Injuries In Rugby Union Research Articles

Do mismatches between teams affect the risk of injury in the Rugby World Cup?

The aim of this study was to assess whether differences in competing teams’ body mass and playing performance affected the risk of injury in rugby union. The study was a prospective, whole population survey of players representing all countries competing at the Rugby World Cup in 2007. The study design followed the consensus statement for epidemiological studies in rugby with the main outcome measures being the incidence and severity of match injuries. Differences in players’ average body mass and mismatches in the teams’ overall and match performances did not create greater risks of injury for the lighter or less successful teams competing at Rugby World Cup 2007.

The Epidemiology of Ankle Injuries in Professional Rugby Union Players

Background Ankle injuries represent a considerable proportion of injuries to professional rugby union players; however, there is a scarcity of detailed epidemiology about these injuries. Purpose To describe the epidemiology and assess the risk factors associated with ankle injuries sustained by a cohort of professional rugby union players. Study Design Descriptive epidemiology study. Method Medical personnel prospectively reported time-loss injuries in professional rugby union in England, and the ankle injuries were evaluated. Results Lateral ankle ligament injuries were the most common injury reported during matches and training, and together with Achilles tendon injuries, they accounted for more than half of the absence due to injury. The incidence rate of injuries was highest in second-row forwards. More than a quarter of injuries were recurrences. Conclusion Lateral ankle ligament injuries and Achilles tendon injuries should be a focus of injury prevention, treatment, and rehabilitation strategies in professional rugby union players.

International Rugby Board Rugby World Cup 2007 injury surveillance study

Objective:to determine the incidence, nature and causes of injuries sustained during the International Rugby Board (IRB) Rugby World Cup 2007.Design:Pospective, whole-population survey.Population:626 international rugby players representing 20 teams competing at...

Tackle Injuries in Professional Rugby Union

Background The tackle is the most dangerous facet of play in rugby union, but little is known about risk factors for tackle injuries. Purpose To estimate the injury risk associated with various characteristics of tackles in professional rugby union matches. Study Design Descriptive epidemiology study. Method All 140 249 tackles in 434 professional matches were coded from video recordings for height and direction of tackle on the ball carrier, speed of tackier, and speed of ball carrier; injuries were coded for various characteristics, including whether the tackier or ball carrier required replacement or only on-field assessment. Results There were 1348 injury assessments requiring only on-field treatment and 211 requiring player replacement. The inciting event and medical outcomes were matched to video records for 281 injuries. Injuries were most frequently the result of high or middle tackles from the front or side, but rate of injury per tackle was higher for tackles from behind than from the front or side. Ball carriers were at highest risk from tackles to the head-neck region, whereas tacklers were most at risk when making low tackles. The impact of the tackle was the most common cause of injury, and the head was the most common site, but an important mechanism of lower limb injuries was loading with the weight of another player. Rates of replacement increased with increasing player speed. Conclusion Strategies for reducing tackle injuries without radically changing the contact nature of the sport include further education of players about safe tackling and minor changes to laws for the height of the tackle.

The Epidemiology of Head Injuries in English Professional Rugby Union

To undertake a detailed epidemiological study of head injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. A 3-season prospective cohort design. 13 English Premiership rugby union clubs. 757 male rugby union players. Anatomical location, diagnosis, severity (number of days unavailable for training and match play), injury incident, and incidence of match and training injuries (injuries/1000 player-hours). Playing position, use of headgear, and activity. The overall incidence of match head injury was 6.6 injuries/1000 player-hours, and each injury resulted, on average, in 14 days lost-time. The overall incidence of match concussions was 4.1 injuries/1000 player-hours resulting, on average, in 13 days lost-time. Concussion was the third most common match injury for all players. A large proportion of the players (48%) were able to return to play safely within 7 days. Match concussions were most commonly associated with tackling head-on (28%), collisions (20%), and being tackled head-on (19%). The midfield backs were the playing position at the greatest risk of sustaining a concussion. Only 42% of players were removed from the field of play immediately after a concussion. Foul play was reported by the player to be associated with match head injury in 17% of cases. Mouthguard and headgear usage was associated with a reduced incidence of concussive injury. The overall incidence of training head injury was 0.05 injuries/1000 player-hours, and the overall incidence of training concussions was 0.02 injuries/1000 player-hours. The results showed that rugby union players were exposed to a high risk of noncatastrophic head injury and concussion, particularly whilst tackling and being tackled head-on. In all, 48% of players sustaining a concussion were able to return to play in less than 7 days. The clinical challenge when assessing the potentially concussed player during a game is compounded by the current regulations regarding the permanent replacement of injured players. Injury prevention strategies should be focussed on minimizing the risk and force of direct contact to the head in the tackle.

