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Rugby World Cup 2011: International Rugby Board Injury Surveillance Study
Abstract
Objective To determine the frequency and nature of injuries sustained during the IRB 2011 Rugby World Cup.
Design A prospective, whole population survey.
Population 615 international rugby players representing 20 teams competing at the IRB 2011 Rugby World Cup in New Zealand.
Method The study was implemented according to the international consensus statement for epidemiological studies in rugby union; the main measures included the players' age (years), stature (cm) and body mass (Kg) and the incidence (number of injuries/1000 player-hours), mean and median severity (days absence), location (%), type (%) and cause (%) of match and training injuries.
Results The incidences of injuries were 89.1/1000 player-match-hours (forwards: 85.0; backs: 93.8) and 2.2/1000 player-training-hours (forwards: 2.7; backs: 1.7). The mean severity of injuries was 23.6 days (forwards: 21.2; backs: 26.2) during matches and 26.9 (forwards: 33.4; backs: 14.3) during training. During matches, lower-limb muscle/tendon (31.6%) and ligament (15.8%) and, during training, lower-limb muscle/tendon (51.4%) and trunk muscle/tendon (11.4%) injuries were the most common injuries. The most common cause of injury during matches was the tackle (forwards: 43.6%, backs: 45.2%), and during training was full and semicontact skills activities.
Conclusion The results confirm that rugby, like other full-contact sports, has a high incidence of injury: the results from IRB Rugby World Cup (RWC) 2011 were similar to those reported for RWC 2007.
... A condition-specific medical history is an integral part of evaluating an injured player, as prior injury vastly influences the probability of re-injuries. Furthermore, re-injuries are often more severe than the initial injury, highlighting the importance of obtaining a personal medical history in the RTP decision-making process (Creighton et al., 2010;Fuller et al., 2013). The literature corroborates the finding of the e-Delphi results in which 86% of participants supported the inclusion of medical history. ...
... Different physical attributes and anthropometrical profiles are required for the different player positions in rugby union. Consequently, the differences between the playing positions will occur with respect to the nature and prevalence of injuries (Fuller et al., 2007;Fuller et al., 2013). Lazarus et al. (2017) concluded that coaching and performance staff should avoid prescribing substantially high weekly load and sustained increases in load during the competitive period of the season. ...
... However, the panel mentioned after the first round (54%) that this practice is both unethical and illegal, but reached agreement (86%) in the second round. The findings on this matter again illustrate that masking of the injury could potentially modify decisions about RTP in rugby union (Fuller et al., 2013). ...
Models and guidelines on factors associated with the safe return to play (RTP) of an injured athlete have been established, but very limited research has been conducted on components necessary for returning an athlete to their previous level of performance, known as return to performance (RTPerf). The study aimed to establish guidelines applicable to RTP and RTPerf in rugby union. A mixed-methods study design using an e-Delphi survey was conducted to obtain the opinions of medical team members of the Currie Cup rugby unions across South Africa on RTP (Part 1 of the study). In Part 2, medical team members and coaches of the Free State Rugby Union were consulted for RTPerf guidelines. Part 1 of the study comprised a three-step decision-based RTP model used to identify RTP components in rugby. The e-Delphi questionnaire was compiled based on literature analyses and vast experience of the authors. Part 1 involved three steps of integrated guidelines for RTP decision-making in rugby union established by agreement (>80%) (first or second round): Step 1: medical history; Step 2: evaluation of participation risk; and Step 3: decision modifiers. Part 2 focused on components to consider during the RTPerf decision-making process, including psychological readiness, limb symmetry index, acute:chronic training load, external load and internal load. Twelve key performance indicators (KPIs) to measure RTPerf in rugby reached consensus (>80%). The comparison of performance profiles and current KPIs of a rugby player could be used to evaluate the player's performance level and whether they truly achieved RTPerf.
... The most common injuries in rugby usually occur from direct contact between players [2][3][4][5][6][7][8]. For its part, tackling is the most injurious element of rugby, although other elements such as the maul, the melee, the scrum and the ruck are also injury risk factors [2][3][4][5][6][7][8]. ...
... The most common injuries in rugby usually occur from direct contact between players [2][3][4][5][6][7][8]. For its part, tackling is the most injurious element of rugby, although other elements such as the maul, the melee, the scrum and the ruck are also injury risk factors [2][3][4][5][6][7][8]. ...
... The injury rates in the 2007, 2011 and 2015 World Cups ranged between 83.9 and 90.1 injuries/1000 competition hours [4,5,7]. In women, this rate was 37.5 injuries/1000 h of competition in the 2006 World Cup and 35.5 injuries/1000 h in the 2010 World Cup [12,13]. ...
Objective:
To describe the injury rate, severity, cause, anatomical location (tissue damaged), recurrence, place and time during matches throughout a season in the Spanish Rugby Union Division de Honor.
Methods:
Observational, prospective and descriptive study conducted in the competition of the Spanish División de Honor de Rugby with 258 players. The data were reported by the medical services of the previously formed clubs.
Results:
Total exposure was 4100 h, during which 220 injuries occurred. The average number of sick days was 36.8. The total injury rate was 53.6 injuries/1000 h of exposure. Three quarters suffered 93 injuries and the forwards sustained a total of 127 injuries, with a total of 48.6 and 58.1 injuries/1000 h of exposure, respectively. Moderate injuries were the most frequent. Specifically, ligament injury was the most frequent, and dislocation was the injury that caused the most sick days. The most injuries occurred in the third quarter of the match, and the most serious injuries occurred in the second quarter.
Conclusions:
The injury rate of Spanish rugby competitors is 53.6 injuries/1000 match hours, with an average of 36.8 sick days. Contact injuries are the most frequent, taking place especially when tackling or being tackled.
... Match injury incidence in men's rugby has previously been reported within the range of 67 to 91 injuries/1000 player-match-hours [5][6][7][8][9][10], and training injury incidence in the range of 1.0 to 3.5 injuries/1000 player-training-hours [5][6][7][8][9]. The match incidence of injury in rugby is higher, but the training incidence of injury is similar compared to football, which reports a match incidence of 36 injuries/1000 player-match-hours and a training incidence of 3.7 injuries/1000 player-training hours [11]. ...
... Match injury incidence in men's rugby has previously been reported within the range of 67 to 91 injuries/1000 player-match-hours [5][6][7][8][9][10], and training injury incidence in the range of 1.0 to 3.5 injuries/1000 player-training-hours [5][6][7][8][9]. The match incidence of injury in rugby is higher, but the training incidence of injury is similar compared to football, which reports a match incidence of 36 injuries/1000 player-match-hours and a training incidence of 3.7 injuries/1000 player-training hours [11]. ...
... This coincides with other studies in which the average age was between 24.8 and 25.3 years [20][21][22] and average height was between 179 and 181.5 cm [10,23,24]. In contrast, some other previously conducted studies reported older average ages of examined players, with ages ranging between 27.4 and 27.6 years [5,7,8]. Furthermore, average height and weight have also been reported to be greater, with between 185.1 and 187.0 cm [5,7,8,20,21] and 100.0-104.1 kg [5,7,8,[20][21][22], respectively, being reported. ...
Background:
We describe and analyze injury incidence, severity, cause of injury, anatomical location, damaged tissue, injury recurrence, and the time and place at which injuries occur over the course of a season.
Methods:
An observational, descriptive, prospective, nomothetic, and multidimensional study was conducted during the 2018-2019 season with 258 players of the top semiprofessional rugby league in Spain (División de Honor de Rugby). Data were reported by the clubs' medical services. Reported time-loss injuries were collected.
Results:
Overall exposure was 4100 h (137 matches), over 35 weeks of competition. A total of 288 injuries were reported, with three of these leading to withdrawal from the sport. A total average of 35.63 days was lost to injury. Overall time-loss injury incidence was 3.41 injuries/1000 h of exposure. Backs suffered 119 injuries corresponding to 3.80 injuries/1000 h of exposure, whilst forwards suffered 169 injuries with 4.27 injuries/1000 h of exposure. Severe injuries were the most frequent injury type.
Conclusions:
Outcomes confirm that more injuries take place during competition, with these also being more severe in nature. Contact injuries were most frequently suffered, above all, due to tackling or being tackled.
... Previous studies looking into time loss injuries have considered both training and match time loss and have considered loss of play during a typical season [8,15,[23][24][25]. However, due to the nature of the sport and Touch National leagues consisting of four multi-day tournaments distributed over several months, it is difficult to quantify the time loss in regards to both training and match play. ...
... The overall injury incidence for elite Touch players during a tournament was 103.5 injuries per 1000 player-match hours, which is similar to the 108.3 injuries per 1000 player-match hours reported for elite Rugby-7s players during tournament match play [15]. However, the injury incidence for Touch is much higher than that reported from the International Rugby Board Rugby World Cup 2011 and 2015, where the overall injury incidence was 89.1 and 90.1 injuries per 1000 player-match hours, respectively [25,29]. Our data also compare less favorably to elite rugby league injury incidence values of 40.3 injuries per 1000 player-match hours from a pooled data analysis [30]. ...
... There was a much greater proportion of transient injuries (76%) reported in Touch compared to other codes of rugby [19,25,29,30]. This resulted in less time loss injuries compared to other codes [19,25,29,30] that might be accounted for by a narrower definition of injury between studies and the exclusion of non-time loss injuries in several studies [19,25,29]. ...
Background: Touch (rugby/football) is a minimal contact sport for which the type and incidence of injuries remains unknown in Europe. Objectives: To establish the incidence, severity and nature of injuries sustained during a four-day European Touch Championship competition. Methods: A prospective cohort design was adopted to record match-related injuries during the European Touch Championships 2016. Injuries were collected from five countries and classified using the Orchard Sports Injury Classification (OSICS-10). Data were combined from all participating countries and injury incidence was recorded as number of injuries/1000 player hours. Results: A total of 135 injuries were recorded during the tournament with injury incidence calculated as 103.5 injuries per 1000 player match hours. Injuries were mainly recorded as transient (76%) occurring most frequently in the lower limb (69%). Injuries occurred more frequently on successive days, with exception to the final day of the tournament. The number of injuries was not different between the first and second half of matches and there was no relationship between the day of the tournament and the half of the match that injury occurred. Conclusion: Match injury incidence was 103.5 injuries per 100 player match hours. The most injured site was that of the lower limb, with the most common injury type reported as muscle/tendon injury. It is postulated that fatigue plays a role in injury incidence during a multiday tournament.
... Lacerations and concussions are considered the most common head injuries in rugby union [100]. Concussion incidence at the Rugby World Cup has increased successively since 2007 (Table 5) [101][102][103]. ...
... In the 2011 Rugby World Cup, forwards suffered 8.8 concussion injuries per 1000 player-hours in comparison to backs who suffered 6.7 [102]. The mean severity of concussion injuries for forwards was 12.8 days, more than double that of backs (6.2 days) [102]. ...
... In the 2011 Rugby World Cup, forwards suffered 8.8 concussion injuries per 1000 player-hours in comparison to backs who suffered 6.7 [102]. The mean severity of concussion injuries for forwards was 12.8 days, more than double that of backs (6.2 days) [102]. ...
