Understanding Prostate Cancer and How Pelvic Health Physiotherapy Can Help

Understanding Prostate Cancer and How Pelvic Health Physiotherapy Can Help

by | Nov 1, 2025 | Active Health Blogs

Prostate cancer is one of those topics many men prefer not to think about – until they have to. It’s often talked about quietly, but it’s something worth bringing into the open. In New Zealand, prostate cancer is the most common cancer diagnosed in men, with more than 4,000 new cases every year. The prostate itself is a small gland about the size of a walnut, sitting just below the bladder and surrounding part of the urethra. It helps produce semen and plays an important role in fertility.

While hearing the word “cancer” can be scary, there’s a lot of positive news. Prostate cancer is usually slow-growing, and thanks to early detection and effective treatments, survival rates are very high – around 96 percent of men are still alive five years after diagnosis. That said, early awareness really matters. Knowing your family history and keeping up with regular check-ups can make a big difference, especially for men with a father, brother, or son who’s been diagnosed.

Most men first hear about prostate testing through the PSA blood test, which measures the level of prostate-specific antigen in the blood. PSA is a protein naturally produced by the prostate, and higher levels can be a sign that something’s changed – but that doesn’t always mean cancer. PSA levels can rise for lots of reasons, such as a urinary infection, recent ejaculation, or even a long bike ride.

Because of this, the PSA test isn’t a diagnosis on its own. Instead, it’s a useful starting point. If the results are elevated, your doctor may suggest more testing, such as imaging or a biopsy, to get a clearer picture. It’s also important to have a proper chat with your GP before getting tested. They can explain the benefits and limitations of PSA testing and help you make an informed decision based on your age, health, and family history.

If prostate cancer is diagnosed, there are several treatment options available, depending on the type and stage of the cancer. Common treatments include surgery (prostatectomy), radiation therapy, and hormone therapy. All of these can be very effective in treating the cancer, but they can also come with side effects that affect your day-to-day life.

One of the most common issues after prostate surgery is urinary incontinence – difficulty controlling your bladder. Almost all men experience some degree of leakage in the early weeks after surgery, though it usually improves with time and the right support. Erectile dysfunction and changes to bladder or bowel function can also occur, especially after surgery or radiation. Hormone therapy, which lowers testosterone levels, can lead to fatigue, mood changes, and weight gain.

There are also newer, less invasive treatments being explored, such as the NanoKnife procedure, which uses electrical pulses to destroy cancer cells. It’s showing some promising results, though it’s not yet widely available in New Zealand.

For men with small, slow-growing cancers, another approach called active surveillance can be a good option. This means keeping a close eye on the cancer with regular testing and scans, rather than jumping straight into treatment. Many men live for years without needing surgery or radiation. Alongside medical monitoring, making positive lifestyle changes – being physically active, maintaining a healthy weight, eating well, and managing stress – can help improve overall health and long-term outcomes.

This is where pelvic health physiotherapists come in.

Many people are surprised to learn that physiotherapists can play a big role in prostate cancer recovery – and even before treatment begins. A pelvic health physiotherapist has specialised training in the muscles, nerves, and connective tissues of the pelvic region. These muscles support your bladder, bowel, and sexual function, so keeping them strong and well-coordinated is key to recovery. To learn more about the pelvic floor muscles check out this link: https://www.youtube.com/watch?v=rQQSqLCF12g

Starting pelvic floor exercises before surgery has been shown to improve bladder control and speed up recovery afterwards. Physiotherapists teach you how to correctly identify and activate the pelvic floor muscles (which isn’t always as easy as it sounds) and provide guidance tailored to your needs. They also offer support for bowel health, bladder retraining, fluid management, and strategies for managing erectile changes.

But pelvic health physiotherapy isn’t just about exercises. It’s also about education and reassurance – helping you understand what’s happening to your body, setting realistic expectations for recovery, and supporting your confidence as you return to daily life. For many men, this support is just as important as the physical rehabilitation itself.

