The burden of an injury in amateur Rugby union players – dr ian kenny

Under the supervision of Dr Ian Kenny and Dr Rachel Sheehan, 2019/20 PESS Sport & Exercise Sciences student Gemma Murphy undertook her final year project on the topic of the burden of rugby injuries. The high quality of Gemma’s work resulted in it being subsequently published in a high impact journal, Physical Therapy in Sport; well done Gemma, a great achievement! Much of the injury epidemiology research to date in rugby and other sports has focussed on the quantitative nature of the injury, for example injury type, how often, player position, and how the injury happened. With a plan to study physiotherapy at masters level, Gemma was interested in the holistic event, including emotional reactions, impact on performance, negative experiences with rehabilitation, and severity of the injury. Here we provide a summary of the FYP project and publication.

Murphy G.P. and Sheehan R.B. (2021) A qualitative investigation into the individual injury burden of amateur rugby players. Physical Therapy in Sport. 50. 74-81. IF 1.926, Q2 

Rugby Union is a sport with approximately 9.6 million members across 123 different countries (World Rugby, 2018a). As the sport continues to grow in popularity, sport and medical personnel need to recognise the demands of Rugby to ensure safe practice of players. The majority of Rugby players participate at an amateur level (World Rugby, 2018b), highlighting the need for focus on such players. Looking at incidence and severity of injury in isolation is not sufficient, as they do not give a comprehensive picture of injury risk. Therefore, it is recommended that a cross-product of the two measures is used, known as “injury burden” (Bahr et al. 2018). It accounts for both frequency and severity, thereby giving a clearer picture of the consequences that injury will have on a team (Hagglund et al. 2013). Injury burden, incidence, and severity among amateur Rugby players has been reported for the past three seasons in the Irish Rugby Injury Surveillance (IRIS) Project (The Irish Rugby Injury Surveillance). However, the formula for injury burden (injury burden = number of injuries X average time lost per injury) is a reflection of the burden on the team, rather than on the individual. It lacks information on the effects of injury after it has occurred. The individual burden experienced by athletes has been associated with exposure to highly stressful demands, that can significantly alter responses to rehabilitation and injury.

Sport injuries have numerous consequences beyond absence from sport, including treatment requirements, financial costs, and possible long-term effects on physical and mental health e.g., impaired musculoskeletal function. The purpose of this study was to investigate the individual injury burden of Irish amateur Rugby players and to explore the differences in experiences of burden across the three phases of injury: onset of injury; rehabilitation; and, RTP (return to play).

In Irish amateur Rugby clubs three male and two female Rugby players were recruited who sustained a severe injury that resulted in a time loss of at least 28 days. Semi-structured interviews were used to explore the injury burden experienced during the three phases of injury.

Figure one shows the model used to structure injury questions, adapted from several previous models (Wiese-Bjornstal et al. 1998; Walker et al. 2007; Podlog et al. 2011; Evans et al. 2012; Forsdyke et al. 2016).

Table one shows the background injury nature to give some severity context.

Findings…… Table 3 shows the factors that contributed to participant’s experience of burden during injury. Individual injury burden were clustered into seven themes across personal (emotional reaction; impact on performance or involvement; lack of knowledge; severity of injury and incapacitation) and situational (exposure to others playing; negative experiences with treatment or rehabilitation; societal burden) dimensions. Findings indicate that individual injury experiences can affect a player’s recovery and rehabilitation outcome, potentially extending the injury process and affecting player availability for the team. As such, injury management should focus on alleviating any injury-related burden experienced by players, as well as burden placed on the team, to maximise rehabilitation outcomes.