The start of the 2015 Rugby World Cup this week is an excellent opportunity to witness the sport’s elite athletes vying to take home the famous Webb Ellis Cup.
Players walking onto the field at matches around the UK should be at the peak of their physical fitness at the start of the tournament. But even before the tournament kicks off, the dreams of some players have been shattered due to injury and their team’s plans need re-jigging; spare a thought for Leigh Halfpenny or Rhys Webb of Wales.
Within Rugby Union, the available evidence suggests the risk of injuries at the senior professional level can be considered high but similar to other full contact sports.
One area of concern is the scrum, which occurs after a minor infringement in play.
Three rows of players from each team bind with each other and against the opposition to try to gain possession of the ball through pushing actions.
Crouch, bind, set!
This year’s World Cup will be the first where the new scrum engagement technique, “crouch, bind, set” will be seen in action. This is something our research group at Bath played a key role in developing, working in partnership with World Rugby.
The technique reduces the distance between the opposing front row players, and hence lowers the speeds and forces involved at the start, or engagement, of the scrum. It also imposes pre-binding between opposition players prior to the main engagement with the intention of reducing the chances of the scrum collapsing.
Our research group conducted a major study to assess the physical demands of rugby scrummaging and to evaluate how these demands could be reduced by making modifications to the scrum engagement.
We tested players ranging from senior international to schoolboy levels and found that this new type of engagement reduced the forces on the front row players by 20-25%.
The results of our study were sufficient for World Rugby to instigate a global law change in August 2013 to bring in “crouch, bind, set” across all levels of the sport.
Large-scale, compulsory education programmes for coaches and referees have also had success in reducing injury. The RugbySmart programme in New Zealand has run since 2001, and subsequent injury surveillance has shown good effect in reducing the risk of specific injuries, such as neck injuries.
The similar BokSmart programme runs in South Africa. Nationwide education programmes are challenging to set up and maintain but may still be a beneficial endeavour in other rugby playing nations as part of the overall coach education programmes.
The physical conditioning and preparation of athletes is another area to target for injury prevention. One avenue is to consider the training load imposed on athletes – as injury risk seems to increase when the training or match load experienced by a player is either too high, too low or changes too rapidly. These results are important because they suggest that careful monitoring of the workload of individual athletes may be beneficial in managing the welfare of a squad of athletes.
In relation to effective preparation of athletes, large-scale studies in other team sports such as football, handball and basketball have shown that specific exercise programmes, focusing on balance, strength and jump training can reduce the number of injuries by 30-40%.
The remaining challenge has been to convince athletes to undertake programmes on a regular basis and thus they suffer the same fate as other public health interventions due to lack of adherence. Studies are being undertaken in adult community and school-age rugby by our research group with the support of the Rugby Football Union in England.
Prevention is performance
It is sometimes said that a focus on injury prevention will detract from time spent training to perform. However, there is a key phrase: “injury prevention is performance”.
We recently demonstrated this in a study showing that over a seven-year period the number of days lost to injury within a squad was associated with team success in terms of league position – fewer days lost was associated with higher league position. This statistical analysis demonstrated that potentially achievable reductions in a squad’s injury burden (for example reducing the number of muscle strains suffered in training) could correspond to real differences in terms of qualification for playoffs or European competitions.
If we want future generations to enjoy the game, the onus is on all working at professional down to grassroots level to ensure rugby is as safe as it can be for all to enjoy.