Interim evaluation of the effect of a new scrum law on neck and back injuries in rugby union

Background:In January 2007 the International Rugby Board implemented a new law for scrum engagement aimed at improving player welfare by reducing impact force and scrum collapses. In New Zealand the...

Evaluation of RugbySmart: A rugby union community injury prevention programme

RugbySmart, a rugby union injury prevention programme, was launched in New Zealand in 2001. It was compulsory for all coaches and referees to complete RugbySmart requirements annually in order to continue coaching or refereeing. After 5 years of implementation the programme partners, Accident Compensation Corporation and New Zealand Rugby Union, evaluated RugbySmart to determine its effectiveness in reducing injuries. The purpose was to evaluate the effect of RugbySmart on reducing injury rates per 100,000 players and resulting injury prevention behaviours. The RugbySmart programme was associated with a decrease in injury claims per 100,000 players in most areas the programme targeted; the programme had negligible impact on non-targeted injury sites. The decrease in injury claims numbers was supported by results from the player behaviour surveys pre- and post-RugbySmart. There was an increase in safe behaviour in the contact situations of tackle, scrum and ruck technique.

Collegiate rugby union injury patterns in New England: a prospective cohort study

Objective: To establish injury profile of collegiate rugby union in the USA Design/setting: 31 men’s and 38 women’s collegiate rugby union teams prospectively recorded injuries during games and practice during...

Catastrophic Injury in Rugby Union

Rugby union is a full contact sport with a relatively high overall risk of injury and a small specific risk of fatal and catastrophic spinal injury. Although catastrophic injuries in rugby union cause public concern and generate strong emotive reactions, the magnitude of society's concern about this type of injury is often dominated by people's perceptions rather than by actual levels of risk. This article assesses published values for the risk of catastrophic injuries in rugby union, evaluates these against the risk standards of the UK Health and Safety Executive (HSE) and compares the values with the risks associated with other common sport and non-sport activities. The assessment showed that the risks of sustaining a catastrophic injury in rugby union in England (0.8/100,000 per year), Ireland (0.9/100,000 per year) and Argentina (1.9/100,000 per year) were within the HSE's 'acceptable' region of risk (0.1-2/100,000 per year), whilst the risks in New Zealand (4.2/100,000 per year), Australia (4.4/100,000 per year) and Fiji (13/100,000 per year) were within the 'tolerable' region of risk (2-100/100,000 per year). The risk of sustaining a catastrophic injury in rugby union was generally lower than or comparable with the levels reported for a wide range of other collision sports, such as ice hockey (4/100,000 per year), rugby league (2/100,000 per year) and American Football (2/100,000 per year). In addition, the risk of catastrophic injury in rugby union was comparable with that experienced by most people in work-based situations and lower than that experienced by motorcyclists, pedestrians and car occupants. Whilst ranking risks provides an effective way of assessing their acceptability, it is recognized that representing risks by a single risk value can be misleading, as account must also be taken of the public's perception of the risks and the inherent differences in the types of risk being considered. However, an acceptable level of risk is often regarded as one that is no greater than the levels of risk that an individual encounters in everyday life. In this respect, the assessment indicated that the risk of sustaining a catastrophic injury in rugby union could be regarded as acceptable and that the laws of the game therefore adequately manage the risk.

343 Spinal cord injuries in South African rugby union: new incidence data and implications for injury prevention

343 Spinal cord injuries in South African rugby union: new incidence data and implications for injury prevention

The Epidemiology of Shoulder Injuries in English Professional Rugby Union

Background Shoulder injuries constitute a considerable risk to professional rugby union players; however, there is a shortage of detailed epidemiologic information about injuries in this population. Purpose To describe the incidence, severity, and risk factors associated with shoulder injuries in professional rugby union. Study Design Descriptive epidemiology study. Method Medical personnel prospectively reported time-loss injuries in professional rugby union in England, and the shoulder injuries were evaluated. Results The incidence of shoulder injuries was significantly lower during training (0.10/1000 player—training hours) compared with matches (8.9/1000 player—match hours). The most common match injury was acromioclavicular joint injury (32%); the most severe was shoulder dislocation and instability (mean severity, 81 days absent), which also caused the greatest proportion of absence (42%) and had the highest rate of recurrence (62%). The majority of match shoulder injuries were sustained in the tackle (65%), and outside backs were the most likely to sustain an injury from tackling (2.4/1000 player-tackles). Injuries sustained during training were significantly more severe (61 days) than were those sustained during match play (27 days), and defensive training sessions carried the highest risk of injury (0.45/1000 player-hours; mean severity, 67 days). A mean of 241 player-days per club per season were lost to shoulder injuries. Conclusion Results suggest the potential to reduce this injury burden by modifying training activities and implementing “prehabilitation” strategies in an effort to minimize the risk of shoulder dislocation/instability.