Prostate cancer may be common, but it doesn’t have to define your life. With early detection, informed decisions, and the right care team, most men go on to live full, active, and healthy lives. Pelvic health physiotherapy plays a vital role in that journey, helping you regain control, strength, and confidence at every stage – before, during, and after treatment.

If you or someone you know is preparing for prostate surgery or managing recovery, it’s never too early (or too late) to see a pelvic health physiotherapist. Taking proactive steps now can make a world of difference to your long-term wellbeing and quality of life.

Get in touch with Active Health Christchurch or Active Health Rangiora below or give us a call! 

Understanding and Managing Constipation: A Pelvic Health Physio’s Guide to Better Digestive Health

Understanding and Managing Constipation: A Pelvic Health Physio’s Guide to Better Digestive Health

by | Oct 15, 2025 | Active Health Blogs

Struggling with constipation? You’re not alone. Constipation is a very common condition that affects people of all ages, from young children to older adults. Understanding how your bowels work and what causes constipation can help you manage it effectively and get back to feeling your best.

How Do Your Bowels Work? Understanding the Digestive Process

Before we dive into constipation relief, it’s helpful to understand the normal digestive process.

The digestive journey begins in your mouth. Food and fluid are broken down through chewing and travel to your stomach, which breaks everything down into a liquid before it moves into the small intestine. The small intestine extracts the nutrients from food to keep us healthy and strong.

The waste, still in liquid form, travels into the large intestine (also called the colon). The colon’s important role is to draw water out of stool to make it a formed soft sausage – not liquid but not too lumpy.

The stool then enters the rectum and puts pressure on the anal sphincter, a circular band of muscles at the base of the rectum. This pressure sends a signal to your brain telling it that it’s time to have a bowel movement. You then decide whether to listen to these signals. If you do, the muscles relax, and the stool is evacuated.

What does healthy stool look like? A good stool consistency is like a soft sausage, smooth and easy to pass – this is Type 4 on the Bristol Stool Chart, which doctors use to assess digestive health.

What Is Constipation? Signs and Symptoms

Constipation is when a person passes hard, lumpy, and often large stool, typically less than once a day. If you’re experiencing painful bowel movements or straining to pass stool, you may be dealing with constipation.

What Causes Constipation?

Constipation occurs when:

  • Dehydration: Too little fluid has been consumed, forcing the body to draw more water from the stool, making it harder and more difficult to pass.
  • Low fibre intake: Not enough fibre in the diet. Fibre helps form the stool, soften it, and propel it along the gut—it’s essential for healthy digestion.
  • Ignoring the urge: The urge to pass stool is ignored. After about 10 minutes, the urge to go passes, but the stool stays in the rectum and becomes harder.

 

Understanding the Constipation Cycle

These factors, either alone or together, cause hard and lumpy poo which can be painful to pass. When stool is painful to pass, the body remembers this and withholds stool. A “poo traffic jam” can build up, which stretches the rectum. Over time, people lose the urge to poop, causing further buildup of hard, firm stool and worsening constipation. A vicious cycle then develops.

Can constipation cause accidents? Yes. In some people, faecal accidents can occur as liquid poo slides past the hard poo and seeps into the underwear. People, especially children, are often unaware this has happened.

The Constipation Cycle: How It Starts and Why It’s Hard to Break

Understanding the constipation cycle is key to breaking free from chronic bowel issues. This cycle can affect anyone, but it’s particularly common in children and older adults. The medical term for this cycle is encopresis when it results in stool leakage.

The 5 Stages of the Constipation Cycle

Stage 1: Uncomfortable Defecation The cycle begins when passing stool becomes uncomfortable or painful. This might be due to pain from hard stool or avoidance because of a social event or unfamiliar bathroom. The discomfort creates anxiety about future bowel movements.

Stage 2: Holding Onto Stool Here’s what happens next: Your body remembers the pain. To avoid repeating the uncomfortable experience, the person (often unconsciously) begins holding onto stool and ignoring the urge to go. This is especially common in children who may withhold stool to avoid discomfort.

