Risk Factors for Injury in Elite Rugby Union:A Series of Longitudinal Analyses

The contacts and collisions that are inherent to elite Rugby Union, alongside changes to players’ physical characteristics and match activities, have raised concerns regarding the level of injury burden associated with the professional game. This programme of research was therefore undertaken to investigate injury risk in this setting. The first study of this thesis (Chapter 3) presents a meta-analytic review of injury data relating to senior men’s professional Rugby Union, which shows an overall match incidence rate of 81 per 1000 player hours; this value is high in comparison with other popular team sports. In Chapter 4, the importance of injuries in the context of performance is demonstrated by showing a substantial negative association exists between injury burden and team success measures. Chapter 5 investigates subsequent injury patterns in this population and identifies injury diagnoses with a high risk of early recurrence, whilst also demonstrating that subsequent injuries are not more severe than their associated index injury. Playing professional Rugby Union on an artificial playing surface does not influence overall acute injury risk in comparison with natural grass surfaces (Chapter 6). Chapters 7 and 8 identify intrinsic risk factors for injury (previous injury, match and training loads) for the first time in this setting, and may be used to inform policies on these pertinent issues. Finally, predictive modelling techniques show some potential for predicting the occurrence and severity of injuries, but require further refinement before they can be implemented within elite Rugby Union teams. Overall, this programme of work highlights the importance of injury prevention for all professional Rugby Union stakeholders, addresses the need to use appropriate statistical techniques to account for the dynamic and clustered nature of sport injury data, and demonstrates approaches through which the injury burden associated with elite Rugby Union may be reduced.

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