How to avoid rugby knee injuries

Your knee joints, alongside your hips and ankles, are major load-bearing joints in your body. This means they carry the full weight of your body and bear high levels of stress. This is especially true of your knee joints when playing sports, such as rugby, which involve sudden changes in direction, twisting and pivoting of the knee, as well as the risk of sudden impact. 

Here, we’ll discuss how to reduce your risk of rugby knee injuries but first it helps to understand the basic anatomy of your knee. 

Your knee anatomy

Your knee contains two joints: the tibiofemoral joint, which is made by the bottom end of your thigh bone (femur) and the top end of your shinbone (tibia), and the patellofemoral joint, which is made between your femur and kneecap (patella).

These joints are encased by an envelope of tissue called the articular capsule. The inner layer of this capsule produces a thick fluid (synovial fluid) that lubricates your knee to aid movement.

In addition to the bones of your knee joint, cartilage and ligaments are present, which support and stabilise your knee and are easily damaged when playing rugby.

Two keys to reducing your risk of knee injury

You can reduce your risk of knee injuries when playing rugby in two ways: through strength and conditioning training, and properly warming up.

Strength and conditioning training builds up the muscles in and around your knee, helping stabilise it. This also helps increase your speed and resistance to fatigue, which reduces your risk of injury.

Warming up increases blood flow to your muscles. This readies them for activity and makes them less likely to rip, tear or twist in a damaging way. A good warm-up also increases the amount of synovial fluid in your knee joint, allowing for smoother movements.

During your warm up, you should activate your: 

• Calf muscles — three muscles in the back of your leg behind your shinbone
• Hip muscles — also known as gluteus muscles, these are found in your buttock area
• Muscles at the back of your knee and thigh — these muscles allow your knee to bend 
• Thigh muscles — this includes your adductors, pectineus and sartorius, as well as your quadriceps, which help you extend your knees, and your hamstrings, which help you bend your knees

Warm-up programmes

Doctors, physiotherapists and athletic trainers have carried out extensive research to develop the most effective warm-up programmes to reduce the risk of knee injuries in athletes. 

One of these programmes is PEP (Prevent Injury and Enhance Performance), a 20-minute warm-up aimed at reducing the incidence of one of the most common sporting knee injuries — tears in the anterior cruciate ligament (ACL). ACL tears often occur in rugby due to tackles but can also occur during play without any contact. 

The success of the PEP programme has seen it adopted by sporting associations, including FIFA and Netball Australia.

You can view two videos demonstrating PEP exercises:

• How to prevent knee injuries
• Key stretches

How to reduce the severity of injuries

With contact sports such as rugby, certain injuries are unavoidable. However, you can reduce their severity, or in some cases prevent them from occurring, by learning to fall.

For example, if you are carrying the ball and are tackled from behind or the side, don’t try to keep running. This increases your risk of injuring your knees, as well as your legs and ankles.

The potential for gaining a few extra metres on the field is far outweighed by the risk of serious injury keeping you off the field for months. So when you feel the weight of a tackler on you, go to the ground immediately.

If you nonetheless sustain an injury on the field, whether through contact or not, it is important to get appropriate treatment as soon as possible.

A moderate to severe injury puts you at significantly greater risk of more injuries in the future. Mitigating the severity of your injury through prompt treatment, therefore, doesn’t just have the short-term benefit of a speedier recovery but also reduces your long-term risk of injury.

Furthermore, once you are on the road to recovery, wait until you are fully healed and given the all clear by your doctor or physiotherapist before returning to training and play.