Investigating Nutrition and Hydration Knowledge and Practice among a Cohort of Age-Grade Rugby Union Players.

Optimal athletic performance relies on meeting specific nutritional requirements, encompassing adequate calorie intake, macronutrient intake, and hydration. Misinformation or misconceptions about these necessities are prevalent among young athletes. This study investigated nutrition and hydration knowledge and practices among 28 male rugby union players aged 16 to 17, participating in Munster Rugby's 2023 Summer Age-Grade Development Programme, specifically the U18's Schools Squad. The Nutrition for Sport Knowledge Questionnaire assessed nutrition knowledge, while the Hydration Assessment Questionnaire evaluated hydration knowledge. Urinalysis for hydration status utilised urine specific gravity measurements pre-exercise on five separate days (1.018 ± 0.008 Usg). Dietary intake was recorded using a 3-day estimated food intake record on the Libro App, analysed with Nutritics software(Version 9.50). Suboptimal nutrition knowledge (49.6 ± 8.2%) and dietary practices were observed, with incongruent nutrient intakes compared to recommendations for adolescent athletes. While superior hydration knowledge (79.0 (77.3, 83.6) %) was evident, pre-exercise urine specific gravity readings indicated significant variation (p < 0.001) and signs of dehydration (USG > 1.020 Usg). No statistically significant correlations were found between knowledge and practices. The study highlights suboptimal nutrition and hydration knowledge and practices in youth athletes, suggesting the need for tailored support and educational interventions to enhance their overall health and performance. Further investigation into barriers and facilitators to dietary adherence is recommended for more effective interventions.

Individual In-Situ GPS-Derived Acceleration-Speed Profiling: Toward Automatization and Refinement in Male Professional Rugby Union Players.

BACKGROUND: Recently a proof-of-concept was proposed to derive the soccer players' individual in-situ acceleration-speed (AS) profile from global positioning system (GPS) data collected over several sessions and games. The present study aimed to propose an automatized method of individual GPS-derived in-situ AS profiling in a professional rugby union setting. METHOD: AS profiles of forty-nine male professional rugby union players representing 61.5 million positions, from which acceleration was derived from speed during 51 training sessions and 11 official games, were analyzed. A density-based clustering algorithm was applied to identify outlier points. Multiple AS linear relationships were modeled for each player and session, generating numerous theoretical maximal acceleration (A0), theoretical maximal running speed (S0) and AS slope (ASslope, i.e., overall orientation of the AS profile). Each average provides information on the most relevant value while the standard deviation denotes the method accuracy. In order to assess the reliability of the AS profile within the data collection period, data were compared over two 2-week phases by the inter-class correlation coefficient. A0 and S0 between positions and type of sessions (trainings and games) were compared using ANOVA and post hoc tests when the significant threshold had been reached. RESULTS: All AS individual profiles show linear trends with high coefficient of determination (r2 > 0.81). Good reliability (Inter-class Correlation Coefficient ranging from 0.92 to 0.72) was observed between AS profiles, when determined 2 weeks apart for each player. AS profiles depend on players' positions, types of training and games. Training and games data highlight that highest A0 are obtained during games, while greatest S0 are attained during speed sessions. CONCLUSIONS: This study provides individual in-situ GPS-derived AS profiles with automatization capability. The method calculates an error of measurement for A0 and S0, of paramount importance in order to improve their daily use. The AS profile differences between training, games and playing positions open several perspectives for performance testing, training monitoring, injury prevention and return-to-sport sequences in professional rugby union, with possible transferability to other sprint-based sports. KEY POINTS: AS profiles computed from rugby union GPS data provide positional benchmarks during training and competition. This study provides automatic detection of atypical data and the computation of error measurement of theoretical maximal acceleration and speed components. This refinement constitutes a step forward for a daily use of ecological data by considering data collection and method reliabilities. This easy-to-implement approach may facilitate its use to the performance management process (talent identification, training monitoring and individualization, return-to-sport).

A high incidence of injury among male university student rugby players requires urgent injury prevention strategies.