... 5,6 It is possible that injuries sustained by players who frequently kick may therefore play a role in limiting the effectiveness of their team. The epidemiology of injuries sustained in rugby activities has been extensively investigated, [7][8][9][10][11][12][13][14][15][16][17][18][19] and although kicking as a potential mechanism of injury has been reported in some studies, [15][16][17][18] it is frequently grouped alongside a combination of "other" mechanisms. Given the importance of kicking for match outcome, 2-4 a more detailed consideration of the nature and causes of injuries sustained while kicking is clearly warranted. ...
... 5,6 It is possible that injuries sustained by players who frequently kick may therefore play a role in limiting the effectiveness of their team. The epidemiology of injuries sustained in rugby activities has been extensively investigated, [7][8][9][10][11][12][13][14][15][16][17][18][19] and although kicking as a potential mechanism of injury has been reported in some studies, [15][16][17][18] it is frequently grouped alongside a combination of "other" mechanisms. Given the importance of kicking for match outcome, 2-4 a more detailed consideration of the nature and causes of injuries sustained while kicking is clearly warranted. ...
... 14,22 The overall propensity for injury due to kicking (0.57/1000 kicks) was lower than that of other match events reported previously (1.1/1000 line-outs; 2.0/1000 rucks). 16 However, a greater number of players are exposed to a potential injury mechanism in each line-out or ruck than in a single kick. Furthermore, when considered by playing position groups (Figure 4), there is not a linear relationship between the proportion of match kicks performed and the number of kicking injuries sustained. ...
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
Fifteen seasons of injury surveillance data and two seasons of match kicking characteristics from professional rugby players were analysed. Incidence, propensity and severity of kicking‐related injuries were calculated together with the locations and types of these injuries. Position‐related differences in match kicking types and volumes were also established.
Results
Seventy‐seven match and 55 training acute‐onset kicking injuries were identified. The match‐kicking injury incidence for backs was 1.4/1000 player‐match‐hours. Across all playing positions, the propensity for match kicking injury was 0.57 injuries/1000 kicks. Fly‐halves sustained the greatest proportion of match kicking injuries (47%) and performed the greatest proportion of match kicks (46%); an average propensity for match kicking injury (0.58/1000 kicks). Scrum‐halves executed 27% of match‐related kicks but had a very low propensity for match kicking injury (0.17/1000 kicks). All other positional groups executed a small proportion of match‐related kicks but a high propensity for match kicking injury. Ninety‐two per cent of match kicking injuries occurred in the pelvis or lower limb, with the majority sustained by the kicking limb. 21% of all match kicking injuries were associated with the rectus femoris muscle.
Conclusion
Match‐kicking profiles and kicking injuries sustained are position‐dependent, which provides valuable insight for developing player‐specific conditioning and rehabilitation protocols.
... Rugby union (rugby) is a full-contact sport with a high injury rate 1) . In previous studies, injury rates reported for the last three Rugby World Cups (2007, 2011, and 2015) ranged from 83.9 to 97.9 injuries/1000 playerhours (PHs) [2][3][4] . These rugby injury rates are higher than those for football (50.8 injuries/1000 PHs during the FIFA World Cup 2014 5) ) and ice hockey (49.4 injuries/1000 PHs in six NHL seasons 6) ). ...
... Many epidemiological studies of injuries in rugby have been reported thus far [2][3][4]7,8,[10][11][12][13][23][24][25][26][27][28][29][30][31][32] . However, the majority of these studies involved professional players [2][3][4]8,10,12,13,[23][24][25][26] . ...
... Many epidemiological studies of injuries in rugby have been reported thus far [2][3][4]7,8,[10][11][12][13][23][24][25][26][27][28][29][30][31][32] . However, the majority of these studies involved professional players [2][3][4]8,10,12,13,[23][24][25][26] . Although research on top competitionlevel players is important, younger players may take longer to recover from concussion symptoms 33,34) , and the recurrence injury risk may increase in those with a history of knee ligament injury or shoulder dislocation 11,35) . ...
To the best of our knowledge, most previous studies regarding the epidemiology of injuries in rugby union (rugby) players have focused on professional players. Therefore, data on injuries in collegiate rugby players in Japan is limited. The purpose of this study was to conduct a prospective injury survey of Japanese male collegiate rugby players over several years and to analyze the injuries that occurred during matches and training according to field position, type of injury, and mechanism of injury. This prospective study initially registered 128 rugby play- ers from one university club. The occurrence of injuries was recorded by athletic trainers dur- ing the rugby seasons between 2017 and 2019. The total injury rate (IR) was 7.26 injuries/1000 player-hours (1000 PHs). The match IR (122.73 injuries/1000 PHs) was almost 31.9 times higher than the training IR (3.84 injuries/1000 PHs). Ankle sprains/ligament injuries (17.7%; 1.28 injuries/1000 PHs) were the most common injuries, in addition to acromioclavicular joint injuries in forwards and hamstring strain injuries in backs. The most common injury mecha- nism was tackling (16.4%). Injury characteristics differed according to field position; therefore, preventive measures according to field position are necessary. Moreover, the high number of tackle injuries suggests that improved tackle skills would help reduce injuries. The IR among Japanese collegiate rugby players was higher than that reported previously. Injury prevention training for collegiate players is necessary to reduce the number of injuries.
... The definitions and procedures used in this study were compliant with the consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union [4] and were also consistent with the procedures used for RWCs 2007, 2011 and 2015 studies. [5][6][7] World Rugby's Institutional Ethics Committee approved the study and all players taking part in RWC 2019 consented to their data being included in this study. The study took place in Japan over a 7 week period commencing on Monday 16 September 2019. ...
... Equivalent anthropometric data for players competing in the 2007, 2011 and 2015 RWCs were retrieved from previous publications. [5][6][7] Match exposures were based on 15 players (backs: 7; forwards: 8) being exposed for 80 minutes per match. No allowances were made for players temporarily (as a result of medical treatment) or permanently (due to the receipt of yellow or red cards) missing during a match. ...
... Equivalent injury data for the 2007, 2011 and 2015 RWCs were retrieved from other published reports. [5][6][7] Statistical analysis Statistical comparisons of players' anthropometric data were calculated using unpaired t-tests. [11] Numbers of injuries were compared using chi-squared tests, z-tests were used to compare incidences and mean severities of injury, and Mann-Whitney U-tests for median severities. ...
Background:
Full contact team sports, such as rugby union, have high incidences of injury. Injury surveillance studies underpin player welfare programmes in rugby union.
Objective:
To determine the incidence, severity, nature and causes of injuries sustained during the Rugby World Cup 2019.
Methods:
A prospective, whole population study following the definitions and procedures recommended in the consensus statement for epidemiologic studies in rugby union. Output measures included players' age (years), stature (cm), body mass (kg), playing position, and group-level incidence (injuries/1000 player-hours), severity (days-absence), injury burden (days absence/1000 player-hours), location (%), type (%) and inciting event (%) of injuries.
Results:
Overall incidences of injury were 79.4 match injuries/1000 player-match-hours (95% CI: 67.4 to 93.6) and 1.5 training injuries/1000 player-training-hours (95% CI: 1.0 to 2.3). The overall mean severity of injury was 28.9 (95% CI: 20.0 to 37.8) days absence during matches and 14.8 (95% CI: 4.1 to 25.5) days absence during training. The most common locations and types of match injuries were head/face (22.4%), posterior thigh (12.6%), ligament sprain (21.7%) and muscle strain (20.3%); the ankle (24.0%), posterior thigh (16.0%), muscle strain (44.0%) and ligament sprain (16.0%) were the most common locations and types of injuries during training. Tackling (28.7%), collisions (16.9%) and running (16.9%) were responsible for most match injuries and non-contact (36.0%) and contact (32.0%) rugby skills activities for training injuries.
Conclusion:
The incidence, severity, nature and inciting events associated with match and training injuries at Rugby World Cup 2019 were similar to those reported for Rugby World Cups 2007, 2011 and 2015.
... Comprehensive injury surveillance is conducted at all these RWCs. [2][3][4][5] These injury surveillance studies have documented a high injury incidence, with concussion as the most common injury. [2][3][4][5] During the 2019 RWC, concussions accounted for 15% of all injuries, while the most common injury location was the head/ neck (27%). ...
... [2][3][4][5] These injury surveillance studies have documented a high injury incidence, with concussion as the most common injury. [2][3][4][5] During the 2019 RWC, concussions accounted for 15% of all injuries, while the most common injury location was the head/ neck (27%). This consistent finding and growing concern over the long-term implications of cumulative head impacts 6 has led to the introduction of several concussion prevention initiatives in recent years. ...
Objectives
This study analysed the overall sentiment of attitudes, opinions, views and emotions expressed in posts on X related to red-carded and yellow-carded tackles during the 2019 Rugby World Cup (RWC).
Methods
Sentiment analysis was conducted on posts on X about red or yellow cards issued at the 2019 RWC. Posts were classified as ‘agree’, ‘disagree’ and ‘neutral’. The frequency of posts, red cards, yellow cards, all injuries, tackle injuries and total number of tackles per match were also synced to the 45-match playing schedule.
Results
Five tackle-related red cards were issued during the 2019 RWC, and 15 tackle-related yellow cards, with 337 and 302 posts identified for each card decision, respectively. For red cards, 42% of posts (n=158/377) agreed with the referee’s decision, 19% (n=71/377) disagreed and 40% were neutral. For yellow cards, 24% (n=73/302) agreed with the referee’s decision, 33% (n=99/302) disagreed and 43% were neutral.
Conclusions
For red cards, posts were 2.2 times more likely to agree with the referee’s decision than disagree. Posts that agreed with a red card decision were also more likely to be shared (reposted) than posts that disagreed with a red card decision. In contrast, sentiments expressed for yellow card decisions were mixed. This may be related to interpreting the degree of danger and whether mitigation is applied. Within the ecosystem of rugby, sharing sentiments on social media plays a powerful role in creating a positive player welfare narrative.
... Therefore, in order to enhance the assets of the sport organisation, a primary focus needs to be placed on injury prevention. Hamstring strain injuries (HSI) have consistently been identified as one of the most common injuries sustained by elitelevel rugby union players (Fuller et al., 2013;Fuller et al., 2017). Indeed HSI were reported to account for 9.8% of all injuries incurred during the (men's) 2019 Rugby World Cup (Fuller et al., 2020). ...
... Indeed HSI were reported to account for 9.8% of all injuries incurred during the (men's) 2019 Rugby World Cup (Fuller et al., 2020). A similar injury prevalence has been reported in other rugby union injury surveillance studies (Fuller et al., 2013;Fuller et al., 2017), where HSI were the most common injury type sustained during matches. Both the injury burden and recurrence rate of HSI are high (Kerin et al., 2022). ...
Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players.
Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify (via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants’ left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants’ left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players.
Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles.
Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries.
... Rugby code injury rates have been studied prospectively across different countries and levels [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In elite men's rugby union, pooled injury incidence has been reported at 81 injuries/1000 player match-hours [3], and at amateur level, 47 injuries/1000 player match-hours [6]. ...
... Comparatively, in elite men's rugby league, pooled injury incidence has been reported at 148 injuries/1000 player match-hours [8] and in amateur rugby league, 62 injuries/1000 player match-hours [4]. Tackling is a common match activity and has repeatedly been found to be the cause of most injuries in rugby union [1,5,6,14,16,17] and rugby league [23,24], and injury risk is also associated with higher cumulative training loads [25]. In response to high-injury rates, efforts have been made to reduce injuries in rugby codes, with programmes such as Tackling Rugby and RugbySmart in New Zealand [26,27], BokSmart in South Africa [28], and Activate in England [29]. ...
