Injury risks associated with tackling in rugby union.

OBJECTIVE: To examine factors associated with tackles in rugby union and to assess their impact on the risk of injury. DESIGN: Two-season (2003/2004 and 2005/2006) prospective cohort design with video analysis. SETTING: 13 English Premiership clubs. PARTICIPANTS: 645 players. MAIN OUTCOME MEASURE: RR (95% CI) calculated by comparing the frequency of occurrence of risk factors in a cohort of players injured during tackles with their frequency of occurrence in tackles in general play. RISK FACTORS: Playing position; player's speed, impact force, head position, head/neck flexion and body region struck in the tackle; sequence, direction and type of tackle; and location and type of injury. RESULTS: High-speed going into the tackle, high impact force, collisions and contact with a player's head/neck were identified as significant (p<0.01) risk factors for ball carriers (BCs) and tacklers. Midfield backs were significantly (p<0.01) more prone to injury when tackling than other players. Relatively few tacklers were penalised by referees for collision tackles (general play: 2.0%; injured players: 3.3%) and tackles above the line of the shoulder (general play: 5.9%; injured players: 16.7%). CONCLUSIONS: Advice in national and international injury prevention programmes for reducing the risk of injury in tackles is strongly supported by the results obtained from this study. These programmes should be reviewed, however, to provide specific advice for each type of tackle. Stricter implementation of the Laws of Rugby relating to collisions and tackles above the line of the shoulder may reduce the number of head/neck injuries sustained by BCs.

Contact events in rugby union and their propensity to cause injury.

OBJECTIVE: The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury. DESIGN: The study was a two-season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player-hours and per 1000 contact events), risk (days lost per 1000 player-hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player-player contact, position on pitch and period of play. RESULTS: Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player-hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event. CONCLUSIONS: Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout--very low; ruck--low; maul and tackle--average; collision and scrum--high.