Lay of the land: narrative synthesis of tackle research in rugby union and rugby sevens

Tackling the tackle 2: Evaluation of referee and player behavioural change as measures of implementation of a law variation in community-level male amateur rugby union

OBJECTIVES

To evaluate player and referee behaviour during a lower tackle height law variation trial in community rugby union ('rugby').

DESIGN

Prospective observational cohort study.

METHODS

In a law variation trial in male amateur community rugby, coded match video surveillance data were analysed. Referee (sanctioning rate) and player (tackler body position) behaviour changes over one season (under the lowered, armpit-level maximum legal tackle height condition) were analysed in three approximately equal periods of the season. Secondarily, an independent professional referee reviewed illegal high tackle sanctioning data.

RESULTS

Overall, 108 matches with 14,780 tackles were filmed and coded. Sanctioned illegal high tackle propensity was significantly higher in the mid-season (41 sanctioned high tackles/1000 tackle events; 95 % CI: 35-47), compared with first and last periods. Upright tacklers in tackles decreased significantly in the final vs. middle period of the season (rate ratio: 0.69; 95 % CI: 0.54-0.88; p < 0.01). Of all the coder-determined high tackles also assessed as high under the new law by the independent referee, 51 % were sanctioned by the on-field referee.

CONCLUSIONS

Positive player and referee behavioural changes were observed during a lowered legal tackle height law variation in this community rugby setting. Increased mid-phase high tackle sanctioning by referees was followed by fewer tackles with upright tacklers in the subsequent (last) phase of the season. Encouraging positive behaviour changes of this nature, particularly if sustained (beyond trial study periods), may contribute to overall injury risk reduction, and hold considerable importance to inform future injury prevention strategies in rugby.

Tackling the tackle 1: A descriptive analysis of 14,679 tackles and risk factors for high tackles in a community-level male amateur rugby union competition during a lowered tackle height law variation trial

OBJECTIVES

In rugby union (rugby), the tackle is the most frequent cause of concussion and thus a target for intervention to reduce concussion incidence. The aim of this study is to describe tackle characteristics and factors associated with illegal high tackles in amateur community-level rugby during a lowered (armpit level) tackle height law variation trial.

DESIGN

Prospective observational cohort study.

METHODS

Video surveillance of a single season, four-league competition with coding of video data according to a predefined coding framework. Descriptive statistics of tackle detail and logistic regression was performed to analyse factors associated with high tackles.

RESULTS

One hundred and eight matches with 14,679 tackles and a mean of 137 (±30) tackles per match were analysed. High tackles (above armpit level) had significantly greater odds of occurring in the lower (2nd-4th) leagues (OR: 1.95; 95 % CI: 1.6-2.4; p < 0.001), front-on tackles (OR: 1.61; 95 % CI: 1.3-2.0; p < 0.001), arm tackles (OR: 1.65; 95 % CI: 1.3-2.1; p < 0.001), bent-at-waist ball carrier (OR: 1.93; 95 % CI: 1.6-2.4; p < 0.001), falling/diving ball carrier (OR: 2.21; 95 % CI: 1.6-3.1; p < 0.001), and an upright tackler (OR: 3.38; 95 % CI: 2.7-4.2; p < 0.001). A falling/diving tackler had significantly lower odds of being associated with a high tackle (OR: 0.44; 95 % CI: 0.3-0.6; p < 0.001).

CONCLUSIONS

Overall mean tackles per match were similar to those of senior amateur and elite rugby. League, tackle type, tackle aspect, and player body positions were associated with high tackles. These findings reiterate the need for ongoing efforts to identify and implement mitigating strategies to reduce tackle-related injury risk.

'Body on the line': experiences of tackle injury in women's rugby union - a grounded theory study

OBJECTIVES

Tackle-related injuries account for up to 67% of all match injuries in women's rugby union. The perspective of women players on tackle injury can help key stakeholders understand psychosocial determinants of tackle injury risk and prevention. We aimed to capture psychosocial processes that explain tackle injury experiences and behaviours in women's rugby union.

METHODS

We conducted a qualitative study using a grounded theory approach. Adult women players, with at least 1-year senior level experience, were recruited from Europe, South Africa and Canada between December 2021 and March 2022. Data were collected through semistructured interviews and analysed in line with grounded theory coding procedures.

