Foot and Ankle Injuries in a Rugby Game

Rugby is a physically demanding sport that requires players to exhibit high fitness, strength, and agility. As such, it is not uncommon for players to experience foot and ankle injuries during a game.  Approximately 15% of rugby injuries are foot and ankle related.[1] These injuries can result from various factors, including collisions with other players, overuse, and improper technique. The followings are some of the foot and ankle injuries that are related to Rugby.

Types of Foot and ankle injuries

• Bones injuries:

• Ligaments injuries:

  • Lateral Ligaments (inversion ankle sprain)

  • Deltoid ligaments (eversion ankle sprain)

• Achilles Tendons injury

• Joints dislocation

Bone Injuries 

Rugby players are also at for stress fractures in the foot and ankle. Stress fractures are small cracks in the bones that occur when they are repeatedly subjected to high-stress levels without adequate rest and recovery. This can happen when a player runs or jumps on hard surfaces, wears inadequate footwear, or has poor biomechanics. Stress fracture symptoms include increased pain over time, swelling, and tenderness in the affected area, and walking is usually impossible. Treatment typically involves rest, immobilization, and a gradual return to activity.  If the above treatment is ineffective, surgery might be an option.

Ankle Sprain

One of the most common foot and ankle injuries in rugby is inverse ankle sprains. Ankle sprains occur when the ligaments that connect the ankle bones(anterior talar fibula ligament or calcaneal fibula ligament are stretched or torn.  Another type of ankle sprain is an eversion ankle sprain is when the deltoid ligaments are stretched or torn when the ankle is twisted outwards.  These can happen when a player lands awkwardly after a jump, twists their ankle while running, or has their ankle rolled over by another player. Symptoms of an ankle sprain include pain, swelling, bruising, and difficulty walking. Treatment typically involves rest, ice, compression, elevation (RICE), and physical therapy to strengthen the ankle and prevent future injury.

Achilles tendinitis | tendinopathy

Another common foot and ankle injury in rugby is Achilles tendinitis and tendinopathy. These conditions occur when the Achilles tendon, which connects the calf muscle to the heel bone, becomes inflamed or irritated(Tendinitis) or the collagen fibres degenerate (Tendinopathy). This can happen when a player overuses their Achilles tendon, such as by running or jumping repeatedly (Tendinopathy) or when the scrum collapses and the foot is forced into dorsiflexion, a sudden injury to the tendon (Tendinitis). Symptoms include pain, stiffness, and swelling in the back of the ankle. The differences in symptoms of both conditions are listed at the below table:

Treatment goals for both conditions are to reduce inflammation and pain and improve mobility.  They typically involve rest, ice, anti-inflammatory medication, and physical therapy to stretch and strengthen the calf muscle.

Turf Toe 

Finally, the turf toe is a common foot injury in rugby. Turf toe occurs when any soft tissue structure in the big toe is strained or torn, typically due to sudden, forceful movements. This can happen when a player pushes off the ground to accelerate or change direction. Symptoms of turf toe include pain, swelling, and difficulty bending the big toe. Treatment typically involves rest, ice, taping to immobilize the toe, and physical therapy to strengthen the muscles and prevent future injury.  Surgery is usually not necessary unless if the symptoms persist or the player’s level of athletic play is affected, surgery might be considered.

In conclusion, foot and ankle injuries are common in rugby due to the physically demanding nature of the sport. Ankle sprains, Achilles tendonitis, stress fractures, and turf toe are among the commonly seen injuries that rugby players may experience. These injuries can be caused by various factors, including collisions with other players, overuse, and improper technique. Treatment typically involves rest, ice, compression, elevation, and physical therapy to strengthen the affected area and prevent future injury. With proper prevention and treatment, rugby players can reduce their risk of foot and ankle injuries and continue to enjoy the sport they love.

References

[1] Barthgate A, Best JP, Craig G, Jamieson M. A prospective study of injuries to elite Australian ruby union players.Br J Sports Med 2002;36(4) 256