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A Prevention Programme for Rugby Injuries Based on an Analysis Among Adolescent Players

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A Prevention Programme for Rugby Injuries Based on an Analysis Among Adolescent Players A PREVENTION PROGRAMME FOR RUGBY INJURIES BASED ON AN ANALYSIS AMONG ADOLESCENT PLAYERS JOHANNES HENDRIKUS BERNHARD HATTINGH M.Sc. (Sport Science) Thesis submitted for the degree Philosophiae Doctor in , Educational Science (Teaching and Learning) at the Potchefstroomse Universiteit vir Christelike Hoer Onderwys Promoter: Prof. E.J. Spamer (PU for CHE) Co-Promoter: Prof. J.L de K. Monteith (PU for CHE) Assistant Promoter: Dr. C. van Rensburg (University of Pretoria) ·2003 Potchefstroom ACKNOWLEDGEMENTS I wish to thank the following persons for their help and support in undertaking this study: , My study leader, Professor Manie Spamer, for his encouragement and very capable guidance. Dr Christa van Rensburg of the Sports Medical School of the University of Pretoria, for providing valuable input, support and advise. Professor M. Monteith, for valuable input and support. The Leopard Rugby Union for allowing me to do this study on rugby teams under their jurisdiction. The PUK Rugby Institute for assisting me in the obtaining of valuable data, and studying rugby teams under their jurisdiction. Professor Steyn and his team, for the statistical data processing. Johan Blaauw, for his excellent advise on language and grammar. Professor Casper Lessing, for his technical advise. Elize Snyman, for her word processing and assistance. My office staff, for their assistance. Acknowledgements SUMMARY The aim of this study is to develop a prevention programme for rugby injuries, based on analysis among adolescent players, with reference to physical and motor, anthropometric and biomechanical and postural variables. A further aim of this prevention programme will be to address and improve the physical and motor, anthropometric and biomechanical and postural standards of young school players, to be introduced at an early school level to curb injury epidemiology. An analysis of literature resources was done by making use of electronic media, a library search and a search of sports and sports medicine journals. Databases such as Pubmed, EbscoHost (Academic Search Elite), Sciencedirect and Medline were used. Also, the chief medical officers of Wales, Englq.nd, Scotland, Ireland, France, New Zealand and Australia, the seven major rugby-playing nations, were contacted via electronic media for input and assistance on the research topics. Special consideration was given to rugby injury epidemiology, the physical and motor and anthropometric standards of elite senior secondary school and junior tertiary rugby players. A new approach involving the biomechanical make-up of players was also introduced. In this study a total of a 331 elite rugby players were used. The players were chosen according to gratification of position and availability, and further divided into four age groups. The two junior groups consisted of 15- and 18-year-old elite provincial school players in the North West Province of South Africa, participating in the Craven week. The two senior teams comprised 19- and 20-year-old elite tertiary education level players of the Potchefstroom University Rugby Institute. Once approval had been granted by the players, the North West Leopards Schools Rugby Union as well as the University of Potchefstroom Rugby Institute, the players were submitted to a test battery. Anthropometric and physical and motor tests were done mid-season. Proper steps were taken to address existing shortcomings identified in the test subjects. Re-tests were done (19- and 20-year-old) at the end of the season to re-evaluate the test subjects. Biomechanical testing of all four identified groups was done pre-season. Once results had been analyzed, the appropriate individual Summary ii programmes were formulated, explained and implemented. This aim was to address the possible risk areas identified by the screening. Results were statistically processed, recorded and compared with earlier literature studies. A prevention programme was compiled: >- Pre-season preparation programme >- Start-of-season level 1: 6 week maintenance programme >- Start-of-season level 2: advanced maintenance programme >- Mid-season 1 week conditioning programme >- Mid-season level 3: most advanced conditioning programme >- Off-season maintenance programme Recommendations were made, and shortcomings of this study identified. Summary iii OPSOMMING Die doel van hierdie studie is die ontwikkeling van en voorkomingsprogram vir rugby beserings. Die studie is gebasseer op en ondersoek op jong volwasse spelers, met verwysing na fisiese en motoriese, antropometriese en biomeganiese en posturale komponente. en Verdere doel van hierdie voorkomingsprogram, is die verbetering van die