Incidence of Injury in Rugby League Football

Tendon and Ligament Injuries in Elite Rugby: The Potential Genetic Influence

This article reviews tendon and ligament injury incidence and severity within elite rugby union and rugby league. Furthermore, it discusses the biological makeup of tendons and ligaments and how genetic variation may influence this and predisposition to injury. Elite rugby has one of the highest reported injury incidences of any professional sport. This is likely due to a combination of well-established injury surveillance systems and the characteristics of the game, whereby high-impact body contact frequently occurs, in addition to the high intensity, multispeed and multidirectional nature of play. Some of the most severe of all these injuries are tendon and ligament/joint (non-bone), and therefore, potentially the most debilitating to a player and playing squad across a season or World Cup competition. The aetiology of these injuries is highly multi-factorial, with a growing body of evidence suggesting that some of the inter-individual variability in injury susceptibility may be due to genetic variation. However, little effort has been devoted to the study of genetic injury traits within rugby athletes. Due to a growing understanding of the molecular characteristics underpinning the aetiology of injury, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose several single nucleotide polymorphisms within candidate genes of interest; COL1A1, COL3A1, COL5A1, MIR608, MMP3, TIMP2, VEGFA, NID1 and COLGALT1 warrant further study within elite rugby and other invasion sports.

Semi-Professional Rugby League Players have Higher Concussion Risk than Professional or Amateur Participants: A Pooled Analysis

A combined estimate of injuries within a specific sport through pooled analysis provides more precise evidence and meaningful information about the sport, whilst controlling for between-study variation due to individual sub-cohort characteristics. The objective of this analysis was to review all published rugby league studies reporting injuries from match and training participation and report the pooled data estimates for rugby league concussion injury epidemiology. A systematic literature analysis of concussion in rugby league was performed on published studies from January 1990 to October 2015. Data were extracted and pooled from 25 studies that reported the number and incidence of concussions in rugby league match and training activities. Amateur rugby league players had the highest incidence of concussive injuries in match activities (19.1 per 1000 match hours) while semi-professional players had the highest incidence of concussive injuries in training activities (3.1 per 1000 training hours). This pooled analysis showed that, during match participation activities, amateur rugby league participants had a higher reported concussion injury rate than professional and semi-professional participants. Semi-professional participants had nearly a threefold greater concussion injury risk than amateur rugby league participants during match participation. They also had nearly a 600-fold greater concussion injury risk than professional rugby league participants during training participation.

Shoulder injuries in adolescent rugby players

BACKGROUND

Rugby is a high-intensity contact sport, frequently causing shoulder injuries. Between the ages of 12 years to 18 years, academy and county level players are being selected for professional contracts, making this is a critical stage of their career. The present study aimed to describe the patterns of injury in adolescent rugby players with shoulder injuries.

METHODS

Academy and county level rugby players in the target age group, over a 7-year period, were included in the present study. Data collected included the mechanism of injury, position and level of play, radiology and surgical findings, and recurrence rate at a minimum of 2 years post-surgery.

RESULTS

One hundred and sixty-nine cases adhered to the inclusion criteria, with most cases involving two or more pathologies in the shoulder (54%). Forwards sustained more shoulder injuries than backs, incurring more labral injuries. By contrast, backs had a higher incidence of bony pathology. The mechanism of injury frequently correlated with player positions. There was a 21% injury recurrence rate, with forwards (7%) and higher level academy players (11%) most likely to suffer a recurrence.

CONCLUSIONS

Shoulder injury patterns in this important group of adolescent contact athletes are complex, with recurrence rates being higher than those in older rugby players.

Treatment of glenohumeral instability in rugby players

Rugby is a high-impact collision sport, with impact forces. Shoulder injuries are common and result in the longest time off sport for any joint injury in rugby. The most common injuries are to the glenohumeral joint with varying degrees of instability. The degree of instability can guide management. The three main types of instability presentations are: (1) frank dislocation, (2) subluxations and (3) subclinical instability with pain and clicking. Understanding the exact mechanism of injury can guide diagnosis with classical patterns of structural injuries. The standard clinical examination in a large, muscular athlete may be normal, so specific tests and techniques are needed to unearth signs of pathology. Taking these factors into consideration, along with the imaging, allows a treatment strategy. However, patient and sport factors need to be also considered, particularly the time of the season and stage of sporting career. Surgery to repair the structural damage should include all lesions found. In chronic, recurrent dislocations with major structural lesions, reconstruction procedures such as the Latarjet procedure yields better outcomes. Rehabilitation should be safe, goal-driven and athlete-specific. Return to sport is dependent on a number of factors, driven by the healing process, sport requirements and extrinsic pressures. Level of evidence V.

