Injuries In Rugby Union Research Articles

Injuries in Australian school-level rugby union

ABSTRACTThere is a high incidence of injuries in rugby union due to the physical nature of the game. In youth rugby union, there are large variations in injury rates reported. Our study investigated the rates of injuries in school-level rugby union players in Australia using the consensus statement for rugby union injuries. Injury surveillance was conducted on 480 rugby players from 1 school in Queensland, Australia. Injury data were collected using paper-based injury recording forms during the 8-week rugby season using a “medical-attention” injury definition. In total, 76 players sustained one or more injuries, with a total of 80 injuries recorded. The overall injury rate was 31.8 injuries/1000 match player hours (95% CI, 25.4–39.4). Concussion had an incidence rate of 6.0/1000 match player hours (95% CI, 3.5–9.6). The incidence of upper limb and lower limb injuries were 9.1 and 9.9/1000 match player hours, respectively (95% CI, 5.9–13.5 and 6.6–14.5). The older age divisions had higher injury rates and most injuries occurred while tackling or being tackled. The injury rates observed in this sample of Australian school rugby union players provides direction for future studies to enable informed decisions relating to development of injury prevention programmes at this level of rugby.

Training volume and soft tissue injury in professional and non-professional rugby union players: a systematic review

AimTo investigate the relationship between training volume and soft tissue injury incidence, and characterise soft tissue injury in rugby union players.DesignA systematic search of electronic databases was performed. The search...

Video analysis of concussion injury mechanism in under-18 rugby

BackgroundUnderstanding the mechanism of injury is necessary for the development of effective injury prevention strategies. Video analysis of injuries provides valuable information on the playing situation and athlete-movement patterns, which...

The Epidemiology of Injuries in Australian Professional Rugby Union 2014 Super Rugby Competition.

Background:Rugby union is a collision-based ball sport played at the professional level internationally. Rugby union has one of the highest reported incidences of injury of all team sports.Purpose:To identify the characteristics, incidence, and severity of injuries occurring in Australian professional Super Rugby Union.Design:Descriptive epidemiology study.Methods:The present study was a prospective epidemiology study on a cohort of 180 professional players from 5 Australian Super Rugby teams during the 2014 Super Rugby Union Tournament. Team medical staff collected and submitted daily training and match-play injury data through a secure, web-based electronic platform. The injury data included the main anatomic location of the injury, specific anatomic structure of the injury, injury diagnosis, training or match injury occurrence, main player position, mechanism of injury, and the severity of the injury quantified based on the number of days lost from training and/or competition due to injury.Results:The total combined incidence rate for injury during training and match-play across all Australian Super Rugby Union teams was 6.96 per 1000 hours, with a mean injury severity of 37.45 days lost from training and competition. The match-play injury incidence rate was 66.07 per 1000 hours, with a mean severity of 39.80 days lost from training and competition. No significant differences were observed between forward- and back-playing positions for match or training injury incidence rate or severity.Conclusion:The incidence of injury for the present study was lower during match-play than has previously been reported in professional rugby union; however, the overall time loss was higher compared with previous studies in professional rugby union. The high overall time loss was due fundamentally to a high incidence of injuries with greater than 28 days’ severity.

Causation Events of Stud Laceration Injuries in Rugby Union

Laceration injuries in rugby union account for approximately 6% of all injuries sustained during match play. Commentators often cite the design of studded footwear as a causal factor in laceration injuries. In order to assess the laceration injury risk of different stud designs, there is a need to develop a testing protocol that is able to replicate the laceration injury event. This study used a questionnaire to identify the play scenarios that result in laceration injuries. The questionnaire was answered by 191 rugby players, of which 72% had experienced one or more stud injuries during their career which hindered them playing rugby. Half of the laceration injuries described by the respondents came from the ruck, and 27% from a tackle. When analysing free-text responses, a deliberate stamp was described in 35% of the responses and a tackle from behind was described in 14% of responses. These injury scenarios are considered to be the dominant cause of laceration injuries. In future work the identified injury scenarios will be replicated in simulated play and kinetic and kinematic measurements will be recorded. This will inform test parameters for future assessment of laceration injury risk of stud designs.

