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Cauliflower ears - Professional rugby's badge of honour or avoidable injury

By Adam Shelverton
Senior Rehabilitation Consultant

Cauliflower ear is an acquired deformity of the outer ear. Despite being synonymous with rugby, it is not the only sport that can cause it as many wrestlers and boxers can attest. In fact anyone that suffers a direct blow to their ear is at risk of developing a cauliflower ear. The incidence of this occurring from a single blow however is very low, but the likelihood of cauliflower ear developing increases dramatically when the ears receive repeated blows. 

The history behind Cauliflower ears

This fact is somewhat worrying when the history of cauliflower ear is researched, as it is well documented that cauliflower ear was initially thought to be a sure sign of insanity during the 1800’s. As modern day medical professionals have obviously disproved this theory it transpires that the increased prevalence of cauliflower ear amongst the clinically insane during the 1800’s was most likely a direct consequence of the care staff’s nursing methods who were tasked with their care!

The bad news is that once cauliflower ear has developed they are unlikely to revert to their normal shape and size and the appearance of them will most likely be altered forever more.

What causes cauliflower ear?

Ears are largely made up of cartilage and they get their blood supply from the tiny blood vessels that are encased in the skin around them. Trauma to an ear in the form of a direct blow, or more commonly in rugby being squeezed and rubbed against in scrums and rucks, will often shear the skin away from the cartilage underneath. The consequences of this are two fold, as blood will start to bleed into the gap between the skin and the cartilage and as the tiny blood vessels are torn away from the underlying cartilage, the cartilage itself will start to die.

Once the cartilage within the ears starts to die it will often contract and contort while new scar tissue is being formed within the ears at the same time and the outcome of this process is more commonly know as Cauliflower Ear.

How can this be treated?

Treatment usually consists of draining blood directly out of the ears using a syringe, so that the swelling is reduced, and a compression bandage is often used following this to try and encourage the skin to reattach to the cartilage underneath.

During competitions such as the 6 nations it is not uncommon for rugby players to have their ears drained before and after the matches to try and limit further injury to their ears. When you consider that the average weight of this years 6 nations packs is over 850kgs it’s not surprising that the majority of the players taking their place in the scrum wont be lining up with their ears looking like they did when they were born!

Protective headgear can help protect ears from trauma in rugby and boxing as they act as a shock absorber but they are also vital at providing protection against more serious head injuries. As seen in the 6 nations matches to date, direct trauma to the head and associated injuries e.g Post-concussive syndrome are becoming a more prevalent and topical issue and a further blog in relation to this will be circulated within the next few months.

Your contact

Your contact

Adam Shelverton

Adam Shelverton

Rehabilitation Manager

Tel: +44 (113) 2906321