Spinal injuries in professional rugby union: a prospective cohort study

Abstract

Objectives: To determine the incidence, severity, nature, and causes of cervical, thoracic, and lumbar spine injuries sustained during competition and training in professional rugby union.

Design: A 2 season prospective cohort design.

Setting: Twelve English Premiership rugby union clubs.

Participants: Five hundred and forty-six male rugby union players of whom 296 were involved in both seasons.

Main outcome measures: Location, diagnosis, severity (number of days unavailable for training and matches), and cause of injury: incidence of match and training injuries (injuries/1000 player-hours).

Risk factors: Player age, body mass, stature, playing position, use of headgear, and activity and period of season.

Results: The incidences of spinal injuries were 10.90 (9.43 to 12.60) per 1000 player match-hours and 0.37 (0.29 to 0.47) per 1000 player training-hours. No player sustained a catastrophic spinal injury, but 3 players sustained career-ending injuries. Overall, players were more likely to sustain a cervical injury during matches and a lumbar injury during training. Forwards were significantly more likely to sustain a spinal injury than backs during both matches (P < 0.01) and training (P = 0.02). During matches, injuries to the cervical (average: 13 days; P < 0.01) and lumbar (13 days; P < 0.01) spine were more severe than injuries to the thoracic (5 days) spine; during training, injuries to the lumbar spine (26 days) were more severe than injuries to the cervical (13 days; P = 0.10) or thoracic (12 days; P = 0.06) spine. A total of 4037 days were lost to competition and training through spinal injuries with lumbar disc injuries sustained during training accounting for 926 days (23%) and cervical nerve root injuries sustained during matches for 621 days (15%). During matches, more injuries were caused by tackles (37%), and during training more injuries were caused by weight-training (33%).

Conclusions: The results showed that rugby union players were exposed to a high risk of noncatastrophic spinal injury during tackling, scrummaging, and weight-training activities; injury prevention strategies, therefore, should be focused on these activities.