Introduction

Introduction

Introduction

Tracking the trends of the modern game

World Rugby tightens artificial turf regulations

Technology in the area of artificial playing surfaces has improved greatly over time and these advances have resulted in artificial turf being widely used for many sports, including rugby. World Rugby Regulation 22 through the Rugby Turf Performance Specification sets a minimum standard for artificial turf for use in rugby union.

The first Fortius International Sports Injury Conference is taking place on October 13th-14th, at the Queen Elizabeth II Conference Centre, in central London.

Regulation

Misconceptions

Testing

Installation

Maintenance

Facilities and One Turf

1. Introduction

Introduction

1. Introduction

What is it?

World Rugby and its member unions takes player safety extremely seriously and it is at the heart of all the training we deliver to coaches, referees and medics, at all levels of the game.

INTRODUCTION

It is time to give concussion an
operational definition: a 3-step process
to diagnose (or rule out) concussion
within 48 h of injury: World Rugby
guideline

Abstract

Section 1 presentations

Introduction

1. Introduction

1. Introduction

• World Rugby acknowledges that the current Policy related to Transgender Sports Participation is out of step with the IOC’s most recent interim guidance which was issued specifically for use in Rio2016.
• The IOC is reviewing this Rio guidance specifically around the appropriate testosterone levels and the technical, testing and logistic aspects of this Policy.
• World Rugby is committed to an inclusive game and is a member of the working group reviewing and updating this IOC policy
• World Rugby will review and update our Policy as soon as the IOC have completed their review.

This World Rugby Concussion Guidance document has been developed to provide guidance and information to persons involved in the Game of Rugby (including the general public) regarding concussion and suspected concussion.

The Rugby Football Union and Premiership Rugby Ltd has conducted an annual injury audit of England and Premiership teams since 2002. An injury is included in the audit if it prevents a player from training and/or playing for more than 24 hrs (see Methods section for a full definition).

Rugby is a dynamic game with a range of unique characteristics – and because of its nature, it has the attraction of being a game that is constantly evolving and changing. Some of these changes are seen as beneficial and some not so; the role of the World Rugby Game Analysis Department is to assess the impact on the shape and attraction of the modern game.

More information on TUEs

Key findings

The IRB is committed to implementing surveillance studies at all major IRB Tournaments and to disseminate the results within the Rugby community. The aims of these studies are:

Session 2 - Game Load

World Rugby does not discriminate and does not have any policy which prevents HIV positive Players from playing the Game.

• The Medicine, Science and Research Group (MSRG)
• World Rugby Scientific Committee (SciCom)
• World Rugby Institutional Ethics Committee (IEC)
• The World Rugby Research Unit (WRRU)

To: Secretaries / Chief Executive Officers of Unions and Regional Associations in Membership of World Rugby

In December 2013, the IRB appointed the following concussion experts to assist with the management and prevention of concussion in Rugby:

Following the 2010 IRB Medical Conference, Dr Colin Fuller (IRB Safety Consultant) identified that regulating, directing or having exacting policies in the sports medical area that were applicable in all Member Unions was not practical or appropriate. Member Unions were noted to work within different levels of legal, economic, social and medical expertise that impacted on each Union's ability to deliver a single uniform medical policy.

Following the recommendation by Dr Fuller, the IRB approved a move from mandating Medical Regulations and Policies to providing Medical Guidelines. The Guidelines produced on medical matters would be based on best practice but their application within individual Member Unions would be based upon the unique social, economic and health provision environment(s) in which individual Unions existed.

This moved the emphasis away from mandating specific actions to identifying best practice that could be used by each Union to develop their own local 'good practice' model (see below).

Exercising in extreme environments is known to be associated with medical complications. The American College of Sports Medicine has developed guidelines for exercising in a hot environment. These guidelines were developed to provide advice during endurance events, in particular, distance foot races. The ACSM recommended using, an on-site Wet Bulb Globe Temperature (WBGT) reading and recommended that consideration should be given to cancelling events when the WBGT was above 28.

Rugby is a team sport played by athletes of varying stature where the game is of an intermittent nature and limited to two 40 minute halves. The intermittent nature of the sport probably allows for greater access to fluid intake during competition when compared with endurance events.