Eccentric Knee Flexor Strength and Risk of Hamstring Injuries in Rugby Union

Background: Hamstring strain injuries (HSIs) represent the most common cause of lost playing time in rugby union. Eccentric knee flexor weakness and between-limb imbalance in eccentric knee flexor strength are associated with a heightened risk of HSIs in other sports; however, these variables have not been explored in rugby union. Purpose: To determine if lower levels of eccentric knee flexor strength or greater between-limb imbalance in this parameter during the Nordic hamstring exercise are risk factors for HSIs in rugby union. Study Design: Cohort study; Level of evidence, 2. Methods: This prospective study was conducted over the 2014 Super Rugby and Queensland Rugby Union seasons. In total, 178 rugby union players (mean age, 22.6 ± 3.8 years; mean height, 185.0 ± 6.8 cm; mean weight, 96.5 ± 13.1 kg) had their eccentric knee flexor strength assessed using a custom-made device during the preseason. Reports of previous hamstring, quadriceps, groin, calf, and anterior cruciate ligament injuries were also obtained. The main outcome measure was the prospective occurrence of HSIs. Results: Twenty players suffered at least 1 HSI during the study period. Players with a history of HSIs had a 4.1-fold (95% CI, 1.9-8.9; P = .001) greater risk of subsequent HSIs than players without such a history. Between-limb imbalance in eccentric knee flexor strength of ≥15% and ≥20% increased the risk of HSIs by 2.4-fold (95% CI, 1.1-5.5; P = .033) and 3.4-fold (95% CI, 1.5-7.6; P = .003), respectively. Lower eccentric knee flexor strength and other prior injuries were not associated with an increased risk of future HSIs. Multivariate logistic regression revealed that the risk of reinjuries was augmented in players with strength imbalances. Conclusion: Previous HSIs and between-limb imbalance in eccentric knee flexor strength were associated with an increased risk of future HSIs in rugby union. These results support the rationale for reducing imbalance, particularly in players who have suffered a prior HSI, to mitigate the risk of future injuries.

Training Activities and Injuries in English Youth Academy and Schools Rugby Union

Background: All rugby training activities carry an injury risk, but in the training environment these injury risks should be more controllable than during matches. Purpose: To (1) describe the incidence, severity, anatomic location, and type of youth rugby training injuries; (2) determine the injury events and type of training activities associated with injuries; and (3) compare 2 levels of play (professional academy vs school) within English youth rugby union. Study Design: Cohort study; Level of evidence, 2. Methods: A 2-season (2006-2007 and 2007-2008) study recorded exposure to training activities and time-loss injuries in male youth rugby union players (age range, 16-18 years) from 12 English Premiership academies (250 player-seasons) and 7 schools (222 player-seasons). Players from the Premiership academies, associated with the top-level professional clubs in England, represented the elite level of youth rugby; the school players were from established rugby-playing schools but were overall considered at a lower level of play. Results: There was a trend for training injury incidence to be lower for the academy group (1.4/1000 player-hours; 95% CI, 1.0-1.7) compared with the school group (2.1/1000 player-hours; 95% CI, 1.4-2.9) (P = .06). Injuries to the ankle/heel and thigh were most common in academy players and injuries to the lumbar spine and ankle/heel region most common in school players. The training activities responsible for injury differed between the 2 groups: technical skills (scrummaging) for school players and contact skills (defense and ruck/maul drills) for academy players. Conclusion: For injury risk management in youth rugby, coaches of school players should focus on the development of the correct technique during practice of technical skills such as scrummaging, weight training, and skills training, and coaches of academy players should consider the extent to which contact drills are necessary during training.

