{"id":10354,"date":"2023-01-13T06:00:21","date_gmt":"2023-01-13T05:00:21","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10354"},"modified":"2023-01-07T01:03:58","modified_gmt":"2023-01-07T00:03:58","slug":"suffering-a-concussion-increases-injury-risk-in-male-rugby-union","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/01\/13\/suffering-a-concussion-increases-injury-risk-in-male-rugby-union\/","title":{"rendered":"Suffering a concussion increases injury risk in male Rugby Union"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Key words: concussion, hamstring, ankle, shoulder, rugby<\/span><\/p>\n<p><span style=\"font-weight: 400\">Rugby Union has one of the highest injury rates of any team sport, with concussion and lower limb injuries particularly common (<\/span><span style=\"font-weight: 400\">1,2)<\/span><span style=\"font-weight: 400\">. Players also sustain multiple injuries during their career, which may impact their risk of future injuries (<\/span><span style=\"font-weight: 400\">3)<\/span><span style=\"font-weight: 400\">. This blog summarises our recent <\/span><a href=\"https:\/\/bjsm.bmj.com\/content\/early\/2022\/12\/13\/bjsports-2021-105238.full\"><span style=\"font-weight: 400\">original research<\/span><\/a><span style=\"font-weight: 400\"> into injury risk in male professional Rugby Union (<\/span><span style=\"font-weight: 400\">4)<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><b>Why did we do this study?<\/b><\/p>\n<p><span style=\"font-weight: 400\">Concussion has been shown to increase injury risk in Rugby Union (<\/span><span style=\"font-weight: 400\">5,6)<\/span><span style=\"font-weight: 400\">, but<\/span> <span style=\"font-weight: 400\">is it the only injury to have this effect? Are changes in concussion return to rugby protocols needed or is the increased injury risk part of injury occurrence regardless of what injury was sustained?<\/span><\/p>\n<p><span style=\"font-weight: 400\">We sought to assess two types of injury risk of common injuries in male Rugby Union:\u00a0<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">A player\u2019s change in injury risk (comparing injury risk before and after a common injury<\/span><span style=\"font-weight: 400\">)<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Differences in subsequent injury risk following a common injured compared to all other injuries<\/span><\/li>\n<\/ol>\n<p><b>How did we carry out this study?<\/b><\/p>\n<p><span style=\"font-weight: 400\">We monitored time-loss injuries of Welsh professional male Rugby Union players over seven seasons<\/span><span style=\"font-weight: 400\">,<\/span> <span style=\"font-weight: 400\">from<\/span><span style=\"font-weight: 400\"> 2012\/13 to 2018\/19. A total of 2888 injuries were sustained by 382 players. The 5<\/span> <span style=\"font-weight: 400\">\u00a0injuries with the highest match injury incidence were: concussion, thigh haematomas, hamstring muscle strains, acromioclavicular joint injuries and lateral ankle sprains. These were named<\/span> <span style=\"font-weight: 400\">common injuries. We then modelled the risk of injury before sustaining a common injury after the risk of injury after it. This allowed us to quantify changes in a player\u2019s injury risk. Subsequent injury risk was also modelled by comparing the risk of injury following one of the common injuries and the risk following all other injuries. This quantified the difference in between-player subsequent injury risk. The number of days between injuries were also calculated for time to next injury.\u00a0<\/span><\/p>\n<p><b>Key findings<\/b><\/p>\n<p><span style=\"font-weight: 400\">Our key findings for concussion were:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Concussion<\/span> <span style=\"font-weight: 400\">was the only injury to elevate a player\u2019s injury risk. Risk increased by 26%<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Concussion<\/span> <span style=\"font-weight: 400\">increased the risk of suffering head\/neck, pelvic and neurological injuries<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Concussion<\/span> <span style=\"font-weight: 400\">increased subsequent injury risk by 24%<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Concussion<\/span> <span style=\"font-weight: 400\">shortened the time to next injury<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Our key findings for lateral ankle sprains were:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">It was the only injury to reduce a player\u2019s injury risk. Risk decreased by 30%<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">It decreased the risk of suffering head\/neck, upper leg and knee, joint\/ligament and neurological injuries<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">No change in subsequent injury risk<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">No change in time to next injury<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Our key findings for thigh haematomas and hamstring muscle strains:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">No change in a player\u2019s injury risk<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Subsequent injury risk increased by 18% and 14%, respectively<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">No change in time to next injury<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Acromioclavicular joint sprains had no effect on a player\u2019s injury risk, subsequent injury risk or time to next injury.<\/span><\/p>\n<p><b>Take-home messages<\/b><\/p>\n<p><span style=\"font-weight: 400\">Concussion return-to-rugby protocols need to mitigate the risk of injury following its<\/span> <span style=\"font-weight: 400\">occurrence. Objective assessments are recommended to ensure players have fully recovered.