Stage 3: Increased Water Absorption in the Rectum When stool stays in the rectum longer than it should, the colon continues doing its job – absorbing water. The longer the stool remains, the more water is drawn out, making it progressively harder and drier.

Stage 4: Hardening of Stool As more water is absorbed, the stool becomes increasingly hard and lumpy. This makes it even more difficult and painful to pass, reinforcing the desire to hold on. A “poo traffic jam” builds up, and the problem worsens.

Stage 5: Increased Difficulty Passing Stool Now the cycle loops back to the beginning. The hard, large stool is even more uncomfortable to pass than before, strengthening the urge to withhold. And so the vicious cycle continues, with each rotation making the problem worse.

What Happens When the Cycle Continues

As the cycle repeats, serious complications develop:

Rectum Distension: The rectum becomes more and more distended (stretched) from the accumulating stool. This constant stretching damages the rectum’s ability to function normally.

Overflow Incontinence: In some cases, particularly in children, the buildup becomes so severe that liquid stool begins to seep around the hard, impacted mass. This is called “stool leakage” or overflow incontinence and causes faecal accidents where liquid poo slides past the blockage and leaks into underwear.

Loss of Rectal Sensation: The stretched rectum gradually loses sensitivity and can no longer send proper signals to the brain.

Loss of Urge to Defecate: People gradually lose the natural urge to poop. Without this signal, even more stools accumulates, becoming harder and larger.

Enlarged Intestines: Over time, chronic constipation can cause the intestines to become enlarged, further complicating the problem.

Difficulty Starting Bathroom Trips: The child or adult may develop significant difficulty initiating bathroom trips, creating behavioural challenges around toileting.

Breaking the Cycle

The good news? This cycle can be broken. The strategies outlined in this guide – proper hydration, adequate fibre, responding to urges, correct positioning, and when necessary, medical intervention – work together to reverse this process. With consistent application of these techniques, the rectum can gradually return to normal size and sensitivity, restoring healthy bowel function.

9 Proven Ways to Manage Constipation Naturally

  1. Drink Plenty of Water for Constipation Relief

How much water should you drink? Drink enough fluids so that your urine is a pale yellow, straw, or champagne colour. This means you’re sufficiently hydrated, and the body doesn’t have to take too much liquid from the stool. Proper hydration is one of the simplest and most effective natural remedies for constipation.

  1. Increase Your Fibre Intake

How much fibre do you need? Children aged 4-8 need 15-20g of fibre per day, progressing to adults who need 25-30g fibre per day.

Best high fibre foods for constipation:

  • Beans and legumes
  • Nuts and seeds
  • Bran and wholemeal foods
  • Fruits and vegetables, especially leafy greens, pears, and kiwifruit

Easy fibre tip: Little swaps like brown bread instead of white bread can quickly increase your fibre intake.

Bonus benefits of fibre: Fibre also has other health benefits, such as increasing the sense of fullness (helping with weight management), and reducing risks of diabetes and heart disease.

  1. Stay Active and Exercise Regularly

Physical activity helps constipation. Even a gentle walk each day can help keep your bowels regular and improve digestive function.

  1. Consider Laxatives When Needed

When should you use laxatives? Laxative medications can help keep stool soft and easy to pass. Talk to your doctor or pharmacist about these options to find the right treatment for your situation.

  1. Don’t Ignore the Urge to Go

When you feel the urge to go to the toilet, it’s important to listen and go. Delaying bowel movements can worsen constipation.

Tip for parents: For children, having toys to play with in the toilet can lessen the disappointment of leaving their other toys, making them less likely to defer.