Background
Rugby union and rugby league are popular team contact sports, but they bring a high risk of injury. Although previous studies have reported injury occurrence across one or several seasons, none have explored the total number of injuries sustained across an entire career. As the first to do so, the aim of this study was to report on cumulative injuries and their perceived long-term impact in retired rugby code athletes compared to athletes from non-contact sports.Methods
One hundred and eighty-nine former rugby code athletes (rugby union n = 145; rugby league n = 44) and 65 former non-contact athletes were recruited to the UK Rugby Health Project between September 2016 and December 2018. Details on sports participation, sports injuries and concussion history, sports injury-related surgeries, and previous and current health were obtained from a validated, online self-report questionnaire.ResultsFormer elite rugby code athletes (n = 83) reported more total injuries per player (median 39, IQR 35) than former amateur rugby code athletes (n = 106; median 23, IQR 30; p = 0.014) and non-contact sports athletes (n = 65; median 7.5, IQR 15; p < 0.001). Concussion was the most frequently reported injury for the elite and amateur rugby code groups, followed by upper/lower back and knee ligament injuries. These injuries also presented with the highest recurrence. Rugby code groups reported a higher continued impact of previous concussion, neck injuries, shoulder dislocation, ACL tears, and knee ligament injuries (p = 0.003–0.045). The reported prevalence of osteoarthritis was more than twofold greater in the elite rugby code group than in non-contact athletes (51% v 22%, p < 0.001). The prevalence of back pain and/or severe and regular joint pain was high across all groups (47–80%), particularly the elite rugby code group. The total number of joint injuries and sport injury-related surgeries was higher in those who reported current osteoarthritis and current severe and regular joint pain (p < 0.001–p = 0.028).Conclusion
Across multiple injury types, past participation in rugby union and rugby league, particularly at elite level, is associated with a high cumulative injury load and a continued impact of previous injuries post-retirement. Given the high number of reported concussions (and their recurrence) and associations between previous injuries during a player’s career and current musculoskeletal conditions, efforts should be prioritized to reduce the occurrence and recurrence of injuries in rugby codes at all levels of the sport. Strategies should also be developed for supporting the specific physical health needs of rugby code athletes post-retirement.
... 1 Being exposed to high physical and biomechanical loads during training and competition, rugby players are associated with a high risk of injury. [2][3][4][5] Timeloss injuries resulting in a long lay-off period are considered as major adverse events for the career of a professional rugby player, sometimes even leading to early retirement. 1 2 6 Known risk factors for these injuries are previous injury, excessive load, fatigue and unsafe behaviour. 1 2 In professional football, psychological factors such as distress and anxiety have been identified as predictors for injuries. ...
... [19][20][21] This sample size is sufficient for testing the relationship between the independent and dependent variables under study as sample size calculation indicated that at least 66 participants were needed (n>50+8m where m is the number of independent variables). 4 Considering a response rate of 33% (analogous with the response rate achieved in other prospective studies among professional athletes) and hypothesising a loss to follow-up rate of no more than 20%, we needed to invite at least 765 potential participants. 20 21 dependent variables: mental health symptoms MHS were operationalised by assessing symptoms of distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use. ...
Objective
This study explored the association between concussion or musculoskeletal injuries, and the onset of mental health symptoms (MHS) in male professional rugby players over a 12-month period.
Methods
Observational prospective cohort study with three measurements over a follow-up period of 12 months. At baseline, 573 participants provided informed consent. A total of 327 male professional rugby players (62% forwards, 38% backs) completed all follow-up assessments at baseline, 6 months and 12 months. The mean (±SD) age, height and weight of the participants at baseline was 25.9 (±4.4) years, 184.9 (±8.7) cm and 101.5 (±14.6) kg, respectively. Number of musculoskeletal injuries and number of confirmed concussions were assessed through single questions. Symptoms of distress, anxiety/depression, sleep disturbance, adverse alcohol use and eating disorders were assessed using validated questionnaires.
Results
Professional rugby players who sustained a concussion within 12 months of baseline were more likely to develop MHS with ORs ranging from 1.5 (95% CI 1.0 to 2.1) for distress to 2.0 (1.2 to 3.6) for adverse alcohol use. Players who sustained a severe injury within 12 months of baseline were more likely to develop symptoms anxiety/depression with an OR of 1.5 (1.1 to 2.0). There was no significant association in both groups for other MHS.
Conclusions
Rugby players who sustained concussion or severe injuries are up to two times more likely to develop symptoms of distress, adverse alcohol use or anxiety/depression.
... Al analizar cuáles son las principales estructuras corporales dañadas, vemos que los músculos/tendones y ligamentos resultan ser las más dañadas (40.5% y 32.9% respectivamente), destacando particularmente la lesión ligamentosa de rodilla como la que más días de reposo deportivo conlleva (1507 días aprox). (1,5,6) Objetivos El siguiente registro pretende caracterizar las atenciones de salud, en base a consulta espontánea, que se llevaron a cabo durante el primer semestre del 2018 en los 2 TIF de Rugby realizados a la fecha, definiendo el segmento corporal y el tipo de lesión más frecuente en los Deportistas TIF de la Universidad de Chile. ...
Introducción: En la Universidad de Chile se desarrollan competencias deportivas internas entre los diversos campus y/o facultades. Las competencias más masivas son los Torneos Inter Facultades (TIF), en los cuales se realizan 4 fechas de Rugby, 2 el primer semestre y 2 el segundo semestre. Objetivos: Caracterizar las atenciones de salud de los Torneos-Inter-Facultades (TIF) de Rugby, definiendo el segmento corporal y el tipo de lesión más frecuente. Materiales y Métodos: Estudio transversal descriptivo. Se consideraron los 2 TIF de Rugby realizados durante el 2018 en Campo Deportivo Juan Gómez Millas. El total de atletas participantes fue de 156: 72 en el primer TIF y 84 en el segundo (12 por equipo). El total de partidos fue 23: en el primer TIF se disputaron 10 partidos y en el segundo. Se consideró como criterio de inclusión la consulta espontánea por lesiones generadas en la competencia o la reagudización de lesión previa durante la competencia, se excluyó a quienes no cumplieran estos requisitos. Resultados: Se realizaron 17 atenciones. Predominando las lesiones en extremidad inferior (64,7%) y en cabeza y cuello (23,5%). Además de ser predominantemente en estructuras músculo-tendíneas y ligamentosas (41,4% y 29,4% respectivamente). Discusión: Se obtuvieron datos similares a los descritos en los campeonatos mundiales de rugby en cuanto a principales regiones corporales afectadas y estructuras corporales. Como principales limitaciones del registro realizado están el bajo número total de atenciones y considerar sólo la consulta espontánea de los participantes.
... Some former players have suggested in an open letter to World Rugby that in professional rugby, the introduction of replacements may increase the number of physical interactions between unfatigued replacements and fatigued starting players, thus increasing the injury risk to starting players and contributing towards overall injury incidence [7,8]. While there is evidence that injury incidence rates in professional rugby match play are higher in the second half of matches compared with the first half [9], and notably in the third quarter [10], it may be only inferred that this is a result of player fatigue and does not account for starters and replacements. Indeed, few studies have investigated injuries in starting and replacement players in team sports. ...
Objectives
The aim of this study was to compare the incidence, severity, and burden of injury in starting and replacement players from professional men’s teams of five rugby unions.
Methods
Match injuries of greater than 24 h time-loss (including data on the severity, match quarter, event, body region) and player minutes of match exposure data were collated for all starting and replacement players in the men’s English Premiership, Welsh Pro14 (both 2016/17–2018/19 seasons), and Australian, New Zealand, and South African Super Rugby (all 2016–2018 seasons) teams. Injury incidences and mean injury burden (incidence × days missed) were calculated, and rate ratios (RRs) (95% confidence intervals [CIs]) were used to compare injury incidence and burden between starting (reference group) and replacement players.
Results
Overall injury incidence was not different between starters and replacements for all injuries (RR = 0.98, 95% CI 0.88–1.10), nor for concussions (RR = 0.85; 95% CI 0.66–1.11). Mean injury burden was higher for replacement players (RR = 1.31, 95% CI 1.17–1.46). Replacement injury incidence was lower than the starters in the third (RR = 0.68, 95% CI 0.51–0.92) and fourth (RR = 0.78, 95% CI 0.67–0.92) match quarters. Injury incidence was not different between starters and replacements for any match event or body region, but compared with starters, replacements’ injury burden was higher in lower limbs (RR = 1.24, 95% CI 1.05–1.46) and in the tackled player (RR = 1.30, 95% CI 1.01–1.66).
Conclusion
This study demonstrated a lower injury incidence in replacement players compared with starters in the second half of matches, with a higher injury burden for replacement players due to higher mean injury severity.
... Para llevar a cabo el registro de lesiones se han venido utilizado distintos sistemas. Sirvan como ejemplo los realizados en las ligas universitarias estadounidenses (Hootman et al., 2007); los Campeonatos del Mundo de Atletismo de 2007 (Junge et al., 2008); el Mundial de Rugby de 2011 (Fuller et al., 2013); o los Juegos Olímpicos de Londres 2012 (Engebretsen et al., 2013). El problema es que muchos de estos resultados no pueden ser comparados entre sí, debido a la heterogeneidad en la definición de lesión, en los métodos de recogida de datos, los periodos observados, el diseño del estudio y/o las características de la muestra utilizada (Butrageño, 2015). ...
... A range of match injury incidence has been reported from 22 to 166.7 per 1000 match hours (Armstrong et al., 2018;Bailey et al., 2023;Barden et al., 2021;Fuller et al., 2016Fuller et al., , 2021Ma et al., 2016;Orr et al., 2021;Schick et al., 2008;Shill et al., 2022;Starling et al., 2023;Taylor et al., 2011;West et al., 2023;Yeomans et al., 2021), whilst training injury incidence is lower and ranges from 0.2 to 12.5 injuries per 1000 training hours (Fuller et al., 2016;King et al., 2021;Schick et al., 2008;Shill et al., 2022). The head, knee and ankle are the most commonly injured body regions during matches, with the head, shoulder and lower limb commonly injured during training (Collins et al., 2008;Fuller et al., 2013Fuller et al., , 2021King et al., 2021;Schick et al., 2008;Shill et al., 2022;Taylor et al., 2011;Yeomans et al., 2021). A concussion is one of the most common match injuries in women's rugby, as are ligament sprains, particularly to the ankle Fuller et al., 2016Fuller et al., , 2021Ma et al., 2016;Schick et al., 2008;Shill et al., 2022;Starling et al., 2023;Taylor et al., 2011;West et al., 2023;Yeomans et al., 2021). ...
This review discusses female‐specific health considerations in injury and illness surveillance and provides rugby‐specific recommendations for future surveillance. Identifying priority injury and illness problems by determining those problems with the highest rates within women's rugby may highlight different priorities than sex comparisons between men's and women's rugby. Whilst sports exposure is the primary risk for health problems in sports injury and illness surveillance, female athletes have health domains that should also be considered. Alongside female athlete health domains, studies investigating rugby injuries and illnesses highlight the need to broaden the health problem definition typically used in rugby injury and illness surveillance. Using a non‐time‐loss health problem definition, recording female‐specific population characteristics, embedding female athlete health domains and having up‐to‐date injury and illness coding systems should be prioritized within surveillance systems to begin to shed light on potential interactions between sports exposure, health domains and, injuries and illnesses. We call for a collaborative approach across women's rugby to facilitate large injury and illness datasets to be generated and enable granular level categorization and analysis, which may be necessary for certain female athlete health domains. Applying these recommendations will ensure injury and illness surveillance systems improve risk identification and better inform injury and illness prevention strategies in women's rugby.
