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Walton H, Gornall H, Shill IJ, Turner AP, Graham N, Paul L, Hendricks S, Tucker R, Palmer D. Lowering the maximum legal tackle height in Scottish community women's rugby: an injury surveillance and video analysis study across two seasons. BMJ Open Sport Exerc Med 2025; 11:e002499. [PMID: 40357055 PMCID: PMC12067820 DOI: 10.1136/bmjsem-2025-002499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Accepted: 04/16/2025] [Indexed: 05/15/2025] Open
Abstract
Objectives The tackle carries the highest risk of concussion in women's rugby union. To reduce concussion risk, a lowered maximum tackle height (LTH) law, lowering the maximum legal tackle height from the shoulder to below the base of the sternum, was implemented across Scottish community rugby. This study aimed to assess the effect of the LTH on player head-contact events, proximity (location nearest the head (~30 cm)) and concussion incidence in Scottish women's community rugby. Methods A retrospective video analysis study, alongside prospective injury data collection, compared differences in game metrics, tackle characteristics and time-loss injury (including concussion) between the pre-LTH (2022/2023) and LTH (2023/2024) seasons. Results Head-to-head and head-to-shoulder proximity to the opponent for the tackler (head: rate ratio (RR):0.71 (95% CI 0.62 to 0.82), shoulder: RR:0.73 (95% CI 0.65 to 0.83)), and ball-carrier (head: RR:0.67 (95% CI 0.58 to 0.77), shoulder: RR:0.68 (95% CI 0.58 to 0.79)) were lower in the LTH season. Head contact to the opponent's shoulder decreased for the tackler (RR: 0.65 (95% CI 0.46 to 0.91)) and ball-carrier (RR: 0.52 (95% CI 0.35 to 0.78)). Tackler body position was lower (upright: RR:0.79 (95% CI 0.75 to 0.83), bent at waist: RR:1.34 (95% CI 1.25 to 1.42)), reducing red-zone (above the base of the sternum) contacts (RR:0.81 (95% CI 0.76 to 0.85)). Although non-significant, tackler concussion rates dropped (IR: 2.83 to 0.52/1000 player match hours; RR: 0.18 (95% CI 0.004 to 1.52)), while ball-carrier concussion rates increased (IR: 1.89 to 4.70/1000 player match hours; RR: 2.49 (95%CI 0.69 to 11.06)). Conclusion Lowering the maximum tackle height to below the base of the sternum showed a reduction in red-zone contacts, head-to-head proximity and head-to-shoulder contact for the tackler and ball-carrier. There were no significant differences in concussion rates in the present study, and the limitations surrounding the small sample of injuries highlight the need for further research on the effect of injury prevention initiatives in women's rugby.
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Affiliation(s)
- Hannah Walton
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
| | - Hamish Gornall
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
| | - Isla J Shill
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
| | - Anthony P Turner
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
| | | | - Lara Paul
- Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Sharief Hendricks
- Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Carnegie Applied Rugby Research (CARR), Leeds Beckett University Carnegie School of Sport, Leeds, UK
| | - Ross Tucker
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
- World Rugby Limited, Dublin, Ireland
| | - Debbie Palmer
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
- Edinburgh Sports Medicine Research Network, The University of Edinburgh Moray House School of Education, Edinburgh, UK
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Owen C, Roe G, Tooby J, Sawczuk T, Brown J, Cross M, Falvey É, Hendricks S, Kemp S, Starling L, Stokes K, Tucker R, Jones B. Evaluating the Probability of Head Acceleration Events in Elite Men's and Women's Rugby Union Match-Play: The Impact of Tackle Height and Body Position. Sports Med 2025:10.1007/s40279-025-02241-2. [PMID: 40335879 DOI: 10.1007/s40279-025-02241-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2025] [Indexed: 05/09/2025]
Abstract
BACKGROUND Head acceleration events (HAEs) are an increasing concern in collision sports owing to potential negative health outcomes. OBJECTIVES The objective of this study is to describe the probabilities of HAEs in tackles of differing heights and body positions in elite men's and women's rugby union. METHODS Instrumented mouthguards (iMGs) were worn in men's (n = 24 teams, 508 players, 782 observations) and women's (n = 26 teams, 350 players, 1080 observations) rugby union matches. Tackle height (i.e. point of contact on ball-carrier) and body positions of tacklers and ball-carriers were labelled for all tackles in which a player wore an iMG. HAEs from the initial impact were identified. Mean player, tackler and ball-carrier exceedance probabilities for various peak linear and angular acceleration thresholds were estimated from ordinal mixed-effects models. RESULTS Contact with ball-carriers' head/neck resulted in the highest mean HAE probabilities for both sexes. The probability of an HAE to the ball-carrier decreased as tackle height lowered. The highest probability for the tackler was initial contact to the ball-carriers upper leg. Body position influenced the probability of HAEs, with falling/diving ball-carriers resulting in higher mean probabilities. When a player, regardless of role, was bent-at-waist, elevated HAE probabilities were observed in men's competitions. Women's data demonstrated similar probabilities of an HAE for all body positions. CONCLUSIONS Initial contact to the ball-carrier's head/neck had the highest chance of an HAE, whilst role-specific differences are apparent for different tackle heights and body positions. Future player-welfare strategies targeting contact events should therefore consider HAE mechanisms along with current literature.
