Targeted Exercise Program Reduces Injuries in Young Rugby Players
Title: risk in schoolboy rugby players with a pre-activity movement control exercise program: a cluster randomized controlled trial.
Author: Hislop et al
Journal: British Journal of Sports Medicine
Objective: To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures.
Sports related injuries have received significant attention in general media and within sports medicine community the last couple of decades. In the US, about 3.5 million injuries occur in organized sports per year. Contact sports are an area of significant interest given that they increase the frequency and severity of injuries, such as American football and rugby.
Musculoskeletal injuries and concussions are associated with missed playing time and are implicated in long term disability and compromised quality of life. For this reason, prevention and risk reduction strategies have begun to be investigated and implemented in an effort to reduce injury
Examples of preventative strategies include general as well as targeted strength and conditioning programs, enhanced movement control, stretching, improved technique, using the correct protective equipment, hydration and appropriate warming up and cooling down.
The authors of this study wanted to assess the efficacy of pre-activity movement control exercise to reduce incidence and burden of rugby-related injuries in a schoolboy population and to determine whether there was a dose-response related effect.
This cluster-randomized controlled trial included 3188 players (118 teams, aged 14–18 years from 40 independent schools). Each team was allocated to receive either the intervention or control program. The intervention program consisted of balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting maneuvers. They assessed efficacy by measuring lost playing time.
441 time-loss match injuries (intervention: 233; control: 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855).
There was a reduction in concussion incidence in the intervention group compared to the control group (RR=0.71, 0.48 to 1.05), although it was not quite statistically significant.When assessing for all injuries, there was no difference between the two groups in aggregate data of injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17).
However, when the trial arm was limited to teams who completed at least 3 weekly sessions, there was a 72% reduction in injury incidence (RR=0.28, 0.14 to 0.51) and a 59% reduction in concussion incidence (RR=0.41, 0.17 to 0.99).
When teams completed 3 or more weekly sessions, there was a staggering reduction in overall match injury incidence and concussion incidence among these rugby players.
These findings are encouraging and provide evidence that preventative measures can be taken to help significantly reduce risk of injury. The authors also identified that there is a dose-related response by seeing the greatest difference in groups who did this intervention three times per week.
It’s worth noting that this study was done in teenagers and needs to be replicated in adults and attempted in other sports.
Hislop, M. D., Stokes, K. A., & Williams, S. (2017). Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial. British Journal of Sports Medicine. doi:10.1136/bjsports-2016-097434