A ketogenic diet rich in fish oil is superior to other fats in preventing NNK-induced lung cancer in A/J mice.

Given that ketogenic diets (KDs) are extremely high in dietary fat, we compared different fats in KDs to determine which was the best for cancer prevention. Specifically, we compared a Western and a 15% carbohydrate diet to seven different KDs, containing either Western fats or fats enriched in medium chain fatty acids (MCTs), milk fat (MF), palm oil (PO), olive oil (OO), corn oil (CO) or fish oil (FO) for their ability to reduce nicotine-derived nitrosamine ketone (NNK)-induced lung cancer in mice. While all the KDs tested were more effective at reducing lung nodules than the Western or 15% carbohydrate diet, the FO-KD was most effective at reducing lung nodules. Correlating with this, mice on the FO-KD had low blood glucose and the highest ß-hydroxybutyrate level, lowest liver fatty acid synthase/carnitine palmitoyl-1a ratio and a dramatic increase in fecal Akkermansia. We found no liver damage induced by the FO-KD, while the ratio of total cholesterol/HDL was unchanged on the different diets. We conclude that a FO-KD is superior to KDs enriched in other fats in reducing NNK-induced lung cancer, perhaps by being the most effective at skewing whole-body metabolism from a dependence on glucose to fats as an energy source.

The associations between unilateral leg strength, asymmetry and injury in sub-elite Rugby League players.

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.

Development of a rugby shoulder function (RSF) questionnaire: An online Delphi study.

OBJECTIVE: Develop a questionnaire to monitor symptoms of player perceived shoulder function/dysfunction. DESIGN: 3-Stage Online Delphi Study. METHODS: Participants: surgeons, sports and exercise medics, academic researchers, strength and conditioning coaches, therapists and athletes split by level of expertise/experience. Stage-1: experts (n = 12) rated constructs/items from the steering group and made changes/proposed additional constructs/items. Stage-2: experts rated/amended new constructs/items from stage-1. Stage-3: experienced professionals (n = 25) rated/ranked constructs/items from stage 2. Consensus thresholds were defined per stage (≥50% agreement/4-5 rating on 1-5 Likert scale (stages 1-2), ≥68% agreement, and items ranked for perceived importance (stage-3)). RESULTS: Stage-1, all four constructs (a. Activities of daily living, b. Range of motion, c. Strength and conditioning, d. Sports specific training and competition) and 26/42 original items achieved consensus. Twelve items were combined into five items. Four new items were also proposed. Stage-2, the combined items and three of the four new items achieved consensus. Stage-3 the four constructs and 22 items all achieved consensus. CONCLUSIONS: Following a 3-stage online Delphi process, involving expert and experienced clinicians, practitioners and athletes, a new four construct, 22 item RSF questionnaire has been developed which can be used with rugby players, to monitor perceived shoulder performance and symptoms.

A global perspective on collision and non-collision match characteristics in male rugby union: Comparisons by age and playing standard.

This study quantified and compared the collision and non-collision match characteristics across age categories (i.e. U12, U14, U16, U18, Senior) for both amateur and elite playing standards from Tier 1 rugby union nations (i.e. England, South Africa, New Zealand). Two-hundred and one male matches (5911 min ball-in-play) were coded using computerised notational analysis, including 193,708 match characteristics (e.g. 83,688 collisions, 33,052 tackles, 13,299 rucks, 1006 mauls, 2681 scrums, 2923 lineouts, 44,879 passes, 5568 kicks). Generalised linear mixed models with post-hoc comparisons and cluster analysis compared the match characteristics by age category and playing standard. Overall significant differences (p < 0.001) between age category and playing standard were found for the frequency of match characteristics, and tackle and ruck activity. The frequency of characteristics increased with age category and playing standard except for scrums and tries that were the lowest at the senior level. For the tackle, the percentage of successful tackles, frequency of active shoulder, sequential and simultaneous tackles increased with age and playing standard. For ruck activity, the number of attackers and defenders were lower in U18 and senior than younger age categories. Cluster analysis demonstrated clear differences in all and collision match characteristics and activity by age category and playing standard. These findings provide the most comprehensive quantification and comparison of collision and non-collision activity in rugby union demonstrating increased frequency and type of collision activity with increasing age and playing standard. These findings have implications for policy to ensure the safe development of rugby union players throughout the world.

