Rugby Injuries

NewsBot · Jun 16, 2018

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Recurrent injury patterns in adolescent rugby
H.A.P. Archbold et al
Phys Ther Sport; Article in Press

•Recurrent injuries comprise 5% of all injuries occurring in a single season of adolescent rugby union.
•On average, there were 0.8 recurrences reported per school per season.
•Recurrent injury to the ankle ligaments, lumbar muscles and concussions carry the greatest burden.
•78% of recurrences were defined as ‘early’, occurring within 2 months of returning to play.
•There were trends that recurrent injuries are more severe than index injuries.
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Objectives
To establish patterns of subsequent injury in U18 rugby, to quantify the burden of within season injury recurrence.

Design
Secondary analysis of prospective data.

Setting
28 Schools in Ireland.

Participants
825 male rugby players (aged 15–18 years).

Main outcome measures
Subsequent injuries were classified as: new, local or recurrent (same site and type as index injury). All recurrent injuries were sub-grouped by body part and diagnosis. Burden was based on frequency, days lost and injury proportion ratios.

Results
A total of 426 injuries were eligible for analysis, of which, 121 were subsequent injuries. The majority of subsequent injuries involved a different body part than their index injury. There were n = 23 cases of within season recurrence. 78% of recurrences occurred within 2 months of return to play. Recurrent injuries comprised 5% of all injuries and their cumulative time loss was 1073 days. Recurrent injury to the ankle ligaments, lumbar muscles and concussions carried the greatest burden.

Conclusion
The burden of recurrent injury in U18 rugby is lower than in the professional game.

However, this population could benefit from targeted secondary prevention efforts including reconsideration of return-to-play protocols for ankle sprain, lumbar muscles and potentially concussion.
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Admin2 · Jun 16, 2018

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NewsBot · Aug 31, 2021

A 6-year retrospective review of injuries sustained during the Singapore Cricket Club International Rugby Sevens tournament
Cunzhi Xu et al
Research in Sports Medicine: 12 Aug 2021

There are limited studies looking at injury statistics for Rugby Sevens. This study aims to assess injury patterns among amateur players participating in the annual Singapore Cricket Club Rugby Sevens International tournament from 2012 to 2017, by performing a retrospective review of their injury data. Outcome measures include injury incidence rate, injury site, and comparative injury incidence between successive days of competition. A total of 343 injuries were recorded over 6 tournaments, with an injury incidence of 348.0 per 1000 player hours. The lower limb was the most commonly injured site (45.8%), and there was greater incidence of injuries on day 3 of competition compared to day 1 in 2013 and 2016. This study reports a higher level of background risk to Rugby Sevens than is reported in literature. A well designed-prospective injury surveillance study will be necessary to confirm these findings and to investigate risk factors to guide injury prevention programmes.
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NewsBot · Sep 26, 2021

Influence of Footwear on Posture and Comfort in Elite Rugby Players
Sylvain Blanchard , Laurence Bellaïche, Zbigniew Kuliberda, Michel Behr
Int J Sports Med

Influence of footwear on posture in athletes is poorly documented despite its potential impact on biomechanics and injury risk. The aim of this study was to investigate effects of different footwear geometries on comfort and posture on a cohort of 48 elite rugby players. Spine posture was characterized by photogrammetry, while center of pressure was measured by means of a force platform. Three different footwear outsoles architectures (one rugby shoe with flat outsole, one rugby shoe with a 10 mm heel rise and foot arch support, and a running shoe with a 10mm heel rise and foot arch support) were compared to non-shod in randomized order. Then comfort felt at the level of foot and spine was also estimated by subjective questionnaires. Compared to the flat rugby model, both other models induced significantly (p<0.05) greater comfort at the level of foot and spine, a slight shift toward of center of pressure and a spinal posture closer to that observed when non-shod. The footwear geometry influences comfort and posture at the level of the foot as well as spine and should be considered in a dual purpose of injury prevention and performance.
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NewsBot · Feb 15, 2022

Characteristics of Plantar Pressure with Foot Postures and Lower Limb Pain Profiles in Taiwanese College Elite Rugby League Athletes
Tong-Hsien Chow et al
Int J Environ Res Public Health. 2022 Jan 20;19(3):1158

Background: This study aimed to explore the differences in the distributions of plantar pressure in static and dynamic states and assess the possible pain profiles in the lower limb between elite rugby league athletes and recreational rugby players.

Methods: A cross-sectional study of 51 college elite rugby athletes and 57 recreational rugby players was undertaken. The arch index (AI) and plantar pressure distributions (PPDs) with footprint characteristics were evaluated via the JC Mat. Rearfoot alignment was examined to evaluate the static foot posture. The elite group's lower-limb pain profiles were examined for evaluating the common musculoskeletal pain areas.

Results: The recreational group's AI values fell into the normal range, whereas the elite group's arch type fell into the category of the low arch. Results from the elite group were: (1) the PPDs mainly exerted on the entire forefoot and lateral midfoot regions in static standing, and transferred to the forefoot region during the midstance phase of walking; (2) the static rearfoot alignment matched the varus posture pattern; (3) the footprint characteristics illustrated the features of low-arched, supinated, dropped metatarsal heads and dropped cuboid feet; and (4) the phalanx and metatarsophalangeal joints, and the abductor hallucis and abductor digiti minimi of the plantar plate were common musculoskeletal pain areas.