The incidence and factors associated with concussion injuries in South African Youth Rugby Union

Background: Rugby union is a sport characterized by frequent high impact collisions and therefore has a relatively high concussion risk. The incidence of concussion in South African youth rugby is largely unknown. Furthermore, there is limited evidence of which factors are associated with increased concussion risk in youth rugby. Therefore the aim of this study was to determine the incidence of concussion and to identify potential risk factors of concussion within South African youth rugby players.

Epidemiology of time-loss injuries in English community-level rugby union

ObjectivesUsing a prospective cohort study design, to establish the incidence and nature of time-loss injuries in English community rugby and to assess the differences between different playing levels.SettingEnglish community rugby...

Match Injuries in English Youth Academy and Schools Rugby Union

Background: Numerous injury epidemiology studies have reported injury patterns in senior rugby union, but investigations in youth rugby are limited. Purpose: To describe the nature of injuries resulting from match play within the English youth rugby union, including a comparison between 2 levels of play within the same age group: professional academy versus school rugby. Study Design: Cohort study; Level of evidence, 2. Methods: A 2-season (2006-2007 and 2007-2008) study obtained information on injuries sustained in male youth rugby union players (age, 16-18 years) from 12 English Premiership academies (n = 250) and 7 schools (n = 222). Match exposure (player-hours) and injury details were recorded. Results: Match injury incidence was 47 per 1000 player-hours for the academy and 35 per 1000 player-hours for the school groups; these rates were statistically different (P = .026). The most common injury site was the lower limb and the most common injury type was a ligament sprain, with injuries to the knee and shoulder region resulting in the greatest burden of injury for both groups. The tackle event was the most common cause of match injury for both academy (51% of injuries) and school (57% of injuries) groups. Conclusion: Overall, the incidence of injury for youth rugby was lower than for previous studies in senior rugby, but injury patterns (location, type) and causes were similar. The study confirmed that match injury incidence was significantly greater in elite academy youth rugby union than schools rugby. The results suggest that the specific focus for injury risk management in youth rugby should be on players’ tackle technique and prevention strategies for knee and shoulder injuries.

Automatic detection of collisions in elite level rugby union using a wearable sensing device

Elite rugby union teams currently employ the latest technology to monitor and evaluate the physical demands of training and games on their players. Tackling has been shown to be the most common cause of injury in rugby union, yet current player monitoring technology does not effectively evaluate player tackling measurements. Currently, to evaluate measurements specific to player tackles, a time-consuming manual analysis of player sensor data and video footage is required. The purpose of this work is to investigate tackle modeling techniques which can be utilised to automatically detect player tackles and collisions using sensing technology already being used by elite international and club level rugby union teams. This paper discusses issues relevant to automatic tackle analysis, describes a technique to detect tackles using sensing data and validates the technique by comparing automatically detected collisions to manually labeled collisions using data from elite club and international level players. The results of the validation show that the system is able to consistently identify collisions with very few false positives and false negatives, achieving a recall and precision rating of 0.933 and 0.958, respectively. The aim is that the automatically detected tackles can provide coaching, medical and strength and conditioning staff with objective tackle-specific measurements, in real time, which can be used in injury prevention and rehabilitation strategies.

The epidemiology of shoulder injuries in rugby union football

BackgroundShoulder injuries are a significant risk in rugby union football. However, the aetiology and the risk factors associated with shoulder injuries are not well understood.ObjectiveTo analyse the incidence and risk...

The impact of compliance on sports injury prevention effect estimates in randomized controlled trials

occurred in players with no history of shoulder injury in the last 3 years (injury incidence rate of 3.5/1000 pph). Extrinsic risk factors were shoulder pads and player position. 36% players used shoulder pads during games. An injury incidence rate of 3.5/1000 pph was recorded for players not wearing shoulder pads during a match compared to 0.8/1000 pph for wearers. Back Five positions had the highest injury incidence rate of 7.9/1000 pph. Being tackled and tackling were the two mechanisms of injury that contributed to 67% of the total time loss. During the season, 41% of participants reported experiencing shoulder pain but that did not stop them from participating in matches and did not appear to be correlated with injury risk. Discussion: A recursive injury model was applied to the study design and analysis. Shoulder pain or impairment did not appear to be associated with injury. Tackling, either as a tackler or being tackled is the main inciting event for shoulder injuries, which is consistent with other studies on injury in rugby union. Recursiveness may not be relevant to shoulder injury risk.