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Potential changes to return-to-rugby protocols include:<\/span><\/p>\n<p><span style=\"font-weight: 400\">1) increasing the minimum time requirements;\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">2) greater levels of physical preparation;\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">3) including proprioceptive training;\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">4) objective assessments and;\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">5) rugby-specific assessments relating to decision making and skill execution.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Ankle ligament rehabilitation may be able to inform concussion rehabilitation due to the association between its occurrence and a reduced risk of head\/neck and neurological injuries<\/span><b>.<\/b><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10355\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk-120x300.png\" alt=\"\" width=\"399\" height=\"997\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk-120x300.png 120w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk-768x1920.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk-614x1536.png 614w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk-640x1600.png 640w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Concussion-increases-injury-risk.png 800w\" sizes=\"auto, (max-width: 399px) 100vw, 399px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><b>Written by<\/b> <span style=\"font-weight: 400\">Isabel S. Moore (1)<\/span><span style=\"font-weight: 400\">\u00a0on behalf of all the co-authors.<\/span><\/p>\n<p><span style=\"font-weight: 400\">(1)\u00a0<\/span><i><span style=\"font-weight: 400\">Cardiff School of Sport &amp; Health Sciences, Cardiff Metropolitan University, Cardiff, UK<\/span><\/i><\/p>\n<p><b>Conflicts of interest: <\/b><span style=\"font-weight: 400\">ISM is an Associate Editor for the British Journal of Sports Medicine. ISM received a research grant from Welsh Rugby Union.\u00a0<\/span><\/p>\n<p><b>References<\/b><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Bitchell CL, Mathema P, Moore IS. Four-year match injury surveillance in male Welsh professional Rugby Union teams. <\/span><i><span style=\"font-weight: 400\">Phys Ther Sport<\/span><\/i><span style=\"font-weight: 400\"> 2020;42:26-32. doi:10.1016\/j.ptsp.2019.12.001<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Williams S, Trewartha G, Kemp S, et al. A Meta-Analysis of Injuries in Senior Men\u2019s Professional Rugby Union. <\/span><i><span style=\"font-weight: 400\">Sport Med<\/span><\/i><span style=\"font-weight: 400\"> 2013;43:1043-1055. doi:10.1007\/s40279-013-0078-1<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Moore IS, Ranson C, Mathema P. Injury Risk in International Rugby Union: Three-year injury surveillance of the Welsh national team. <\/span><i><span style=\"font-weight: 400\">Orthapedic J Sport Med<\/span><\/i><span style=\"font-weight: 400\"> 2015;3:1-9. doi:10.1177\/2325967115596194<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Moore, IS, Bitchell CL, Vicary D, et al. <\/span><span style=\"font-weight: 400\">Concussion increases within-player injury risk in male professional rugby union. <\/span><i><span style=\"font-weight: 400\">Br J Sports Med.<\/span><\/i><span style=\"font-weight: 400\"> doi:\u00a010.1136\/bjsports-2021-105238<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Cross M, Kemp S, Smith A, et al. Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: A 2-season prospective study of clinical outcomes. <\/span><i><span style=\"font-weight: 400\">Br J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2016;50:926-931. doi:10.1136\/bjsports-444 2015-094982<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Rafferty J, Ranson C, Oatley G, et al. On average, a professional rugby union player is more likely than not to sustain a concussion after 25 matches. <\/span><i><span style=\"font-weight: 400\">Br J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2018;44:1-5. doi:10.1136\/bjsports-2017-098417<\/span><\/li>\n<\/ol>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key words: concussion, hamstring, ankle, shoulder, rugby Rugby Union has one of the highest injury rates of any team sport, with concussion and lower limb injuries particularly common (1,2). Players also sustain multiple injuries during their career, which may impact their risk of future injuries (3). This blog summarises our recent original research into injury [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2023\/01\/13\/suffering-a-concussion-increases-injury-risk-in-male-rugby-union\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":463,"featured_media":10355,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[8271,16068,1757],"class_list":["post-10354","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-concussion","tag-featured","tag-rugby"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Suffering a concussion increases injury risk in male Rugby Union - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/?p=10354\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Suffering a concussion increases injury risk in male Rugby Union - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"Key words: concussion, hamstring, ankle, shoulder, rugby Rugby Union has one of the highest injury rates of any team sport, with concussion and lower limb injuries particularly common (1,2). 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