Considering the significant differences between endurance foot racing and Rugby, a review of other sports Heat Guidelines, more closely aligned to Rugby was undertaken. This investigation revealed that the National Rugby League (NRL) in Australia had developed Heat Guidelines during 2000 following research undertaken by Dr John Brotherhood.

The outcome of this research revealed that “relying on the WBGT was limited as it only took into account ambient temperature, globe temperature (radiant heat) and humidity and 70% of this reading was dependent on humidity”. In addition it was identified that “the WBGT was not recorded by weather bureaus and a figure had to be estimated from the Wet Bulb Temperature”.

Dr. Brotherhood placed more weight on the Belding Hatch Stress Index (BHSI) than the WBGT. BHSI is calculated by dividing the Evaporative requirement of the player by the Maximum Evaporative capacity of the environment x 100. A figure of 100 represents an equilibrium between heat loss and heat gain.

In 2001 the NRL adopted guidelines based on the Heat Stress Index measured using a Whirling Hygrometer to assess environmental conditions. Since the introduction of these guidelines there has not been a reported incidence of heat illness during a competition game.

The recommended guidelines are based on utilizing the Heat Stress Index as measured by the Whirling Hygrometer at the site of the game.

Infectious diseases are spread directly or indirectly from an infected individual. Athletes interact closely with team-mates, opponents, and team staff. In addition they frequently share training and gym equipment, facilities-training rooms/grounds, accommodation, housing, towels, water bottles and supplies and commonly undertake both domestic and international travel.

Furthermore international travel exposes athletes to indigenous diseases for which they may have little or no natural immunity. Finally there is some information to suggest that athletes tend to be risk takers which may increase their risk for acquiring infections.

The categories of potential risk factors for spreading infection are:

The following medical facilities will be available at the match venue on match days:

rugby-related

The full scoring system and chart are available at the following web site:

Information taken from: Fuller et al. Injury risks associated with tackling in rugby union.

Foul play

The aim of this study was to assess whether differences in competing teams’ body mass and playing performance affected the risk of injury in rugby union. The study was a prospective, whole population survey of players representing all countries competing at the Rugby World Cup in 2007. The study design followed the consensus statement for epidemiological studies in rugby with the main outcome measures being the incidence and severity of match injuries. Differences in players’ average body mass and 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.

To read the text of this paper in full, visit:

Objective:

• RECOGNISE AND REMOVE - learn to recognise the signs and symptoms of concussion and remove a player from the field if ANY doubt.
• PROTECT OUR YOUNG ATHLETES - The IRB recommends different return to play protocols for different ages.
• Concussion must be taken extremely seriously to safeguard the long term welfare of players.
• All players with a diagnosed concussion must be removed from the field of play and not return to play or train on the same day. Players with a diagnosed concussion must go through a graduated return to play program (GRTP), described later in this document.
• All players with a suspected concussion where no appropriately trained personnel are present must be assumed to have a diagnosed concussion and must be removed from the field of play and not return to play or train on the same day. In this situation, players must go through a graduated return to play (GRTP) protocol.
• For elite competitions, where approved by the IRB’s Chief Medical Officer and Head of Technical Services, players with a head injury where the diagnosis is not immediately apparent must be removed from play and can be assessed by a certified medical professional (CMP - defined as "A Certified Medical Professional who has successfully completed the IRB on line education programme for Match Day Medical Staff") assisted by the Pitch Side Concussion Assessment (PSCA) Tool.
• Players who complete a GRTP must receive medical clearance from a doctor or an approved healthcare professional (as defined by each Union) before returning to play
• The IRB recognises that there is considerable diversity in health care support across and within each Member Union. Because of this diversity each Union is encouraged to identify the roles and responsibilities of medical and healthcare practitioners and to establish a definition of approved healthcare professional relevant to their respective jurisdictions. Each Union will be responsible for confirming who is approved to diagnose concussion, provide a clearance to start a GRTP, monitor a GRTP and provide a clearance to return to play.

