Simon P T Kemp

University College London | UCL · Academic Department of Surgery

This study quantified and compared the collision and non-collision match characteristics across age categories (i.e. U12, U14, U16, U18, Senior) for both amateur and elite playing standards from Tier 1 rugby union nations (i.e. England, South Africa, New Zealand). Two-hundred and one male matches (5911 min ball-in-play) were coded using computerise...

Objective To establish match injury rates and patterns in elite female rugby union players in England. Method We conducted a six-season (2011/2012–2013/2014 and 2017/2018–2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used. Re...

Objectives To investigate the influence of previous season match exposure on injury incidence and burden in elite men's rugby union. Design A three-season (2016–17 to 2018–19) retrospective cohort design was used to collect and analyse injury and exposure data across English Premiership rugby union teams. Method Generalised linear mixed-effects m...

Background: One strategy to prevent and manage concussion is to reduce head impacts, both those resulting in concussion and those that do not. Because objective data on the frequency and intensity of head impacts in rugby union (rugby) are sparse, stakeholders resort to individual perceptions to guide contact training. It is unknown whether there...

The use of artificial playing surfaces in professional rugby union is growing, but their effect on the injury risk profile remains unclear. The aim of this study was to examine the effect of playing surface on match injury risk in men’s professional rugby in England. Six seasons of injury data (2013/14-2018/19) were collected from 15 professional E...

Background Rugby is a collision sport with high rates of head injury. The effect of rugby participation at the elite level on cerebral grey matter structure is unclear. Methods Data from 44 active professional rugby players, including 21 acquired within one week of mild traumatic brain injury, and 47 healthy controls were analysed. Whole-cortex an...

Objectives The COVID19-induced suspension of the 2019–20 professional England rugby union season resulted in players being exposed to an extended time of restricted training, coupled with a congested match schedule once competition resumed. We assessed the impact of these changes on match and training injuries in the final 20-weeks of the season fo...

Interpreting the physical qualities of youth athletes is complex due to the effects of growth, maturation and development. This study aimed to evaluate the effect of position, chronological age, relative age and maturation on the physical qualities of elite male academy rugby union players. 1,424 participants (n = 2,381 observations) from nine Rugb...

This study evaluated the validity and utility of antigen-detection rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2 in elite sports. The data on utility, ease of use and application for Ag-RDTs as a new testing format were positive from players and staff. This evaluation was limited by the low prevalence of SARS-CoV-2 circulating within the three sq...

Background Concussion is one of the key player welfare issues in rugby union. Independent Matchday Doctors (IMDDs), supported by live video feeds, were brought in to elite men’s rugby union matches in England over the 2019–2020 season to support the in-match off-field head injury assessment (HIA) process. Objectives To determine whether rugby unio...

Background The acute: chronic workload ratio (ACWR) is a widely adopted training load aggregation tool to manage injury risk in sport. Recently, methodological concerns have been raised regarding this approach. Objective To establish best-fit calculation methods for the ACWR when assessing injury risk, and to assess reproducibility of methods betw...

Background Concussion is one of the key player welfare issues in rugby union. A post-match assessment is a mandatory part of the head injury assessment (HIA) process in elite men’s rugby union, something unique to the sport and not seen in many other sporting settings. There is little evidence surrounding the potential value of this mandatory post-...

Background Understanding the risk of concussion and how this injury occurs in rugby union match play can inform future injury reduction strategies. This has been investigated in professional rugby but not in the UK elite level pathway. Objective Describe the incidence of concussion and characteristics of tackles resulting in concussion in British...

Background There is a perceived high risk of injury within youth rugby, but the available evidence in this population is limited. Understanding injury rates and patterns can inform injury reduction strategies. Objective To describe the incidence and severity of schoolboy rugby injuries and determine whether there are differences between age groups...

Background The risk of injury in professional rugby union is high compared with other sports. Modifiable risk factors such as training load provide an attractive target for risk management. Objective To explore the influence of training load and other known risk factors on soft tissue injury risk. Design Observational cohort. Setting Thirteen pr...

Objectives: The BRAIN-Q is a tool aimed at maximising the accuracy, and minimising measurement error, for retrospectively assessing concussions. This paper reports agreement of the BRAIN-Q tool when compared to extant questionnaire questions, and reproducibility when compared with its telephonic version (tBRAIN-Q). Methods: The BRAIN-Q entails a...

Objective: The BRAIN Study was established to assess the associations between self-reported concussions and cognitive function among retired rugby players. Methods: Former elite-level male rugby union players (50+ years) in England were recruited. Exposure to rugby-related concussion was collected using the BRAIN-Q tool. The primary outcome meas...

Aim To describe trends in the incidence of match concussions and time to return-to-play in professional rugby union. Methods Match concussion incidence (injuries per 1000 player-match-hours) and time to return-to-play (mean and median days absence) were recorded in 3006 male professional rugby union players over 16 seasons (2002/03 – 2018/19). Re...

The Youth Rugby Injury Surveillance Project (YRISP) collects match exposure and match injuries from schools across England at the under-13, under-15 and under-18 age groups. The aim of the project is to better understand the risk, types and mechanisms of injuries in schoolboy rugby across different age groups. This informs strategies to reduce inju...

