Collision sports

Sports in which players collide as part of the game are called collision sports. These are high energy, fast moving sports with frequent impact against opponents and the ground. As a result, the patterns of injury are less likely to be predictable and can often be significant because of the body mass of opponents, their speed and momentum, and the random nature of the collision.

Collision sports include rugby union, rugby league and American football. Professional players in these sports are prepared for collision as much as is possible, but even careful planning of fitness, strength, conditioning and muscle building programmes cannot prevent injury. As a result, hand and wrist injuries are frequently encountered. These are true 'injuries', occurring at a specific time in a specific way, and the incident is often remembered. Sometimes the pace of the game means that the exact injury time cannot be accurately recalled by the player, which means the doctor or physiotherapist have no details of the injury mechanism and this can produce difficulty in reaching a diagnosis.

A suspicious approach to any injury is always helpful. The suspicion of a wide range of different injuries will enable the examining doctor or physiotherapist to ensure that possibilities are not ignored. Sometimes, it is helpful to allow the acute pain and swelling from an injury to settle before a more accurate examination can take place. Local measures of ice, compressive strapping and elevation of the injured part will allow this to occur at an early stage.

In spite of the unpredictable nature of impact, there are some injuries which occur frequently in collision sports. Fractures are common, particularly of the thumb, scaphoid and fingers. X-rays will be helpful in planning the best treatment. Torn ligaments are also seen regularly, usually in the thumb and finger joints as players grapple each other, but also in the small bones of the wrist after falling or forcible movements. These injuries are best assessed as early as possible. Delay can cause the torn ligament to shrink and make surgical repair impossible.

Mr Campbell has been treating professional rugby union and rugby league players for over 10 years, and is now the specialist Medical Adviser to 7 Engage Super League clubs, International Rugby League and Rugby Union teams, and numerous Premiership and professional Rugby Union clubs.