BCA rugby health expert reveals top injures this Rugby World Cup

Ulrik Sandstrøm, chiropractor and Board Member of the British Chiropractic Association, has been involved in elite level sports chiropractic for over two decades and is passionate about delivering the highest quality care to athletes by working within integrated medical teams. As chiropractor to Leicester Tigers Rugby and chiropractic consultant to England Rugby, he has worked closely with many rugby stars, developing an evidence, patient-centred approach to their care.

Commenting on when the most injuries happen during a match, Ulrik said:

Generally, most injuries occur in the game rather than training, and particularly in the first part of the second half. So, between 40 and 60 minutes is when we are likely to see the highest peak in injuries. We often put this down to the fact that players are fatigued because they’ve had a full first half and then 15 minutes of cooling down and then they’re straight back out, playing at full intensity again. Many players will sit on static bikes keeping warm during half time to keep their legs ticking over as a preventative measure.

What’s also interesting to note is that in game time, backs players tend to get more injuries than forwards. Whereas in training, forwards tend to get more injuries than backs. In training, the backs generally don’t get hit as hard as they would during a game, but forwards do get involved with live scrums, lineouts etc., which carry more risk.

Commenting on hamstring and groin injuries:

“Because rugby is a running sport, you tend to see a lot more hamstring and groin injuries than you would in other sports. Hamstring injuries can take anywhere from a few days to a few months to heal properly, depending on the severity of the injury, and groin injuries can take six to eight weeks to fully recover from, leading to time out of training and a slow return to play. When a player is injured, it’s important to work with the player to develop an individual evidence-based treatment plan that reduces their pain as soon as possible and supports them throughout their recovery period. 

Hamstring and groin injuries usually occur from sudden changes of direction or high speed when running, so players can limit the occurrences of these kinds of injuries by making sure their muscles are thoroughly warmed-up before matches. Warm up drills are usually very individual and designed by the strength and conditioning team to fit the particular tasks and injury profile of each player. As chiropractors and members of the BCA, we always take an evidence, patient-centred approach to care – and create bespoke care packages for all patients.

Commenting on hip injuries:

You see a lot of high impact injuries in rugby due to the nature of the game – it’s not uncommon for a player to make 10 or more tackles per match. Hip injuries, known as hip pointers, occur after direct impact to the front of the hip and are very common in rugby due to tackles. The usual recovery time is one to three weeks, depending on the severity of the condition, but severe injuries can take closer to eight weeks to properly heal. When treating an injured player in a sporting competition like the Rugby World Cup, it is often the case that other healthcare professionals will be present. Working collaboratively and communicating effectively with the other clinicians within the team is paramount to ensure the athlete gets the best treatment and guidance from the whole medical team.

Commenting on concussion and neck injuries:

Mild head and spine injuries are common in rugby, especially during high contact play like scrums, tackles, and rucks, but can be very painful so need to be looked at carefully. I see several ‘stingers’ in rugby – stingers are essentially traction injuries of the nerve bundle coming from the neck and are usually caused by tackling someone. Depending on how severe the injury is, a stinger will cause an electric-stinging pain, which usually doesn’t last long but can continue for hours or even days in bad cases. They can take anywhere from two weeks to a few months to recover from and can sometimes be associated with a marked weakness of the arm muscles. These injuries are very often co-managed by the team chiropractor to make sure the athlete is on the right course of treatment. Stingers were certainly one of those conditions often waiting for me on Monday mornings at Leicester Tigers.

Concussion is clearly a potentially serious injury – especially if players get them repeatedly. We are seeing a number of neurological conditions, such as MND and Parkinson’s, now being linked to concussions, which is why the RFU are making changes to tackle laws to reduce the risk of head injuries.


About the British Chiropractic Association: The BCA is the largest and longest-standing association for chiropractors in the UK and has been named ‘Best Professional Body of the Year’ at the Memcom Excellence Awards 2022 for its Repositioning Project which has played a pivotal role in changing the healthcare landscape for the better. As well as promoting international standards of education and exemplary conduct, the BCA supports chiropractors to progress and develop to fulfil their professional ambitions with honour and integrity, at every step. The BCA is raising awareness about the rigour, relevance and evidence driving the profession and the association’s ambition for chiropractic to be more closely embedded within mainstream healthcare.

The BCA is the home for chiropractors who provide patient-centred, evidence-based care and offer full transparency to their patients. Through the Patient Charter BCA chiropractors provide reassurance to their patients and that they will empower them to make an informed decision about their treatment.