A Unique Insight Into the Incidence of Rugby Injuries Using Referee Replacement Reports
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34 Br J Sports Med 2001;35:34–37 Br J Sports Med: first published as 10.1136/bjsm.35.1.34 on 1 February 2001. Downloaded from A unique insight into the incidence of rugby injuries using referee replacement reports J C M Sharp, G D Murray, D A D Macleod Abstract survey on injuries occurring during competi- Objectives—To obtain further infor- tive club rugby11 in Scotland, reviewing the mation on the incidence of injuries and accident and emergency department records of playing positions aVected in club rugby in all injured players in the Scottish Borders dur- Scotland. ing the season 1990–1991 (H J Vander Post, Methods—Routine reports of injury (per- personal communication), and encouraging manent) and blood (temporary) replace- clubs to report to the SRU all players admitted ments occurring in competitive club to hospital or dying as a result of playing or rugby matches by referees to the Scottish practising rugby. More recent epidemiological Rugby Union during seasons 1990–1991 to studies established jointly with Edinburgh 1996–1997 were analysed. University Department of Public Health Sci- Results—A total of 3513 injuries (87 per ences reviewed injuries occurring in adult and 100 scheduled matches) and 1000 blood school boy rugby in the Scottish Borders and replacements (34 per 100 scheduled Edinburgh schools.12 matches) were reported. Forwards ac- A further initiative was established in 1988– counted for 60% of the injury and 72% of 1989 when referees were asked to record all the blood replacements. Flankers and the replacements made for injured players during front row were the most commonly re- club matches in the competitive leagues. This placed forwards while wing and centre paper reports the findings from this study, three quarters were the most vulnerable which we believe to be unique, reviewing 3513 playing positions among backs. The inci- injury and 1000 blood replacement reports dence of injury replacements increased as over seven seasons of Scottish Rugby (1990– the match progressed up until the last 10 1991 to 1996–1997). minutes when the trend was reversed. Blood replacements showed a diVerent Materials and methods pattern with 60% occurring during the In the season 1988–1989, rugby referees in first half of the match. Scotland were required to notify the SRU of Conclusion—The most important finding any player who had to leave the field as the of the study was reliability of referees in result of injury or other “medical” reason—for documenting the vulnerability of certain example, hypothermia—for whom a replace- http://bjsm.bmj.com/ playing positions, and the timing when ment player was permitted. The quality of injuries took place, thus assisting coaches and team selectors when choosing re- SRU CHAMPIONSHIP Division ....................... placement players for competitive club RESULT CARD and representative rugby matches. This study re-emphasises the need for continu- K.O. ....................................... Date ............/............/............ ing epidemiological research. HOME TEAM AWAY TEAM (Br J Sports Med 2001;35:34–37) on September 25, 2021 by guest. Protected copyright. ................................................ ................................................ Keywords: rugby injuries; referee replacement reports; Scottish Rugby Union Pen. Drop Try Con Pen. Drop Try Con No. No. During the 1970s, rugby union was criticised by the media alleging an increase in aggressive Pts. Pts. and deliberately dangerous play. Numerous FINAL ........... ........... Honorary Medical clinical and epidemiological studies of rugby SCORE Advisors, Scottish injury were subsequently reported from the REPLACEMENTS Rugby Union 1–5 6–10 British Isles and overseas, identifying an ........... ........... ........... Position ........... ........... ........... J C M Sharp apparently greater incidence and severity of D A D Macleod ........... ........... ........... Time ........... ........... ........... injury and the vulnerability of certain playing PLAYERS RETIRING NOT REPLACED Department of positions, in particular front row forwards. Medical Statistics, The Scottish Rugby Union (SRU) led the ........... ........... ........... Position ........... ........... ........... University of way in the British Isles, following the introduc- ........... ........... ........... Time ........... ........... ........... Edinburgh tion of competitive club rugby based on BLEEDING PLAYERS RETIRING TEMPORARILY G D Murray national leagues in Scotland in 1973, with a ........... ........... ........... Position ........... ........... ........... Correspondence to: series of research projects which collected ........... ........... ........... ........... ........... ........... MrDADMacleod, St information about the nature, incidence, and Time John’s Hospital, Livingston, causes of injury in an eVort to enhance preven- Referee's Signature ............................................................. West Lothian EH54 6PP, Name ....................................... Club .................................. Scotland, UK tion and treatment. These studies included Accepted 24 August 2000 establishing the first national coordinated Figure 1 Scottish Rugby Union result card. www.bjsportmed.com Rugby injuries and referee replacement reports 35 Br J Sports Med: first published as 10.1136/bjsm.35.1.34 on 1 February 2001. Downloaded from 25 bleeding, or illness. As a result, the value of ref- eree replacement reports in monitoring the Injury replacements occurrence of rugby injuries was diminished. Blood replacements Referees continued to report temporary blood 20 replacements for a further season until the end of 1996–1997 but this has subsequently been discontinued. The data presented are purely descriptive, 15 without any formal statistical analysis. To make replacement rates comparable, they are sum- marised as replacements per 100 scheduled 10 matches, or, when reporting on specific playing positions, as replacements per player per 100 scheduled matches. This allows for the fact that the reporting of injury and blood replacements 5 does not span exactly the same seasons, that No. of injury/blood replacements (%) the number of matches per season varies, and that the diVerent positions have one or two players per team (and hence two or four players 0 1 2 3 4 5 6 7 8 9 10 11 12 13 per match). Match week Figure 3 Injury (1990–1995) and blood (1993–1995) replacements by match week Results number. Reports on 3513 injury replacements (87 per recording replacements was improved in the 100 scheduled matches) and 1000 temporary season 1990–1991 by the introduction of a blood replacements (34 per 100 matches) redesigned prepaid postal match result card on were received by the SRU from referees of which the referee could also record the playing competitive club matches during the seven position of the injured player and the time dur- seasons 1990–1991 to 1996–1997. The ing the match that the replacement took place number of reports of injury replacements (fig 1). The number of players per team who increased from 410 in 1990–1991 (64 per 100 could be replaced because of injury increased matches) to 554 in 1994–1995 (87 per 100 from three in 1990–1991 to four in 1995– matches), when up to three replacements were 1996. In addition, during 1993–1994, the laws permitted per match for each team. The total of rugby also permitted temporary replace- number of injury replacements increased to ment for the treatment of players who were 989 in 1995–1996 (116 per 100 matches) bleeding. Their position and time of injury when the number of replacements permitted were similarly recorded. had been increased to four per team and the With eVect from November 1996, substi- playing season extended. Reports of tempo- tutes were permitted in rugby union for tactical rary replacement of players because of bleed- http://bjsm.bmj.com/ reasons as well as replacements for injury, ing varied from season to season, peaking at Table 1 Type of replacement by playing position (backs/forwards) and season 1990–1997 1990–1991 1991–1992 1992–1993 1993–1994 1994–1995 1995–1996 1996–1997 Totals “Injury” replacements (permanent) Backs 164 185 225 203 228 385 — 1390 (40%) Forwards 245 263 299 380 325 600 — 2112 (60%) Unspecified 1 —321 4—11 on September 25, 2021 by guest. Protected copyright. Totals 410 448 527 585 554 989 — 3513 “Blood” replacements (temporary) Backs — — — 56 62 91 72 281 (28%) Forwards — — — 175 139 230 175 719 (72%) Totals 231 201 321 247 1000 Totals 410 448 527 816 755 1310 247 4513 Table 2 “Injury” and “blood” replacement reports by individual playing positions, 1990–1997 Injury replacements 1990–1996 Blood replacements 1993–1997 Rate per player Rate per player Playing position Number per 100 matches Rank order Number per 100 matches Rank order Backs Full back 182 2.3 10 37 0.6 8 Wing 3/4 419 2.6 6 54 0.5 10 Centre 401 2.5 7 88 0.7 7 Stand-oV 191 2.4 9 33 0.6 9 Scrum half 197 2.4 8 69 1.2 6 Forwards Prop 554 3.4 2 183 1.5 3 Hooker 244 3.0 3 78 1.3 4 2nd row 446 2.9 5 144 1.2 5 Flanker 633 3.9 1 212 1.8 1 No 8 235 2.9 4 102 1.7 2 Unspecified 11 3513 1000 www.bjsportmed.com 36 Sharp, Murray, Macleod Br J Sports Med: first published as 10.1136/bjsm.35.1.34 on 1 February 2001. Downloaded from Table 3 Injury replacement by division (I–VII), 1990–1991 to 1994–1995 Match week number Division 12345678910111213Totals (%) I 43271523214127232629182225340(13.4) II 29 46 30 35 33 34 30 37 24 38 17 24 27 404 (16.0) III 26 40 40 29 31 32 26 32 27 35 22 30 22 392 (15.5) IV 25 40 24 34 30 34 39 20 33 29 26 35 33 402 (15.9) V 33384140363335273638272426434(17.2) VI 27 29 25 22 25 18 20 25 25 30 20 9 10 285 (11.3) VII24192029202622122418141425267(10.6) Totals 207 239 195 212 196 218 199 176 195 217 144 158 168 2524 321 in 1995–1996 (38 per 100 matches) but ted per team (from three to four) and in the decreasing to 247 (29 per 100 matches) in the format of competitive club rugby in Scotland following season (table 1).