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Affiliation(s)
- Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- England Performance Unit, Rugby Football League, Manchester, UK.
| | - Greg Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Obesity Institute, Leeds Beckett University, Leeds, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- The Division of Sport and Exercise Medicine (DiSEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Matt Cross
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Éanna Falvey
- World Rugby, Dublin, Ireland
- School of Medicine and Health, University College Cork, Cork, Ireland
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Simon Kemp
- Rugby Football Union, Twickenham, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Lindsay Starling
- World Rugby, Dublin, Ireland
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | - Keith Stokes
- Rugby Football Union, Twickenham, UK
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | - Ross Tucker
- The Division of Sport and Exercise Medicine (DiSEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
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Roe G, Sawczuk T, Starling L, Gilthorpe MS, Salmon D, Falvey É, Hendricks S, Rasmussen K, Stokes K, Tooby J, Owen C, Tucker R, Jones B. Contact-events and associated head acceleration events in semi-elite women's rugby union: A competition-wide instrumented mouthguard study. J Sports Sci 2025; 43:933-942. [PMID: 40130348 DOI: 10.1080/02640414.2025.2481355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2025]
Abstract
This study aimed to quantify contact-events and associated head acceleration event (HAE) probabilities in semi-elite women's rugby union. Instrumented mouthguards (iMGs) were worn by players competing in the 2023 Farah Palmer Cup season (13 teams, 217 players) during 441 player-matches. Maximum peak linear acceleration (PLA) and peak angular acceleration (PAA) per-event were used as estimates of in vivo HAE (HAEmax), linked to video analysis-derived contact-events and analysed using mixed-effects regression. Back-rows had the highest number of contact-events per full-match (44.1 [41.2 to 47.1]). No differences were apparent between front-five and centres, or between half-backs and outside-backs. The probability of higher HAEmax occurring was greatest in ball-carries, followed by tackles, defensive rucks and attacking rucks. Probability profiles were similar between positions but the difference in contact-events for each position influenced HAEmax exposure. Overall, most HAEmax were relatively low. For example, the probability of a back-row experiencing a PLA HAEmax ≥25g was 0.045 (0.037-0.054) for ball carries (1 in every 22 carries), translating to 1 in every 2.3 full games. This study presents the first in-depth analysis of contact-events and associated HAEmax in semi-elite women's rugby union. The HAEmax profiles during contact-events can help inform both policy and research into injury mitigation strategies.
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Affiliation(s)
- Gregory Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Lindsay Starling
- World Rugby Research Unit, Dublin, Ireland
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | | | | | - Éanna Falvey
- World Rugby Research Unit, Dublin, Ireland
- Alan Turing Institute, British Library, London, UK
- School of Medicine & Health, University College Cork, Cork, Ireland
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Karen Rasmussen
- People Safety, New Zealand Rugby Union, Wellington, New Zealand
| | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
- Medical Department, Rugby Football Union, Twickenham, UK
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Ross Tucker
- World Rugby Research Unit, Dublin, Ireland
- Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, University of Stellenbosch, South Africa
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- England Performance Unit, Rugby Football League, Manchester, UK
- Premiership Rugby, London, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
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Sachs R, Gibson M, Henry K, Birrell M. Comparison of Injuries in the First 3 Years of Premier Rugby Sevens Between Male and Female Players. Sports Health 2025:19417381251325131. [PMID: 40082798 PMCID: PMC11907578 DOI: 10.1177/19417381251325131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2025] Open
Abstract
BACKGROUND Premier Rugby Sevens (PR7S) is a new professional rugby league. Our study aims to examine injury data from PR7S over the last 3 years to clarify the incidence of injury per event and determine any trends within injuries to specific body regions related to both sex and year of competition. Understanding these injury patterns will assure relevant player education campaigns related to injury awareness, inform sex-specific injury prevention strategies, and help medical professionals care for athletes more effectively in future competitions. HYPOTHESIS There will be a difference in injury patterns and data between men and women throughout the last 3 years of data. STUDY DESIGN Cohort study. LEVEL OF EVIDENCE Level 3. METHODS This is a cohort study including the whole population of athletes from PR7S from 2021 to 2023. After each of the 9 events, athletes filled out a postevent injury form in Health Insurance Portability and Accountability Act compliant electronic health record with their team athletic trainer which included name, date of birth, event, injury type, and location of injury. RESULTS When comparing injury rates year to year, there was a statistically significant increase from 7 to 62 injuries among female athletes (P = 0.004). The number of injuries in male athletes stayed relatively the same. Despite having 432 athletes for both sexes, lower extremity injuries in female athletes have increased each year, whereas male athlete lower extremity injuries have stayed roughly the same throughout the study. CONCLUSION There were statistically more injuries in female athletes compared with male athletes. CLINICAL RELEVANCE These results are similar to other studies including other sports showing increased lower extremity injuries among female athletes compared with male athletes. More research needs to be done to evaluate the causes of increased injuries into to develop prevention strategies in rugby and in other sports.
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Affiliation(s)
- Rachel Sachs
- University of Missouri Kansas City, Kansas City, Missouri
- University Health, Kansas City, Missouri
| | - Margaret Gibson
- University of Missouri Kansas City, Kansas City, Missouri
- University Health, Kansas City, Missouri
| | | | - Morgan Birrell
- University of Missouri Kansas City, Kansas City, Missouri
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5
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Leese R, Kolstad A, Sant'Anna RT, McKay CD, West SW. High tackle headache: implications of referee agreement for tackle height law change. BMJ Open Sport Exerc Med 2025; 11:e002347. [PMID: 39897992 PMCID: PMC11781086 DOI: 10.1136/bmjsem-2024-002347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 12/19/2024] [Indexed: 02/04/2025] Open
Abstract
Objectives Rugby Union has a relatively high risk of injury. Early evidence suggests a benefit of lowering tackle height to reduce head and neck injuries, although concerns persist among stakeholders regarding implementation challenges. This study aimed to understand whether referees can reach the same conclusion regarding tackle height in a controlled environment (ie, video) and whether priming influenced these decisions. Methods Forty-eight active referees completed a questionnaire based on high-tackle decision-making guidelines after watching tackles. Participants were randomly assigned one of two instructional videos containing a high or legal tackle to investigate the impact of priming on law interpretation. Results The percent agreement regarding tackle height was 78.1% between participants, 62.7% between participants and an experienced analyst, and 74.0% between participants and a gold-standard referee. Mean intra-rater reliability when determining whether a tackle was high was substantial (percent agreement: 91.2%). For high tackles, 83% of participants agreed on the danger level, 57% on the contact location and 71% on the presence of mitigating factors. No significant effects of priming were observed. Inter-rater agreement among participants and the gold-standard referee was moderate for all items except danger and height, which showed strong agreement. Conclusion These results suggest a need for improved referee training to support changes to the legal tackle height.
