What are the repercussions of a very common shoulder injury – like Robbie Farah’s during the first round of State Of Origin 2015?
Farah was injured in the 28th minute following a dumping tackle by Justin Hodges. The tackle resulted in Farah falling heavily onto his left shoulder, leaving him with a Grade 3 acromioclavicular joint sprain (also known as the AC joint). This was not going to stop him from leading his NSW side, so at half time the joint was padded up and strapped for some support by the medical team.
The common rugby league injury occurs due to stretching or tearing of the ligaments that connect the collar bone to the shoulder blade, situated at the point of the shoulder. The injury is graded in severity of damage and separation on a scale of 1 to 6 (see image below).
The usual mechanism of the injury is contact through the point of the shoulder. A small impact will cause some stretching and minimal deformity of the joint, whereas a larger impact can cause ligament rupture and a visible step within the joint. Pain will be felt with lying on the affected shoulder, overhead arm movements, moving the arm across the body and lifting or pushing movements.
Treatment will vary depending on the grade of the injury however initially the goal is always attempting to manage the pain. This is best accomplished by immobilising the arm in a sling and using an ice pack to reduce swelling and for a numbing effect. Following this, the aim is to gradually restore full pain free function of the shoulder which would involve soft tissue massage, joint mobilisation, strapping, exercises and more.
Any player with an ‘AC’ joint injury should be assessed by a Physiotherapist to determine if the injury can be treated conservatively. In more severe cases involving higher degree of separation and fractured bone, a surgical review is necessary.
The prognosis of the injury is determined by the grade as well as the amount of treatment received.
At the time the West Tigers Club doctor Peter Lorentzos announced that Robbie Farah was likely be rehabilitated in time for the 2nd State of Origin match in Melbourne, which left the medical staff 3 weeks of intensive physiotherapy to get him back on the field.
