# Exploring Initial Management Practices Related to Anterior Shoulder Dislocation in the United Kingdom and Ireland Professional Rugby Union: An Observational Online-Based Survey

## TL;DR

This study surveyed rugby medical staff in the UK and Ireland to understand how they manage shoulder dislocations during games.

## Contribution

The study provides insights into current pitch-side practices for managing anterior shoulder dislocations in professional rugby.

## Key findings

- Most responders attempt shoulder reduction in the medical room with normal neurovascular status.
- Variations exist in reduction techniques and number of attempts, with the Spaso technique being most common.

## Abstract

Objective

In this study, we aimed to identify current medical practice regarding shoulder dislocation pitch-side management within men’s and women’s professional rugby union in the United Kingdom (UK) and Ireland.

Methods

An online questionnaire containing 38 questions, validated by an expert panel of clinicians, was distributed to team medical personnel at 41 professional UK and Ireland rugby teams. Distribution was conducted via the Rugby Football Union and Irish Rugby Football Union to medical personnel at English and Irish professional teams.

Results

Thirty-nine completed questionnaires were received, and one response was excluded. Most responders were doctors (n=22; 58%) and physiotherapists (n=15; 39%) and worked in the Gallagher Premiership (n=14; 37%). Most responders would attempt reduction in the medical room with normal neurovascular status (n=29; 76%). Many responders would attempt medical room reduction with motor nerve and vascular impairment, respectively (n=19; 50% and n=17; 45%). Responders would have one and two attempts at reduction in 53% (n=20) and 37% (n=14) of cases, respectively, and the Spaso technique was the most common method used (n=16; 42%).

Conclusions

While the initial management practices related to anterior shoulder dislocation in professional rugby union are fairly consistent amongst pitch-side clinicians, notable variations were also observed, including reduction settings with neurovascular impairments, reduction techniques, and reduction attempt numbers.