  1. Use the Proper Toilet Posture

The right position can make a significant difference in how easily you pass stool:

  • Elevate your knees higher than hips – This changes the angle of the rectum from being bent (good for continence) to being straight (better for elimination). Consider using a footstool.
  • Relax your elbows on your knees – This relaxes the body and reduces straining
  • Take a deep breath in and then say “MOOO” – This helps propel the stool easily by using the abdominal muscles in the correct pattern
  • For kids: Blowing toys like bubbles and whistles have the same effect and make toilet time fun

 

  1. Try Abdominal Massage for Constipation

Gentle abdominal massage can help stimulate bowel movements and provide natural constipation relief.

  1. Be Aware of Other Factors That Affect Constipation

Several things can contribute to constipation:

  • Medications: Some medications can affect movements through the bowel
  • Travel: Changes in routine and diet can trigger constipation
  • Stress: Periods of high stress can impact digestive function

 

  1. When to See a Pelvic Floor Physiotherapist

Pelvic floor physiotherapists specialise in bowel and bladder health. They can help with constipation and other issues related to defecation, providing personalised treatment strategies.

Take Control of Your Digestive Health

Constipation doesn’t have to be a constant struggle. By understanding how your bowels work and implementing these evidence-based management strategies, you can break the cycle and restore healthy bowel habits. Remember, if constipation persists despite these measures, consult with your healthcare provider to rule out underlying conditions.

Start today: Choose one or two strategies from this list and begin incorporating them into your daily routine. Your digestive system will thank you!

Need Professional Support?

If you need help managing constipation or have concerns about your bowel health, our pelvic health team is here to support you. We offer personalised assessment and treatment strategies to help you or your child achieve better digestive health.

Contact us today to learn more about how we can help.

This information is for educational purposes. Always consult with your doctor or healthcare provider for medical advice tailored to your individual situation.

The Best Stretches for Gardeners from a Physio: Prevent Aches and Keep Moving

The Best Stretches for Gardeners from a Physio: Prevent Aches and Keep Moving

by | Sep 23, 2025 | Active Health Blogs, Physiotherapy

 Spring has sprung, and New Zealand gardens are calling! Whether you’re planting vegetables, pruning fruit trees, or tackling that long-awaited garden makeover, hours of bending, digging, and reaching can leave your body feeling less than fresh. But don’t let aches and pains keep you from enjoying your green sanctuary.

As physiotherapists, we see countless gardeners each season struggling with preventable injuries. The good news? With the right stretches and movement strategies, you can keep your body as healthy as your plants.

Why Gardening Can Be Tough on Your Body

Gardening is essentially a full-body workout in disguise. You’re constantly switching between movements that challenge different muscle groups:

  • Prolonged bending strains your lower back and hamstrings
  • Repetitive digging tightens hip flexors and can cause shoulder impingement
  • Kneeling for extended periods creates knee stiffness and quad tension
  • Overhead reaching (hello, fruit tree pruning!) can trigger neck and shoulder pain
  • Carrying heavy items like bags of soil or full watering cans stresses your entire kinetic chain

The problem isn’t the activities themselves – it’s doing them without proper preparation and recovery.

Your Pre-Garden Warm-Up Routine

Never jump straight from the couch to the compost bin. These dynamic stretches will prepare your body for garden work:

1: Gentle Spinal Rolls

  • Stand tall, feet hip-width apart
  • Slowly roll your spine down vertebra by vertebra, reaching toward your toes
  • Hold for 3-5 seconds, then slowly roll back up
  • Repeat 5 times

Why it works: Mobilises your entire spine and gently stretches your hamstrings – perfect prep for all that bending ahead.

2: Hip Circles

  • Place hands on hips, feet shoulder-width apart
  • Make slow, controlled circles with your hips – 5 in each direction
  • Gradually increase the size of the circles

Why it works: Lubricates hip joints and activates the muscles you’ll use for squatting and kneeling.

3: Shoulder Blade Squeezes

  • Extend arms out to sides at shoulder height
  • Squeeze shoulder blades together, imagining you’re holding a tennis ball between them
  • Hold for 5 seconds, release, repeat 8 times

Why it works: Activates your posterior chain and counteracts the forward head posture common in gardening tasks.

