Twenty year analysis of professional men’s rugby union knee injuries from the English premiership

[Which Tyler]

Abstract
Full Text

Science For Sport's summary

Twenty-year analysis of knee injuries in men’s professional rugby
OBJECTIVE
Rugby poses a high risk of injury due to the repetitive contact nature of the sport. Specifically, the knee joint is one of the most frequently injured joints during both matches and training.
The purpose of this study was to investigate the incidence, severity and burden of specific knee injury diagnoses over twenty English Premiership rugby seasons.

WHAT THEY DID
Injury data were collected over twenty rugby seasons (2002-2022) from English Premiership clubs. This included the time of injury, injury diagnosis, and time loss. Injury severity was determined by the number of days absent from either matches or training, categorized as 2-7 days, 8-28 days, 29-84 days, and >84 days. Knee injury burden and injury incidence were calculated and collected.

WHAT THEY FOUND
A total of 2128 knee injuries were reported, of which 1519 occurred in matches and 609 occurred in training. The rate of knee injury in matches was 9.8/1000 hours of exposure. The mean days lost due to knee injury were 50 in matches and 51 in training sessions.
During matches, the most common injury to the knee involved the medial collateral ligament, followed by chondral meniscal injuries, while anterior cruciate ligament (ACL) injuries were the most severe and caused the most time loss.
Injuries of 2-7 days’ time loss were the most common (29%), followed by 8-28 days (28%), and 29-84 days (26%). Except for ACL injuries, the tackle event was responsible for the greatest proportion of knee injuries (46%), and the ball carrier was at greater risk of injury than the tackler.

Practical Takeaways
Understanding the patterns in specific knee injury diagnoses may better inform practitioners of rates of specific knee injury types and expected timelines to recovery.
Since MCL injuries were the most common injury seen in the knee, emphasis on strength and conditioning measures that emphasize the medial compartment of the knee is important for injury risk reduction.
Although more importance has been placed on injury prevention, this study shows that the number of knee injuries has not decreased over twenty years, while the severity has increased. There are likely several contributing factors to this, including games becoming quicker with athletes utilizing higher speeds and more force during tackles. In addition, changes in playing surface have also been shown to increase the risk of injury with the transition from natural grass to artificial turf.

Jordan’s Comments
As a result of knee injury rates not reducing over time while severity has increased, athletes need to ensure that they are fully prepared for the demands of their sport. From a rehabilitation standpoint, our profession can and needs to do a better job when it comes to return-to-sport criteria to reduce the likelihood of re-injury in athletes.
While there is no one method to prevent injuries, being strong is more protective against injury. Emphasizing this through sound strength and conditioning both in season and in the off-season, while managing workload, can help address this area.

Particularly interested in this bit from the abstract:
"The incidence of match knee injury was 44% higher on artificial pitches than grass pitches, with no significant difference in severity between surfaces."

[Oakboy]

That's pretty condemnatory of artificial surfaces, isn't it? Maybe, it should be 30 games maximum reduced by one for every two games played on non-grass?

[Danno]

Those things surely have to be binned

[Puja]

That's pretty condemnatory of artificial surfaces, isn't it? Maybe, it should be 30 games maximum reduced by one for every two games played on non-grass?

I mean, sure, if you just want to see just how many games Itoje will play over his limits in a season.

Puja