... It also holds one of the highest incidences of injury for a professional sport [2]. However, this incidence is lower in amateur rugby than in professional rugby [3][4][5][6][7][8][9]. It has been shown to be affected by age and level of play, and to be higher during actual rugby matches [10,11]. ...
(1) Background: Due to the risk factors involved and the special characteristics of the game, rugby players are reported to have elevated levels of injury. The aim of this longitudinal prospective cohort study with a 2b level of evidence is to investigate the incidence of injury in the Spanish Men’s Senior National Rugby XV team, identify the most frequent injury types, and the game actions that cause them. (2) Methods: we studied a total of 72 players from the Spanish Men’s Senior National Rugby XV team while they played the Nation’s Cup for four consecutive seasons. We recorded all the injuries occurring both during games and training sessions, according to World Rugby consensus. (3) Results: Out of a total of 27 injuries, the higher incidence was during the matches as opposed to the training sessions (100.0 [95% CI: 62.0–132.9] per 1000 player hours (ph) and 1.17 [95% CI: 0–2.5] per 1000 ph during matches and training, respectively). The most common injuries were muscular injuries (41.6 [95% CI: 16.3–66.9] per 1000 ph) and concussion (29.1 [95% CI: 7.8–50.4] per 1000 ph). Tackling caused more injuries (50.0 [95% CI: 22.4–77.5] per 1000 ph). (4) Conclusions: Muscular injuries and concussion are the most common, 28% of concussion cases are diagnosed after the match, and tackling is the game action causing most of these injuries, with a higher incidence in players who play the whole match.
... Injuries are common in team sports such as soccer [1] and rugby [2]. Incidence rates in these sports can involve a significant financial cost for their sporting organizations [3][4][5]. ...
Injuries are common in team sports and can impact both team and individual performance. In particular, hamstring strain injuries are some of the most common injuries. Furthermore, hamstring injury ratios, in number of injuries and total absence days, have doubled in the last 21 seasons in professional soccer. Weakness in hip extensor strength has been identified as a risk factor in elite-level sprinters. In addition, strength imbalances of the hamstring muscle group seem to be a common cause of hamstring strain injuries. In this regard, velocity-based training has been proposed to analyze deficits in the force-velocity profile. Previous studies have shown differences between men and women, since there are biomechanical and neuromuscular differences in the lower limbs between sexes. Therefore, the aim of this study was to compare the load-velocity profile between males and females during two of the most important hip extension exercises: the hip thrust and the deadlift. Sixteen men and sixteen women were measured in an incremental loading test following standard procedures for the hip thrust and deadlift exercises. Pearson's correlation (r) was used to measure the strength of the correlation between movement velocity and load (%1RM). The differences in the load-velocity relationship between the men and the women were assessed using a 2 (sex) × 15 (load) repeated-measures ANOVA. The main findings revealed that: (I) the load-velocity relationship was always strong and linear in both exercises (R 2 range: 0.88-0.94), (II) men showed higher velocities for light loads (30-50%1RM; effect size: 0.9-0.96) than women for the deadlift, but no significant differences were found for the hip thrust. Based on the results of this study, the load-velocity equations seem to be sex-specific. Therefore, we suggest that using sex-specific equations to analyze deficits in the force-velocity profile would be more effective to control intensity in the deadlift exercise.
... Participants scoring moderate to poor in the LESS recorded significantly higher power and reactive strength index, increased contact time but not INTRODUCTION Injury surveillance data demonstrates that elite rugby union has a high lower-limb injury occurrence, 1 with an incidence rate of 41.1 injuries per 1000 player-hours in match situations. 2 Furthermore, data from the 2015 Rugby World Cup indicates that at the international level, knee ligament injuries are responsible for causing the greatest time loss at almost 30% of the total days lost due to injury. 3 Domestically, injury surveillance of the English Premiership indicates that knee injuries also accounted for the highest number of days lost. ...
Background:
The Landing Error Scoring System (LESS) is a clinical test that assesses landing biomechanics during a drop-jump task. Performance measures such as jump height, power, contact time and reactive strength index are used commonly in athletic populations. Comparing results from the LESS against these performance measures has not been reported in elite rugby union.
Purpose:
To report i.) normative LESS scores for elite rugby union players ii.) correlations between LESS scores and performance measures and iii.) differences in performance measures between LESS scoring groups. A secondary purpose was to report the intra- and inter-rater reliability of the LESS test when used in elite rugby union players. # Study DesignCross-sectional design.
Methods:
Thirty-six male, elite rugby union players participated. Each participant completed three trials of the LESS and performance measures were recorded concurrently using the OptojumpTM. LESS trials were scored independently by the authors. Statistical analyses were used to confirm reliability, data normality, and between group differences (p<0.05).
Results:
The LESS test is a reliable testing tool in elite rugby union players (excellent intra- (ICC=0.96) and inter-rater (ICC=0.94) reliability). One player demonstrated an excellent LESS score, six players had good scores, eight players moderate scores and the majority of the group, 21 players, scored poorly. LESS scores were correlated to contact time (r = -0.461, p = 0.005) only. Participants with moderate to poor LESS scores (a score ≤5) produced greater power (p=0.036, η2 = 0.139), contact time (p=0.002, η2 = 0.268) and reactive strength index (p=0.016, η2 = 0.180). There were no differences in jump height (p=0.842) between players scoring excellent to good and moderate to poor.
Conclusion:
The results of the current study demonstrate excellent intra- and inter-rater reliability for the LESS, supporting its use as a clinical assessment tool in elite rugby union players. The majority of players presented with moderate to poor LESS scores, indicating an area of concern in this population. Participants scoring moderate to poor in the LESS recorded significantly higher power and reactive strength index, increased contact time but not jump height. This suggests participants with high-risk landing biomechanics may also produce higher performance measures, but these do not necessarily result in an improved jump height.
... A meta-analysis of international Rugby Union injury surveillance data found similar injury rates to other collision sports and higher rates than other team sports. 1 Injury rates of international professional rugby have been well documented in other studies, with comparable results. [2][3][4][5][6][7] Despite the amount of evidence describing injury rates in international rugby, to the authors' knowledge, no study has reported similar data in a US professional league. Along with injury rates, an important metric for evaluation is the time for return to play. ...
Background
As American rugby becomes increasingly popular, an understanding of injury rates and patterns is essential for injury prevention, management, and player safety initiatives. We evaluated the injury characteristics and associated time loss sustained at the professional rugby level in the United States over one season.
Methods
One professional rugby team was followed, and all injury data were prospectively collected over 13 consecutive weeks, with eight games during this period. Player involvement in games and practices was recorded by a licensed medical professional. For each described injury event, the timing, body area injured, and time lost from the sport caused by the injury were recorded. The Mid-P exact test was utilized to calculate injury rates with 95% confidence intervals as well as an injury rate ratio (IRR) to quantify differences in injury rates.
Results
A total of 49 injuries over 2,456 athletic exposures (AEs) were included in our 13-week study period of one professional rugby season, with an overall injury rate of 19.95/1000 AEs. IRR between games versus practice was 5.21. Overall, 43% of the injuries occurred in the lower extremities and 18% in upper extremities, and there was a 12% incidence of concussion. Average time lost from sport was increased for game-related injuries (8.2 days) and concussion (7.8 days); however, severe injuries occurred more often in the lower extremity (n=4).
Conclusions
The overall injury rates in this study correspond with previous amateur and international rugby literature showing a trend toward increased injury risk during gameplay at a professional level.
Level of Evidence
Level IV.
... This has been attributed to greater player size, speed with multidirectional nature of play, increased competitiveness, more aggression, and also foul play [171]. Additionally, rugby as a sport has well-established injury surveillance systems enabling documentation of training and matchrelated injuries to players on a regular basis [110,120,166,[172][173][174][175][176][177][178][179]. ...
Rugby is a team sport like soccer, American football, and ice hockey that have been discussed in earlier chapters. This sport is full contact in nature, and consequently its players are susceptible to a significant number of injuries. This chapter provides a brief overview of the popular formats of this sport and discusses the injuries amongst the players with respect to the epidemiology, common sites, and the unique mechanics involved in the causation of injuries. Subsequently, the salient aspects of injury prevention are presented. The final section of this chapter includes wheelchair rugby which is a team sport of paralympic athletes.
... Strain and sprain injuries had the highest incidence in both professional and amateur Rugby, while fracture and bone stresses had the highest severity among professional players. Severity of training injuries was similar to match injuries, with a mean 26.9 days and 23.6 days absent, respectively (Fuller et al. 2013). Contact events, such as tackling, account for the majority of injuries in Rugby matches . ...
Objective
To examine the individual experiences of injury burden in amateur Rugby players across the onset of injury, rehabilitation, and return to play.
Design
Qualitative.
Setting
Irish amateur Rugby clubs.
Participants
Three male and two female Rugby players who sustained a severe injury that resulted in a time loss of at least 28 days.
Main outcome measures
Semi-structured interviews were used to explore the injury burden experienced during the three phases of injury.
Results
Hierarchical content analysis revealed 36 codes representing individual injury burden, which were clustered into seven themes across personal (emotional reaction; impact on performance or involvement; lack of knowledge; severity of injury and incapacitation) and situational (exposure to others playing; negative experiences with treatment or rehabilitation; societal burden) dimensions.
Conclusions
The findings indicate that individual injury experiences can affect a player’s recovery and rehabilitation outcome, potentially extending the injury process and affecting player availability for the team. As such, injury management should focus on alleviating any injury-related burden experienced by players, as well as burden placed on the team, to maximise rehabilitation outcomes.
... Although the most common diagnosis related to the knee joint was the medial collateral ligament sprain (MCL); ACL rupture was the most severe injury. This is in agreement with reports on amateur, professional, national and international rugby [5,14,17,[25][26][27][28]. Although the evidence indicates that the treatment of this injury is by surgical resolution, the player's decision, their psychosocial context, and their condition as copers justify the conservative treatment for many of them [29]. ...
Objectives: Exposure to different types of injuries in rugby union is common. It is important to know about the injury epidemiology for medical teams care in order to optimize players´ performance and the treatment of common injuries but there is limited specific information related to amateur rugby union. The purpose of this study is to determine the incidence, prevalence, injury burden, severity, nature of injuries sustained by senior amateur male rugby players from three clubs in Argentina during a given season.
Methods: An observational, analytical, prospective, multicenter study was developed. Data collection was conducted from March 15, 2019 to November 2, 2019, during a complete season under the applicable standards of the Rugby Injury Consensus Group according to the Orchard Sports Injury and Illness Classification System.
Incidence (injuries/1000 player-match-hours), prevalence (%), severity (time loss), injury burden (days lost/1000 player-match-hours), injured location and type of injury (%) were estimated.
Results: 250 players and 180 injuries were assessed. Injury prevalence was 52.4%. Incidence rate per match and training was 30.9/1000 player-match-hours, and 0.77/1000 player-training-hours, respectively.
