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Concussion increases within-player injury risk in male professional rugby union

Moore, Isabel S.; Bitchell, Charlotte Leah; Vicary, Danielle; Rafferty, James; Robson, Ben Charles; Mathema, Prabhat

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Authors

Isabel S. Moore

Charlotte Leah Bitchell

Danielle Vicary

James Rafferty

Ben Charles Robson

Prabhat Mathema



Abstract

Objectives To assess within-player change in injury risk and between-player subsequent injury risk associated with concussive and common non-concussive injuries in professional rugby union. Methods This prospective cohort study in Welsh professional male rugby union analysed within-player and between-player injury risk for five common injuries: concussion, thigh haematoma, hamstring muscle strain, lateral ankle sprain and acromioclavicular joint sprain. Survival models quantified within-player injury risk by comparing precommon (before) injury risk to postcommon (after) injury risk, whereas between-player subsequent injury risk was quantified by comparing players who had sustained one of the common injuries against those who had not sustained the common injury. HRs and 95% CIs were calculated. Specific body area and tissue type were also determined for new injuries. Results Concussion increased the within-player overall injury risk (HR 1.26 (95% CI 1.11 to 1.42)), elevating head/neck (HR 1.47 (95% CI 1.18 to 1.83)), pelvic region (HR 2.32 (95% CI 1.18 to 4.54)) and neurological (HR 1.38 (95% CI 1.08 to 1.76)) injury risk. Lateral ankle sprains decreased within-player injury risk (HR 0.77 (95% CI 0.62 to 0.97)), reducing head/neck (HR 0.60 (95% CI 0.39 to 0.91)), upper leg and knee (HR 0.56 (95% CI 0.39 to 0.81)), joint and ligament (HR 0.72 (95% CI 0.52 to 0.99)) and neurological (HR 0.55 (95% CI 0.34 to 0.91)) injury risk. Concussion (HR 1.24 (95% CI 1.10 to 1.40)), thigh haematomas (HR 1.18 (95% CI 1.04 to 1.34)) and hamstring muscle strains (HR 1.14 (95% CI 1.01 to 1.29)) increased between-player subsequent injury risk. Conclusion Elevated within-player injury risk was only evident following concussive injuries, while lateral ankle sprains reduced the risk. Both concussion and ankle injuries altered head/neck and neurological injury risk, but in opposing directions. Understanding why management of ankle sprains might be effective, while current concussion management is not at reducing such risks may help inform concussion return to play protocols.

Journal Article Type Article
Acceptance Date Nov 18, 2022
Online Publication Date Dec 13, 2022
Publication Date Apr 1, 2023
Deposit Date Jan 12, 2023
Publicly Available Date Jan 12, 2023
Journal British Journal of Sports Medicine
Print ISSN 0306-3674
Electronic ISSN 1473-0480
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 57
Issue 7
Pages 395-400
DOI https://doi.org/10.1136/bjsports-2021-105238
Keywords Original research, 1506, 2314, Hamstring Muscles, Ankle, Shoulder, Sporting injuries
Public URL https://uwe-repository.worktribe.com/output/10273393
Publisher URL https://bjsm.bmj.com/content/early/2022/12/13/bjsports-2021-105238

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