The epidemiology of injuries in English youth community rugby union

IntroductionRecent studies report the incidence and epidemiology of injury in professional rugby union; however, there is limited research in amateur and youth rugby. Injuries in youth rugby may have consequences...

Rugby Union on-field position and its relationship to shoulder injury leading to anterior reconstruction for instability

Due to the unique demands of each position on the Rugby Union field, the likelihood of an athlete sustaining a dislocation of their shoulder joint that requires surgical reconstruction may be affected by their position on the field. 166 patients with 184 involved shoulders requiring anterior reconstruction following an on-field Rugby Union injury between January 1996 and September 2008 were analysed. The mean age at time of injury was 18 years with the mean age at time of surgery being 20 years. The most prevalent mechanism of injury was a tackle in 66.3% of players. Players were more likely to suffer injury to their non-dominant shoulder than their dominant side (McNemar's Test, p < 0.001). Statistical analysis using chi-squared test of goodness of fit showed there was not a uniform risk of injury for all player positions. Positions with significantly different risk of injury were five-eighth (increased risk) and wing (reduced risk). Although we observed an increased risk in flankers and fullbacks, and a lower risk in second row, these results did not reach statistical significance after application of the Bonferroni correction. This information can be utilized by team staff to assist in pre-season conditioning as well as the development of improved muscle co-ordination programmes for the non-dominant shoulder, and planning a graduated return to sport by the player recovering from surgical reconstruction of the shoulder for instability.

Incidence, severity, aetiology and type of neck injury in men's amateur rugby union: a prospective cohort study

BackgroundThere is a paucity of epidemiological data on neck injury in amateur rugby union populations. The objective of this study was to determine the incidence, severity, aetiology and type of neck injury in Australian men's amateur rugby union.MethodsData was collected from a cohort of 262 participants from two Australian amateur men's rugby union clubs via a prospective cohort study design. A modified version of the Rugby Union Injury Report Form for Games and Training was used by the clubs physiotherapist or chiropractor in data collection.ResultsThe participants sustained 90 (eight recurrent) neck injuries. Exposure time was calculated at 31143.8 hours of play (12863.8 hours of match time and 18280 hours of training). Incidence of neck injury was 2.9 injuries/1000 player-hours (95%CI: 2.3, 3.6). As a consequence 69.3% neck injuries were minor, 17% mild, 6.8% moderate and 6.8% severe. Neck compression was the most frequent aetiology and was weakly associated with severity. Cervical facet injury was the most frequent neck injury type.ConclusionsThis is the first prospective cohort study in an amateur men's rugby union population since the inception of professionalism that presents injury rate, severity, aetiology and injury type data for neck injury. Current epidemiological data should be sought when evaluating the risks associated with rugby union football.

Rugby union injuries in Scottish schools

Rugby union is the most popular worldwide collision sport, yet concerns have been raised regarding the safety of the sport due to the physical, high impact nature and an increasing number of injuries. A prospective, cohort study of the incidence, pattern and severity of injuries in rugby players in six Scottish schools during the second half of the 2008-09 season. Definition of injury and severity of injury were taken from International Rugby Board (IRB) consensus guidelines. Injury report forms and exposure data for match play were completed by a nominated staff member. Four hundred and seventy consent forms with survey information were returned. Of 37 rugby injuries in the study, 11 occurred during training. Head and face were the most injured body part and sprain/ligament injury the most common injury. Twenty injuries required attendance at Accident & Emergency with one admission. The tackle was the commonest phase of play causing injury. In the 193 matches played, the injury incidence during the match play was 10.8 injuries per 1000 player hours. This study confirms the feasibility of collecting relevant injury data in schools rugby in Scotland. The findings are consistent with other studies with respect to incidence and profile of injuries sustained.

