Training loads, injury profiles and illness in elite South African rugby players

Background Professional Rugby Union is a popular international team sport and is known to have one of the highest reported incidences of injury and illness across sporting codes. The Super Rugby tournament is played annually between professional Rugby Union teams and is one of the most competitive sports tournaments in the world. The demanding nature of the tournament has been associated with high rates of injury and illness, but the relationship between training loads on injury and illness profiles are unclear. As a result, the Super Rugby tournament is a platform to further investigate injury, illness and training load patterns within Rugby Union. Epidemiological data on training loads, injury profiles and illness patterns assist the development of preventative measures. Aim The aim of this study was to assess the relationships between training loads, injury profiles and illness rates in elite South African rugby players competing in the 2017 Super Rugby tournament. Specific objectives (a) To determine the incidence of training and match injuries during pre-season training, and early and late competition during the 2017 Super Rugby tournament; (b) To determine the incidence of illness during pre-season training, and early and late competition during the 2017 Super Rugby tournament; (c) To determine the anatomical site, type, mechanism and time-loss of injuries sustained during preseason training, and early and late competition during the 2017 Super Rugby tournament; (d) To determine potential associations between internal and external training loads; and injury and illness, respectively. Methods A descriptive, observational, surveillance study design was conducted on the 2017 Super Rugby tournament. Thirty-nine adult participants were recruited from one South African team over a complete season, including preseason, early and late competition. Data were collected from the team medical personnel who routinely collected data on a daily basis. Training load data included squad size, training or match day, the duration of training or matches, and internal and external training load measures for training and matches. Injury data included the participants age, the injury counts, the type of injury, the main and specific anatomical location, and the mechanism and severity of injury. Illness data included illness counts, the bodily system affected, symptoms and cause of illness, the specific diagnosis and time-loss. Results The overall incidence of injury was 12.8 per 1000 player hours. The majority (48.8%) of injuries occurred in the early competition phase. The incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). The lower limb (62.5%) sustained the greatest proportion of injuries. Muscle or tendon injuries accounted for 64.9% of all injuries. The tackle accounted for 28.8% of all injuries and 37.5% of all injuries were of a ‘moderate' severity. The proportion of players that sustained a time-loss injury was 76.9% (n = 30) and 25.6% (n = 10) of players sustained a time-loss injury severe enough to prevent eight days or more of participation in training or matches. The overall incidence of illness was 1.8 per 1000 player days. The proportion of players that acquired an illness was 28.3% (n = 11). Acute respiratory tract infections (28.6%) was the most common specific A significant negative correlation between injury and internal training loads were detected in the preseason phase (r = -0.34, p = 0.03). There were no significant correlations between external training load and injury incidence. No significant correlations were observed between internal and external training loads and illness incidence. There were no significant odds ratios demonstrated between internal and external acute to chronic ratios, and injury and illness risk. Conclusion The incidence of match injuries in this study was significantly higher than previously reported incidence rates in the Super Rugby tournament. The profiles of match and training injuries, anatomical location, type, mechanism and severity of injuries are similar to previous studies. Illness rates were significantly lower than reported in previous studies. Internal training load and injury were significantly correlated in the preseason phase. Further studies are required to determine the relationship of training loads on injury and illness over consecutive seasons and in multiple teams. diagnosis. A large majority of illnesses (64.3%) did not result in time-loss