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Affiliation(s)
- Ruth Leese
- Department for Health, University of Bath, Bath, UK
| | - Ash Kolstad
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ricardo T Sant'Anna
- Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
| | - Carly D McKay
- Department for Health, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
| | - Stephen W West
- Department for Health, University of Bath, Bath, UK
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
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6
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Solomons R, Schippers R, Leach L. The risk factors and predictors of injury among collegiate rugby players under the age of 20. J Sports Med Phys Fitness 2024; 64:1313-1320. [PMID: 39287575 DOI: 10.23736/s0022-4707.24.15862-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND The risk of injury in rugby is high, due to the contact nature of the game. Players are constantly exposed to impact and collision during training and match-play. Rugby union consists of various risk factors that predispose players to injury. The aim of the study was to determine the risk factors of injury and to predict the risk of injury per playing position during match-play. METHODS The study followed a quantitative, non-experimental, and cross-sectional research design. A total of 252 male rugby players, aged 18 to 20 years, who played in a collegiate rugby competition in South Africa (SA) for the 2022 season were conveniently sampled for the study. The playing position, time of injury (whether during a match or training), use of protective equipment, and phase of play in which the injury occurred were recorded. Injury data was captured by qualified healthcare professionals using an adapted injury surveillance questionnaire. RESULTS The study found that potential risk factors for injury included illegal or dangerous play, playing in the second half of the match (more specifically the third quarter of the match), and playing in the offensive part of the field (more specifically between the opposition-22 and halfway line). Contact events were the most common cause of match injury (91.1%). The half of the match in which an injury was sustained was significantly different between forwards and backs (P=0.011). A statistically significant association was found between playing position and the phase of play in which injury was sustained (P=0.021). Regression analysis showed that playing between the opposition-22 m line and the halfway line was a significant predictor of injury for both forwards and backs (P=0.035). CONCLUSIONS In conclusion, potential risk factors for injury were related to dangerous play, time during the match (specifically the third quarter of the match), and location of play (specifically between the opposition-22 m line and halfway line). The area of play was a significant predictor of injury for all players. It is recommended that greater efforts in collecting epidemiological data need to be made to broaden the knowledge base on injuries and provide strategies to coaches and players to reduce the risk of injury in rugby.
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Affiliation(s)
- Renaldo Solomons
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape (UWC), Bellville, South Africa -
| | - Raven Schippers
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape (UWC), Bellville, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape (UWC), Bellville, South Africa
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Moore IS, McCarthy‐Ryan M, Palmer D, Perkins J, Verhagen E. Is your system fit for purpose? Female athlete health considerations for rugby injury and illness surveillance systems. Eur J Sport Sci 2024; 24:1688-1700. [PMID: 39639642 PMCID: PMC11621385 DOI: 10.1002/ejsc.12089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 12/07/2024]
Abstract
This review discusses female-specific health considerations in injury and illness surveillance and provides rugby-specific recommendations for future surveillance. Identifying priority injury and illness problems by determining those problems with the highest rates within women's rugby may highlight different priorities than sex comparisons between men's and women's rugby. Whilst sports exposure is the primary risk for health problems in sports injury and illness surveillance, female athletes have health domains that should also be considered. Alongside female athlete health domains, studies investigating rugby injuries and illnesses highlight the need to broaden the health problem definition typically used in rugby injury and illness surveillance. Using a non-time-loss health problem definition, recording female-specific population characteristics, embedding female athlete health domains and having up-to-date injury and illness coding systems should be prioritized within surveillance systems to begin to shed light on potential interactions between sports exposure, health domains and, injuries and illnesses. We call for a collaborative approach across women's rugby to facilitate large injury and illness datasets to be generated and enable granular level categorization and analysis, which may be necessary for certain female athlete health domains. Applying these recommendations will ensure injury and illness surveillance systems improve risk identification and better inform injury and illness prevention strategies in women's rugby.