RESULTS

Twenty-one players, aged 20-48 years with a mean 10.6 years of rugby playing experience, participated. In our analysis, we identified three categories central to participants' experiences of tackle injury: (1) embodied understandings of tackle injury, (2) gender and tackle injury risk and (3) influences on tackle injury behaviours. Participants reported a sense of fear in their experience of tackling but felt that tackle injuries were an inevitable part of the game. Tackle injury was described based on performance limitations. Tackle injury risks and behaviours were influenced by gendered factors perpetuated by relations, practices and structures within the playing context of women's rugby union.

CONCLUSION

Women's tackle injury experiences were intertwined with the day-to-day realities of marginalisation and under preparedness. Grounded in the voices of women, we have provided recommendations for key stakeholders to support tackle injury prevention in women's rugby.

Mental Fatigue Impairs Tackling Technique in Amateur Rugby Union Players

PURPOSE

To test the effects of mental fatigue (MF) on tackling technique on the dominant and nondominant shoulders in rugby union.

METHODS

Twenty male amateur rugby union players and a total of 953 tackles were analyzed. A randomized crossover counterbalanced design was used across a non-MF (control) and an MF condition. During each condition, each player performed 24 tackles, divided into 4 sets of 6 tackles (3 tackles on each shoulder). In the MF condition, players performed the Stroop Task between each set of tackles. A video recording of each tackle was used to evaluate each player's technical proficiency. A score of 1 point was awarded if a specific technique was performed correctly, and 0 point was given if not. The total score, measured in arbitrary units (AU) out of 11, represents the player's overall tackling proficiency.

RESULTS

Overall, players displayed a significantly lower technical proficiency score in the MF condition compared to control (set 2: control 7.30 [7.04-7.57] AU vs MF 6.91 [6.70-7.12] AU, P = .009, effect size (ES) = 0.30 small and set 3: control 7.34 [7.11-7.57] AU vs MF 6.88 [6.66-7.11] AU, P = .002, ES = 0.37 small). For the nondominant shoulder, players had a significantly lower technical proficiency score during the MF condition at set 2 (control 7.05 [6.68-7.41] AU vs MF 6.69 [6.42-6.96] AU, P = .047, ES = 0.29 small) and set 3 (control 7.14 [6.83-7.45] AU vs MF 6.61 [6.35-6.87] AU, P = .007, ES = 0.49 small).

CONCLUSIONS

MF can diminish a player's overall tackling proficiency, especially when tackling on the nondominant shoulder. The physiological mechanism for this finding may be impaired executive function and suboptimal functioning of neural signals and pathways, which result in less skillful coordination of movement. To further understand and explain MF-induced physiological changes in tackling, the feasibility of monitoring brain activity (such as electroencephalogram) and neuromuscular function (such as electromyogram) needs to be investigated. The findings from this study may also contribute to the development of more effective tackle training programs for injury prevention and performance.

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.

Tackling sport-related concussion: effectiveness of lowering the maximum legal height of the tackle in amateur male rugby - a cross-sectional analytical study

OBJECTIVE

Rugby union ('rugby') is popular globally, with most of its participants being amateur. Concern regarding sport-related concussion (SRC) sustained during rugby is increasing. SRC occurs most frequently in the tackle, yet few interventions have aimed to mitigate this risk factor. This study investigated the influence of a lowered legal tackle height on SRC incidence in amateur rugby.

DESIGN

Cross-sectional analytical study: 2018 (control-standard tackle height) and 2019 (intervention-lowered legal tackle height) seasons.

SETTING

South African collegiate student rugby competition.

PARTICIPANTS

Between 800 and 900 male amateur student players (age: 20±1.6 years) in each year.

INTERVENTION

Maximum legal tackle height lowered from line of the shoulder on the ball carrier to the line of the armpit.

OUTCOME MEASURES

Number of overall (medical attention) and time-loss (≥1 day lost) injuries, head injuries and SRCs in 2018 and 2019 (dependent variables); events associated with injury incidents (independent variables).