Time-loss injuries versus non-time-loss injuries in the first team rugby league football: a pooled data analysis

OBJECTIVE

To describe the injury rates in first team rugby league in terms of those injuries that require missed playing time and those that do not.

DESIGN

A pooled data analysis from 2 independent databases.

SETTING

Rugby league match and training environment over several seasons from 1990 to 2003.

MAIN OUTCOME MEASURES

Injuries were reported as rates per 1000 hours of participation and as percentages with their associated 95% confidence intervals (CIs).

RESULTS

A total of 1707 match injuries were recorded. Of these injuries, 257 required players to miss the subsequent match. The remaining 1450 injuries did not require players to miss the next game. They represented 85% (95% CI, 83-87) of all injuries received and recorded. The ratio of non-time-loss (NTL) to time-loss (TL) injuries was 5.64 (95% CI, 4.96-6.42). There were 450 training injuries, of which 81 were TL injuries and 369 NTL injuries. The NTL training injury rate was 4.56 (95% CI, 3.58-5.79) times higher than TL injury rate.

CONCLUSIONS

Non-time-loss injuries represent the largest proportion of injuries in rugby league. If NTL injuries are not recorded, the workload of practitioners is likely to be severely underestimated.

Match and training injuries in rugby league: a review of published studies

Rugby league is an international collision sport played by junior, amateur, semiprofessional and professional players. The game requires participants to be involved in physically demanding activities such as running, tackling, passing and sprinting, and musculoskeletal injuries are common. A review of injuries in junior and senior rugby league players published in Sports Medicine in 2004 reported that injuries to the head and neck and muscular injuries were common in senior rugby league players, while fractures and injuries to the knee were common in junior players. This current review updates the descriptive data on rugby league epidemiology and adds information for semiprofessional, amateur and junior levels of participation in both match and training environments using studies identified through searches of PubMed, CINHAL, Ovid, MEDLINE, SCOPUS and SportDiscus databases. This review also discusses the issues surrounding the definitions of injury exposure, injury rate, injury severity and classification of injury site and type for rugby league injuries. Studies on the incidence of injuries in rugby league have suffered from inconsistencies in the injury definitions utilized. Some studies on rugby league injuries have utilized a criterion of a missed matchas an injury definition, total injury incidences or a combination of both time-loss and non-time-loss injuries, while other studies have incorporated a medical treatment injury definition. Efforts to establish a standard definition for rugby league injuries have been difficult, especially as some researchers were not in favour of a definition that was all-encompassing and enabled non-time-loss injuries to be recorded. A definition of rugby league injury has been suggested based on agreement by a group of international researchers. The majority of injuries occur in the match environment, with rates typically increasing as the playing level increases. However, professional level injury rates were reportedly less than semiprofessional participation. Only a few studies have reported training injuries in rugby league, where injury rates were reported to be less than match injuries. Approximately 16-30% of all rugby league injuries have been reported as severe, which places demands upon other team members and, if the player returns to playing too early, places them at an increased risk of further injuries. Early research in rugby league identified that ligament and joint injuries were the common injuries, occurring primarily to the knee. More recently, studies have shown a change in anatomical injury sites at all levels of participation. Although the lower limb was the frequent injury region reported previously, the shoulder has now been reported to be the most common injury site. Changes in injury site and type could be used to prompt further research and development of injury reduction programmes to readdress the issue of injuries that occur as a result of participation in rugby league activities. Further research is warranted at all participation levels of rugby league in both the match and training environments to confirm the strongest risk factors for injury.

