An Analysis of Knee Injuries in Rugby League: The Experience at the Newcastle Knights Professional Rugby League Team.
ABSTRACT: BACKGROUND:Epidemiologic data in professional sport is becoming an increasingly valuable tool in identifying frequently occurring injuries and developing strategies to reduce their occurrence. Currently, there is a paucity of literature on the epidemiology of knee injuries in professional male rugby league players. METHODS:We retrospectively reviewed medical records from a single male professional rugby league team (Newcastle Knights), competing in Australia, and evaluated knee injuries and time to return to play. RESULTS:In total, 89 knee injuries occurred, with an injury incidence of 616.7 injuries per 1000 players. The most frequently occurring knee injuries were medial collateral ligament (416.7 injuries per 1000 players) and chondral/meniscal injuries (416.7 injuries per 1000 players). For all injury types, being tackled was the most common mechanism of injury, and the median time to return to play was 1 day. Anterior cruciate ligament injuries accounted for the longest time to return to play (median 236.0 days). CONCLUSION:Medial collateral ligament and chondral/meniscal injury types were the most frequent injuries; however, anterior cruciate ligament injuries accounted for the most time missed from sport despite being less common. Professional male rugby league players incur similar knee injury types compared to rugby union based upon our study and other similar studies.
Project description:To examine the anthropometric characteristics of an Australian National Rugby League team and identify the relationship to type and incidence of injuries sustained during a professional season. It was hypothesised that body composition would not change discernibly across a season and that injury would be negatively related to preseason bone and muscle mass.A repeated measure, prospective, observational, cohort study.Griffith University, Gold Coast, Australia.37 professional male Australian National Rugby League players, 24.3 (3.8) years of age were recruited for preseason 1 testing, of whom 25 were retested preseason 2.Primary outcome measures included biometrics; body composition (bone, muscle and fat mass; dual-energy x-ray absorptiometry; XR800, Norland Medical Systems, Inc); bone geometry and strength (peripheral quantitative CT; XCT 3000, Stratec); calcaneal broadband ultrasound attenuation (BUA; QUS-2, Quidel); diet and physical activity history. Secondary outcome measures included player injuries across a single playing season.Lean mass decreased progressively throughout the season (pre=81.45(7.76) kg; post=79.89(6.72) kg; p?0.05), while whole body (WB) bone mineral density (BMD) increased until mid-season (pre=1.235(0.087) g/cm(2); mid=1.296(0.093) g/cm(2); p?0.001) then decreased thereafter (post=1.256(0.100); p?0.001). Start-of-season WB BMD, fat and lean mass, weight and tibial mass measured at the 38% site predicted bone injury incidence, but no other relationship was observed between body composition and injury.Significant anthropometric changes were observed in players across a professional rugby league season, including an overall loss of muscle and an initial increase, followed by a decrease in bone mass. Strong relationships between anthropometry and incidence of injury were not observed. Long-term tracking of large rugby league cohorts is indicated to obtain more injury data in order to examine anthropometric relationships with greater statistical power.
Project description:BACKGROUND:Rugby union and rugby league are popular team contact sports, but they bring a high risk of injury. Although previous studies have reported injury occurrence across one or several seasons, none have explored the total number of injuries sustained across an entire career. As the first to do so, the aim of this study was to report on cumulative injuries and their perceived long-term impact in retired rugby code athletes compared to athletes from non-contact sports. METHODS:One hundred and eighty-nine former rugby code athletes (rugby union n?=?145; rugby league n?=?44) and 65 former non-contact athletes were recruited to the UK Rugby Health Project between September 2016 and December 2018. Details on sports participation, sports injuries and concussion history, sports injury-related surgeries, and previous and current health were obtained from a validated, online self-report questionnaire. RESULTS:Former elite rugby code athletes (n?=?83) reported more total injuries per player (median 39, IQR 35) than former amateur rugby code athletes (n?=?106; median 23, IQR 30; p?=?0.014) and non-contact sports athletes (n?=?65; median 7.5, IQR 15; p?<?0.001). Concussion was the most frequently reported injury for the elite and amateur rugby code groups, followed by upper/lower back and knee ligament injuries. These injuries also presented with the highest recurrence. Rugby code groups reported a higher continued impact of previous concussion, neck injuries, shoulder dislocation, ACL tears, and knee ligament injuries (p?=?0.003-0.045). The reported prevalence of osteoarthritis was more than twofold greater in the elite rugby code group than in non-contact athletes (51% v 22%, p?<?0.001). The prevalence of back pain and/or severe and regular joint pain was high across all groups (47-80%), particularly the elite rugby code group. The total number of joint injuries and sport injury-related surgeries was higher in those who reported current osteoarthritis and current severe and regular joint pain (p?<?0.001-p?=?0.028). CONCLUSION:Across multiple injury types, past participation in rugby union and rugby league, particularly at elite level, is associated with a high cumulative injury load and a continued impact of previous injuries post-retirement. Given the high number of reported concussions (and their recurrence) and associations between previous injuries during a player's career and current musculoskeletal conditions, efforts should be prioritized to reduce the occurrence and recurrence of injuries in rugby codes at all levels of the sport. Strategies should also be developed for supporting the specific physical health needs of rugby code athletes post-retirement.
