Doug King

BACKGROUND: The aims of this study were to survey amateur female domestic soccer and rugby league players on their sports bra use, to compare prior use of sports bra to wearing a custom fitted sports bra with polymer inserts over a competition season in New Zealand, and to compare breast injuries with different sports bra utilization over a competition season. METHODS: Players were invited to participate in a baseline survey of sports bra use. Players who completed the survey were provided with the opportunity to wear a sports protection bra and inserts and to complete post-match surveys reporting any breast injuries. The study duration was one competition season in 2023. RESULTS: 93 players (41 soccer open, 29 soccer U16, 23 league) completed the baseline survey. Of these 79 players (32 soccer open, 24 soccer U16, 23 league) utilised the sports breast protector during the season. There were 25 breast injuries over the study resulting in a pooled breast injury incidence of 41.3 (95% CI: 26.7 to 61.1) per 1,000 match-hrs. Eight of 25 injuries (32%) occurred to players wearing the sports protection bra (i.e., 5/79 =10% sports breast protector players; 9/14 = 64% other players; 14/93 = 15% all players). Of the 34 participants who reported a previous breast injury, there were 2.6 ±1.4 breast injuries per player in the previous year and, more than a third (37.5%) reported either wearing a padded bra or did not use strategies to prevent breast injuries. CONCLUSION: It is important that players, coaches, and team medical support associated with female sports are educated on the injury risk to breasts in training and competition enabling these players to be encouraged to report and seek treatment if necessary.

A total of 31,655 tackles in 48 professional rugby league matches were coded from video for height and direction of tackle on the ball carrier. Injuries were recorded by team medical staff for injury date, time, site, type, mechanism, severity, and player position. Tackle-related injuries were most frequently the result of two tacklers being involved in tackling the ball carrier from the side at shoulder or midtorso body levels. The ball carrier had a higher injury rate when tackled from behind his visual field at shoulder height and in the fourth quarter of matches. Tacklers had a higher risk of injury when tackling from the side of the ball carrier, as the first tackler, and in the third quarter of matches. Coaches should focus on practicing correct technique during tackling with two or more tacklers and when tackling in the ball carrier's blind vision area.

The aim of this study was to describe the effect of player positional groups on the nature of tackles that result in tackle-related injuries in professional rugby league matches. Prospective observational epidemiology analyses for tackle-related injuries and video analyses for the nature of tackles were conducted for a single team in the National Rugby League (NRL) throughout the 2007 and 2008 competitions for a total of 48 games. Risk ratios (RR) were calculated for comparisons between positional groups (adjustable, hit-up forwards or outside backs). The total missed match tackle-related injury rate was 57.8 per 1 000 player hours. Hit-up forwards recorded significantly more total tackle-related injuries than outside backs (RR: 1.3; P=0.049), but not more than adjustables (RR: 1.0; P=0.922). Hit-up forwards recorded significantly more chest-back tackle-related injuries than adjustables (RR: 6.0; P=0.008). Outside backs recorded significantly more tackle injuries as the ball carrier than the tackler (RR: 2.4; P=0.015) while adjustables recorded significantly more tackle injuries as the tackler than the ball carrier (RR: 1.8; P<0.001). Hit-up forwards had a higher incidence of contusions, and sprains while adjustables had a higher incidence of fracture/dislocations. There were no differences in injury severity between the positional groups. Player positional group had an effect on tackle-related injury type and injury site. Hit-up forwards and outside backs recorded more tackle-related injuries as a ball carrier than as a tackler, while in contrast, adjustables recorded more tackle-related injuries as the tackler than the ball carrier.

King et al. reported that of 5 941 moderate to serious claims resulting in medical treatment for rugby league injuries, the knee, shoulder, and head and neck body sites and soft tissue and fracture-dislocation injuries were most frequent and costly in the New Zealand national no-fault injury compensation corporation database during 1999 to 2007. However, additional analyses of knee, shoulder and head and neck body sites by soft tissue and fracture-dislocation injury types was required to enable a greater understanding of the nature of injuries most likely to be seen by sports medical personnel dealing with rugby league players. From 1999 to 2007 the injury claims and costs for head and neck soft tissue, fracture-dislocations, shoulders soft tissue significantly increased. Knee soft tissue injury claims and costs significantly decreased from 1999 to 2007. There was no significant difference in knee fracture-dislocation injury claims but there was a significant increase in knee fracture-dislocation injury costs from 1999 to 2007. Changes in the nature of injuries may be related to changes in defensive techniques employed in rugby league during this time. Sports medical personnel dealing with rugby league players should focus their injury prevention strategies on reducing musculoskeletal injuries to the head and shoulder. There should be a focus on increasing awareness of correct tackling technique, head injury awareness and management of suspected cervical spine injuries.

