Rugby is a tough sport played by tough men and women, and for many, that’s part of its appeal. The very physical nature of the game combined with a lack of or very light protective equipment means that injuries are common. We've been doing a series recently on what it's like to return to rugby from a broken leg or a serious ACL tear. But injuries don't necessarily need to be that severe for them to affect your playing career. Having said that, bruises, strains, sprains, and abrasions are the norm, and any player who doesn’t suffer at least a few minor niggles probably isn't playing hard enough!
Of all the injuries that rugby players risk, neck injuries are potentially the most serious, with a broken neck being right at the top of the list. A neck injury can occur during a mistimed or 'spear' tackle or a collapsed maul, but the most likely source of neck injury is the scrum.
Because of the demands of scrummaging, front row and back row forwards are the players most likely to suffer neck injuries. Perhaps surprisingly, it's the hard-tackling fullbacks and wingers who come in a close second. (1) There is little doubt that the risk of suffering a neck injury is correlated with your position on the field. But any player can suffer a neck injury which means neck strength training is a must, irrespective of position.
Studies reveal (2) that a program of regular strength training can reduce the risk and severity of neck injuries in rugby. There is also some evidence to suggest that neck strength plays a role in preventing concussion during both expected and unexpected impacts with the head. Neck strength (or a comparable lack thereof) is one of the most prominent reasons given for why we see women reporting greater incidences of concussion in sports that both men and women play.
Mechanisms of injury
Neck injuries happen for several different reasons:
- Forced hyperextension e.g. in the collapse of a scrum
- Forced lateral flexion e.g. the scrum wheels
- Forced rotation e.g. having your head twisted in a scrum
- Compression e.g. head-on impact
- Forced flexion e.g. a hard tackle causing the head to snap forward violently
- Any and all of the above e.g. high tackles
The muscles, ligaments, intervertebral discs, the cervical vertebrae and even the spinal cord itself can be damaged in any of these incidents. Stronger muscles can help absorb and dissipate force which makes them your first line of defense against neck injury.
The neck, properly called the cervical spine, is made up of seven vertebrae and many muscles – some small and others quite large. Each vertebra is separated by a cushion of fibrocartilage called a disc. The disc provides shock absorbency. Vertebrae are connected by non-contractile, non-elastic tissue called ligaments which provide stability help prevent extraneous movement.
The neck is a very mobile joint that is capable of several different movements including flexion, extension, rotation, and lateral flexion. Very mobile joints are inherently unstable which increases their potential for injury, think shoulders for a good example of this.
A human's neck is really 'designed' for nothing more than supporting the weight of your head. Forces placed on a front rower's neck during a rugby scrum exceed balancing the force of your skull many, many times over. When the scrum engages, the front row forwards are exposed to stresses approaching and exceeding 3000 pounds of compressive force – assuming each player only weighs 200lbs.(3) The bigger the packs, the higher the stress will be. Rule changes have made scrummaging safer, but there is no getting away from the fact that when 16 burly players come together in a scrum, the neck of any forward is going to take a hammering, especially in the front row.
Neck strengthening exercises
Warning: If you are new to neck training, do not do too much too soon. Over-zealous neck work can lead to severe muscle soreness and unpleasant headaches. Increase exercise intensity and volume gradually. The exercises below are listed in order of difficulty.
1) Extension exercises
Extension exercises target the muscles on the back of your neck. Having strong neck extensors will help prevent your chin from being pulled down toward your chest, something that can happen if a scrum collapses.
Isometric towel extensions – loop a towel over the back of your head and hold the ends in your hands in front of your face. Force your head back against the towel while resisting the movement with your arms. Hold for 15-30 seconds.
Simple neck extensions – lie on your front on an exercise bench so that your head is unsupported. Lower your head down toward the floor and then lift it up toward the ceiling. Do as many reps as it takes to fatigue your rear neck muscles.
Head harness extensions – once you have mastered the previous exercises, you should be ready to start lifting some heavier loads. Wearing a head harness, sit on an exercise bench or chair with your hands on your thighs for support. Lower your chin to your chest and then lift your head and look up toward the ceiling. Repeat 12-15 times. Alternatively, as shown in this video, you can also perform this exercise lying on a bench. If you do not have a head harness, wrap a weight plate in a towel for comfort and hold it on the back of your head.
Stability ball bridge – sit on a stability ball. Walk your feet forward and lean back until the back of your head is resting on the ball. From here, move your feet a little further forward and support more weight using your neck. The further forward your feet, the more stress will be on your neck. Hold for 15-30 seconds.
Rear neck bridge – lie on your back on the floor. Bend your legs and place your feet close to your butt. Fold your hands across your abdomen. Lift your hips and butt off the floor and roll back onto the back and then the top of your head. Return to the starting position and repeat. This is a difficult exercise that is only suitable for those with an already strong neck. Less advanced players should replace this exercise with the wall rear neck bridge.
2) Lateral flexion exercises
Lateral flexion involves taking your ear down toward your shoulder. Developing your lateral flexors can help increase neck stability which is important during a wheeling scrum or any other time your head is forced sideways.
Isometric neck lateral flexion – place your hand flat against the side of your head. Raise your arm, so it’s in a strong position. Press your head against your hand as hard as you can while resisting with your arm. Hold for 15-20 seconds and then change sides.
Simple lateral flexion – lie on your side on an exercise bench. Lower your head down toward the floor and then raise it back up toward the ceiling. Keep your head neutral – do not turn your neck. Do as many reps as it takes to fatigue your side neck muscles. Perform the same number of reps on each side.
Head harness lateral flexion – as above but while wearing a head harness. If you do not have a head harness, wrap a weight in a towel and hold it on the side of your head. Repeat 12-15 times and do the same number of reps on each side.
