Match and Training Load Exposure and Time-Loss Incidence in Elite Rugby Union Players

Relationship between the contact load and time-loss injuries in rugby union

Objective

Quantifying and managing the matches and training loads of players is important for injury prevention. As rugby union is a full-contact sport and frequent contact injuries occur, it might also be important to quantify and manage players' contact loads. This study aimed to clarify the relationship between contact load and injury incidence in elite rugby union players.

Methods

Forty-eight elite rugby union players (27.0 ± 3.5 years) in Japan were monitored during one season (8 months). The contact load, an index of training load, was evaluated as collision count and collision load measured using a global positioning system device, and then calculated using the acute:chronic workload ratio (ACWR) based on the exponentially weighted moving average (EWMA). The association between the EWMA-ACWR of contact load and injury incidence was analyzed using generalized estimating equations.

Results

Of the 58 injuries during one season, 70.7% were contact injuries. Collision counts and collision load calculated by EWMA-ACWR were associated with the risk of injury (p < 0.01 both), with the odds ratios were 4.20 [95% confidence interval (CI): 1.74-10.11] and 4.44 (95% CI: 1.95-10.13), respectively.

Conclusion

Contact load calculated using EWMA-ACWR was associated with injury in elite rugby union players.

Assessing pre-season workload variation in professional rugby union players by comparing three acute:Chronic workload ratio models based on playing positions

Quantifying the pre-season workload of professional Rugby Union players, in relation to their respective positions not only provides crucial insights into their physical demands and training needs but also underscores the significance of the acute:chronic workload ratio (ACWR) in assessing workload. However, given the diversity in ACWR calculation methods, their applicability requires further exploration. As a result, this study aims to analyze the workload depending on the player's positions and to compare three ACWR calculation methods. Fifty-seven players were categorized into five groups based on their playing positions: tight five (T5), third-row (3R), number nine (N9), center, and third line defense (3L). The coupled and uncoupled rolling averages (RA), as well as the exponentially weighted moving average ACWR method, were employed to compute measures derived from GPS data. Changes throughout the pre-season were assessed using the one-way and two-way analysis of variance. The results revealed that N9 covered significantly greater distances and exhibited higher player load compared to T5 and 3L [p < 0.05, effect size (ES) = 0.16-0.68]. Additionally, 3L players displayed the highest workload across various measures, including counts of accelerations and decelerations (>2.5 m s-2), accelerations (>2.5 m s-2), acceleration distance (>2 m s-2), high-speed running (>15 km h-1), very high-speed running (>21 km h-1, VSHR), sprint running (>25 km h-1, SR) distance. When using coupled RA ACWR method, centers exposed significantly greater values to T5 (p < 0.05, ES = 0.8) and 3R (p < 0.05, ES = 0.83). Moreover, centers exhibited greater (p < 0.05, ES = 0.67-0.91) uncoupled RA ACWR values for VHSR and SR than T5 and 3R. When comparing the three ACWR methods, although significant differences emerged in some specific cases, the ES were all small (0-0.56). In light of these findings, training should be customized to the characteristics of players in different playing positions and the three ACWR calculation methods can be considered as equally effective approaches.

Impact of Weekly Training-Load Structure and Content on the Risk of Injury in Professional Rugby Union Match-Play

ABSTRACT

Chéradame, J, Loursac, R, Piscione, J, Carling, C, Decq, P, and Jacqmin-Gadda, H. Impact of weekly training-load structure and content on the risk of injury in professional Rugby Union match-play. J Strength Cond Res 38(9): 1613-1619, 2024-The aim of this study was to investigate the impact of different components of daily training load during the week preceding the match on the risk of sustaining a match injury in professional rugby union. A cohort of 72 players from a single professional French club participated. Global positioning system-derived data including total distance (TD) and high-speed distance in addition to ratings of perceived effort (RPE) for both on- and off-pitch (gym-based strength conditioning work) training were collected for each training session over 3 seasons (2017-2020). The association between the daily measures of external and internal training load over the week preceding the day of the match (MD) and the subsequent risk of injury in match-play was estimated using a mixed-effects logistic model adjusted for contextual and individual factors. A total of 184 injuries were sustained in 128 matches (incidence: 81.2 injuries per 1,000 player hours). Higher RPE values for the strength conditioning session on MD-5 ( p < 0.001) and for the on-pitch session on MD-1 ( p = 0.04) were associated with an increased risk of injury in matches. On MD-2, a higher TD covered and that run at high speed (>MAS) were, respectively, associated with a higher ( p = 0.03) and lower risk ( p = 0.02) of injury in matches played. This study in professional rugby union shows that different components of external and internal load had varying influences on injury risk and particularly in relation to the day on which these were performed in the week leading up to the next match. At MD-2, training load favoring intensity rather than volume could reduce the risk of match-play injury.

