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U.S. Rugby-7s Men's and Women's Ankle Injury Incidence and Mechanism: A 7-Year Comparison

U.S. Rugby-7s Men's and Women's Ankle Injury Incidence and Mechanism: A 7-Year Comparison

Kiera Guyor Borthwick, BS, MD (2026), UNITED STATES Victor Lopez Jr., DO, UNITED STATES Richard Ma, MD, UNITED STATES Christian Victoria, MPH, UNITED STATES Xinning Li, MD, UNITED STATES Joseph Kocan, MD, UNITED STATES Giulia DiSanto, MSAT, MD (2025), UNITED STATES Som Singh, MD (2023), UNITED STATES Answorth A. Allen, MD, UNITED STATES

Rugby Research and Injury Prevention Group, New York, New York, UNITED STATES

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Summary: USA Rugby-7 amateur players sustained frequent ankle match injuries, and women were more likely to have injuries from contact between players and the ground as a mechanism than compared to men.


Rugby-7s is rapidly gaining popularity in the U.S. population. The lower extremity is one of the most commonly injured body regions in rugby-7s.


The goal of this investigation was to determine the incidence of musculoskeletal ankle injuries among men’s and women’s rugby-7s athletes. We hypothesized that ankle match injuries would be frequent among a running collision sport such as rugby-7s.


A 7-year prospective epidemiological study (2010-2016) of USA Rugby-sanctioned rugby 7-a-side events at all levels of play. Participants included 50,979 athletes (males=36,199; females=14,780). Following the rugby injury consensus statement, the Rugby Injury and Evaluation (RISE) Report methodology was implemented. Ankle injury data are reported as injuries and biomechanisms per 1000 player-hours (ph).


In total, 282 ankle injuries were reported across the data collection period. A majority (n=268, 95.0%) of the injuries were musculoskeletal in nature, meanwhile others were abrasions/bruises/contusions or other. Ankle musculoskeletal injury incidence did not differ between men (10.57/1000ph, n=180) and women (11.71/1000ph, n=87) (P=0.43). Sprains and ligament injuries were the most common musculoskeletal injury (n=241) and also did not differ by sex (men: 9.52/1000ph, n=162) (women: 10.50/1000ph, n=78) (P=0.47). Among both sexes combined, fractures (0.65/1000ph, n=16) and dislocations (0.08/1000ph, n=2) were found in less frequency. Among men and women, contact injuries (7.89/1000ph) were significantly more frequent than non-contact injuries (2.58/1000ph) (P<0.01). Contact injuries due to the combined impact of another player and the ground were more frequent among women (2.42/1000ph, n=18) as compared to men (1.06/1000ph, n=18) (P=0.01). The tackle was the phase of play that generated the most musculoskeletal ankle injuries as compared to all other phases of play (6.58/1000ph v. 4.01/1000ph, respectively) (P<0.01). New musculoskeletal ankle injuries were significantly more common than recurrent injuries (7.57/1000ph v. 3.23/1000ph, respectively) (P<0.01). Sprains and ligament injuries represented the most common among time-loss (n=87) and recurrent (n=71) injuries.


Musculoskeletal ankle injuries are common in the emerging rugby-7s population, yet there is limited data available on injury incidence in both community men’s and women’s populations. Men and women have similar patterns of injury, with the exception of contact injuries involving both the ground and another player. Technique and foot stability during contact events (i.e., tackles) should be emphasized in the female population. For both males and females, a combination of strengthening and flexibility exercises should be integrated to improve the range of motion and stability of the ankle joint.

Lopez V, Jr., Ma, R., Weinstein M.G., Hume P.A., Cantu R.C., Victoria C., Queler S.C., Webb K.J.A., Allen A.A. (2020). United States Rugby-7s under-19 tournament players injury rates during a 5-year epidemiological study. Sports Med Open 27;6(1):41. doi: 10.1186/s40798-020-00261-y.

Ma, R., Lopez, V. Jr., Weinstein, M.G., Chen, J.L., Black, C.M., Gupta, A.T., Harbst, J.D., Victoria, C. & Allen, A.A. (2016). Injury Profile of American Women’s Rugby-7s. Med Sci Sports Exerc, 48(10):1957-66. doi: 10.1249/MSS.0000000000000997

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