The England Rugby Injury & Training Audit 2008-09, the world's largest continuous injury study in professional rugby union, was unveiled today and maps the frequency and risk of injuries at Guinness Premiership and England level.
The sixth season of the study (2008-9) recorded 769 match injuries from the Guinness Premiership, EDF Energy Cup and European competitions and 258 training injuries. An injury is defined as preventing a player from training and/or playing for more than 24 hours.
The results show that the likelihood of sustaining a match injury increased in the 2008-9 season, reversing the downward trend that had been established since the 2002-3 season.
Elite players suffered an extra 119 injuries over the course of the 2008-9 season - an increase of 20 per cent or 0.3 injuries per club per match from the 2007-08 season. In the England Senior team, match injuries fell to 23 from 55 although the small number of matches make it difficult to draw any statistical assumptions in this area.
The average numbers of days' absence as a result of each match injury, at the professional club level, increased from 19 to 23 days.
Consequently, the total number of days absence as a result of match injury increased to 2285 days/1000hrs in 2008-9 compared with 1613 days absence/1,000 hrs in 2007-8 - the highest level reported since the study began in 2002-3.
However, the total number of training injuries decreased from 318 to 258 - a reduction of 19%.
Dr Simon Kemp, RFU Head of Sports Medicine, said: "This audit is pivotal in both providing the baseline data needed to assess trends in injury and in guiding further investigation into injuries that are common, severe or increasing in incidence. It generates robust high-quality data with which to inform risk management.
"What we saw last season was an increase in both the likelihood of a match injury and the length of time an injury keeps a player out.
"It's difficult to be sure as to the precise reasons for this increase but a small increase in two uncommon injuries (anterior cruciate ligament ruptures and foot fractures) both of which typically keep a player out for more than 84 days were responsible for 50 per cent of this increase.
"We now need to integrate the injury audit with a video analysis of the structure of the elite game and of game injury events. This will give us a better understanding of the relationship between changes in the frequency and nature of game events (tackles, rucks, mauls, scrums, lineouts, restarts) i.e. the overall shape of the game and injury risk.
"We have based our recommendations on an accepted injury risk management process. This involves not only improving the quality of the data we collect but also looking to develop how we evaluate and then mitigate risk by involving a multi-disciplinary group, rather than just medics, in the processes. Players, coaches, conditioners, referees, law makers, the disciplinary process all have key roles to play.
"We will be commissioning specific studies into knee anterior cruciate ligament and medial collateral ligament injuries, as well as hamstring injuries which are a continuing source of days lost, so that we can better understand why these injuries occur, how they might be prevented and what we can do to treat them better."
Phil Winstanley, Rugby Director at Premier Rugby, said: "The injury audit is a world leading study that asks when injuries occur, as they will in rugby, why they happen and how we can avoid them in the future. It is another example of the extensive medical work that currently goes on at the Elite level in England, alongside programmes like the Pitchside Immediate Trauma Care course, CogSport and the development of minimum medical provision at all clubs.
"The specific studies into knee ligament and hamstring injuries borne out of this latest report, as well as the monitoring of the impact of the IRB law change at the breakdown, are designed to further improve practice in England and ensure that as the game grows and changes, player welfare remains our primary concern."
Damian Hopley, Chief Executive of the Rugby Players' Association, said: "The increased number of injuries reported in this invaluable audit are of significant concern to the RPA and our members, and the findings reinforce the requirement for further research into acceptable levels of workload and demands made of rugby players by the modern elite game.
"This commitment to further research, seeking to investigate the underlying causes of the rise in injuries, will be crucial in ensuring we continue to optimally manage our players' health, protection and welfare effectively."