RESULTS

There was no statistically significant difference in incidences of time-loss injuries (IRR: 0.79; 95% CI: 0.6 to 1.1; p=0.13), head injuries (IRR: 0.83; 95% CI: 0.5 to 1.3; p=0.42) and SRC (IRR: 0.69; 95% CI: 0.4 to 1.2; p=0.20). In 2018 and 2019, most time-loss head injuries (57%, n=43) and SRCs (55%, n=26) occurred during the tackle.

CONCLUSIONS

Despite a trend towards reducing injuries, head injuries and SRC, lowering maximum legal tackle height to armpit level did not change SRC incidence in this amateur male rugby cohort. Most time-loss head injuries and SRCs occurred during the tackle. Further tackle-related interventions to reduce SRC incidence require investigation.

Longitudinal study of six seasons of match injuries in elite female rugby union

ObjectiveTo establish match injury rates and patterns in elite female rugby union players in England.

METHOD

We conducted a six-season (2011/2012-2013/2014 and 2017/2018-2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used.

RESULTS

Five-hundred and thirty-four time-loss injuries were recorded during 13 680 hours of match exposure. Injury incidence was 39 injuries per 1000 hours (95% CIs 36 to 42) with a mean severity of 48 days (95% CIs 42 to 54) and median severity of 20 days (IQR: 7-57). Concussion was the most common specific injury diagnosis (five concussions per 1000 hours, 95% CIs 4 to 6). The tackle event was associated with the greatest burden of injury (615 days absence per 1000 hours 95% CIs 340 to 1112), with 'being tackled' specifically causing the most injuries (28% of all injuries) and concussions (22% of all concussions).

CONCLUSIONS

This is the first multiple-season study of match injuries in elite women's rugby union players. Match injury incidence was similar to that previously reported within international women's rugby union. Injury prevention strategies centred on the tackle would focus on high-burden injuries, which are associated with substantial player time-loss and financial costs to teams as well as the high-priority area of concussions.

Video-based technical feedback and instruction improves tackling technique of community rugby union players

The aims of this study were to test the change and retention of player's overall tackling technique and technical components following a player-specific video-based technical feedback and instruction intervention on both their dominant and non-dominant shoulders. Twenty-four (n = 24) rugby union players participated in a non-randomized control-intervention, which consisted of a video-based technical feedback and instruction group (video-based technical feedback) and a no video-based technical feedback and instruction group (control). During 3 sessions (baseline, intervention, retention) separated by one week, participants in each group performed six tackles (3 tackles on each shoulder) on a tackle simulator. In total, 432 tackles (video-based technical feedback = 216, control = 216) were analysed. Each tackle was analysed using a standardized list of technical criteria (arbitrary units, AU). For the dominant shoulder, tackling technique scores significantly improved from baseline to intervention for both groups. For the non-dominant shoulder, only the video-based technical feedback group improved their tackling technique from baseline to intervention (baseline 6.89 [6.33-7.45] AU vs. intervention 7.72 [7.35-8.10] AU p = .001, ES = 0.60 moderate). For the retention session, the video-based technical feedback group scored significantly higher than the control group, for dominant (video-based technical feedback 8.00 [7.60-8.40] AU vs. control 7.22 [6.83-7.62] AU p = .014, ES = 0.66 moderate) and non-dominant (video-based technical feedback 8.11 [7.81-8.41] AU vs. control 7.22 [6.90-7.55] p = .004, ES = 0.96 moderate) tackles. This study demonstrates the efficacy of video-based technical feedback as a method to optimize tackle training for player safety and performance. HIGHLIGHTSVideo-based technical feedback can improve tackling technique in both dominant and non-dominant shoulders.Video-based technical feedback group continued to improve following a retention interval of one week.The video-based technical feedback group showed a significant (with a moderate effect size) improvement from baseline for two techniques - namely, "body position - upright to low" and "drive through contact with legs and shoulders".Video-based technical feedback can be used as a method to optimize tackle training for injury prevention and performance.

Return to rugby following musculoskeletal injuries: A survey of views, practices and barriers among health and sport practitioners

STUDY DESIGN AND SETTING

Returning rugby players to the sport following musculoskeletal injuries is a multi-factorial and challenging process. A cross-sectional observational study was conducted among health and sport practitioners involved with injured rugby players in South Africa.

OBJECTIVES AND OUTCOME MEASURES

The views, current practices and barriers encountered by health and sport practitioners during return to rugby were investigated using a self-developed online survey.

