Abstract
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.
Similar content being viewed by others
References
Gabbett TJ. Science of rugby league football: a review. J Sports Sci 2005; 23 (9): 961–76
Gibbs N. Injuries in professional rugby league: a three year prospective study of the South Sydney Professional Rugby League Football Club. Am J Sports Med 1993; 21 (5): 696–700
Gissane C, Jennings D, Kerr K, et al. A pooled data analysis of injury incidence in rugby league football. Sports Med 2002; 32 (3): 211–6
Meir R, Arthur D, Forrest M. Time and motion analysis of professional rugby league: a case study. Strength Cond Coach 1993; 1 (3): 24–9
Coutts A, Reaburn P, Abt G. Heart rate, blood lactate concentration and estimated energy expenditure in a semiprofessional rugby league team during a match: a case study. J Sports Sci 2003; 21: 97–103
Brewer J, Davis J. Applied physiology of rugby league. Sports Med 1995; 20 (3): 129–35
Gabbett TJ, Jenkins D. Applied physiology of rugby league. Sports Med 2008; 38 (2): 119–38
Gabbett TJ. Incidence of injury in semi professional rugby league players. Br J Sports Med 2003; 37 (1): 36–44
Gabbett TJ. Influence of playing position on the site, nature and cause of rugby league injuries. J Strength Cond Res 2005; 19 (4): 749–55
Meir R, Newton R, Curtis E, et al. Physical fitness qualities of professional rugby league football players: determination of positional differences. J Strength Cond Res 2001; 15 (4): 450–8
Clark L. A Comparison of the speed characteristics of elite rugby league players by grade and position. Strength Cond Coach 2002; 10: 2–12
Gabbett TJ. Incidence of injury in junior and senior rugby league players. Sports Med 2004; 34 (12): 849–59
Hodgson Phillips L, Standen PJ, et al. Effects of seasonal change in rugby league on the incidence of injury. Br J Sports Med 1998; 32 (2): 144–8
Hodgson L, Standen PJ, Batt ME. An analysis of injury rates after seasonal change in rugby league. Clin J Sports Med 2006; 16 (4): 305–10
Stephenson S, Gissane C, Jennings D. Injury in rugby league: a four year prospective survey. Br J Sports Med 1996; 30 (4): 331–4
Gissane C, Jennings DC, Standing P. Incidence of injury in rugby league football. Physio 1993; 79: 305–10
Gissane C, Jennings DC, Cumine AJ, et al. Differences in the incidence of injury between rugby league forwards and backs. Aust J Sci Med Sport 1997; 29 (4): 91–4
Gissane C, Jennings D, White J, et al. Injury in summer rugby league football: the experiences of one club. Br J Sports Med 1998; 32 (2): 149–52
Gissane C, White J, Kerr K, et al. Physical collisions in professional rugby league: the demands on different player positions. Clev Med J 2001; 4: 137–46
Gissane C, Jennings D, Jennings S, et al. Physical collisions and injury rates in professional super league rugby: the demands of different player positions. Clev Med J 2001; 4: 147–55
Gissane C, Jennings D, Kerr K, et al. Injury rates in rugby league football: impact of change in playing season. Am J Sports Med 2003; 31 (6): 954–8
Seward H, Orchard J, Hazard H, et al. Football injuries in Australia at the elite level. Med J Aust 1993; 159 (5): 298–301
Orchard J, Seward H. Epidemiology of injuries in the Australian football league: seasons 1997-2000. Br J Sports Med 2002; 36 (1): 39–45
Orchard JW, Hoskins W. Rugby league injuries at State of Origin level [online]. Available from URL: http://www.injuryupdate.com.au/images/research/Origininjuries20002006.pdf [Accessed 2009 Dec 1]
Gabbett TJ. Influence of physiological characteristics on selection in a semi-professional first grade rugby league team: a case study. J Sports Sci 2002; 20 (5): 399–406
King DA, Gabbett TJ. Injuries in the New Zealand semiprofessional rugby league competition. NZ J Sports Med 2009; 36 (1): 6–15
Gabbett TJ. Training injuries in rugby league: an evaluation of skill-based conditioning games. J Strength Cond Res 2002; 16 (2): 236–41
Gabbett TJ. Influence of training and match intensity on injuries in rugby league. J Sports Sci 2004; 22: 409–17
