England Professional Rugby Injury Surveillance Project 2012-2013 Season Report England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
• Theoverallrisk(incidenceanddaysabsence)ofmatchandtraininginjuryinthePremiershipremainedstableduringthe2012-13seasonandwaswithinthe“normalrange”ofseasonbyseasonvariationseensincethestudybeganin2002.
• 335traininginjuriesthatledtotimelostfromtrainingand/ormatchplaywerereportedinthe2012-13season.Athirdofallreportedinjuriesoccurredintraining(rugbyskillsandstrengthandconditioningcombined),apotentiallycontrollableenvironment
- Theseverityoftraininginjurieswashigherthantheexpectednormalrangein2012-13.Thisislikelyduetotheincreaseinincidenceofmoreseveretraininginjuriesresultingingreaterthan28daysabsence.
- Theinjuriesthatcontributedmosttothisrisewereinferiortib/fibsyndesmosisinjuries(highanklesprains)andgrade2kneemedialcollateralligamentinjuries(MCL).
- Itishopedthatthepilotstudybeingundertakentocapturetheintensityandloadoftrainingin2013-14anditsrelationshipwithinjurywillallowbettercontextualisationofthischange.
• Aclearassociationbetweeninjuryburdenmeasuresandteamperformancefortheperiod2006-2012wasfoundwithalowerinjuryburdenassociatedwithahigherleaguepointstally.Therewasalsoasignificantinteractionbetweeninjuryburdenandsquadsize,suchthattherelationshipbetweeninjuryburdenandteamperformancedecreasedwitheachadditionalsquadmember.Thesefindingshighlighttheimportantrolethatmedicalandfitnessstaffhaveinreducingtheincidenceofandminimisingthetimelostinjuriesinordertoimproveteamperformancealongwiththeimportanceofanappropriatesquadsize.
• Concussionwas,forthesecondconsecutiveseason,themostcommonPremiershipmatchinjury.Theincidencefor2012-13wasabovetheexpectedvariationforthefirsttimeduringthestudyperiod.Itisthoughtthatthisincreaseiscausedbyanincreasedawarenessofconcussionandthusagreaterfocusandunderstandingofdiagnosis.Thishighlightstheimportanceofaco-ordinatedconcussionriskmanagementpolicy.The2013-14IRBPitchSideConcussionAssessment(PSCA)processisbeingtrialledinthePremiershipandLVCup.TheInjurySurveillanceGroupisalsospecificallyauditingConcussionmatchinjuriesandthereturntoplaypathway.Theresultsofwhichwillbeavailableinlate2014.
• Themedical/injuryelementsofthedatacollectionforthesurveillanceprojectwillbeintegratedintothenewRugbySquadelectronicmedicalrecorddatabaseforthe2013-14season.Thiswillprovidenewopportunitiestosurveyillnessandnontime-lossinjuries,deliverbespokediagnosisspecificquestionnairesandbettercorrelatetrainingloadandmatchinjuryrisk.
Executive summary
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Contents
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ExecutiveSummary
Background
Definitions
Keyfindings Matchinjuryincidenceandseverity
Traininginjuryincidenceandseverity
Injuryburdenandperformance
Reporting variability Injury recurrence
Matchinjuries Traininginjuries
Injuriesleadingtoretirement
MatchInjuryeventTimeinseason
Trainingvolume
Traininginjuryevent Concussion
Hamstringinjuries
Mostcommonmatchinjuries
Injury diagnosis
Highestrisktraininginjuries
Highestriskmatchinjuries
Englandmatchandtraininginjuryrisk
Mostcommontraininginjuries
Matchinjuries
Traininginjuries
RFUinjurysurveillanceprojectmethods
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AuthoredbytheEnglandProfessionalRugbyInjurySurveillanceProjectSteeringGroup
ChairedbyDrSimonKemp(ChiefMedicalOfficerRFU)andcomprising,MatthewCross(PhDStudentandInjurySurveillanceProjectResearchAssistant,UniversityofBath),DrJohnBrooks(ExInjuryRiskAnalystandExHarlequinsandEnglandSaxons),DrColinFuller(RiskManagementConsultantIRBandFIFA),NickJohnston(HighPerformanceDirectorWorcesterWarriors),DrTimAnstiss(RPAMedicalAdvisor),MrAndySmith(ConsultantinEmergencyMedicine,MidYorkshireNHSTrustandPremiershipRugbyClinicalGovernanceAdvisor),AileenTaylor(PhysiotherapistandExInjuryAuditResearchAssistant),DrGrantTrewartha(SeniorLecturer,UniversityofBath),SeanWilliams(PhDStudent,UniversityofBath)andDrKeithStokes(InjurySurveillanceProjectPrincipalInvestigator,UniversityofBath)
ThecontentofthereportisbasedondatacollectedandanalysedbyMatthewCross(UniversityofBath)
Theauthorswouldliketoacknowledgewithconsiderablegratitude,theworkofthedoctors,physiotherapistsandstrengthandconditioningstafffromPremiershipclubsandEnglandteamswhohaverecordedinjuryandtraininginformationthroughouttheproject
Timeofinjury
England Senior side
Currentpublications
Supplementarydata
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
IntroductionTheRugbyFootballUnion(RFU)andPremierRugbyLtd(PRL)firstcommissionedaninjurysurveillancestudyacrossthePremiershipandEnglandteamsin2002thatremainsdrivenanddirectedtowardstheimprovementofplayerwelfarethroughoutthegame.Thisreportpresentspremiership-widekeyfindingsfromthe2012-13season,butparticipatingclubsalsoreceiveindividualmid-andend-of-seasonreportscomparingtheirdatatoaPremiershipaverage.Theaimistoprovideinformationthatinformsbestpracticeguidelinesateachclub.The2012-13seasonresultsinthisreportarecomparedlongitudinallywiththeresultsfrom9previousseasons’research.TheRFUinjurysurveillanceprojectispivotalinbothprovidingthebaselinedataneededtoassesstrendsininjuryandinguidingfurtherinvestigationintoinjuriesthatarecommon,severeorincreasinginincidence.
ThemethodsfortheRFUInjurySurveillanceProjectcanbefoundattheendofthisreport.Supportingtablesareincludedinthesupplementarydatafilealongsidethisreport.
