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McBride L1, Oxford S2
1Coventry University, Physiotherapy, Coventry, United Kingdom, 2Coventry University, Sport Science, Coventry, United Kingdom
Background: Rugby union has one of the highest occurrences of reported match and training injuries among contact sports. The game involves considerable loading and impact to the head and neck and a growing prevalence of concussion and sub-concussive events highlights the need to explore preventative strategies. Strength training is important in building players' resilience to withstand the rigours of their sport, and a recommendation to reduce the injury burden is to strengthen the neck muscles to enable players to dissipate energy from the forces of collisions. However, evidence detailing protocols of strength training for the neck is scarce.
Purpose: This preliminary inquiry was designed to discover what screening data is currently collected by medics, physiotherapists and strength and conditioning coaches from professional rugby players regarding the neck, and to ascertain their neck exercise protocols.
Methods: Survey methodology was employed via an online questionnaire platform following ethical approval and pilot of design (n=4) to ensure validity. This was sent to the head of medical services at 40 professional and semi-professional rugby union clubs for distribution. Forty-two questionnaires were received for analysis from teams at all levels including: international (n=1); Premiership (n=16); academy (Premiership n=8, national n=4, Championship n=1); Championship (n=4); National League 1 (n=4); women's (n=2); Mitre 10 Cup (New Zealand) (n=2). Respondents consisted of: physiotherapists (n=28); strength and conditioning coaches (n=6); club doctors (n=4); sports rehabilitators/therapists (n=3); an athletic performance manager (n=1). Data was analysed descriptively and quantitatively.
Results: Pre-season screening of players' necks was reported by 55% (n=23) of respondents and the majority was undertaken by physiotherapists. Most (96%, n=22) measured isometric neck strength, 83% (n=19) active range of motion and 30% (n=7) proprioception. Respondents reported screening of all Premiership teams, compared to only 50% at academy level. Strength was measured, predominantly with hand-held dynamometers or the Don Gatherer system kit. Exercise prescription for the neck was reported by 71% (n=30) of respondents, all citing injury prevention as the primary reason. They were most likely (75%, n=25) to incorporate neck exercises at least twice per week into the gym programmes of front row forwards, in the Premiership, with 100% (n=30) prescribing isometric strength, predominantly using a harness with cable stack and/or bands, held for a set time. Only 50% (n=15) reported these being performed with a playing position-specific bias. 80% (n=24) prescribed endurance exercises. Neck exercises were prescribed for other playing positions on average only once per week (50%, n=15) or after injury (30%, n=9); where isometric holds were again the most common mode of strength training.
Conclusion(s): Currently, physiotherapists play a major role in injury prevention for elite rugby players. Despite strong evidence in the literature that training programmes can improve neck strength and reduce injury risk these preliminary findings demonstrate a lack of consistency in approach towards neck screening and exercise protocols within professional rugby.
Implications: To promote safe and effective spinal exercise provision for rugby players, the next phase of this research will involve experts in the field devising an evidence-based exercise protocol for elite rugby players using a Delphi study methodology.
Keywords: Rugby Union, Cervical spine, Strength exercises
Funding acknowledgements: Non received
Purpose: This preliminary inquiry was designed to discover what screening data is currently collected by medics, physiotherapists and strength and conditioning coaches from professional rugby players regarding the neck, and to ascertain their neck exercise protocols.
Methods: Survey methodology was employed via an online questionnaire platform following ethical approval and pilot of design (n=4) to ensure validity. This was sent to the head of medical services at 40 professional and semi-professional rugby union clubs for distribution. Forty-two questionnaires were received for analysis from teams at all levels including: international (n=1); Premiership (n=16); academy (Premiership n=8, national n=4, Championship n=1); Championship (n=4); National League 1 (n=4); women's (n=2); Mitre 10 Cup (New Zealand) (n=2). Respondents consisted of: physiotherapists (n=28); strength and conditioning coaches (n=6); club doctors (n=4); sports rehabilitators/therapists (n=3); an athletic performance manager (n=1). Data was analysed descriptively and quantitatively.
Results: Pre-season screening of players' necks was reported by 55% (n=23) of respondents and the majority was undertaken by physiotherapists. Most (96%, n=22) measured isometric neck strength, 83% (n=19) active range of motion and 30% (n=7) proprioception. Respondents reported screening of all Premiership teams, compared to only 50% at academy level. Strength was measured, predominantly with hand-held dynamometers or the Don Gatherer system kit. Exercise prescription for the neck was reported by 71% (n=30) of respondents, all citing injury prevention as the primary reason. They were most likely (75%, n=25) to incorporate neck exercises at least twice per week into the gym programmes of front row forwards, in the Premiership, with 100% (n=30) prescribing isometric strength, predominantly using a harness with cable stack and/or bands, held for a set time. Only 50% (n=15) reported these being performed with a playing position-specific bias. 80% (n=24) prescribed endurance exercises. Neck exercises were prescribed for other playing positions on average only once per week (50%, n=15) or after injury (30%, n=9); where isometric holds were again the most common mode of strength training.
Conclusion(s): Currently, physiotherapists play a major role in injury prevention for elite rugby players. Despite strong evidence in the literature that training programmes can improve neck strength and reduce injury risk these preliminary findings demonstrate a lack of consistency in approach towards neck screening and exercise protocols within professional rugby.
Implications: To promote safe and effective spinal exercise provision for rugby players, the next phase of this research will involve experts in the field devising an evidence-based exercise protocol for elite rugby players using a Delphi study methodology.
Keywords: Rugby Union, Cervical spine, Strength exercises
Funding acknowledgements: Non received
Topic: Sport & sports injuries; Musculoskeletal: spine
Ethics approval required: Yes
Institution: Coventry University
Ethics committee: Coventry University Ethics Committee
Ethics number: P60723
All authors, affiliations and abstracts have been published as submitted.
