Match and training injury incidence in rugby league: A systematic review, pooled analysis, and update on published studies

Abstract

In studies reporting rugby league injuries, match injuries varied depending upon participation level. To review and update pooled data estimates for rugby league injury epidemiology and add information for participation levels in match and training environments. A systematic review and pooled analysis for published studies reporting rugby league match and training injuries. Searches were performed in the PubMed, CINHAL, ScienceDirect, Scopus, SPORTDiscus, SpringerLink, and Wiley Online databases. Studies were considered if they reported on rugby league match or training injuries between Jan 1990 to June 2021. Two authors (DK, TC) extracted the study characteristics, numerical data and assessed the article quality, by adhering to the protocol for systematic review of observational studies (MOOSE) and the STrengthening and Reporting of OBservational studies in Epidemiology (STROBE) statement. The 46 studies included a combined exposure of 419,037 h and 18,783 injuries incorporating 158,003 match-hr and 15,706 match injuries (99.4 [95%CI: 97.9-101.0] per 1000 match-hr) and 264,033 training-hr and 3077 training injuries (11.8 [95%CI: 11.4-12.2] per 1000 training-hr). Of included studies, 47.9% utilised a medical attention/treatment injury definition. There was a five-fold difference in injuries for the semi-professional participation level (431.6 per 1000 match-hr) compared with professional (RR: 4.92; p < 0.001) and elite (RR: 3.77; p < 0.001) participation levels. The hooker recorded the highest pooled injury incidence (93.1 per 1000 match-hr). Compared to the 2014 analysis there was a 10-fold increase for head-neck region (RR: 10.7; p < 0.001) injury incidence, and more injuries for the ball carrier (RR: 1.1; p = 0.008) and tackler (RR: 1.2; p = 0.001). There was a three-fold decrease in injury incidence in the first half (RR: 2.9; p < 0.001) and a two-fold decrease in the second half (RR: 2.3; p < 0.001) of matches. While rugby league match and training injury incidence had decreased since 2014, the increase in head injuries, and greater injury rate at the semi-professional level, mean further injury prevention interventions are needed.

Keywords

Rugby league / Injury epidemiology / Match / Training / Pooled analysis / Concussion

Compared with the pooled analysis in 2014, the current analysis showed:

The hooker playing position continues to have the highest match injury risk (93.1 per 1000 match-hr).

The lower limb (64.5 per 1000 match-hr) continues to be the body region with the highest injury risk.

The quadriceps was the most reported injury site (28.5 per 1000 match-hr).

The incidence of concussion in studies reporting on rugby league match injuries increased (7.7 vs. 11.6 per 1000 match-hr); and

Most concussions took 28 days to recover, which conflicts with the Concussion in Sport Consensus Statement that reported 80%-90% of all concussions recover in seven to ten days.

Funding

No sources of funding were used to assist in the preparation of this article.

Submission statement

As corresponding author, I hereby state that the manuscript has not been published previously, that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

Authors' contribution

Contributor statement: According to the definition given by the International Committee of Medical Journal Editors (ICMJE), the authors listed above qualify for authorship based on making one or more of the substantial contributions to the intellectual content of:

(i) Conception and design (DK, TC); and/or

(ii) Acquisition of data (DK); and/or

(iii) Analysis and interpretation of data (DK, TC, PH); and/or

(iv) Participated in drafting of the manuscript (DK, TC, PH, KH); and/or

(v) Critical revision of the manuscript for important intellectual content (DK, TC, PH, KH).

Data availability statement

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Conflict of interest

DK, TC, PH and KH declare that they have no conflicts of interest relevant to the content of this review.

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