Normative values for internal and external glenohumeral rotation strength in rugby players: A systematic review with meta-analysis

This systematic review aims to provide normative values for internal and external glenohumeral rotation strength in rugby players. From the inception to March 2021, the search strategy was (strength OR torque) AND shoulder AND rugby using PubMed, Scopus, Web of Science, and SPORTDiscus databases, with no language restrictions. This systematic review includes 15 articles involving 573 rugby players and presenting internal or external glenohumeral rotation strength values. Two main methods are used to assess glenohumeral rotation strength in rugby players: isokinetic and isometric methods; in the isometric method, the upper arm is abducted at either 0° or 90°. Owing to differences in isokinetic procedures and a lack of studies assessing isometric strength when the upper arm is in a neutral position, normative internal or external glenohumeral rotation strength values are only provided for isometric contractions when the upper arm is abducted at 90° based on 311 shoulders of 163 male rugby union players, with 2.04 ± 0.15 N.kg-1 and 2.11 ± 0.13 N.kg-1 for internal and external glenohumeral rotation strength, respectively. These findings may help strength and conditioning coaches and physical therapists, provide objective evidence when deciding whether or not rugby union players should return to sport.

Tobacco-related risk behaviors among amateur rugby players, coaches and referees: targets for prevention

Background

High prevalence of smoking has been documented in France and new patterns of tobacco and nicotine consumption are emerging, especially in some sports. In amateur rugby population, such attitudes could be harmful, but data are scarce as well as their knowledge of the risk.

Purpose

We analyzed tobacco consumption in French amateur players, coaches and referees.

Methods

Each amateur players [>12-y/o], coaches and referees licensed in the French Rugby Federation and participating in the Burgundy amateur championship was invited to answer to an electronic anonymous questionnaire during the 2017–2018 sport season.

Results

683 [sex ratio M/F = 0.9] answers were obtained and fit for analysis. Among them, 559 (81.8%) were players, 167 (24,5%) were coaches and 74 (10.8%) were referees. 176 subjects (25.8%) were current smokers, 126 (18.4%) daily smokers, 54 (37% of usual smokers) smoked more than 10 cigarettes a day and 97 (14.2%) were ex-smokers. Moreover, 24 referees (32.4%) and 47 coaches (28.2%) were current smokers. Most smoked 2 hours before or after a rugby session (86.4% of smokers), including coaches (89.4%) and referees (89%). Although 109 smokers (61.9%) considered quitting, only 27 (24.8%) considered vaping to aid them. Only 28 subjects (4.1%) usually vaped, of whom 15 daily (1.9%); 21 of them (75%) vaped in the 2 hours before or after a rugby session. Number of cigarettes in the 19 dual users was not different compared with non-vaping smokers. Among the 28 vapers, motivation to vape included lower risk than smoking (13), consider to quit (12), cheaper than smoking (8), festive and socializing (6), avoid to smoke (3), respect the performance (2). Other tobacco or nicotine products were infrequent: waterpipe (7), dry snuff (1) and none used snus. The knowledge about risk was incomplete: 35 (5.1%) subjects do not know that smoking is dangerous for their health and 12 (1.8%) think it is not. 246 (36%) and 195 (28.6%) do not know if smoking is more dangerous in the 2 hours before or after sport; 45 (6.6%) and 18 (2.6%) think it is not. Moreover, 27.5% of coaches were unaware on the risk of smoking before a sport session and 19.2% on the risk after. 244 subjects (35.7%) do not know if vaping is less dangerous than smoking; 272 (39.8%) are not informed of the potential risk of nicotine when vaping.

Conclusion

Despite information, prevalence of smoking remains high in the French amateur rugby players, coaches and referees. Smokers usually smoke in the 2 hours before or after the sport session. This is dangerous for them and for their peers. The low knowledge about the CV risk is of great concern, especially when considering the coaches and referees considering both their symbolic position and their educational role. Vaping and other patterns of nicotine exposure are infrequent; none of them use snus. Targeted education programs are urgently needed to reduce acute and chronic risk of tobacco consumption in this population.

Funding Acknowledgement

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): CHU Dijon Bourgogne ARS Bourgogne Franche Comté

Impact of the national prevention policy and scrum law changes on the incidence of rugby-related catastrophic cervical spine injuries in French Rugby Union

BACKGROUND AND AIMS

Catastrophic cervical spine injuries are rare in rugby union but require close monitoring. The aim of this study was to analyse the incidence of severe cervical spine injuries and determine the impact of a national prevention programme and new scrum rules implemented by the French Rugby Union.

METHODS

A prospective study was performed between 2006 and 2013 including all players affiliated to the French Rugby Union. All cervical spine injuries resulting in death, tetraplegia or a permanent neurological deficit were included. Prevention programmes were implemented from 2007 to 2013 and a change in scrum rules in 2010. To measure the impact of rule changes, results between 2006-2010 and 2010-2013 were compared using a Poisson regression.

RESULTS

Altogether, 31 injuries were observed and the mean annual incidence was 1.6 per 100 000 players. There were significantly more injuries in senior players compared to junior players (3.5 vs 0.6 per 100 000 players; CI 95% (2.1 to 4.9) vs (0.1 to 1.0)). Incidence decreased from 1.8 in 2006 to 1.0 per 100 000 players in 2013 (p<0.0001). After 2010, there were significantly fewer injuries during scrums (p=0.02). In contrast, there were significantly more injuries in backs during 2010-2013 compared to 2006-2010 (p=0.003).

CONCLUSIONS

The incidence of catastrophic cervical spine injuries has declined in French Rugby Union. The implementation of specific prevention programmes and scrum law changes has notably resulted in a decrease in scrum injuries in forwards. This prospective study should be continued to monitor the future progression of injuries and adapt prevention programmes accordingly.