Developments2012-13Inlinewiththecontinuedgrowthininterestinconcussionandsubsequentplayermanagement,the2012-13seasonsawtheRFUintroduceaconcussionauditacrossall12premiershipclubs.Thiswasintroducedtoimproveunderstandingofthetimecourseresolutionofconcussionin professional rugby union and includes an audit of return toplaypractices.DatacollectionforthisstudyhasbeenrunningalongsidetheIRBglobaltrialofthePitchsideSuspectedConcussionAssessmentTool(PSCA).BoththeRFUconcussionstudyandtheIRBPSCAtrialcontinueintothe2013-14season,andthefindingswillbereportedin2014.
Inastudyrelatedtotheinjurysurveillanceproject,apilotstudysupportedbytheRFU,PRLandRugbyPlayers
Association(RPA)wasconductedin2012-13tocomparetheincidenceandnatureoftime-loss,non-time-lossandabrasioninjuriesduringmatchesplayedonartificialturfandnaturalgrass.Thisstudyhasbeenextendedtoafullstudythatwillcontinuethroughthe2013-14season.
Lookingforward2013-14Themedical/injuryelementsofthedatacollectionforthesurveillanceprojecthavebeenintegratedintothenewRugbySquadelectronicmedicalrecorddatabaseforthe2013-14season.Thiswillprovidenewopportunitiestosurveyillnessandtodrilldownonareasofspecificimportancethroughthedevelopmentofbespokedatacapturemethods.
Forthefirsttime,inapilotstudyalignedwiththeinjurysurveillanceproject,individualplayertrainingintensityandloadwillbecapturedfromanumberofPremiershipclubsin2013-14.Theaimofthisstudyistoinvestigatetherelationshipbetweentrainingintensityandloadandinjuryrisk,somethingnotyetexploredwithintheremitofthesurveillanceproject.
IncollaborationwiththeRFUlawsgroup,therewillalsobeanevaluationofthelawtrialamendmenttothescrumengagementsequence.ThischangeisbasedonresearchconductedbytheUniversityofBathonbehalfoftheIRB.Nextseason’sinjurysurveillancereportwillcommentupontheeffectofthislawamendmentonscruminjuryrisk.
Background
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Definitions InjuryAninjurywasdefinedas‘anyinjurythatpreventsaplayerfromtakingafullpartinalltrainingactivitiestypicallyplannedforthatdayand/ormatchplayformorethan24hoursfrommidnightattheendofthedaytheinjurywassustained’.Forexample,ifaplayerwasinjuredduringamatchonSaturdayandhewasabletotakeafullpartintrainingonMonday,theincidentwouldnotbeclassedasaninjury.Iftheplayer’strainingwasrestrictedonMondayduetotheinjuryreceivedonSaturday,theincidentwouldbeclassedasaninjuryandreported.
Injury severityInjuryseveritywasmeasuredastime(days)lostfromcompetitionandpracticeanddefinedasthenumberofdaysfromthedateoftheinjurytothedatethattheplayerwasdeemedtohaveregainedfullfitnessnotincludingthedayofinjuryorthedayofreturn.Aplayerwasdeemedtohaveregainedfullfitnesswhenhewas‘abletotakeapartintrainingactivities(typicallyplannedforthatday)andwasavailableformatchselection.’
Recurrent injuryAninjuryofthesametypeandatthesamesiteasanindexinjuryandwhichoccursafteraplayer’sreturntofullparticipationfromtheindexinjury.
Injury incidence and days absenceThelikelihoodofsustaininganinjuryduringmatchplayortrainingisreportedastheInjuryincidence.TheInjuryincidenceisthenumberofinjuriesexpressedper1,000player-hoursofmatchexposure(ortrainingexposure).Equallyimportanttotheplayerand/orhisteamishowlongplayersareabsent.Thisisknownasinjuryseverityandismeasuredindaysabsence.
StatisticalsignificanceAresultisconsideredtobestatisticallysignificantiftheprobabilitythatithasarisenbychanceislessthan5%or1in20.Inthisreportstatisticalanalysishasbeenperformedforthematchandtraininginjuryincidenceanddaysabsence.SPCchartinghasbeenusedtoshowtheexpectedlimitsofthesystemwithupperandlowerlimitssetat+/-2standarddeviationsfromthemean.
ThE ovERall RISk of InjuRy In ThE PREmIERShIP haS BEEn STaBlE SInCE 2002
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Match injury incidence and severity SummaryofmatchinjuryriskMatchinjuryriskremainswithintheexpectedlimitsofnaturalseason-to-seasonvariationbasedonthedatasince2002(Forabreakdownofincidenceandseveritybyseasonsee table S1).
Likelihoodorincidenceofinjury588matchinjuriesthatledtotimelostfromtrainingand/ormatchplaywerereportedinthe2012-13seasoncomparedwithameanof678injuriesfortheperiod2002-12.Thematchincidencefor2012-13was73/1000playerhours.Thisincidenceislowerthaninpreviousseasonsandlikelyreflectsthedropoffin2-3dayinjuriesseenintable S2.405teammatcheswereincludedintheanalysisduring2012-13equatingtoanaverageof49matchinjuriesperclubfortheseasonand1.5injuriesperclubpermatch.Thisisaround6injuriesperclublowerfortheseasonthanin2011-12.
Severityofinjuriesanddaysabsencefromplayingandtrainingasaresultofmatchinjuries Theaverageseverityof25daysforaninjurybeforereturntoavailabilityformatchselectionalsofallswithinexpectednaturalvariationbasedondatasince2002,howeverfigure1bshowsatrendingpatternhighlightinganincreaseintheseverityofmatchinjuriesfortheperiodsince2002.
Thetotalnumberofdaysabsenceasaresultofmatchinjuriesfor2012-13wasverysimilartothemeanacrossthestudyperiod.Theaveragedaysabsenceperclubpermatchin2012-13was35(Foramoredetailedbreakdownofinjuryincidenceby severity type see table S2).
key findings
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Training injury incidence and severity SummaryoftheTraininginjuryrisk335traininginjuries(rugbyskillsandstrengthandconditioningcombined)thatledtotimelostfromtrainingand/ormatchplaywerereportedinthe2012-13season. Thisequatedtoanincidencerateof2.6/1000playerhoursoraround28injuriesperclubperseason(Aseasonbyseasonbreakdowncanbeseenintable S3).
Theincidenceofinjuryintrainingfellwithintheexpectedlimitsofnaturalseason-to-seasonvariationbasedonthedatasince2002,andwasverysimilartothemeanincidenceforthestudyperiod(2.6vs.2.4/1000playerhours).Theseverityoftraininginjuries(29days)washigherthantheboundsofexpectednaturalvariation.Thisislikelyduetotheincreaseinincidenceofmoreseveretraininginjuries(>28days) (table S4).Theinjuriesthatcontributedmosttothisrise wereinferiortib/fibsyndesmosis(totaldaysabsence953days,meanseverity56days)andkneeMCLgrade2injury(totaldaysabsence611days,meanseverity61days).