Project description:This article reviews tendon and ligament injury incidence and severity within elite rugby union and rugby league. Furthermore, it discusses the biological makeup of tendons and ligaments and how genetic variation may influence this and predisposition to injury. Elite rugby has one of the highest reported injury incidences of any professional sport. This is likely due to a combination of well-established injury surveillance systems and the characteristics of the game, whereby high-impact body contact frequently occurs, in addition to the high intensity, multispeed and multidirectional nature of play. Some of the most severe of all these injuries are tendon and ligament/joint (non-bone), and therefore, potentially the most debilitating to a player and playing squad across a season or World Cup competition. The aetiology of these injuries is highly multi-factorial, with a growing body of evidence suggesting that some of the inter-individual variability in injury susceptibility may be due to genetic variation. However, little effort has been devoted to the study of genetic injury traits within rugby athletes. Due to a growing understanding of the molecular characteristics underpinning the aetiology of injury, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose several single nucleotide polymorphisms within candidate genes of interest; COL1A1, COL3A1, COL5A1, MIR608, MMP3, TIMP2, VEGFA, NID1 and COLGALT1 warrant further study within elite rugby and other invasion sports.
Project description:BACKGROUND:Rugby league is a collision sport, where players are expected to be physically competent in a range of areas, including aerobic fitness, strength, speed and power. Several studies have attempted to characterise the physical demands of rugby league match-play, but these studies often have relatively small sample sizes based on one or two clubs, which makes generalisation of the findings difficult. Therefore, the aim of this review was to synthesise studies that investigated the physical demands of professional rugby league match-play. METHODS:SPORTDiscus, CINAHL, MEDLINE (EBSCO) and Embase (EBSCO) databases were systematically searched from inception until October 2018. Articles were included if they (1) recruited professional rugby league athletes aged ??18?years and (2) provided at least one match-play relevant variable (including playing time, total and relative distance, repeat high-intensity efforts (RHIE), efforts per RHIE, accelerations and decelerations, total and relative collisions). Meta-analyses were used to provide pooled estimates ±?95% confidence intervals. RESULTS:A total of 30 studies were included. Pooled estimates indicated that, compared to adjustables and backs, forwards have less playing time (-?17.2?±?5.6 and -?25.6?±?5.8?min, respectively), cover less 'slow-speed' (-?2230?±?735 and -?1348?±?655?m, respectively) and 'high-speed' distance (-?139?±?108 and?-?229?±?101?m, respectively), but complete more relative RHIEs (+?0.05?±?0.05 and +?0.08?±?0.04 per minute, respectively), and total (+?12.0?±?8.1 and?+?12.8?±?7.2 collisions, respectively) and relative collisions (+?0.32?±?0.22 and?+?0.41?±?0.22 collisions per minute, respectively). Notably, when the distance was expressed relative to playing time, forwards were not different from adjustables and backs in slow-speed (P???0.295) and high-speed (P???0.889) relative distance. The adjustables and backs subgroups were similar in most variables, except playing time (shorter for adjustables, -?8.5?±?6.2?min), slow-speed distance (greater for adjustables, +?882?±?763?m) and total relative distance (greater for adjustables, +?11.3?±?5.2?m·min-1). There were no significant differences between positional groups for efforts per RHIE, accelerations and decelerations (P???0.745). CONCLUSIONS:These results indicate the unique physical demands of each playing position and should be considered by strength and conditioning and tactical coaches when planning for professional rugby league performance. PROTOCOL REGISTRATION: https://osf.io/83tq2/.