Objectives:

Objectives:

Objective:

• RECOGNISE AND REMOVE - learn to recognise the signs and symptoms of concussion and remove a player from the field if ANY doubt.
• PROTECT OUR YOUNG ATHLETES - The IRB recommends different return to play protocols for different ages.
• Concussion must be taken extremely seriously to safeguard the long term welfare of players.
• All players with a diagnosed concussion must be removed from the field of play and not return to play or train on the same day. Players with a diagnosed concussion must go through a graduated return to play program (GRTP), described later in this document.
• All players with a suspected concussion where no appropriately trained personnel are present must be assumed to have a diagnosed concussion and must be removed from the field of play and not return to play or train on the same day. In this situation, players must go through a graduated return to play (GRTP) protocol.
• For elite competitions, where approved by the IRB’s Chief Medical Officer and Head of Technical Services, players with a head injury where the diagnosis is not immediately apparent must be removed from play and can be assessed by a certified medical professional (CMP - defined as "A Certified Medical Professional who has successfully completed the IRB on line education programme for Match Day Medical Staff") assisted by the Pitch Side Concussion Assessment (PSCA) Tool.
• Players who complete a GRTP must receive medical clearance from a doctor or an approved healthcare professional (as defined by each Union) before returning to play
• The IRB recognises that there is considerable diversity in health care support across and within each Member Union. Because of this diversity each Union is encouraged to identify the roles and responsibilities of medical and healthcare practitioners and to establish a definition of approved healthcare professional relevant to their respective jurisdictions. Each Union will be responsible for confirming who is approved to diagnose concussion, provide a clearance to start a GRTP, monitor a GRTP and provide a clearance to return to play.

Session 2 - Cervical Spine

The IRB is committed to implementing surveillance studies (SS) at all major IRB Tournaments and to disseminate the results within the Rugby community. The aims of these studies are to record and analyse injuries and illnesses sustained by male and female players at individual Tournaments, to identify changing patterns of injury and to bring injury-related areas of concern to the attention of the IRB Chief Medical Officer.

The IRB Pacific Nations Cup (PNC) is an international Tournament for the six IRB Tier 2 countries located on the rim of the Pacific Ocean. As the level of exposure each year in the Tournament is relatively small, apart from the incidence of injury and anthropometric parameters, data from all Tournaments have been combined to provide a more meaningful analysis of the available data.

Objective:

Background:

The IRB is committed to implementing surveillance studies (SS) at all major IRB Tournaments and to disseminate the results within the Rugby community. The aims of these studies are to record and analyse injuries and illnesses sustained by male and female players at individual Tournaments, to identify changing patterns of injury and to bring injury-related areas of concern to the attention of the IRB Chief Medical Officer.

There have been no previous reports related to the injury epidemiology for Women’s Rugby Sevens: this review therefore provides the first analysis of injuries sustained in international women’s Rugby Sevens.

1. Objective:

The annual injury audit by Premiership Rugby, the Rugby Players’ Association and the Rugby Football Union shows a 20% reduction in the likelihood of sustaining a match injury in season 2009-10 compared with the previous season

There was also a reduction in the severity of each injury from 23 days to 22 days and as a result a commensurate reduction in the total number of days absent due to injury of 26%.

The data is contained in the seventh England Rugby Premiership Training & Injury Audit 2009-10 presented and accepted by the Professional Game Board on January 20.

The injury audit has been conducted since the 2002-3 season and is the largest continuous study of injuries in world rugby.

An injury is defined in the study as ‘any injury that prevents a player from taking a full part in all training activities typically planned for that day and/or match play for more than 24 hours’.

Data was gathered from all registered Premiership Rugby players and covered training and playing in all the major competitions. Data was also gathered from the elite England team, but due to the relatively low number of matches played, the main body of the audit is based on data gathered from the Premiership Rugby clubs.

Background:

Objective:

Because the risk of injury in many sports is high, governing bodies and individuals involved with these sports have a responsibility to manage the risks at acceptable levels. Risk management provides a structured framework within which risks can be identified, evaluated, assessed, and controlled through appropriate mitigation strategies. Exploring inferences obtained from the relationship between risk and the incidence and severity of injury contributes to the understanding and control of risks in sport. Studies related to intrinsic and extrinsic risk factors should be focused on determining which factors cause an athlete's risk level to fall within the high-risk or low-risk regions of the population's risk distribution. Risk values can be used to derive risk contours, which illustrate the interdependence of incidence and severity on the development of effective risk mitigation strategies. The wide variation in the levels of risk across different sports is used to demonstrate the impact that athletes' perception and acceptance of risk have on their choice of sport. Finally, the use of incidence and severity data for predicting the prevalence of injury in a team and for the economic evaluation of intervention programmes is discussed.