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Affiliation(s)
- Isabel S. Moore
- Cardiff School of Sport and Health SciencesCardiff Metropolitan UniversityCardiffUK
| | - Molly McCarthy‐Ryan
- Cardiff School of Sport and Health SciencesCardiff Metropolitan UniversityCardiffUK
| | - Debbie Palmer
- UK Collaborating Centre on Injury and Illness in SportEdinburgh Sports Medicine Research NetworkInstitute for SportPE and Health SciencesUniversity of EdinburghEdinburghUK
- Sport Injury Prevention Research CentreUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in SportsDepartment of Public and Occupational HealthAmsterdam Movement ScienceAmsterdam UMCAmsterdamthe Netherlands
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Scantlebury S, Jones B, Owen C, Brown J, Collins N, Fairbank L, Till K, Phillips G, Stokes K, Whitehead S. Time to level the playing field between men and women - Given similar injury incidence: A two-season analysis of match injuries in elite men and women's (Super League) rugby league. J Sci Med Sport 2024; 27:765-771. [PMID: 39043494 DOI: 10.1016/j.jsams.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 06/10/2024] [Accepted: 07/01/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVES To compare match injury incidence, severity and burden in men's and women's elite rugby league. DESIGN A prospective cohort epidemiological study. METHODS Time loss match injury data were collected from all men's (11,301 exposure hours) and women's (5,244 exposure hours) Super League clubs. RESULTS Injury incidence and burden were not different between men and women (mean [95 % CI]; 54 [45 to 65] vs. 60 [49 to 74] per 1000 match-hours; p = 0.39, and 2332 [1844 to 2951] vs. 1951 [1560 to 2440] days lost per 1000 match-hours; p = 0.26). However, injury severity was greater for men than women (42 [35-50] vs. 35 [29 to 42]; p = 0.01). Lower limbs accounted for 54 % and 52 % of injuries for men and women, with the head/face the most frequently injured location due to concussion (12 [10 to 15] and 10 [8 to 14] per 1000 match-hours for men and women). Injuries to the knee had the greatest burden for men and women (708 [268-1868] and 863 [320-2328] days lost per 1000 match-hours). Being tackled was the most common injury mechanism for men and women (28 % and 38 %) with greater burden (p < 0.01) than other injury mechanisms. CONCLUSIONS Male and female rugby league players have similar injury incidence and burden; however, injury severity was higher in men. Head/face injuries have the highest injury incidence and knee injuries have the highest burden. These injuries should be the focus for prevention initiatives at a league (via laws), player, and coach level, with equal and specific focus for both men's and women's rugby league players.
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Affiliation(s)
- Sean Scantlebury
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom.
| | - Ben Jones
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, the University of Cape Town and the Sports Science Institute of South Africa, South Africa; School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia; Premiership Rugby, United Kingdom
| | - Cameron Owen
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom
| | - James Brown
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, the University of Cape Town and the Sports Science Institute of South Africa, South Africa; Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Neil Collins
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, United Kingdom
| | - Kevin Till
- Carnegie School of Sports, Leeds Beckett University, United Kingdom
| | - Gemma Phillips
- Carnegie School of Sports, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Hull Kingston Rovers, United Kingdom
| | - Keith Stokes
- Rugby Football Union, United Kingdom; Centre for Health and Injury and Illness Prevention in Sport, University of Bath, United Kingdom; UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, United Kingdom
| | - Sarah Whitehead
- Carnegie School of Sports, Leeds Beckett University, United Kingdom
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9
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Monteleone G, Tramontana A, Sorge R. Clinical and ultrasonographic evaluation of uninjured dominant shoulder in amateur rugby players vs a control group: a pilot study. J Ultrasound 2024; 27:605-611. [PMID: 38581554 PMCID: PMC11333414 DOI: 10.1007/s40477-024-00897-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Rugby is a sport involving a great number of shoulder collisions. Traumatic stress of the shoulder can weaken the static stabilizers and promote major injuries as dislocation or full-thickness tears of the rotator cuff. The goal of this study is to evaluate the clinical and ultrasonographic dominant shoulder factures in a group of amateur rugby players, with no history of shoulder injuries, and to compare them with those of a control group. METHODS 52 male subjects join in the study: 26 amateur rugby players and 26 subjects, which did not practice rugby or competitive sport. Clinical history was obtained from all subjects, followed by dominant shoulder physical and ultrasonographic exams. RESULTS Rugby players showed a higher prevalence of positive clinical test, suggesting subacromial impingement than control group (p = 0.01). Among rugby group, five players (19,2%) showed positive test for radiculopathy (p = 0,02), and ten players (73,1%) reported shoulder pain needing pain-reliever drugs at list one time in the last six months (p = 0.001). In rugby group, ultrasound exams showed 23,1% degenerative changes and 30,8% tendon calcifications in supraspinatus tendons (p < 0.05). CONCLUSIONS Uninjured dominant shoulder of rugby players shows higher prevalence of clinical and ultrasound changes compare to control. Some rugby players without history of cervical symptoms show positive clinical test of cervical radiculopathy. Clinical and ultrasonographic monitoring of the shoulder can play a role in prevention and knowledge of silent shoulder damage in these athletes.
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Affiliation(s)
- Giovanni Monteleone
- Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy, Via Montpellier 1, 00133.
- School of Sport and Exercise Sciences, University of Rome "Tor Vergata", Rome, Italy.
| | - Alfonso Tramontana
- Rey Juan Carlos University Madrid Spain Physical Medicine 81 and Rehabilitation, Calle tulipan s/n, Mostoles, 28933, Madrid, Spain
| | - Roberto Sorge
- Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
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10
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Tondelli E, Kenny IC, Comyns TM, Zabaloy S. Differences and correlations between horizontal and vertical single-leg jump performance, dynamic balance, and ankle dorsiflexion range of motion in male amateur rugby players according to playing positions. J Bodyw Mov Ther 2024; 38:281-288. [PMID: 38763571 DOI: 10.1016/j.jbmt.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES To explore the differences and correlations in the Y-Balance Test (YBT) scores, ankle-dorsiflexion range of motion (ADFROM), single-leg drop jump (SLDJ) and single-leg hop for distance (SLHD) in amateur male rugby players by playing positions and limb dominance. DESIGN Cross-sectional study. SETTING Argentinian amateur rugby club. PARTICIPANTS Male (n = 58) senior amateur rugby players. MAIN OUTCOME MEASURES ADFROM, YBT (anterior [AN], posteromedial, posterolateral, and composite [COM]), SLDJ and SLHD performances. RESULTS Forwards demonstrated different anthropometric traits than backs (p < 0.001 to 0.003; ES: -0.508 to -1.331), whereas the latter attained better jump performance (p < 0.001-0.05; ES: 0.297-1.349) and YBTCOM scores compared to the former, irrespective of limb dominance (p: 0.007-0.034; ES: 0.569-0.730). With regards to the associations, forwards' BMI (rho: -0.35 to -0.52, ES: 0.184) and ADFROM values (rho: 0.41 to 0.53, ES: 0.184; r: 0.43 to 0.50, ES: 0.184) were associated to jump performance among both limbs. In contrast, for the backs, leg length was associated with SLHD (rho: 0.42-0.45, ES: 0.214) and YBTCOM (rho: -0.67 to -0.76, ES: 0.215). Likewise, ADFROM values (r: 0.44-0.56, ES: 0.185) were moderately associated to YBTAN in both limbs. CONCLUSIONS Backs attained better dynamic balance, wider ADFROM, and better unilateral vertical and horizontal jumps performances in dominant and non-dominant limb, compared to forwards. Additionally, ADFROM maybe an important aspect to consider when aiming to improve balance and jump performance among forwards and backs.