The median injury severity score was 23 (IQR 12.7-52) days lost accounting for an injury burden of 97.3/1000 player-hours. Of the total, 113 (62.8%) injuries were contact injuries. The lower limbs were the most commonly affected (58.9%). Hamstring strain injury had the highest incidence and anterior cruciate ligament tear was the most severe injury.
Conclusion: The prevalence, incidence, and injury burden reported in this study are unprecedented and would add knowledge for the amateur rugby union community. Trainers, physicians, and physical therapists, should consider it to improve their clinical practice.
... As a new sport the risk of injury in enduro is currently unknown. There is an increasing recognition of the importance of injury recording from international governing bodies [3][4][5][6][7]. Understanding the magnitude and nature of injury in sport is an important first step in developing and implementing prevention initiatives and reducing the risk associated with sport participation. ...
The sport of Enduro is the newest International Cycling Union sanctioned discipline in mountain biking. There are a number of studies reporting mountain biking injury to date however there are none detailing injuries in Enduro. The aim of the present study was to determine the rate, severity and nature of rider injury during the Enduro World Series. Rider injury, and race and practice exposure data were recorded prospectively during 10 events across the 2017 and 2018 seasons. Incorporating 2010 riders (males 90%; females 10%) from 46 countries. 8.9% of riders were injured with mean 12.3 days time-loss per injury. Racing injury incidence was 38.3/1000 hours and practice injury incidence 3.6/1000 hours (p=0.01). The shoulder/clavicle (12.8% of all injuries), hand (9.0%) and head (9.0%) were the most injured locations. Concussion injury was the most frequent diagnosis (7.4%), and shoulder/clavicle fractures caused the greatest burden (442 total days lost). Of those with concussion 28.6% continued racing, and 42.9% reported no time-loss (i. e. time off) post-race. In conclusion, the rate of injury during EWS race events was comparable to Downhill racing. Targeted injury prevention strategies around rider concussion education and rider qualification criteria may help to reduce the risk of injury in Enduro.
... The number of studies within each sport varied, with 31 studies in football/soccer [4,25,30,, 13 in rugby (two rugby sevens, eleven rugby union) [2,27,[65][66][67][68][69][70][71][72][73][74][75], five in athletics [76][77][78][79][80], one in Olympic multi-event [81] and one in cricket [70] (Table 2). There were no studies from aquatic sports, horseracing or tennis. ...
Background
Injury surveillance in professional sport categorises injuries as either “new” or “recurrent”. In an attempt to make categorisation more specific, subsequent injury categorisation models have been developed, but it is not known how often these models are used. The aim was to assess how recurrent and subsequent injuries are reported within professional and elite sport.
Methods
Online databases were searched using a search strategy. Studies needed to prospectively report injury rates within professional or elite sports that have published consensus statements for injury surveillance.
Results
A total of 1322 titles and abstract were identified and screened. One hundred and ninety-nine studies were screened at full text resulting in 81 eligible studies. Thirty studies did not report recurrent injuries and were excluded from data extraction. Within the studies that reported recurrent injuries, 21 reported the number and percentage; 13 reported only the proportion within all injuries; three reported only the number; five reported the number, percentage and incidence; and two only reported the incidence. Seven studies used subsequent injury terminology, with three reporting subsequent injury following concussion, one using an amended subsequent injury model and three using specific subsequent injury categorisation models. The majority of subsequent injuries (ranging from 51 to 80%) were categorised as different and unrelated to the index injury. The proportion of recurrent injuries (exact same body area and nature related to index injury) ranged from 5 to 21%.
Conclusions
Reporting recurrent or subsequent injuries remains inconsistent, and few studies have utilised subsequent injury models. There is limited understanding of subsequent injury risk, which may affect the development of injury prevention strategies.
Trial Registration
CRD42019119264
... The World Rugby (formerly International Rugby Board) World Cup injury surveillance studies illustrate that ankle joint injuries are among the most commonly sustained lower limb musculoskeletal injuries during international tournaments. [1][2][3] Although the largest percentage of ankle joint injuries sustained in professional rugby union are lateral ligament sprains, ankle syndesmosis ligament injuries are not uncommon. 4 Understanding the sport-specific mechanisms of injury associated with prevalent musculoskeletal injuries in a particular sport is fundamental to the success of injury prevention initiatives. ...
Background
The mechanisms of acute ankle syndesmosis ligament injuries in professional rugby union are not well understood.
Aim
To describe the mechanisms of acute ankle syndesmosis ligament injuries in male professional rugby union players using systematic visual video analysis.
Methods
All time-loss acute ankle syndesmosis ligament injuries identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2013/2014 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three Chartered Physiotherapists (analysts) independently assessed all videos with a final consensus meeting convened to describe the injury mechanisms. One of the analysts developed a qualitative description of each injury mechanism.
Results
Thirteen acute ankle syndesmosis injuries were included in this study. The most common biomechanical presentation of the injured limb was characterised by hip flexion, knee flexion, knee valgus, ankle dorsiflexion, pronation and external rotation of the foot. Six of the included injuries (46%) were the result of an external load application to the injured limb (ie, direct contact injuries). In the other seven instances (54%), the injury was the result of a collapse of the injured player’s body mass over the injured ankle joint, while tackling or being tackled, without direct contact to the injured limb (ie, indirect contact injuries).
Conclusion
Injuries incurred while tackling were exclusively the result of suboptimal tackle mechanics. A majority of injuries incurred while being tackled involved a posterior tackle, which often resulted in a posterior collapse of the injured player’s centre of mass over a fixed externally rotated foot.
... Along recent years, World Rugby (the sports' governing body) has shown considerable interest in the improvement of players' health and welfare. A large number of studies has been published, in these past years, concerning Rugby Union fifteens injuries (Bird et al. 1998;Brooks et al. 2005;Schneiders et al. 2009;Haseler et al. 2010;Fuller et al. 2013;Fuller et al. 2008;Williams et al. 2013). However, regarding the sevens variant, we can find a different reality as the available literature is clearly insufficient (Cruz-Ferreira et al. 2017). ...
Introduction: Rugby Sevens is one of the fastest growing sports in the world, especially the sevens variant after its inclusion in the Summer Olympics’ programme. The Portuguese University Sevens Championship is an amateur tournament that takes place every year.
Objectives: To gather a set of relevant data regarding the profile of the Portuguese university rugby sevens’ players, as well as the epidemiology of injuries at this level of competition.
Methodology: Firstly, an observational study was conducted to collect data regarding each player anthropometry, individual experience, training habits and warm-up routines. Secondly, a prospective cohort study including all participating athletes was conducted, to identify and describe all injuries occurring during the competition. A follow-up period until the return to sport from all injured players was conducted.
Results: A total of 87 players from 8 teams competed in the tournament. On average, athlete’s heighted 178.6 cm (± 6.65) and weighted 83.34 kg (± 11.22). Total match exposure was 53.67 player match-hours and the injury incidence rate was 186.2 per 1000 player match-hours (94.7-332.4, CI 95%). Average severity was 26.6 days (± 6.23). Most injuries occurred on the second half (n=6), following contact events with the opponent (n=8). Lower limb (n=6) and joint/ligament (n=7) injuries were the most frequent.
Discussion: The overall injury incidence rate was higher than any previously reported in the literature. Insufficient training and warm-up routines of the injured players strengthens the idea that these are key elements in injury prevention. The small sample limits the results' statistical significance.
Conclusions: Similar but larger studies must be conducted to gain better knowledge of the individual profile of the Portuguese university rugby player and the burden of injuries at this level of competition.
... Along recent years, World Rugby (the sports' governing body) has shown considerable interest in the improvement of players' health and welfare. A large number of studies has been published, in these past years, concerning Rugby Union fifteens injuries (Bird et al. 1998;Brooks et al. 2005;Schneiders et al. 2009;Haseler et al. 2010;Fuller et al. 2013;Fuller et al. 2008;Williams et al. 2013). However, regarding the sevens variant, we can find a different reality as the available literature is clearly insufficient (Cruz-Ferreira et al. 2017). ...
Introduction: Rugby Sevens is one of the fastest growing sports in the world, especially the sevens variant after its inclusion in the Summer Olympics’ programme. The Portuguese University Sevens Championship is an amateur tournament that takes place every year.
Objectives: To gather a set of relevant data regarding the profile of the Portuguese university rugby sevens’ players, as well as the epidemiology of injuries at this level of competition.
Methodology: Firstly, an observational study was conducted to collect data regarding each player anthropometry, individual experience, training habits and warm-up routines. Secondly, a prospective cohort study including all participating athletes was conducted, to identify and describe all injuries occurring during the competition. A follow-up period until the return to sport from all injured players was conducted.
Results: A total of 87 players from 8 teams competed in the tournament. On average, athlete’s heighted 178.6 cm (± 6.65) and weighted 83.34 kg (± 11.22). Total match exposure was 53.67 player match-hours and the injury incidence rate was 186.2 per 1000 player match-hours (94.7-332.4, CI 95%). Average severity was 26.6 days (± 6.23). Most injuries occurred on the second half (n=6), following contact events with the opponent (n=8). Lower limb (n=6) and joint/ligament (n=7) injuries were the most frequent.
Discussion: The overall injury incidence rate was higher than any previously reported in the literature. Insufficient training and warm-up routines of the injured players strengthens the idea that these are key elements in injury prevention. The small sample limits the results' statistical significance.
Conclusions: Similar but larger studies must be conducted to gain better knowledge of the individual profile of the Portuguese university rugby player and the burden of injuries at this level of competition.
... As Rugby-7s is a more open format having less players on the same size field as Rugby-15s, it is played differently and requires different physical demands compared to . As a result, injury patterns between the two formats are different with Rugby-7s typically having higher incidence of injury compared to 15s [6,21]. ...
Background:
There is a lack of injury data for the new Olympic sport of Rugby-7s, particularly for involved youth.
Objective:
To determine injury rates and characteristics for players participating in U.S. Rugby-7s U19 (under 19 years of age) tournaments.
Methods:
Injury data were collected, using the Rugby Injury Survey & Evaluation report methodology, at 24 U.S. Rugby-7 s U19 tournaments over 30 tournament days (2010-2014). Tournament medical-attention injuries and time-loss injuries (days absent before return to training/competition including post tournament) were recorded.
Results:
During the 2101 playing hours (3072 males, aged 17.2 ± 1.5 years; 732 females, 16.6 ± 1.3 years of age), there were 173 tournament injuries with an overall injury incidence of 82.4/1000 player-match-hours (ph) (CI 70.5-95.6). Acute injuries (79.5/1000 ph) occurred during tackling (56.2/1000 ph) and involved joints/ligaments (32.8/1000 ph) of lower extremities (31.9/1000 ph). Head and neck injuries, including concussions, were common (males 21.9/1000 ph; females 22.0/1000 ph). Medical-attention injury incidences (49.5/1000 ph; n = 104; 95% CI 40.5-60.0) were higher than time loss (32.8/1000 ph; n = 69; 95% CI 25.5-41.6). Overall, injury incidences found no difference between sex (RR 0.78; p = 0.369). Time-loss injuries resulted in an average of 35.5 d to return to sport.
Discussion:
This study is the first to report match injury incidences for U19 participants in Rugby-7s. Overall, match injury incidence among U.S. U19 Rugby-7s tournaments was similar compared to adult U.S. community Rugby-7s. Recurrent injury risk was notable in this population. Community injury surveillance studies are essential to understand risk from participation in amateur sports. Knowledge of these injury patterns in U19 Rugby-7s will help identify areas to direct resources to enable growth of Rugby-7s in youths and emerging countries being exposed to Rugby-7 s. Age-based injury frequency and patterns in rugby and its various formats are needed for the development of evidence-based, sport-specific, and population-specific injury prevention initiatives.