OBJECTIVES: Determine the epidemiology and clinical characteristics of training and match injuries in university student rugby players over a two-season period. DESIGN: Prospective cohort. SETTING: Varsity Cup (VC) and Young Guns (YG) rugby tournaments (2018 and 2019). PARTICIPANTS: 171 male university student rugby players. MAIN OUTCOME MEASURES: For time-loss injuries: injury incidence (injuries per 1000 player-hours), injured player proportion (% of injured players) and the frequency (n, %) of injury characteristics (new or recurrent, anatomical region, body area, severity. RESULTS: The injury incidence was 2.4 per 1000 player-hours for training injuries and 131.1 per 1000 player-hours for match injuries. The overall injured player proportion was 59.6%. New injuries (83.9%) were more frequent than recurrent injuries. Most injuries occurred in the lower limb involving muscle/tendon (56.7%) and ligament/joint capsule (27.2%). The shoulder (19.6%) and ankle (15.7%) were the most common body areas of injury during matches and training, respectively. CONCLUSIONS: There was a high injured player proportion and match injury incidence among university student rugby players. Most injuries were new. Lower limb injuries were most common in training whereas upper limb injuries were most common in matches. These findings highlight the need to prioritise future injury prevention among university student rugby players.

Validation of an instrumented mouthguard in rugby union-a pilot study comparing impact sensor technology to video analysis.

Background: To better understand the biomechanical profile of direct head impacts and the game scenarios in which they occur in Rugby Union, there is a need for an on-field validation of a new instrumented mouthguard (IMG) against the reference standard. This study considers the potential of a combined biomechanical (IMG) and video analysis approach to direct head impact recognition, both of which in isolation have limitations. The aim of this study is to assess the relationship between an instrumented mouthguard and video analysis in detection of direct head impacts in rugby union. Design: Pilot Study - Observational Cohort design. Methods: The instrumented mouthguard was worn by ten (3 backs, 7 forwards) professional Rugby Union players during the 2020-21 Gallagher Premiership (UK) season. Game-day video was synchronized with timestamped head acceleration events captured from the instrumented mouthguard. Direct Head Impacts were recorded in a 2 × 2 contingency table to determine sensitivity. Impact characteristics were also collected for all verified head impacts to further the understanding of head biomechanics during the game. Results: There were 2018 contact events that were reviewed using video analysis. Of those 655 were categorized as direct head impacts which also correlated with a head acceleration event captured by the IMG. Sensitivity analysis showed an overall sensitivity of 93.6% and a positive predictive value (PPV of 92.4%). When false positives were excluded due to ball out of play, mouthguard removal or handling after a scoring situation or stoppage, PPV was improved (98.3%). Most verified head impacts occurred in and around the ruck contest (31.2%) followed by impacts to the primary tackler (28.4%). Conclusion: This pilot validation study demonstrates that this IMG provides a highly accurate measurement device that could be used to complement video verification in the recognition of on-field direct head impacts. The frequency and magnitude of direct head impacts derived from specific game scenarios has been described and allows for greater recognition of high-risk situations. Further studies with larger sample sizes and in different populations of Rugby Union players are required to develop our understanding of head impact and enable strategies for injury mitigation.

Talent identification and development in an English Premiership rugby union club: the perspectives of players and coaches.

The pathway towards senior professional status in sport is affected by a multitude of factors. An abductive examination of the talent identification and development processes at an English Premiership rugby union (RU) club was undertaken for the present study. Part one examined the perspectives on the selection and development processes of senior academy male players (n = 8), whereas part two explored the perceptions of male coaches (n = 7). A total of three focus groups were used. Three main themes were confirmed by players and coaches: (a) task constraints, (b) performer constraints, and (c) environmental constraints. Specifically, although athletes and coaches believed that performer constraints were highly impactful on players' career in RU, there were inconsistencies surrounding the task and environmental constraints. Despite an indication that three common themes impacted an players path, this preliminary study shows an imbalance in the understanding of some of the key factors perceived to be important for talent progression in the present rugby academy. More research using similar qualitative methods is recommended to better understand the differences in opinions between players and coaches. Meanwhile, practitioners should consider implementing objective and holistic strategies to improve the talent pathway in English RU academies.

