Recent Trends in Rugby Union Injuries
Section snippets
Rugby Union Injury Literature Methodologies
Rugby union injury literature to date has been dominated by epidemiological studies [18], [21], [22], [23], [24], [25], [26], case reports [27], [28], [29], [30], [31], [32], and reports of nonfatal catastrophic spinal injuries [5]. Prospective epidemiological studies are particularly useful for identifying injuries of highest incidence and severity, and more importantly, those of highest risk (a product of incidence and severity) [33], [34] in different cohorts of players. These injuries can
Injuries Sustained During Matches
Match injuries constitute the largest proportion of the rugby-related injuries reported in epidemiological studies, typically contributing 80% to 90% of all injuries [18], [23], [25], [37], [45], [48], although the proportion depends on a number of factors, but predominately the ratio of training to match play. The risk of sustaining an injury in a rugby union match appears to be higher than in many other sports [4], [41], irrespective of the definition of injury (Fig. 3, Fig. 4); however,
Injuries Sustained During Training
A large number of rugby union players spend a greater proportion of time taking part in training activities for rugby than playing matches. Nevertheless, training injuries typically only constitute between 10% and 20% of all injuries in senior rugby union [18], [23], [25], [37], [45], [48], although the proportion appears to be higher in schoolboy rugby union (21%–37%) [41], [58], [59]. This difference may be because of the greater proportion of time spent in higher risk game-related training
Injury Severity, Injury Risk, and Injury Risk Factors
Reporting trends in the frequency of injuries in rugby union injury epidemiology (the incidence) without taking account of the severity of injuries may fail to highlight the injuries of greatest concern. Although a large proportion of the injuries reported in rugby union epidemiology allow a player to return to play within 7 days [12], [18], [25], [37], it is often the more severe injuries that together cause the greatest total absence. Therefore a measure of injury risk that considers the days
Padded Equipment and Mouth Guards
One potential method of reducing injury risk is by the wearing of padded equipment and mouth guards; although there is no stipulation that this equipment must be worn in the rules of the game. Shoulder pads, headgear, and chest pads that are worn during matches must be no thicker than 1 cm when uncompressed (0.5 cm for padding on other areas) and be no denser than 45 kg per cubic meter [3]. Helmets, padded headgear, and shoulder pads are used in many other collision and contact sports to
Catastrophic Spinal Injuries
Little is known about noncatastrophic spinal injuries [99], [100]; however, “nonfatal catastrophic (spinal) injuries” [6] have received considerable focus in the medical literature over several decades [5], [123], [124], [125], [126], [127], [128], [129], [130], [131], [132], [133], [134], [135], [136], [137], [138], [139], [140], [141], [142], [143] because of their devastating consequences. Nevertheless, these injuries are extremely rare (reported to be around 1 per 10,000 players per season
Long-term Health Implications
Few studies have been published and very little is known about the long-term health impact of rugby union injuries [145], [146], [147], [148]. In a 4-year follow-up study of amateur players, it was revealed that 26% of those who had ceased playing had done so because of a rugby injury (the largest category of retired players), with the knee (35%), back (14%), and shoulder (9%) the most common injury locations [148]. Furthermore, 35% of men who sustained an injury in the original epidemiological
Injury Research in the Future
The recently published IRB consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union should allow future research to be more consistent and comparable than is currently the case [6]. Our understanding of the etiology and epidemiology of rugby union injuries has improved with the increase in published research post-professionalism; however, there are still a number of major gaps, and further research is required to progress our understanding:
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Summary
The game of rugby union has evolved over nearly 2 centuries, and is now one of the world's most popular participation team sports. Recent drivers for change in the way the game is played have included rule modifications aimed to both reduce the risk of serious injury and to keep the ball in play longer, and the advent of professionalism in 1995. Trends from published studies show a high incidence of injury compared with other team sports; an apparent increase in injury risk since the advent of
Acknowledgement
The authors would like to thank Ed Morrison (Rugby Football Union Elite Referee Development Officer) for his assistance in documenting rugby union law changes.
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