Welcome to this special BJSM e-Edition on #RugbyMedicine. The sport of rugby union has come a long way in its quest to enhance player welfare and safety, and we hope this e-Edition provides an insight into the sport’s journey, as well as some of its more modern initiatives and advances. The e-Edition has been split into two main sections that correspond to areas within the field that have seen major advances, with then a sprinkling of other #RugbyMedicine gold-dust on top.
We are hugely grateful to many people for collaborating on this project, especially those who have helped contribute new & exciting material. A huge thanks goes to Drs Martin Raftery, Eanna Falvey & Ross Tucker, Dominic Rumbles and Sir Bill Beaumont for their help in determining the scope & content, as well as Drs Simon Kemp & Keith Stokes for their support of the project. A huge thanks also to the likes of (soon to be Dr) Gautam Menon, Ania Tarazi and Jimmy Walsh for creating some of the brilliant animations/podcasts that feature so heavily.
Your feedback is most welcome, please do get in touch with us via the usual social media channels if you have any queries, but in the meantime, we hope you enjoy this resource (as well as #RWC2019!)
Dr Steffan Griffin | @SteffanGriffin
BJSM Senior Associate Editor & Editorial Fellow (on behalf of the BJSM Editorial team)
As Chief Medical Officer for World Rugby I would like to welcome everyone to this rugby medicine, e-edition of the British Journal of Sports Medicine. This e-edition has been produced to coincide with our Rugby World Cup that is being held in Japan from September 19 to November 2 in 2019. Our Rugby World Cup, played every four years, is our game’s most elite competition bringing together the 20 top nations from around the world.
Player welfare, as you will hear from Sir Bill Beaumont, Chairman of World Rugby, is the sport’s number 1 priority. Contributions to this e-edition come not only from World Rugby but also recognise research and welfare programs developed and introduced by some of our larger national Unions.
I would like to thank the BJSM for coordinating this new and exciting method of scientific journalism and in particular would like to recognise the enthusiasm and tireless efforts of Dr Steffan Griffin who initiated and coordinated this exciting project.
Dr Martin Raftery
Chief Medical Officer, World Rugby
In the first #GameChanger, we cover one of the hottest topics in Sport & Exercise Medicine, and one that’s constantly making headlines, concussion. In the section below, you will find resources covering everything from law-changes to landmark papers.
World Rugby’s Concussion Journey: From Description to Intervention
with Dr Martin Raftery and Dr Ross Tucker
High tackle sanction framework
As mentioned in the podcast, at #RWC2019 you will see match officials continue to use the decision making framework for high tackles. The link below takes you to a video that walks you through the issue, which is also summarised nicely in the infographic below
The game of rugby has evolved significantly over the last few decades, and it only take a quick search of historical matches on YouTube to see this first-hand. As mentioned in the podcast, a lot of these laws have been informed by collaborative research studies from around the globe. Below are some seminal papers that informed these initiatives, and an animation of the study that led to some of the recent law changes.
Tackling concussion in professional rugby union: a case–control study of tackle-based risk factors and recommendations for primary prevention
Matthew J Cross, Ross Tucker et al.
Concussion at a practical level
We have seen a huge paradigm shift in the way people view concussions over the last few years, but how have things evolved at a practical level? In this video, we hear from Associate Professor Jon Patricios about his experiences of working pitchside in rugby, and what the current state of play is.
Upset that you haven’t seen a single link to an #EpiStudy yet? You can relax. Though by no means a definitive list of studies, below is a link to some studies that have helped inform all of the above interventions & initiatives, enjoy!
Andrew J. Gardner, Grant L. Iverson et al
Graham Kirkwood, Nikesh Parekh et al
Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016
Paul McCrory, Willem Meeuwisse et al
Joshua Kamins, Erin Bigler et al
What is the difference in concussion management in children as compared with adults? A systematic review
Gavin A Davis, Vicki Anderson et al
The International Rugby Board (IRB) Pitch Side Concussion Assessment trial: a pilot test accuracy study
Gordon Ward Fuller, Simon P T Kemp, Philippe Decq
#GameChangerTwo: Injury prevention
We’ve tackled one of the most controversial & topical injuries, but what about injuries and their prevention in general? In this section, we hear again about the (still ongoing) journey taken by World Rugby, and we delve into some of the most recent interventions and advances, from passports to prevention programmes.
Prioritising Player Welfare with World Rugby
Dr Martin Raftery and Dr Ross Tucker join the BJSM to discuss World Rugby’s injury prevention journey, and most recent player welfare initiatives. We also hear from World Rugby chairman Sir Bill Beaumont on how rugby has evolved in this regard.
One of the intervention we will see rolled out this year is the Load Passport, so what exactly does this look like?
Click here for further information and World Rugby resources.
Load monitoring in rugby
We hear a lot about load these days, but what exactly does this encompass, and how should we go about collecting this data? This podcast with Dr Stephen West PhD delves into the pitfalls of current data collection methods, and provides some golden practical tips about how to best collect load data. Below are some accompanying papers too.
Managing player load in professional rugby union: a review of current knowledge and practices #Paywall
Kenneth L Quarrie, Martin Raftery, Josh Blackie et al.
Stephen W West, Sean Williams, Simon P T Kemp et al
Injury Prevention in rugby
You’ve heard of the FIFA11+ and a few other injury prevention programmes of the same ilk, but what about Activate? Activate relates to the evidence-based injury prevention programme in rugby, designed & implemented by the long-standing collaboration between the University of Bath, and the Rugby Football Union, and now adopted by World Rugby. Below you will find not only the original research papers, but some additional resources that provide some additional insight into the project.
Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial
Matthew J Attwood, Simon P Roberts et al
Activate is the RFU’s Injury Prevention Exercise Programme, and you can find out more about the project here.
Injury Surveillance in Rugby
Below you will find a number of links to key epidemiological papers, as well as some resources that detail the issue in a more interactive format, and keep your eyes peeled for more content in this area with some giants of the field.
S Williams, G Trewartha et al
C Yeomans, IC Kenny et al
C Bleakley, M Tully, S O’Connor
A Cruz-Ferreira, E Cruz-Ferreira et al
A Freitag, G Kirkwood et al.
N Gabb, G Trewartha et al
#RWC2019 – A medical perspective
Though we hope you enjoy the Rugby World Cup for the action on the field, if you’re wondering about anything from the medical set-up at the event, to what it must be like to prepare a team to peak in time for a unique competition, then we have you covered. Below are a list of resources that do exactly that – we hope you enjoy these as much as the matches themselves!
Dr Geoff Davies & Mr Prav Mathema
Professor Mutsuo Yamada
The end of the road…?
As you get stuck into this e-Edition, we’re happy to announce that we will also be adding some additional content to this resource over the course of #RWC2019. So if you’re interested in some key SEM topics such as female athlete health and knowledge translation, keep your eyes peeled for some more cutting edge content!