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Shoulder injuries are common in contact and collision sports, including ice hockey (15%), (8) rugby league (10%), (9) and Australian Rules football (8%). (20) In previous studies of professional rugby [...], Background: Shoulder injuries constitute a considerable risk to professional rugby union players; however, there is a shortage of detailed epidemiologic information about injuries in this population. Purpose: To describe the incidence, severity, and risk factors associated with shoulder injuries in professional rugby union. Study Design: Descriptive epidemiology study. Method: Medical personnel prospectively reported time-loss injuries in professional rugby union in England, and the shoulder injuries were evaluated. Results: The incidence of shoulder injuries was significantly lower during training (0.10/1000 player-training hours) compared with matches (8.9/1000 player-match hours). The most common match injury was acromioclavicular joint injury (32%); the most severe was shoulder dislocation and instability (mean severity, 81 days absent), which also caused the greatest proportion of absence (42%) and had the highest rate of recurrence (62%). The majority of match shoulder injuries were sustained in the tackle (65%), and outside backs were the most likely to sustain an injury from tackling (2.4/1000 player-tackles). Injuries sustained during training were significantly more severe (61 days) than were those sustained during match play (27 days), and defensive training sessions carried the highest risk of injury (0.45/1000 player-hours; mean severity, 67 days). A mean of 241 player-days per club per season were lost to shoulder injuries. Conclusion: Results suggest the potential to reduce this injury burden by modifying training activities and implementing 'pre-habilitation' strategies in an effort to minimize the risk of shoulder dislocation/instability. Keywords: risk factors; injury surveillance; shoulder dislocation/instability; acromioclavicular joint injuries

Objectives: The Professional Rugby Injury Surveillance Project is the largest and longest running rugby union injury surveillance project globally and focuses on the highest level of rugby in England.Methods: We examined match injuries in professional men's rugby over the period 2002/2003 to 2018/2019 and described trends in injuries over this time.Results: Over the period 2002/2003-2018/2019, 10 851 injuries occurred in 1 24 952 hours of match play, equating to a mean of 57 injuries per club per season and one injury per team per match. The mean incidence, severity (days absence) and burden (days absence/1000 hours) of injury were 87/1000 hours (95% CI 82 to 92), 25 days (95% CI 22 to 28) and 2178 days/1000 hours (95% CI 1872 to 2484), respectively. The tackle accounted for 43% injuries with running the second most common activity during injury (12%). The most common injury location was the head/face with an incidence of 11.3/1000 hours, while the location with the highest overall burden was the knee (11.1 days/1000 hours). Long-term trends demonstrated stable injury incidence and proportion of injured players, but an increase in the mean and median severity of injuries. Concussion incidence, severity and burden increased from the 2009/2010 season onwards and from 2011 to 2019 concussion was the most common injury.Conclusion: The rise in overall injury severity and concussion incidence are the most significant findings from this work and demonstrate the need for continued efforts to reduce concussion risk as well as a greater understanding of changes in injury severity over time. [ABSTRACT FROM AUTHOR]

Rugby union is a popular team sport that demands high levels of physical fitness and skill. The study aim was to examine trends in training volume and its impact on injury incidence, severity and burden over an 11-season period in English professional rugby. Data were recorded from 2007/08 through 2017/18, capturing 1,501,606 h of training exposure and 3,782 training injuries. Players completed, on average, 6 h 48 minutes of weekly training (95% CI: 6 h 30 mins to 7 h 6 mins): this value remained stable over the 11 seasons. The mean incidence of training-related injuries was 2.6/1000 player-hours (95% CI: 2.4 to 2.8) with a mean severity rising from 17 days in 2007/08 to 37 days in 2017/18 (Change/season = 1.773, P <0.01). Rate of change in severity was dependent on training type, with conditioning (non-gym-based) responsible for the greatest increase (2.4 days/injury/season). As a result of increasing severity, injury burden rose from 51 days absence/1000 player-hours in 2007/08 to 106 days' absence/1000 player-hours in 2017/18. Despite the low incidence of injury in training compared to match-play, training accounted for 34% of all injuries. Future assessments of training intensity may lead to a greater understanding of the rise in injury severity. [ABSTRACT FROM AUTHOR]

An eight-season (2005/06-2012/13) prospective cohort design was used to record time-loss injuries in 15 English Premiership teams. Data pertaining to a total of 1 556 players and 9 597 injuries (8 180 subsequent) were included in the analysis. Injuries subsequent to an index injury were classified as (1) New: different site; (2) Local: same site (and different type); or (3) Recurrent: same site and type. The severity of subsequent injuries (days missed) was compared with their related index injury. The proportions of early (< 2 months), late (2-12 months) and delayed (> 12 months) subsequent injuries were compared across injury classifications and diagnosis groupings. The majority of subsequent injuries (70 %) were classified as new injuries, with 14 % local and 16 % recurrent. A large proportion of recurrent subsequent injuries (42 %) occurred within two months of return-to-play. Subsequent injuries were not more severe than their corresponding index injury (effect sizes < 0.20). Specific local and recurrent subsequent injury diagnoses with the highest risk of occurring within two months of return-to-play were: 'neck muscle strain', 'ankle joint capsule sprain', and 'cervical nerve root' injuries. These findings may be used to drive targeted secondary prevention efforts, such as reconsideration of return-to-play protocols for neck muscle strain injuries. [ABSTRACT FROM AUTHOR]