Furtherresearchintothemanagementoftheseinjuriesmaybeofparticularinteresttoclinicians.Thisincreaseininjuryseveritycombinedwithnosignificantchangeintrainingvolumemaymeanthatthemostlikelyexplanationisanincreaseintrainingintensity.Theprocessofcapturing training load and intensity in selected clubs will startin2013-14andshouldproveinvaluableinordertocontextualisetheseresults.
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Figure 1a: Incidenceratesofmatchinjuriesoverthestudyperiodwithmean±2xstandarddeviationshown.Note-foranormaldistribution,95%ofalldatashouldfallbetween(Mean-2xstandarddeviation)and(Mean+2xstandarddeviation).
Figure 1b: Severityofmatchinjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure 1c: Daysabsence/1000hrsfrommatchinjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure 2a: Incidenceratesoftraininginjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure 2b: Severityoftraininginjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure 2c: Daysabsence/1000hrsfortraininginjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Injury burden and performance SummaryofmatchinjuryriskWehaveexploredtheassociationbetweeninjuryburden andleagueperformanceinthePremiershipfrom2006-2012.Ithasbeensuggestedthattherearetwomajorcomponentsofsportsteamperformance;playerskillandplayerdurability,andthatplayerdurabilitymaybeanunder-recognisedfacetofteamsuccess.ThisisthefirstinvestigationoftheassociationbetweeninjuriesandteamperformanceineliteRugbyUnion.
Therelationshipbetweenteamseasonperformance(Premiershipleaguepointstally)andinjuryburden(‘overallinjuryincidence×meanabsenceperinjury’)formatchandtraininginjuriescombinedwasdetermined.Teamsquadsizewasalsoincludedintheanalysistodeterminewhethertheeffectofinjuryburdenonteamperformancedependedonsquadsize.Thethresholdforsmallestworthwhilechangewassetatthreeleaguepoints.
Aclearassociationbetweeninjuryburdenmeasuresandteamperformancewasfoundwithalowerinjuryburdenassociatedwithahigherleaguepointstally.Achangeof42injurydaysper1000playerhours(95%CI;26to111)wasassociatedwithachangeinleaguepointstallyof3points.Therewasalsoasignificantinteractionbetweeninjuryburdenandsquadsize,suchthattherelationshipbetweeninjuryburdenandteamperformancedecreasedwitheachadditionalsquadmember.Thesefindingshighlighttheimportantrolethatmedical,physiotherapistsandfitnessstaffhaveinreducingtheincidenceand/orseverityofinjuriesinordertoimproveteamperformance.Moredetailedresultsofthisanalysiswillbepublishedseparatelytothisreport.
Workedexample1Theaverageclubin2012-13sustained77injuries(49matchand28training)withanaverageseverityof27days. Thecombinedincidenceforeachclubwas6.7/1000playerhours,meaningtheinjuryburdenfortheaverageclubis 182days/1000hours.Thismeansthatareductionofasingleinjuryleadstoareductionin2.4days/1000hoursofinjuryburden.For2012-13ifaclubreducedtheirtotalnumberofinjuriesby18thiswouldgiverisetoareductioninburdenof42days/1000hours,andtherefore,basedonthemodelwouldbeattributedtoanadditional3leaguepoints.
Workedexample2Reducingtheaverageseverityofinjury(duetoa‘real’changecausedbyimprovementsinthetreatmentandmanagementofaplayer,ratherthanrushingaplayerbacktocompetitionbeforefullrecoveryhasoccurred)canalsoinfluenceperformance(asinjuryburdenistheproductofincidenceandseverity).In2012-13,a1dayreductioninaverageseveritycauseda6.7days/1000hourreductionininjuryburden.Toachieveaworthwhilechangeinperformance(3leaguepoints)theaverageseveritywouldneedtobereducedby6days.
Thetwoexamplesabovedealexclusivelywiththereductionofincidenceorseveritytohighlighttheireffect,butthemostlikelyoutcomewouldbeasimultaneouschangeinbothvariablesleadingtoaworthwhilechangeinperformance.
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Reporting variability Followingcommentsmadeaspartofthescientificpeer-reviewprocessforpapersrecentlypublishedbythegroup,andforinternalqualityassuranceweinvestigatedthevariabilityinreportingoftimeloss(i.e.,onedayormore)andmatchtimeloss(i.e.eightdaysormore)withinandbetweenclubsfortheperiod2002-13.Ithaspreviouslybeenstatedthatthereliabilityinthereportingofinjurieswithaseverityoflessthan7daysisnotasgoodasthoseinjuriesthataremoresevere(≥8days).
Therewasnocleardifferenceinthevariabilityofreportingwhenusingaone-dayversusaneight-daydefinitionofinjury.Thisindicatesthatthereliabilityofreportingofinjuriesthataremild(accordingtotheIRBconsensusstatement)isasgoodasmoderateinjuries.Clinically,injuriesthatcarryaseverityoflessthaneightdaysrepresentalargeproportionoftreatmenttimeandburdenuponclubmedicalstaffandthus,wewillcontinuetocollectdataonthisbasis.Moredetailedresultswillbepublishedinashortpaperseparatelytothisreport.
Injury recurrence SummaryofrecurrentinjuryriskRecurrentinjuryriskformatchandtrainingin2012-13remainswithintheexpectedlimitsofnaturalseason-to-seasonvariationbasedonthedatasince2002(althoughseason2002-03fallsoutsideofwhatisexpected). Therehashowever,beenadecreaseeveryyearsince 2008-09.The2012-13incidencerateforrecurrentmatchinjuries(4.2/1000playerhours)wasbelowthemeanincidenceof9.1/1000playerhoursfortheperiod2002-12.
Fornewinjuriestheseveritywas20daysforboth2002-12and2012-13andforrecurrentinjuries28daysand26daysrespectively.Theseverityofmatchnewvs.recurrentinjuriesby season can be seen in table S5.
Themostcommonlyreportedrecurrentmatchinjuryforseason2012-13wasHamstringmuscleinjury(4injuries).Moredetailofthemostcommonrecurrentmatchinjuries can be seen in table S6.
NB.Concussionwasnotincludedintheanalysisofrecurrentinjury as subsequent concussions are considered as a repeat injuryratherthanarecurrenceofthesameindexinjury.