Conclusions:
The match injury incidence of U19 participants in U.S. Rugby-7s was similar to the incidence among adult participants. Recurrent match injury risk was high at 23%. There were no significant differences in injury incidences between males and females. The first three matches of a tournament day result in the most injuries.
... In rugby union match play, the time during the game when the most injuries occur is consistently reported as the second half (Bathgate et al., 2002b;Brooks et al., 2005a;Fuller, Laborde, Leather and Molloy, 2008;Fuller, Sheerin and Targett, 2013;Kemp et al., 2013). However, when broken down by quarter, there are inconsistencies as to whether the 3 rd or 4 th quarter is responsible for a greater number of injuries. ...
The rate of injury in professional rugby union is high compared to that of other team sports. As such, the need for injury mitigation strategies is evident. One emerging approach is the appropriate management of player load, with multiple studies across different sports demonstrating the association between load and injury risk. The aim of this thesis, therefore, is to build upon the small amount of work undertaken in rugby union to further our understanding of this modifiable risk factor to aid governing bodies and club practitioners make informed decisions around player loading patterns.
... Shoulder injuries are the third most common injury in rugby union behind head and neck and lower limb injuries, 2,6,7,12 and the shoulder is the second most commonly injured joint. 14 The shoulder injury group can be further subdivided into hematomas, fractures, acromioclavicular joint injuries, instability-dislocation, and rotator cuff tears. ...
Background
Mechanisms previously described for traumatic shoulder injuries in rugby may not adequately describe all the mechanisms that result in shoulder dislocations.
Purpose
To investigate the mechanism of shoulder dislocation events in professional rugby players through use of systematic video analysis.
Study Design
Case series; Level of evidence, 4.
Methods
In our series, 39 cases of shoulder dislocations from games played in top professional leagues and international matches across a 2-year period were available for video analysis. All cases were independently assessed by 2 analysts to identify the sequence of events occurring during shoulder dislocation. This included injury circumstance such as contact with another player or the ground, game scenario, injury timing, and the movements and force vectors involved in the dislocation mechanism.
Results
We identified 4 distinct injury mechanisms. The previously described mechanisms “try scorer,”“tackler,” and “direct impact” were identified in 67% of cases. We describe a new injury mechanism occurring in the “poach position,” accounting for 18% of all shoulder dislocations studied. The remaining 15% could not be categorized. Shoulder dislocations occurred to a ball carrier in 15% of cases (n = 6) and a non–ball carrier in 85% of cases (n = 33). The injury most commonly occurred during a tackle (49%; n = 19) followed by ruck/maul (26%; n = 10). Time of injury showed that 36% (n = 14) of cases occurred in the last quarter of the game.
Conclusion
Shoulder dislocations have now been shown to occur predominantly as a result of 1 of 4 distinct mechanisms, most frequently in the second half of the game. A new mechanism for shoulder dislocation has been described in this series, termed the poach position.
Problem ozljeđivanja u ragbiju veoma je prisutan. Prvi je cilj ovg rada identiicirati i bjasniti vrstu i
težinu zljeda te rizične aktre zljeđivanja kd hrvatskih ragbijaša. Drugi je cilj vg rada identiicirati
i bjasniti razlike prema igračkim pzicijama kd hrvatskih ragbijaša s bzirm na vrstu i težinu zljeda
te rizične aktre zljeđivanja. Primjenm hi kvadrat testa s razinm značajnsti d 0.05 je utvrđen da ne
pstje statistički značajne razlike između igrača linije i skupa kd hrvatskih ragbijaša s bzirm na vrstu
zljeda. U ragbiju prevladavaju zljede ka psljedica traume, a manjim dijelm vezane su za sindrme
prenaprezanja. Najveći brj zljeda je nasta ka psljedica aktivnsti baranja. Rezultati vg istraživanja
treneri mgu iskristiti u prnalaženju prevencijskih mjera tijekm planiranja i prgramiranja treninga št bi
uključival blju tehničku izvedbu baranja ka i jačanje mekih tkiva kja dminantn sudjeluju u baranju.
Kd baranja se javljaju i ptresi mzga kje je mguće smanjti jačanjem mišića vrata te time smanjiti
akceleraciju glave pa bi bil pželjn da se vježbe snage za te mišiće uvrste u redviti trenažni prces.
Fifteen-a-side rugby union (“rugby”) is a full-contact sport played separately by men and women, with large injury incidences reported previously. Context specific injury surveillance fulfils governing bodies’ duty of care to understand risks to player welfare, yet no contemporary match injury epidemiology studies exist for international players in Scotland. The current study therefore aimed to describe the incidence, severity, burden and nature of match injuries sustained by Scotland’s men’s and women’s national teams. A prospective cohort study of injuries recorded in matches across the 2017/18 and 2018/19 seasons was undertaken, with injury and exposure definitions in line with the international consensus for injury surveillance in rugby. Injury incidence was 120.0 (men) and 166.7/1,000 player match hours (women), injury severity was 12.0 (median) and 31.2 days (mean) for men, and 11.0 (median) and 30.2 days (mean) for women. Injury burden was 3,745 (men) and 5,040 days absence/1,000 player match hours (women). Concussion was the most common specific injury for men (22.5/1,000 hours) and women (26.7/1,000 hours). No statistical differences were found for incidence or severity measures between sexes. Injury incidence was greater than recent Rugby World Cup studies. High incidences of concussion reinforces the need for prevention strategies targeting this injury.
The purpose of this study was to describe the incidence, severity, and burden of injuries in Japanese male collegiate rugby union players. Initially, 170 male collegiate rugby union players from one university club were registered in this epidemiological surveillance
study. The occurrence of injuries was recorded by a team medical staff during the 2017–2021 playing seasons. The incidence of injuries was 6.87 injuries/1000 h. This incidence was significantly
higher during matches (100.37 injuries/1000 h) than that during training (3.63 injuries/1000 h). The severity of injuries was 31.0 days, and there were no significant differences between matches and training, or forwards and backs. The burden of injuries was 213.1 days/1000 h. This burden was significantly higher during matches (2887.8 days/1000 h) compared to training (120.1 days/1000 h). Matches had higher incidence of ankle sprain/ligament injuries (15.80 injuries/1000 h) and concussion (15.36 injuries/1000 h). The most common injury site was the ankle (1.24 injuries/1000 h). However, the greatest severity and burden were observed for knee injuries (severity: 59.1 days, burden: 48.6 days/1000 h). Furthermore, the greatest burden of injury type was knee sprain/ligament injuries (39.4 days/1000 h). In addition, the incidence of acromioclavicular joint injury was significantly higher in forwards, whereas hamstring strain was significantly higher in backs. The common injury mechanisms identified were being tackled (16.0%) and tackling (14.7%), followed by overuse (12.1%). In order to improve the player welfare of the Japanese collegiate rugby union players, it is necessary to work on the prevention strategy considering the injury profile.
Objective
This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports.
Design
Systematic review and meta-analysis.
Data sources
CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020.
Eligibility criteria
Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports.
Method
Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible.
Results
Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269).
Conclusion
Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports.
PROSPERO registration number
CRD42020200022.
Study design and setting
Returning rugby players to the sport following musculoskeletal injuries is a multi-factorial and challenging process. A cross-sectional observational study was conducted among health and sport practitioners involved with injured rugby players in South Africa.
Objectives and outcome measures
The views, current practices and barriers encountered by health and sport practitioners during return to rugby were investigated using a self-developed online survey.
Results
64 practitioners participated in the survey including physiotherapists, orthopaedic surgeons, biokineticists and sports physicians. Return to sport (RTS) protocols were considered important, however, participants also indicated that they were slightly more likely to use anecdotal protocols compared to published protocols. Time frames, stages of healing, pain and subjective ratings along with functional outcome measures (such as range of motion, muscle function and proprioception) and sport-specific skills were rated as important and commonly utilised in different RTS phases (i.e., return to non-contact, return to contact and return to matches). The most commonly perceived barriers encountered were related to lack of access and time-constraints.
Conclusion
Return to rugby guidelines with consideration of a broad range of criteria and common barriers encountered should be developed to facilitate safe, practical and time-efficient return to rugby following musculoskeletal injuries.
L'analyse biomécanique du geste sportif s’inscrit dans une double perspective d’optimisation de la performance et de prévention des blessures. Les travaux qui ont été menés au cours de cette thèse s’appliquent au rugby et s’articulent autour de deux axes : l’optimisation de la performance du lancer en touche et l’amélioration de la prise en charge des commotions cérébrales.Le lancer en touche est à l’origine de 50% des essais qui sont marqués au niveau international et malgré l’importance stratégique de cette phase de jeu, peu d’études biomécaniques sont présentes dans la littérature scientifique. Dans un premier temps, nous avons proposé un dispositif d’évaluation de la performance du lancer qui permet de quantifier simultanément la précision et le timing du lancer. Par la suite, une série d’expérimentations a été réalisée afin de mieux comprendre les facteurs biomécaniques impliqués dans cette phase de jeu. La première a permis de caractériser l’influence de la stabilité posturale dynamique sur la précision du lancer sur de longues distances, tandis que la seconde a permis d’identifier les paramètres cinématiques 3D associés à la performance du lancer chez des joueurs de différents niveaux d’expertise.L’étude des commotions cérébrales revêt un intérêt croissant dans le monde du rugby, notamment en raison de la hausse de son incidence constatée lors des deux dernières décennies. De plus, le plaquage est identifié comme la principale cause de commotion cérébrale et certains facteurs sont susceptibles d’en augmenter le risque. Le travail réalisé dans cette seconde partie de thèse a consisté d’une part, à évaluer l’intérêt du NeuroTracker (outil d’évaluation perceptivo-cognitif) dans la détection et le suivi de retour au jeu des joueurs ayant subi une commotion cérébrale. D’autre part, un dispositif de simulation d’impact a été développé afin de reproduire des plaquages de type « non anticipés » dans des conditions sécuritaires et reproductibles. La réponse biomécanique à ce type d’impact a par la suite été analysée dans un groupe de rugbymen professionnels, mettant en évidence l’influence des caractéristiques morphologiques liées au poste sur le risque de commotion cérébrale.Toutes les expérimentations réalisées dans le cadre de cette thèse ont été effectuées au centre d’entraînement du Racing 92 afin de favoriser le transfert des résultats vers les équipes médicales et sportives.
Background
Professional rugby presents significant injury and illness risks to players, which need to be regularly assessed to monitor the effects of interventions and competition rules changes.
Hypothesis/Purpose
The purpose of this study was to determine the incidence and nature of time-loss injuries and illness during the pre-season and competition period of the 2017 Super Rugby tournament in a single South African team.
Study Design
Descriptive Epidemiology Study
Methods
Forty-five adult players were recruited from one 2017 Super Rugby South African team, with 39 included in the final data set. Daily injury and illness data were routinely collected during the season by support staff over a 28-week period (January to July 2017), based on standardized injury and illness definitions. Retrospective analyses of the data were performed.
Results
The incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). Twenty one percent of all injuries occurred during the tackle; 37.5% of all injuries were of a “moderate” severity. The proportion of players who sustained a time-loss injury was 76.9% (n=30). The overall incidence of illness was 1.8 per 1000 player days. Acute respiratory tract infection (28.6%) was the most common diagnosis, and the majority of illnesses (64.3%) did not result in time-loss.