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Affiliation(s)
- Eduardo Tondelli
- Discipline of Sport Physiotherapy, Faculty of Medical Sciences, Pontifical Catholic University of Argentina, Buenos Aires, Argentina.
| | - Ian C Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
| | - Thomas M Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
| | - Santiago Zabaloy
- Faculty of Physical Activity and Sports, University of Flores, Buenos Aires, Argentina
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11
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Hunzinger KJ, Schussler E. The 50 Most Cited Papers on Rugby since 2000 Reveal a Focus Primarily on Strength and Conditioning in Elite Male Players. JOURNAL OF SPORTS MEDICINE (HINDAWI PUBLISHING CORPORATION) 2023; 2023:6991769. [PMID: 38148987 PMCID: PMC10751173 DOI: 10.1155/2023/6991769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/06/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
We sought to conduct a bibliometric analysis and review of the most cited publications relating to rugby since 2000 in order to identify topics of interest and those that warrant further investigations. Clarivate Web of Science database was used to perform a literature search using the search term "rugby." The top 200 papers by citation count were extracted and reviewed for the inclusion criteria: all subjects were rugby players. The top 50 manuscripts were included for analysis of author, publication year, country of lead authors, institution, journal name and impact factor, topic, participant sex, and level of rugby. The total number of citations was 9,071 (average of 181.4 citations/article), with an average journal impact factor of 7.21; the top article was cited 407 times at the time of analysis. The most frequent publication was the Journal of Strength and Conditioning Research (26%), followed by the British Journal of Sports Medicine (20%) and the Journal of Sports Sciences (18%). Forty-eight (96%) of the manuscripts contained only male subjects, with 1 manuscript including females only and 1 manuscript containing mixed sexes. Thirty-three (66%) of the manuscripts focused on professional rugby players, with the next highest player group being mixed levels (10%). Twenty-eight (56%) concentrated on topics regarding strength and conditioning, 11 (22%) on injury, and 4 (8%) on physiology. Despite rugby being one of the most injurious sports and community players representing the largest component of the player pool, most of the top-cited rugby articles are cohort studies of professional male athletes focused on performance and strength and conditioning, noting the bias in research towards socially relevant topics that may not impact the majority of stakeholders and long-term health of rugby athletes. These findings highlight the need for further research among women and community athletes and on topics in injury prevention.
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Affiliation(s)
| | - Eric Schussler
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, USA
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12
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Teahan C, Whyte EF, O'Connor S. Gaelic games players' awareness and use of, and attitudes towards injury prevention exercise programmes. Phys Ther Sport 2023; 64:17-26. [PMID: 37647826 DOI: 10.1016/j.ptsp.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The aim was to determine the awareness of and use of injury prevention exercise programmes (IPEPs) among adult Gaelic games players and to investigate Gaelic games players' attitudes to injury prevention and barriers and facilitators to successful IPEPs use. METHODS A recruitment email was sent to all clubs and county boards throughout Ireland (whose email was available online) and the survey was advertised on social media platforms. Adult players completed an anonymous survey, including awareness, use, and attitudes towards injury prevention and injuries. Frequencies and descriptive statistics were conducted, a chi-squared test was used to assess any differences in awareness and use of IPEPs, a Mann-Whitney U test was used to examine differences between groups for attitudes to injury prevention (men vs women; elite vs non-elite). RESULTS A third of players (32.4%) stated awareness of IPEPs. However, only 13.4% correctly identified one. A significantly greater number of men (35.7%) used IPEPs compared to women (26.5%) (p = 0.04). The Activate (65.5%) and GAA15 (32.5%) were most used. Players had a positive attitude towards injury prevention but agreed that injuries were an issue (68.2%) and stated that their coach didn't have enough knowledge how to use IPEPs was a large barrier (41.6%). CONCLUSION Despite this positive attitude to injury prevention and believing injuries are an issue, adoption remains low. Organisations/clubs should educate players on the benefits of using IPEPs and support structures put in place to gain greater implementation, which is critical to mitigating the risk of injury.