Ofrecurrentmatchinjuriesin2012-13,52%occurredwithinonemonthofreturntoplay,32%within1-6months,3%greaterthanayearand12%werenotspecified.Thisisasimilarproportionofreportedrecurrentinjuriesoccurringwithinonemonthofreturntoplaywhencomparedtopreviousseasons(61%intheperiod2008-2012).
Between2007-08and2010-11therewasadecreaseintheincidenceofrecurrenttraininginjuriesandthisincidence hasremainedthesameforthelast3seasons.Theincidenceofrecurrenttraininginjuriesin2012-13(0.1/1000playerhours)wasbelowtheincidenceobservedin2002-12(0.28). Inadditiontheseverityofnewvs.recurrenttraininginjuriescan be seen in table S7.
Workdefiningpracticaltoolstohelpmedicalteamsandcoachesevaluatewhenaplayerisappropriatelyrehabilitatedfromcommonandhighriskinjuriesshouldcontinue.ThesurveillanceprojectusestheIRBconsensusdefinitionofwhatconstitutesarecurrentinjury(aninjuryofthesametypeandatthesamesiteasanindexinjuryandwhichoccursafteraplayer’sreturntofullparticipationfromtheindexinjury).
ConCuSSIon waS ThE moST Common PREmIERShIP maTCh InjuRy
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Match injuries
Training injuries
Injuries leading to retirementThenumbersofplayersretiringwithareportableinjuryfromwhichaplayerdidnotreturntofullfitnesshavebeencollectedeachseason.Fiveplayersretiredinthe2012-13seasonwithanunresolvedinjury.Thelocationsoftheseinjurieswere2–Cervicalspine,2–Shoulder&1-Concussion.
Thenumberofretirementsasaresultofinjuryfromwhichtheplayerhadbeendeemedtohavereturnedtofullfitnessbeforeretirementarenotreportedinthesurveillanceprojectandthereforearenotincludedinthisreport.Thefiguresinthisreportthereforedonotreflectthetotalnumberofplayerswhoretireasaresultofinjury.
Time of injuryTheprofileforthetimingofinjurieswithinamatchremainedsimilartotheperiod2002-12.Thepercentageofinjuriesforwhichnoprecisetimeofinjurywasidentifiedwasidenticaltothatreportedin2011-12at10%ofallmatchinjuries.Thisremainssimilartotheproportionofinjuriesforwhichnoknownassociatedeventisidentified.
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Time in season Therehasbeennosignificantchangeoverthestudyperiodinthetimeduringtheseasonwheninjuriesoccur.ThisseasonsawasignificantdifferenceintheincidenceofinjuriesreportedinNovemberandFebruary,andwillbeexaminedfurthernextseason.InjuriesweresustainedthroughouttheseasonwithapeakininjuryincidenceseeninApril,thelastfullmonthoftheseasonin2012-2013.
Match injury eventTheprofileofinjurycausationleadingtomatchtime-lossinjuryremainsverysimilarwhencomparedtotheperiod2002-12.Thetackleremainsthemostcommonmatcheventresultingininjury.Themostcommoninjuriesasaresultofthetacklein2012-13were:
Ball carrier:anklelateralsprain,MCLinjury,concussion,inferiortibiofibularsyndesmosisinjury,andcostochondral/sternal injury
Tackler:concussion,Acromioclavicularjointinjury, inferiortibiofibularsyndesmosisinjuryandcervicalstinger/burner injury
Thesefindingsremainsimilartothepastthreeseasons.
Runningremainsthesecondmostcommonmatcheventassociatedwithinjury,(15%ofallmatchinjuryevents). Themostcommonmatchinjuriesasaresultofrunningarecalfmuscleinjuryandhamstringmuscleinjury,thesetwogroupingsalonecombinedtomakeup60%ofallinjuriesrelatedtorunning.
Theincidenceofinjuryassociatedwithcollisioneventswassimilarfor2012-13whencomparedwith2002-12,ofthetotalnumberofinjuriesresultingfromcollisions;theproportion ofthoseresultingfromperceivedaccidentalcollisionwas70%in2012-13,lessthanthe82%reportedinseasons2011-12and2010-11.
Theincidenceofinjuriesforwhichtheassociatedeventwasnotidentifiedwasthesamein2012-13as2011-12(10%)andverysimilarto2010-11(11%).
Mean: 10
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Figure 4a: Incidenceratesofrecurrentmatchinjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure 4b: Incidenceratesofrecurrenttraininginjuriesoverthestudyperiodwithmean±2xstandarddeviationshown
Figure5:Percentagedistributionbymatchquarter
Figure6:Incidenceratesofmatchinjuriesbymonth oftheseason
Figure 7: Incidenceratesofmatchinjuriesbyinjuryevent
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Training injury eventWhencomparedtotheperiod2002-12therewasnosignificantchangeintheincidenceratesforany trainingmodality.
Sincethestudybeganin2002,thelikelihoodofsustainingatraininginjuryduringstrengthandconditioningsessions(weightsandnon-weights)hasvariedfromalowerlimitof 1.3injuriesper1000hoursandanupperlimitof2.7injuriesper1000playerhours,withanaverageseverityofinjurybetween13and24daysandthetotaldaysabsence/1000hoursbetween23and49days(abreakdownofincidence by severity grouping can be seen in table S4).
Duringconditioningnonweightstrainingsessions,mostinjurieswereasaresultofrunningrelatedactivities(75%).Duringrugbyskillcontactsessions,mostinjuries(30%)resultedfromrunningrelatedactivities,withthetacklebeingthesecondmostcommoncauseofinjury(16%).
ConcussionDuring2012-13therewere54reportedmatchconcussions(35Premiership,10EuropeanCompetition&9Nationalcupcompetition)and5trainingconcussions.Duringthe2012-13season91%ofreportedconcussionsoccurredinmatchplayand9%intraining.90%ofplayerswentthroughtheseasonwithoutsustainingaconcussion.10%ofplayerssustained 1ormoreconcussionswithnoplayersustainingmorethan 2separateconcussiveeventswithintheseason.
Themeanincidenceformatchconcussionsduringthestudyperiodwas4.6/1000hours.Theincidencefor2012-13felloutsidetheexpectedvariationforthefirsttimeduringthestudyperiod.Itisthoughtthatthisincreaseiscausedbyanincreasedawarenessofconcussionandthusagreaterfocusandunderstandingofdiagnosis.TheIRBpreliminarydatafromthePSCAtrialshowsa25%increaseinthenumberofconcussedplayersbeingremovedfromplaywhencomparedwithpreviousseasons.Asmentionedearlierinthisreport,moredetailedresultsfocusingonconcussionandsubsequentplayermanagementandrecoverywillbepublishedseparately.