Conclusion
This study presented a longer study period than previous research by including the pre-season training, but represented only one single team. The incidence of match injuries was significantly higher than previously reported in Super Rugby tournaments, whereas illness rates were significantly lower. Support staff in professional rugby need to be trained on the standardized Orchard System of Classifications to ensure good quality data that can be compared to other teams within the same or other sporting codes.
Level of evidence
Level 3
Introduction:
The sequelae of concussion is of growing concern within Rugby. World Rugby has introduced rule changes to improve player welfare and reducing head injury frequency. We aimed to report the incidence of head injuries and head injury assessment (HIA) at the 2019 Rugby World Cup (RWC).
Methods:
We reviewed all 45 tournament matches; recorded the number of head injuries, the injured player's position, the mechanism of injury, whether the player had an HIA and if they returned to play following injury. We compared these findings to previous RWCs.
Results:
We recorded 68 head injuries (1.33/game). Thirty-six players (52.9%) were removed from the field of play for an HIA. Of these 23 (63.9%) failed and therefore considered to have concussion. The head injury rate in 2019 was 37.8 per 1000 player hours which increased from previous tournaments (22.0 in 2015; 14.6 in 2011; 4.7 in 2007). The concussion rate was 23 per 1000 player hours in 2019 which was lower than 29 in 2015. In 2019, 63.9% of HIAs were failed compared to 48.7% in 2015. We identified 17 cases where medical staff didn't attend to a player suffering a head injury on-field. Of which four players underwent an HIA after the match doctor reviewed the incident.
Conclusion:
We recorded a higher rate of head injuries and a player was more likely to fail their HIA than in previous tournaments. These findings may represent a greater awareness from medical staff and the benefits of education. However, 25% of head injuries not receiving an initial on-field assessment provides room for improvement.
Background
Not all anterior cruciate ligament (ACL) injuries are preventable. While some ACL injuries are unavoidable such as those resulting from a tackle, others that occur in non-contact situations like twisting and turning in the absence of external contact might be more preventable. Because ACL injuries commonly occur in team ball-sports that involve jumping, landing and cutting manoeuvres, accurate information about the epidemiology of non-contact ACL injuries in these sports is needed to quantify their extent and burden to guide resource allocation for risk-reduction efforts.
Objective
To synthesize the evidence on the incidence and proportion of non-contact to total ACL injuries by sex, age, sport, participation level and exposure type in team ball-sports.
Methods
Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, Scopus and SPORTDiscus) were searched from inception to July 2021. Cohort studies of team ball-sports reporting number of knee injuries as a function of exposure and injury mechanism were included.
Results
Forty-five studies covering 13 team ball-sports were included. The overall proportion of non-contact to total ACL injuries was 55% (95% CI 48–62, I ² = 82%; females: 63%, 95% CI 53–71, I ² = 84%; males: 50%, 95% CI 42–58, I ² = 86%). The overall incidence of non-contact ACL injuries was 0.07 per 1000 player-hours (95% CI 0.05–0.10, I ² = 77%), and 0.05 per 1000 player-exposures (95% CI 0.03–0.07, I ² = 97%). Injury incidence was higher in female athletes (0.14 per 1000 player-hours, 95% CI 0.10–0.19, I ² = 40%) than male athletes (0.05 per 1000 player-hours, 95% CI 0.03–0.07, I ² = 48%), and this difference was significant. Injury incidence during competition was higher (0.48 per 1000 player-hours, 95% CI 0.32–0.72, I ² = 77%; 0.32 per 1000 player-exposures, 95% CI 0.15–0.70, I ² = 96%) than during training (0.04 per 1000 player-hours, 95% CI 0.02–0.07, I ² = 63%; 0.02 per 1000 player-exposures, 95% CI 0.01–0.05, I ² = 86%) and these differences were significant. Heterogeneity across studies was generally high.
Conclusion
This study quantifies several key epidemiological findings for ACL injuries in team ball-sports. Non-contact ACL injuries represented over half of all ACL injuries sustained. The proportion of non-contact to total ACL injuries and injury incidence were higher in female than in male athletes. Injuries mostly occurred in competition settings.
Groin/hip injuries are prevalent in rugby union (RU). Assessment of hip muscle strength is important when designing bespoke injury prevention and rehabilitation programmes.
Objective
The primary aim of this study was to determine normative values of hip muscle strength in elite-level RU players. A secondary aim of this study was to compare the Copenhagen Hip and Groin Outcome Score (HAGOS) between players with and without a history of groin/hip injury.
Design
Cross-sectional cohort study.
Setting
Professional RU club.
Participants
58 male professional RU players competing in the PRO14 league elite club level competition.
Main outcome measures
Handheld dynamometry eccentric strength values of hip abduction (ABD), adduction (ADD), internal rotation (IR) and external rotation (ER), HAGOS.
Results
Players' dominant (DOM) and non-dominant (NDOM) hip strength values were, 2.38 and 2.34 N m/kg for ABD, 2.79 and 2.71 N m/kg for ADD, 2.69 and 2.55 N m/kg for IR, and 2.65 and 2.54 N m/kg for ER. ADD:ABD strength ratio was 1.17 ± 0.26 for the DOM limb and 1.16 ± 0.24 for the NDOM limb. There was no clinically significant difference in strength between players’ DOM and NDOM limbs. Players with a history of groin/hip injury scored lower on four of the HAGOS subscales (pain; symptoms; sport; quality of life) compared to those without a history of groin/hip injury.
Conclusions
This study may help establish normative hip strength and HAGOS values for elite-level RU players. The results presented have important implications for the assessment of hip muscle strength and could provide clinical markers for return-to-play following injury.
Resumen
Introducción: El desarrollo de cualidades específicas en jugadores de Rugby Seven optimiza su desempeño.
Objetivo: Caracterizar cualidades antropométricas, fisiológicas y funcionales en jugadores profesionales de Rugby Seven.
Métodos: Estudio transversal en 14 seleccionados nacionales de Rugby Seven. Se rescataron datos demográficos, tácticos, antropométricos (índice de masa corporal (IMC) y composición corporal), fisiológicos (consumo de oxígeno (VO2)) y funcionales (Running-based Anaerobic Sprint Test (RAST) y saltos verticales (Squat Jump (SJ ) y Counter Movement Jump (CMJ)).
Se comparó a los atletas según posición de juego (forwards y backs) con prueba de Mann-Whitney y Fisher y se buscaron asociaciones entre variables demográficas y resultados funcionales con regresión lineal simple y ANOVA (significancia: p
Objective: To analyse rugby athletes' judgement knowledge and decisions-made where there is the potential to minimise error and prevent injury. Material and methods: A prospective cohort of 300 rugby athletes participated in the Division 2A Senior Rugby All-Ireland Championships in the period of 2010-2011. The athletes came from the Dublin University Football Club and opposing Clubs, ten match fixtures videoed, injury data were collated with informed consent obtained. Results: Time durations for the scrum had a mean throw in-clearance of 3.128s (SD 2.109), the tackle, mean clearance time 4.135s (SD 3.0320) and the lineout, mean throw in-clearance 4.072s (SD 3.2584). On space dimensions the scrum, short-arm binding was preferred, Fisher's exact test: p-value = 0.094 and variations in alignment, p-value = 0.056. Of the injury data a Chi-squared test, confirmed significant differences p < 0.05 with the hooker compared to the locks in the scrum 33.156 for cervical and lumbar spinal injuries respectively. In open play, loose forwards sustained cervical injuries, p < 0.05 due to the tackle compared to midfield backs 28.917 with lower limb injuries attributed to running and being tackled. Conclusion: Judgement analysis on the scrum, tackle, and lineout showed consistent delays in recovery and completion from ball clearances respectively. Variations in alignments occurred with inconsistencies at the post-set in the scrum. In contrast applying Judgement knowledge with reference to the Laws of the Game there is the potential to minimise error and prevent injury.
Objectives
To avoid injuries and keep up their performances, rugby players have to make relevant choices of footwear adapted to their individual specificities as well as to the type of turf and playing conditions. The diversity and heterogeneity of playing surfaces on which modern rugby is played make this choice all the more complicated. This study examines the relevance of a comparative functional protocol for a subjective assessment of footwear as well as the influence of the technical characteristics of different shoe models.
Materials and methods
Forty-two professional rugby players were tested on synthetic turf. They performed a series of controlled characteristic movements of rugby (jump reception, straight running, change of direction) with different shoe models. Procedure ended with a standardized subjective comparison of models including 7 criteria.
Results
Comparative tests between models tested for each player brought to significant differences (P < 0.05). Technical properties of the models having received the most favorable assessments were: screwed or hybrid cleats, aluminum cleats, circular cleat design and existence of arch support.
Conclusions
This protocol seems to be a relevant tool to help rugby players to choose the type of shoes according to their individual specificities and pitch conditions. What's more, results shed new light on the kind of cleats to be preferred on synthetic turf.
Low reactive level laser therapy (LLLT) using low power laser has attracted attention not only for pain relief but also for its contribution to conditioning the players i.e. in improving muscle fatigue in recent years. This article describes the current status of the medical operation in teams and future interventions by LLLT for collision sports involving contact play, specifically rugby, where the author is mainly involved.
Objectives
The purpose of this review was to synthesise both injury prevention and performance tackle-related research to provide rugby stakeholders with information on tackle injury epidemiology, including tackle injury risk factors and performance determinants, and to discuss potential preventative measures.
Design
Systematic review and narrative synthesis.
Data sources
PubMed, Scopus and Web of Science.
Eligibility criteria
Limited to peer-reviewed English-only publications between January 1995 and October 2018.
Results
A total of 317 studies were identified, with 177 in rugby union and 13 were in rugby sevens. The tackle accounted for more than 50% of all injuries in rugby union and rugby sevens, both at the professional level and at the lower levels, with the rate of tackle injuries higher at the professional level (mean 32/1000 player-hours) compared with the lower levels (mean 17/1000 player-hours). A player’s tackle actions and technical ability were identified as major risk factors for injury and a key determinant of performance.
Summary/conclusion
Evidence-based education, progressive tackle technique training with a high potential to transfer and law changes have been proposed as key modifiers of player tackle actions and technical ability. Conceivably, all three modifiers working in unison (as opposed to separately) will have a higher potential at reducing tackle injury risk while enhancing performance. With the guidance of tackle injury and performance studies, as well as stakeholder engagement, experiential and explorative tackle research has the potential to inspire innovative injury prevention and performance strategies.
The aim of this study was to describe the incidence, nature and causes of match injuries in men’s international rugby sevens and to compare these to values for international rugby fifteens. The study comprised a 10-season, whole population, prospective study of the Sevens World Series. Over the ten seasons, the overall incidence of injury was 122.4 (95% CI = 116.3 to 128.9) injuries/1000 player-match-hours and the mean severity of injury was 43.0 (95% CI = 40.3 to 45.7) days-absence. There was an increasing trend in the incidence of injury over the ten-season period (slope = 5.3 injuries/1000 player-hours/season, R² = 0.68, p = 0.003) but no trend in the mean severity of injury (slope = 0.02 days/season, R² < 0.01, p = 0.971). Head/face (15.7%), knee (15.6%), ankle (15.4%) and shoulder/clavicle (11.9%) were the most common injury locations and ligament sprain (30.5%), muscle strain (16.4%), concussion (12.6%) and haematoma/bruise (10.6%) the most common types of injury sustained. Being-tackled (33.1%), tackling (23.4%), running (16.1%) and collisions (12.4%) were the most common events leading to injury. These results indicate that the burden of injury in international rugby sevens is two to three times higher than that reported for international rugby fifteens.
