Are we currently underestimating the risk of scrum-related neck injuries in rugby union front-row players?

Brown, James; Lambert, Mike; Hendricks, Sharief; Readhead, Clint; Verhagen, Evert; Burger, Nicholas; Viljoen, Wayne

doi:10.1136/bjsports-2013-092869

Cited by 5 publications

(5 citation statements)

References 16 publications

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“… 10 The frequent engagement in high-velocity collisions and impacts during contact activities such as the tackle and scrum, which varies depending on position, commonly result in musculoskeletal system injuries 11 and place players at risk of head and neck injury. 12 13 Given the physical nature of the sport, the incidence of concussion in rugby is high, 14 15 estimated between 4 and 13.4 concussions per 1000 contact hours. 13 16–18 This is recognised as one of the highest rates of concussion of all full-contact sports.…”

Section: Introductionmentioning

confidence: 99%

Influence of playing rugby on long-term brain health following retirement: a systematic review and narrative synthesis

Cunningham

Broglio

Wilson

2018

BMJ Open Sport Exerc Med

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ObjectivesThe aim of this review was to systematically investigate long-term brain health in retired rugby players.MethodsSix databases were systematically searched from inception to January 2018 using Medical Subject Headings and keywords. Two reviewers independently screened studies for inclusion. Cross-sectional studies of living retired male or female rugby players in which at least one cognitive test was used as an outcome measure were included. Data extraction was performed using Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methodological quality was assessed independently by two reviewers using the Downs and Black methodological quality tool.ResultsThis review yielded six studies with an overall methodological quality of ‘moderate’. A total of 672 male retired rugby players (mean ages of 38–52 years) were included in this review. Three studies investigated neuropsychological functioning in retired rugby players in comparison with controls, with no significant evidence of decreased performance in the majority of tests when compared with controls. Five out of the six studies explored self-reported measures of cognition. Three studies compared retired rugby players to controls, one of which found significantly increased subjective cognitive complaints among retired rugby players. The other two studies found that persistent postconcussion symptoms were associated with a higher number of self-reported concussions. Two studies reported decreased fine motor control in retired rugby players in comparison with controls. Neurometabolites and electrophysiological changes were explored by two studies, with minimal and non-significant findings.ConclusionsOverall findings are mixed. Methodological biases reduce the overall study quality and limited the conclusions that can be drawn. Findings of decreased fine motor control in retired athletes may be influenced by lack of controlling for evidence of upper limb musculoskeletal injuries. While some studies show evidence of reduced cognitive function among former athletes, the results are not significantly lower than population norms. Cognitive findings from this review are inconsistent within and across study cohorts and are biased towards positive findings when self-report methods were selected. Current evidence suggests that large gaps remain in the understanding of the cause-and-effect relationships between playing rugby and long-term brain health in retired players.

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Section: Introductionmentioning

confidence: 99%

Influence of playing rugby on long-term brain health following retirement: a systematic review and narrative synthesis

Cunningham

Broglio

Wilson

2018

BMJ Open Sport Exerc Med

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“…Consequently, Front-row Forwards, who have relatively high exposure to contact with the opposition (Brown et al, 2014;Duthie, Pyne, & Hooper, 2003), are particularly vulnerable (Brooks & Kemp, 2011;Usman & McIntosh, 2012).…”

Section: Introductionmentioning

confidence: 99%

Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards

Davies¹,

Moore

Moran³

et al. 2016

Physical Therapy in Sport

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Objectives: To provide normative values for cervical range of motion (CROM), isometric cervical and shoulder strength for; International Senior professional, and International Age-grade Rugby Union front-row forwards.Design: Cross-sectional population study Setting: All international level front-row players within a Rugby Union Tier 1 Nation.Participants: Nineteen Senior and 21 Age-grade front-row forwards underwent CROM, cervical and shoulder strength testing.Main outcome measures: CROM was measured using the CROM device and the Gatherer System was used to measure multi-directional isometric cervical and shoulder strength.Results: The Age-grade players had significantly lower; cervical strength (26 -57% deficits), cervical flexion to extension strength ratios (0.5 vs. 0.6), and shoulder strength (2 -36% deficits) than the Senior players. However, there were no differences between front-row positions within each age group. Additionally, there were no differences between age groups or front-row positions in the CROM measurements.Conclusions: Senior Rugby Union front-row forwards have greater cervical and shoulder strength than Age-grade players, with the biggest differences being in cervical strength, highlighting the need for position specific normative values.Importantly, Age-grade players should be evaluated to ensure they have developed sufficient cervical strength prior to entering professional level Rugby Union.

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“…The collection of players' demographics, rugby injuries and exercise history using a questionnaire is a limitation, primarily due to player recall bias. However significant sport epidemiological research has been conducted via questionnaires [4,7,8]. This study's questionnaire was adapted from the RICG consensus paper (Fuller et al) on rugby injuries and the most popular South African youth rugby questionnaire (Van Heerden) to acquire the rugby injury and exercise history [4,18].…”

Section: Methodsmentioning

confidence: 99%

“…The International Rugby Board established a Rugby Injury Consensus Group (RICG) to agree on appropriate definitions and methodologies to standardize the recording of injuries and reporting of studies in rugby union [4]. Another limitation of previous youth rugby epidemiological investigations was that majority of the papers' primarily concentrated on reporting on the nature and causation of spinal cord injuries and concussions [2,3,5,6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The only intrinsic risk factor positively associated with incidence of rugby injury was the advance in age among schoolboys [3]. As the boys get older their competitiveness increases resulting in a more demanding game, with tackles producing more injuries [2,7,8,11]. The most vulnerable player positions for rugby injury were hookers, wings, fullbacks and centers, while the safest playing positions were tightforward and scrum half [1].…”

Section: Introductionmentioning

confidence: 99%

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Knee Injuries: A Burden of Schoolboy Rugby Players

Ellapen¹,

Heerden²,

Taylor³

et al. 2016

BJMMR

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Background: School rugby injuries are a great concern to all rugby loving nations. There have been anecdotal reports by sport medical professionals that deviant quadriceps angle are associated with rugby knee injuries. This study aimed to document the nature of acute musculoskeletal rugby knee injuries among schoolboys participating in the Rugby A-League of the Upper Highway area of Kwa Zulu-Natal over a 12 month period (July 2013-June 2014). Materials and Methods: Data were collected from 115 high school rugby players via voluntary parental informed consent and player assent. Players completed a self-report musculoskeletal injury and exercise history questionnaire probing the nature of acute rugby knee injuries, predisposing risk factors (quadriceps angle, injury and exercise history). Probability was set at p≤ 0.05. Results: Twenty-four players sustained acute musculoskeletal knee injuries (p<0.001). The mechanisms producing the acute musculoskeletal injuries, were tackling (52.1%), diving/falling (43.47%) and rapid rotational movement at high velocity (4.34%) (p<0.05). The intrinsic risk factor Original Research Articlepredisposing rugby players' to knee injury was deviant quadriceps angles (p<0.05). Exercise history did not predispose the players' to knee injury (p<0.05). Conclusion: Players sustained a high prevalence of knee injuries associated with deviant quadriceps angles.

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Are we currently underestimating the risk of scrum-related neck injuries in rugby union front-row players?

Cited by 5 publications

References 16 publications

Influence of playing rugby on long-term brain health following retirement: a systematic review and narrative synthesis

Influence of playing rugby on long-term brain health following retirement: a systematic review and narrative synthesis

Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards

Knee Injuries: A Burden of Schoolboy Rugby Players

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