Physical Fitness Tests as Predictors of High-Intensity Running Performance in Rugby.

Understanding the physical fitness elements that influence high-intensity running ability during rugby matches is crucial for optimizing player performance and developing effective training strategies. In this study, we aimed to investigate the relationships between various physical fitness components and high-intensity running ability in rugby. For this purpose, 60 Japanese university rugby players were randomized into four groups and two matches were played. The participants were monitored in two matches, and their running abilities were assessed using GPS sensors. The running time was divided into three running velocity categories: distance run at ≤5.4 km/h (low-intensity running); distance run at 5.5~17.9 km/h (medium-intensity running), and distance run at ≥18.0 km/h ≤(high-intensity running) and backs and forwards were evaluated separately. To determine which physical fitness test is more predictive of performance, we decided to correlate several physical test performances with the running time intensities during the matches. Independently of the position, the high-intensity running time correlated with the repeated sprint ability (RSA) and the 40 m sprint speed. The results suggest that RSA measured in the field is the most important high-intensity running ability predictor during a match for both positions.

Lower systemic nitric oxide bioactivity, cerebral hypoperfusion and accelerated cognitive decline in formerly concussed retired rugby union players.

NEW FINDINGS: What is the central question of this study? What are the molecular, cerebrovascular and cognitive biomarkers of retired rugby union players with concussion history? What is the main finding and its importance? Retired rugby players compared with matched controls exhibited lower systemic nitric oxide bioavailability accompanied by lower middle cerebral artery velocity and mild cognitive impairment. Retired rugby players are more susceptible to accelerated cognitive decline. ABSTRACT: Following retirement from sport, the chronic consequences of prior-recurrent contact are evident and retired rugby union players may be especially prone to accelerated cognitive decline. The present study sought to integrate molecular, cerebrovascular and cognitive biomarkers in retired rugby players with concussion history. Twenty retired rugby players aged 64 ± 5 years with three (interquartile range (IQR), 3) concussions incurred over 22 (IQR, 6) years were compared to 21 sex-, age-, cardiorespiratory fitness- and education-matched controls with no prior concussion history. Concussion symptoms and severity were assessed using the Sport Concussion Assessment Tool. Plasma/serum nitric oxide (NO) metabolites (reductive ozone-based chemiluminescence), neuron specific enolase, glial fibrillary acidic protein and neurofilament light-chain (ELISA and single molecule array) were assessed. Middle cerebral artery blood velocity (MCAv, doppler ultrasound) and reactivity to hyper/hypocapnia ( CVR CO 2 hyper ${\mathrm{CVR}}_{{\mathrm{CO}}_{\mathrm{2}}{\mathrm{hyper}}}$ / CVR CO 2 hypo ${\mathrm{CVR}}_{{\mathrm{CO}}_{\mathrm{2}}{\mathrm{hypo}}}$ ) were assessed. Cognition was determined using the Grooved Pegboard Test and Montreal Cognitive Assessment. Players exhibited persistent neurological symptoms of concussion (U = 109(41) , P = 0.007), with increased severity compared to controls (U = 77(41) , P < 0.001). Lower total NO bioactivity (U = 135(41) , P = 0.049) and lower basal MCAv were apparent in players (F2,39  = 9.344, P = 0.004). This was accompanied by mild cognitive impairment (P = 0.020, 95% CI, -3.95 to -0.34), including impaired fine-motor coordination (U = 141(41) , P = 0.021). Retired rugby union players with history of multiple concussions may be characterised by impaired molecular, cerebral haemodynamic and cognitive function compared to non-concussed, non-contact controls.

Effects of 24-week prebiotic intervention on self-reported upper respiratory symptoms, gastrointestinal symptoms, and markers of immunity in elite rugby union players.