Applied physiology of rugby league

Rugby league football is played in several countries worldwide. A rugby league team consists of 13 players (6 forwards and 7 backs), with matches played over two 40-minute halves separated by a 10-minute rest interval. Several studies have documented the physiological capacities of rugby league players and the physiological demands of competition, with the physiological capacities of players and the physiological demands of competition increasing as the playing level is increased. However, there is also evidence to suggest that the physiological capacities of players may deteriorate as the season progresses, with reductions in muscular power and maximal aerobic power and increases in skinfold thickness occurring towards the end of the rugby league season, when training loads are lowest and match loads and injury rates are at their highest. Player fatigue and playing intensity have been suggested to contribute to injuries in rugby league, with a recent study reporting a significant correlation (r=0.74) between match injury rates and playing intensity in semi-professional rugby league players. Studies have also reported a higher risk of injury in players with low 10-m and 40-m speed, while players with a low maximal aerobic power had a greater risk of sustaining a contact injury. Furthermore, players who completed <18 weeks of training prior to sustaining their initial injury were at greater risk of sustaining a subsequent injury. These findings provide some explanation for the high incidence of fatigue-related injuries in rugby league players and highlight the importance of speed and endurance training to reduce the incidence of injury in rugby league players. To date, most, but not all, studies have investigated the movement patterns and physiological demands of rugby league competition, with little emphasis on how training activities simulate the competition environment. An understanding of the movement patterns and physiological demands of specific individual positions during training and competition would allow the development of strength and conditioning programmes to meet the specific requirements of these positions. In addition, further research is required to provide information on the repeated effort demands of rugby league. A test that assesses repeated effort performance and employs distances, tackles and intensities specific to rugby league, while also simulating work-to-rest ratios similar to rugby league competition, is warranted.

Physiological and anthropometric characteristics of junior elite and sub-elite rugby league players, with special reference to starters and non-starters

While several studies have documented the physiological and anthropometric characteristics of senior rugby league players, investigations of the physical qualities of junior rugby league players are limited. The purpose of this study was to investigate the physical qualities of junior rugby league players competing at the elite and sub-elite level, and determine if pre-season fitness measures were significantly different for the players selected to play in the first game of the season (i.e. starters) compared to the players not selected (i.e. non-starters). Thirty-six junior sub-elite and 28 junior elite rugby league players participated in this study. All sub-elite players were registered with the same junior recreational rugby league club, while elite players were members of a National Rugby League club junior development program. Subjects underwent measurements of anthropometry (height, body mass, and sum of seven skinfolds), speed (10m, 20m, and 40m sprint), change of direction speed (505 test), estimated lower body power (vertical jump), and estimated maximal aerobic power (multi-stage fitness test) at the beginning of the competitive season. Elite players had better developed speed, change of direction speed, vertical jump, and maximal aerobic power than sub-elite players. Elite starters were taller and heavier than non-starters, while sub-elite starters were taller and had greater change of direction speed than non-starters. A high estimated maximal aerobic power was a common discriminator between starters and non-starters for both elite and sub-elite competitors. These findings demonstrate that some physical qualities can discriminate starters and non-starters in elite and sub-elite junior rugby league teams.

Training injuries in New Zealand amateur rugby league players

This study investigated the incidence, site, nature and severity of training injuries in a New Zealand amateur rugby league team. The incidence of injuries was prospectively studied in a senior amateur rugby league club over one domestic season. All injuries sustained during training sessions were recorded. Injury data was collected from a total of 77 training sessions. Information recorded included the date, time, site, nature, cause and severity of injury. A total of 66 training injuries were recorded. The total injury incidence was 22.4 per 1000 training hours. Injuries resulting in missed training sessions were 16.9 per 1000 h. The most common injury site was the thigh for both overall injuries and injuries resulting in missed training weeks. The incidence of overexertion injuries peaked immediately prior to the commencement of the competitive season. The high rates of overexertion injuries suggest that an increase in intensity may contribute to training injuries in amateur rugby league players. An understanding of the demands of training, and the effects that injuries have on players is essential for the identification of injury prevention strategies.

An analysis of injury rates after the seasonal change in rugby league

OBJECTIVES

To determine whether the increase in the incidence of injury found for the first summer season in which rugby league (RL) was played in the UK was repeated in subsequent summer seasons.

DESIGN

A retrospective and prospective cohort study design.

SETTING AND PARTICIPANTS

Injuries were recorded from all players who took part in 141 games over 3 summer seasons (1997 to 1999) for 1 professional team. These were compared against rates from previously collected data for 3 earlier winter and 1 summer season.

ASSESSMENT OF RISK FACTORS

For each injury it was recorded in which season it occurred; how many games or training sessions, if any, were subsequently missed; the type, site and severity of injury.

MAIN OUTCOME MEASURES

Injuries were reported as rate per 1000 hours, also broken down into severity according to the number of games missed and whether subsequent training sessions were missed.

RESULTS

A sustained increase in injury incidence has been found comparing summer RL over RL played in the winter. There was an increase in injury rates for all sites and types, but not all reached significance.

