Comparative Injury StudiesComparative Injury Studies

Michael Keating, MS, ATC, CSCSUSA Rugby

Medical Services

What does everyone want to know???

Is rugby safer than football??

Recent Literature ReviewRecent Literature Review

1. Injuries…HS Rugby Players 05-06 – Collins et al – 2008 (RIO Rugby study)

2. Collegiate Rugby Union Injuries – Kerr et al – 2008

3. Injuries in US HS Athletes – Darrow et al – 20094. Tackle Injuries in Pro Rugby – Quarrie &

Hopkins – 2008

RIO Study RIO Study

1. Online reporting of ~ 60 clubs during 2005-2006

2. Online reporting mechanism3. Looked at over 62,000 player exposures 4. Examined over 290 total injuries5. 75% of the reporting was completed by coach

Rio StudyRio StudyInjury rate per 1,000 playerexposures

2005Rugby Rio

2006Rugby Rio

HS Football

Total 6.6 4.7 4.4

Game 15.9 15.0 12.1

Practice 1.5 1.1 2.5

Rio StudyRio StudyInjury rate per 10,000 player

exposures2005

Rugby Rio2006

Rugby RioHS Football

Concussion** 8.6 8.2 4.6

Fracture 8.8 8.2 4.9

Knee 5.2 6.3 6.6

RIO Study RIO Study

1. Fractures, Concussions and Ligament Sprains were the most common injuries – each comprised ~ 16% of all injuries

2. Almost 60% of all injuries occurred during the tackle, 75% involved contact with another player

3. Females had more ligament injuries as compared to males (20.8% > 14.9%)

4. More likely to suffer injury in game v. practice (10:1)

Collegiate Rugby Injuries - USA Collegiate Rugby Injuries - USA

1. Online reporting of ~ 70 clubs during 2005-2006

2. Online reporting mechanism3. Looked at almost 70,000 player exposures 4. Examined 850 total injuries5. 83% of the reporting was completed by coach

Collegiate Rugby Injury StudyCollegiate Rugby Injury StudyInjury rate per 1,000 playerexposures Rugby Football

Game 22.5 41.4*(35.9)

Practice 5.5 5.9

Collegiate Rugby Injury StudyInjury rate per 1,000 playerexposures Rugby Football

Concussion 2.0 4.5

Fracture 1.5+

Sprains 3.5+

College Rugby Injury Study College Rugby Injury Study

1. Ligament Sprains, Muscle Strains and Concussions were the most common injuries

2. Almost 50% of all injuries occurred during the tackle, 75% involved contact with another player

3. More likely to suffer injury in game v. practice (4:1)4. Possible lower injury rates as compared to other

studies secondary to lower standard of play

Future Direction Future Direction

1. Continue to utilize and fund research focusing on youth and college rugby

2. Higher participation of clubs3. Reliable reporting from medical personnel4. Equipment variations/improvements5. Tackle, scrum, lineout, ruck and maul education6. Anthropometric measures of players

Injury PreventionInjury Preventionforfor

RugbyRugby

Acute Injuries vs. Gradual Onset/OveruseAcute Injuries vs. Gradual Onset/Overuse

Overuse or Gradual OnsetOveruse or Gradual Onset

• Used to be a prime concern and still is at Elite Level

• Identify underlying pathology and pathomechanics during screen

• Proper Dynamic Warm-up• Prescribe exercise specific to demands• “Injury Prevention” programs??•Long Term Athletic Development Model

MethodsMethods

Acute InjuriesAcute Injuries

• Previously little to no thought in this arena and now IS the FOCUS• How do we approach this??

Acute InjuriesAcute Injuries

• Absolutely begins and ends with education and coaching!

Acute InjuriesAcute Injuries

• Techniques/skills – especially in contact• Training Sessions – contact vs. limited

contact •LTAD

Optimal development of young playersOptimal development of young players

• Influence of growth and maturity on early success• Dangers of overspecialisation at an early age (physical and

skills-related)• Long-term consequences (skill-base, injury, burnout)• Some evidence (Hartwig et al 2008) that high training

volumes better tolerated than high competition volumes• Overall lack of information – urgent need for longitudinal

observational studies form 16 – 21 years

Anti-DopingAnti-Dopinginin

RugbyRugby

Key is early education that is Key is early education that is both Consistent/Persistentboth Consistent/Persistent

&&RelevantRelevant

ResourcesResources

1.1.USADA – www.usantidoping.orgUSADA – www.usantidoping.org2.2.IRB – new site – www.keeprugbyclean.comIRB – new site – www.keeprugbyclean.com3.3.WADAWADA