Leeds Carnegie full back has shoulder surgery – what will his rehab involve?

Leigh Hinton (30) of Guinness Premiership Rugby Union teamLeeds Carnegie’s (full back injured his AC joint in early August during the club’s pre-season tour of France (vs Aurillac). He has now had a surgical repair now and begins the rehabilitation that the club hope will ensure he returns to play in October. He faces 10 weeks of hard work following this operation so good luck to him – although with a complete physiotherapy and strength and conditioning team behind him 24/7, being highly motivated,  and with 100% of his day focussed on recovery he has all the odds in his favour.

“AC” stands for acromioclavicular and refers to the joint that is the only bony link between the shoulder girdle and the trunk. Most people know about the “shoulder blade” but few realise that it is part of the same bone that provides the “socket” for the upper arm bone – humerus – and also connects to the collar bone (clavicle) at the front of the shoulder/upper chest. The AC joint (pointed out below) is a small and vulnerable joint, particularly for rugby players for whom it is a very common injury. Snowboarders, wrestlers (see pic below) and anyone involved in a sport/profession are also susceptible as they will inevitably experience impacts to the AC either directly or from heavy or awkward falls on to an outstretched arm. The scapula is most commonly forced downwards whilst the clavicle remains relatively fixed.

Injuries to the joint  are graded (I-VI) from stretched or partially torn ligaments to partial dislocations (subluxation) to complete dislocation and muscle tears.

Hinton told BBC Radio Leeds “It’s very frustrating but these things happen…Once I’ve recovered from the operation it will be like starting pre-season all over again and will have a hard 10-week training programme set out for me.”

Leeds director of Rugby Andy Key said, “Initially we hoped the injury would recover with rehabilitation but the specialists advised surgery so we have had that done as soon as possible to get Leigh back out on the pitch at the earliest possible opportunity.” Again with a team of professionals around you things run much more efficiently and the time line from injury to recovery is much reduced.

The op that Hinton has had will provide some instant structural strength but surgery slows the rehab process  so 10 weeks is required.  Hinton is philisophical about the “frustration” of it but we know the frustration isn’t so easy to shrug off when you feel like its taking forever or its difficult to see the progress you are making. At times like this you need an experienced physiotherapist or strength coach to help you become more aware of your situation, offer clearer insight, put your progressions into context and point out your areas of ill discipline in following your routine, or the imbalance in your approach.

Many people become overly focussed on strength and intensity whilst ignoring quality movement – ironic because true strength and intensity only comes with good movement abilities.

this is where the AC joint is - this shoulder was injured taking an impact during wrestling sparring

this is where the AC joint is - this shoulder was injured taking an impact during wrestling sparring

Rehabilitation should ensure that your shoulder should regain full mobility and be strong and secure through its full range, powerful and stable moving through all the various angles that its likely to experience and is resilient against reinjury when used at high speed and/or against a high load.

It is these angles, ranges, speeds and loads that are often inadequately explored by the recovering athlete.

What also needs to be considered is the implications the injury has for the future and the need for a long term plan for joint mobility and health. The long term plan often gets short shrift due to the short sighted approach of insurance cover, the demand for discipline and a lifestyle change in the injured man or woman.

If you are a Balance client you can take advantage of a complete team and extended network of professionals for the short term interventions and the long term strategy. If  you are out of area tell us where you are and maybe we can link you to a team near you.

To see how the Leeds Carnegie website reported the news got to http://tinyurl.com/lbzoxh

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