Project description:OBJECTIVES:To determine (1) the prevalence of ankle osteoarthritis (OA) among former professional football and rugby players, (2) assess the association between ankle injuries or ankle surgeries with ankle OA, and (3) compare the mental and physical quality of life (QoL) between former professional football and rugby players with and without OA. METHODS:We conducted a questionnaire-based observational study with a cross-sectional design. Former professional football and rugby players were recruited by the Football Players Worldwide and the International Rugby Players. Information concerning ankle OA, sustained ankle injuries and ankle surgeries was gathered (medical record or most recent medical professional). Health-related QoL was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) physical and mental health scores. RESULTS:Overall, 553 former professional football (n=401) and rugby (n=152) players were enrolled in the study (response rate of 56%). Ankle OA prevalence among former professional football and rugby players was 9.2% and 4.6%, respectively. Football players were more likely to suffer from ankle OA following every ankle injury and/or surgery. Football and rugby players with ankle OA had similar PROMIS physical and mental health scores to the norm for the general population. CONCLUSION:Former professional football and rugby players had higher ankle OA prevalence than the general population (3.4%). Football players are more likely to suffer from ankle OA following every ankle injury and/or surgery. No clinically relevant difference was seen for physical or mental health-related QoL among football and rugby players. Preventive measures for ankle injuries are recommended.
Project description:Using a prospective cohort study design, to establish the incidence and nature of time-loss injuries in English community rugby and to assess the differences between different playing levels.English community rugby clubs.Injury information for 4635 matches was collected during seasons 2009/2010 (46 clubs), 2010/2011(67 clubs) and 2011/2012 (76 clubs). Clubs were subdivided into groups A (semiprofessional), B (amateur) and C (recreational) for analysis.Any injury resulting in 8 days or greater absence from match play was reported by injury management staff at the clubs. The primary outcome measure was injury incidence (per 1000 player match-hours) and the secondary outcome measure was severity (ie, days absence).Overall match injury incidence was 16.9 injuries per 1000 player match-hours. Incidence was higher for group A (21.7; 95% CI 19.8 to 23.6) compared with group B (16.6; 95% CI 15.2 to 17.9) and C (14.2; 95% CI 13.0 to 15.5, both p<0.001). The mean time-loss was 7.6 weeks absence, with knee and shoulder injuries the most severe with mean absences of 11.6 and 9.3 weeks, respectively. Half of all injuries occurred to the lower limb, with knee and ankle joint/ligament injuries the most common diagnoses. Shoulder joint/ligament injuries were the most common and severe upper limb injuries. Contact events accounted for 80% of all injuries and tackles accounted for 50%. Running was the most common non-contact injury event, of which 56% were hamstring injuries.More time-loss injuries occur at higher levels of community rugby. Injury prevention strategies should focus on good technique in the tackle and conditioning exercises for the knee, ankle, hamstrings and shoulder.
Project description:<h4>Introduction</h4>Rugby football (Union and League) provides physical activity (PA) with related physical and mental health benefits. However, as a collision sport, rugby research and media coverage predominantly focus on injuries in elite players while the overall impact on health and well-being remains unclear. This study aims to provide a greater understanding of the risks and benefits of rugby participation in a diverse sample of men and women, current and former rugby Union and League players from recreational to the elite level of play. We will explore: (1) joint-specific injuries and concussion; (2) joint pain and osteoarthritis (OA); (3) medical and mental health conditions; (4) PA and sedentary behaviour and (5) well-being (quality of life, flourishing and resilience).<h4>Methods and analysis</h4>The Rugby Health and Well-being Study is designed in two phases: (1) a UK-wide cross-sectional survey and (2) cross-validation using health register data from Scotland. Participants will be at least 16 years old, current or former rugby players who have played rugby for at least one season. We will report standardised, level of play-, sex- and age-stratified prevalence of joint injury, concussion, medical conditions and PA. We will describe injury/concussion prevention expectations and protective equipment use. Rugby-related factors associated with injury, pain, OA, PA, health and well-being will be explored in regression models. We will compare joint pain intensity and duration, elements of pain perception and well-being between recreational and elite players and further investigate these associations in regression models while controlling for confounding variables. In the second phase, we will validate self-reported with health register data, and provide further information on healthcare use.<h4>Ethics and dissemination</h4>The Yorkshire and the Humber-Leeds East Research Ethics Committee (REC reference: 19/HY/0377) has approved this study (IRAS project ID 269424). The results will be disseminated through scientific publications, conferences and social media.
