Jan 29, 2015
Rugby Injury Breakdown

By R. Dawn Comstock

Dawn Comstock, PhD, Principle Investigator at The Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital, analyzes injury rates and trends for rugby while sharing the results from two new studies.

Rugby, with its fast pace and exciting nature, serves as an important social and physical outlet for millions of players worldwide, and this popularity is catching on in the United States. Recent years have seen American boys’ and girls’ youth rugby clubs increase in number by 15 percent and 31 percent, respectively. As its popularity continues to grow, more coaches, athletic trainers, and physicians will find themselves treating rugby-related injuries and fielding questions from concerned parents about its comparative safety. Although the medical literature is abound with studies examining international rugby injuries and prevention programs, until recently there has been a scarcity of large-scale research examining rugby injuries in this country.

All of this changed recently with the release of two major studies examining U.S. rugby injuries. So what did these new studies tell us? One of the first questions that comes to mind is just how dangerous is rugby? The good news is that U.S. youth rugby appears to be safer than international youth rugby. U.S. high school rugby injury rates are much lower than rugby injury rates in countries such as New Zealand and the United Kingdom. How do they compare to other U.S. sports? High school rugby injury rates among males are very similar to football injury rates. For girls, rugby injury rates are about twice as high as injury rates seen in soccer.

How often do rugby-related injuries occur? • Overall, a U.S. high school rugby team with 20 players saw one injury for every 10 times they practiced or competed. • Injuries were much more frequent in competition compared to practice. On average, a high school rugby team with 20 players experienced one injury in every three matches. • Nationally, an estimated 9,000 visits were made to emergency departments for rugby-related injuries every year.

What types of injuries are seen in rugby? • The most commonly injured body sites were the head (22 percent), ankle (13 percent), shoulder (13 percent), and knee (11 percent). • Rugby injuries tended to be fractures (16 percent), concussions (16 percent), incomplete ligament sprains (16 percent), contusions (nine percent), and incomplete muscle-tendon strains (nine percent). • Injuries resulted most frequently following impact with another player (51 percent), impact with the surface or ground (25 percent), after being stepped or fallen on (seven percent), and after rotation around a planted foot (six percent). • The majority of all rugby injuries occurred while being tackled (31 percent) or tackling (29 percent). • Although almost half of all players returned to play in less than 10 days (46 percent), one in four injured players took longer than three weeks to recover. These more severe injuries commonly involved the knee, shoulder, or clavicle. How can we prevent rugby-related injuries? • Prevention programs targeting safe tackling techniques have a large potential for decreasing rugby injuries. Strategies include providing coaches with materials to help them run proper tackling drills, showing players videos demonstrating proper tacking techniques, and encouraging referees to penalize unsafe tackling. • Coaches and athletic trainers should ensure that all players are well conditioned and are adequately prepared for the physical nature of matches. • Concussions account for one in five rugby injuries. Repeated concussions can have very negative consequences, and preventing a recurrent concussion begins with properly managing the first concussion. All coaches and athletic trainers should obtain a copy of the “Heads Up: Concussion in High School Sports” toolkit published by the Centers for Disease Control and Prevention at: http://www.cdc.gov/ncipc/tbi/coaches_tool_kit.htm.


• Collins CL, Micheli LJ, Yard EE, Comstock RD. Injuries Sustained By High School Rugby Players in the United States, 2005-2006. Archive of Pediatric Adolescent Medicine. 2008 Jan;162(1):49-54.

• Yard EE, Comstock RD. Injuries Sustained by Rugby Players Presenting to United States Emergency Departments, 1978 through 2004. Journal of Athletic Training. 2006 Jul-Sep; 41. (3): 325-31.

Dawn Comstock, PhD, is a principle investigator at the Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital. She is also an assistant professor at The Ohio State University in the College of Medicine and the College of Public Health. Her research interests include the epidemiology of sports, recreation, and leisure activity-related injuries among children and adolescents as well as the life-long health benefits associated with an active childhood. She can be reached at [email protected].

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