Objectives:
To report match injury incidence, burden and mechanism over a four-year period in professional male Welsh Regional Rugby Union.
Design:
Descriptive; Longitudinal.
Setting:
Welsh Regional Rugby Union.
Participants:
Four Welsh Regional male Rugby Union teams. Main OutcomeMeasures: All time-loss injuries sustained between July 1, 2012 and June 30, 2016. Incidence (injuries/1000 h), severity (mean and median days lost per injury), burden (days-lost/1000 h) and proportions (%) were calculated.
Results:
The overall injury incidence and burden was 99.1 injuries/1000 h and 2570.3 days-lost/1000 h. Concussion represented the highest incidence and burden of all specific injuries, with increases in burden from 2012/13 (86.5 days-lost/1000 h) to 2015/16 (302.4 days-lost/1000 h). Acromio-clavicular (AC) joint injuries increased in burden from 2012/13 to 2015/16 (71.3 vs 130.6 days-lost/1000 h). However, anterior thigh haematomas decreased in incidence (8.2 vs 2.4 injuries/1000 h) and burden (48.6 vs 17.7 days lost/1000 h) across the same period. Tackle events contributed to the highest proportion of match injuries (being tackled: 20-31%, tackling: 30-42%).
Conclusions:
Injury incidence was higher than previously reported for professional Rugby Union. Decreases in anterior thigh haematoma and increases in concussion and AC joint injuries were shown, identifying a change in contact-related match injury risk.
To investigate the evolution of anthropometric characteristics in World Cup rugby players and identify elements associated with performance.
Age, weight and height were collected for 2692 World Cup rugby players as well as rankings in each World Cup, and collective experience of winners, finalists, semifinalists and quarter finalists in comparison to the rest of the competitors. Anthropometric parameters were compared according to age and position (back and forwards).
From 1987 to 2007, forwards and backs have become heavier by 6.63 and 6.68 kg and taller by 0.61 and 1.09 cm, respectively. The collective experience of the forwards' pack is a value increasing with the final ranking attained, as well as the weight of forwards and the height of backs.
For all Rugby World Cups, the highest performing teams have the tallest backs and heaviest forwards with the highest percentage of collective experience.
To determine the frequency and nature of injuries sustained by the 416 players from 16 countries participating in the 1995 Rugby World Cup played in South Africa in May/June 1995.
The study was a prospective analysis of all injuries requiring medical attention during that competition. Data were collected by the match doctors on duty at each of the venues at which the matches were played. Data were collated and analysed.
There were 48 preliminary and 7 final-round matches. Of a total of 70 injuries during the tournament, 58 occurred during the preliminary matches (frequency 30 injuries per 1000 player hours); the frequency was somewhat higher during the 7 final-round matches (43 injuries per 1000 player hours). Overall injury frequency was 1 injury every 0.8 matches during the preliminary and 1 every 0.6 matches during the final-round matches. Thirty per cent of injuries were to ligaments, 27% were lacerations and 14% were muscle strains. The lower limb accounted for 42% of all injuries, the upper limb for 29% and the face for 17%. Fifty-six per cent of injuries occurred during the tackle phase of play, 23% during the ruck and maul, 11% during open play and 9% during foul play. The scrum and line-out together contributed only 1% of all injuries. Loose forwards suffered 25% of all injuries; centres and wings 20%; prop forwards and half-backs 16% each; locks 14%; hookers 7% and fullbacks 3%. One player suffered a paralysing spinal cord injury during a preliminary match. The incidence of catastrophic neck injuries in the tournament was therefore 4.6 per 10,000 player hours.
The frequency of injury in this competition is the highest yet recorded in any group of rugby players. The risk of rugby injury is therefore greatest in the best players in the game, challenging the view that superior fitness, skill and experience can reduce the risk of rugby injury. In contrast, the larger size, greater speed and superior competitiveness and commitment of the best rugby players in the world would explain why they are at the highest risk of injury. The high frequency of injury in international rugby has implications for: (i) the frequency with which such matches should be played; and (ii) the number of players needed to complete a season of international rugby.
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.
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.
A two season prospective design was used to study match injuries associated with 546 rugby union players at 12 English Premiership clubs. Team clinicians reported all match injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury. Match exposures for individual players were recorded on a weekly basis. Loss of time from training and match play was used as the definition of an injury.
The overall incidence of injury was 91 injuries/1000 player-hours, and each injury resulted on average in 18 days lost time. Recurrences, which accounted for 18% of injuries, were significantly more severe (27 days) than new injuries (16 days). Thigh haematomas were the most common injury for forwards and backs, but anterior cruciate ligament injuries for forwards and hamstring injuries for backs caused the greatest number of days absence. Contact mechanisms accounted for 72% of injuries, but foul play was only implicated in 6% of injuries. The ruck and maul elements of the game caused most injuries to forwards, and being tackled caused most injuries to backs. The hooker and outside centre were the playing positions at greatest risk of injury.
On average, a club will have 18% of their players unavailable for selection as a consequence of match injuries.
To study match injury patterns and incidence during the Rugby World Cup 2003 (RWC 2003); to compare these patterns and rates with comparative rugby injury data; and to assess differences between teams playing at different levels (eight finalists v 12 non-finalists).
Data were collected prospectively during the tournament. All injuries were recorded by the 20 participating team physicians. These were submitted to the tournament medical officer. An injury was defined as an event which forced a player either to leave the field or to miss a subsequent game or both.
189 injuries were recorded over 48 matches. This corresponds to 97.9 injuries per 1000 player-hours. Pool matches yielded a higher injury rate than non-pool matches. The 12 non-finalist teams sustained significantly higher injury rates than the eight finalist teams. The player positions open side flanker, inside centre, and number 8 were the most frequently injured positions. There was a low concussion rate, which may reflect under-reporting. The non-finalist teams had a higher rate of recurrent injury.
The injury rate was higher than comparative data. Mismatches in the areas of skill, fitness, and the availability of resources for medical care of players may explain these differences.
to determine the incidence, nature and causes of injuries sustained during the International Rugby Board (IRB) Rugby World Cup 2007.
Pospective, whole-population survey. Population: 626 international rugby players representing 20 teams competing at the IRB Rugby World Cup 2007 in France.
The survey followed the international consensus procedures for studies of injuries in rugby union; the main outcome measures were incidence of match and training injuries (number of injuries/1000 player hours), severity (days absence), location, type and cause of injury.
the incidence of injuries was 83.9/1000 player-match hours (forwards 84.0; backs 83.7) and 3.5/1000 player-training hours (forwards 3.5; backs 3.6). The average severity of injuries was 14.7 days (forwards 14.0; backs 15.5) during matches and 17.8 (forwards 15.9; backs 19.8) during training. Lower limb muscle and ligament injuries were the main injuries during both matches and training. Most injuries were sustained in the tackle during matches and in full-contact skills activities during training.
This study shows the application of the methodology described in the international consensus statement on injury surveillance studies in rugby union and provides benchmark values for the incidence, severity, nature and causes of match and training injuries sustained during the IRB Rugby World Cup.
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 reach an agreement on the appropriate definitions and methodologies to standardise 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 in order 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 finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non-fatal 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.
Injury classification systems are generally used in sports medicine (1) to accurately classify diagnoses for summary studies, permitting easy grouping into parent categories for tabulation and (2) to create a database from which cases can be extracted for research on specific injuries. Clarity is most important for the first purpose, whereas diagnostic detail is particularly important for the second. An ideal classification system is versatile and appropriate for all sports and all data collection scenarios. The Orchard Sports Injury Classification System (OSICS) was developed in 1992 primarily for the first purpose, a specific study examining the incidence of injury at the elite level of football in Australia. As usage of the OSICS expanded into different sports, limitations were noted and therefore many revisions have been made. A recent study found the OSICS-8, whilst superior to the International Classification of Diseases Australian Modification (ICD-10-AM) in both speed of use and 3-coder agreement, still achieved a lower level of agreement than expected. The study also revealed weaknesses in the OSICS-8 that needed to be addressed. A recent major revision resulted in the development of the new 4-character OSICS-10. This revision attempts to improve interuser agreement, partly by including more diagnoses encountered in a sports medicine setting. The OSICS-10 should provide far greater depth in classifications for the benefit of those looking to maintain diagnostic information. It is also structured to easily collapse down into parent classifications for those wanting to preserve basic information only. For those researchers wanting information collected under broader injury headings, particularly those not using fully computerized systems, the simplicity of the OSICS-8 system may still suffice.
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.
1 to 1.1) 0.1 (0.0 to 1.0) 0.3 (0
- Haematoma
Haematoma/contusion/
bruise
0.4 (0.1 to 1.1)
0.1 (0.0 to 1.0)
0.3 (0.1 to 0.7)
3.3 (1.6 to 5.1)
8.0 (*)
4.5 (1.9 to 7.1)
(Continued)
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3.8 (0.8 to 6.7)
8) Muscle rupture/tear
- Muscle
Muscle/tendon
All injuries
1.5 (0.9 to 2.7)
1.4 (0.7 to 2.6)
1.5 (1.0 to 2.2)
26.2 (7.4 to 45.1) 15.1 (0.1 to 30.1)
21.4 (8.9 to 33.8)
Muscle rupture/tear/
strain/cramp
1.1 (0.6 to 2.0)
1.3 (0.7 to 2.4)
1.2 (0.7 to 1.8)
27.1 (5.0 to 49.2) 15.9 (0 to 32.6)
21.5 (7.8 to 35.2)
5 (0.2 to 1.3) 0.0 (–) 0.3 (0.1 to 0.7) 65.3 (0 to 186.0) – 65.3 (0 to 186.0) Lesion of meniscus
- Dislocation
Dislocation/subluxation 0.0 (–)
0.0 (–)
0.0 (–)
–
–
–
Sprain/ligament
0.5 (0.2 to 1.3)
0.0 (–)
0.3 (0.1 to 0.7)
65.3 (0 to 186.0)
–
65.3 (0 to 186.0)
Lesion of meniscus/
cartilage/disc
0.5 (0.2 to 1.3)
0.0 (–)
0.3 (0.1 to 0.7)
38.8 (0 to 97.8)
–
38.8 (0 to 97.8)
Rugby World Cup 2011: Statistical review and match analysis. IRB; Dublin: 2011. http://www.irb.com/mm
- Rugby International
- Board
International Rugby Board. Rugby World Cup 2011: Statistical review and match
analysis. IRB; Dublin: 2011. http://www.irb.com/mm/Document/NewsMedia/MediaZone
/02/06/06/64/111026I RBGAMEANALYSIS2011IRBRugbyWorldCupStatisticalReview.pdf
(accessed 7 March 2012).
Statistical review and match analysis
International Rugby Board. Rugby World Cup 2011: Statistical review and match
analysis. IRB; Dublin: 2011. http://www.irb.com/mm/Document/NewsMedia/MediaZone
/02/06/06/64/111026I RBGAMEANALYSIS2011IRBRugbyWorldCupStatisticalReview.pdf
(accessed 7 March 2012).