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Longitudinal study of six seasons of match injuries in elite female rugby union
  1. Lindsay Toyah Starling1,
  2. Niki Gabb1,
  3. Sean Williams1,
  4. Simon Kemp2,
  5. Keith A Stokes1,2
  1. 1Department for Health, University of Bath, Bath, UK
  2. 2Medical Services, Rugby Football Union, Twickenham, UK
  1. Correspondence to Dr Keith A Stokes, Department for Health, University of Bath, Bath, UK; k.stokes{at}


To establish match injury rates and patterns in elite female rugby union players in England.

Method We conducted a six-season (2011/2012–2013/2014 and 2017/2018–2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used.

Results Five-hundred and thirty-four time-loss injuries were recorded during 13 680 hours of match exposure. Injury incidence was 39 injuries per 1000 hours (95% CIs 36 to 42) with a mean severity of 48 days (95% CIs 42 to 54) and median severity of 20 days (IQR: 7–57). Concussion was the most common specific injury diagnosis (five concussions per 1000 hours, 95% CIs 4 to 6). The tackle event was associated with the greatest burden of injury (615 days absence per 1000 hours 95% CIs 340 to 1112), with ‘being tackled’ specifically causing the most injuries (28% of all injuries) and concussions (22% of all concussions).

Conclusions This is the first multiple-season study of match injuries in elite women’s rugby union players. Match injury incidence was similar to that previously reported within international women’s rugby union. Injury prevention strategies centred on the tackle would focus on high-burden injuries, which are associated with substantial player time-loss and financial costs to teams as well as the high-priority area of concussions.

  • Injuries
  • Rugby
  • Women in sport
  • Epidemiology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Twitter @starling_linds, @drsimonkemp, @drkeithstokes

  • Contributors LTS and NG contributed equally as the primary authors of the manuscript and all other authors were involved in initial conception of the paper, interpretation of findings and provided significant feedback in refining the final manuscript. KS takes overall responsibility for the manuscript as guarantor.

  • Funding Funding for this study was provided by the Rugby Football Union through support of NG’s PhD and to support data collection in more recent years.

  • Competing interests SK and KS are employed by the Rugby Football Union.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.