Gabbett TJ. Influence of the limited interchange rule on injury rates in sub-elite rugby league players. J Sci Med Sport 2005; 8 (1): 111–5
Gabbett TJ, Domrow N. Relationships between training load, injury, and fitness in sub-elite collision sport athletes. J Sports Sci 2007; 25 (13): 1507–19
Gabbett TJ. Reductions in pre-season training loads reduce training injury rates in rugby league players. Br J Sports Med 2004; 38 (6): 743–9
King DA, Gabbett TJ. Injuries in a national women’s rugby league tournament: an initial investigation. NZ J Sports Med 2007; 34 (2): 18–22
Gabbett TJ. Incidence, site, and nature of injuries in amateur rugby league over three consecutive seasons. Br J Sports Med 2000; 34 (2): 98–103
Lythe MA, Norton RN. Rugby league injuries in New Zealand. NZ J Sports Med 1992; 20: 6–7
King DA, Gabbett TJ. Amateur rugby league match injuries in New Zealand. NZ J Sports Med 2009; 36 (1): 16–21
King DA, Gabbett TJ. Training injuries in New Zealand amateur rugby league players. J Sci Med Sport 2008; 11 (6): 562–5
Raftery M, Parker R, Stacey E, et al. Incidence of injury in junior rugby league in the Penrith and district rugby league area. Westmead: Children’s Hospital Institute of Sports Medicine, Research and Development Office, The New Children’s Hospital, 1999: 1–22
Gabbett TJ. Incidence of injury in junior rugby league players over four competitive seasons. J Sci Med Sport 2007; 11 (3): 323–8
King DA. Incidence of injuries in the 2005 New Zealand national junior rugby league competition. NZ J Sports Med 2006; 34 (1): 21–7
Gabbett TJ. Incidence of injury in amateur rugby league sevens. Br J Sports Med 2002; 36 (1): 23–7
King DA, Gabbett TJ, Dreyer C, et al. Incidence of injuries in the New Zealand national rugby league sevens tournament. J Sci Med Sport 2006; 9 (1-2): 110–8
Norton R, Wilson M. Rugby league injuries and patterns. NZ J Sports Med 1995; 22: 37–8
Hoskins W, Pollard H, Hough K, et al. Injury in rugby league. J Sci Med Sport 2006; 9 (1-2): 46–56
Brooks JHM, Kemp SPT. Recent trends in rugby union injuries. Clin J Sports Med 2008; 27 (1): 51–73
van Mechelen W, Hlobil H, Kemper HCG. Incidence, severity, aetiology and prevention of sports injuries: a review of concepts. Sports Med 1992; 14 (2): 82–99
Ekstrand J, Karlsson J. The risk for injury in football: there is a need for a consensus about definition of the injury and the design of studies. Scand J Med Sci Sports 2003: 13 (3): 147–9
Orchard JW, Newman D, Stretch R, et al. Methods for injury surveillance in international cricket. Br J Sports Med 2005; 39 (4): e22
Finch C. A new framework for research leading to sports injury prevention. J Sci Med Sport 2006; 9 (1): 3–9
Brooks JHM, Fuller CW. The influence of methodological issues on the results and conclusions from epidemiological studies of sports injuries: illustrative examples. Sports Med 2006; 36 (6): 459–72
Finch CF. An overview of some definitional issues for sports injury surveillance. Sports Med 1997; 24 (3): 157–98
Gissane C, White J, Kerr K, et al. Health and safety implications of injury in professional rugby league football. Occ Med 2003; 53: 512–7
King DA, Gabbett TJ, Gissane C, et al. Epidemiological studies of injuries in rugby league: suggestions for definitions, data collection and reporting methods. J Sci Med Sport 2009; 12 (1): 12–9
Hodgson L, Gissane C, Gabbett TJ, et al. For debate: consensus injury definitions in team sports should focus on encompassing all injuries. Clin J Sports Med 2007; 17 (3): 188–91
Orchard J, Hoskins W. For debate: consensus injury definitions in team sports should focus on missed match playing time. Clin J Sports Med 2007; 17 (3): 192–6
Fuller CW, Molloy MG, Bagate C, et al. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. Clin J Sports Med 2007; 17 (3): 177–81
Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 2006; 40 (3): 193–201
Estell J, Shenstone B, Barnsley L. Frequency of injuries in different age-groups in an elite rugby league club. Aust J Sci Med Sport 1995; 27 (4): 95–7