RESULTS

64 practitioners participated in the survey including physiotherapists, orthopaedic surgeons, biokineticists and sports physicians. Return to sport (RTS) protocols were considered important, however, participants also indicated that they were slightly more likely to use anecdotal protocols compared to published protocols. Time frames, stages of healing, pain and subjective ratings along with functional outcome measures (such as range of motion, muscle function and proprioception) and sport-specific skills were rated as important and commonly utilised in different RTS phases (i.e., return to non-contact, return to contact and return to matches). The most commonly perceived barriers encountered were related to lack of access and time-constraints.

CONCLUSION

Return to rugby guidelines with consideration of a broad range of criteria and common barriers encountered should be developed to facilitate safe, practical and time-efficient return to rugby following musculoskeletal injuries.

A novel application of entropy analysis for assessing changes in movement variability during cumulative tackles in young elite rugby league players

The aim of this study was to identify between-position (forwards vs. backs) differences in movement variability in cumulative tackle events training during both attacking and defensive roles. Eleven elite adolescent male rugby league players volunteered to participate in this study (mean ± SD, age; 18.5 ± 0.5 years, height; 179.5 ± 5.0 cm, body mass; 88.3 ± 13.0 kg). Participants performed a drill encompassing four blocks of six tackling (i.e. tackling an opponent) and six tackled (i.e. being tackled by an opponent while carrying a ball) events (i.e. 48 total tackles) while wearing a micro-technological inertial measurement unit (WIMU, Realtrack Systems, Spain). The acceleration data were used to calculate sample entropy (SampEn) to analyse the movement variability during tackles performance. In tackling actions SampEn showed significant between-position differences in block 1 (p = 0.0001) and block 2 (p = 0.0003). Significant between-block differences were observed in backs (block 1 vs 3, p = 0,0021; and block 1 vs 4, p = 0,0001) but not in forwards. When being tackled, SampEn showed significant between-position differences in block 1 (p = 0.0007) and block 3 (p = 0.0118). Significant between-block differences were only observed for backs in block 1 vs 4 (p = 0,0025). Movement variability shows a progressive reduction with cumulative tackle events, especially in backs and when in the defensive role (tackling). Forwards present lower movement variability values in all blocks, particularly in the first block, both in the attacking and defensive role. Entropy measures can be used by practitioners as an alternative tool to analyse the temporal structure of variability of tackle actions and quantify the load of these actions according to playing position.

Tackle Technique and Changes in Playerload™ During a Simulated Tackle: An Exploratory Study

In collision sports, the tackle has the highest injury incidence, and is key to a successful performance. Although the contact load of players has been measured using microtechnology, this has not been related to tackle technique. The aim of this study was to explore how PlayerLoad™ changes between different levels of tackling technique during a simulated tackle. Nineteen rugby union players performed twelve tackles on a tackle contact simulator (n = 228 tackles). Each tackle was recorded with a video-camera and each player wore a Catapult OptimEyeS5. Tackles were analysed using tackler proficiency criteria and split into three categories: Low scoring(≤5 Arbitrary units (AU), medium scoring(6 and 7AU) and high scoring tackles(≥8AU). High scoring tackles recorded a higher PlayerLoad™ at tackle completion. The PlayerLoad™ trace was also less variable in the high scoring tackles. The variability in the PlayerLoad™ trace may be a consequence of players not shortening their steps before contact. This reduced their ability to control their movement during the contact and post-contact phase of the tackle and increased the variability. Using the PlayerLoad™ trace in conjunction with subjective technique assessments offers coaches and practitioners insight into the physical-technical relationship of each tackle to optimise tackle skill training and match preparation.