A clash of values has been identified between those who assert that:1. all childhood injuries, regardless of origin, are inherently undesirable and should be prevented and;2. those who believe that some measure of injury to children is an acceptable compromise for the physical benefits associated with physical activity and the development of abilities to appraise and deal with risks.A debate regarding whether the tackles and collisions permitted in schools' rugby represent acceptable risks, and what steps should be taken if they do not, exemplifies the issue.Questions regarding the magnitude of injury risks in sport are issues of fact and can be quantified via the results of injury surveillance studies. Risks are neither high nor low in isolation; they are relatively high or low with reference to other activities or across groups participating in an activity. Issues of the acceptability of a given degree of risk are value dependent. Research regarding perceptions of risk reveals wide variations in the degree of risk people view as acceptable. Factors impacting on risk perception include whether the risks are well known and understood, whether they are 'dread' risks and the degree to which people undertake the risks voluntarily and feel they have control over them.Based on the evidence currently available, the risks to children playing rugby do not appear to be inordinately high compared with those in a range of other childhood sports and activities, but better comparative information is urgently needed. Further evidence, however, should not necessarily be expected to result in the resolution of acceptable risk debates-pre-existing values shape our perspectives on whether new evidence is relevant, valid and reliable. [ABSTRACT FROM AUTHOR]

Background: A negative association between injuries and team success has been demonstrated in professional football, but the nature of this association in elite Rugby Union teams is currently unclear.Aim: To assess the association between injury burden measures and team success outcomes within professional Rugby Union teams.Methods: A seven-season prospective cohort design was used to record all time-loss injuries incurred by English Premiership players. Associations between team success measures (league points tally and Eurorugby Club Ranking (ECR)) and injury measures (injury burden and injury days per team-match) were modelled, both within (changes from season to season) and between (differences averaged over all seasons) teams. Thresholds for the smallest worthwhile change in league points tally and ECR were 3 points and 2.6%, respectively.Results: Data from a total of 1462 players within 15 Premiership teams were included in the analysis. We found clear negative associations between injury measures and team success (70-100% likelihood), with the exception of between-team differences for injury days per team-match and ECR, which was unclear. A reduction in injury burden of 42 days (90% CI 30 to 70) per 1000 player hours (22% of mean injury burden) was associated with the smallest worthwhile change in league points tally.Conclusions: Clear negative associations were found between injury measures and team success, and moderate reductions in injury burden may have worthwhile effects on competition outcomes for professional Rugby Union teams. These findings may be useful when communicating the value of injury prevention initiatives within this elite sport setting. [ABSTRACT FROM AUTHOR]

The article focuses on injury trends among rugby union football players following the rise of professionalism in 1995 and changes to several of the game's rules. An overview of the history and development of this version of rugby is provided and the most prevalent types of injury are discussed. Various approaches to injury prevention are assessed.

Background: Foot injuries represent a small but important proportion of injuries to professional rugby union players. There are no detailed epidemiological studies regarding these injuries. The aim of this study was to describe the epidemiology of foot injuries sustained by a cohort of professional rugby union players and identify areas that may be targeted for injury prevention in the future., Methods: Medical personnel prospectively recorded injuries in professional Premiership rugby union players in England over four seasons. Injuries to the foot were identified and the time away from training and playing was reported., Results: A total of 147 foot injuries were sustained resulting in 3542 days of absence in total. Acute events accounted for 73% of all foot injuries, with chronic, mostly overuse conditions, accounting for 25% (undiagnosed 2%). Chronic conditions led to proportionately more time away from training and playing (p=<0.001). Specifically, stress fractures in the foot accounted for 8% of the total foot injuries but 22% of the absence. Navicular stress fractures had the longest recovery time with the mean return to training and match play of 188 days., Conclusion: In collision sports such as rugby, some injuries may be inevitable but clinicians should always be seeking ways to minimise their occurrence and impact. This study revealed a high proportion of morbidity associated with chronic and overuse foot injuries in these professional athletes. With greater attention paid to risk factors, some of these injuries, and importantly, recurrent injuries may be avoided., (Copyright © 2010 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Objective: To examine factors associated with tackles in rugby union and to assess their impact on the risk of injury., Design: Two-season (2003/2004 and 2005/2006) prospective cohort design with video analysis., Setting: 13 English Premiership clubs., Participants: 645 players., Main Outcome Measure: RR (95% CI) calculated by comparing the frequency of occurrence of risk factors in a cohort of players injured during tackles with their frequency of occurrence in tackles in general play., Risk Factors: Playing position; player's speed, impact force, head position, head/neck flexion and body region struck in the tackle; sequence, direction and type of tackle; and location and type of injury., Results: High-speed going into the tackle, high impact force, collisions and contact with a player's head/neck were identified as significant (p<0.01) risk factors for ball carriers (BCs) and tacklers. Midfield backs were significantly (p<0.01) more prone to injury when tackling than other players. Relatively few tacklers were penalised by referees for collision tackles (general play: 2.0%; injured players: 3.3%) and tackles above the line of the shoulder (general play: 5.9%; injured players: 16.7%)., Conclusions: Advice in national and international injury prevention programmes for reducing the risk of injury in tackles is strongly supported by the results obtained from this study. These programmes should be reviewed, however, to provide specific advice for each type of tackle. Stricter implementation of the Laws of Rugby relating to collisions and tackles above the line of the shoulder may reduce the number of head/neck injuries sustained by BCs.