Analyzing activity and injury risk in elite curling athletes: seven workload monitoring metrics from session-RPE

Objective

The study aimed to compare the differences in the performance of seven session-rating of perceived exertion (RPE)-derived metrics (coupled and uncoupled acute: chronic workload ratio (ACWR), weekly ratio of workload change, monotony, standard deviation of weekly workload change, exponentially weighted moving average (EWMA), and robust exponential decreasing index (REDI)) in classifying the performance of an injury prediction model after taking into account the time series (no latency, 5-day latency, and 10-day latency).

Design

The study documented the RPE of eight curlers in their daily training routine for 211 days prior to the Olympic Games.

Methods

Seven Session-RPE (sRPE)-derived metrics were used to build models at three time series nodes using logistic regression and multilayer perceptron. Receiver operating characteristic plots were plotted to evaluate the model's performance.

Results

Among the seven sRPE-derived metrics multilayer perceptron models, the model without time delay (same-day load corresponding to same-day injury) exhibited the highest average classification performance (86.5%, AUC = 0.773). EMWA and REDI demonstrated the best classification performance (84.4%, p < 0.001). Notably, EMWA achieved the highest classifying accuracy in the no-delay time series (90.0%, AUC = 0.899), followed by the weekly load change rate under the 5-day delay time series (88.9%, AUC = 0.841).

Conclusion

EWMA without delay is a more sensitive indicator for detecting injury risk.

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.

The effect of rugby training on indirect markers of gut permeability and gut damage in academy level rugby players

Purpose

To assess indirect markers of intestinal endothelial cell damage and permeability in academy rugby players in response to rugby training at the beginning and end of preseason.

Methods

Blood and urinary measures (intestinal fatty acid binding protein and lactulose:rhamnose) as measures of gastrointestinal cell damage and permeability were taken at rest and after a standardised collision-based rugby training session in 19 elite male academy rugby players (age: 20 ± 1 years, backs: 89.3 ± 8.4 kg; forwards: 111.8 ± 7.6 kg) at the start of preseason. A subsample (n = 5) repeated the protocol after six weeks of preseason training. Gastrointestinal symptoms (GIS; range of thirteen standard symptoms), aerobic capacity (30–15 intermittent fitness test), and strength (1 repetition maximum) were also measured.

Results

Following the rugby training session at the start of preseason, there was an increase (median; interquartile range) in intestinal fatty acid binding protein (2140; 1260–2730 to 3245; 1985–5143 pg/ml, p = 0.003) and lactulose:rhamnose (0.31; 0.26–0.34 to 0.97; 0.82–1.07, p < 0.001). After six weeks of preseason training players physical qualities improved, and the same trends in blood and urinary measures were observed within the subsample. Overall, the frequency and severity of GIS were low and not correlated to markers of endothelial damage.

Conclusions

Rugby training resulted in increased intestinal endothelial cell damage and permeability compared to rest. A similar magnitude of effect was observed after six weeks of pre-season training. This was not related to the experience of GIS.

The Use of Global Positioning and Accelerometer Systems in Age-Grade and Senior Rugby Union: A Systematic Review

Background

Global positioning systems (GPS) imbedded with accelerometer systems (AS) are used in rugby union (RU) to collect information on absolute and relative distances, distances in different speed zones, high-speed running (HSR) distances, repeated high-intensity efforts (RHIE) and collisions and impacts. This information can be used to monitor match play which can then be used to plan training sessions. The objective of this review was to conduct a systematic review of studies which have reported the use of GPS and AS.

Methods

A systematic review of the use of GPS and AS in both age-grade and senior rugby was conducted. The authors systematically searched electronic databases from January 2010 until March 2020. Keywords included rugby union, GPS, global position* and microtechnology.

Results

A total of 51 studies met the eligibility criteria and were included in this review. There was a total of 34 studies utilising GPS and AS in senior RU players (mean ± SD; age 26.2 ± 1.9 years; height 185.7 ± 2.6 cm; mass 101.3 ± 4.2 kg) and 17 studies in age-grade RU players (mean ± SD; age 17.6 ± 1.5 years; height 182.1 ± 3.3 cm; mass 87.1 ± 8.6 kg). The results of this review highlighted that there are differences between backs and forwards and within these positions in these groups during both match play and training sessions. The backs covered greater total absolute, relative and HSR distance compared to forwards. Forwards are involved in more collisions and impacts than backs. When investigating the most intense periods of match play, studies in this review highlighted that the demands during these periods outweigh the average demands of the game. It was proposed that a rolling average over different time epochs is the best way to assess this and ensure that the most intense periods of play are assessed and monitored.

Conclusions

The information highlighted in this review can be used to help coaches assess performances in match play, allow them to plan appropriate training sessions and monitor training load.

