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A demanding sport

Rugby is one of the oldest and most popular sports in the world, one with a largely forgotten past. In 1920 and 1924, the United States rugby team won gold medals at the Olympic games. After several decades of being excluded from the Olympics, rugby returned to the games in 2016.

In recent years, Rugby has experienced a resurgence in elementary schools, middle schools, high schools, and colleges around the country. Massachusetts made high school rugby an official varsity sport for girls and boys in 2017.

Rugby is a demanding sport. Athletes are required to run like soccer players and tackle like American football players. Not surprisingly, rugby players sustain their share of injuries.

The constant running in rugby increases the potential for overuse injuries like sprains and strains, tendinitis, and bursitis. More common, however, are traumatic injuries when players collide with other players or hit the ground while scrumming, rucking, and tackling. This can lead to dislocations, fractures, and concussions, often due to improper tackling technique.

What are the most common rugby injuries?

Broken bones and dislocated fingers may occur when a player is tackled or knocked to the ground.

Concussions may result from blows to the head by other players or falls to the ground. Players showing concussion symptoms — headaches, dizziness, nausea — should be removed from the game immediately and they should not resume play until cleared by a medical professional.

Flexor tendon injuries like “jersey finger” occur when a player grabs another player’s jersey, and the tendon is pulled off the bone.

Overuse injuries may result from constant running. Rugby players often sustain strains, soreness, tendinitis, and bursitis.

Quick changes of direction on the field may cause knee injuries like medial collateral ligament (MCL) and anterior cruciate ligament (ACL) injury and meniscus tears.

Facial injuries may occur in rugby as players are not required to wear protective masks. Cuts, bruises, and facial fractures are possible.

How can coaches, parents, and players prevent rugby injuries?

Conditioning is critical to withstanding the demands of rugby. Players are encouraged to engage in a training program that emphasizes strength, endurance, and flexibility. Also, rugby puts different demands on players depending on the positions they play on the field. Coaches should create position-specific conditioning programs.

Play by the rules. Foul play hurts your team and increases the risk of injuries. Seek out leagues and coaches that emphasize fair play. The introduction of the card system for foul play, such as high tackles, has done much to improve player safety.

  • When a player gets a yellow card, they must leave the field for 15 minutes.
  • When a player gets a red card, they are removed from the field for the rest of the game. No substitutions are allowed for a player who receives a red card.

Practice proper tackling, rucking, and scrumming technique. In rugby, in order to protect players’ necks and heads, it’s illegal to be in contact with an opponent’s shoulders while tackling them. This is far different from the American football tackling technique of driving through an opponent. Coaches should teach, and players should practice, correct rugby technique.

Wear the right equipment, including a fitted, high-quality mouth guard. Other equipment such as headgear, shoulder pads, chest pads, and ear guards are not required by most leagues, but may reduce the risk of injury.

If you’re hurt, get off the field. Playing through pain hurts your team and hurts yourself. Take care of yourself to avoid injuries that could cause you to miss the rest of the season.

Rest and recovery

Rest is the key to recovering from overuse injuries. Soreness, strains, and sprains only get better when players stop playing and allow their bodies time to recover. Rugby players should consider taking time off during the week and between seasons so their bodies can regain strength and flexibility.

Overall conditioning is another important factor in recovery. Simply put: the better shape you’re in, the more likely you’ll recover from most injuries. Focus on strengthening the neck, shoulder, hip, and core.

How we care for rugby injuries at Boston Children’s Hospital

As the largest and most experienced pediatric and young adult sports medicine practice in the country, the Sports Medicine Division at Boston Children's combines personalized care with innovative treatment for each athlete we treat.

Our Sports Medicine team consists of sports medicine physicians, orthopedic surgeons, physical therapists, podiatrists, athletic trainers, sports psychologists, dietitians, and many others who collaborate in every aspect of our patients’ care and their recovery.

Our Anterior Cruciate Ligament (ACL) Program help athletes recover from ACL injuries. Our research-based injury prevention services help reduce athletes’ risk of repeat ACL tears or sprains and we offer comprehensive psychological support, if needed, to address the social and emotional impact of an ACL injury.

The Micheli Center for Sports Injury Prevention, part of Boston Children’s Sports Medicine Division, offers ACL injury prevention classes and an ACL Return-to-Play program.

Our Sports Concussion Clinic is the leading research-based sports concussion program in the nation. Our team of experts provides comprehensive care for athletes with sports concussions, and offers concussion prevention and recovery education for athletes and their families.