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249 The epidemiology of head, neck and face injuries of adult men’s and women’s U.S. rugby-7s players
  1. Shen-Ying Richard Ma1,2,3,
  2. Christian Victoria2,4,
  3. Danielle C Ompad4,
  4. Meryle G Weinstein2,5,
  5. Robert C Cantu6,7,8,9,10,
  6. Jordan Genece11,2,
  7. Answorth A Allen2,3,12,13,14,
  8. Victor Lopez2,3,15,16
  1. 1University of Missouri, Missouri Orthopaedic Institute and Thompson Laboratory for Regenerative Orthopaedics, Columbia, USA
  2. 2Rugby Research and Injury Prevention Group, Hospital for Special Surgery, New York, USA
  3. 3Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
  4. 4New York University, College of Global Public Health, Urban Epidemiology Lab, New York, USA
  5. 5New York University, Steinhardt School of Culture, Education and Human Development, New York, USA
  6. 6Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, USA
  7. 7Department of Neurosurgery and Sports Medicine, Emerson Hospital, Concord, USA
  8. 8Sports Neurology and Concussion Program, Brigham and Women’s Hospital, Boston, USA
  9. 9Concussion Legacy Foundation, Waltham, USA
  10. 10World Rugby, Independent Concussion Group, Dublin, Ireland
  11. 11Mt. Sinai Hospital, Department of Dermatology, New York, USA
  12. 12Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, USA
  13. 13National Basketball Association, New York Knickerbockers, New York, USA
  14. 14USA Basketball, Colorado Springs, USA
  15. 15USA Rugby Empire and New England Geographic Union RFUs, New York/Boston, USA
  16. 16Northeast Rugby Academy, USA Rugby Development Program and USOC-Community Olympic Development Program, New York/Boston, USA


Background Head and neck injuries are a collision sport concern, however there is a lack of Rugby-7s injury data, particularly in emerging Rugby nations.

Objective To determine the head, neck, and face (HNF) match injury rates and characteristics in US Rugby-7s.

Design Prospective descriptive epidemiology study.

Setting USA Rugby-sanctioned tournaments/series and championships (2010–2016).

Participants 42,054 adult U.S. players (3,481 teams and 7,673 Rugby-7s matches).

Assessment of Risk Factors Match injury rates, site, type, and severity.

Main measurement outcome Incidence (per 1000 player-hour (ph)), severity and details of mechanisms were captured using Rugby Injury Survey & Evaluation (RISE) report methodology. All-injuries (medical-attention and time-loss) and time-loss injuries were defined. Days (d) absent before return-to-training/competition (including post-tournament) were recorded.

Results A total of 498 HNF injuries were encountered (all-injury rate=16.7/1000ph; men=17.3/1000ph; women=15.5/1000ph; IRR:1.1; CI:0.9–1.4). Head/face was the most commonly injured site (all-injuries=90.8%; time-loss=86.8%) followed by neck/cervical spine (all-injuries=9.2%; time-loss=13.2%). Concussions were the most common type of injury (36.7%; 6.1/1000ph) followed by facial lacerations (28.7%; 4.8/1000ph). Incidence of concussions was similar between sexes (IRR:1.0; CI:0.7–1.3). Longer return-to-sport were seen among women (46.4d) than men (32.1d; P=0.047) post-concussion. Scalp/face lacerations were more common among men than women (IRR:2.5; CI:1.6–4.1; P<0.001). Time-loss injuries occurred similarly among men and women (IRR:1.5; CI:1.0–2.6; P=0.061). HNF injury severity was similar between sexes (29.3±32.4 days absent from play). The tackle (71.5%) was the most common injury event. Men sustained HNF injuries mostly with direct contact with another player (IRR:1.3; CI:1.0–1.7; P=0.023), while women were injured with impact with the playing surface (IRR:1.8; CI:1.0–3.2; P=0.032).

Conclusions Incidence of HNF injuries were similar between sexes among U.S. rugby-7s players. Sex differences with concussion severity and contact mechanism of HNF injuries were seen between sexes. Recognition of HNF injury patterns and sex differences will allow for a more effective injury prevention plan in this emerging U.S. collision sport.

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