The safety of rugby union, especially the tackle, has previously been questioned but limited data are available to understand the collision and non-collision match characteristics between different age categories and playing standards.The frequency of collision and non-collision match characteristics increase with age and playing standard except for the frequency of scrums and tries which are lowest at the Senior Elite level. The activity of the tackle and ruck are also different between age categories and playing standards.Hierarchical cluster analysis demonstrated clear differences in all and collision match characteristics between junior (i.e. U12, U14, U16), and amateur (i.e. U18 and senior) and elite (i.e. U18 and senior) playing levels.Governing bodies and practitioners should be aware of the differences in collision and non-collision match characteristics by age and playing standard, when reviewing future versions of rugby union.

The effect of acute sleep extension vs active recovery on post exercise recovery kinetics in rugby union players.

BACKGROUND: Elite rugby players experience poor sleep quality and quantity. This lack of sleep could compromise post-exercise recovery. Therefore, it appears central to encourage sleep in order to improve recovery kinetics. However, the effectiveness of an acute ergogenic strategy such as sleep extension on recovery has yet to be investigated among athletes. AIM: To compare the effects of a single night of sleep extension to an active recovery session (CON) on post-exercise recovery kinetics. METHODS: In a randomised cross-over design, 10 male rugby union players participated in two evening training sessions (19:30) involving collision activity, 7-days apart. After each session, participants either extended their sleep to 10 hours or attended an early morning recovery session (07:30). Prior to (PRE), immediately after (POST 0 hour [h]), 14h (POST 14) and 36h (POST 36) post training, neuromuscular, perceptual and cognitive measures of fatigue were assessed. Objective sleep parameters were monitored two days before the training session and over the two-day recovery period. RESULTS: The training session induced substantial decreases in countermovement jump mean power and wellness across all time points, while heart rate recovery decreased at POST 0 in both conditions. Sleep extension resulted in greater total sleep time (effect size [90% confidence interval]: 5.35 [4.56 to 6.14]) but greater sleep fragmentation than CON (2.85 [2.00 to 3.70]). Between group differences highlight a faster recovery of cognitive performance following sleep extension (-1.53 [-2.33 to -0.74]) at POST 14, while autonomic function (-1.00 [-1.85 to -0.16]) and upper-body neuromuscular function (-0.78 [-1.65 to 0.08]) were better in CON. However, no difference in recovery status between groups was observed at POST 36. CONCLUSION: The main finding of this study suggests that sleep extension could affect cognitive function positively but did not improve neuromuscular function the day after a late exercise bout.

Injury risk factors and barriers to their mitigation for women playing rugby league: a Delphi study.

This study aimed to 1) develop a consensus (≥70% agreement between experts) on injury risk factors specific to women playing rugby league, 2) establish the importance of the identified injury risk factors and the feasibility of mitigating these risk factors and 3) establish context specific barriers to injury risk management. Aim 1: A Delphi panel, consisting of 12 experts in rugby league and injury (e.g., physiotherapists, research scientists) were asked to identify injury risk factors specific to women playing rugby league. Aim 2: seven coaches of women's rugby league teams were asked to rate each risk factor that achieved consensus by their importance and feasibility to manage. Aim 3: Coaches reported barriers which restrict injury risk factor mitigation. Of the 53 injury risk factors which achieved consensus, the five injury risk factors with the highest combination of importance and feasibility ratings were: "poor tackle technique", "a lack of pre-season intensity", "training session are too short", "the current medical standards", and "limited access to physiotherapists". Following the identification of injury risk factors, their feasibility to manage and context specific barriers, this study proposes three constraint driven, integrated solutions which may reduce the barriers which limit injury risk factor management.

The Effect of Rugby Union Match Play on Sleep Patterns and Subsequent Impact on Postmatch Fatigue Responses.