CONCLUSIONS

Data collected over 6 seasons indicate a higher risk of sustaining an injury playing summer RL, but the cause may be related to a combination of factors. These may include the ground or weather conditions associated with summer rugby, player characteristics or changes in the game itself and future research needs to investigate these further.

Incidence of injuries in the New Zealand national rugby league sevens tournament

This study investigated the incidence, site, nature and causes of injuries sustained in the New Zealand national rugby league sevens tournament. A total of 218 players competing in 47 matches were studied. All injuries sustained within the tournament were prospectively recorded. Injuries were categorised according to the severity assessment at the time of the injury. Information obtained included the time, site, nature and cause of the injury. The incidence of injury was 497.6 per 1000 playing hours. More than 40% (216.1 per 1000) of injuries sustained occurred within the lower limbs. The shoulder was the single most commonly injured site (78.6 per 1000). Sprains were the most common injury type (189.9 per 1000). The ball-carrier sustained significantly more (p<0.05) injuries than the tackling player (216.1 per 1000 [43.4%] versus 117.8 per 1000 [23.7%]). There were significantly more injuries on the first day of competition than on the second day of competition (600.4 per 1000 [76.3%] versus 320.9 per 1000 [23.7%]). The findings of higher injury rates on the first day of competition and during the second period of matches suggest that playing intensity and player fatigue may contribute to injuries in rugby league sevens.

Injury in rugby league

It was the purpose of this review to document the range, incidence, location and mechanism of injury occurring in the sport of rugby league. Rugby league is a collision sport played in Europe and the Pacific regions including Australia. The sport is well established and has competitions ranging from junior to elite professional. Due to the contact nature of the game, injury is relatively common. The most common injuries are musculotendinous in nature and afflict the lower limb more frequently than elsewhere. Despite the high incidence of minor (sprains/strains) to moderate musculoskeletal injury (fracture, ligament and joint injury) and minor head injuries such as lacerations, nasal fractures and concussions, rare more serious spinal cord and other injuries causing death have also been recorded. The literature on rugby league injury is small but growing and suffers from a lack of consistent definition of what an injury is, thereby causing variability in the nature and incidence/prevalence of injury. Information is lacking on the injury profiles of different age groups. Importantly, there has been little attempt to establish a coordinated injury surveillance program in rugby league in the junior or professional levels. The implementation of such programs would require a universal definition of injury and a focus on important events and competitions. The implementation could provide important information in the identification and prevention of risk factors for injury.

Science of rugby league football: A review

The purpose of this paper is to provide a comprehensive review of the science of rugby league football at all levels of competition (i.e. junior, amateur, semi-professional, professional), with special reference to all discipline-specific scientific research performed in rugby league (i.e. physiological, psychological, injury epidemiology, strength and conditioning, performance analysis). Rugby league football is played at junior and senior levels in several countries worldwide. A rugby league team consists of 13 players (6 forwards and 7 backs). The game is played over two 30 - 40 min halves (depending on the standard of competition) separated by a 10 min rest interval. Several studies have documented the physiological capacities and injury rates of rugby league players. More recently, studies have investigated the physiological demands of competition. Interestingly, the physiological capacities of players, the incidence of injury and the physiological demands of competition all increase as the playing standard is increased. Mean blood lactate concentrations of 5.2, 7.2 and 9.1 mmol . l(-1) have been reported during competition for amateur, semi-professional and professional rugby league players respectively. Mean heart rates of 152 beats . min(-1) (78% of maximal heart rate), 166 beats . min(-1) (84% of maximal heart rate) and 172 beats . min(-1) (93% of maximal heart rate) have been recorded for amateur, semi-professional and junior elite rugby league players respectively. Skill-based conditioning games have been used to develop the skill and fitness of rugby league players, with mean heart rate and blood lactate responses during these activities almost identical to those obtained during competition. In addition, recent studies have shown that most training injuries are sustained in traditional conditioning activities that involve no skill component (i.e. running without the ball), whereas the incidence of injuries while participating in skill-based conditioning games is low. Collaborative research among the various sport science disciplines is required to identify strategies to reduce the incidence of injury and enhance the performance of rugby league players. An understanding of the movement patterns and physiological demands of different positions at all standards of competition would allow the development of strength and conditioning programmes to meet the precise requirements of these positions. Finally, studies investigating the impact of improvements in physiological capacities (including the effect of different strength and conditioning programmes) on rugby league playing performance are warranted.

