Modelling injury-burden in rugby sevens

Paving the path for injury prevention in rugby-7s: A systematic review and meta-analysis

This review and meta-analysis aimed to describe the current rugby-7s injury epidemiological literature by examining injury data from both sexes, all levels of play, and their associated risk factors. Studies published up until March 2024 were included. These studies were retrieved from six databases using search terms related to rugby-7s or sevens, tackle, collision, collision sport, injury, athlete, incidence rate, mechanism, and risk factor. Only peer-reviewed original studies using prospective or retrospective cohort designs with a clearly defined rugby-7s sample were considered. Included studies needed to report one injury outcome variable. Non-English and qualitative studies; reviews, conference papers, and abstracts were excluded. Twenty studies were included. The meta-analysis used the DerSimonian-Laird continuous random-effects method to calculate the pooled estimated means and 95% confidence interval. The estimated mean injury incidence rate for men was 108.5/1000 player-hours (95% CI: 85.9-131.0) and 76.1/1000 player-hours (95% CI: 48.7-103.5) for women. The estimated mean severity for men was 33.9 days (95% CI: 20.7-47.0) and 44.2 days (95% CI: 32.1-56.3) for women. Significantly more match injuries occurred in the second half of matches, were acute, located at the lower limb, diagnosed as joint/ligament, and resulted from being tackled. Fatigue, player fitness, and previous injuries were associated with an increased risk of injury. There were no statistically significant differences between women's and men's injury profiles. However, the inherent cultural and gendered factors which divide the two sports should not be ignored. The findings from this review will help pave the way forward beyond the foundational stages of injury prevention research in rugby-7s.

"Road to Rio": A Case Study of Workload Periodization Strategy in Rugby-7s During an Olympic Season

The objective of this manuscript was to examine the periodization strategy of an international Rugby-7s team during an Olympic season. Training load data were collected in 14 elite male players over a 48-week period during the 2015–2016 Olympic season. The season consisted of 3 macrocycles including: preseason (12-weak duration), in-season (25-weak) fragmented into four 4–7 weeks mesocycles (In-1–4) and the final preparation for the Rio 2016 Olympic Games (Olympic preparation, 11-weak). External training load (TL) such as the total distance (TD), the high-intensity distance (HID) and the number of accelerations performed, was monitored in training and competition over the entire duration of the season using a global positioning system (GPS) devices. The rating of perceived exertion (RPE) was multiplied by the session duration (min) to provide an internal TL (session-RPE) value for all training sessions and competitions. The Olympic preparation may enable planning of higher external TL compared to the preseason (TD, 21 ± 13%, moderate; total accelerations, 27 ± 4%, moderate) whereas no difference was observed for internal TL values between these two periods. High-intensity distance (HID) and internal TL (session-RPE) were lower (−11.0 ± 7.8%, small and −38 ± 3%, moderate, respectively) during the in-season compared to preseason. Internal TL, TD as well as HID were lower in the third in-season mesocycle (In-3) compared with the first in-season mesocycle (In-1) (−25 ± 12%, moderate; −32 ± 4%, moderate; −49 ± 8%, moderate, respectively). The staff managed the workload considering the in-season as the main part of the “Road to Rio.” The strategy to reduce the workload at the middle of the season and to induce weeks of regeneration at the end of the in-season was highlighted by the training availability of 100% of the squad at the beginning of the Olympic preparation. The workload periodization strategy of an Olympic season differs from the strategy previously described during a non-Olympic season.

Eight-season epidemiological study of match injuries in women's international rugby sevens

This study aimed to describe anthropometry and incidence, nature and causes of match injuries in women's international rugby sevens and to compare these with results reported previously for men's international rugby sevens. The study comprised an 8-season, prospective study of World Rugby's women's Sevens World Series. Over the eight seasons, the overall incidence of injury was 105.6 (95% CI: 96.0 to 116.3) injuries/1000 player-match-hours with a mean injury severity of 53.4 (95% CI: 46.9 to 59.9) days-absence. There were no statistically significant trends for backs or forwards in the incidence (backs: p = 0.470; forwards: p = 0.242) or mean severity (backs: p = 0.098; forwards: p = 0.544) of injuries sustained over the 8-season period. Head/face (20.8%), knee (19.7%), ankle (11.3%) and shoulder/clavicle (8.4%) were the most common injury locations while ligament sprain (31.7%), concussion (15.6%), haematoma/bruise (11.5%) and fracture (11.5%) were the most common types of injury sustained. Being-tackled (35.4%), tackling (26.3%), collisions (13.8%) and rucks (8.8%) were the match events responsible for most injuries. The study indicates that injury burden in women's international rugby sevens (5,640 days-absence/1000 player-match-hours; 95% CI: 5,123 to 6,209) is similar to that reported previously for men's international rugby sevens (5,263 days-absence/1000 player-match-hours; 95% CI: 5,000 to 5,540).