OBJECTIVES: Elite rugby union players face numerous physiological and psychological stressors which can increase upper respiratory and gastrointestinal illness risk, and in turn can compromise training and competitive performance. This study aimed to investigate the effect of daily prebiotic supplementation on upper respiratory symptoms, gastrointestinal symptoms, and markers of immune function in elite rugby union players. METHODS: Thirty-three elite rugby union players were randomly assigned to consume a prebiotic (2.8 g/day galactooligosaccharide) or placebo (2.8 g/day maltodextrin), daily for 168 days under double-blind conditions. Participants completed daily and weekly questionnaires for self-reported upper respiratory and gastrointestinal symptoms respectively. Blood and saliva samples were collected at 0, 84, and 168 days for assessment of plasma TNF-α and CRP, and saliva IgA respectively. RESULTS: The prebiotic group experienced a 2-day reduction in upper respiratory symptom duration (P = 0.045). Gastrointestinal symptom severity and incidence were lower in the prebiotic group compared to the placebo group (P < 0.001, P = 0.041) respectively. Salivary immunoglobulin A secretion rate was 42% greater in the prebiotic group compared to the placebo group at day 168 (P = 0.004), no differences in CRP and TNF-α were found (P > 0.05). CONCLUSION: A 168-day dietary prebiotic intervention reduced the duration of upper respiratory symptoms and reduced the incidence and severity of gastrointestinal symptoms in elite rugby union players. These findings suggest that seasonal prebiotic interventions may be beneficial for reducing illness in elite rugby union players, improving their availability to train and compete.Key pointsElite athletes are susceptible to upper respiratory symptoms and gastrointestinal symptoms which may impact upon training availability and competition performance.For the first time, this study shows that a dietary prebiotic intervention can reduce the duration of upper respiratory symptoms by 2 days in elite rugby union players.Dietary prebiotic supplementation can improve the incidence and severity of gastrointestinal symptoms experienced by elite rugby union players.Prebiotic supplementation was able to increase salivary IgA secretion after 168 days.These findings can inform practice suggesting that seasonal prebiotic use has the potential to modulate immune function and reduce illness in elite rugby union, which may improve a player's availability to train and compete.The mechanisms by which prebiotics reduce URS and GIS require further research exploration.

"Getting on the same page" enhancing team performance with shared mental models-case studies of evidence informed practice in elite sport.

Within high performing, team invasion sports, collective decision making and coordination between teammates are essential characteristics. There is a wealth of evidence supportive of shared mental models as being an important construct to underpin team coordination. Yet, to this point, there is limited research considering the coaches' voices in the application of shared mental models in high performance sport, nor the challenges coaches face throughout the process. Given these limitations, we provide two case studies of evidence informed practice which privilege the voice of coaches who work in elite rugby union. In doing so, we aim to offer a deeper insight regarding the development, implementation, and continued use of shared mental models to enhance performance. Through these first-person case studies, we present the development of two shared mental models and the processes taken, challenges faced, and coaching methods used to underpin them. The case studies are then discussed with implications for coaches' practice supporting the development of their players' collective decision making.

Sport-related concussion disclosure in women's rugby-A social identity approach.

Introduction: Sport-related concussion (SRC) is a risk of collision sports such as women's rugby. To support appropriate SRC diagnosis and management, an understanding of the factors that encourage SRC disclosure is necessary. To date, research has focused on ascertaining individual player knowledge and attitudes towards SRC disclosure. Methods: We chose to investigate the potential influence of group identification effects by examining the role of social identity on SRC disclosure in elite women's rugby. Seventeen elite players from the United Kingdom and Ireland were interviewed and their transcripts thematically analysed. Results: The data highlighted that the players shared a very strong social identity as women in rugby and were acutely aware that their experiences were different to their male counterparts. The shared social identity had both positive and negative implications for SRC disclosure. The players interviewed did not feel comfortable disclosing their symptoms to their coach and often felt that medical staff either did not listen to them or were unavailable to them. Mediators such as communication, trust in medical teams, perceived pressure, positive injury management experience, and player role models were identified. Discussion: This research could be utilised to inform sport psychology interventions to enhance SRC disclosure in elite women's rugby.

New Zealand Youth Rugby Sevens: A Comparative Match Demands Study.

