A Profile of Isometric Cervical Strength in Elite Professional Male Rugby Players.

OBJECTIVES: To (1) provide position-specific normative data for isometric cervical muscle strength and endurance in professional, male rugby players and (2) assess the relationship between age, height, weight, and playing position with cervical muscle strength and endurance. DESIGN: Cross-sectional study. METHODS: Professional rugby players completed peak isometric cervical strength testing followed by a test of cervical muscle endurance. Descriptive statistics for continuous variables with strength normalized to body weight were performed. Multiple linear regression was used to estimate associations between strength measurements. RESULTS: In total, 136 players participated including front-row forwards (27%), other forwards (28%), and backs (45%). Front-row forwards had significantly greater peak isometric cervical muscle strength than other position groups, with backs having the lowest strength. Extension produced the highest force for all 3 position groups (429 N ± 104 N), whereas flexion produced the least (275 N ± 65 N). Age was associated with increased isometric cervical muscle strength. There was a statistically significant relationship between peak flexion strength and flexion endurance (P = .003). The average time for the endurance tests were 55.7 (±17.1) seconds and 52.9 (±20.1) seconds for extension and flexion, respectively. Other forwards had lower cervical extension muscle endurance than backs and front-row forwards. CONCLUSIONS: Normative values for peak and endurance isometric strength in professional rugby players illustrate significant differences between playing position. Consider age, body weight, and intraindividual variability when interpreting cervical strength and endurance results. J Orthop Sports Phys Ther 2024;54(3):1-8. Epub 29 January 2024. doi:10.2519/jospt.2024.11830.

Injury Trends in Irish Amateur Rugby: An Epidemiological Comparison of Men and Women.

BACKGROUND: Rugby union is a physically demanding sport that carries an inherent risk of injury. Despite being a popular and widely played team sport, little is known about injuries occurring across the male and female amateur game. PURPOSE: To establish and compare injury incidence, nature, and severity in male and female Irish amateur rugby union. STUDY DESIGN: Prospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Data were collected prospectively from 25 male teams (959 players) and 8 female teams (234 players) over 2 full seasons. Both time-loss (24-hour time-loss injury definition) and non-time-loss match injury reports were collected, alongside match exposure data. RESULTS: Time-loss match injury incidence rates were 49.1/1000 and 35.6/1000 player-hours for male and female players, respectively. Concussion and ankle ligament sprains were the most common diagnoses for male (5.6/1000 and 4.4/1000 player-hours, respectively) and female players (5.5/1000 and 3.9/1000 player-hours, respectively). Anterior cruciate ligament injuries presented the highest injury burden for male and female players with 200.3 and 307.2 days of absence per 1000 player-hours, respectively. In female players, 83% of noncontact injuries occurred in the fourth quarter of match play. CONCLUSION: While female players had a lower overall injury incidence rate compared with male players, concussion and ankle ligament injuries were the most common injuries in both cohorts. In female players, a high rate of noncontact injuries in the second half points to the need for strength and conditioning training programs to reduce fatigue-related injuries. CLINICAL RELEVANCE: Establishing the incidence and burden of rugby-related injuries is an essential step in minimizing injury risk. This epidemiological information will aid the development of future reduction strategies, including education and coaching strategies and strength and conditioning programs, informed by the most common injuries observed and the mechanism of injury.

The relationship between physical and wellness measures and injury in amateur rugby union players.

OBJECTIVES: To investigate factors associated with injury in amateur male and female rugby union players. DESIGN: A prospective cohort study. SETTING: Amateur rugby clubs in Ireland. PARTICIPANTS: Male (n = 113) and female (n = 24) amateur rugby union players from 5 of the top 58 amateur clubs in Ireland. MAIN OUTCOME MEASURES: Pre-season testing included physical tests assessing hamstring flexibility, dorsiflexion range of movement, adductor muscle strength and foot position. Wellness questionnaires assessed sleep quality (PSQI), coping skills (ACSI-28) and support levels (PASS-Q). Players were monitored throughout the season for injury. RESULTS: The time-loss match injury incidence rate was 48.2/1000 player hours for males and 45.2/1000 player hours for females. Two risk profiles emerged involving; 'age + navicular drop + training pitch surface' (53%) and 'age + navicular drop + groin strength' (16%). An inverse relationship between groin strength and groin injury was found for the 'backs' players (-0.307, p < 0.05). Using the PSQI, 61% of players had poor sleep quality, however no relationship between the wellness questionnaires and injury was found. CONCLUSION: Two injury risk profiles emerged, associated with subsequent injury occurrence. Using these risk profiles, individualized prevention strategies may be designed regarding deficits in groin muscle strength and identifying foot alignment.

