By Tadhg Peavoy

Johnny Sexton’s game against France came to an end last Saturday due to whiplash suffered in collision, or repeated collisions, at Stade de France. A continuation of the same injury he suffered initially against Wales in Dublin six days beforehand.

The out-half will be relieved to have avoided concussion, having suffered four in 2014, and as a result serving a 12-week stand down period. But whiplash in itself is a serious injury and one that takes plenty of effort to heal completely, depending on the severity.

I know from personal experience. My own playing days were effectively ended at 19-years-old due to the same injury. Having suffered the injury at under-15s in the Leinster Junior League I was prone to serious neck and shoulder pain for the next four years. Trying to get the issue fixed involved chiropractic, physiotherapy and acupuncture, but ultimately a year after U18 level I had to call it a day as the pain was too serious to quell. Four years of treatment later the issue was resolved, bar the odd flair up now and again over ten years later.

So what is the injury exactly? It’s known medically as a sudden distortion of the neck and is often caused by car crashes, which collisions in rugby are similar to. This can come from a tackle, a clash of bodies, or from a misplaced head and neck when entering a breakdown.

A minor whiplash can have few symptoms but a serious one can have huge problems: neck, shoulder and back pain, pins and needles and chronic headaches. All of this, of course, can be compounded in rugby by playing and training while the injury heals.

There are a number of theories on the cause of the pain. The two main ones being: 1) stretching of the spine, most especially the ligament; and 2) the deformation of the cervical spine into an S shape due to the impact of the collision. There is also the theory that damage to the trapezium muscles covering the neck and inner back is the primary cause.

From my own personal experience it was a combination of all three and chiropractic, acupuncture, physiotherapy and trapezium strengthening exercises in combination proved the most effective forms of treatment.

The hope with Sexton’s incident is that the injury is mild and he can overcome it in a fortnight to face England at Twickenham. However, the medics will need to assess whether rushing him back is the correct course of action given the potential for worsening the condition through a relapse of the injury from a return to action before full recovery.

It’s an injury not often mentioned in relation to rugby, but a common one none the less, that needs careful monitoring. Out-halves, being the most prone to head and neck injuries – followed by hookers – need to be gently eased back from it, and like concussion, awareness is key.