Background:

Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow-up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non-fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union.

This paper is a revision and update of the recommendations developed following the 1st (Vienna) and 2nd (Prague) International Symposia on Concussion in Sport.^{1 2} The Zurich Consensus statement is designed to build on the principles outlined in the original Vienna and Prague documents and to develop further conceptual understanding of this problem using a formal consensus-based approach.

A detailed description of the consensus process is outlined at the end of this document. This document is developed for use by physicians, therapists, certified athletic trainers, health professionals, coaches and other people involved in the care of injured athletes, whether at the recreational, elite or professional level. While agreement exists pertaining to principal messages conveyed within this document, the authors acknowledge that the science of concussion is evolving and therefore management and return to play decisions remain in the realm of clinical judgement on an individualised basis. Readers are encouraged to copy and distribute freely the Zurich Consensus document and/or the Sports Concussion Assessment Tool (SCAT2) card and neither is subject to any copyright restriction. The authors request, however that the document and/or the SCAT2 card be distributed in their full and complete format.

The following focus questions formed the foundation for the Zurich concussion consensus statement:

Background:

To investigate the effect of the proposed law changes (ELV) in Rugby Union on the physical demands of the players when compared to existing rules.

World Rugby Regulation 22 is the regulatory framework relating to artificial surfacing for the Game of Rugby binding on all Unions and Associations. The programme which aims to boost global participation, will for the first time, regulate and standardise the development, performance and maintenance of artificial turf worldwide through the appointment of World Rugby Preferred Turf Producers and World Rugby Accredited Test Institutes to ensure that the highest possible player welfare and performance standards are achieved.

World Rugby has just launched its Preferred Turf Producer scheme to ensure that installed pitches are both safe to play on and, through research and development, can evolve with the needs of Rugby.

World Rugby Regulation 22 is the regulatory framework relating to artificial surfacing for the Game of Rugby binding on all Unions and Associations. The programme which aims to boost global participation, will for the first time, regulate and standardise the development, performance and maintenance of artificial turf worldwide through the appointment of World Rugby Preferred Turf Producers and World Rugby Accredited Test Institutes to ensure that the highest possible player welfare and performance standards are achieved.

Test Institutes that meet the criteria set out by FIFA/World Rugby and pass an annual testing regime are eligible to perform tests in accordance with World Rugby Regulation 22.

Technology in the area of artificial playing surfaces has improved over time and artificial playing surfaces are widely used including in Rugby. World Rugby has produced the World Rugby Artificial Rugby Turf Performance Specification to set a minimum standard for artificial playing surfaces which may be used in rugby. The World Rugby Artificial Rugby Turf Performance Specification stipulates the testing and approval procedures which Manufacturers and other entities involved in the installation of artificial playing surfaces must comply with in order for their products to be approved for use in Rugby. The Game may not be played on any artificial surface which does not meet the World Rugby Artificial Rugby Turf Performance Specification, the requirements of Regulation 22 and Law 1 of the Laws of the Game. The World Rugby Artificial Rugby Turf Performance Specification will be amended over time as technology and research evolves in the area of artificial playing surfaces.

One Turf

To download the full Technical Document for the Specification of World Rugby Artificial Rugby Turf Performance, click the PDF icon at the top or bottom of the screen.

