Background This report contrasts injury rates, types and potential risk factors between two equal length yet markedly different international rugby campaigns.

Objective To compare tournament injury problems and potential risk factors for single nation versus combined nation international rugby teams.

Design Details of all time-loss injuries, training and match exposure for the Wales Team during the 2013; 6 Nations, and British and Irish Lions (BIL) during the Australia tour. Analysis was based on consensus injury surveillance methods.

Setting International Rugby Union.

Participants All Wales (n=36) and 2013 BIL squad (n=45) players.

Risk factor assessment Contrasting injury exposure, rates and severity.

MainoOutcome measurement Training and match injury; exposure, incidence, (per 1000hours), prevalence (% of players unavailable) and days-lost per injury.

Results Wales played 5 matches and BIL 10 in a similar time period. 81% of Wales' squad players played in at least one match as compared to 98% of BIL. Wales had 28% more training hours exposure. Wales had a higher injury incidence/1000 hrs than BIL (total 27 vs. 18, match 260 vs. 90, training 5 vs. 4) and prevalence (15 vs. 10%), but fewer days-lost per injury (11 vs. 17). For Wales, 67% of the squad sustained injuries, with an average of 1.6 injuries per injured player whilst 54% of BIL sustained injuries (1.1 per injured player). Forty-seven percent of Wales players started in a match and half were replaced in at least one game as compared to 62% of BIL players and 92% being replaced. Of the match injuries, 81% of Wales' players, versus 56% BIL, completed the match.

Conclusions Higher injury rates for Wales may have been due to factors such as; lower substitution rates, greater starter match exposure and previously injured players returning to play in the same tournament.