Stingers and burners
Stingers and burners (transient neck pain) are common in rugby due to the body of the opposition in the
tackle causing trauma to the brachial plexus, which is the network of nerves running from the spine to the shoulder, arm and hand.
Symptom
Stingers and burners are caused by a crushing trauma to the nerve root. Symptoms include a burning pain that can be localised in the shoulder area or that can "shoot" down the arm to the hand.
Severe cases can result in paresthesia (numbness or loss of sensation) and weakness. The worst symptoms are usually short lived, but full recovery can take some time.
Treatment
Nerve damage is unlike muscles or tendons, in that heat and massage can aggravate it further. Apply ice to the neck-shoulder area to help reduce the pain by helping to calm the traumatised nerve. But you will
have to wait until the damage completely resolves itself.
During this time, the injured player should not take part in contact training. Active treatment includes gentle stretching of the neck and, hence, the nerve within pain limits.
Cramp
Cramp is an involuntary painful muscle contracture which can occur suddenly at any time during training or play. It commonly occurs in the calf muscles (medial and lateral gastrocnemius) but can occur in any.
The precise cause of muscle cramp is unclear. Dehydration and excessive sodium loss are thought to play a major role.
Nutritional advice given by the International Olympic Committee (IOC) to athletes competing in warmer climates, and with excessive sweating, emphasises the need to ensure adequate salt replacement over and above normal diet salt intake.
It is thought taking too much water to replace fluids lost via sweat will dilute the body's remaining salts. Isotonic drinks can be used as salt replacement fluids.
Overall effects are dependent on the degree of training and acclimatisation for individual players. It is also thought that cramp could be caused by over-stimulation of the muscle particularly when it is fatigued.
Symptoms
The main symptom of cramp is pain and extreme tightness of the muscle. If cramps occur in the toes it can cause them to move into unnatural positions.
Treatment
Treatment involves sustained stretching of the muscle. If it occurs on the field, a team mate or first-aider can slowly stretch the calf muscle of the affected player.
The affected player should lie on his back and raise the leg with cramp up at an angle of about 45 degrees. The person helping them should hold the leg by the ankle and press down on the toes and ball of the foot as shown below.
To help the muscle relax, gently rub or massage the affected area. More severe cases of cramp may benefit from heat pads on the affected area.
If no other person is available to help, an affected player can carry out their own calf stretch. The player should place his hands and the foot of the leg experiencing cramp on the ground as shown in the picture below.
He should push back with his hands and raise his buttocks upwards at the same time. He will find himself lifting up onto the ball of his foot, stretching the calf.
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