Association of ground hardness with injuries in rugby union

Background:Ground hardness is considered one of the possible risk factors associated with rugby injuries.Objectives:To examine the contribution of ground hardness, rainfall and evapotranspiration to the incidence of injury, and to...

Consensus Statement on Injury Definitions and Data Collection Procedures for Studies of Injuries in Rugby Union

Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to agree on appropriate definitions and methodologies to standardize the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow-up meeting was arranged in Dublin at which time all definitions and procedures were finalized. At this stage, all authors confirmed their agreement with the consensus statement. The agreed-on document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, nonfatal catastrophic injury, and training and match exposures together with criteria for classifying injuries in terms of severity, location, type, diagnosis, and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union.

The Epidemiology of Knee Injuries in English Professional Rugby Union

Background Detailed injury epidemiology is an invaluable tool for reducing risks associated with sporting injuries. Very little accurate injury surveillance data exist regarding knee injuries in professional rugby. Hypotheses (1) Knee injuries have a greater impact on the game than injuries to other body locations. (2) Anterior cruciate ligament and medial collateral ligament injuries cause the greatest days absent from training and match play. Study Design Descriptive epidemiology study. Methods Medical personnel prospectively reported time-loss injuries sustained by 546 professional rugby union players from 12 clubs in England over 2 seasons, and the knee injuries were evaluated. Results Injuries to the knee accounted for the highest number of days absent due to injury (7776 days, 21%) and were characteristically severe, with a disproportionately high number of days missed per injury (37 days). Anterior cruciate ligament injuries accounted for the greatest proportion of days missed of all knee injuries (29%), followed by medial collateral ligament injuries (25%). Most severe injuries occurred during contact, mostly during a tackle, and most commonly in the final 20 minutes of a match. Injuries tended to be more common in backs. Injuries sustained during training accounted for 16% of all knee injuries. Each club studied had a mean of 10 knee injuries per season resulting in a total of 353 days absent. Conclusions The incidence of knee injuries sustained during matches was higher than that reported in all other football codes, surpassed only by rugby union at the international level. Knee injuries accounted for the highest player absence due to injury; 5% of an average playing squad were absent at any one time due to knee injuries.

Spinal Injuries in Professional Rugby Union: A Prospective Cohort Study

To determine the incidence, severity, nature, and causes of cervical, thoracic, and lumbar spine injuries sustained during competition and training in professional rugby union. A 2 season prospective cohort design. Twelve English Premiership rugby union clubs. Five hundred and forty-six male rugby union players of whom 296 were involved in both seasons. Location, diagnosis, severity (number of days unavailable for training and matches), and cause of injury: incidence of match and training injuries (injuries/1000 player-hours). Player age, body mass, stature, playing position, use of headgear, and activity and period of season. The incidences of spinal injuries were 10.90 (9.43 to 12.60) per 1000 player match-hours and 0.37 (0.29 to 0.47) per 1000 player training-hours. No player sustained a catastrophic spinal injury, but 3 players sustained career-ending injuries. Overall, players were more likely to sustain a cervical injury during matches and a lumbar injury during training. Forwards were significantly more likely to sustain a spinal injury than backs during both matches (P < 0.01) and training (P = 0.02). During matches, injuries to the cervical (average: 13 days; P < 0.01) and lumbar (13 days; P < 0.01) spine were more severe than injuries to the thoracic (5 days) spine; during training, injuries to the lumbar spine (26 days) were more severe than injuries to the cervical (13 days; P = 0.10) or thoracic (12 days; P = 0.06) spine. A total of 4037 days were lost to competition and training through spinal injuries with lumbar disc injuries sustained during training accounting for 926 days (23%) and cervical nerve root injuries sustained during matches for 621 days (15%). During matches, more injuries were caused by tackles (37%), and during training more injuries were caused by weight-training (33%). The results showed that rugby union players were exposed to a high risk of noncatastrophic spinal injury during tackling, scrummaging, and weight-training activities; injury prevention strategies, therefore, should be focused on these activities.