Development of a Novel Coaching Platform to Improve Tackle Technique in Youth Rugby Players: A Proof of Concept

Rugby union is a field sport that is played at amateur and professional levels by male and female players globally. One of the most prevalent injury risks associated with the sport involves tackle collisions with opposition players. This suggests that a targeted injury reduction strategy could focus on the tackle area in the game. In amateur rugby union, injuries to the head, face and shoulder are the most common injury sites in youth rugby playing populations. A suboptimal tackle technique may contribute to an increased injury risk in these populations. One proposed mitigation strategy to reduce tackle-related injuries in youth populations may be to increase tackle proficiency by coaching an effective tackle technique. The present study aimed to demonstrate a proof of concept for a tackle technique coaching platform using inertial measurement units (IMUs) and a bespoke mobile application developed for a mobile device (i.e., a mobile phone). The test battery provided a proof of concept for the primary objective of modelling the motion of a player in a tackle event. The prototype (bespoke mobile application) modelled the IMU in a 3D space and demonstrated the orientation during a tackle event. The participants simulated ten tackle events that were ten degrees above and ten degrees below the zero degree of approach, and these (unsafe tackles) were indicated by a red light on the mobile display unit. The parameters of ten degrees above and below the zero angle of approach were measured using an inclinometer mobile application. These tackle event simulations provided a real-time stream of data that displayed the angle of tackles on a mobile device. The novel coaching platform could therefore constitute part of an injury reduction strategy for amateur or novice coaches to instruct safer tackle practice in youth rugby playing populations.

A game for all shapes and sizes? Changes in anthropometric and performance measures of elite professional rugby union players 1999–2018

Background

Rugby union player size has increased since the game turned professional in 1995. Changes in physical and performance capability over this period have yet to be fully described.

Hypothesis

Increases in player momentum would result from changes in body mass.

Methods

Within-player rates of change in anthropometric and kinetic variables with season played were sampled in three successively studied professional rugby union club cohorts playing at the highest level of European competition between 1999 and 2019. Data comprised 910 seasons of observation for 291 elite male players. Most players had 2, 3 or 4 seasons of observation. Mixed-effects modelling distinguished changes independent of position played, club and international status.

Results

With each season played, player body mass, fat-free mass and maximum speed increased significantly, while per cent fat decreased. The mean maximal velocity of a rugby player in 1999 was 8.2 (±0.18) m/s, which in 2019 had risen to 9.1 (±0.10) m/s. Player’s momentum in 2019 was 14% more than those playing in 1999. In the Front Five, momentum increased in this period by >25%, mainly driven by greater running speed, disproving our hypothesis.

Conclusions

The momentum of players, particularly forwards, increased markedly over 20 seasons of professional rugby. The resulting forces generated in collisions are thus significantly greater, although these may be mitigated by better player conditioning. Proactive regulation to address player safety may be required to address the changing nature of anthropometric measures and physical performance, minimising injury rates and potential long-term sequelae.

Poor isometric neck extension strength as a risk factor for concussion in male professional Rugby Union players

BACKGROUND

Concussion is one of the highest burden injuries within professional Rugby Union ('rugby') and comes with a high health and financial cost to players and teams. Limited evidence exists as to the existence of modifiable intrinsic risk factors for concussion, leaving athletes and clinicians with few options when developing prevention strategies.

OBJECTIVE

To investigate whether neck strength is significantly associated with concussion incidence in professional male rugby players.

METHODS

225 rugby players were assessed for neck strength at three time points throughout the 2018/2019 season using a method of isometric contraction. Associations with clinically diagnosed concussion injuries are presented as incidence rate ratios (IRRs) with 95% CIs.

RESULTS

Thirty concussions occurred in 29 players during the study period; a rate of 13.7 concussions per 1000 hours played. Greater neck strength was observed at mid and end of season time points versus preseason across the study population. There was a significant association between extension strength and concussion; a 10% increase for extension strength was associated with a 13% reduction in concussion rate (adjusted IRR (95% CI) 0.87 (0.78 to 0.98). No other significant associations were observed between concussion incidence and any other unique neck strength range or composite score.

CONCLUSION

Higher neck extension strength is associated with lower concussion rates in male rugby players. Neck strength is a modifiable intrinsic risk factor for concussion and may be an important component of a strength and conditioning regime.