The aim of this study was to compare the incidence, nature, and cause of injuries sustained in rugby union played on artificial turf and grass. The study comprised a two-season investigation of match injuries sustained by six teams competing in Hong Kong's Division 1 and training injuries sustained by two teams in the English Premiership. Injury definitions and recording procedures were compliant with the international consensus statement on epidemiological studies of injuries in rugby union. There were no significant differences in the overall incidence (rate ratio = 1.42; P = 0.134) or severity (P = 0.620) of match injuries sustained on the two surfaces. The lower limb and joint (non-bone)/ligament injuries were the most common location and type of match injury on both surfaces; the incidence of anterior cruciate ligament injuries was nearly four times higher on artificial turf than grass but the difference was not statistically significant (rate ratio = 3.82; P = 0.222). There were no significant differences in the overall incidence (rate ratio = 1.36; P = 0.204) or severity (P = 0.302) of training injuries sustained on artificial turf and grass. The lower limb and muscle/tendon injuries were the most common location and type of training injury on both surfaces. The results indicate that the overall risks of injury on artificial turf are not significantly different from those experienced on grass; however, the difference in the incidence of anterior cruciate ligament injuries on the two surfaces is worthy of further study.

Definitions

Session 4 - RWC and CG

The full policy is available

• Dr Filippo Bottiglia – FIR – Subject expert
• Dr Mike England – RFU – Community Rugby and Academic research experience
• Dr Colin Fuller – World Rugby Risk Management Consultant – Rugby, Non-Rugby and Academic research experience
• Mark Harrington – World Rugby Head of Technical Services
• Dr Simon Kemp – RFU – Northern Hemisphere representative
• Rob Nichol – IRPA – Player representative - CMO appointee
• Dr Ken Quarrie – NZRU – Southern Hemisphere representative
• Dr Martin Raftery – World Rugby Chief Medical Officer – Chair
• Clint Readhead – SARU – CMO appointee
• Dr Preston Wiley – Rugby Canada – Tier 2 Rugby and Academic research experience
• Dr Mutsuo Yamada – JRU – High Performance Tier 2 representative

The key findings from the 2013-14 season were:

The Council, at its recent Annual Meeting agreed that 90 minutes be adopted as the maximum playing time permitted in one day for Age Grade Rugby Players.

In association with the above decision the Council also agreed that Unions be requested to ensure that Unions engaging in Age Grade Rugby consider their duty of care and that all necessary safety requirements are adhered to.

Yours sincerely,

Previous IRB Rugby Sevens surveillance studies reported the incidence and nature of match injuries sustained during the IRB Sevens World Series in 2008/09, 2010/11, 2011/12 and 2012/13 and the IRB Rugby World Cup Sevens in 2009 and 2013. This report continues the IRB’s on-going study of Rugby Sevens by reporting injuries and illnesses sustained during the 2013/14 IRB HSBC Sevens World Series. The report also describes, for the first time, illnesses and training injuries sustained during the 2013/14 Rugby Sevens Series.

The Terms of Reference outline the objectives and responsibilities of this Group as:

The objective of this Independent Concussion Advisory Group is to assist the IRB to further develop, implement and monitor a world class concussion risk management plan for the entire sport.

This Group will be responsible for reviewing the existing and monitoring future concussion risk management plans, identifying deficiencies and making recommendations for improving the safety and welfare of players with respect to concussion. This Group will also support the IRB by identifying new and evolving issues within the science around concussion which will assist the IRB to retain a world class risk management strategy.

The Independent Concussion Advisory Group will not be required to undertake activities with respect to the development or implementation of concussion risk management strategies but will support the IRB Chief Medical Officer or IRB Working Groups in the development and implementation of strategic interventions.

On isolated occasions, feedback of IRB concussion documents may be sort.

This Group requested that a Concussion Guidance for General Public document be developed (attached with this email). Utilizing previous documents as CMO of the IRB, I developed a draft document which was modified with input from this Advisory Group. This document was approved by the IRB Board on March 12, 2014 for public distribution.

335 training injuries that led to time lost from training and/or match play were reported in the 2012-13 season. A third of all reported injuries occurred in training (rugby skills and strength and conditioning combined), a potentially controllable environment

Traditionally, medical policies had been developed within World Rugby by first world medical personnel for first world medical environments and these were imposed on non-first world Member Unions whether or not national healthcare facilities were compatible with the requirements of the policies. The role of World Rugby is to identify medical risks within the Game, develop 'best practice' Guidelines and disseminate these Guidelines to all Unions for adaptation to each Union's unique environment. World Rugby Medical Guidelines now recognise that strategies may be different in the various jurisdictions.