Ten-season epidemiological study of match injuries in men's international rugby sevens

The aim of this study was to describe the incidence, nature and causes of match injuries in men's international rugby sevens and to compare these to values for international rugby fifteens. The study comprised a 10-season, whole population, prospective study of the Sevens World Series. Over the ten seasons, the overall incidence of injury was 122.4 (95% CI = 116.3 to 128.9) injuries/1000 player-match-hours and the mean severity of injury was 43.0 (95% CI = 40.3 to 45.7) days-absence. There was an increasing trend in the incidence of injury over the ten-season period (slope = 5.3 injuries/1000 player-hours/season, R² = 0.68, p = 0.003) but no trend in the mean severity of injury (slope = 0.02 days/season, R² < 0.01, p = 0.971). Head/face (15.7%), knee (15.6%), ankle (15.4%) and shoulder/clavicle (11.9%) were the most common injury locations and ligament sprain (30.5%), muscle strain (16.4%), concussion (12.6%) and haematoma/bruise (10.6%) the most common types of injury sustained. Being-tackled (33.1%), tackling (23.4%), running (16.1%) and collisions (12.4%) were the most common events leading to injury. These results indicate that the burden of injury in international rugby sevens is two to three times higher than that reported for international rugby fifteens.

A 2-Year Prospective Study of Injury Epidemiology in Elite Australian Rugby Sevens: Exploration of Incidence Rates, Severity, Injury Type, and Subsequent Injury in Men and Women

BACKGROUND

Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only.

PURPOSE

To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed.

RESULTS

Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P = .011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence.

CONCLUSION

Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens.

Injury Risk (Burden), Risk Matrices and Risk Contours in Team Sports: A Review of Principles, Practices and Problems

The aim of this review was to provide insights into and a critical assessment of injury burden, risk matrices and risk contours in the context of team sports. Injury burden is the product of injury incidence and mean severity, and is normally reported as days' absence/1000 player-hours. An important feature of injury burden is that equal values can reflect quite different numerical combinations of injury incidence and severity. The timeframe over which injury burden affects a team depends on the incidence and severity values of the injuries sustained. Injury burden is evaluated through the use of risk matrices and risk contours. The main benefits of using risk matrices, and the reasons for their widespread acceptance, are the minimal data inputs required, the ease of understanding the visual data presentation, the transparent nature of the evaluation criteria and the simplicity with which the conclusions can be communicated to stakeholders. Injury burden is most often used for the identification of injuries that cause the greatest loss of time for players, ranking the importance of injury risk factors and prioritising injury prevention plans. Although risk matrices are commonly used for evaluating risks during the risk assessment process, there is little evidence to demonstrate that they improve decision-making, as they have a number of limitations, including potential inconsistencies and discrepancies when evaluating and ranking risks. These limitations suggest that physicians, physiotherapists and sports scientists should only use injury burden, risk matrices and risk contours when they fully understand their strengths and weaknesses.

Modeling the impact of players' workload on the injury-burden of English Premier League football clubs

The loss of players through injury is known to affect team performance in many sports; it is important, therefore, for professional teams to be able to quantify the likely injury-burden that will be encountered throughout a season. A kinetic model, based on the rates at which match and training injuries are sustained and resolved, a team's squad size and the 2017/2018 season fixture schedule for teams competing in the English Premier League, is used to produce daily forecasts of injury-burden experienced by a typical team. The incidences and median severities of match (incidence: 26.9 injuries/1000 player-match hours, 95% CI: 21.5-33.7; severity: 17.5 days, 95% CI: 13.0-28.0) and training (incidence: 4.3 injuries/1000 player-training hours, 95% CI: 3.4-5.5; severity: 14.0 days, 95% CI: 11.0-22.0) injuries were determined using data collected from four English Premier League football clubs during the 2016/2017 season. Time-to-recovery curves for the match and training injuries sustained in the Premier League closely matched the time-to-recovery curves predicted by the kinetic model used in this study. The kinetic model predicted higher match and lower training injury burdens and a higher overall injury burden for successful teams competing in both national and European club competitions compared to teams competing only in national competitions. The model also showed that, in terms of injury-burden, there were no benefits in adopting a 4-week mid-season break during the season: reducing the number of clubs competing in the Premier League would, however, reduce the overall injury burden during a season.