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Affiliation(s)
- Calvin Teahan
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland.
| | - Enda F Whyte
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O'Connor
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
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13
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McLeod S, Tucker R, Edwards S, Jones B, Page G, Spiegelhalter M, West SW, Iverson GL, Gardner AJ. A case-control study of tackle based head impact event (HIE) risk factors from the first three seasons of the National Rugby League Women's competition. Front Sports Act Living 2023; 5:1080356. [PMID: 37334015 PMCID: PMC10272446 DOI: 10.3389/fspor.2023.1080356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The tackle is the most injurious event in rugby league and carries the greatest risk of concussion. This study aims to replicate previous research conducted in professional men's rugby league by examining the association between selected tackle characteristics and head impact events (HIEs) in women's professional rugby league. Methods We reviewed and coded 83 tackles resulting in an HIE and every tackle (6,318 tackles) that did not result in an HIE for three seasons (2018-2020) of the National Rugby League Women's (NRLW) competition. Tackle height, body position of the tackler and ball carrier, as well as the location of head contact with the other player's body were evaluated. Propensity of each situation that caused an HIE was calculated as HIEs per 1,000 tackles. Results The propensity for tacklers to sustain an HIE was 6.60 per 1,000 tackles (95% CI: 4.87-8.92), similar to that of the ball carrier (6.13 per 1,000 tackles, 95% CI: 4.48-8.38). The greatest risk of an HIE to either the tackler or ball carrier occurred when head proximity was above the sternum (21.66 per 1,000 tackles, 95% CI: 16.55-28.35). HIEs were most common following impacts between two heads (287.23 HIEs per 1,000 tackles, 95% CI: 196.98-418.84). The lowest propensity for both tackler (2.65 per 1,000 tackles, 95% CI: 0.85-8.20) and ball carrier HIEs (1.77 per 1,000 tackles, 95% CI: 0.44-7.06) occurred when the head was in proximity to the opponent's shoulder and arm. No body position (upright, bent or unbalanced/off feet) was associated with an increased propensity of HIE to either tackler or ball carrier. Conclusions In the NRLW competition, tacklers and ball carriers have a similar risk of sustaining an HIE during a tackle, differing from men's NRL players, where tacklers have a higher risk of HIEs. Further studies involving larger samples need to validate these findings. However, our results indicate that injury prevention initiatives in women's rugby league should focus on how the ball carrier engages in contact during the tackle as well as how the tackler executes the tackle.
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Affiliation(s)
- Shreya McLeod
- School of Medicine and Public Health, College of Health, Medicine, & Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Discipline of Physiotherapy, School of Allied Health, Australian Catholic University, Sydney, NSW, Australia
| | - Ross Tucker
- Department of Exercise, Institute of Sport and Exercise Medicine (ISEM), University of Stellenbosch, South Africa
- World Rugby Ltd., Dublin, Ireland
| | - Suzi Edwards
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, NSW, Australia
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- Division of Physiological Sciences, Department of Human Biology, UCT Research Centre for Health Through Physical Activity (HPALS), Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- England Performance Unit, Rugby Football League, Red Hall, Leeds, United Kingdom
- Leeds Rhinos Rugby League Club, Leeds, United Kingdom
- Premiership Rugby, London, United Kingdom
| | - Georgia Page
- School of Medicine and Public Health, College of Health, Medicine, & Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Mily Spiegelhalter
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- England Performance Unit, Rugby Football League, Red Hall, Leeds, United Kingdom
- Leeds Rhinos Rugby League Club, Leeds, United Kingdom
| | - Stephen W. West
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, United Kingdom
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, United Kingdom
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, MA, United States
| | - Andrew J. Gardner
- School of Medicine and Public Health, College of Health, Medicine, & Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, NSW, Australia
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- Hunter Medical Research Institute, New Lambton, NSW, Australia
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14
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Mlv SK, Mahmood A, Vatsya P, Garika SS, Mittal R, Nagar M. Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India. World J Clin Cases 2023; 11:3464-3470. [PMID: 37383898 PMCID: PMC10294183 DOI: 10.12998/wjcc.v11.i15.3464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/16/2023] [Accepted: 04/17/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) tears are common sports-related injuries. Their incidence is not the same either for all the sports or for the same sport across various nations. This information is maintained by many sports leagues in their registries. However, very few nationwide registries exist for such injuries. This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India. AIM To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India. METHODS All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied. Patients with multi-ligament injuries or a history of previous knee surgery were excluded. The patients' history was obtained from the hospital records, they were interviewed telephonically, and online questionnaires were given. Their demographic data was analyzed and compared to the existing literature. RESULTS A total of 124 patients were operated on for ACL reconstruction during this period. The mean age of the patients was 27.97 years. One hundred and thirteen patients (91.1%) were male and 11 (8.9%) were female. The majority of the patients (47.6%) sustained this injury by road traffic accidents (RTA) followed by sports-related injuries (39.5%). The commonest presenting complaint was giving way of the knee in 118 patients (95.2%). The mean duration from the injury to the first hospital visit among the patients was 290.1 d. The mean duration from the injury to surgery was 421.8 d. CONCLUSION ACL patients' demography is different in developing nations as compared to the developed world. RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause. There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery. This, in turn, leads to poorer prognosis and longer rehabilitation. National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries.
