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Back pain and rugby

Why is low back pain so common in rugby?

Not only is low back pain particularly common in rugby, but it has a high rate of recurrence. The question then needs to be asked; why?


When you stop to consider the kilometres a player runs, tackles and clean outs made, being tackled, pilfering/jackaling, and number of scrums packed in a game you can be lead to think well why not? But this should not be the case, low back pain should not be considered normal in rugby.


What increases your risk of low back pain in rugby?
Firstly, let’s stop to think about the common features and body requirements in good tackle technique, clean out, pilfer/jackaling, and scrum shape. Now, I’m not going to pretend to be a rugby coach but this is what I do know;

  • Tackle technique: low wrap. Get low. Drive with your legs.
  • Clean out: get low. Drive with your legs
  • Pilfer/Jackal: stay on your feet, get low, bend over (and get that ball!)
  • Scrum shape: maintain your bind. Get low (sink hips and knees). Knees under hips. Drive with your legs.

A common theme here is – GET LOW.
Let’s now think about what flexibility is required to actually achieve such positions:

  1. Adequate hip flexion range (bringing your knee toward your chest) 
  2. Adequate hamstring length

If you do not have these things, then achieving ‘good shape’ or ‘good technique’ is impossible and the result is putting excessive pressure on your lower back.


What can I do about it?
The good news is in the majority of cases hip flexion range of movement, and hamstring flexibility are CHANGEABLE.


Hip flexion range can be limited by either hip joint stiffness, tight gluteals, or both. It is important to determine which of these are limiting your hip flexibility so you can target them more specifically (your physio can help with this).

 

Self-mobilisation using a band can help improve hip joint mobility (3 x 1min each side).

 

    

Figure 4 stretch  (30s each side)

 

    

Piriformis stretch (30s each side)

 

Hamstring length can be limited by either muscular tightness, neural tension, or both. When stretching the hamstring muscle you should feel it in the muscle belly, not behind your knee. If you are feeling it behind your knee then that is the sciatic nerve you are feeling (which doesn’t like to be stretched this way). Change your hamstring stretch to have a slight knee bend so that you feel the stretch in your muscle instead.

Sciatic nerve sliders (also known as slump sliders) help with the neural flexibility side of things. Nerves hate being stretched from both ends at the same time, so ensure you perform these exactly as shown in the photos: leg up, head up; leg down head down.

 

    

Slump Sliders (3x15 each side)

 

One last thing to consider…
As your flexibility improves it is then important that you strengthen your muscles in this new range. If you do not perform strengthening exercises that work your muscles through your new range then you can put yourself at risk of other injuries. 
At Ascend we love being part of your team. Don’t just rest and let your pain settle down, get to the core of the problem and then raise the bar higher and set some goals this year.  Call 9387 2699 to work with our physios to achieve your peak performance.