Injury Trends and Prevention in Rugby Union Football

Rugby union football has long been one of the most popular sports in the world. Its popularity and number of participants continue to increase in the United States. Until 1995, rugby union primarily was an amateur sport. Worldwide there are now flourishing professional leagues in many countries, and after a long absence, rugby union will be returning to the Olympic games in 2016. In the United States, rugby participation continues to increase, particularly at the collegiate and high school levels. With the increase in rugby professional athletes and the reported increase in aggressive play, there have been changes to the injury patterns in the sport. There is still significant need for further epidemiologic data as there is evidence that injury prevention programs and rule changes have been successful in decreasing the number of catastrophic injuries in rugby union.

Risk of injury associated with rugby union played on artificial turf

The aim of this study was to compare the incidence, nature, and cause of injuries sustained in rugby union played on artificial turf and grass. The study comprised a two-season investigation of match injuries sustained by six teams competing in Hong Kong's Division 1 and training injuries sustained by two teams in the English Premiership. Injury definitions and recording procedures were compliant with the international consensus statement on epidemiological studies of injuries in rugby union. There were no significant differences in the overall incidence (rate ratio = 1.42; P = 0.134) or severity (P = 0.620) of match injuries sustained on the two surfaces. The lower limb and joint (non-bone)/ligament injuries were the most common location and type of match injury on both surfaces; the incidence of anterior cruciate ligament injuries was nearly four times higher on artificial turf than grass but the difference was not statistically significant (rate ratio = 3.82; P = 0.222). There were no significant differences in the overall incidence (rate ratio = 1.36; P = 0.204) or severity (P = 0.302) of training injuries sustained on artificial turf and grass. The lower limb and muscle/tendon injuries were the most common location and type of training injury on both surfaces. The results indicate that the overall risks of injury on artificial turf are not significantly different from those experienced on grass; however, the difference in the incidence of anterior cruciate ligament injuries on the two surfaces is worthy of further study.

Impact of the International Rugby Board's experimental law variations on the incidence and nature of match injuries in southern hemisphere professional rugby union.

To examine the epidemiology of match injuries in southern hemisphere professional rugby union and assess the impact of the International Rugby Board (IRB) Experimental Law Variations. One-season whole population prospective cohort. Twenty-seven teams (813 players) taking part in the 2008 Super 14 and Vodacom Cup competitions. Incidence, severity, location, type and cause of injury. The incidence in the Super 14 competition (96.3 injuries/1 000 player-match hours; 95% confidence interval (CI) 69.0 - 111.7) was significantly higher (p = 0.003) than that in the Vodacom Cup (71.2; CI 60.0 - 84.5); injury severity was significantly lower (p < 0.001) in the Super 14 (mean 13.4 days; median 5) than the Vodacom Cup (mean 21.2; median 12). There were no significant differences between the two competitions in type or location of injury: lower limb muscle/ tendon (Super 14: 27.8%; Vodacom Cup: 25.7%) and joint (non-bone)/ligament (Super 14: 18.8%; Vodacom Cup: 24.3%) were the most common injuries. Injury causation was similar for the two competitions but there were significantly fewer ruck/maul (p = 0.001) and more tackled (p = 0.010) injuries in Super 14 compared with English Premiership rugby and fewer collision (p = 0.002) and more tackling (p < 0.001) injuries compared with Rugby World Cup. In the Vodacom Cup, there were significantly more tackling (p < 0.001) injuries compared with Rugby World Cup. The incidence, nature and causes of injuries in southern hemisphere professional club rugby played under IRB Experimental Law Variations were similar to those for professional club rugby in the northern hemisphere and Rugby World Cup played under the previous Laws of Rugby.