- Data shows risk of injury in the Aviva Premiership and England Senior squad remained stable
- Dr Simon Kemp says "there is still work to be done"
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The latest England Professional Rugby Injury Surveillance Project Report published today (PDF 2MB) shows that the risk of injury in the Aviva Premiership and England Senior squad remained stable in the 2012/13 season.
Overall rates of Premiership match injuries*, their severity and total days’ absence were all slightly lower than in 2012/13, and within the expected limits of natural season-to-season variation. There has been no significant rise in injury rates since the surveillance project began in 2002.
However, recurrence of match injuries (accepted to be a marker of the completeness of rehabilitation) has fallen markedly over the past decade from a peak of 17 per 1000 player hours in 2002/3 to 4 per 1000 hours in 2012/13.
Concussion was for the second season the most common Premiership match injury (54 concussions were reported in matches, and 5 in training). The incidence of match concussion was 6.7 per 1000 player hours. This equates to one concussion reported per team every four matches.
This was above the mean figure of 4.6 per 1000 player hours over the last decade and fell outside the expected variation for the first time during the study period. This increase in concussion incidence is likely to be related to increased awareness, greater focus on and understanding of criteria for diagnosis together with the introduction of Pitchside Suspected Concussion Assessment trial in the Premiership in 2012/13.
The Injury Surveillance Project Steering Group is auditing concussion match injuries and the return to play pathway during the 2013/14 season, the results of which will be available in late 2014. Further action in this area has been taken by the Professional Game Board, which has approved the introduction of a mandatory concussion education programme in the professional game along with a number of other initiatives before the start of the 2014-15 season.
There was a clear relationship over the period 2006-13 between injury burden, squad size and team performance, with a lower injury burden being associated with a higher league points tally. Injury burden decreased with each additional squad member, highlighting the importance of an appropriate squad size and the performance benefit of minimising player days lost to injury.
The report also notes that 36 per cent of all injuries took place in the potentially controllable training environment. The authors believe there is scope to reduce injury risk in training without compromising performance and the Injury Surveillance Project Steering Group is running a pilot study to capture training loads and intensity in season 2013/14.
Rates of injury for England Senior side training and matches also remained stable. While the number of match injuries (31) increased, their average severity (24 days) decreased and neither was deemed statistically significant when measured over the period.
RFU Chief Medical Officer Dr Simon Kemp said: "It is encouraging to see overall injury rates remain stable in English professional rugby and the surveillance work that takes place is evidence of a serious, data-driven approach to managing injury risk. The club medical and conditioning teams deserve our thanks for consistently collecting this data since 2002.
"The figures show the importance of our focus on concussion in recent seasons and concussive injuries – and the way return to play is managed – are being investigated more closely as a result.
"There is still more work to be done in reducing the risk of injury during training without compromising performance and I hope that the work being done this season to investigate the relationship between training load/training intensity and subsequent injury risk will help move our understanding forwards in the area."
Phil Winstanley, Rugby Director of Premiership Rugby, added: "This is the world’s largest audit of injuries in professional rugby, it informs the development of our medical strategies and is an excellent example of how all the stakeholders in the professional game – the RFU, Premiership Rugby and the Rugby Players Association – are working together to deliver best practice.
“There have been significant strides made in recent years, particularly in rehabilitation of players which has led to the reduction of injury recurrence, and that is a testament to the work of club medical teams throughout the country."
Finally, David Barnes, the Rugby Director of the Rugby Players’ Association said: "The injury audit is an extremely important piece of research that allows the professional game to understand the risks that the players face in training and in games. It is encouraging that, once again, the overall trend for the injury data remains stable, however it is crucial that all three stakeholders continue to develop further methods for reducing the risk of injury to players.”
*An injury is defined as any injury that prevents a player from taking a full part in all training activities typically planned for that day and/or match play for more than 24 hours from midnight at the end of the day the injury was sustained.