Is the Acute: Chronic Workload Ratio (ACWR) Associated with Risk of Time-Loss Injury in Professional Team Sports? A Systematic Review of Methodology, Variables and Injury Risk in Practical Situations

BACKGROUND

The acute: chronic workload ratio (ACWR) is an index of the acute workload relative to the cumulative chronic workloads. The monitoring of physical workloads using the ACWR has emerged and been hypothesized as a useful tool for coaches and athletes to optimize performance while aiming to reduce the risk of potentially preventable load-driven injuries.

OBJECTIVES

Our goal was to describe characteristics of the ACWR and investigate the association of the ACWR with the risk of time-loss injuries in adult elite team sport athletes.

DATA SOURCES

PubMed, EMBASE and grey literature databases; inception to May 2019.

ELIGIBILITY CRITERIA

Longitudinal studies that assess the relationship of the ACWR and time-loss injury risk in adult professional or elite team sports.

METHODS

We summarized the population characteristics, workload metrics and ACWR calculation methods. For each workload metric, we plotted the risk estimates for the ACWR in isolation, or when combined with chronic workloads. Methodological quality was assessed using a modified version of the Downs and Black scale.

RESULTS

Twenty studies comprising 2375 injuries from 1234 athletes (all males and mean age of 24 years) from different sports were included. Internal (65%) and external loads (70%) were collected in more than half of the studies and the session-rating of perceived exertion and total distance were the most commonly collected metrics. The ACWR was commonly calculated using the coupled method (95%), 1:4 weekly blocks (95%) and subsequent week injury lag (80%). There were 14 different binning methods with almost none of the studies using the same binning categories.

CONCLUSION

The majority of studies suggest that athletes are at greater risk of sustaining a time-loss injury when the ACWR is higher relative to a lower or moderate ACWR. The heterogenous methodological approaches not only reflect the wide range of sports studied and the differing demands of these activities, but also limit the strength of recommendations.

PROSPERO REGISTRATION NUMBER

CRD42017067585.

Workload a-WEAR-ness: Monitoring Workload in Team Sports With Wearable Technology. A Scoping Review

OBJECTIVES

To (1) identify the wearable devices and associated metrics used to monitor workload and assess injury risk, (2) describe the situations in which workload was monitored using wearable technology (including sports, purpose of the analysis, location and duration of monitoring, and athlete characteristics), and (3) evaluate the quality of evidence that workload monitoring can inform injury prevention.

DESIGN

Scoping review.

LITERATURE SEARCH

We searched the CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, HealthSTAR, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science databases.

STUDY SELECTION CRITERIA

We included all studies that used wearable devices (eg, heart rate monitor, inertial measurement units, global positioning system) to monitor athlete workload in a team sport setting.

DATA SYNTHESIS

We provided visualizations that represented the workload metrics reported, sensors used, sports investigated, athlete characteristics, and the duration of monitoring.

RESULTS

The 407 included studies focused on team ball sports (67% soccer, rugby, or Australian football), male athletes (81% of studies), elite or professional level of competition (74% of studies), and young adults (69% of studies included athletes aged between 20 and 28 years). Thirty-six studies of 7 sports investigated the association between workload measured with wearable devices and injury.

CONCLUSION

Distance-based metrics derived from global positioning system units were common for monitoring workload and are frequently used to assess injury risk. Workload monitoring studies have focused on specific populations (eg, elite male soccer players in Europe and elite male rugby and Australian football players in Oceania). Different injury definitions and reported workload metrics and poor study quality impeded conclusions regarding the relationship between workload and injury. J Orthop Sports Phys Ther 2020;50(10):549-563. doi:10.2519/jospt.2020.9753.

Training Load and Injury Among Middle School-Aged Athletes

CONTEXT

Young athletes are encouraged to participate in high-intensity sport programs. However, most research on the association between training volume (TV) and injury has been performed on adult or professional athletes.

OBJECTIVE

To evaluate the association between acute and chronic TV (hours/week) and reported injury (yes/no) and evaluate the relationship between acute : chronic TV and injury while controlling for sex, age, and prior injury in young athletes.

DESIGN

Cohort study.

SETTING

Online surveys.

PATIENTS OR OTHER PARTICIPANTS

Middle school-aged adolescents.

MAIN OUTCOME MEASURE(S)

We conducted a baseline survey at the start of the 2017-2018 academic year. The baseline survey solicited information regarding demographics, injury history, and primary sport. Subsequent surveys were delivered electronically at the start of each week. Information obtained with the weekly survey included weekly TV and injuries sustained the previous week. Injuries were reported and classified (eg, acute or gradual onset) by the participants. Weekly TV was aggregated as rolling averages over the prior 2, 3, and 4 weeks. Acute:chronic TV was calculated for each participant for every week as the prior week TV divided by the TV during the prior 2 (1 : 2), 3 (1 : 3), and 4 (1 : 4) weeks of the study period.

