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Incidence of Musculoskeletal Injuries In University Rugby-7s: A 6-Year Prospective Epidemiological Investigation

Incidence of Musculoskeletal Injuries In University Rugby-7s: A 6-Year Prospective Epidemiological Investigation

Victor Lopez Jr., DO, UNITED STATES Kiera Guyor Borthwick, BS, MD (2026), UNITED STATES Richard Ma, MD, UNITED STATES Christian Victoria, MPH, UNITED STATES Miho J. Tanaka, MD, PhD, UNITED STATES Ailsa McNaught, BS (2024), UNITED STATES Nailah Coleman, MD, 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: Men and women collegiate rugby-7s athletes face a high incidence of musculoskeletal injuries.


Background

Rugby is played on more than 900 higher educational campuses in the United States, and its popularity continues to grow. Specifically, rugby-7s is growing on the collegiate level, especially with its acknowledgment of women’s rugby in the NCAA and since its introduction into the Olympics in 2016. To date, there is limited data on injury incidence in collegiate rugby-7s populations.

Objective

To analyze and compare musculoskeletal injury incidence in U.S. male and female university rugby-7s populations. We hypothesized that match injuries would be frequent among a running collision sport such as rugby-7s.

Methods

Prospective epidemiological data collected at U.S. rugby-7s tournaments (2011-2016). Participants included 4458 athletes (men=3411, women=1047). The Rugby Injury and Evaluation (RISE) Report was utilized to collect injury data. Data were reported as injury incidence (injuries per 1000 playing hours [ph]).

Results

In total, 296 injuries were reported in the university population, and 183 (62%) were of musculoskeletal origins (male=138, female=45). Incidence of musculoskeletal knee injuries was 11.23/1000ph (n=35) and did not differ by sex (P=0.15). Incidence of musculoskeletal ankle injuries was 8.02/1000ph (n=25) and did not differ by sex (P=0.70). Sprains and ligament injuries were the most common injury type among men and women (25.66/1000ph, n=80). Females had a higher incidence of sprain and ligament injuries compared to men (respectively, 36.47/1000ph v. 22.77/1000ph) (P=0.06). Likewise, females had a higher incidence of acute injuries compared to men (respectively, 63.83/1000ph v. 46.76/1000ph) (P=0.09). Overall, the incidence of acute injuries was significantly higher than that of overuse injuries (50.36/1000ph v. 8.02/1000ph) (P<0.01). The incidence of new injuries was also significantly higher than that of recurrent injuries (41.06/1000ph v. 16.68/1000ph) (P<0.01). The phase of play that resulted in the most musculoskeletal injuries was the tackle (38.82/1000ph) as compared to all other phases of play (17.64/1000ph) (P<0.01). Musculoskeletal injury incidence did not vary by position (P=0.30). Men had an increase in the number of musculoskeletal injuries from the first half (n=52) to the second half (n=73), while females had a decrease from the first half (n=21) to the second half (n=18).

Conclusions

Musculoskeletal injuries are the majority of injuries experienced by collegiate rugby-7s athletes. Females have higher incidences of sprain and ligament injuries, so attention should be directed to strengthening and proprioceptive exercises to improve joint stability in this population. Warm-up regiments with stretching and dynamic aspects should be encouraged to reduce acute injury, particularly among females. Finally, technique should be emphasized during fatigue in the male population to target musculoskeletal injury in the second half.

References
Lopez V, Jr., Ma, R, Weinstein MG, Hume PA, Cantu RC, Victoria C, Queler SC, Webb KJA, Allen AA (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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