Orchard J. Missed time through injury and injury management at an NRL club. Sports Health 2004; 22 (1): 11–9
O’Connor D. Groin injuries in professional rugby league players: a prospective study. J Sports Sci 2004; 22: 629–36
Gabbett TJ, Domrow N. Risk factors for injury in subelite rugby league players. Am J Sports Med 2005; 33 (3): 428–34
Pringle RG, McNair P, Stanley S. Incidence of sporting injury in New Zealand youths aged 6-15. Br J Sports Med 1998; 32 (1): 49–52
Gabbett TJ. Influence of injuries on team playing performance in rugby league. J Sci Med Sport 2004; 7 (3): 340–6
Powell JW, Dompier TP. Analysis of injury rates and treatment patterns for time-loss and non-time-loss injuries among collegiate student athletes. J Ath Train 2004; 39 (1): 56–70
Timpka T, Ekstrand J, Svanstrom L. From sports injury prevention to safety promotion in sports. Sports Med 2006; 36 (9): 733–45
Junge A, Dvorak J. Influence of definition and data collection on the incidence of injuries in football. Am J Sports Med 2000; 28 (5 Suppl.): S40–6
Schootman M, Powell JW, Torner JC. Study designs and potential biases in sports injury research: the case-control study. Sports Med 1994; 18 (1): 22–37
Chambers RB. Orthopedic injuries in athletics (ages 9 to 17): comparison of injuries occurring in six sports. Am J Sports Med 1979; 7: 195–7
Hodgson Phillips L. Sports injury incidence. Br J Sports Med 2000; 34 (2): 133–6
Gabbett TJ. Severity and cost of injuries in amateur rugby league: a case study. J Sports Sci 2001; 19 (5): 341–7
Hodgson Phillips L. Methodology in research. In: MacAuley D, Best T, editors. Evidence-based sports medicine. Cornwall: BMJ Publishing Group, 2002: 12–28
Garraway WM, McLeod D. Epidemiology of rugby football injuries. Lancet 1995; 345: 1485–7
Stevenson MR, Hamer P, Finch CF, et al. Sport, age, and sex specific incidence of sports injuries in Western Australia. Br J Sports Med 2000; 34 (3): 188–94
Sandelin J, Santavirta S, Lättilä R, et al. Sports injuries in a large urban population: occurrence and epidemiological aspects. Int J Sports Med 1987; 9 (1): 61–6
Knowles SB, Marshall SW, Guskiewicz KM. Issues in estimating risks and rates in sports injury research. J Ath Train 2006; 41 (2): 207–15
Gabbett TJ. Physiological characteristics of junior and senior rugby league players. Br J Sports Med 2002; 36 (5): 334–9
Takarada Y. Evaluation of muscle damage after a rugby match with special reference to tackle plays. Br J Sports Med 2003; 37 (5): 416–9
Gibbs N. Common rugby league injuries: recommendations for treatment and preventative measures. Sports Med 1994; 18 (6): 438–50
Addley K, Farren J. Irish rugby injury survey: Dungannon football club. Br J Sports Med 1988; 22 (1): 22–4
King DA. Injuries in the New Zealand Bartercard cup competition. Dunedin: University of Otago, 2007
Walker RD. Sports injuries: rugby league may be less dangerous than union. Practitioner 1985 Mar; 229 (1401): 205–6
Meir R, McDonald KN, Russell R. Injury consequences from participation in professional rugby league: a preliminary investigation. Br J Sports Med 1997; 31 (2): 132–4
Alexander D, Kennedy M, Kennedy J. Injuries in rugby league football. Med J Aust 1979; 2: 341–2
Alexander D, Kennedy M, Kennedy J. Rugby league football injuries over two competitive seasons. Med J Aust 1980; 2: 334–45
Meir R. Evaluating players’ fitness in professional rugby league: reducing subjectivity. Strength Cond Coach 1993; 1 (4): 11–7
Larder P. The rugby league coaching manual. 2nd ed. London: Kingswood Press, 1992
Orchard J. Is there a relationship between ground and climatic conditions and injuries in football? Sports Med 2002; 32 (7): 419–32
Acknowledgements
No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
King, D.A., Hume, P.A., Milburn, P.D. et al. Match and Training Injuries in Rugby League. Sports Med 40, 163–178 (2010). https://doi.org/10.2165/11319740-000000000-00000
Published:
Issue Date:
DOI: https://doi.org/10.2165/11319740-000000000-00000