Rugby sevens has established itself on the world stage since its inclusion in the 2016 Olympics. Participation among New Zealand (NZ) youth has surged. Sevens games have specific high demands, but little is known about these competitive demands in regards to youth. Two NZ male youth squads (U15, n = 13; U19, n = 14) were monitored during a national sevens tournament. Microsensor technology captured heart rate (HR) and kinematic performance. The rating of perceived exertion (RPE) was collected for U15 matches only. U19 and U15 players ran 108 ± 11 and 116 ± 13 m·min-1 at an average speed (VAVG) of 6.5 ± 0.6 and 6.9 ± 0.8 km·h-1. Peak speeds (VPEAK) reached 33.7 km·h-1, and high-intensity running distance (HIRD) averaged 252 ± 102 m. U15 (44.3 ± 9.2 game-1) and U19 (39.4 ± 6.1 game-1) showed different sprint rates. U15 covered more moderate-velocity distance (20-80% VMAX) and less low-velocity distance (<20% VMAX). RPE was 13 ± 1 (U15). An average HR of 90.0 ± 3.9% HRMAX was recorded. Upwards of 57% of game time was played at >95% HRMAX. Youth sevens competition is specifically demanding. U15 can experience greater loads than older peers in rugby. Coaches can use this information to optimize players' physical development.

Tackle direction and preferred side affect upper body loads and movements in rugby union tackling.

Tackling in Rugby Union is associated with most match injuries. New tackle regulations have been explored to reduce injuries, but limited quantitative evidence is available to inform any law changes. Using a novel tackle simulator, we investigated upper body loading under different tackling conditions: direction of approach (0° - frontal, 45° and 90° to the ball carrier direction) and side of body (dominant vs. non-dominant). Peak impact force between tackler and simulator , and head and upper trunk segment motions were measured from 10 male players. Impact load averages were 17% higher at (0°) compared with (90°), across the two different tackling sides (p = 0.093), with the highest impact force measured during dominant-side shoulder tackles at 0° (5.63 ± 1.14 kN). Trunk resultant accelerations were higher (+19%, p = 0.010) at 0° compared with 90°, with the highest resultant acceleration measured in frontal tackles with the dominant shoulder (17.52 ± 3.97 g). We observed higher head lateral bending around the impact when tackling with the non-dominant shoulder at 45° (p = 0.024) and 90° (p = 0.047). Tackling from an offset angle from frontal may be safer. Deficiencies in tackling techniques on the non-dominant side should be reduced.

Injury Occurrence in Amateur Rugby: Prospective Analysis of Specific Predictors over One Half-Season.

Background and objectives: The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically analyse sports and injury factors as potential predictors of musculoskeletal injuries in senior-level amateur rugby players. Methods: The participants in this study were 101 senior-level rugby players from Croatia (average of 24.64 years old). At baseline, all participants were tested on sociodemographic and anthropometric parameters (age, body height and mass), consumption of dietary supplements, preseason injury status and training volume, and sport factors (position in game). Data on injury occurrence (dependent variable), prevalence of pain, training status, and characteristics of the played match were surveyed prospectively once a week during the three-month period (one half-season). Results: The logistic regression revealed a higher injury occurrence in forward players of the 1st row, 2nd row (OR = 5.07; 95% CI: 1.64-15.69), and center (OR = 4.72; 95% CI: 1.28-14.31), with reference to outside back players. When observed univariately, higher body mass, higher level of competition, more weekly training sessions, self-perceived pain, and playing with pain were significant injury risk factors. The multivariate logistic regression identified pre-season injury (OR = 1.30, 95% CI: 1.09-1.52), higher level of the game/match (OR = 1.44, 95% CI: 1.13-1.76), higher body mass (OR = 1.03, 95% CI: 1.01-1.05), and pain prevalence (OR = 5.71, 95% CI: 3.22-7.70) as multivariate predictors of injury occurrence over the season. Conclusion: The results of this study showed that among sport factors, the playing position, level of competition, and training exposure represent major injury risk factors. Therefore, in order to reduce the number of injuries, special emphasis should be placed on the specific tackling technique of forward players, which could both increase their situational efficiency and protect them from injuries. Additionally, perceived pain, injury history, and playing with injury were noted among injury factors as the ones that can be predictors of future injuries. In that manner, it is important that coaching and medical staff monitor players with previous injuries and with pain symptoms in order to act preventively against injury occurrence.