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Hamstring injuries Hamstringinjuriesremainthemostcommonandhighestrisktraininginjuryacrossthestudyperiod,themajorityofwhicharethoughttobepreventable.Therewasnochangeintheincidenceofhamstringtraininginjuriesin2012-13whencomparedto2002-12(0.39/1000hours).Thedifferenceindaysabsence/1000hourswasalsonotsignificant(9.5vs.6.1).Acommonviewpointisthattrainingoffersacontrollableenvironmentwhereinjuriescanbereduced.Itisclearfromthedatathatthishasnotyetbeenachieved.Aseasonbyseasonbreakdowncanbeseenintable S9.
Training volume ThetotaltrainingvolumeperplayeratPremiership clubsin2012-13waslowerthanthatfortheperiod 2002-12(5.9hours/weekvs.6.6hours/week).Trainingvolumeforstrengthandconditioningandrugbyskillswerebothlessthanseenintheperiod2002-12(3.1vs.3.7hours/weekand2.7vs.2.9hours/weekrespectively)althoughnoneofthesedifferenceswerestatisticallysignificant. Asimilarproportionoftimespentincontactandnon-contactsessionsmeansthatchangeinincidencedoesnotappeartoberelatedtochangeintypeoftraining.Aseasonbyseasonbreakdowncanbeseenintable S8.
Theriskofinjuryduringtrainingisafunctionofthecontent/activity,thevolumeandtheintensity.Itishopedthatthetrainingloadpilotstudymentionedabovewillgivevaluableinsightintotheroleoftheintensityofthetrainingsessiononinjuryriskwhichcurrentlyremainsunclear.
Injury diagnosis Summaryofthemostcommonandhighestrisk matchinjuriesConcussionwas,forthesecondconsecutiveseason,themostcommonmatchinjurywiththehighestincidenceseensince2002.ThisriseinincidenceislikelyduetoacombinationofincreasedawarenessthroughtheRFUconcussionaudit&PSCAtrial,increasingeducationandawarenessactivitiesfromtheIRBandRFUandgreatermediaattention. ThePSCAtrialison-goingandthus,thedirectimpactof thetoolonplayerremovalcannotbecommentedupon.
The2012-13seasonalsosawalargeriseinincidenceofinferiortibiofibularsyndesmosisinjuries,possiblyduetoanincreasedawarenessofthesignsandsymptomsamongstmedicalpractitionersnationally.MCLinjuriesareseeninthetop5mostcommonmatchinjuriesagainin2012-13.Thighhaematomadroppedoutofthe3mostcommoninjuriesforthefirsttimesince2002.
Inferiortibiofibularsyndesmosisinjurieswasthehighestriskmatchinjuryforthefirsttimein2012-13,afterdroppingoutofthetop5matchhighestriskinjuriesin2011-12(theyweresecondhighestrankedin2010-11).
Overalltherehasbeenverylittlechangeinthehighestriskmatchinjuriesoverthestudyperiod.
Rugby skills
- contact
Rugby skills
- non-contact
Conditioning
weights
Conditioning
non-weights
0
1
2
3
4
5
6
Inci
denc
e/10
00hr
s
2002-12 2012-13
7
8
9
2002-03
2003-04
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
0
1
2
3
4
5
6
Inci
denc
e/10
00hr
s
Incidence Mean Lower limit-2SD Upper limit-2SD
Mean: 4.63
2012-13: 6.77
8
Figure8:Incidence rates of training injuries by session type
Figure9:Incidenceper1000playerhoursofmatch concussions by season
1/3 of all REPoRTEd InjuRIES oCCuR In TRaInIng (RugBy SkIllS and CondITIonIng)
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Most common match injuries
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Highest risk match injuries
Figure10.Incidencerates(incidence/1000hours)andmovementofthetop5mostcommonmatch injurieseachseasonfor2009-13
Thigh haematoma
Hamstring muscle
Ankle lateral ligament
Concussion
Calf muscle
200
9-10
Thigh haematoma
Hamstring muscle
AC joint
Concussion
Calf muscle
2010-11
Concussion
Hamstring muscle
Thigh haematoma
Calf muscle
MCL
2011-12
Concussion
Hamstring muscle
Syndesmosis
MCL
Thigh haematoma
2012-13
Knee cartilage
Shoulder dislocation
Foot fracture
Hamstring muscle
MCL
200
9-10
ACL
Syndesmosis
MCL
Tib/fib fracture
AC joint
2010-11
ACL
MCL
Hamstring muscle
Shoulder dislocation
PCL/LCL2011-12
Syndesmosis
MCL
Hamstring muscle
ACL
Clavicle fracture
2012-13
Figure11.Daysabsence/1000hoursandmovementofthetop5highestriskmatchinjuriesacrossthestudyperiod
4.9
4.9
4.0
3.9
3.7
5.4
4.6
4.8
3.9
3.7
5.1
5.0
4.9
4.8
4.0
6.7
4.9
3.8
3.6
3.3
124
114
104
102
97
184
131
108
97
92
186
148
119
108
92
145
141
130
108
95
Summaryofthemostcommonandhighestrisk training injuriesTheprofileofthemostcommontraininginjuriesisverysimilartothatseenacrossthisstudyperiod.Theonlychangein2012-13isthedecreasedincidence/rankofHipflexor/Quadricepsinjuryandafirstappearanceintothetop5mostcommontraininginjuriesforlumbarsofttissueinjury.
Hamstringmuscleinjuriesremainedthemostcommontraininginjurythroughoutthestudy.Hamstringmuscle,ACLinjuriesandLumbardisc/nerverootinjuriesremainthehighestrisktraininginjuriesthroughoutthestudyperiod.
