Participating in team sports, particularly field-based, contact team sports comes with inherent risk of sustaining injury. Fortunately for players and practitioners however, there are many international projects investigating the injury epidemiology across a variety of sports and populations, which ultimately help guide interventions aiming to reduce the risk and rate of injuries.
One example of these longitudinal projects is the Irish Rugby Injury Surveillance project, happening right here at UL. The IRIS project monitors injuries among Ireland’s highest amateur men’s and women’s rugby union leagues, and junior and senior cup schools games. Since partnering with the IRFU ahead of the 2017-2018 season, annual reports (download here) have shown both similar and differing trends among both the men’s and women’s All-Ireland League (AIL) Clubs. Click here for a recent poster presented at the 2021 European College of Sport Science Congress which addresses the incidence rate, type, match event and timing among other insights from the three seasons for amateur clubs.
While surveillance will continue into the 2021-2022 season, now it is time to make these data actionable! We are designing a programme which addresses these key findings. In addition to the three annual reports, elements of this programme will be designed utilising research-supported best practices in injury reduction, including focus group data from various people involved in the game. Why incorporate qualitative data for a quantitative problem? Well, injury reduction programmes have been rolled out before in similar settings, including most popularly the FIFA 11+. The FIFA 11+ was updated and designed to reduce the injury rates in football globally. From a meta-analysis on multiple clustered-randomized controlled trials performed by Thorborg et al., the FIFA 11+ programme has shown to be effective, reducing injuries by 39%. However, multiple studies have discussed the importance of compliance being a determining factor for effectiveness. Compliance may be low with these types of intervention programmes due to multiple variables including exercise selection, time needed to complete, and lack of specificity. Studies across many sporting levels from professional soccer to high school lacrosse have reported challenges when trying to implement this programme for injury avoidance. Therefore, any new programme must not only be designed using data specific to the cohort that it is targeted for (i.e. Irish rugby clubs), but it must incorporate current practices within the AIL, at least as far as warm-up strategies go. One key discussion topic addressed during our focus groups was “please describe the current warm-up structure for your club at trainings”. From this conversation starter we learned that the resources and practices around warm-ups varied greatly. Since we sat down separately with players, coaches, physiotherapists, and strength and conditioning coaches (S&C), we were able to discuss any challenges regarding physical preparation for Rugby clubs. Once we finish analysing all the focus group data we will be able to report our findings to you.
A warm-up structure may play into the health and long-term success of the team and the individual. If designed and implemented appropriately, this warm-up could be considered more of its own independent physical preparation period, not only addressing short-term readiness for the immediate training or match ahead of them, but for long-term development and robustness to build player durability. A warm-up programme potentially could include three phases: Readiness, Robustness, and Performance. The first phase, Readiness, could be structured to increase core temperature, take joints through a full range of movement and set the scene for the squad mentally, giving an opportunity for players to check in with one another, and importantly, for coaches to check in with their players. Some examples of exercises a team may want to include in this phase are high knees, heel flicks, and skipping and shuffling variations. These movements can be executed in a variety of formats, leaving some autonomy up to the players and coaches when fulfilling the principles of the phase so that they do not become redundant or boring. This should aid in compliance of the programme over the course of a long season.
The second phase, Robustness, could target specific areas of the body including the ankle, knee, hip, shoulder and neck. Exercises may include squatting, hinging or crawling patterns. Teams may also benefit from implementing the Nordic Hamstring Curl, which has been shown to halve the rate of hamstring injuries when included in these types of programmes as reported in a meta-analysis by Van Dyk et al.
The third phase that could be useful in a team warm-up is a period which emphasizes activities that match closely with the intensity of the sport or session ahead. This section might focus on Performance and should address both the contact and speed demands of rugby. In IRIS injury reports, the tackle event contributed to the most injuries in comparison to all other parts of the game. Thus, priming players for the tackle in a more controlled setting initially ahead of full-contact is important. This may include some shoulder strength and stability exercises, or more dynamic stations such as partner grappling and ball-fending were technique can be emphasised. Additionally, because of the high speed of play, priming players’ nervous system and posterior chain (hamstring/gluteal complex) is important ahead of full-training to reduce risk of injury but to also enhance their performance. This can be completed through a few reps of acceleration and high speed running drills. Finally, while the design and content of a team’s warm-up programme is critical, implementation is the key. So coaches, players, and support staff need to always remember that being creative and adaptable is important to keep players engaged. Other tips for coaches to consider when implementing a structured warm-up to keep compliance and effectiveness high are: creative variations, player autonomy, partner exercises, total duration, fun and competition.
IRFU Livestream Webinar #6 – Warmups Why and What
IRFU Livestream Webinar #7 – Training Hard and Smart Workload Guidelines
IRFU Livestream Webinar #9 – Getting Contact Ready
Patrick Dolan is a Postgraduate Researcher in the Department of Physical Education and Sport Sciences, University of Limerick.