Allometric scaling for normalizing maximal oxygen uptake in elite rugby union players / Normalización del consumo de oxígeno máximo por escala alométrica en jugadores de rugby unión de élite

Introduction: The relation of a biological variable to body mass is typically characterized by an allometric scaling law. Thepurpose of this study was to evaluate the relationship between oxygen consumption (VO2max), as a parameter of aerobicexercise performance, and body composition in rugby players. Material and method: The sample included one hundred and seven males of the Spanish rugby team. Age: 25.1 ± 3.4 years;body mass (BM): 89.8 ± 11.7 kg, height: 182.4 ± 6.5 cm; 52 backs (BR) and 55 forwards (FR). Maximum oxygen consumption(VO2max, l.min-1) was measured during treadmill exercise test with progressive workload. Anthropometrical measurementswere performed to estimate the fat-free mass (FFM) and muscle mass (MM). The allometric exponent “b” was determined fromequation y = a * xb; where “y” is VO2max and, “x” is the corresponding mass (BM, FFM or MM) and “a” is one constant. Results: The VO2max was 4.87 ± 0.56 l.min-1, BR vs FR, 4.67 ± 0.48 l.min-1 vs 5.06 ± 0.06 l.min-1; FFM: 77.5±7.7 kg, 73.5±7 kg vs81.3±6.3 kg; and MM: 52.9±6.5 kg, 49.6±5.6 kg vs 56.1±5.8 kg. The allometric exponents (p <0.0001; R2 = 0.4) were: 0.58 for BM(95% CI: 0.45 - 0.72); 0.71 for FFM (95% CI: 0.53 - 0.90); and 0.58 for MM (95% CI: 0.43 - 0.73). Significant differences (p <0.0001)were found BR vs FR according to their anthropometric characteristics and VO2max with respect to BM and MM without allo-metric scaling. While the VO2max indexed by means of allometric scaling was similar between BR and FR. Conclusions: In comparative studies, the VO2max should be expressed proportional to the 0.58 power of body mass or relatedto FFM in order to take into account the variability in of body composition in rugby players.(AU)

Introducción: La relación de una variable biológica con la masa corporal se caracteriza típicamente por una ley de escalaalométrica. El propósito del estudio fue evaluar la relación entre el consumo máximo de oxígeno (VO2max), como parámetrode rendimiento aeróbico, y la composición corporal en jugadores de rugby. Material y método: La muestra incluyó a 107 varones de la selección española de rugby. Edad: 25,1 ± 3,4 años; masa cor-poral (MC): 89,8 ± 11,7 kg, talla: 182,4 ± 6,5 cm; 52 defensas (DF) y 55 delanteros (DL). El VO2max (l.min-1) se determinó en tapizcon carga progresiva hasta el máximo esfuerzo. Mediante técnica antropométrica se estimó la masa libre de grasa (MLG) y lamasa muscular (MM). El exponente alométrico “b” se determinó por la ecuación y = a * xb; donde “y” es VO2max, “x” es la masacorrespondiente (MC, MLG o MM) y “a” es una constante. Resultados: El VO2max fue 4,87 ± 0,56 l.min-1, DF vs DL, 4,67 ± 0,48 l.min-1 vs 5,06 ± 0,06 l.min-1; MLG: 77,5 ± 7,7 kg, 73,5 ± 7 kg vs81,3 ± 6,3 kg; y MM: 52,9 ± 6,5 kg, 49,6 ± 5,6 kg vs 56,1 ± 5,8 kg. Los exponentes alométricos (p <0,0001; R2 = 0,4) fueron: 0,58para MC (IC 95%: 0,45 - 0,72); 0,71 para MLG (IC del 95%: 0,53 - 0,90); y 0,58 para MM (IC del 95%: 0,43 - 0,73). Se encontrarondiferencias significativas (p <0,0001) DF vs DL según sus características antropométricas y VO2max con respecto a BM y MM sinescalado alométrico. Mientras que el VO2max indexado mediante escalado alométrico fue similar entre DF y DL. Conclusiones: En estudios comparativos el VO2max debería expresarse a la potencia de 0.58 de MC o con MLG debido a lavariabilidad de la composición corporal en jugadores de rugby.(AU)

An exploratory study into the relationship between playing at home or away and concussion.