PURPOSE: Sleep is recognized as an important recovery strategy, yet little is known regarding its impact on postmatch fatigue. The aims of this study were to (1) describe sleep and postmatch fatigue, (2) understand how sleep is affected by contextual and match factors, and (3) assess how changes in sleep can affect postmatch fatigue. METHODS: Twenty-three male rugby union players were monitored across 1 season (N = 71 player-match observations). Actigraphy was used during preseason to establish baseline sleep quality and quantity. Sleep was then measured 1 and 2 days after each match day (MD + 1 and MD + 2). Global positioning systems, notational analysis, and rating of perceived exertion represented external and internal load from matches. Subjective wellness and a standardized run were used to characterize postmatch fatigue 2 days prior (baseline) and at MD + 1 and MD + 2. Linear mixed models established the magnitude of change (effect size [ES]) between baseline, MD + 1, and MD + 2 for sleep and postmatch fatigue. Stepwise forward selection analysis ascertained the effect of match load on sleep and the effect of sleep on postmatch fatigue. Each analysis was combined with magnitude-based decisions. RESULTS: Sleep characteristics and neuromuscular and perceptual postmatch fatigue were negatively affected at MD + 1 and MD + 2 (ES = small to very large). Kickoff and travel time had the greatest effect on sleep (ES = small). Wellness and soreness were influenced by sleep (fall-asleep time and fragmentation index) and collisions, respectively (ES = small). CONCLUSION: Sleep quality and quantity were affected independently of the match load (ie, running activity) sustained, and changes in sleep marginally affected postmatch fatigue.

Playing through the pain: The prevalence of perceived shoulder dysfunction in uninjured rugby players using the Rugby Shoulder Score.

OBJECTIVE: This study aimed to investigate the prevalence of self-reported shoulder dysfunction using the Rugby Shoulder Score (RSS) reported in arbitrary units (AU) of rugby players available for match selection (uninjured). DESIGN: Cross-sectional survey. METHODS: Paper survey at the mid-point of the season of uninjured players (n = 86 males (mean age (±SD): 26 ± 6.9y) from 8 squads (professional n = 34; amateur; n = 52)), using the RSS, subjective impact on rugby performance and previous shoulder injury, analysed using a Mann-Whitney U test. RESULTS: 55% of players reported a level of RSS dysfunction despite being uninjured. Players who also reported their shoulder was impacting on performance had significantly higher median RSS (61, IQR 28AU, p = 0.02) than those who reported no impact on performance (40, IQR 22AU). CONCLUSIONS: Findings from this study show that over half of players were playing with a level of self-reported shoulder dysfunction. This figure is higher in the professional game, for those with a history of previous injury and for forwards.

Autoregulation in Resistance Training: A Comparison of Subjective Versus Objective Methods.

ABSTRACT: Shattock, K and Tee, JC. Autoregulation in resistance training: A comparison of subjective versus objective methods. J Strength Cond Res 36(3): 641-648, 2022-Autoregulation (AR) is a resistance training periodization approach that adjusts training prescription in response to individual rates of athlete adaptation. AR training prescription can make use of either subjective (rating of perceived exertion [RPE]) or objective (barbell velocity) intensity descriptors. The aim of this research was to compare the efficacy of these 2 approaches in improving sport-specific physical performance measures. Using a randomized crossover design, 20 amateur rugby union players completed two 6-week blocks of training with training intensity prescribed using either objective velocity-based (VB) (measured using a wearable accelerometer device) or objective RPE-based intensity prescriptions. Training volume was matched for both groups while training intensity was equivalent but prescribed using either VB or RPE measures. Performance measurements were countermovement jump (CMJ), 1 repetition maximum back squat and bench press, and 10-, 20-, and 40-m sprint. Testing was conducted before and immediately after each training block. The likelihood that observed changes in performance measures were meaningful was assessed using magnitude-based decisions. Both training programs induced practically meaningful improvements in CMJ (VB most likely +8.2, ±1.1%; RPE likely +3.8, ±0.9%), back squat (VB most likely +7.5, ±1.5%; RPE possibly +3.5, ±1.8%), and bench press (VB most likely +7.7, ±2.1%; RPE possibly +3.8, ±0.9%). Changes in sprint test performance were very likely trivial for both programs. Objective AR programming resulted in larger improvements in CMJ (likely 4.2, ±1.2%), squat (likely 3.7, ±1.5%) performance, and bench press (possibly 3.7, ±1.5%) performance. Autoregulation periodization improved strength and CMJ, but not sprint performance. Autoregulation effects are augmented through the use of objective intensity prescription.

Does lower-limb asymmetry increase injury risk in sport? A systematic review.

OBJECTIVE: The aim of this review was to synthesize the current understanding relating to the risks of lower body functional asymmetry with injury in athletic populations. METHODS: An iterative data mining and sampling approach was used to construct a search phrase from key words, which were used to identify studies within SPORTdiscus, Medline and Academic Search Complete databases. Additional references were sourced from the reference lists of these articles. RESULTS: After screening, 31 papers were reviewed, from an initial search identifying 302 possible studies. A total of 6228 participants were involved in the studies, of which soccer players were the most observed sporting demographic (n = 2171). Of the 31 studies reviewed eight found no statistical association between lower limb asymmetry and injury risk, 10 studies provided partial statistically significant evidence and a further 10 provided statistically significant statistical links. CONCLUSION: Overall moderate to lower quality evidence for functional asymmetry as a risk factor for injury in sport was observed. While the possibility of a relationship between lower limb functional asymmetry and injury risk cannot be ruled out, further higher quality investigations, adopting standardised methodologies, is required.

