The process for developing a shoulder-specific injury prevention programme in community youth rugby union

Singh, Vincent

Abstract

Background: Sustaining a shoulder injury may cause a youth rugby player to discontinue participating which, combined with the resulting risk of long term health conditions, warrants a better understanding about the implementation of shoulder injury prevention strategies.
Purpose: To develop an implementable shoulder - specific injury prevention exercise programme (IPEP) for community youth rugby players.
Methods: Step one involved a systematic evaluation of the strength and quality of the literature pertaining to the benefits of IPEPs with the potential to reduce common shoulder injury risk factors in rugby. Additionally, exercises from randomised control trials using neuromuscular training that demonstrated efficacy which was considered important in rugby were also included. In step two, we presented the first draft of the shoulder IPEP to an invited multidisciplinary technical project group (TPG) for consultation. The TPG consisted of five therapists with specialisation in shoulder injuries in youth rugby and two expert academic researchers who had previously investigated the efficacy and effectiveness of IPEPs in rugby and other sports. The feasibility of the IPEP was tested in step three on two university level rugby players to determine its acceptability and whether the exercises could be completed successfully. In step four the shoulder IPEP was used in a pilot study with community youth rugby players and feedback was obtained about the IPEP from players and coaches.
Results: The researcher identified the following priorities from the literature; thoracic spine mobility, scapular control, rotator cuff muscle strength and exercises that incorporate core stability and the kinetic chain. The TPG suggested; that the progression criteria for each level of the IPEP was clarified, static exercises were incorporated with kinetic chain movement patterns and core stability exercises where possible, instructional text be simplified using cues and phrases, regressions to the Nordic hamstring exercise was included, to include isometric neck strength exercises and progress to multiple planes of movement, and closed kinetic chain and upper limb plyometric exercises were included. Feedback from the feasibility trial informed on technical aspects of coaching and instruction of the exercises in the IPEP. Following the pilot study only the coaches provided feedback on the IPEP with the FIFA 11+ coach saying they liked doing the IPEP as they felt like their “team was getting better as doing the exercises” however, it left them with “limited time to practice other rugby skills”. The coach using the shoulder IPEP liked “learning about some exercises that might decreased the risk of injury” however felt that it was not specific enough and would like to see a “contact element” included.
Conclusion(s): This shoulder - specific IPEP for rugby used research evidence to formulate a programme that was agreed to be appropriate and suitable by the TPG, stakeholders, and together with input from a feasibility trial, was implemented in a pilot study for community youth rugby players.
Implications: This IPEP is directly relevant to shoulder injury prevention in community youth rugby players and provides a more comprehensive understanding about developing a shoulder IPEP in real - world settings.

Funding acknowledgements: This research is supported by the Private Physiotherapy Education Foundation.

Ethics approval: University of Bath
Ethics Committee: Research Ethics Approval Committee for Health
Ethics number: EP 15/16 251

• Presentation Conference Type: Poster
• Conference Name: World Confederation for Physical Therapy Congress 2019
• Start Date: May 10, 2019
• End Date: May 13, 2019
• Deposit Date: May 14, 2021
• Keywords: Rugby union, shoulder, injury prevention
• Public URL: https://uwe-repository.worktribe.com/output/7177673