Post-Garden Recovery Stretches

These stretches target the areas most commonly tight after garden sessions:

1: Kneeling Hip Flexor Stretch – for your hips and lower back

  • Step into a lunge position, back knee on the ground (use a garden kneeler or folded towel if needed)
  • Tuck your tailbone under and lean forward gently
  • Feel the stretch in the front of your back leg’s hip
  • Hold 30-45 seconds each side

Pro tip: This is especially important after digging, which keeps your hips in flexion for extended periods.

2: Seated Hamstring Stretch – for your lower back

  • Sit on the edge of a garden bench or chair
  • Extend one leg straight, heel on ground, toe pointing up
  • Gently lean forward with a straight back until you feel a stretch
  • Hold 30 seconds, switch legs

Perfect for: After transplanting seedlings or weeding at ground level.

3: Wall Angel – for your shoulders and neck

  • Stand with your back against a wall, feet slightly away from the wall (or legs against the wall too if you want a deeper stretch)
  • Slowly slide arms up and down the wall, maintaining contact
  • Perform 10-15 repetitions

Why it’s brilliant: Reverses all that forward reaching and overhead work while strengthening your upper back.

4: Supine Spinal Twist – for your lower back

  • Lie on your back, knees bent to 90 degrees
  • Keep knees together, slowly lower them to one side
  • Keep opposite shoulder on the ground
  • Hold 30 seconds each side

Essential for: Releasing tension in your lower back and obliques after carrying, lifting, and twisting.

Smart Gardening Habits to Prevent Pain

Stretching is just one piece of the puzzle. Here are physio-approved strategies to keep you gardening comfortably:

Change positions frequently: Set a timer for every 15-20 minutes to remind yourself to stand, walk around, and switch tasks.

Use proper tools: Long-handled tools reduce bending. Ergonomic grips reduce hand and wrist strain. A good kneeler saves your knees and back.

Mind your posture: When lifting soil bags or plants, squat down – lift with your legs, not your back and keep your weight in your heels. Keep the load close to your body.

Stay hydrated: Dehydration increases muscle cramping and fatigue. Keep a water bottle handy.

Listen to your body: Some muscle fatigue is normal, but sharp or persistent pain is your body’s warning signal.

 

When to see a Physiotherapist?

While these stretches can prevent and relieve minor aches, some situations warrant professional attention:

  • Pain that persists for more than a few days
  • Sharp, shooting pain that radiates down your arms or legs
  • Numbness or tingling in your hands or feet
  • Pain that interferes with sleep or daily activities
  • Any injury that occurred during a specific incident (like a fall or sudden twist)

A physiotherapist can assess your specific movement patterns, identify weak links in your kinetic chain, and create a personalised programme to keep you gardening pain-free.

 

Your Action Plan

  1. Before gardening: Complete the 5-minute warm-up routine
  2. During gardening: Change positions every 15-20 minutes, stay hydrated, and listen to your body
  3. After gardening: Perform the recovery stretch sequence while your muscles are still warm
  4. Daily maintenance: Include gentle movement and stretching in your routine, even on non-gardening days 

Your garden should be a source of joy, not pain. By incorporating these physiotherapy-approved stretches and movement strategies, you’re investing in many more seasons of healthy, comfortable gardening.

Remember, the best stretch routine is the one you’ll actually do consistently. Start with just a few exercises that feel good to you and gradually build your repertoire as they become habit.

Love gardening but struggle with aches and stiffness?

Book a session with one of our physiotherapists today and get a personalised plan to stay strong, flexible, and pain-free while gardening. With expert guidance on stretches, posture, and movement, you can enjoy every planting, digging, and pruning session without discomfort.

Let’s make sure your body feels as good as your garden looks!