The role of player mass and contact speed on head kinematics and neck dynamics in rugby union tackling

Tackling is the most common cause of general injuries in rugby union, with player speed and mass identified as risk factors. This study aimed to use multibody modeling simulations to examine how tackler and ball carrier mass and contact speed affect inertial head kinematics and neck dynamics. Simulations were run by independently varying the ball carrier and tackler mass (from 60 to 110kg) and speed (from 0 to 10 m/s). Peak resultant inertial neck dynamics (force and moment) and head kinematics (linear acceleration, angular acceleration, and angular velocity) were extracted from each simulation. The greatest inertial head kinematics and neck dynamics sustained by a player was when there was the greatest mass disparity in the tackle, with the lighter player experiencing greatest inertial neck dynamics and head kinematics by up to 24% in comparison with the scenario when both players were the lightest mass (60 kg). As a player's mass increased, the magnitude of their head kinematics and neck dynamics diminished, but increased for their direct opponent, irrespective of whether they were the tackler or ball carrier. For speed, the greatest inertial head kinematics and neck dynamics sustained by the ball carrier and tackler were when they were both traveling at the highest speed. In theory, large discrepancies in mass of players, and high speeds into a tackle should be avoided.

Trends in match concussion incidence and return-to-play time in male professional Rugby Union: A 16-season prospective cohort study

AIM

To describe trends in the incidence of match concussions and time to return-to-play in professional rugby union.

METHODS

Match concussion incidence (injuries per 1000 player-match-hours) and time to return-to-play (mean and median days absence) were recorded in 3006 male professional rugby union players over 16 seasons (2002/03 - 2018/19).

RESULTS

From 2002/03 to 2009/10, incidence of concussions was stable at 4.3/1000 player-match-hours. From 2009/10 to 2018/19, there was an increase in concussion incidence, with the highest incidence in 2016/17 at 20.9/1000 player-match-hours (95% CI: 17.9-24.3). Annual prevalence of concussion also increased, suggesting more players were concussed rather than the same players sustaining more concussions. Before the introduction of standardized graduated return-to-play (GRTP) guidelines in 2011, 27% of players returned to play in <6 days. After the introduction of the GRTP, this decreased to 7%, with no players returning in <6 days after 2014/15. Between 2002/03 and 2018/19, incidence of all other injuries remained stable.

CONCLUSIONS

From 2009/10 onwards, the incidence of diagnosed concussions increased. Since the introduction of the GRTP, there has been a dramatic reduction in the number of players returning in <6 days.

Return to play protocols for musculoskeletal upper and lower limb injuries in tackle-collision team sports: A systematic review

Athletes in tackle-collision teams are at high risk of musculoskeletal injuries resulting in absence from play due to the high impact nature of the sport. There is a paucity of research to guide the management and assessment methods needed to facilitate the return to play (RTP) process. This review aimed to describe, synthesise and evaluate RTP protocols implemented for musculoskeletal injuries in tackle-collision teams. A systematic search of Scopus, PubMed, Web of Science and Ebsco Host was conducted for RTP management protocols and assessment modalities following upper and lower limb musculoskeletal injuries in tackle-collision team athletes. Prospective and retrospective quantitative controlled trials, cohort, case-control, case-series and cross-sectional observation studies published between January 2000 and March 2020 were considered. The main outcome measures were the proportion of athletes to RTP, associated time-loss and reinjury risk. 5265 articles were screened. 34 studies met the eligibility criteria of which 23 involved management and 11 assessment modalities. Management involved surgical or conservative strategies along with exercise-based rehabilitation. Assessment modalities included radiographic assessment, clinical evaluation and subjective ratings. Promising RTP management included progressive weight-bearing and exercised-based rehabilitation for ankle sprains as well as surgery, the use of a sling and exercise-based rehabilitation for shoulder instability. MRI scans showed promise in predicting time-loss following hamstring and calf strains in tackle-collision athletes. There are currently no clear guidelines for RTP after musculoskeletal injuries in tackle-collision sports. Future research should investigate efficient management strategies evaluated through valid and reliable assessment methods to better guide clinicians.

Tackler and ball-carrier technique during moderate and severe injuries (≥8 days lost) compared with player-matched and team-matched injury-free controls in Elite Rugby Union

OBJECTIVE

To analyse tackler and ball-carrier technical proficiency during moderate and severe contact injuries (≥8 days lost) in professional rugby union, and compare it with injury-free event-matched controls from the same player and from the same team.

METHODS

Technical proficiency for 74 (n=74) (moderate and severe; ≥8 days lost) tackler and ball-carrier injuries during The Currie Cup (2014-2018) and 623 matched non-injury events (253 own controls, 370 team controls) were examined through video analysis using a standardised list of technical criteria.