The Travel Demands of an Elite Rugby Sevens Team: Effects on Objective and Subjective Sleep Parameters.

PURPOSE: To explore the effects of travel related to international rugby sevens competition on sleep patterns. METHODS: A total of 17 international male rugby sevens players participated in this study. Actigraphic and subjective sleep assessments were performed daily during 2 separate Sevens World Series competition legs (Oceania and America). The duration of each competition leg was subdivided into key periods (pretour, precompetition, tournament 1, relocation, tournament 2, and posttour) lasting 2 to 7 nights. Linear mixed models in combination with magnitude-based decisions were used to assess (1) the difference between preseason and key periods and (2) the effect of travel direction (eastward or westward). RESULTS: Shorter total sleep time (hours:minutes) was observed during tournament 2 (mean [SD], 06:16 [01:08]), relocation (06:09 [01:09]), and the pretour week (06:34 [01:24]) compared with the preseason (06:52 [01:00]). Worse sleep quality (arbitrary units) was observed during tournament 1 (6.1 [2.0]) and 2 (5.7 [1.2]), as well as during the relocation week (6.3 [1.5]) than during the preseason (6.5 [1.8]). When traveling eastward compared with westward, earlier fall-asleep time was observed during tournament 1 (ES - 0.57; 90% CI, -1.12 to -0.01), the relocation week (-0.70 [-1.11 to -0.28]), and the posttour (-0.57 [-0.95 to -0.18]). However, possibly trivial and unclear differences were observed during the precompetition week (0.15 [-0.15 to 0.45]) and tournament 2 (0.81 [-0.29 to 1.91]). CONCLUSION: The sleep patterns of elite rugby sevens players are robust to the effects of long-haul travel and jet lag. However, the staff should consider promoting sleep during the tournament and relocation week.

Locomotor characteristics of the women's inaugural super league competition and the rugby league world cup.

Understanding the locomotor characteristics of competition can help rugby league (RL) coaches optimise training prescription. To date, no research exists on the locomotor characteristics of women's RL. The aim was to compare whole match and peak locomotor characteristics of women's RL competition at international (RL World Cup [WRLWC]) and domestic level (Super League [WSL]). Microtechnology data were collected from 58 players from 3-WSL clubs and 1-WRLWC team. Participants were classified into forwards (n = 30) and backs (n = 28). Partial least squares correlation analysis established which variables were important to discriminate between the level of competition (international vs. domestic) and positional group (forwards vs. backs). Linear mixed-effects models estimated the differences between standards of competition and positional group for those variables. International forwards were most likely exposed to greater peak 1-min average acceleration (standardised mean difference = 1.23 [0.42 to 2.04]) and peak 3-min average acceleration (1.13 [0.41 to 1.85]) than domestic forwards. International backs likely completed greater peak 1-min average acceleration (0.83 [0.08 to 1.58]) than domestic backs and possibly greater high-speed-distances (0.45 [-0.17 to 1.07]). Findings highlight the need for positional specific training across levels to prepare representative players for the increased match characteristics of international competition.

Convergent Validity, Reliability, and Sensitivity of a Running Test to Monitor Neuromuscular Fatigue.

PURPOSE: To investigate the convergent validity, reliability, and sensitivity over a week of training of a standardized running test to measure neuromuscular fatigue. METHODS: Twenty male rugby union players were recruited for the study, which took place during preseason. The standardized running test consisted of four 60-m runs paced at  ~5 m·s-1 with 33 seconds of recovery between trials. Data from micromechanical electrical systems were used to calculate a running-load index (RLI), which was a ratio between the mechanical load and the speed performed during runs. RLI was calculated by using either the entire duration of the run or a constant-velocity period. For each type of calculation, either an individual directional or the sum of the 3 components of the accelerometer was used. A measure of leg stiffness was used to assess the convergent validity of the RLI. RESULTS: Unclear to large relationships between leg stiffness and RLI were found (r ranged from -.20 to .62). Regarding reliability, small to moderate (.47-.86) standardized typical errors were found. The sensitivity analysis showed that the leg stiffness presented a very likely trivial change over the course of 1 week of training, whereas RLI showed very likely small to a most likely large change. CONCLUSIONS: This study showed that RLI is a practical method to measure neuromuscular fatigue. In addition, such a methodology aligns with the constraint of elite team-sport setup due to its ease of implementation in practice.

