This requires fundamentals such as recruitment of the deep core muscles to increase power, postural alignment to facilitate biomechanically efficient movement and lateral thoracic breathing to increase oxygen intake and preserve energy. This, coupled with the dynamic flexibility training that Pilates provides, is key for rehabilitation.
Core strength is essential to performance as it supports the body which in turn allows full force transfer. For example, when tackling a player you hit them with your shoulder. A strong core would allow all the force in your legs to be transmitted through into your shoulder and onto the opponent. A weak core would not transmit anywhere near the same force, causing the body to collapse under the pressure, often resulting in a missed tackle.
During scrums or collisions there is considerable risk to the neck, spine and shoulders through misalignment and compression, as well as an increased risk of acute sprains to muscles and tendons. Therefore mobility, flexibility and strength in these areas are paramount for prevention of injury when moving the body through flexion, hyper-extension and rotation in these unstable positions.
Exercises such as the chest opener or an adaptation of spine stretch incorporating arm circles are suitable. A flow from Side Bend into Mermaid Stretch repeated will also aid in the strength and rehabilitation of common problems such as frozen shoulder. Likewise, the Push-Up lying on a Swiss ball will also help to improve shoulder joint articulation through controlled resistance. Strengthening exercises suitable to the injury and postural rehabilitation should also be included, such as Double Leg Stretch and shoulder retraction exercises such as The Dart and Spine Stretch into Seated Row (using a resistance band).
A large proportion of injuries can also be attributed to the discrepancy in the working of the global and local muscles. Global muscles such as the hamstrings, quadriceps and chest are known to generate speed and power, making them extremely important for rugby players. Local muscles due to their usual attachment to the spine are purpose-built to produce low levels of force for a long period of time. In Pilates, we follow the principle of stamina to focus on the engagement and endurance of the powerhouse muscles that are often neglected by traditional forms of strength training. Neglect allows them to weaken and for the nerves to become inactive, causing loss of function and an over reliance on the global muscles. The result is fatigue as they are forced to perform the role of both stabiliser and mobiliser to provide the needed support. Postural defects and muscle imbalances will present themselves, power output is reduced and the risk of injury escalates.
Therefore, when choreographing a repertoire for clinical results, focus on postural alignment, dynamic stretching and mobility in all planes of movement to remain functional. Emphasis should be placed on the training of the neutral spine as kyphosis and lordosis may be prominent, adding to the risk of injury. Players in the front row of a scrum are particularly at risk, as the compressive loading of the spine in a non-neutral position becomes limited in its ability to distribute force.
With any agility-based movements, injuries such as torn ligaments or joint degradation are common and are caused by extrinsic factors such as directional changes or tackles, or intrinsic factors such as overtraining and overuse. Your role is to offer clinical Pilates adaptations such as the use of the magic circle or Pilates balls to enhance stability and alignment. For example, adapt the Swan Dive by holding the magic circle in front of the body and applying pressure during chest elevation to aid alignment and strength through the thoracic spine and shoulder girdle. Emphasis should be placed on the depression of the shoulders and the opening of the chest muscles to counteract the probable tightness, lack of mobility or chronic injury. A Pilates ball under each hand can also be used in this exercise to challenge and strengthen the latissimus dorsi and posterior deltoids. Imbalances in flexibility, mobility and strength can also be determined from such exercises, providing a foundation for future programming.
Similarly the ball can be used between the knees in Shoulder Bridge whilst incorporating arm raises. Or, in other modifications such as the One Leg Stretch the ball can be passed into an oblique twist, thus mimicking the sport through effective mobilising and strengthening movements. The Saw exercise also releases commonly affected areas including the shoulders, hamstrings, chest and hips. The use of a block under the sitting bones and a band across the thoracic spine and under the arms could be particularly beneficial here.
Take into account the common prevalence of hamstring strains. These are often caused by a lack of core control, stability or mobility in the lumbar spine and pelvis as opposed to just being a flexibility issue in the affected area. Therefore, range of motion testing is an essential component when assessing an athlete, as it provides information on their capabilities.
Incorporate exercises that focus on the stabiliser muscles of the pelvis as well as flexibility in the muscles. For example, a resistance band on the foot to perform one leg circles, Scissors modified (head and shoulders down with the band across both feet, lowering and lifting one leg at a time), or Double Leg Kick (holding a band shoulder-width apart behind the back) to allow for a safer and more comfortable opening of the chest.
By amalgamating mobility and strength variations and facilitating testing in the initial sessions will allow programmes to be effectively tailored to reflect results, the stage of recovery, muscle imbalances, sporting and positional requirements.