie: glute weakness, calf tightness.
- Reduce pain levels.
- Reduce muscle tightness.
- Facilitate the regrowth of strong tendon fibres to cope with the demands of TRL.
- Provide a progressive strengthening program of the tendon and surrounding tissues.
To prevent the occurrence of tendon overuse injuries it is important to slowly load the tendon leading up to TRL season. Going for runs around the neighbourhood will help prepare your tendons for the load they will experience during TRL. As has already been mentioned, a dynamic warm up will also increase temperature and blood flow to the tendon, preparing the tendon for the game.
Muscle tightness of the calf (for Achilles tendinopathy) and quads (for patella tendinopathy) will increase the pull on the weakened tendon and contribute to the condition. Stretching each leg muscle group for 30 seconds, 3 times a day will reduce this constant pulling on the tendon. Another contributing factor to tendon overuse injuries may be the type of footwear you are using for TRL. The flash, bright coloured type of boots often sacrifice support for style, producing poor biomechanics and putting players at a higher risk of tendon problems.
Touch Rugby League provides a great way to get together with friends and enjoy the fast thrills of rugby league without the heavy contact. So don’t put yourself at unnecessary risk of injury. Before each match, be sure to warm up and stretch correctly. If you’ve got any existing injuries, listen to your body and don’t exceed your injury’s limit. If you suffer an injury on the field or just want to learn more about how you can make the most out of the TRL season, the team at Maximize Health will be happy to chat. Call us on (07) 3343 5494.