Although the exact implementation strategy may vary from country to country, the underpinning World Rugby philosophy of player welfare should be the same across all countries. Each national governing body for Rugby has a responsibility to review the guidance prepared by World Rugby and to implement the guidance in a way that is demonstrably appropriate to the circumstances within that country.

It is also possible that strategies not only vary from country to country but may also vary within different sectors of the game within a single country. For example, an appropriate strategy in professional Rugby may be different from an appropriate strategy at the community level of Rugby.

In summary, each Union has the responsibility to adapt the 'best practice' guidelines developed by World Rugby to the local environment with a view to implementing 'good practice' within their jurisdiction.

Heat illness can range from heat exhaustion to heat stroke, with heat stroke being a

Infections can be transmitted by person to person contact, by common source exposure or by vector-borne transmission.

The primary focus of attention should be on primary prevention by use of hygiene measures, use of immunisation (vaccinations) and use of interventions to prevent secondary spread of infection. Secondary prevention measures include prevention of recurrence and prevention of onward spread of infection from a source patient.

Education of players in key aspects of infection is a key element of prevention.

An appropriate room or area for the use of players (from both participating teams) and
match officials (including referees and assistant referees) who are injured or ill. Such a facility will include:

potential

Final grading of impairment is summarised as:

2010; 44: 159-167.

Law 10.4 - Dangerous Play and Misconduct

Copyright © 2008 Sports Medicine Australia Published by Elsevier Ltd

Introduction

Introduction

Session 4 - Concussion

The studies were conducted in accordance with the definitions and protocols described in the IRB approved consensus statement on definitions and procedures for injury surveillance studies in rugby union (Fuller et al., 2007).

The definition of injury was: ‘Any injury sustained during a PNC Tournament match that prevents a player from taking a full part in all normal training activities and/or match play for more than one day following the day of injury’. Incidents where a player’s absence from match play and/or training was caused by training activities, illness or other medical conditions not related to a PNC match were not included. A recurrent injury was defined as: ‘An injury (as defined above) of the same type and at the same site as an index injury and which occurs after a player’s return to full participation from the index injury’. Injuries were classified using the appropriate OSICS 8 Code (Orchard, 1995). Injury location, type and cause together with the event leading to the injury were also recorded.

Injury severity was defined as the number of days a player was injured. A player was deemed to be ‘injured’ until he could undertake full normal training and be available for match selection, whether or not he was actually selected. Medical staff were required to make an informed clinical judgement about a player’s fitness to train/play on those days when players were not scheduled to train or play. Injured players were followed after each Tournament to obtain their return to play date.

The complete lists of categories and sub-categories used for injury locations and injury types are provided in the rugby injury consensus publication (Fuller et al., 2007).

Differences in players anthropometric data were assessed using unpaired t-tests; differences in the incidences of injury were assessed using z-tests. Statistical significance was accepted at the p≤ 0.05 level.

All studies were conducted in accordance with the definitions and protocols described in the IRB approved consensus statement on definitions and procedures for injury surveillance studies in rugby union (Fuller et al., 2007).

The definition of injury was: ‘Any injury sustained during a Women’s Seven’s Challenge Cup, Sevens World Series or Rugby World Cup Tournament match that prevents a player from taking a full part in all normal training activities and/or match play for more than one day following the day of injury’. Incidents where a player’s absence from match play and/or training was caused by training activities, illness or other medical conditions not related to a Seven’s Challenge Cup, Sevens World Series or Rugby World Cup Sevens match were not included. A recurrent injury was defined as: ‘An injury (as defined above) of the same type and at the same site as an index injury and which occurs after a player’s return to full participation from the index injury’. Injuries were classified using the appropriate OSICS 8 Code (Orchard, 1995). Injury location, type and cause together with the event leading to the injury were also recorded.

Injury severity was determined by the number of days a player was injured. A player was deemed to be ‘injured’ until she could undertake full normal training and be available for match selection, whether or not she was actually selected. Medical staff were required to make an informed clinical judgement about a player’s fitness to train/play on those days when players were not scheduled to train or play. Injured players were followed after each Tournament to obtain their return to play date.

The complete lists of categories and sub-categories used for injury locations and injury types are provided in the rugby injury consensus publication (Fuller et al., 2007).