This paper describes the nature, height, site and direction of tackles seen in professional rugby league. Retrospective observational analysis was conducted using videos of 80 rugby league matches from 2008. There were 50,019 tackles recorded representing 701 ±64 tackles per match. Nearly 50% of tackles involved tacklers from behind the visual fields of the ball carrier, most tackles involved either two or three tacklers and most tackles involved contact with the mid-torso and hip-thigh region of the ball carrier. Significantly more players were involved in the tackle in the first, than the second half of matches (χ²=4.3, df=1, p=0.038). Significantly more tackles were recorded in the defence than the attack side of the field. Forwards were more commonly involved in the tackle than backs. Forwards were significantly more involved in tackle events than backs but when viewed in player groups, adjustables were involved in significantly more tackle events than outside backs and hit-up forwards. Coaches should focus on getting players to practice correct tackle technique during tackling with two or more players involved in the tackle and especially, when making a tackle in the ball carriers blind vision area.

The aim of this study is to monitor changes in stress and recovery of amateur rugby league players competing in a premier representative competition. A prospective observational cohort design was used in a rugby league match environment over the 2009 representative competition season with 30 registered members in the regional representative rugby league team. Members of the team completed the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) on the first training session following every scheduled match throughout the representative competition season. Injuries were reported as rate per 1,000 match hours. A repeated measure of analysis was used to evaluate differences in the RESTQ-Sport scale scores among the different measure taken. Significant changes were observed in Social Stress between weeks 1 and 4; Fatigue between pre-competition and week 5; and Lack of Energy between week 3 and week 4. The statistical differences observed in the Social Stress scale between weeks 4 and 5 may be related to the programming of the competition. Although the RESTQ-Sport did not predict any future performance or injury of the players, it did reflect how the players were dealing with the effects of amateur participation and the other requirements of life (work, relationships, etc.).

Rugby league is an international collision sport played by junior, amateur, semiprofessional and professional players. The game requires participants to be involved in physically demanding activities such as running, tackling, passing and sprinting, and musculoskeletal injuries are common. A review of injuries in junior and senior rugby league players published in Sports Medicine in 2004 reported that injuries to the head and neck and muscular injuries were common in senior rugby league players, while fractures and injuries to the knee were common in junior players. This current review updates the descriptive data on rugby league epidemiology and adds information for semiprofessional, amateur and junior levels of participation in both match and training environments using studies identified through searches of PubMed, CINHAL, Ovid, MEDLINE, SCOPUS and SportDiscus® databases. This review also discusses the issues surrounding the definitions of injury exposure, injury rate, injury severity and classification of injury site and type for rugby league injuries. Studies on the incidence of injuries in rugby league have suffered from inconsistencies in the injury definitions utilized. Some studies on rugby league injuries have utilized a criterion of a missed match as an injury definition, total injury incidences or a combination of both timeloss and non-time-loss injuries, while other studies have incorporated a medical treatment injury definition. Efforts to establish a standard definition for rugby league injuries have been difficult, especially as some researchers were not in favour of a definition that was all-encompassing and enabled non-time-loss injuries to be recorded. A definition of rugby league injury has been suggested based on agreement by a group of international researchers. The majority of injuries occur in the match environment, with rates typically increasing as the playing level increases. However, professional level injury rates were reportedly less than semiprofessional participation. Only a few studies have reported training injuries in rugby league, where injury rates were reported to be less than match injuries. Approximately 16–30% of all rugby league injuries have been reported as severe, which places demands upon other team members and, if the player returns to playing too early, places them at an increased risk of further injuries. Early research in rugby league identified that ligament and joint injuries were the common injuries, occurring primarily to the knee. More recently, studies have shown a change in anatomical injury sites at all levels of participation. Although the lower limb was the frequent injury region reported previously, the shoulder has now been reported to be the most common injury site. Changes in injury site and type could be used to prompt further research and development of injury reduction programmes to readdress the issue of injuries that occur as a result of participation in rugby league activities. Further research is warranted at all participation levels of rugby league in both the match and training environments to confirm the strongest risk factors for injury.