Rugby injuries from the perspective of a Sports Chiropractor
Rugby Union injuries – Specific Risk factors
As promised in the previous introductory article listed below are specific injury risk factors identified by current research with in the sport of rugby union. Hopefully some will find the information interesting if not useful. Hopefully by the end of this series of articles it will begin to help people understand that the scope of the sports chiropractor extends beyond that of just treatment of lower back pain, neck pain and sciatica.
Age and ethnicity
With regard to age, 21-34 year olds had an increased risk of injury, which increased as they got older (Chalmers, Samaranayaka et al. 2012) (Bleakley, Tully et al. 2011). Players of pacific island ethnicity had a 48% higher risk of injurywhen compared with Maori and non-Maori rugby players (Chalmers, Samaranayaka et al. 2012).
Level of play
Players in Senior A and Presidents/social grades were at higher risk of injury when compared to under 18 and 19 year old players. The Presidents or social grade teams had a 92% higher risk compared with the Under 18 and 19 grade (Chalmers, Samaranayaka et al. 2012).
Chalmers et al, 2012 found that taller and heavier players, more specifically those with a BMI of above 25 kg/m2 were associated with a higher risk of injury (Chalmers, Samaranayaka et al. 2012), however, Fuller et al, 2010 found that when looking at a whole team, average body mass did not create greater risks of injury for the lighter teams competing at Rugby World Cup 2007 (Fuller, Caswell et al. 2010)
Strenuous physical activity
Players reporting strenuous physical activity of greater than or equal to 40 hours per week were at 54% higher risk of becoming injured while playing rugby (Chalmers, Samaranayaka et al. 2012)
Chalmers et al, 2012 found that injury risk was lower for players wearing mouth guards and shin guards compared with non-users, however the wearing of headgear and shoulder padding appeared to be associated with higher risk, with those wearing headgear 23% more likely to sustain injury compared with non-users (Chalmers, Samaranayaka et al. 2012).
Hooker and outside centre were identified by Brooks et al, 2005 as the playing positions at greatest risk of injury (Brooks, Fuller et al. 2005) with midfield backs being significantly more prone to injury when tackling, than other players. (Fuller, Ashton et al. 2010). Hookers and props have a disproportionate risk of cervical spine injury, usually as a result of scrummaging (Quarrie, Cantu et al. 2002). Chalmers et al, 2012 found that there was no evidence of an association between injury rate and position but that playing out of usual position appeared to be associated with higher risk (Chalmers, Samaranayaka et al. 2012).
Fuller et al, 2010 found that mismatches in the teams’ overall and match performances did not create greater risks of injury for the lighter or less successful teams competing at Rugby World Cup 2007 (Fuller, Caswell et al. 2010)
Previous history of injury
Players with a history of greater than or equal to two injuries in the past 12 months, or those who had played while injured in the past 12 months had a 46% higher risk of injury (Chalmers, Samaranayaka et al. 2012).
Knowing risk factors helps me in my role as a sports chiropractor but can equally be as useful for those actively involved in the game of rugby. Shoulder pain, knee pain, neck and lower back pain are the most common rugby related complaints I see in my sports chiropractic practice, however less commonly chest pain, hip and heel pain respond very well to sports chiropractic therapies.
Bleakley, C., M. Tully, et al. (2011). “Epidemiology of Adolescent Rugby Injuries: A Systematic Review.” Journal of Athletic Training 46(5): 555-565.
Brooks, J. H. M., C. W. Fuller, et al. (2005). “Epidemiology of injuries in English professional rugby union: part 1 match injuries.” British Journal of Sports Medicine 39(10): 757-766.
Brooks, J. H. M., C. W. Fuller, et al. (2005). “Epidemiology of injuries in English professional rugby union: part 2 training Injuries.” British Journal of Sports Medicine 39(10): 767-775.
Chalmers, D. J., A. Samaranayaka, et al. (2012). “Risk factors for injury in rugby union football in New Zealand: a cohort study.” British Journal of Sports Medicine 46(2): 95-102.
Fuller, C. and A. Taylor (2011). IRB Injury Surveillance Study, HSBC Sevens World Series 2010/11, International Rugby Board.
Fuller, C. W., T. Ashton, et al. (2010). “Injury risks associated with tackling in rugby union.” British Journal of Sports Medicine 44(3): 159-167.
Fuller, C. W., J. H. M. Brooks, et al. (2007). “Contact events in rugby union and their propensity to cause injury.” British Journal of Sports Medicine 41(12): 862-867.
Fuller, C. W., S. E. Caswell, et al. (2010). “Do mismatches between teams affect the risk of injury in the Rugby World Cup?” Journal of Science and Medicine in Sport 13(1): 36-38.
Fuller, C. W., L. Clarke, et al. (2010). “Risk of injury associated with rugby union played on artificial turf.” Journal of Sports Sciences 28(5): 563-570.
Fuller, C. W., F. Laborde, et al. (2008). “International Rugby Board Rugby World Cup 2007 injury surveillance study.” British Journal of Sports Medicine 42(6): 452-459.
Fuller, C. W., M. Raftery, et al. (2009). “Match injuries in Southern Hemisphere professional rugby union: Impact of the International Rugby Board’s Experimental Law Variations.” South African Medical Journal 99(4).
Fuller, C. W. and A. Taylor (2011). IRB Injury Surveillance Study: U-20 Tournaments: JWC and JWRT 2011, International Rugby Board.
Fuller, C. W., A. Taylor, et al. (2010). “Epidemiological Study of Injuries in International Rugby Sevens.” Clinical Journal of Sport Medicine 20(3): 179-184 110.1097/JSM.1090b1013e3181df1091eea.
Quarrie, K. L., R. C. Cantu, et al. (2002). “Rugby union injuries to the cervical spine and spinal cord.” Sports medicine (Auckland, N.Z.) 32(10): 633-653.
Quarrie, K. L. and W. G. Hopkins (2008). “Tackle Injuries in Professional Rugby Union.” The American Journal of Sports Medicine 36(9): 1705-1716.