The Hurt Locker: Where Rugby Injuries Can Ruin Lives

World Rugby, Union and League, demands the running and endurance of 11-a-side football combined with heavy contact and rough tackling. Where there is smoke, there is fire. With such a volatile match play event, there is always a potential for injury both mild and serious (such as traumatic injuries sustained during collisions with other players or the ground surface during scrumming, rucking & tackling etc)

Most Common Rugby Injuries

Medial collateral ligament (MCL) injury
What is it? The MCL is a ligament found in our knee, which works with other ligaments to give us stability during running and walking. Injury is caused by the fibres that make up the ligament being torn or completely ruptured.
Why does it occur? MCL injuries are more likely to occur in players who play in a back position, due to the increased likelihood of being tackled and the requirement for fast changes of directions. The force of a tackle can place excessive strain on the ligament causing the tear.
What can be done to prevent it? Conditioning training can be undertaken to improve the strength of the knee and speed work, which improves the resilience of the knee to the stresses and strains of sudden changes of direction.

Calf Muscle Injury
What is it? A calf strain is a tear to the either the Gastrocnemius or Soleus muscle, most commonly at the point where they join the Achilles tendon.
Why does it occur? Multiple factors such as, not warming up effectively, insufficient recovery time between matches, weak or tight calf muscles, poor running, speed work on very tired muscles, over stretching or incorrect stretching, structural problems e.g. over-pronation (rolling inwards) or over- supination (rolling outwards) of the foot.
What can be done to prevent it? Implementation of effective recovery techniques (e.g. ice baths), conditioning training and corrective rehabilitation to improve running technique can prevent injury.

Thigh Haematoma
What is it? Haematoma are caused by a direct blow to the affected area. They are basically a severe bruise as the trauma causes damage to the blood vessels leading to blood leaking around the tissue forming a large clot.
Why does it occur? From physical contact and impact. As rugby is a contact sport these injuries are bound to happen.
What can be done to prevent it? Not much! It is very difficult to prevent without changing what makes rugby such a great game. Early implementation of RICE (rest, ice, compression and elevation) principles can dramatically reduce recovery time and should be implemented as soon as possible post injury.

Hamstring Injury
What is it? It is a tear of the muscle fibres that make up the hamstring (bicep femoris, semi-tendinosus and semi-membranosus).
Why does it occur? Multiple factors such as, not warming up effectively, insufficient recovery time between matches, weak or tight hamstring muscles, poor running, speed work on very tired muscles, over stretching or incorrect stretching and structural problems.
What can be done to prevent it? Implementation of effective recovery techniques (e.g. ice baths), conditioning training and corrective rehabilitation to improve running technique can help prevent injury.

Concussion
What is it? Concussions are traumatic head injuries that occur from both mild and very severe blows to the head.   Why does it occur? It is simply caused by the physical contact nature of rugby.                                                                    What can be done to prevent it? Not much! It is very difficult to prevent without changes what makes rugby such a great game. The RFU work hard to ensure they have a robust process in place to manage suspected head injuries effectively.

Overuse Injuries
Because rugby involves a great deal of running, tendinitis in the knee or ankle, medial tibial stress syndrome (shin splints) and bursitis are all overuse injuries commonly seen. Although these are usually not considered “serious” injuries, they can adversely affect performance and possibly lead to more complicated conditions if not properly addressed by a qualified sports medicine professional.

As it is a collision sport, traumatic injuries do occur in rugby. They can include fractured bones, dislocated fingers and elbows, cuts, sprained ligaments and strained tendons or muscles and deep muscle bruises. There has been an increase of facial fractures, especially of the nose because helmets are not worn.

Injury Treatment
When recovering from a rugby injury there are a few things to consider. As with most sports, regaining strength and flexibility after an injury are important to a successful rehabilitation. Neck, shoulder, hip and core strength, as well as flexibility of the hamstrings and hip flexors are important for overall conditioning and can minimize the chances of an athlete sustaining a secondary injury. Because rugby is a continuously moving sport, working to regain a high level of endurance also plays a large role in the effectiveness of a player returning from a rugby injury.

Injury Prevention

Practice a balanced and structured training regimen involving strength, flexibility and endurance.

Always use proper technique when tackling, rucking and scrumming.

Learn proper positioning during game play to minimize risky moves.

Use a quality, properly fitted mouth guard.

Participate at a level consistent with ability.

Adhering to the rules for the formation of the scrum.

Ask your athletic trainer or other sports medicine professional about any training or injury questions.

 

 


Medical malpractice negligence: Doctors and Hospitals Living in Fear

Medical malpractice happens. It is a fact of life for thousands of innocents both locally and internationally and in many cases, it can be a game changer. The temptation is to think, to hope, to hypothesize, that it will never happen to you? You will never be hit by lightning, never suffer a collision with a bus or indeed play the starring role in a medical malpractice case? The numbers don’t lie people, it could be you or I caught out, woefully unprepared and or poorly informed. How to deal with a negligence case, how to navigate through the red tape of  a malpractice  case, those are the big questions and the key answers open for intensive debate.