PRIMARY OBJECTIVE: To investigate the effect of home and away game travel on risk of concussion across different levels of rugby union. RESEARCH DESIGN: Exploration study across school, university, and professional rugby teams. METHODS AND PROCEDURES: Retrospective analysis of concussion incidence and symptomology of surveillance data and prospective data collection for potential concussions via surveys. Data was collected from school rugby teams (n = 344 matches, over 2 years), a university rugby (n = 6 matches), and a professional rugby team (n = 64 matches, over two seasons). MAIN OUTCOMES AND RESULTS: School level rugby had an increased prevalence of concussions in away matches (p = 0.02). Likewise, there was a significant increase (p < 0.05) in concussions at away matches in university rugby. In addition, the professional rug by team had significant differences in recovery times and symptoms with away fixtures, including longer recovery times (p < 0.01), more initial symptoms (p < 0.01), as well as greater and more severe symptoms at 48 hours (p < 0.05). CONCLUSIONS: This research highlights an increased prevalence of concussion in school and university-aged rugby players away from home, as well as increased symptoms, symptom severity, and recovery times in professional rugby players.

"It's always the bare minimum" - A qualitative study of players' experiences of tackle coaching in women's rugby union.

OBJECTIVES: Tackle coaching forms a cornerstone of training in rugby and is designed to enhance performance and mitigate tackle injury. The athlete voice can help key stakeholders understand the psychosocial determinants that shape skill development in relation to tackle coaching. We aimed to capture player experiences of tackle coaching in women's rugby union. DESIGN: Qualitative study using the grounded theory approach. METHODS: Current women rugby union players, with at least 1-year senior level experience, were recruited from Europe, Africa and North America between December 2021 and March 2022 to participate in the study. Data were collected through semi-structured interviews and analysed in line with grounded theory coding procedures. RESULTS: The 21 players were aged 20-48 years with a mean 10.6 years of rugby playing experience. Analysis revealed that the experiences of tackle coaching that shaped women's tackle skill development and sense of preparedness ranged from constraining to empowering, and gender was a pivotal influence in creating meaning. Participants expected and accepted the bare minimum in tackle coaching as the price that they had to pay for inclusion in rugby. CONCLUSIONS: Participants' experiences of tackle coaching were entangled in inequitable club structures and cultures where men's rugby is the norm. Empowering tackle coaching in women's rugby union must be bespoke to the given context and the needs of women players. The recommendations offered in this paper encourage discussion as to how best to empower women's tackle development in rugby.

The balancing act - Physiotherapists' experiences of managing rugby-related concussion in the community.

BACKGROUND: New Zealand Rugby (NZR) implemented a concussion management pathway (CMP) to improve management at the community level. Physiotherapists play an important role in the CMP. OBJECTIVE: This study explored physiotherapists' experiences in the management of community rugby-related concussion as part of the CMP. METHODS: We adopted a pragmatic, descriptive qualitative approach to explore perceptions of twenty-four physiotherapists involved in the CMP. Thematic analysis was used to analyze data. RESULTS: Four themes represented participants' experiences: 1) 'walking the tight rope between player welfare and performance' described the balancing act between different attitudes and priorities of the various rugby stakeholders; 2) empowering physiotherapists' authority and responsibilities, described the influence of physiotherapists' authority within the team and concussion management responsibilities; 3) multi-directional communication, described the role of communication between multiple stakeholders; and 4) the influence of context, which included the complexity of concussion, concussion knowledge of the physiotherapists and team, resource support for the physiotherapist, and access to a medical doctor. CONCLUSION: Physiotherapists had positive attitudes toward the CMP and are well-positioned to play an active role in the pathway. Priorities of other stakeholders, authority of the physiotherapist and the communication flow influences physiotherapists' ability to optimally manage players with concussion.

Gene variants previously associated with reduced soft tissue injury risk: Part 1 - independent associations with elite status in rugby.