RESULTS

A total of 244 recruits participated. Higher average TV over the prior 4 weeks (odds ratio [OR] = 0.97; 95% confidence interval [CI] = 0.93, 1.00; P = .05) was associated with fewer reported injuries. Additionally, higher average TV over the prior 2 (OR = 0.96; 95% CI = 0.93, 0.99; P = .04), 3 (OR = 0.95; 95% CI = 0.91, 0.99; P = .02), and 4 (OR = 0.95; 95% CI = 0.91, 0.99; P = .05) weeks was associated with fewer reported acute injuries the following week. Acute:chronic TV and any injury type were not related.

CONCLUSIONS

Consistent, higher levels of physical activity may offer protection against acute injury in young athletes.

Does an Optimal Relationship Between Injury Risk and Workload Represented by the "Sweet Spot" Really Exist? An Example From Elite French Soccer Players and Pentathletes

Objective

To examine the relationships between the occurrence and severity of injuries using three workload ratios (ACWR, EWMA, REDI) in elite female soccer players and international male and female pentathletes.

Materials and Methods

Female soccer players in the U16 to U18 national French teams (n = 24) and international athletes (n = 12, 4 women and 8 men) in the French modern pentathlon team were monitored throughout an entire season. The Acute Chronic Workload Ratio (ACWR), the Exponentially Weighted Moving Averages (EWMA), and the Robust Exponential Decreasing Index (REDI) were calculated for internal load by the ROE method in soccer and external load in pentathlon. The occurrence and severity of injuries (determined according to time-loss) were quantified in the sweet spot zone [0.8; 1.3] and compared to the other zones of load variation: [0; 0.8], [1.3; 1.5], [1.5; +8], using the three ratios.

Results

Over the study period, a total of sixty-six injuries (2.75 per athlete) were reported in the soccer players and twelve in pentathletes (1 per athlete). The cumulative severity of all injuries was 788 days lost in soccer and 36 in pentathlon: respectively, 11.9 days lost per injury in soccer player and 3.0 per pentathlete. The mean values across the three methods in soccer showed a higher number of injuries detected in the [0; 0.8] workload ratio zone: 22.3 ± 6.4. They were 17.3 ± 3.5 in the sweet spot ([0.8-1.3] zone) and 17.6 ± 5.5 in the [1.5; +8] zone. In comparison to the [1.5; +8] zone, soccer players reported a higher number of days lost to injuries in the presumed sweet spot and in the [0-0.8] zone: 204.7 ± 28.7 and 275.0 ± 120.7 days, respectively. In pentathletes, ten of the twelve injuries (83.3%) occurred in the presumed sweet spot. REDI was the only method capable of tracking workloads over all-time series.

Conclusion

In the present cohort of elite soccer players and pentathletes, acute chronic workload calculations showed an association with injury occurrence and severity but did not provide evidence supporting existence of a sweet spot diminishing injury risk.

Understanding the association between external training load measures and injury risk in Elite Gaelic football

BACKGROUND

The current investigation examined the association between external training load variables and injury risk within elite Gaelic football.

METHODS

Workload and injury variables were collected from thirty-seven elite Gaelic footballers (mean±SD age of 24.2±2.9 years) from one elite squad across a two-season observational period. External training load variables included total distance (m), High speed running (m; ≥17.1 km·h^-1), Sprint distance (m; 22 km·h^-1), Accelerations (n), Average metabolic power (W·kg^-1), high-power distance (m; ≥25 W·kg^-1). Cumulative 1- weekly, 2-weekly, 3-weekly and 4-weekly training loads; acute: chronic workload ratio (ACWR) was analysed across specific distributions of low, moderate and high loading with respect to a reference group of the measure quantified. General estimating equations were utilized to understand the association of these variables with injury risk.

RESULTS

Strong associations (AUC>0.50) were observed amongst models developed for one weekly loading for relative distance, average metabolic power and high-power indices with similar trends observed for two, three and four weekly which showed a strong positive association within injury risk for all external loading metrics (AUC>0.50), with average metabolic power, and high-power distance showing the strongest association across the three-four week loading scales (AUC>0.60). When the ACWR was considered for external load measures these showed a positive linear association with injury risk (AUC>0.50). When intensity measures were considered relative distance showed an associated risk for injury across one and two-weekly models but not three and four weekly models. When odds risk association was considered a consistent trend towards moderate loading across external loading measures was apparent within the observed cohort.

CONCLUSIONS

The current investigation reports for the first time the injury association for external loading measures within elite Gaelic football. Data show that a range of measures are associated with increased or decreased injury risk depending on the loading scheme applied by coaches within elite Gaelic football.