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Most common training injuries Highest risk training injuries
Figure12.Incidenceratesandmovementofthetop5mostcommontraininginjuriesacrossthestudyperiod
Hamstring muscle
Calf muscle
Ankle lateral ligament
Abductor muscle
Hip flexor/quad muscle
200
9-10
Hamstring muscle
Calf muscle
Hip flexor/quad muscle
Abductor muscle
Ankle lateral ligament
2010-11
Hamstring muscle
Calf muscle
Hip flexor/quad muscle
Abductor muscle
Ankle lateral ligament
2011-12
Hamstring muscle
Calf muscle
Abductor muscle
Ankle lateral ligament
Hip flexor/quad muscle
2012-13
Hamstring muscle
Knee cartilage
Archilles tendon
Lumber disc/nerve root
Syndesmosis
200
9-10
Hamstring muscle
ACL
Calf muscle
Ankle lateral ligament
Knee cartilage 2010
-11Hamstring muscle
Lumber disc/nerve root
Calf muscle
Ankle lateral ligament
Tib/fib fracture
2011-12
Hamstring muscle
ACL
Lumber disc/nerve root
Calf muscle
Lumber soft tissue
2012-13
Figure13.Daysabsence/1000hoursandmovementofthetop5highestriskmatchinjuriesacrossthestudyperiod
0.38
0.20
0.12
0.11
0.09
0.45
0.30
0.15
0.14
0.11
0.42
0.24
0.11
0.10
0.09
0.39
0.29
0.18
0.10
0.09
6.1
3.8
3.3
2.8
2.6
6.9
6.8
3.8
3.7
3.1
7.3
6.5
3.4
2.1
2.1
9.5
6.3
5.3
4.9
4.5
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
EnglandmatchandtraininginjuryriskNostatisticallysignificantchangeinriskwasseenin2012-13.
ThelikelihoodofsustaininganinjurywhilstplayingfortheEnglandseniorsideincreasedforthefirsttimesince2007-08,howevertheaverageseverityofinjuriesinmatchandtrainingdecreased.Thesechangeswerenotstatisticallysignificant.
Note:therelativelysmallnumberofseniorEnglandtrainingsessionsinthestudymakesthedifferencesseeninthisgroupmuchmorelikelytohavearisen“bychance”ratherthantobetheresultofa“true”difference,reflectedinthewide95%Confidenceintervalsandthelackofstatisticalsignificanceintheresults.
MatchInjuries
England Senior side
24
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Traininginjuries
Total number of injuries
Injuries / 1000 hrs (95% CI)
Injuries per match
Average sever-ity, days
Days absence / 1000 hrs (95% CI)
Days absence per match
2002-03 53 221(169-289) 4.4 19 4264(4010-4533) 85
2003-04 83 207(167-256) 4.1 11 2371(2225-2527) 47
2005-06 30 136(95-195) 2.7 10 1391(1243-1556) 28
2006-07 30 136(95-195) 2.7 28 3836(3586-4104) 77
2007-08 55 162(119-205) 3.2 24 3876(2852-4901) 78
2008-09 23 96(57-135) 1.9 8 813(480-1145) 16
2009-10 23 88(52-125) 1.8 19 1712(1012-2411) 34
2010-11 14 78(37-119) 1.5 23 1789(852-2726) 36
2011-12 16 62(31-92) 1.2 29 1754(894-2613) 35
2012-13 31 111(78-158) 2.2 24 2618(1841-3722) 52
Rugby skills Strength and conditioning
Injuries / 1000 hrs (95% CI)
Average severity, days
Days absence / 1000 hrs (95% CI)
Injuries / 1000 hrs (95% CI)
Average severity, days
Days absence / 1000 hrs (95% CI)
2002-03 4.5(2.6-8.0) 15 69(60-80) 4.0(1.0-15.9) 4 16(8-32)
2003-04 7.6(5.3-11.0) 12 89(80-99) 6.3(3.8-10.3) 13 79(68-90)
2005-06 0.6(0.1-4.0) 4 2(1-6) - - -
2006-07 9.8(5.9-16.3) 15 149(131-169) - - -
2007-08 7.3(4.5-10.1) 9 74(46-103) 2.5(0.5-4.6) 12 34(7-61)
2008-09 6.5(3.0-10.0) 20 135(62-209) 12.1(4.2-20.0) 18 233(81-385)
2009-10 5.3(3.4-8.3) 8 46(30-73) 4.0(2.0-8.6) 6 26(12-55)
2010-11 1.7(0.8-3.5) 7 12(5.7-26) 4.4(1.8-10.5) 5 22(9.1-52.5)
2011-12 3.2(1.4-5.1) 22 70(31-110) 2.8(0.4-5.3) 18 51(6-95)
2012-13 3.7(1.6-9.0) 20 58(24-139) 1.1(0.2-7.8) 9 10(1-71)
Table4:Englandtraininginjuryincidence,averageseverity&daysabsencesince2002-03
Table3:Englandmatchinjuryincidence,averageseverity&daysabsencesince2002-03
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Writteninformedconsentwasobtainedfrom591registeredPremiershipsquadplayersforthe2012-13season.Threeplayersdidnotgiveconsentandassuchtheirdatawerenotrecorded.Atotalof405gameswereincludedintheanalysesforthe2012-2013season.
InjuriessustainedintrainingandinallmatchesintheAvivaPremiership,LVAnglo-WelshcupandEuropeanCompetitions(HeinekenandEuropeanChallengeCup) wereincluded.
InjuriessustainedwhileplayersrepresentedEnglandwerereportedseparatelyandareanalysedseparatelyinthisreport.
Matchandtraininginjurydata,andtrainingexposuredata,wereprovidedbyall12Premiershipclubsin2012-2013.Acompletesetofdatawerecollected.
MedicalpersonnelateachPremiershipclubandtheEnglandseniorteamreportedthedetailsofeveryinjurysustainedbyaplayerattheirclub/teamthatwereincludedinthe
studygrouptogetherwiththedetailsoftheassociatedinjuryeventusingastandardinjuryreportform.Strengthandconditioningstaffrecordedthesquad’sweeklytrainingschedulesandexposureonastandardtrainingreportform.Teammatchdayswerealsorecordedbystrengthandconditioningstaff.
InjurydiagnoseswererecordedusingOrchardcodes(OSICS).Thissportsspecificinjuryclassificationsystemallows detailed diagnoses to be reported and injuries to be groupedbybodypartandinjurypathology.
TheinjurydefinitionsanddatacollectionmethodsutilisedinthisstudyarealignedwiththeIRBConsensusstatementoninjurydefinitionsanddatacollectionproceduresforstudiesof injuries in rugby union
Rfu injury surveillance project methods
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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Furtherdetailedinformationoninjuryriskinthiscohortofplayerscanbeobtainedfromthefollowingpeerreviewedpublicationsthatanalysedatacollectedaspartofthesurveillanceproject
Abstracts/presentations
JHMBrooks,CWFuller,SPTKemp&DBReddin.TheIncidence,SeverityandNatureofInjuriesCausedbyTacklinginProfessionalRugbyUnionCompetition.Presented(poster)atTheAmericanCollegeofSportsMedicineAnnualMeeting,1stJune2006.Publishedin:MedicineandScienceinSportsandExercise2006:38(5)S351-352.