Psychosocial outcomes associated with soccer academy involvement: Longitudinal comparisons against aged matched school pupils.

Despite literature highlighting numerous risks to the healthy psychosocial development of youth elite academy soccer players, little of this research is based on high-quality research designs. This study employed a prospective longitudinal cohort design to track psychosocial outcomes of academy involvement within male youth elite soccer players (n = 33, U12-U16 age groups) compared to age-matched soccer-active school pupils (n = 44) over 12 months. Participants completed questionnaires assessing the most commonly raised psychosocial concerns at four equally spaced data collection periods (T1-T4). Repeated measures multivariate analysis of variance (MANOVAs) indicated that, over the year, both groups reported a healthy and improving stress and recovery balance, as well as positive and stable needs satisfaction and physical, psychological and social well-being. Academy players reported stable positive school-related quality of life, whereas school pupils reported increases from T3 to T4. Academy players reported consistent significantly higher total athletic identity and exclusivity of identity. Findings suggest that many concerns around negative psychosocial impacts of soccer academy involvement did not materialise in this context. However, heightened athletic identities remained a concern.

Pacing characteristics of whole and part-game players in professional rugby union.

Contemporary theories on players' intensity distribution in team sports suggest that they regulate their outputs using pacing strategies. There is currently limited information on how movement patterns and pacing strategies of rugby union players in different position groups (forwards and backs) vary when exposed to different bout types (whole game, starter or finisher). Global positioning system (GPS) and accelerometer data were collected from 100 professional match participations to determine temporal effects on movement patterns. For forwards, finishers (players who entered the game as substitutes) demonstrated significantly greater high-speed running distance (% difference, ± 90%CI; magnitude-based inference and effect size) (↑ 55, ±17%; very likely large) and acceleration frequency (↑ 78, ±59%; very likely large) than whole game players. For backs, starters (players who started the game and were later substituted) displayed greater high-speed running distance than whole game players (↑ 27, ±21%; ES = likely medium) but this difference did not achieve statistical significance (p = .07). Forwards displayed "slow-positive" pacing strategies regardless of bout type, while backs displayed "flat" pacing strategies. Forwards and backs adopt different pacing strategies regardless of bout type, with forwards demonstrating progressively greater performance decrements over the course of the match. These findings reflect differing physical demands, notably contact and running loads, of players in different positions.

The Quality, Quantity, and Intraindividual Variability of Sleep Among Students and Student-Athletes.

BACKGROUND: Student-athletes are subject to significant demands due to their concurrent sporting and academic commitments, which may affect their sleep. This study aimed to compare the self-reported sleep quality, quantity, and intraindividual variability (IIV) of students and student-athletes through an online survey. HYPOTHESIS: Student-athletes will have a poorer sleep quality and quantity and experience more IIV. STUDY DESIGN: Case-control study. LEVEL OF EVIDENCE: Level 4. METHODS: Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while sleep quantity and IIV were assessed using the Consensus Sleep Diary. Initially, the PSQI and additional questions regarding sport participation habits were completed by 138 participants (65 students, 73 student-athletes). From within this sample, 44 participants were recruited to complete the sleep diary for a period of 14 days. RESULTS: The mean PSQI score was 6.89 ± 3.03, with 65% of the sample identified as poor sleepers, but no difference was observed between students and student-athletes. Analysis of sleep patterns showed only possibly to likely small differences in sleep schedule, sleep onset latency, and subjective sleep quality between groups. IIV analysis showed likely moderate to possibly small differences between groups, suggesting more variable sleep patterns among student-athletes. CONCLUSION: This study highlights that sleep issues are prevalent within the university student population and that student-athletes may be at greater risk due to more variable sleep patterns. CLINICAL RELEVANCE: University coaches should consider these results to optimize sleep habits of their student-athletes.

Sports Injury Prevention is Complex: We Need to Invest in Better Processes, Not Singular Solutions.

