A prospective study of injuries and training amongst the England 2003 Rugby World Cup squad

Objectives: To assess the aetiology, incidence, severity, and causes of injuries to England rugby union players during preparation for and participation in the 2003 Rugby World Cup.

Method: A 63 week prospective design was employed to study the training practices and injuries of England rugby players. The team physician reported all training and match injuries and provided details of the location, diagnosis, severity, and mechanism of each injury. The team fitness coach reported details of the number and duration of training sessions and the time dedicated to rugby and conditioning training. Players' stature, body mass, and skinfolds were measured at the beginning and end of the study period.

Results: The overall incidence of injury was 17 injuries/1000 h of exposure (match: 218 injuries/1000 h; training: 6.1 injuries/1000 h). The major locations of injuries were the lower (60%) and upper (17%) limbs and the most common diagnoses were muscle and tendon (50%) and joint (non-bone) and ligament (41%) injuries. The highest incidences of match injuries occurred whilst being tackled (50 injuries/1000 h) and in a ruck or maul (35 injuries/1000 h), whilst the greatest incidences of training injuries occurred during endurance running (24 injuries/1000 h) and contact activities (20 injuries/1000 h). Players' average body mass increased and skinfold measurement decreased significantly over the study period.

Conclusions: The incidence of match injuries at international level was found to be higher than previously reported. The tackle, ruck, and maul elements of match play and the endurance running and contact elements of training presented the highest risk of injury for all players.

     

Attitudes to mouthguards and prevalence of orofacial injuries in four teams competing at the second Rugby World Cup.

The opportunity was taken to conduct a questionnaire survey of the members of four competing countries at the second Rugby World Cup tournament (Australia, Ireland, Scotland, Wales) regarding the prevalence of orofacial injuries and attitudes to mouthguards. The results show that while all players in each team believed that mouthguards provided local protection, approximately one in five of each team did not wear one. The average age when players first started wearing mouthguards varied from 12.7 years for Australia to 18.1 years for Wales, while the percentage of wearers willing to play without their mouthguard ranged from only 4.6% for Australia to 15.8% for Wales. Just less than half of the total group had previously sustained an orofacial injury playing rugby.     

A systematic video analysis of 69 injury cases in World Cup alpine skiing

We have limited insight into how injuries occur in professional ski racing. The aim of this study was to describe the injury situations in World Cup alpine skiing. Injuries reported through the International Ski Federation Injury Surveillance System for three consecutive World Cup seasons (2006–2009) were obtained on video. In total, 69 injuries and 124 runs of matched controls were analysed by five experts to evaluate the skiing situation, skier behavior, as well as piste‐related factors. A chi‐square test (95% CI, P ≤ 0.05) was used to examine whether there was a difference between course sections regarding where the injury situation occurred. The skier was most frequently turning (n = 55) or landing from a jump (n = 13) at the time of injury. Most of the injuries to the head and upper body (96%) resulted from crashes, while the majority of knee injuries (83%) occurred while the skier was still skiing. Gate contact contributed to 30% of the injuries, while 9% occurred at contact with safety nets/material. Almost half of the injuries (46%) occurred in the final fourth of the course. A particular concern was the high contribution of inappropriate gate contact and the high‐energy impacts to the body when crashing.     

Injury surveillance and prevention practices across Rugby schools in Ireland

ObjectivesTo ascertain the extent of injury surveillance and prevention practices currently in operation and the availability of qualified personnel across Rugby playing schools in the Republic of Ireland.DesignCross-sectional survey design.SettingRugby playing schools across Ireland.ParticipantsThe Rugby games master, head Rugby coach or teacher/coach with knowledge of all Rugby activities in the school.ResultsNinety-three Rugby playing schools responded and reported 356 (97% male, 3% female) school Rugby teams. Rugby injuries were formally monitored in 86% of schools. Injury recorders were primarily coaches (61%). Physiotherapy provision was available in 28% of schools, 14% of schools provided access to a medical doctor and 44% of schools provided access to an S&C coach. Structured warm-ups were undertaken in 66% of schools, weekly gym sessions in 49% of schools and 31% of schools did not implement any formal injury prevention measures.ConclusionsInjury monitoring practices, medical personnel accessibility and the frequency of injury prevention practices varies considerably across Rugby playing schools in Ireland. Future injury surveillance and prevention systems should be suitable for use by non-medical personnel and reflect the structural organisation of the school Rugby game so that data are not solely representative of the elite, well-resourced schools.     

Injuries among World Cup ski and snowboard athletes

There is little information available on injuries to World Cup skiers and snowboarders. The aim of this study was to describe and compare the injury risk to World Cup athletes in alpine skiing, freestyle skiing, snowboarding, ski jumping, Nordic combined and cross country skiing. We performed retrospective interviews with the International Ski Federation (FIS) World Cup athletes from selected nations during the 2006–2007 and 2007–2008 winter seasons and recorded all acute injuries occurring during the seasons. We interviewed 2121 athletes and recorded 705 injuries. There were 520 (72%) time‐loss injuries and 196 (28%) severe injuries (absence >28 days). In freestyle skiing, alpine skiing and snowboarding, there were 27.6, 29.8 and 37.8 time‐loss and 14.4, 11.3 and 13.8 severe injuries per 100 athletes per season, respectively. In Nordic combined, ski jumping and cross country skiing, there were 15.8, 13.6 and 6.3 time‐loss and 3.3, 5.6 and 0.7 severe injuries per 100 athletes per season, respectively. In conclusion about 1/3 of the World Cup alpine, freestyle and snowboard athletes sustain a time‐loss injury each season, while the risk is low in the Nordic disciplines. A particular concern was the high proportion of severe injuries observed among alpine, freestyle and snowboard athletes, which is in contrast to most other sports.     

Injuries among elite snowboarders (FIS Snowboard World Cup)

Background

Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries.

Objective

To describe the incidence and type of injuries among female and male snowboarders at international elite level.

Method

At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs.

Results

The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee.

Conclusion

The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while that for the snowboard slalom disciplines is lower. The injury pattern is different from recreational athletes, with a greater share of knee injuries and fewer wrist injuries. Compared with national level, the injury risk appears to be lower at World Cup level.     

Incidence of injury in elite junior Rugby Union: a prospective descriptive study

The high incidence of injury in Rugby Union is well documented, particularly at elite levels of competition. This article describes the incidence and nature of all injuries sustained by elite Western Australian junior Rugby Union players during the 26 weeks up to and including the 1997 National Championship campaign. Informed consent was gained for each participant (n = 44) prior to completion of an extensive baseline questionnaire. Exposure and injury data were collected at each training session and game. The injury incidence rate over the 26 week period was 13.26/1000 player hours. Injury data were analysed by phase of play, position, severity and if occurred at games or training. The incidence of injury was significantly associated with the position played (chi2 = 67.49, p value = 0.008) and the phase of play in which the injury occurred (chi2 = 8.07, p value = 0.042). Tackling was the most dangerous phase of play (52% of injuries) and the most common site of injury was the lower limb (37%). Most injuries occurred during games (56%) and the flanker was the position most at risk of injury (12%). Further research is needed to identify the aetiology of injury at all levels of competition and to use these findings to develop effective injury prevention strategies in this sport. Position-specific risk factors should also be investigated, as should the mechanism of injury associated with tackling which is the phase of play in which significantly more injuries occur in rugby.