Wall side neck bridge – place and hold a folded towel against a wall at shoulder height. Place the side of your head on the towel. Move your feet ways from the wall, so your weight is pressing against the towel. Push the side of your head into the towel and roll onto the top of head moving your body away from the wall. Roll back onto the side of your head and repeat. Work both sides of your neck equally.
3) Flexion exercises
Flexion is the action of pulling your chin down to your chest and targets the muscles at the front of your neck. Strong neck flexors can help prevent forced neck extension which can happen when you are dropped onto your back in a tackle, and your head snaps backward.
Isometric flexion – place the palms of both hands against your forehead. Push your head into your hands while resisting with your arms. Hold for 15-20 seconds.
Simple neck flexion – lie on your back on the floor or an exercise bench. Lift your head off the floor and tuck your chin into your chest. Lower your head and repeat. Do as many reps as it takes to fatigue your rear front muscles.
Head harness flexion – wearing a head harness, lie on your back on an exercise bench. Lift your head and tuck your chin into your chest. Lower your head just below the level of the bench and repeat.
Front stability ball neck bridge – place and hold a stability ball against a wall at around shoulder height. Lean forward and place your forehead against the ball. Walk your feet back to increase the load on your neck flexors. Push with your legs to make the exercise more demanding. Hold for 15-20 seconds.
You can also hold weights in your hands and add a head roll to make this exercise more challenging. Check out this video to discover how.
Front neck bridge – kneel down on the floor and place your forehead on an exercise mat or folded towel. Place your hands next to your head, palms flat on the floor. Walk your feet back. Lift your butt and support your weight on your feet, hands, and forehead. Rock your head forward and back. As your strength increases, take your hands away, so your weight is on your feet and head only. For a less demanding exercise, perform against a wall.
4) Trapezius Exercises
Your trapezius or traps support your neck from behind. They elevate your shoulder girdle and do not directly move your head and neck, but they do attach onto the base of your skull and cross your neck by default. Subsequently, strong traps may help reduce neck injury, especially when caused by impact.
The trapezius can be divided into three compartments – the upper, middle, and lower. The upper trapezius pulls your shoulders upward, the middle trapezius pulls your shoulders back and together, and your lower trapezius pulls your shoulders downward. Upper traps are the most important for neck strength and health.
Shrugs – this common exercise can be performed using a barbell, dumbbells, or kettlebells. Holding a heavy weight and with your arms straight, shrug your shoulders up to your ears. Lower your shoulders and repeat. Avoid circling your shoulders backward or forward; this does nothing for your traps and increases wear and tear on your shoulders.
Calf raise machine shrugs – removing your arms from the shrug exercise makes it harder and prevents cheating. Stand under a calf raise machine with the pads resting on your shoulders. Lift your shoulders up toward your ears and then lower them again.
Farmer’s walk – working your grip, core, and traps all at the same time, this is a very rugby-specific exercise. Lift and hold a heavy dumbbell in each hand. Walk a set distance or for a set time. Keep your upper traps engaged by elevating your shoulders slightly and keeping them up for the duration of your set. Use just one weight to increase core activity. Incidentally, farmers walks are a critical part of session 1 in our off-season superset strength sessions eBook available here as a free download.
Overhead shrugs – where regular shrugs involve pulling a weight up using your traps, overhead shrugs are more about pushing. Hold a barbell, dumbbells, or kettlebells, above your head. Your hands should be roughly shoulder-width apart. Shrug your shoulders up to your ears and then lower them again.
Waiter’s walk – this is an overhead version of the farmer’s walk. Press and hold a heavy weight overhead. Elevate your shoulders slightly. Brace your core and walk for a set distance or time. Use just one weight to increase core activity.
Programming Neck Training
Because your neck muscles are not directly involved in other strength and conditioning training, you can include it almost anywhere in your workout schedule. As many neck exercises can be done at home, you could do it on your rest days. Alternatively, do your neck work after completing your gym sessions.
Gradually increase the intensity and volume of your neck training and strive to develop strength by adding weight where you can. Make sure you also spend some time stretching your neck muscles to avoid excessive tightness. Be sure to include exercises from each of the exercise categories to strengthen your neck from all angles. Avoid neck training before full-contact practice or matches as fatigued neck muscles could contribute to injury rather than prevent it.
The importance of nutrition
Adding neck training to an already full training calendar means you need to be eating as well as possible to support muscle growth and recovery. Supplement your healthy diet with Ruck Harder and Ruck Recovery to get the most from all of your workouts.
Neck strength could make the difference between improved rugby performance and serious injury so make sure you commit to getting and keeping your neck as strong as possible.
Reference 1 – Incidence, severity, etiology and type of neck injury in men's amateur rugby union: a prospective cohort study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907385/
Reference 2 – Can a Specific Neck Strengthening Program Decrease Cervical Spine Injuries in a Men's Professional Rugby Union Team? A Retrospective Analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772600/
Reference 3 – Danger of 250 stone (3,500 lbs.) pressure if the scrum collapses http://www.telegraph.co.uk/news/uknews/1416118/Danger-of-250-stone-pressure-if-the-scrum-collapses.html
Reference 4 - "researchers at Nationwide Children's Hospital in Columbus, Ohio and the Colorado School of Public Health (Collins, 2014) found that neck strength was a significant predictor of concussion, with the odds of concussion falling by 5% for every one pound increase in aggregate neck strength." http://www.momsteam.com/health-safety/stronger-necks-may-reduce-concussion-risk-study#ixzz4ZHxRfGzv
Reference 5 - Image courtesy of Charlie, Flickr.com