Christchurch Clinics

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Rangiora Clinics

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Small Injuries, Big Consequences: Your Off-Season Action Plan

Small Injuries, Big Consequences: Your Off-Season Action Plan

by | Jul 28, 2025 | Active Health Blogs

As the winter sports season winds down, rugby grounds quieten, netball courts empty out, and football clubs prepare for their off-season break, there’s a natural transition period for winter athletes everywhere. But before you pack away your boots and forget about those minor aches and pains, it’s time for an honest conversation about what your body has been telling you.

 

The “It’s Nothing” Trap

How many times this winter have you said, “It’s just a twinge,” or “I’ll just push through”? If you’re like most winter sports enthusiasts, probably more than you’d care to admit. That slight knee discomfort after a rugby match, the persistent ankle pain after football training or the shoulder that “just feels a bit stiff” following netball games – these aren’t badges of honour. They’re your body’s early warning system.

The end of winter sports season presents a crucial opportunity. Those minor issues you’ve been ignoring? Now is the perfect time to address them, before they develop into the kind of problems that sideline you next season or, worse, impact your daily life and work performance.

Why Small Problems Become Big Ones

When we ignore minor injuries, our bodies compensate. That slightly sore knee changes how you walk, which affects your hip, which impacts your lower back, which influences your posture at work. Before you know it, what started as a small rugby tackle has become a complex pattern of pain affecting everything from your morning commute to your productivity at the office.

Winter sports are particularly notorious for creating these compensation patterns. The high-impact nature of rugby, the explosive jumping and pivoting in netball, the quick direction changes and physical contact in football – they all place unique stresses on our bodies. Add in the competitive environment that encourages playing through pain and the adrenaline that keeps us pushing through discomfort, and it’s easy to see why minor injuries get ignored.

The Real Cost of Waiting

Male placing hand on lower back to signal it is sore after waking up in the morning

For individuals, untreated minor injuries often mean:

  • Longer recovery times when you finally do seek treatment
  • Higher treatment costs due to complexity
  • Potential time off work for what could have been a simple fix
  • Risk of missing out on next season’s activities

For employers, the impact is equally significant. Employees who don’t address minor sports injuries often develop chronic pain conditions that affect their work performance, increase sick leave usage, and can lead to more serious workplace injury claims when existing problems are aggravated by daily activities.

What Qualifies as a “Small” Problem Worth Attention?

You might be wondering if your particular issue warrants professional attention. Here are some common post-winter sports complaints that absolutely deserve assessment:

Joint Issues:

  • Knee pain or stiffness that persists after activity
  • Ankle instability or recurring “tweaks”
  • Shoulder discomfort, especially after falls
  • Hip tightness that affects your normal stride

Muscle and Movement Problems:

  • Persistent lower back stiffness
  • Neck tension that won’t resolve
  • Hamstring or calf tightness that limits movement
  • Balance issues or feeling “unsteady”

The Subtle Signs:

  • Feeling like you’re moving differently than before
  • Needing more warm-up time before activities
  • Avoiding certain movements without realising it
  • General fatigue that seems disproportionate to activity level

The Multi-Disciplinary Advantage

At Active Health, we understand that winter sports injuries rarely fit into neat categories. That’s why our approach includes physiotherapy for movement and strength issues, podiatry for foot and ankle problems that affect your entire kinetic chain, and pelvic health services – because yes, those awkward falls and impacts can affect your pelvic floor function too.

This comprehensive approach means we can identify and address the root cause of your problems, not just the symptoms. We can also spot the compensation patterns that might be developing and address them before they become entrenched.

Your Off-Season Action Plan

  1. Honest Assessment Take stock of how your body feels compared to the beginning of winter. What hurts? What feels different? What movements feel restricted or uncomfortable?
  2. Professional Evaluation Book a comprehensive assessment with our team. We’ll evaluate not just your specific complaints, but your overall movement patterns and identify areas of concern you might not have noticed.
  3. Targeted Treatment Based on your assessment, we’ll develop a treatment plan that addresses your specific needs, whether that’s hands-on therapy, exercise prescription, or education about injury prevention.
  4. Build for Next Season Use your off-season wisely. This is the perfect time to address weaknesses, improve flexibility, and build the strength and stability that will make you more resilient when winter sports season returns.