fisiese en motoriese, antropometriese en biomeganiese en posturale komponent standaarde van jong skool spelers, asook die implimentering van hierdie voorkomingsprogram op en vroee skool stadium vir die vermindering van beserings epidimiologie. Met behulp van elektroniese media, biblioteek materiaal en sport en sport en medisyne joernale, is 'n ondersoek van literatuur studies gedoen. Data basisse soos Pubmed, EbscoHost (Academic Search Elite). Sciencedirect en Medline was gebruik. Hoof mediese beamptes van Wallis, Engeland, Skotland, lerland, Frankryk, Nieuzeeland en Australie, die 7 hoof rugby-spelende nasies, is ook gekontak vir bydrae en bystand tot die studie. Spesifieke aandag is gegee aan rugby beserings epidimiologie, die fisiese en motoriese en antropometriese standaarde van elite senior sekondere skool en junior tersiere rugby spelers. In Nuwe benadering tot die biomeganiese samestelling van die spelers is ook uitgelig. In totaal is 331 elite ruby spelers vir hierdie studie gebruik. Spelers is gekies na aanleiding van gratifikasie van posisie en beskikbaarheid. Spelers is in 4 groepe verdeel, 15- en 18-jaar-oud elite Noord-wes provinsiale skool spelers soos aan Craven week deelgeneem, en die senior groep die 19- en 20-jaar-oud elite tersiere spelers van die Potchefstroomse Universiteit Rugby Insituut. Na goedkeuring van spelers, Noord-wes Luiperd skool rugby unie en Potchefstroomse Universiteit Rugby Instituut, is die spelers aan toetsbatterye onderwerp. Antropometriese, fisiese en motoriese toetse is mid-seisoen gedoen. Stappe is geneem om tekortkominge uitgewys, aan te spreek. Her-toetsings (19- en 20-jaar-oud) is aan einde van seisoen gedoen. AI 4 groepe is voor-seisoen biomeganies getoets. Opsomming iv Biomeganiese resultate is verwerk, en individuele programme is geskryf, verduidelik en geimplimenteer, met die doe I om die geidentifiseerde risiko areas aan te spreek. Resultate is statisties verwerk en genoteer en met vroere literatuur studie vergelyk. Voorkomingsprogram soos volg is daargestel: >- Voor-seisoen voorbereidingsprogram >- Begin van seisoen vlak 1: 6 weke onderhoudsprogram >- Begin van seisoen vlak 2: Gevorderde onderhoudsprogram >- Mid-seisoen 1 week kondisioneringsprogram >- Mid-seisoen vlak 3: Mees gevorderde kondisioneringsprogram >- Af-seisoen onderhoudsprogram Aanbevelings is gemaak, en tekortkominge van hierdie studie is ook uitgewys. Opsomming v TABLE OF CONTENTS ACKNOWLEDGEMENTS ................................................................................................1 SUMMARY ......................................................................................................................11 OPSOMMING ................................................................................................................ IV TABLE OF CONTENTS ..... : ............................................. ; ............................................ VI LIST OF TABLES................................... : ............. : ...................................... ~ .................. X LIST OF FIGURES .......................................................................................................XII LIST OF ABBREVIATIONS .....................................~ ..................................................XIX CHAPTER 1: PROBLEM STATEMENT AND SUBSTANTIATION, RESEARCH AIMS AND OBJECTIVES .........................................................................................................1 1.1 INTRODUCTION AND PROBLEM STATEMENT 1 1.2 RESEARCH AIMS 4 1.3 METHOD OF INVESTIGATION 4 1.3.1 Review of literature sources 4 1.3.2 Empirical investigation 5 CHAPTER 2: LITERATURE SURVEY: RUGBY EPIDEMIOLOGY ................................7 2.1 INTRODUCTION 7 2.2 HISTORICAL EPIDEMIOLOGY 7 2.3 INJURY DEFII\JITIONS 11 2.4 REASONS FOR HIGH INJURY RATES 17 2.5 INJURY INCIDENCE 30 2.6 THE INJURY AS SUCH 38 Table of Contents vi CHAPTER 3: EMPIRICAL INVESTIGATION: MATERIALS AND METHODS .............59 3.1 INTRODUCTION 59 3.2 SELECTION OF SAMPLE 61 3.3 BATTERY OF TESTS 62 3.3.1 Anthropometric variables 62 3.3.2 Physical and motor variables 65 3.3.3 Injury history questionnaire 71 3.3.4 Institute sports medical clinic attendance records 72 3.3.5 Biomechanical and postural analysis 73 CHAPTER 4: RESULTS AND DiSCUSSiON ....... ;........................................................ 89 4.1 INTRODUCTION 89 4.2 INDIVIDUAL AGE-GROUPER STATUS 89 4.2.1 15-year-old elite school rugby players 90 4.2.2 18-year-old elite school rugby players 95 4.2.3 19-year-old (freshmen) junior elite club rugby players 99 4.2.4 20-year-old (seasonal) junior elite club rugby players 104 4.3 COMPARISON OF RESULTS ACCORDING TO FORWARD AND BACK-LINE RUGBY PLAYERS 109 4.3.1 15-year-old elite school rugby players 109 4.3.2 18-year-old elite school rugby players 115 4.3.3 19-year-old (freshmen) junior elite club rugby players 120 4.3.4 20-year-old
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