The coronavirus disease 2019 (COVID-19) pandemic has caused disruption to professional and recreational sports across the world. The SARS-CoV-2 virus can be transmitted by relatively large respiratory droplets that behave ballistically, and exhaled aerosol droplets, which potentially pose a greater risk. This review provides a summary of end-to-end...

The 2019-20 WRISP report can be found here: https://rpubs.com/sw356/WRISP

Background: Rugby union demands a multifaceted approach to training, given the multiple physical and technical attributes required to play the sport. Objectives: The aim of this study is to describe the distribution of training throughout the week and investigate how this may be influenced by match-related factors. Methods: Training load data (sess...

Monitoring the physical load undertaken by athletes and examining the subsequent relationship with performance and injury and illness risk is common practice in high performance sport. Less attention has been paid to the psychological factors contributing to the overall load experienced and the impact upon health status and performance. This paper...

Concussion is the most common match injury in rugby union. Some players wear padded headgear, but whether this protects against concussion is unclear. In professional male rugby union players, we examined: (i) the association between the use of headgear and match concussion injury incidence, and (ii) whether wearing headgear influenced time to retu...

Objectives To examine the interactions between SARS-CoV-2 positive players and other players during rugby league matches and determine within-match SARS-CoV-2 transmission risk. Methods Four Super League matches in which SARS-CoV-2 positive players were subsequently found to have participated were analysed. Players were identified as increased-ris...

A review of risk factors affecting airborne transmission of SARS-CoV-2 was synthesised into an ‘easy-to-apply’ visual framework. Using this framework, video footage from two cricket matches were visually analysed, one pre-COVID-19 pandemic and one ‘COVID-19 aware’ game in early 2020. The number of opportunities for one participant to be exposed to...

Training load monitoring has grown in recent years with the acute:chronic workload ratio (ACWR) widely used to aggregate data to inform decision-making on injury risk. Several methods have been described to calculate the ACWR and numerous methodological issues have been raised. Therefore, this study examined the relationship between the ACWR and in...

Laryngeal trauma is a life‐threatening injury in contact sports. Due to its potentially devastating consequences, the prevention, diagnosis, and management of neck trauma both pitch side and at the hospital are essential for athletes.

The COVID-19 pandemic has necessitated many novel responses in healthcare including sport and exercise medicine. The cessation of elite sport almost globally has had significant economic implications and resulted in pressure to resume sport in very controlled conditions. This includes protecting pitch-side medical staff and players from infection....

Objectives Evaluate the interactions between SARS-CoV-2 positive players and other players during rugby league matches, to determine the risk of in-game SARS-CoV-2 transmission. Design Observational. Setting Super League rugby league during four matches in which SARS-CoV-2 positive players were retrospectively found to have participated (2 nd Aug...

Objective To scope the relationships between rugby union, and health and well-being. Design Scoping review. Data sources Published and unpublished reports of any age, identified by searching electronic databases, platforms and reference lists. Methods A three-step search strategy identified relevant published primary, secondary studies and grey...

Objectives The Professional Rugby Injury Surveillance Project is the largest and longest running rugby union injury surveillance project globally and focuses on the highest level of rugby in England. Methods We examined match injuries in professional men’s rugby over the period 2002/2003 to 2018/2019 and described trends in injuries over this time...

Mild traumatic brain injury is a relatively common event in contact sports and there is increasing interest in the long-term neurocognitive effects. The diagnosis largely relies on symptom reporting and there is a need for objective tools to aid diagnosis and prognosis. There are recent reports that blood biomarkers could potentially help triage pa...

Purpose Whilst kicking in Rugby Union can be influential to match outcome, the epidemiology of kicking injuries remains unknown. This study therefore aimed to investigate the epidemiology of injuries attributed to kicking in professional rugby, including playing position‐specific effects and differences in kicking volumes and kick types. Methods F...

Context Individual and team injury burden and performance are 2 key considerations facing practitioners in the daily prescription of an athlete's training load. Whereas a considerable number of researchers have examined univariate relationships between training load and performance, training load and injury, or injury and performance, few investiga...

Case Studies in Sports Psychiatry - edited by Amit D. Mistry August 2020

Objectives To determine (1) the prevalence of ankle osteoarthritis (OA) among former professional football and rugby players, (2) assess the association between ankle injuries or ankle surgeries with ankle OA, and (3) compare the mental and physical quality of life (QoL) between former professional football and rugby players with and without OA. M...

The COVID-19 pandemic in 2020 has resulted in widespread training disruption in many sports. Some athletes have access to facilities and equipment, while others have limited or no access, severely limiting their training practices. A primary concern is that the maintenance of key physical qualities (e. g. strength, power, high-speed running ability...

Introduction Understanding whether concussion in sport is associated with worsening cognitive function in later life will likely have immediate repercussion on sports concussion prevention and management policy and sporting rules and regulations. This systematic review aims to summarise the evidence on the association between concussion sustained b...