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Affiliation(s)
- Sai Krishna Mlv
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Asjad Mahmood
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Pulak Vatsya
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Siva Srivastava Garika
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ravi Mittal
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manoj Nagar
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal 462020, India
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15
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Lempke LB, Bergeron G, O'Connor S, Lynall RC, Resch JE, Walton SR. Concussion Assessment and Management Practices Among Irish and Canadian Athletic Therapists: An International Perspective. J Athl Train 2023; 58:293-304. [PMID: 35724361 PMCID: PMC11215646 DOI: 10.4085/1062-6050-0097.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Certified athletic therapists in Ireland and Canada serve essential concussion assessment and management roles, but their health care practices and concussion knowledge have not been established. OBJECTIVE To examine Irish and Canadian athletic therapist cohorts' (1) concussion knowledge, (2) current concussion assessment and management techniques across all job settings, and (3) the association of concussion assessment and management practices with years of clinical experience and highest degree attained. DESIGN Cross-sectional cohort study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS Licensed Irish (49.7%, n = 91/183) and Canadian (10.1%, n = 211/2090) athletic therapists. MAIN OUTCOME MEASURE(S) Athletic therapists completed an online survey assessing their demographics, concussion knowledge (symptom recognition, patient-clinician scenarios), frequency of concussions assessed annually, and assessment and return-to-play (RTP) measures using a modified, previously validated survey. Symptom recognition consisted of 20 (8 true, 12 false) items on recognition of signs and symptoms that were scored as total correct. Descriptive statistics and odds ratios were used to examine survey responses where appropriate. RESULTS Irish (86.8%, n = 46/53) and Canadian (93.4%, n = 155/166) athletic therapists indicated RTP guidelines were the most common method for determining RTP. Symptom recognition scores were 72.8% ± 17.0% among Irish and 76.6% ± 17.0% among Canadian athletic therapists. Irish (91.2%, n = 52/57) and Canadian (90.4%, n = 161/178) athletic therapists reported standardized sideline assessments as the most used concussion assessment method. Irish and Canadian athletic therapists' use of 2-domain (Irish: 38.6% [n = 22/57]; Canadian: 73.6% [n = 131/178]) and 3-domain (Irish: 3.5% [n = 2/57]; Canadian: 19.7% [n = 35/178]) minimum assessments (ie, symptoms, balance, or neurocognitive) was not associated with education or clinical experience (P ≥ .07), except for Canadian athletic therapists with master's degrees having greater odds of completing 2-domain assessments at initial evaluation than those with bachelor's degrees (odds ratio = 1.80; 95% CI = 1.41, 1.95). CONCLUSIONS Irish and Canadian athletic therapists demonstrated similar concussion knowledge; however, most did not fully adhere to international consensus guidelines for concussion assessment as evidenced by low 2- and 3-domain assessment use. Athletic therapists should aim to implement multidimensional concussion assessments to ensure optimal health care practices and patient safety.
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Affiliation(s)
- Landon B. Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
- School of Kinesiology, Michigan Concussion Center, University of Michigan, Ann Arbor
| | - Glen Bergeron
- Department of Kinesiology and Applied Health, The University of Winnipeg, Manitoba, Canada
| | - Siobhán O'Connor
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Ireland
| | - Robert C. Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Jacob E. Resch
- Exercise and Sport Injury Laboratory, Department of Kinesiology, University of Virginia, Charlottesville
| | - Samuel R. Walton
- Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond
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16
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Starling LT, Gabb N, Williams S, Kemp S, Stokes KA. Longitudinal study of six seasons of match injuries in elite female rugby union. Br J Sports Med 2023; 57:212-217. [PMID: 36428090 DOI: 10.1136/bjsports-2022-105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
| | - Niki Gabb
- Department for Health, University of Bath, Bath, UK
| | | | - Simon Kemp
- Medical Services, Rugby Football Union, Twickenham, UK
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK .,Medical Services, Rugby Football Union, Twickenham, UK
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17
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Ryan L, Daly E, Blackett AD. Sport-related concussion disclosure in women's rugby-A social identity approach. Front Sports Act Living 2023; 5:1058305. [PMID: 37090816 PMCID: PMC10114594 DOI: 10.3389/fspor.2023.1058305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/15/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Sport-related concussion (SRC) is a risk of collision sports such as women's rugby. To support appropriate SRC diagnosis and management, an understanding of the factors that encourage SRC disclosure is necessary. To date, research has focused on ascertaining individual player knowledge and attitudes towards SRC disclosure. Methods We chose to investigate the potential influence of group identification effects by examining the role of social identity on SRC disclosure in elite women's rugby. Seventeen elite players from the United Kingdom and Ireland were interviewed and their transcripts thematically analysed. Results The data highlighted that the players shared a very strong social identity as women in rugby and were acutely aware that their experiences were different to their male counterparts. The shared social identity had both positive and negative implications for SRC disclosure. The players interviewed did not feel comfortable disclosing their symptoms to their coach and often felt that medical staff either did not listen to them or were unavailable to them. Mediators such as communication, trust in medical teams, perceived pressure, positive injury management experience, and player role models were identified. Discussion This research could be utilised to inform sport psychology interventions to enhance SRC disclosure in elite women's rugby.
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Affiliation(s)
- Lisa Ryan
- Department of Sport, Exercise and Nutrition, Atlantic Technological University, Galway, Ireland
- Correspondence: Lisa Ryan
| | - Ed Daly
- Department of Sport, Exercise and Nutrition, Atlantic Technological University, Galway, Ireland
| | - Alexander D. Blackett
- Department of Sport and Exercise, School of Health Science & Wellbeing, Staffordshire University, Stoke-on-Trent, United Kingdom
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18
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Tondelli E, Zabaloy S, Comyns TM, Kenny IC. Effect of COVID-19 lockdown on injury incidence and burden in amateur rugby union. Phys Ther Sport 2023; 59:85-91. [PMID: 36525741 PMCID: PMC9737509 DOI: 10.1016/j.ptsp.2022.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To analyse match and training injury incidence rates and burden from pre-(2019) and post-COVID-19 (2021) seasons; To analyse injury related variables as mechanisms, type, body locations, severity and the differences of the most common injuries according to playing positions. DESIGN An observational study was performed according to the consensus statement on injury definitions and data collection from World Rugby. Injury variables were collected retrospectively for 2019 season and prospectively during 2021 season. SETTING Argentinian amateur rugby club. PARTICIPANTS Male (n = 110) senior amateur rugby players. MAIN OUTCOME MEASURES Match and training time loss injuries, time of exposures and injury related variables. RESULTS Training incidence rate during post-lockdown season (4.2/1000 player-training-hours) was significantly higher (p < 0.001) than the pre-lockdown season (0.9/1000 player match hours). Post-lockdown hamstring strain injury (HSI) and concussions match incidence rates were significantly (p < 0.001; p < 0.05 respectively) higher in comparison with 2019 season. Regarding playing positions, backs showed a significantly increase (p < 0.05) in HSI match incidence rate post lockdown. CONCLUSIONS After the COVID-19 lockdown, training incidence rate was significantly higher than previous season (2019), showing the impact of the lockdown restrictions. Coaches and medical staff must consider that players probably need more lead-in time for conditioning and more monitoring after periods of no rugby.