Incidence, Risk, and Prevention of Hamstring Muscle Injuries in Professional Rugby Union

Background The incidence of hamstring muscle injuries in professional rugby union is high, but evidence-based information on risk factors and injury-prevention strategies in this sport is limited. Purpose To define the incidence, severity, and risk factors associated with hamstring muscle injuries in professional rugby union and to determine whether the use of hamstring strengthening and stretching exercises reduces the incidence and severity of these injuries. Study Design Cohort study (prevention); Level of evidence, 3. Methods Team clinicians reported all hamstring muscle injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury; loss of time from training and match play was used as the definition of an injury. Players’ match and training exposures were recorded on a weekly basis. Results The incidence of hamstring muscle injuries was 0.27 per 1000 player training hours and 5.6 per 1000 player match hours. Injuries, on average, resulted in 17 days of lost time, with recurrent injuries (23%) significantly more severe (25 days lost) than new injuries (14 days lost). Second-row forwards sustained the fewest (2.4 injuries/1000 player hours) and the least severe (7 days lost) match injuries. Running activities accounted for 68% of hamstring muscle injuries, but injuries resulting from kicking were the most severe (36 days lost). Players undertaking Nordic hamstring exercises in addition to conventional stretching and strengthening exercises had lower incidences and severities of injury during training and competition. Conclusion The Nordic hamstring strengthening exercise may reduce the incidence and severity of hamstring muscle injuries sustained during training and competition.

Managing Pain and Injury in Non-elite Rugby Union and Rugby League: A Case Study of Players at a British University

Studies of elite and professional athletes have pointed to a high level of tolerance of pain among such athletes, coupled with a willingness to continue training and competing even when injured and in pain. The central object of this article is to examine some of the ways in which non-elite players of rugby union and rugby league at a British university respond to and manage pain and injury. The central finding is that the attitudes and behaviour of the non-elite rugby players appear to be broadly similar to the attitudes and behaviour of elite and professional athletes in other sports. This suggests that key elements of the ‘culture of risk’ which has been identified in elite and professional sport are not confined to elite sport but that they are also characteristic of non-elite sport. Particularly important in this regard is the culture of ‘playing hurt’, that is, continuing to play with pain and injury, the value of which is clearly accepted by the non-elite rugby players in this sample. These findings suggest that the ‘culture of risk’ cannot be adequately explained in terms of relatively recent commercial and financial pressures in professional and elite sport to ‘play hurt’, but that it may be a more deeply rooted characteristic of sport at all levels. The paper also examines some of the implications of these findings for government policies designed to improve the health of the nation by encouraging people to participate in sport.

Epidemiology of injuries in English professional rugby union: part 2 training Injuries

Objectives: To undertake a detailed epidemiological study of training injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. Methods: A two season...

Epidemiology of injuries in English professional rugby union: part 1 match injuries

Objectives: To undertake a detailed, large scale epidemiological study of match injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. Methods: A...

Evaluation of protective equipment for prevention of injuries in rugby union

Rugby union has a high rate of injury. The increased use of protective equipment may help mitigate these injuries. This study investigated the injury prevention effectiveness of the protective equipment used in rugby union. A cohort of 304 rugby players in Dunedin, New Zealand was followed weekly during the 1993 club season to assess protective equipment use, participation in rugby, and injury outcomes. Generalized Poisson regression was used to model the rate of injury while adjusting for covariates such as level of competition, playing position, and injury history. The use of mouthguards appeared to lower the risk of orofacial injury [rate ratio (RR) = 0.56, 95% confidence interval (CI): 0.07-4.63], and padded headgear tended to prevent damage to the scalp and ears (RR = 0.59, 95% CI: 0.19-1.86). Support sleeves tended to reduce the risk of sprains and strains (RR = 0.58, 95% CI: 0.26-1.27). The risk of concussion was not lessened by the use of padded headgear (RR = 1.13, 95% CI: 0.40-3.16) or mouthguards (RR = 1.62, 95% CI: 0.51-5.11). There was no evidence of protective effects for any other equipment item (taping, shinguards, and grease). The protective equipment used in rugby union has limited effectiveness in preventing injuries. The results are supportive, however, of a role for mouthguards and padded headgear in preventing orofacial and scalp injuries, respectively, and for support sleeves in preventing sprains and strains.