RESULTS

Mean technical proficiency score for injured tacklers during front-on tackles was 6.19/16 (arbitrary units (AU) 95% CI 4.89 to 7.48), which was significantly different to their own controls (8.90/16 AU, 95% CI 8.37 to 9.43, p<0.001, effect size (ES)=1.21, large) and team controls (9.93/16 AU, 95% CI 9.50 to 10.40, p<0.001, ES=1.71, large). Mean technical proficiency score for injured ball-carriers during front-on tackles was 5.60/14 AU (95% CI 4.65 to 6.55), which was significantly different to their own controls (8.08/14 AU, 95% CI 7.56 to 8.60, p<0.001, ES=1.16, moderate) and team controls (8.16/14 AU, 95% CI 7.75 to 8.57, p<0.001, ES=1.25, large).

CONCLUSION

For the tackler and ball-carrier, for both front-on and side-on/behind tackles, overall technical proficiency scores were significantly lower for the injury-causing event, when compared with the player's own injury-free tackles and the team's injury-free tackles. Through analysing player and team controls, player technique deficiencies for the injured player and player technique deficiencies that expose all players to injury were highlighted, which may inform injury prevention strategies and policies, and assist coaches in optimising training to reduce tackle injury risk.

Tackle injury epidemiology and performance in rugby league - narrative synthesis

Background

In rugby league (RL), the ability to repeatedly engage in the tackle, whether as a ball carrier or tackler, is essential for team success and player performance. It is also the leading cause of injury, with over 90% of total injuries occurring during the tackle in professional and amateur cohorts. To effectively reduce the risk of injury and optimise performance, establishing the extent of the 'problem', through injury surveillance or descriptive performance studies is required.

Objective

The purpose of this narrative synthesis was to systematically search and synthesise tackle injury epidemiology and tackle performance frequency in RL. To achieve this objective, a systematic review was conducted.

Methods

The search was limited to English-only articles published between January 1995 and October 2018. Based on the search criteria, a total of 53 studies were found: 32 focused on tackle injury epidemiology (nine cases studies) and 21 focused on tackle frequency.

Results

In general, over 600 tackles may occur during an RL match. Tackle injury frequencies (both overall and time-loss injuries) ranged between 47%-94% at the professional level, and between 38%-96% for the lower levels of play. A greater proportion of injuries occurring in professional RL are severe time-loss injuries when compared to lower levels of play. Most time-loss and overall injuries occur to players who are tackled, i.e., ball carriers, across all levels of play.

Conclusion

This narrative synthesis will facilitate tackle injury prevention and performance research in RL, and act as a reference document for coaches and practitioners.

Training injury incidence in an amateur women's rugby union team in New Zealand over two consecutive seasons

OBJECTIVES

To describe the training injury incidence in amateur women's rugby union in New Zealand over two consecutive seasons.

DESIGN

A prospective cohort observational study METHODS: A total of 69 amateur women's rugby 15s team playerswere observed. Training exposure and training injury incidence were calculated.

RESULTS

The 38 training injuries resulted in a total injury incidence of 11.4 (8.3-15.6) per 1,000 training-hours. There were 12 injuries that resulted in a time-loss injury incidence of 3.6 (95% CI: 2.0-6.3) per 1,000 training-hours. Forwards recorded more total (RR: 1.8 [95% CI: 0.9-3.5]; p=0.0516) and time-loss (RR: 2.0 [95% CI: 0.6-6.6]; p=0.2482) injuries than Backs. The tackle was the most common injury cause for total (3.0 [95% CI: 1.6-5.6] per 1,000 training-hours.) injuries, but collisions (1.5 [95% CI: 0.6-3.6] per 1,000 training-hours.) with the ground or another person were the most common cause for time-loss injuries.The training injuries occurred most often to the lower limb and during the latter part of training sessions. These injuries were mostly minor in nature resulting in minimal time-loss away from training.

DISCUSSION

The time-loss injury incidence (3.6 per 1,000 training-hours.) for the amateur women's rugby 15s team players was higher than that reported for National (1.2 per 1,000 training-hours.) and Rugby World Cup for women (0.2 to 3.0 per 1,000 training-hours.) competitions.

CONCLUSION

The training injury incidence in amateur women's rugby union in New Zealand was higher than that reported for national and international rugby union injury incidences.