According to the Journal of the American Medical Association (JAMA), medical negligence is the third leading cause of death in the U.S.A, that is, behind heart disease and cancer. In 2012, over $3 billion was spent in medical malpractice payouts, averaging one payout every 43 minutes. Medical malpractice occurs when a health-care provider deviates from the recognized “standard of care” in the treatment of a patient. The “standard of care” is defined as what a reasonably prudent medical provider would or would not have done under the same or similar circumstances. In essence, it boils down to whether the provider was negligent.

A malpractice claim exists if a provider’s negligence causes injury or damages to a patient. However, experiencing a bad outcome isn’t always proof of medical negligence. Also, on occasion, health-care providers will inform a patient that the person has received negligent medical care from a previous health-care provider and—presumably in an effort at complete honesty—will sometimes tell a patient that they, themselves, have made a mistake.

Insurance companies typically want to settle with an injured person directly if they can, and this allows them to do so before the full extent of injuries are known, as well as preventing the injured person from hiring an attorney who could increase the settlement value of the claim through their representation. Consequently, most experienced medical malpractice attorneys will not pursue a case unless the injuries and damages documented in the records—after they’ve been reviewed by an expert in the pertinent specialty—are substantial and justify it.

Being proactive about medical care is undoubtedly the best step. Patients should do research to understand their health condition, and document their symptoms. They should ask health-care providers a written list of questions that they feel are important, and expect—indeed, demand—full and complete answers. It’s also critical not to allow yourself to be intimidated by the medical system. Speak up and advocate for your own well-being. If patients sense that something is wrong, they should tell—or ask—their health-care providers. Although it’s important to trust your doctor or nurse, it’s also important to listen to your body … and use common sense. Also advisable: Have a family member or friend accompany you on important visits to health-care providers.

Patients choose not to pursue valid medical-malpractice claims for numerous reasons: Some are concerned that other doctors will learn of their cases and refuse to treat them. Some fear—incorrectly—that it will lead to an increase in the cost of their medical care. And others forgo valid claims due to the perceived personal and financial costs associated with litigation.

Although the medical school adage of “treat the patient and not the test” has value, it’s also important for health-care providers to carefully assess the information provided by the tests that they order. I’ve witnessed many instances in which highly abnormal test results were either interpreted incorrectly or disregarded by physicians—sometimes with fatal consequences.

Hospital systems and health-insurance companies significantly impact the quality of medical care that patients receive. Your health is too important to place in the hands of a provider who hasn’t earned your confidence, isn’t answering questions or isn’t giving you—or your condition—adequate time and attention. Always be on guard or as a very wise medical patient once said “Always hope for the best but prepare for the worst”.


Standing Up for the Rights of Disabled Workers

It is still an unfortunate fact that some employers will take advantage of vulnerable workers in their employ. It may be business owners exploiting newly arrived migrants or refugees, by not informing these people of their rights under Australian Government laws. Even more despicable, are the employers who exploit disabled workers in their employ, with under paying of wages and not providing adequate support and workplace conditions. Some businesses think that just giving disabled workers a job is enough and that they do not consider them deserving of a proper wage.

Standing Up for the Rights of Disabled Workers

Businesses that work in the charity sector have, unfortunately, been the worst offenders in this regard and they employ more disabled workers than any other sector. Australian Disability Enterprises (ADE) pays some of their intellectually disabled workers less than $2 per hour to pack boxes in their sheltered workshops. They manage to get away with this appalling rate of pay by basing their remuneration on productivity via the Business Services Wage Assessment Tool (BSWAT). One wonder whether our legalised treatment of those with intellectual disabilities actually belongs back in the eighteenth century.

Probono legal service groups are beginning to challenge some of the worst economic mistreatment of disabled workers, but the Australian Government needs to close these loopholes. The dignity of work is one thing, but if you are being woefully exploited, so that in addition to full time work you require welfare payments just to survive, something is wrong. I remember delivering charity ribbons to letter boxes for an Anglican charity many years ago, when I was down on my luck. This kind of position is filled by many disabled people. I worked out that I was earning about $3 an hour.

Reasonable rates of pay must be afforded to disabled workers. When a disabled person purchases a product or buys a cup of coffee, they do not get a reduced price. So, why should they be made to suffer at the production end of the equation? Compassion does not mean it is OK to pay peanuts to vulnerable people. Compassion is of a higher order altogether. With technology achieving so many things in workplaces, it surely must be possible to invest some friendly computerised technology into these charitable industries, which employ so many people with disabilities. Let’s get out of the dark ages and smarten up, compassionately. There are wonderful organisations who support disabled people and their families in Sydney and throughout Australia.  The disability service provider in South West Sydney is helping many vulnerable people meet and overcome some of the pressing challenges in their lives. We need more organisations like this and greater government funding in this sector, not less. Did you hear that Malcolm Turnbull?