JHMBrooks,CWFuller,SPTKemp.TheIncidence,SeverityandNatureofGroinInjuriesinProfessionalRugbyUnion.PresentedatTheAmericanCollegeofSportsMedicineAnnualMeeting,1stJune2006.Publishedin:MedicineandScienceinSportsandExercise2006:38(5)S351.
JHMBrooks,CWFuller,SPTKemp&DBReddin.Theincidence,severityandnatureofinjuriescausedbybeingtackledinprofessionalrugbyunion.Presented(oral)atTheFacultyofSportsandExerciseMedicine,RoyalCollegeofPhysiciansIreland(RCPI)andRoyalCollegeofSurgeons,Ireland(RCSI)AnnualScientificMeeting,Dublin,5thSeptember2005
JHMBrooks,CWFuller,SPTKemp.Theincidence,severity,andnatureofscrummaginginjuriesinprofessionalrugbyunion.Presented(poster)at1stWorldCongressofSportsInjuryPrevention,Oslo,Norway23rd-25thJune2005.Publishedin:BrJSportsMed39:377.
Publications
SWilliams,GTrewartha,SPTKemp&KAStokesAmeta-analysisofinjuriesinseniormen’sprofessionalrugbyunion.SportsMedicine2013;43(10)1043-1055.
CWFuller,AETaylorJHMBrooks&SPTKempChangesinthestature,bodymassandageofEnglishprofessionalrugbyplayers:A10-yearreview,JournalofSportsSciences2012DOI:10.1080/02640414.2012.753156
SCCheng,ZKSivardeen,WAWallace,DBuchanan,DHulse,KJFairbairn,SPKemp&JHBrooks.Shoulderinstabilityinprofessionalrugbyplayers-thesignificanceofshoulderlaxity.ClinicalJournalofSportsMedicine2012Sep;22(5):397-402
CJPearce,JHMBrooks,SPKemp&JDCalder.TheepidemiologyoffootinjuriesinprofessionalrugbyunionplayersFoot&AnkleSurgery.2011Sep;17(3):113-8.Epub2010Mar5.
JHMBrooks&SPTKempInjurypreventionprioritiesaccordingtoplayingpositioninprofessionalrugbyunionplayers.BritishJournalofSportsMedicine2011Aug;45(10):765-75.Epub2010May19
RASankey,JHMBrooks,SPTKemp&FSHaddadTheepidemiologyofankleinjuriesinprofessionalrugbyunionplayers.AmericanJournalofSportsMedicineDec2008;36:2415-2424
CWFuller,TAshton,JHMBrooks,RJCancea,JHall,&SPTKempInjuryrisksassociatedwithtacklinginrugbyunion.BritishJournalofSportsMedicine2010;44(3):159-167
JHMBrooks,CWFuller,SPTKemp&DBReddinAnassessmentoftrainingvolumeinprofessionalrugbyunionanditsimpactontheincidence,severityandnatureofmatchandtraininginjuries.JournalofSportsSciences200826:8,863-873
SPTKemp,ZHudson,JHMBrooks&CWFuller.TheepidemiologyofheadinjuriesinEnglishprofessionalrugbyunion.ClinicalJournalofSportsMedicine2008;18:227-234
CWFuller,JHMBrooks,RJCancea,JHall,&SPTKempContacteventsinrugbyunionandtheirpropensitytocauseinjury.BritishJournalofSportsMedicine,Dec2007;41:862-867
JHeadey,JHMBrooks&SPTKemp.TheepidemiologyofshoulderinjuriesinEnglishprofessionalrugbyunion.AmericanJournalofSportsMedicine,Sep2007;35:1537-1543
RJDallana,JHMBrooks,SPTKemp&AWWilliams.TheepidemiologyofkneeinjuriesinEnglishprofessionalrugbyunion.AmericanJournalofSportsMedicine,May2007;35:818–830
CWFuller,JHMBrooks&SPTKemp.Spinalinjuriesinprofessionalrugbyunion:aprospectivecohortstudy.ClinicalJournalofSportMedicine,2007;17(1):10-16
JHMBrooks,CWFuller,SPTKemp&DBReddin.Incidence,riskandpreventionofhamstringmuscleinjuriesinprofessionalrugbyunion.AmericanJournalofSportsMedicine,2006;34:1297-1307
JHMBrooks,CWFuller,SPTKemp&DBReddin.EpidemiologyofinjuriesinEnglishprofessionalrugbyunion:part1matchinjuries.BritishJournalofSportsMedicine,Oct2005;39:757-766
JHMBrooks,CWFuller,SPTKemp&DBReddin.EpidemiologyofinjuriesinEnglishprofessionalrugbyunion:part2traininginjuries.BritishJournalofSportsMedicine,Oct2005;39:767–775.