The Return-to-Work Connection

For employers reading this, consider the connection between your employees’ off-season health and their workplace performance. An employee dealing with unresolved knee pain from skiing isn’t just uncomfortable – they’re at higher risk for workplace injury, more likely to take sick days, and less productive overall. Supporting your team’s recovery from winter sports activities is an investment in your business’s success.

We work closely with employers to provide assessments and treatment plans that get employees back to full function quickly, reducing the risk of more serious problems down the track.

Don’t Wait for “Next Time”

Those minor aches and pains aren’t just part of being active – they’re opportunities to prevent bigger problems and ensure you’re ready for whatever comes next. Don’t let this winter’s small problems become next season’s big regrets.

Ready to address those lingering issues? Contact our team for a comprehensive assessment. We specialise in helping rugby players, netballers, and footballers recover smart and return stronger.

With 10 clinics across New Zealand, we have experienced clinicians ready to support your return to good health. Not sure who to see? We can help point you in the right direction:

Christchurch Clinics

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Rangiora Clinics

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Hamilton Clinics

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The Most Common Rugby Injuries We See: Prevention, Treatment, and Recovery

The Most Common Rugby Injuries We See: Prevention, Treatment, and Recovery

by | Jul 16, 2025 | Active Health Blogs, How-To Guides

Rugby is a physically demanding sport that pushes your body to its limits. The combination of high-impact collisions, rapid direction changes, and intense physical contact creates unique injury patterns that we see regularly in our clinic. Understanding these common injuries and how to manage them properly can make the difference between a quick recovery and a prolonged absence from the game.

Injury #1: AC Joint Injuries

What it is: The acromioclavicular (AC) joint connects your collarbone to your shoulder blade. In rugby, AC joint injuries commonly occur from direct impact during tackles, being tackled, or falling onto an outstretched arm. Players typically experience pain at the top of the shoulder and have difficulty lifting their arm overhead. The injury can range from a mild sprain to complete joint separation.

How we rehab it:

  • Early management: Pain and inflammation control through ice, anti-inflammatory medications, and sling support for comfort. Rest from aggravating activities while maintaining pain-free range of motion.
  • Strength and stability phase: Progressive strengthening of rotator cuff and scapular stabilizers. Manual therapy to restore joint mobility and reduce muscle tension.
  • Sport-specific return: Gradual return to contact activities, starting with non-contact drills and progressing to full tackle practice. Often requiring taping or extra padding for support with initial return to contact – see picture.

Key tips:

  • Rest initially, gradually introducing some passive movement exercises building up to full range of movement – no early return to contact activities as could impact rehab progress
  • Gradual increase in activity based on pain levels and function
  • Communication with coaches, GP, and physio is essential for safe return
  • Don’t ignore persistent pain or weakness- work on return to muscle symmetry to avoid longstanding issues and reduce reinjury rates.

Injury #2: Concussion

What it is: Concussion is a traumatic brain injury caused by a blow or jolt to the head or body that causes the brain to move rapidly within the skull. In rugby, concussions commonly occur from head-to-head contact during tackles, contact with the ground, or collisions during play. Players may experience headache, dizziness, confusion, memory problems, nausea, or loss of consciousness. Symptoms can be immediate or delayed.

How we assess it:

Maddox questions and vestibular testing are both used as diagnostic tools if players present with any signs or symptoms of concussion, they are then to be immediately removed from play. After concussion testing has been conducted they will commence a 21 day suspension from contact activity. Initially exertion can cause symptoms to flare up or return so important to build up activity levels slowly.

How we rehab it:

  • Early management: Complete physical and cognitive rest initially. Medical assessment is essential – any suspected concussion requires immediate removal from play and professional evaluation.
  • Strength and stability phase: Gradual return to light physical activity as symptoms allow, monitoring for symptom return. Vestibular and balance training if dizziness or balance issues persist.
  • Sport-specific return: Structured return-to-play protocol with progressive stages: light aerobic exercise, sport-specific exercise, non-contact training, full-contact practice, then return to play.

