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Rugby Union: faster, higher, stronger: keeping an evolving sport safe
  1. Andrew D Murray1,
  2. Iain Robert Murray2,
  3. James Robson3
  1. 1Sport and Physical Activity Policy, Edinburgh, UK
  2. 2Department of Trauma and Orthopaedics, The University of Edinburgh, Edinburgh, UK
  3. 3Medical Department, Scottish Rugby Union, Edinburgh, UK
  1. Correspondence to Dr Andrew D Murray, Sport and Physical Activity Policy, Scottish Government, St Andrew's House, 2 Regent Road, Edinburgh EH1 3DG, UK; docandrewmurray{at}

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Since the International Rugby Board (IRB) declared Rugby Union an ‘open’ game thus effectively ushering in professionalism, players have become faster and stronger.1 Force equals mass multiplied by acceleration: logically increased force at collision will lead to more injuries. Surveillance studies and injury databases have provided comprehensive datasets which confirm changing patterns of injury in rugby.2 We examine what is being done, and how safety can be improved in rugby.


Rugby Union is experiencing unprecedented global growth. In total, 3.5 million men, women and children play worldwide, with 117 Unions in membership of the IRB.3 Modern rugby is ever more physically demanding due to increases in ball in play time, and speed of play. A fourfold increase in tackles and rucks per game has been noted.4–6 Teams with the tallest and heaviest players outperformed others in the Rugby World Cup.7 The IRB have appointed a Chief Medical Officer, a safety consultant and working groups to ensure that safety is maintained.

Injury trends

Epidemiological data provide insight into changes in the nature and frequency of injuries. Some injuries are unavoidable and ‘uncontrollable’, whereas others result from dangerous play. An international consensus statement on definitions and procedures used for injury surveillance has allowed meaningful comparisons of results across studies.8 The establishment of major event surveillance studies including the (2007) Rugby World Cup Injury Surveillance Study,2 …

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  • Contributors AD, IM and JR were all involved in the conception, drafting, revising and final approval of this article

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.