There is growing evidence of genetic contributions to tendon and ligament pathologies. Given the high incidence and severity of tendon and ligament injuries in elite rugby, we studied whether 13 gene polymorphisms previously associated with tendon/ligament injury were associated with elite athlete status. Participants from the RugbyGene project were 663 elite Caucasian male rugby athletes (RA) (mean (standard deviation) height 1.85 (0.07) m, mass 101 (12) kg, age 29 (7) yr), including 558 rugby union athletes (RU) and 105 rugby league athletes. Non-athletes (NA) were 909 Caucasian men and women (56% female; height 1.70 (0.10) m, mass 72 (13) kg, age 41 (23) yr). Genotypes were determined using TaqMan probes and groups compared using Χ2 and odds ratio (OR). COLGALT1 rs8090 AA genotype was more frequent in RA (27%) than NA (23%; P = 0.006). COL3A1 rs1800255 A allele was more frequent in RA (26%) than NA (23%) due to a greater frequency of GA genotype (39% vs 33%). For MIR608 rs4919510, RA had 1.7 times the odds of carrying the CC genotype compared to NA. MMP3 rs591058 TT genotype was less common in RA (25.1%) than NA (31.2%; P < 0.04). For NID1 rs4660148, RA had 1.6 times the odds of carrying the TT genotype compared to NA. It appears that elite rugby athletes have an inherited advantage that contributes to their elite status, possibly via resistance to soft tissue injury. These data may, in future, assist personalised management of injury risk amongst athletes.Highlights The elite rugby athletes we studied had differing genetic characteristics to non-athletes regarding genetic variants previously associated with soft-tissue injury risk.COLGALT1 rs8090, COL3A1 rs1800255, MIR608 rs4919510, MMP3 rs591058 and NID1 rs4660148 were all associated with elite status in rugby.We propose that elite rugby athletes might possess an inherited resistance to soft tissue injury, which has enabled them to achieve elite status despite exposure to the high-risk environment of elite rugby.

Left ventricular function and mechanics in backs and forwards elite rugby union players.

ABSTRACTPurpose: The aim of the present study was to assess left ventricular (LV) morphological and regional functional adaptations in backs and forwards elite rugby union (RU) players. METHODS: Thirty-nine elite male RU players and twenty sedentary controls have been examined using resting echocardiography. RU players were divided into two groups, forwards (n = 22) and backs (n = 17). Evaluations included tissue Doppler and 2D speckle-tracking analysis to assess LV strains and twisting mechanics. RESULTS: The elite RU players exhibited an LV remodelling characterized by an increase in LV mass indexed to body surface area (82.2 ± 13.2 vs. 99.9 ± 16.1 and 119.7 ± 13.4 g.m-2, in controls, backs and forwards; P < .001). Compared to backs, forwards exhibited lower global longitudinal strain (19.9 ± 2.5 vs. 18.0 ± 1.6%; P < .05), lower early diastolic velocity (16.5 ± 1.8 vs. 15.0 ± 2.3 cm.s-1; P < .05) and lower diastolic longitudinal strain rate (1.80 ± 0.34 vs. 1.54 ± 0.26 s-1; P < .01), especially at the apex. LV twist and untwisting velocities were similar in RU players compared to controls, but with lower apical (-46.2 ± 22.1 vs. -28.2 ± 21.7 deg.s-1; P < .01) and higher basal rotational velocities (33.9 ± 20.9 vs. 48.4 ± 20.7 deg.s-1; P < .05). CONCLUSION: RU players exhibited an increase in LV mass which was more pronounced in forwards. In forwards, LV global longitudinal strain was depressed, LV filling pressures were decreased, and LV relaxation depressed at the apex.Highlights Elite RU players exhibited LV hypertrophy, especially in forwards players.LV regional function suggested a drop in LV relaxation and an increase in LV filling pressures in RU players, with higher alterations in forwards.LV remodelling was associated with regional alterations in torsional mechanics: higher rotations and rotational diastolic velocities at the basal level of LV but lower rotation and rotational diastolic velocities at the apex were observed in RU players.