Incidence of injury in junior and senior rugby league players

Rugby league is an international collision sport played at junior, amateur, semi-professional and professional levels. Due to the high numbers of physical collisions and tackles, musculoskeletal injuries are common. A large percentage of injuries result in long-term employment and study limitations, medical costs and loss of income. Review articles addressing the applied physiology of rugby league and common rugby league injuries have been published. However, both of these review articles have focused on the professional rugby league player. This review addresses the extent of the injury problem in rugby league in all levels of competition (i.e. junior, amateur, semi-professional and professional). The incidence of rugby league injuries typically increases as the playing level is increased. The majority of studies have shown that the head and neck is the most common site of match injuries in senior rugby league players, while knee injuries are the most common site of injury in junior rugby league players. Muscular injuries are the most common type of injury sustained by senior rugby league players, while junior rugby league players more commonly sustain fractures. Injuries are most commonly sustained in tackles, by the tackled player. Thigh and calf strains are the most common injuries sustained during rugby league training, while overexertion is the most common cause of training injuries. Player fatigue may influence the incidence of injury, with most sub-elite (amateur and semi-professional) rugby league injuries occurring in the second half of matches or the latter stages of training sessions. The majority of training injuries occur in the early stages of the season, while match injuries occur in the latter stages of the season, suggesting that changes in training and playing intensity may influence the incidence of injury in rugby league. Injury prevention studies are required to reduce the incidence, severity and cost of rugby league injuries. These injury prevention strategies could include coaching on defensive skills, correct tackling technique, correct falling technique and methods to minimise the absorption of impact forces in tackles. Game-specific attacking and defensive drills practised before and during fatigue may also encourage players to make appropriate decisions under fatigued conditions and apply learnt skills during the pressure of competitive matches. Further studies investigating risk factors for injury in junior and senior rugby league players, injuries sustained by specific playing positions and the influence of injuries on playing performance are warranted.

Influence of injuries on team playing performance in Rugby League

All injuries have the potential to impact on individual sporting performance and as a result may influence team playing performance. However, the influence of injuries on team playing performance is unclear. The purpose of this study was to investigate the influence of injuries on team playing performance in Rugby League. All injuries sustained by one semi-professional first grade Rugby League team were prospectively studied during the 2001 competitive season. An injury was defined as any pain or disability suffered by a player during a match. Team playing performance for each match was estimated from the metres gained while in possession of the football, points scored, points conceded, the final points differential and the completion rates of attacking sets of tackles. A total of 294 injuries were recorded. The average metres gained for all matches was 1471 (95% confidence interval, CI: 1383 to 1559) m. The team averaged 42 (95% CI: 32 to 51) points in attack each match and conceded an average of 15 (95% CI: 9 to 21) points in defence. The average completion rate for the season was 65.3 (95% CI: 60.6 to 70.0)%. There was no significant association (p>0.05) between the number of injuries sustained and team-playing performance. These findings suggest that injuries have minimal impact on team-playing performance in Rugby League. Further research on a larger sample (including winning and losing teams), is required to provide a detailed analysis of the influence of injuries on team playing performance in Rugby League.

Influence of training and match intensity on injuries in rugby league

The aim of this study was to examine the influence of perceived intensity, duration and load of matches and training on the incidence of injury in rugby league players. The incidence of injury was prospectively studied in 79 semi-professional rugby league players during the 2001 season. All injuries sustained during matches and training sessions were recorded. Training sessions were conducted from December to September, with matches played from February to September. The intensity of individual training sessions and matches was estimated using a modified rating of perceived exertion scale. Training load was calculated by multiplying the training intensity by the duration of the training session. The match load was calculated by multiplying the match intensity by the time each player participated in the match. Training load increased from December (278.3 [95% confidence interval, CI 262.2 to 294.5] units) to February (385.5 [95% CI 362.4 to 408.5] units), followed by a decline until September (98.4 [95% CI 76.5 to 120.4] units). Match load increased from February (204.0 [95% CI 186.2 to 221.8] units) to September (356.8 [95% CI 302.5 to 411.1] units). More training injuries were sustained in the first half of the season (first vs second: 69.2% vs 30.8%, P < 0.001), whereas match injuries occurred more frequently in the latter stages of the season (53.6% vs 46.4%, P < 0.001). A significant relationship (P < 0.05) was observed between changes in training injury incidence and changes in training intensity (r = 0.83), training duration (r = 0.79) and training load (r = 0.86). In addition, changes in the incidence of match injuries were significantly correlated (P < 0.05) with changes in match intensity (r = 0.74), match duration (r = 0.86) and match load (r = 0.86). These findings suggest that as the intensity, duration and load of rugby league training sessions and matches is increased, the incidence of injury is also increased.