Differences in players anthropometric data were assessed using unpaired t-tests; differences in the incidences, mean severity and proportions of injuries were assessed using z-tests and differences in median severity using a Mann-Whitney U test. Statistical significance was accepted at the p=0.05 level, although it is recognised that this could identify some differences that occur by chance due to the number of statistical comparisons being made in the study.

All studies were conducted in accordance with the definitions and protocols described in the IRB approved consensus statement on definitions and procedures for injury surveillance studies in rugby union (Fuller et al., 2007).

The definition of injury was: ‘Any injury sustained during a Sevens World Series or Rugby World Cup Sevens Tournament match that prevents a player from taking a full part in all normal training activities and/or match play for more than one day following the day of injury’. Incidents where a player’s absence from match play and/or training was caused by training activities, illness or other medical conditions not related to a Sevens World Series or Rugby World Cup Sevens match were not included. A recurrent injury was defined as: ‘An injury (as defined above) of the same type and at the same site as an index injury and which occurs after a player’s return to full participation from the index injury’. Injuries were classified using the appropriate OSICS 8 Code (Orchard, 1995). Injury location, type and cause together with the event leading to the injury were also recorded.

Injury severity was determined by the number of days a player was injured. A player was deemed to be ‘injured’ until he could undertake full normal training and be available for match selection, whether or not he was actually selected. Medical staff were required to make an informed clinical judgement about a player’s fitness to train/play on those days when players were not scheduled to train or play. Injured players were followed after each Tournament to obtain their return to play date.

The complete lists of categories and sub-categories used for injury locations and injury types are provided in the rugby injury consensus publication (Fuller et al., 2007).

Differences in players anthropometric data were assessed using unpaired t-tests; differences in the incidences, mean severity and proportions of injuries were assessed using z-tests and differences in median severity using a Mann-Whitney U test. Statistical significance was accepted at the p=0.05 level, although it is recognised that this could identify some differences that occur by chance due to the number of statistical comparisons being made in the study.

• 636 match injuries at Premiership Rugby clubs were reported in 2009-10; an average of 1.6 injuries per match leading to an average absence from playing and training of 22 days
• The likelihood of sustaining an injury dropped from 100 injuries per 1,000 hours in 2008-9 to 80 injuries per 1,000 hours in 2009-10
• Small decrease in the number of knee Anterior Cruciate Ligament (ACL) injuries, which had significantly affected the figures in 2008-9, but injuries fell across all levels of severity
• Reduced likelihood and reduced severity meant that the average days’ absence per club, per match, fell from 46 days in 2008-9 to 34 days in 2009-10, a reduction of 26%
• Largest drop seen in the incidence of recurrence of injury. Days absence per 1,000 hours due to recurrence of an injury dropped from 485 in 2008-9 to 207 in 2009-10, a decrease of 43% and reported as “a marker of the completeness of rehabilitation by Premiership Rugby and England medical and conditioning staff and a very encouraging trend”

Clinical Journal of Sport Medicine

• To establish the biomechanics of different scrummaging techniques to assess potential injury risk
• To identify playing, coaching and match official techniques that provide for effective scrummaging with a reduced risk of serious injury to players
• To provide data and information to enable Law amendments to be considered in relation to the scrum

British Journal of Sports Medicine

• Which symptom scale and which sideline assessment tool is best for diagnosis and/or follow up?
• How extensive should the cognitive assessment be in elite athletes?
• How extensive should clinical and neuropsychological (NP) testing be at non-elite level?
• Who should do/interpret the cognitive assessment?
• Is there a gender difference in concussion incidence and outcomes?

Portable Global Positioning Systems (GPS) were worn by players in numerous positions (e.g. Prop, Hooker, Lock, No. 8, No. 7, Half-back, Wing, Fullback etc) during competitive rugby games. The players were competing in the Air New Zealand Cup (Premier Provincial 1st XV [Existing Rules - ANZC]) or the Provincial Development Competition (Provincial 2nd XV [New Rules - ELV]). Players were often replaced (substituted) before the end of games (normally during the second half) and therefore the data will be presented in “first half” analysis or “per minute” analysis. The GPS recorded distance covered, time and velocity. This was downloaded and is summarised below.