Conclusions: Characteristics of higher plantar loads beneath forefoot and midfoot associated with low-arched supinated feet in bipedal static stance could be the traceable features for the foot diagram of elite rugby league athletes. The limb pain profiles of the elite rugby league athletes within this study echoed the literature on rugby injuries, and reflected the features of metatarsophalangeal joint pains and dropped cuboids. The relationships among the low-arched supinated feet, metatarsophalangeal joint pains and cuboid syndrome are worth further studies.
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NewsBot · Feb 23, 2022

Postural evaluation and risk of musculoskeletal injuries in professional male rugby players: a proof-of-principle study
Francesco Agostini et al
J Sports Med Phys Fitness 2022 Feb 21

Background: Rugby is the most played contact sport in the world and is characterized by muscle-tendon structures injuries due to trauma. Posture in ideal balance allows the maximum effectiveness of a gesture in absence of pain. and an adequate posture might have a role in trauma related sport prevention. Aim of this proof-of-principle study was to investigate if sports activity might cause postural changes in National League rugby players and whether it correlates with an increased risk of injuries.

Methods: Male rugby players from a National League were included in the study. The athletes underwent a postural questionnaire, an analysis of plantar support (3D-PodoScanalyzer) and a postural-evaluation (Formetric4D). The tests were performed at T0 (on-season), T1 (off-season) and T2 (pre-season).

Results: Twenty-six male rugby players, mean aged 22.5 years old, were included. The analysis of plantar support showed statistically significant variability in 6 values: left Arch index (p=0.004), right Staheli index (p=0.042), midfoot symmetry (p=0.030), isthmus symmetry (p=0.048), arch length symmetry (p=0.027), height of the left plantar arch (p=0.009). The postural evaluation showed statistically significant variability in only two values: rotation of the pelvis (p=0.013) and kyphotic angle (p=0.050).

Conclusions: The data of our study show, during the intense phases of the championship, a prevalence of injuries to the left lower limb and an increase in the cavity of the ipsilateral foot. The study also shows that the training conducted by the athletes examined improves the values of the pelvic rotation and the kyphotic angle.
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NewsBot · May 18, 2023

Injury Rates, Mechanisms, Risk Factors and Prevention Strategies in Youth Rugby Union: What’s All the Ruck-Us About? A Systematic Review and Meta-analysis
Stephen W. West, Isla J. Shill, Stuart Bailey, Reid A. Syrydiuk, K. Alix Hayden, Debbie Palmer, Amanda M. Black, Brent E. Hagel, Keith A. Stokes & Carolyn A. Emery
Sports Medicine (2023)

Background
Rugby Union is a collision team sport played globally. Despite this, significant concerns have been raised regarding the sport’s safety, particularly in youth players. Given this, a review of injury rates, risk factors and prevention strategies is required across different youth age groups as well as in males and females.

Objective
The objective of this systematic review (SR) and meta-analysis was to investigate injury and concussion rates, risk factors and primary prevention strategies in youth rugby.

Methods
To be included, studies were required to report either rates, risk factors or prevention strategies in youth rugby and to have a randomised controlled trial, quasi-experimental, cohort, case control, or ecological study design. Exclusion criteria included non-peer-reviewed grey literature, conference abstracts, case studies, previous systematic reviews and studies not written in English. Nine databases were searched. The full search strategy and list of sources are available and pre-registered on PROSPERO (Ref: CRD42020208343). Each study was assessed for risk of bias using the Downs and Black quality assessment tool. Meta-analyses were conducted using a DerSimonian Laird random effect model for each age group and sex.

Results
Sixty-nine studies were included in this SR. The match injury rates (using a 24-h time-loss definition) were 40.2/1000 match hours (95% CI 13.9–66.5) in males and 69.0/1000 match hours (95% CI 46.8–91.2) in females. Concussion rates were 6.2/1000 player-hours (95% CI 5.0–7.4) for males and 33.9/1000 player-hours (95% CI: 24.1–43.7) for females. The most common injury site was lower extremity (males) and the head/neck (females). The most common injury type was ligament sprain (males) and concussion (females). The tackle was the most common event associated with injury in matches (55% male, 71% females). Median time loss was 21 days for males and 17 days for females. Twenty-three risk factors were reported. The risk factors with the strongest evidence were higher levels of play and increasing age. Primary injury prevention strategies were the focus of only eight studies and included law changes (n = 2), equipment (n = 4), education (n = 1) and training (n = 1). The prevention strategy with the most promising evidence was neuromuscular training. The primary limitations included a broad range of injury definitions (n = 9) and rate denominators (n = 11) used, as well as a limited number of studies which could be included in the meta-analysis for females (n = 2).

Conclusion
A focus on high-quality risk factor and primary prevention evaluation should be considered in future studies. Targeting primary prevention and stakeholder education remain key strategies in the prevention, recognition and management of injuries and concussions in youth rugby.
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NewsBot · Jun 28, 2023

The associations between unilateral leg strength, asymmetry and injury in sub-elite Rugby League players
Mark Helme et al
Phys Ther Sport. 2023 Jun 1

Objectives: The aim of this study was to analyse the relationship between unilateral leg strength, associated asymmetries and the injuries suffered by sub-elite Rugby League (RL) players in one competitive season.

Design: A prospective cohort design was used.

Method: Unilateral leg strength was measured using the rear foot elevated split squat five repetition maximum test. Injuries were recorded using the Orchard classification system and were used to quantify relative risk (RR), mean severity, burden, player availability and survival time.

Results: No measures of leg strength were related to RR, relative leg strength was found to have a significant, but not meaningful correlation with total time lost to lower body injury, lower body injury burden and lower body injury survival time.

Conclusions: The data from the current study indicates a possible positive effect of increasing relative leg strength for injury outcomes in sub-elite RL players. This supports a heuristic that multi-joint lower body strength training for RL players has a potential dual effect of enhancing physical performance and reducing injury time loss, with minimal risk of harm.
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