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Affiliation(s)
- Eduardo Tondelli
- Sport Physiotherapy, Faculty of Medical Sciences, Pontifical Catholic University of Argentina, Buenos Aires, Argentina.
| | - Santiago Zabaloy
- Faculty of Physical Activity and Sports, University of Flores, Buenos Aires, Argentina
| | - Thomas M Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
| | - Ian C Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
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19
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King DA, Hume PA, Hind K, Clark TN, Hardaker N. The Incidence, Cost, and Burden of Concussion in Women's Rugby League and Rugby Union: A Systematic Review and Pooled Analysis. Sports Med 2022; 52:1751-1764. [PMID: 35113388 PMCID: PMC9325800 DOI: 10.1007/s40279-022-01645-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The extent of concussion injury in the rugby codes for women is unclear. OBJECTIVE Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. METHODS We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women's concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. RESULTS The pooled analysis match injury incidence of women's concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women's rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8-11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women's rugby 15 s (RR 9.3, 95% CI 1.29-66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. CONCLUSIONS Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women's rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences.
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Affiliation(s)
- Doug A King
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand.
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand.
- School of Science and Technology, University of New England, Armidale, NSW, Australia.
- Wolfson Research Institute for Health and Wellbeing, Department of Sport and Exercise Sciences, Durham University, Durham, UK.
- Emergency Department, Hutt Valley District Health Board, Private Bag 31-907, Lower Hutt, New Zealand.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
- National Institute of Stroke and Applied Neuroscience (NISAN), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
| | - Karen Hind
- Wolfson Research Institute for Health and Wellbeing, Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Trevor N Clark
- Faculty of Sport, Event Management, Tourism and Hospitality, International College of Management Sydney, Manly, NSW, Australia
| | - Natalie Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
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20
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O'Bryan SM, Connor KR, Drummer DJ, Lavin KM, Bamman MM. Considerations for Sex-Cognizant Research in Exercise Biology and Medicine. Front Sports Act Living 2022; 4:903992. [PMID: 35721874 PMCID: PMC9204149 DOI: 10.3389/fspor.2022.903992] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 12/15/2022] Open
Abstract
As the fields of kinesiology, exercise science, and human movement developed, the majority of the research focused on male physiology and extrapolated findings to females. In the medical sphere, basing practice on data developed in only males resulted in the removal of drugs from the market in the late 1990s due to severe side effects (some life-threatening) in females that were not observed in males. In response to substantial evidence demonstrating exercise-induced health benefits, exercise is often promoted as a key modality in disease prevention, management, and rehabilitation. However, much like the early days of drug development, a historical literature knowledge base of predominantly male studies may leave the exercise field vulnerable to overlooking potentially key biological differences in males and females that may be important to consider in prescribing exercise (e.g., how exercise responses may differ between sexes and whether there are optimal approaches to consider for females that differ from conventional approaches that are based on male physiology). Thus, this review will discuss anatomical, physiological, and skeletal muscle molecular differences that may contribute to sex differences in exercise responses, as well as clinical considerations based on this knowledge in athletic and general populations over the continuum of age. Finally, this review summarizes the current gaps in knowledge, highlights the areas ripe for future research, and considerations for sex-cognizant research in exercise fields.
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Affiliation(s)
- Samia M. O'Bryan
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kathleen R. Connor
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Devin J. Drummer
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kaleen M. Lavin
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
| | - Marcas M. Bamman
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
- *Correspondence: Marcas M. Bamman
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21
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The Epidemiology of Injuries in Spanish Rugby Union División de Honor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073882. [PMID: 35409565 PMCID: PMC8997440 DOI: 10.3390/ijerph19073882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/13/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND We describe and analyze injury incidence, severity, cause of injury, anatomical location, damaged tissue, injury recurrence, and the time and place at which injuries occur over the course of a season. METHODS An observational, descriptive, prospective, nomothetic, and multidimensional study was conducted during the 2018-2019 season with 258 players of the top semiprofessional rugby league in Spain (División de Honor de Rugby). Data were reported by the clubs' medical services. Reported time-loss injuries were collected. RESULTS Overall exposure was 4100 h (137 matches), over 35 weeks of competition. A total of 288 injuries were reported, with three of these leading to withdrawal from the sport. A total average of 35.63 days was lost to injury. Overall time-loss injury incidence was 3.41 injuries/1000 h of exposure. Backs suffered 119 injuries corresponding to 3.80 injuries/1000 h of exposure, whilst forwards suffered 169 injuries with 4.27 injuries/1000 h of exposure. Severe injuries were the most frequent injury type. CONCLUSIONS Outcomes confirm that more injuries take place during competition, with these also being more severe in nature. Contact injuries were most frequently suffered, above all, due to tackling or being tackled.
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22
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Silvers-Granelli H. Why Female Athletes Injure Their ACL's More Frequently? What can we do to mitigate their risk? Int J Sports Phys Ther 2021; 16:971-977. [PMID: 34386276 PMCID: PMC8329328 DOI: 10.26603/001c.25467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 01/13/2023] Open
Affiliation(s)
- Holly Silvers-Granelli
- Velocity Physical Therapy, Santa Monica, CA; Major League Soccer Medical Research Committee, New York, New York
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