360 Physiotherapy Norwich » sports injury

A pain in the neck: serious neck pain in rugby

admin — Fri, 20 Mar 2015 17:12:15 +0000

Severe cervical spine injury in rugby union (rugby) exerts a major impact on the individual who sustains the injury and on the broader society. The estimated risk is estimated to be between 2-100 per every 100, 000 player exposure hours – which I am informed is considered to be ‘tolerable’ risk. However, the financial impact is also significant, with the lifetime cost for a 20-year-old individual who became quadriplegic having been reported to be between $2 and 3 million in the late 1990s.
There has been a lot of debate and law changes in order to try and prevent significant neck injury in rugby. Recent research studies have emphasised certain benefits of age-matching and weight-matching forward players. There is now a stipulation in Scotland, by the Scottish rugby union, that all school forwards will only be certificated to play in the front row after strength testing. Numerous other preventive strategies, such as de-powering the scrum through player positioning and sequential engagement, have also been attempted with mixed success. There have also been law changes to tackles (for example the spear tackle) and the breakdown area to try and improve the safety of the game.
In modern rugby, all professional teams are required to have present on match days a physiotherapist and doctor who are trained in immediate pitch side management of serious spinal injury, which includes the immobilisation of the cervical spine, how to spinal board a player, how to safely remove from the field of play, the use of oxygen and much more. This is to ensure that all suspected spinal injuries are managed correctly in the critical first moments and the best possible outcome is delivered.
On Sunday the 22nd of March 2015 it will be 10 years to the day since the tragic accident that saw Matt Hampson the England U21 international injure his neck so severely that he has been left paralysed from the neck down and breathing via the aid of a ventilator. Aged just 20 at the time of the incident, during a training session, a scrum collapsed forcing the player to spend the next 17 months in hospital. More recently, Owen Williams, the welsh international centre suffered a “significant injury” to his cervical vertebrae and spinal cord while playing for Cardiff Blues in a tournament in Singapore last June. Hopefully, as is being reported in the media, he is making good progress and his prognosis is a good one.
Matt Hampson has in fact set up a foundation with the aim to help people get busy living again after a life altering injury and it is estimated the foundation has raised in excess of one million pounds. Hopefully, none of us will ever need to be in a position to have to use the foundation (the risk as mentioned previously is low), but it is certainly good to know that the facility is there.

A pain in the neck……

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Lower back pain

admin — Wed, 11 Mar 2015 14:28:22 +0000

If you have lower back pain, you are not alone. About 80% of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed work days. In a large survey, more than a quarter of adults reported experiencing low back pain during the past 3 months, with an 80% chance of recurrence within a 12 month period after onset. Of those interviewed, 45% of those who have an acute episode of back pain will go on to experience chronic symptoms which persist for longer than 3 months.

The lower back is an intricate structure of interconnected and overlapping elements:

Tendons and muscles and other soft tissues
Highly sensitive nerves and nerve roots that travel from the lower back down into the legs and feet
Small and complex joints
Intervertebral discs with their gelatinous inner cores.

An irritation or problem with any of these structures can cause lower back pain and/or pain that radiates or is referred to other parts of the body. Pain from resultant lower back muscle spasms can be severe and feel disabling.

Classification systems can be useful in subgrouping and hence managing low back pain. Various systems have been developed over the years, most recently with chronic low back pain being classified into 2 groups:

1. Specific back pain disorders – this is where there is a true pathobiological origin such as those mentioned above – disc, ligament injury etc

2. Non-specific back pain disorders – this is where pain cannot be attributed to a single structural injury

The most specific way of diagnosing lower back pain is with an MRI, however the results should be interpreted with caution (have a look at my previous blog on the use of scans for more details!) as there have been studies that have shown people with no back pain to have changes on MRI, and conversely those with chronic and severe symptoms can have a clear MRI!

Due to the complex nature of lower back pain there is no universal method for managing or treating it. Of all the injuries seen, lower back pain must be taken on a case by case basis, with the treatment strategy put together for the exact symptoms on presentation. Treatments may include hot and cold, strengthening exercises, stretches and flexibility, massage, posture correction, lumbar mobilisation, acupuncture and…..manipulation. However, manipulation is not always the cure it can be sold as…..if it were, people would be clicking backs all the time and curing things very quickly and charging a lot for it! Because believe me, if I, or anyone else, could click someone’s lower back and make their pain resolve straight away, then we would all be doing it!!!!

If you are in any doubt however you should make sure you get your lower back checked out, either by us at 360-physio, your GP or another trusted healthcare professional

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