US Men's Rugby 7-A-Side Ankle Injuries Over 7 Years

PURPOSE: The goal was to analyze injury incidence, severity, and risk factors for ankle injuries among men’s rugby-7s players at all levels of play. METHODS: A prospective epidemiological study on ankle injury incidence (injuries/1000 playing hours [ph]) and associated risk factors. Data were collected with the Rugby Injury Survey & Evaluation (RISE) report from men at USAR-sanctioned rugby-7-a-side events (2010-2016). Injury definitions and analyses complied with the rugby consensus statement. Injury severity was reported based on the number of days lost from play: slight (0-1d), minimal (2-3d), mild (4-7d), moderate (8-28d), and severe (>28 d). RESULTS: Total injury rate was 11.75/1000 ph (n = 200) (backs = 12.23/1000 ph, forwards = 9.46/1000 ph; P = 0.09). More injuries were medical attention (n = 113, 6.64/1000 ph) compared to time-loss (n = 77, 4.52/1000 ph). A majority of injuries were slight, minimal, or mild in severity (n = 118, 6.93/1000 ph) compared to moderate or severe (n = 41, 2.41/1000 ph; P < 0.01). The tackle was the highest-risk phase of play (n = 112, 6.58/1000 ph). Most injuries were a result of contact (n = 143, 72%), yet many were also a result of non-contact events (i.e., change of direction, slipping) (n = 47, 24%). The top three injury types were sprain/ligament injuries (n = 172, 10.10/1000 ph), fractures (n = 11, 0.65/1000 ph), and hematomas/contusions (n = 7, 0.41/1000 ph). Sprain/ligament injuries were a significantly higher proportion of recurrent injuries (88%, 2.94/1000 ph) and time-loss injuries (81%, 3.64/1000 ph) compared to all other injury types (P < 0.01 for both). CONCLUSIONS: Ankle injuries are common and represent a significant injury burden for rugby-7s players. Sprains and ligament injuries have the highest incidence among both time-loss and recurrent injuries and could be addressed through strengthening exercises with proper rehabilitation and return-to-play protocols, respectively. Technique and ankle stability (i.e., planting feet) during tackling and direction changes should be emphasized in practice to build ankle strength and reduce technical errors that may result in injury. Grants: USAR’s Empire/New England RFUs & HSS-ISMR (ID 2028), National Operating Committee on Standards for Athletic Equipment (44-16).