Project description:Collision sports, such as Rugby Union (“Rugby”) have a particularly high risk of injury. Of all injuries common to collision sports, concussions have received the most attention due to the potentially negative cognitive effects in the short- and long-term. Despite non-professional Rugby players comprising the majority of the world’s playing population, there is relatively little research in this population. Stellenbosch Rugby Football Club (“Maties”), the official rugby club of Stellenbosch University, represents one of the world’s largest non-professional Rugby clubs, making this an ideal cohort for community-level injury surveillance. The aim of this study was to describe the incidence and events associated with concussion in this cohort. Baseline demographics were obtained on the 807 male student Rugby non-professional players who registered for the 10-week long 2018 season, which comprised 101 matches and 2,915 of exposure hours. All match-related injuries were captured by the medical staff of Stellenbosch Campus Health Service on an electronic form developed from the consensus statement for injury recording in Rugby. The mean age, height and weight of this cohort were 20 ± 2 years, 182 ± 7 cm and 88 ± 14 kg, respectively. Overall, there were 89 time-loss injuries, which equated to an injury rate of 30.6 per 1,000 match hours [95% confidence intervals (CIs): 24.2–36.9], or about one injury per match. The most common injury diagnosis was “concussion” (n = 27 out of 90 injuries, 30%), at a rate of 9.3 per 1,000 match hours (95% CIs: 5.8–12.8). The three most common mechanisms of concussion in the present study were performing a tackle (33%), accidental collision (30%) and being tackled (11%). Concussion was the most common injury in this population, at a rate that was six times higher than the most comparable study from the UK, which had far more exposure time over six seasons and wider range of player ability, from recreational to semi-professional. This might be explained by the training and vigilance of the club’s first aiders observing all matches for concussion. Future studies should try to explain this high rate and subsequently reduce these concussions. The addition of video surveillance data would assist in identifying the etiology of these concussions injuries in order to develop specific targeted interventions.
Project description:As women's rugby league grows, the need for understanding the movement patterns of the sport is essential for coaches and sports scientists. The aims of the present study were to quantify the position-specific demographics, technical match statistics, and movement patterns of the National Rugby League Women's (NRLW) Premiership and to identify whether there was a change in the intensity of play as a function of game time played. A retrospective observational study was conducted utilizing global positioning system, demographic, and match statistics collected from 117 players from all NRLW clubs across the full 2018 and 2019 seasons and were compared between the ten positions using generalized linear mixed models. The GPS data were separated into absolute (i.e., total distance, high-speed running distance, and acceleration load) and relative movement patterns (i.e., mean speed, mean high speed (> 12 km·h<sup>-1</sup>), and mean acceleration). For absolute external outputs, fullbacks covered the greatest distance (5,504 m), greatest high-speed distance (1,081 m), and most ball-carry meters (97 m), while five-eighths recorded the greatest acceleration load (1,697 m·s<sup>-2</sup>). For relative external outputs, there were no significant differences in mean speed and mean high speed between positions, while mean acceleration only significantly differed between wingers and interchanges. Only interchange players significantly decreased in mean speed as their number of minutes played increased. By understanding the load of NRLW matches, coaches, high-performance staff, and players can better prepare as the NRLW Premiership expands. These movement patterns and match statistics of NRLW matches can lay the foundation for future research as women's rugby league expands. Similarly, coaches, high-performance staff, and players can also refine conditioning practices with a greater understanding of the external output of NRLW players.
Project description:Numerous studies have documented the incidence and nature of injuries in professional rugby union, but few have identified specific risk factors for injury in this population using appropriate statistical methods. In particular, little is known about the role of previous short-term or longer-term match exposures in current injury risk in this setting.Our objective was to investigate the influence that match exposure has upon injury risk in rugby union.We conducted a seven-season (2006/7-2012/13) prospective cohort study of time-loss injuries in 1253 English premiership professional players. Players' 12-month match exposure (number of matches a player was involved in for ?20 min in the preceding 12 months) and 1-month match exposure (number of full-game equivalent [FGE] matches in preceding 30 days) were assessed as risk factors for injury using a nested frailty model and magnitude-based inferences.The 12-month match exposure was associated with injury risk in a non-linear fashion; players who had been involved in fewer than ?15 or more than ?35 matches over the preceding 12-month period were more susceptible to injury. Monthly match exposure was linearly associated with injury risk (hazard ratio [HR]: 1.14 per 2 standard deviation [3.2 FGE] increase, 90% confidence interval [CI] 1.08-1.20; likely harmful), although this effect was substantially attenuated for players in the upper quartile for 12-month match exposures (>28 matches).A player's accumulated (12-month) and recent (1-month) match exposure substantially influences their current injury risk. Careful attention should be paid to planning the workloads and monitoring the responses of players involved in: (1) a high (>?35) number of matches in the previous year, (2) a low (<?15) number of matches in the previous year, and (3) a low-moderate number of matches in previous year but who have played intensively in the recent past. These findings make a major contribution to evidence-based policy decisions regarding match workload limits in professional rugby union.