Rugby as a sport has traditionally gotten more notoriety and higher levels of participation in other countries, but it is growing quickly in the United States. USA Rugby teams are having more success at an international level. Youth and high-school rugby are also growing at tremendous rates. As the sport grows, it is important for players, parents, and coaches less familiar with the game to implement some ideas to prevent rugby injury and keep the sport as safe as possible.
Incorporate speed and endurance training
Rugby players with lower speed and lower max VO2 (maximal aerobic power) are at increased risk for injury.2 Players who train for less than 18 weeks prior to an initial injury are at increased risk for a subsequent injury as well.2 Also, several rugby injuries seem to occur more frequently late in games when the players are fatigued. Therefore, incorporating speed and endurance training into workouts and practices for rugby teams might decrease injury rates.
Fully recover from rugby injury prior to returning to play
It makes sense that in a contact and collision sport such as rugby that players suffer who suffer moderately severe injuries are at increased risk of sustaining a subsequent injury.2 Due to the significant force involved in the collisions and the speed and power of the players, it is essential that players fully heal from their injuries, recover full range of motion and strength, and have completed functional training prior to returning to the practice field.
Emphasize proper tackling technique
The tackle is felt to be the most dangerous aspect of rugby, as it has been shown to be responsible for up to 58% of all injuries in the sport.3 Now as rugby is a sport that involves tackling, and by the very nature of tackles in rugby, injuries will never be completely eliminated. Having said that, coaches and players should emphasize proper techniques and avoid dangerous tackles. Particularly, care should be taken to avoid hitting the ball carrier at the level of the shoulder or above to minimize the risk of head-to-head contact. Teaching players to keep their chins off their chests, to keep their eyes open, and to be aware of the locations of other players as they tackle is essential to minimize the risk of injury to the head and neck.3
Consider teaching players to fall to the ground when an opponent jumps on the ball carrier.
It has been shown that circumstances where a tackler jumps on a ball carrier from the side or behind and the ball carrier tries to keep running leads to increased risk for more serious knee, leg, and ankle injuries.3 Obviously trying to continue running possibly gains extra distance on the field, but it potentially sets up the player for multiple games missed due to a serious injury. Teaching ball carriers to go to the ground immediately when they feel the weight of a tackler might decrease the risk of these more serious lower extremity injuries.
Consider having players participate in a balance and proprioception training program to decrease ankle injuries
Lateral ankle sprains have been shown to be a common injury in professional rugby union players. Poor balance and lack of proprioception have been identified as risk factors for lateral ankle sprains. Since a large percentage of ankle injuries in rugby are sustained in noncontact activities, training programs to teach proprioception and balance might decrease the rate of ankle injuries. These programs might especially help the risk of recurrent injuries, which are also common in the sport.4
Incorporate ACL prevention programs into training
While ACL injuries are uncommon in terms of absolute numbers when looking at rugby injuries as a whole, they do account for the largest proportion of missed days due to knee injuries in the sport as they are typically among the most severe.1 ACL prevention programs might not eliminate the risk of ACL injuries that occur by tackling, but they may help decrease the rate of noncontact mechanisms for tearing the ligament. If even one player on a team can be saved from ACL injury, that would be a significant benefit for the player and the team, as it can take 9-12 months to get back to rugby after ACL reconstruction.
Keep playing fields safe
Rugby teams, especially at the youth and recreational level, often do not have dedicated fields to use for their own practices and games. Often these teams and leagues borrow fields that belong to other sports or use generic city parks. Care should be used to ensure that fields are safe. Players and coaches must make sure that there are no dangers on the field, such as holes and rocks. There should also be adequate lighting and enough room on the perimeter of the field to avoid injuries from players being tackled toward the edges of the field.
Note: This post also appears on the STOP Sports Injuries campaign blog.
1. Dallalana RJ, Brooks JHM, Kemp SPT, Williams AM. The epidemiology of knee injuries in English professional rugby union. Am J Sports Med. 2007;35:818-830.
2. Gabbett TJ, Domrow N. Risk factors for injury in subelite rugby league players. Am J Sports Med. 2005;33:428-434.
3. Quarrie KL, Hopkins WG. Tackle injuries in professional rugby union. Am J Sports Med. 2008;36:1705-1716.
4. Sankey RA, Brooks JHM, Kemp SPT, Haddad FS. The epidemiology of ankle injuries in professional rugby union players. Am J Sports Med. 2008;36:2415-2424.