Using an expert consensus-based approach, a rugby union Video Analysis Consensus (RUVAC) group was formed to develop a framework for video analysis research in rugby union. The aim of the framework is to improve the consistency of video analysis work in rugby union and help enhance the overall quality of future research in the sport. To reach conse...

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statement...

Background Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statem...

Objectives Most concussions in rugby union occur during tackles. We investigated whether legislating to lower maximum tackle height would change tackle behaviour, and reduce concussion incidence rate. Methods In a single group intervention, 12 elite men’s teams played in two competitions during the 2019/2020 season. The Championship (control, 90 g...

Introduction Transitioning out of professional football is a challenging time in most players’ lives. During these pre- and post-retirement years, professional footballers may struggle with their mental, musculoskeletal, neurocognitive and cardiovascular health. Currently, longitudinal data about these health conditions is lacking. This article pre...

Rugby union is a popular team sport that demands high levels of physical fitness and skill. The study aim was to examine trends in training volume and its impact on injury incidence, severity and burden over an 11-season period in English professional rugby. Data were recorded from 2007/08 through 2017/18, capturing 1,501,606 h of training exposure...

Objectives: The vast majority of rugby union ('rugby') participants are community-based players; however, the majority of injury surveillance studies reported relate to the elite, professional game. A potential reason for this dearth of studies could be the perceived difficulty of using the consensus statement for injury recording at the community...

Introduction Rugby union is played by over eight million people across the world and is considered a form of moderate-to-vigorous physical activity. Consequently, playing rugby may confer health benefits; however, to date, the principal focus of research has been on associated injuries and potential detrimental long-term health sequelae. This proto...

In an effort to combat growing demands on players, athlete monitoring has become a central component of professional sport. Despite the introduction of new technologies for athlete monitoring, little is understood about the practices employed in professional rugby clubs. A questionnaire was circulated amongst conditioning staff across the 12 Premie...

Evidence is accumulating on the possible increased risks of neurodegenerative disease in former (professional) sportspersons. This study will assess the associations between a history of repetitive low-level head trauma and general and neurological health in retired professional footballers aged 50+in England. The main exposure measures are concuss...

The aim of the project is to better understand the risk, types and mechanisms of injuries in schoolboy rugby across different age groups. This will allow us to better inform injury prevention strategies, such as rule changes, so that the safety of the game can be improved for those participating.

Objectives To describe: (1) how we developed a concussion module and (2) whether the concussion module is feasible (in terms of relevance, added value and suitability) and enhances knowledge and changes attitude of professional footballers about concussion. Developing the concussion module We developed the concussion module based on two structured...

Objectives: This study aimed to determine the prevalence of hand and wrist osteoarthritis in former elite cricket and rugby union players, by sport and playing position, and to define the prevalence of severe hand injury, and its association with hand osteoarthritis. Design: Cross-sectional. Methods: Data from cross-sectional studies of former...

Rugby union is a late specialisation sport. As a consequence, youth players may still be engaged in other activities and sports throughout the year as they transition to rugby specialisation. Limited research exists quantifying rugby union training and matches as well as engagement in other activities and sports. Therefore, the aim of this study wa...

The Rugby Football Union (RFU) and Premiership Rugby Ltd (PRL) first commissioned an injury surveillance study across the Premiership and Senior England team in 2002 that remains driven and directed towards the improvement of player welfare in professional Rugby Union. This report presents the Premiership-wide key findings from the 2015-16 season a...

Introduction The diagnosis of mild traumatic brain injury or sports-related concussion is a challenge for all clinicians, players, coaches and parents involved in contact sports. Currently, there is no validated objective biomarker available to assess the presence or severity of concussion in sport, and so it is necessary to rely on subjective meas...

A systems modelling approach can be used to describe and optimise responses to training stimuli within individuals. However, the requirement for regular maximal performance testing has precluded the widespread implementation of such modelling approaches in team-sport settings. Heart rate variability (HRV) can be used to measure an athlete's adaptat...

Background The King-Devick (KD) test is an objective clinical test of eye movements that has been used to screen for concussion. We characterised the accuracy of the KD test and the World Rugby Head Injury Assessment (HIA-1) screening tools as methods of off-field evaluation for concussion after a suspicious head impact event. Methods A prospectiv...

Background Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. Purpose To provide guidance on the choice of injury definition for injury surveillance studies b...

The Rugby Football Union (RFU) and Premiership Rugby Ltd (PRL) first commissioned an injury surveillance study across the Premiership and Senior England team in 2002 that remains driven and directed towards the improvement of player welfare in professional Rugby Union. This report presents the Premiership-wide key findings from the 2015-16 season a...

Introduction Relatively little is known about the long-term health of former elite rugby players, or former sportspeople more generally. As well as the potential benefits of being former elite sportspersons, there may be potential health risks from exposures occurring during an individual’s playing career, as well as following retirement. Each cont...

IntroductionNumerous studies have documented the incidence and nature of injuries in professional rugby union, but few have identified specific risk factors for injury in this population using appropriate statistical methods. In particular, little is known about the role of previous short-term or longer-term match exposures in current injury risk i...

Background/aim Concussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion. Methods 182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional...