Nicholas Burger

Tackle technique and tackle-related injuries in high-level South African Rugby Union under-18 players: real-match video analysis

Background The high injury rate associated with rugby union is primarily due to the tackle, and poor contact technique has been identified as a risk factor for injury. We aimed to determine whether the tackle technique proficiency scores were different in injurious tackles versus tackles that did not result in injury using real-match scenarios in high-level youth rugby union. Methods Injury surveillance was conducted at the under-18 Craven Week tournaments (2011–2013). Tackle-related injury information was used to identify injury events in the match video footage and non-injury events were identified for the injured player cohort. Injury and non-injury events were scored for technique proficiency and Cohens effect sizes were calculated and the Student t test (p<0.05) was performed to compare injury versus non-injury scores. Results The overall mean score for front-on ball-carrier proficiency was 7.17±1.90 and 9.02±2.15 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind ball-carrier proficiency was 4.09±2.12 and 7.68±1.72 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). The overall mean score for front-on tackler proficiency was 7.00±1.95 and 9.35±2.56 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind tackler proficiency was 5.47±1.60 and 8.14±1.75 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). Summary Higher overall mean and criterion-specific tackle-related technique scores were associated with a non-injury outcome. The ability to perform well during tackle events may decrease the risk of injury and may manifest in superior performance.

Contact technique and concussions in the South African under-18 Coca-Cola Craven Week Rugby tournament

Abstract In rugby union, understanding the techniques and events leading to concussions is important because of the nature of the injury and the severity and potential long-term consequences, particularly in junior players. Proper contact technique is a prerequisite for successful participation in rugby and is a major factor associated with injury. However, the execution of proper contact technique and its relationship to injury has yet to be studied in matches. Therefore, the aim of this study was to compare contact techniques leading to concussion with a representative sample of similarly matched non-injury (NI) contact events. Injury surveillance was conducted at the 2011–2013 under-18 Craven Week Rugby tournaments. Video footage of 10 concussive events (5 tackle, 4 ruck and 1 aerial collision) and 83 NI events were identified (19 tackle, 61 ruck and 3 aerial collisions). Thereafter, each phase of play was analysed using standardised technical proficiency criteria. Overall score for ruck proficiency in concussive events was 5.67 (out of a total of 15) vs. 6.98 for NI events (n = 54) (effect size = 0.52, small). Overall average score for tackler proficiency was 7.25 (n = 4) and 6.67 (n = 15) for injury and NI tackles, respectively (out of 16) (effect size = 0.19, trivial). This is the first study to compare concussion injury contact technique to a player-matched sample of NI contact techniques. Certain individual technical criteria had an effect towards an NI outcome, and others had an effect towards a concussive event, highlighting that failure to execute certain techniques may substantially increase the opportunity for concussion.

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study

Objectives The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Design Observational cohort study. Setting Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Participants Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Outcome measures Tackle-related injury severity (‘time-loss’ and ‘medical attention’), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ2 analysis was used to detect linear trends between injuries and increasing match quarters. Results The 2012 under-13 Craven Week had a significantly greater ‘time-loss’ injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of ‘overall’ (‘time-loss’ and ‘medical attention’ combined) and ‘time-loss’ tackle-related injuries occurring at the under-13 Craven Week. The proportion of ‘overall’ and ‘time-loss’ injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). Conclusions There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies targeting the tackle may only be effective once the rate and nature of injuries have been accurately determined.

Mechanisms and Factors Associated With Tackle-Related Injuries in South African Youth Rugby Union Players:

Background: The majority of injuries in rugby union occur during tackle events. The mechanisms and causes of these injuries are well established in senior rugby union. Purpose: To use information from an injury database and assess video footage of tackle-related injuries in youth rugby union matches to identify environmental factors and mechanisms that are potentially confounding to these injuries. Study Design: Descriptive epidemiological study. Methods: Injury surveillance was conducted at the under-18 Craven Week rugby tournament. Tackle-related injury information was used to identify injury events in match video footage (role-matched noninjury tackle events were identified for the cohort of injured players). Events were coded using match situational variables (precontact, contact, and postcontact). Relative risk ratio (RRR; ratio of probability of an injury or noninjury outcome occurring when a characteristic was observed) was reported by use of logistic regression. Results: In comparison with the first quarter, injury risk was greater in the third (RRR = 9.75 [95% CI, 1.71-55.64]; P = .010) and fourth quarters (RRR = 6.97 [95% CI, 1.09-44.57]; P = .040) for ball carriers and in the fourth quarter (RRR = 9.63 [95% CI, 1.94-47.79]; P = .006) for tacklers. Ball carriers were less likely to be injured when they were aware of impending contact (RRR = 0.14 [95% CI, 0.03-0.66]; P = .012) or when they executed a moderate fend (hand-off) (RRR = 0.22 [95% CI, 0.06-0.84]; P = .026). Tacklers were less likely to be injured when performing shoulder tackles (same side as leading leg) in comparison to an arm-only tackle (RRR = 0.02 [95% CI, 0.001-0.79]; P = .037). Ball carriers (RRR = 0.09 [95% CI, 0.01-0.89]; P = .040) and tacklers (RRR = 0.02 [95% CI, 0.001-0.32]; P =.006) were less likely to be injured when initial contact was made with the tackler’s shoulder/arm instead of his head/neck. Conclusion: The relative risk of tackle-related injury was higher toward the end of matches. Incorrect technique may contribute to increased injury risk. Implementing recovery strategies between matches, training safe and effective techniques, and improving levels of conditioning may counter the negative effects of fatigue. These findings may assist stakeholders in youth rugby to formulate injury prevention strategies and may improve the preparation of field-side medical staff for managing tackle-related injuries at these or similar tournaments.

Video analysis of concussion injury mechanism in under-18 rugby

Background Understanding the mechanism of injury is necessary for the development of effective injury prevention strategies. Video analysis of injuries provides valuable information on the playing situation and athlete-movement patterns, which can be used to formulate these strategies. Therefore, we conducted a video analysis of the mechanism of concussion injury in junior-level rugby union and compared it with a representative and matched non-injury sample. Methods Injury reports for 18 concussion events were collected from the 2011 to 2013 under-18 Craven Week tournaments. Also, video footage was recorded for all 3 years. On the basis of the injury events, a representative ‘control’ sample of matched non-injury events in the same players was identified. The video footage, which had been recorded at each tournament, was then retrospectively analysed and coded. 10 injury events (5 tackle, 4 ruck, 1 aerial collision) and 83 non-injury events were analysed. Results All concussions were a result of contact with an opponent and 60% of players were unaware of the impending contact. For the measurement of head position on contact, 43% had a ‘down’ position, 29% the ‘up and forward’ and 29% the ‘away’ position (n=7). The speed of the injured tackler was observed as ‘slow’ in 60% of injurious tackles (n=5). In 3 of the 4 rucks in which injury occurred (75%), the concussed player was acting defensively either in the capacity of ‘support’ (n=2) or as the ‘jackal’ (n=1). Conclusions Training interventions aimed at improving peripheral vision, strengthening of the cervical muscles, targeted conditioning programmes to reduce the effects of fatigue, and emphasising safe and effective playing techniques have the potential to reduce the risk of sustaining a concussion injury.

ARE WE CURRENTLY UNDERESTIMATING THE RISK OF SCRUM-RELATED NECK INJURIES IN RUGBY UNION FRONT-ROW PLAYERS?

To understand the risk of incurring a particular rugby injury, and to identify risk factors related to this injury, it is necessary to know the injury counts and the time that the players are exposed to the risk of sustaining that injury.1 The latter poses an interesting debate with respect to the scrum as there are various ways in which the exposure can be expressed. While they are not the only two methods, ‘exposure’ in sports injury epidemiology has often been calculated either by the ‘Athlete at risk’ method or the ‘Athlete participation’ method.2 ![Formula][1] ![Formula][2] The ‘athlete participation’ method is sometimes the only way to calculate injury incidence rates for certain investigations, such as for catastrophic injury risk,3 in which data are mainly collected retrospectively. However, this method typically underestimates injury rates as the exact time at risk is not quantified.2 Where match time is recorded, the current consensus statement for the surveillance of injuries in rugby union4 provides a formula for the calculation of match exposure. This consensus statement, which defines terms and preferred methodology, has significantly advanced the quality of research on injuries associated with rugby union by offering guidelines for a standardised approach, enabling universal comparison of injury risk and risk factors.5 For the majority of rugby union epidemiological studies, it is assumed that within one team ( Team A ) 15 players (the number of players per team on the field at one time) are at risk for Y minutes (80 min for senior level) over Z number of matches during a season/tournament.1 ,4 This exposure calculation assumes that all 15 players of the team are at equal risk of injury during this time: Y (minutes of match) ×Z (number of matches). However, the 15 players are comprised of two broad positional groupings: … [1]: /embed/graphic-1.gif [2]: /embed/graphic-2.gif

Facts and values: on the acceptability of risks in children’s sport using the example of rugby — a narrative review

A clash of values has been identified between those who assert that: 1. all childhood injuries, regardless of origin, are inherently undesirable and should be prevented and; 2. those who believe that some measure of injury to children is an acceptable compromise for the physical benefits associated with physical activity and the development of abilities to appraise and deal with risks. A debate regarding whether the tackles and collisions permitted in schools’ rugby represent acceptable risks, and what steps should be taken if they do not, exemplifies the issue. Questions regarding the magnitude of injury risks in sport are issues of fact and can be quantified via the results of injury surveillance studies. Risks are neither high nor low in isolation; they are relatively high or low with reference to other activities or across groups participating in an activity. Issues of the acceptability of a given degree of risk are value dependent. Research regarding perceptions of risk reveals wide variations in the degree of risk people view as acceptable. Factors impacting on risk perception include whether the risks are well known and understood, whether they are ‘dread’ risks and the degree to which people undertake the risks voluntarily and feel they have control over them. Based on the evidence currently available, the risks to children playing rugby do not appear to be inordinately high compared with those in a range of other childhood sports and activities, but better comparative information is urgently needed. Further evidence, however, should not necessarily be expected to result in the resolution of acceptable risk debates—pre-existing values shape our perspectives on whether new evidence is relevant, valid and reliable.

Assessing tackle performance using a novel collision sport simulator in comparison to a “live” one-on-one tackling drill

ABSTRACT It is necessary to study the rugby tackle as it is associated with successful performance outcomes and is responsible for the majority of contact injuries. A novel collision sport simulator was developed to study tackle performance. The main aim of this validation study was to assess tackle technique performance between two different conditions: simulator versus a standardised one-on-one tackle drill previously used to assess technique. Tackling proficiency was assessed using a list of technical criteria. Mean scores, standard deviations and Cohen’s d effect sizes were calculated. Mean overall score for dynamic i.e. running simulator tackles was 7.78 (95%CI 7.58–7.99) (out of 9) or 87% (standard deviation or SD±8.94), and mean overall score for dynamic “live” tackles was 7.85 (95%CI 7.57–8.13) (out of 9) or 87% (SD±9.60) (effect size = 0.08; trivial; p > 0.05). Mean overall score for static i.e. standing simulator tackles was 7.45 (95%CI 7.20–7.69) (out of 9) or 83% (SD±10.71), and mean overall score for static “live” tackles was 8.05 (95%CI 7.83–8.27) (out of 9) or 89% (SD±7.53) (effect size = 0.72; moderate; p < 0.001). The simulator replicates dynamic tackle technique comparable to real-life tackle drills. It may be used for research analysing various aspects of the tackle in rugby and other contact sports.