The design, development, implementation and evaluation of IRISweb; A rugby-specific web-based injury surveillance system.

OBJECTIVES: To describe the development, implementation and evaluation of a comprehensive injury surveillance system. DESIGN: The four phases; i) A survey of 58 medical professionals working in amateur rugby. ii) The design of a web-based injury surveillance system (IRISweb). iii) Recruitment of 21 of the top 58 amateur clubs to use IRISweb. iv) An evaluation survey of the 21 participating clubs. SETTING: Irish amateur rugby clubs. PARTICIPANTS: Medical professionals working in amateur rugby. MAIN OUTCOME MEASURES: Phase one investigated the injury monitoring practices in operation prior to the IRIS project. Phase four investigated the effectiveness and usefulness of IRISweb. RESULTS: Twenty-one clubs were recruited, however 2 clubs failed to provide a full season of data (10% dropout rate). Eighty-two percent of the remaining 19 clubs rated IRISweb as 'good' or 'very good'. Facilitators of injury surveillance were; increased player adherence (65%) and notifications to update the system (59%), however, poor player adherence (71%) and medical staff availability (24%) were the main barriers. CONCLUSIONS: The IRIS project is the first prospective long-term injury surveillance system in Irish amateur rugby, effectively tracking injuries to guide future evidence-based injury prevention strategies. This study highlights facilitators and barriers to injury surveillance within amateur sport.

Current injury monitoring and player education practices in Irish amateur rugby union.

OBJECTIVES: To ascertain current injury surveillance and player education practices in Irish amateur rugby union. DESIGN: Cross-sectional survey. SETTING: Amateur rugby clubs in Ireland. PARTICIPANTS: Medical professionals and rugby coaches of the top 58 amateur rugby clubs in Ireland. MAIN OUTCOME MEASURES: The survey investigated the current injury and training load monitoring practices in operation in Irish amateur rugby. It also explored whether player education sessions regarding injury prevention and concussion recognition and management were conducted in these clubs. RESULTS: Forty-four clubs completed the survey, giving an overall response rate of 76%. Ninety-one percent of the responding clubs monitored injuries. Sixty-four percent of these clubs operated return to play protocols for all injuries, while 36% operated return to play protocols for concussion only. Injury prevention education was conducted by 71% of these clubs and 82% educated players on concussion recognition and management. CONCLUSIONS: Implementing effective injury monitoring strategies in both amateur and professional sport settings may aid in minimizing injury risk. In Ireland, 91% of the responding clubs monitored injuries and 71% educated players on injury prevention. By implementing one centralized injury surveillance system for Irish amateur rugby, injury trends can be effectively monitored and used to guide prevention strategies.

The Incidence of Injury in Amateur Male Rugby Union: A Systematic Review and Meta-Analysis.

BACKGROUND: Rugby union is a physically demanding, full-contact team sport that has gained worldwide popularity. The incidence of injury in rugby union has been widely reported in the literature. While comprehensive injury surveillance and prevention programmes have been implemented within the professional game, there is a need for similar strategies in the amateur game. Despite recent increases in the volume of research in rugby, there is little consensus regarding the true incidence rate of match and training injuries in senior amateur male rugby union players. OBJECTIVE: The aim of the current review was to systematically review the available evidence on the epidemiology of time-loss injuries in senior amateur male rugby union players and to subsequently conduct a meta-analysis of the findings. METHODS: A comprehensive search of the PubMed, Scopus, SportDiscus and Google Scholar electronic databases was performed using the following keywords; ('rugby' OR 'rugby union') AND ('amateur' OR 'community') AND ('injur*' OR 'pain*'). Six articles regarding the incidence of injury in senior amateur male rugby union players, in both matches and training, were retrieved and included in the meta-analysis to determine the overall incidence rate of match injury, with descriptive analyses also provided for other reported variables. RESULTS: The overall incidence rate of match injuries within senior amateur rugby union players was 46.8/1000 player hours [95% confidence interval (CI) 34.4-59.2]. Contact events accounted for the majority of injuries, with the tackler more at risk than the player being tackled, and with respective incidence rates of 15.9/1000 player hours (95% CI 12.4-19.5) and 12.2/1000 player hours (95% CI 9.3-15.1). CONCLUSION: This meta-analysis found that the incidence rate of injury in amateur rugby union players was lower than that in professional players, but higher than the incidences reported in adolescent and youth rugby players. By understanding the true incidence and nature of injuries in rugby, injury prevention strategies can best be implemented. Future prevention strategies may best be aimed towards the tackle area, specifically to the tackler, in order to minimize injury risk.