Injury rates in rugby league football: impact of change in playing season

BACKGROUND

In 1996, the professional rugby league moved its playing season from the autumn and winter months to the spring and summer.

PURPOSE

To determine whether the change in playing season altered the risk of player injury.

STUDY DESIGN

Prospectively collected data comparing two cohorts.

METHODS

Injuries incurred by all players in one club during match play were recorded over 9 seasons: 4 winter (138 games) and 5 summer (144 games). Each injury was classified according to site, type, player position, activity at the time of injury, and number of games missed as a result of injury.

RESULTS

The total exposure time during this study was 4876 player-hours (winter, 2386, summer, 2490). The relative risk of injury doubled after the move from winter to summer. Winter rugby accounted for 72 injuries, and summer rugby, for 150 injuries.

CONCLUSIONS

Risk of injury to players in a professional rugby league club greatly increased as a result of changing the playing calendar, possibly as a result of environmental factors. However, other factors, such as increased conditioning levels, which have been a direct consequence of players moving to full-time professionalism, may have increased injury potential.

A pooled data analysis of injury incidence in rugby league football

OBJECTIVE

The aim of this study was to summarise the injury rates in professional rugby league football.

METHODS

Previously published studies were identified from database searches of the literature from Medline, Sports Discus and Web of Science. A total of 18 articles, which reported the prospective injury data collection for at least one playing season in professional rugby league worldwide, were included. The definition of injury adopted required an injured player to miss the subsequent game through injury. Ten studies satisfied the injury definition criteria for inclusion. A review of articles and extraction of relevant data were carried out independently by two authors.

RESULTS

A total of 517 injuries were reported during 12819 hours of exposure (753 games), which resulted in an overall injury rate of 40.3 injuries per 1000 hours [95% confidence interval (CI) 36.9 to 43.8]. Most injuries were to the lower half of the body (20.7 per 1000 hours, 95% CI 17.7 to 24), with the trunk receiving the least (6.7 per 1000 hours, 95% CI 5 to 8.6).

CONCLUSIONS

Injury rates in professional rugby league are higher than in some other contact sports, probably because of the large number of physical collisions that take place. This pooled data analysis provides more accurate estimates of injury incidence in the game of professional rugby league football.

Injury in summer rugby league football: the experiences of one club

OBJECTIVE

To investigate whether the movement of the playing season from winter to summer would alter the risk of injury to players taking part in first team European professional rugby league.

METHODS

The study design was a historical cohort design comparing winter and summer seasons in first team European rugby league, which recorded injuries received by players during match play. Each injury was classified according to site, type, player position, activity at the time of injury, and time off as a result of injury.

RESULTS

The risk of injury when playing summer rugby league was higher than when playing winter rugby league (relative risk = 1.67 (95% confidence interval 1.18 to 2.17)). Both forwards (1.08 (0.28 to 1.88)) and backs (2.36 (2.03 to 2.69)) experienced an increased risk of injury.

CONCLUSIONS

Summer rugby may have resulted in a shift of injury risk factors as exhibited by a change in injury patterns. This may be due to playing conditions, but there were also some law changes. Changes in playing style, team tactics, player equipment, fitness preparation, and the reduced preseason break may also have had confounding effects on injury risk.

Injury in rugby league: a four year prospective survey

OBJECTIVE

To investigate the incidence of injury in English professional rugby league over a period of four playing seasons.

METHODS

All injuries that were received by players during match play were recorded. Each injury was classified according to site, type, player position, team playing for, activity at the time of injury, and time off as a result of injury.

RESULTS

The overall injury rate was 114 (95% confidence interval 105 to 124) per 1000 playing hours, the most frequent type of injury were muscular injuries [34 (29 to 40) per 1000 playing hours], while the most frequently injured site was the head and neck region [38 (16 to 25) per 1000 playing hours]. Players received the largest percentage of injuries when being tackled [46.3% (41.9 to 50.7)], most injuries required less than one week away from playing and training [70.1% (66.1 to 74.2)], and forwards had a higher injury rate than backs (139 v 93 injuries per 1000 hours).

CONCLUSIONS

The high rates of injury in rugby league are undoubtedly due to the high amount of bodily contact in the game. Being tackled has the highest risk of injury, because of being hit forcibly by other players. Forwards suffer higher injury rates than backs, probably because they are involved in a larger number of physical collisions.