JHMBrooks,CWFuller,SPTKemp&DBReddinAprospectivestudyofinjuriesandtrainingamongsttheEngland2003RugbyWorldCupsquadBritishJournalofSportsMedicine,May2005;39:288–293
Current publications
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
Supplementary data
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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TableS1:Matchinjuryincidence,averageseverityanddaysabsencesince2002-3
Season Total number of match injuries
Injuries / 1000 hrs (95% CI)
Injuries per club per match
Average severity, days (95%CI)
Days absence / 1000 hrs (95% CI)
Days absence per club per match
2002-03 748 100(92-107) 2.0 16(15-17) 1556(1444-1667) 31
2003-04 653 88(82-95) 1.8 20(19-22) 1773(1637-1909) 35
2005-06 482 75(68-82) 1.5 21(19-23) 1591(1449-1733) 32
2006-07 755 90(84-97) 1.8 21(20-23) 1879(1745-2013) 38
2007-08 660 83(77-89) 1.7 19(18-21) 1613(1490-1736) 32
2008-09 769 100(93-107) 2.0 23(21-25) 2285(2123-2446) 46
2009-10 636 80(73-86) 1.6 22(20-24) 1722(1588-1856) 34
2010-11 746 93(86-99) 1.9 21(20-23) 1917(1779-2054) 38
2011 -12 655 82(76-88) 1.6 27(25-29) 2222(2052-2392) 44
2012-13 588 73(67-79) 1.5 25(23-27) 1784(1645-1936) 35
TableS2:Matchinjuryseveritysince2002-03
TableS3:Traininginjuryincidence,averageseverityanddaysabsencesince2002-3
Season Incidence /1000 hrs
2 - 3 days
4 – 7days
8 - 21 days
22 - 28 days
29- 84 days
> 84 days
All
2002-03 24 33 26 4 9 3 100
2003-04 19 26 23 3 14 4 88
2005-06 10 19 24 5 13 3 75
2006-07 17 30 22 6 11 5 90
2007-08 15 24 26 4 10 4 83
2008-09 18 30 26 5 14 6 100
2009-10 15 21 25 4 10 4 80
2010-11 17 27 27 5 11 5 93
2011-12 13 21 22 6 13 7 82
2012-13 6 20 24 6 13 4 73
Total number of training injuries
Rugby skills Strength and conditioning
Season Injuries / 1000 hrs (95% CI
Average severity, days
Days absence / 1000 hrs (95% CI)
Injuries / 1000 hrs (95% CI
Average severity, days
Days absence / 1000 hrs (95% CI)
2002-03 159 3.3(2.7-4.0) 28 93(90-97) 2.3(1.7-3.0) 13 29(27-31)
2003-04 217 1.7(1.4-2.0) 26 44(42-45) 1.3(1.1-1.6) 17 23(22-24)
2005-06 203 2.2(1.9-2.6) 22 49(47-51) 1.5(1.2-1.9) 16 24(22-25)
2006-07 209 2.1(1.7-2.5) 18 37(35-38) 1.6(1.3-2.0) 16 25(24-27)
2007-08 318 3.2(2.7-3.7) 19 60(51-68) 2.7(2.2-3.1) 15 44(36-52)
2008-09 258 2.5(2.1-2.9) 26 63(53-73) 2.4(2.0-2.9) 17 41(34-49)
2009-10 298 2.8(2.4-3.2) 21 59(50-67) 2.1(1.7-2.4) 18 37(30-43)
2010-11 340 3.1(2.7-3.5) 25 76(66-87) 2.6(2.1-3.0) 17 41(34-48)
2011-12 323 2.7(2.4-3.1) 26 68(59-78) 2.2(1.8-2.6) 18 39(32-46)
2012-13 335 3.2(2.9-3.6) 33 106(93-121) 2.0(1.7-2.4) 24 49(41-60)
Incidence / 1000 hrs
2 - 3 days
4 – 7days
8 - 21 days
22 - 28 days
29- 84 days
> 84 days
All
2002-03 0.64 0.49 1.11 0.18 0.42 0.18 3.0
2003-04 0.21 0.40 0.52 0.11 0.30 0.08 1.6
2005-06 0.46 0.58 0.60 0.10 0.35 0.10 2.2
2006-07 0.57 0.42 0.51 0.10 0.20 0.07 1.9
2007-08 0.50 0.76 0.94 0.14 0.38 0.07 2.8
2008-09 0.43 0.57 0.77 0.17 0.31 0.10 2.4
2009-10 0.33 0.76 0.70 0.19 0.34 0.07 2.4
2010-11 0.48 0.76 0.91 0.21 0.32 0.13 2.8
2011-12 0.25 0.62 0.82 0.15 0.30 0.14 2.3
2012-13 0.35 0.55 0.79 0.19 0.49 0.21 2.6
TableS4:Traininginjuryincidenceinseverityclassificationssince2002-03
England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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England Professional Rugby Injury Surveillance Project 2012-2013 Season Report
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New injuries Recurrent injuries
Injuries / 1000 hrs
Average severity, day
Days absence / 1000 hrs
Injuries / 1000 hrs
Average severity, days
Days absence / 1000 hrs
2002-03 /1000hrs 14 1084 17 24 436
2003-04 72 18 1333 12 34 433
2005-06 67 20 1372 9 31 277
2006-07 76 21 1574 7 33 260
2007-08 74 19 1444 8 21 167
2008-09 85 21 1800 13 34 483
2009-10 72 21 1515 7 29 206
2010-11 87 21 1776 5 26 140
2011-12 77 27 2106 4 23 114
2012-13 68 25 1659 4 26 122
TableS5:Newandrecurrentmatchinjuryincidence,averageseverityanddaysabsence
Diagnosis Number of injuries Average Severity
Hamstring muscle injury 4 33
Ankle syndesmosis injury 4
Calf muscle 3 37
Tibial Stress Injuries 3 6
2007-08 0.50 0.76
2008-09 0.43 0.57
2009-10 0.33 0.76
2010-11 0.48 0.76
2011-12 0.25 0.62
2012-13 0.35 0.55
TableS6:Thefivemostcommonmatchinjuryrecurrencesduring2012-13
New injuries Recurrent injuries
Injuries / 1000 hrs
Average severity, day
Days absence / 1000 hrs
Injuries / 1000 hrs
Average severity, days
Days absence / 1000 hrs
2002-03 2.5 21 54 0.5 34 15
2003-04 1.3 21 27 0.3 36 11
2005-06 1.8 19 35 0.4 21 8
2006-07 1.7 17 30 0.2 16 3
2007-08 2.3 17 39 0.5 24 11
2008-09 2.0 21 41 0.4 27 10
2009-10 2.2 20 44 0.2 22 4
2010-11 2.7 20 53 0.1 58 7
2011-12 2.2 22 49 0.1 47 4
2012-13 2.6 29 69 0.1 34 4
TableS7:Newandrecurrenttraininginjuryincidence,averageseverityanddaysabsence
Training Hrs per week
Year Rugby Skills Strength & Conditioning
Total
2002-03 3.9 2.5 6.4
2003-04 5.0 3.7 8.7
2005-06 4.3 3.1 7.4
2006-07 4.1 3.1 7.2
2007-08 3.0 2.7 5.7
2008-09 3.2 2.6 5.8
2009-10 3.2 2.9 6.1
2010-11 3.1 2.8 5.9
2011-12 3.6 2.8 6.4
2012-13 3.1 2.7 5.9
TableS8:Averageplayertraininghoursperweek TableS9:Hamstringtraininginjuries,incidenceand daysabsenceper1000hrs2002-2011
Year Incidence/1000hrs Days Absence/1000hrs
2002-03 0.45 6.4
2003-04 0.21 4.2
2004-05 0.36 4.6
2006-07 0.32 5.1
2007-08 0.59 9.5
2008-09 0.36 5.0
2009-10 0.38 6.1
2010-11 0.45 6.9
2011-12 0.42 7.3
2012-13 0.39 9.5