In recent years, an understanding has developed that sports injuries are the emergent outcomes of complex, dynamic systems. Thus, the influence of local contextual factors on injury outcomes is increasingly being acknowledged. These realisations place injury prevention research at a crossroads. Currently, injury prevention researchers develop universally applicable injury prevention solutions, but the adoption of these solutions in practice is low. This occurs because implementation contexts are both unique and dynamic in nature, and as a result singular, static solutions are often incompatible. In contrast, practitioners address injury prevention through iterative cycles of trial and error, aiming to optimise the injury prevention process within their own unique contexts. The purpose of this critical review is to draw attention to the misalignment between research and practice-based approaches to injury prevention. In light of this, we propose alternative research approaches that acknowledge the process-driven nature of injury prevention in practice. We propose that a core focus of sport injury prevention research should be to provide practitioners with useful and relevant information to support their decision making around their localised injury prevention practice. Through this approach, injury prevention research ceases to be about what works, and begins to engage with understanding what works in what contexts and why?

Incidence and characteristics of injury in under-19 academy level rugby league match play: A single season prospective cohort study.

Academy rugby league competition is an important step along the pathway to professional status, but little is known about injury at this level of the game. The aim of this research was to establish the nature, incidence and burden of injury in English academy rugby league. Using an observational prospective cohort study design, and a time-loss injury definition, the injury outcomes of three professional rugby league academies were recorded during the 2017 season. A total of 87 injuries occurred in 59 matches for an overall injury incidence of 85 (95%CI 67-103) injuries per 1000 hours played. The mean severity of injury was 22 ± 19 days resulting in an overall injury burden of 1898 (95%CI 1813-1983) days lost per 1000 hours. The tackle event was the most common cause of injury (77% of all injuries). Forwards sustained a greater proportion of injuries than backs (forwards 67% vs. backs 33% of injuries). Concussion (13 (6-20) per 1000 hours) and ankle sprains (11 (4-17) per 1000 hours) were the most commonly diagnosed injuries. The shoulder joint was the most commonly injured site (17 (9-25) per 1000 hours). The incidence of injury for academy rugby league is similar to senior professional rugby league.

Bigger, stronger, faster, fitter: the differences in physical qualities of school and academy rugby union players.

Limited research has compared the physical qualities of adolescent rugby union (RU) players across differing playing standards. This study therefore compared the physical qualities of academy and school Under-18 RU players. One-hundred and eighty-four (professional regional academy, n = 55 school, n = 129) male RU players underwent a physical testing battery to quantify height, body mass, strength (bench press and pull-up), speed (10, 20 and 40 m), 10 m momentum (calculated; 10 m velocity * body mass) and a proxy measure of aerobic fitness (Yo-Yo Intermittent Recovery Test Level 1; IRTL1). The practical significance of differences between playing levels were assessed using magnitude-based inferences. Academy players were taller (very likely small), heavier (likely moderate) and stronger (bench press possibly large; pull-up plus body mass likely small) than school players. Academy players were faster than school players over 20 and 40 m (possibly and likely small), although differences in 10 m speed were not apparent (possibly trivial). Academy players displayed greater 10 m momentum (likely moderate) and greater IRTL1 performance (likely small) than school players. These findings suggest that body size, strength, running momentum, 40 m speed and aerobic fitness contribute to a higher playing standard in adolescent rugby union.

The efficacy of an iterative "sequence of prevention" approach to injury prevention by a multidisciplinary team in professional rugby union.

OBJECTIVES: Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union. DESIGN: Observational longitudinal cohort study. METHODS: Epidemiological injury data was collected from a professional rugby union team for 5 consecutive seasons. Following each season, these data informed multidisciplinary intervention strategies to reduce injury risk. The effectiveness of these strategies was iteratively assessed to inform future interventions. Specific examples of intervention strategies are provided. RESULTS: Overall team injury burden displayed a likely beneficial decrease (-8%; injury rate ratio (IRR) 0.9, 95%CI 0.9-1.0) from 2012 to 2016. This was achieved through a most likely beneficial improvement in non-contact injury burden (-39%; IRR 0.6, 95%CI 0.6-0.7). Contact injury burden was increased, but to a lesser extent (+18%; IRR 1.2, 95%CI 1.1-1.3, most likely harmful) during the same period. CONCLUSIONS: The range of skills required to effectively manage complex injury phenomena in professional collision sport crosses disciplinary boundaries. The evidence presented here points to the effectiveness of a multidisciplinary approach to reducing injury risk. This model will likely be applicable across a range of team and individual sports.