Key tips:

  • Rest initially – complete rest from sport and limit cognitive activities until cleared
  • Gradual increase in activity only when symptom-free at rest
  • Communication with coaches, GP, and physio is crucial – never self-diagnose or self-clear
  • Must be medically cleared before returning to any contact activities

Injury #3: ACL rupture

What it is: The ACL is a ligament that attaches your tibia to your femur and helps stabilise your knee. In rugby they are commonly injured during sided step movements where the foot is planted and the knee caves in. Players may hear a “pop,” experience immediate pain and swelling, and have difficulty bearing weight. The knee may feel unstable or give way with reduced range of movement.

How we rehab it:

  • Early management: Knee brace for support and stability when mobilising. Pain and swelling control with ice and compression, light knee and ankle range of movement exercises
  • Strength and stability phase: Progressive strengthening of quadriceps, hamstrings, and hip muscles. Neuromuscular training to restore proper movement patterns and joint stability.
  • Surgery/conservative management- some athletes may opt for surgical reconstruction of their ACL to enable return to sport.
  • Post surgical strengthening; A range of techniques and equipment is used to regain knee range of movement and strength after reconstruction surgery.
  • Sport-specific return: Advanced strengthening, plyometric training, and sport-specific drills including cutting, pivoting, and contact preparation.
  • Strength testing; using a VALD dynamometer and force decks strength and endurance testing is conducted to ensure muscle symmetry of over 90 % between the affected and unaffected limb allowing for a safe return to play.

Key tips:

  • Rest initially – never return to play with an acute knee injury
  • Gradual increase in activity following a structured progression
  • Communication with coaches, GP, and physio is crucial for appropriate return timing
  • Complete rehabilitation is essential to prevent re-injury and long-term problems

General Prehab (Prevention) Tips

Strength Training:

  • Focus on functional movements: squats, lunges, deadlifts
  • Include unilateral (single-leg) exercises for balance and stability
  • Strengthen core muscles for better body control during contact

Mobility and Flexibility:

  • Regular stretching routine focusing on hips, ankles, and shoulders
  • Dynamic warm-up before training and matches
  • Address muscle tightness before it becomes problematic

Proper Technique:

  • Master safe tackling and rucking techniques
  • Practice falling and landing mechanics
  • Work on body positioning during contact situations

Load Management:

  • Gradually increase training intensity and volume
  • Allow adequate recovery between sessions
  • Monitor fatigue levels and adjust accordingly

General Rehabilitation Tips

Follow Professional Guidance:

  • Stick to your rehabilitation program even when feeling better
  • Progress through all phases – don’t skip steps
  • Regular check-ins with your physiotherapist

Listen to Your Body:

  • Pain is your body’s warning system – don’t ignore it
  • Swelling and stiffness indicate ongoing inflammation
  • Respect the healing timeline – rushing back leads to re-injury, follow professional guidance regarding return to play.

Maintain Fitness:

  • Keep up cardiovascular fitness with appropriate activities-even in the off season
  • Maintain strength in uninjured areas
  • Stay mentally engaged with the team when possible

Communication is Key:

  • Keep coaches informed of your progress
  • Work with your GP for any medical concerns
  • Be honest with your physiotherapist about symptoms and goals

 Get Back in the Game Safely

Rugby injuries require in depth knowledge and experience to manage effectively. Our physiotherapists understand the unique demands of rugby and can guide you through a safe, effective recovery that gets you back to peak performance.

At Active Health, we provide comprehensive assessment, hands-on treatment, and sport-specific rehabilitation programs tailored to rugby players. Whether you’re dealing with a new injury or want to prevent problems before they start, we’re here to help.

Don’t let an injury keep you on the sidelines longer than necessary. Book an appointment with our team today and get back to playing the game you love safely and confidently.

Image credit: Andrew Wilson Photography, SkySports