New rugby warm-up regime can halve num­ber of in­juries

The Guardian Australia - - Environment / Science - Jamie Doward

A se­ries of ex­er­cises per­formed be­fore rugby matches can dra­mat­i­cally re­duce in­jury, ac­cord­ing to a bench­mark study that the game’s coaches hope will re­but the charge that they do not take the is­sue of con­cus­sion se­ri­ously.

The pro­gramme, known as Ac­ti­vate, is the re­sult of a project by health re­searchers at the Uni­ver­sity of Bath and Eng­land Rugby. The re­sults, pub­lished in the Bri­tish Jour­nal of Sports Medicine, sug­gest that the ex­er­cises can sig­nif­i­cantly re­duce con­cus­sion and lower limb in­juries.

Re­searchers fol­lowed the progress of 81 men’s com­mu­nity rugby club teams and nearly 2,000 play­ers over the course of a sea­son, dur­ing which play­ers per­formed the pro­gramme. In­ci­dence of con­cus­sion was re­duced by up to 60%, with lower-limb in­juries down by as much as 40%. The closer the pro­gramme was ob­served by play­ers, the greater the ef­fect. The best re­sults oc­curred when teams prac­tised the warm-up at least twice a week.

The regime fo­cuses on bal­ance, strength and agility in or­der to bet­ter pre­pare play­ers for the phys­i­cal chal­lenges they face in matches. Split into four stages, it takes roughly 20 min­utes to com­plete. The ex­er­cises are tar­geted to im­prove func­tional and core strength, par­tic­u­larly lower-limb bal­ance and neck strength, all of which as­sist a player in deal­ing with the phys­i­cal de­mands of the game. “By re­plac­ing stretch­ing ex­er­cises that play­ers typ­i­cally do be­fore train­ing and matches with ex­er­cises that fo­cus on bet­ter con­trol of move­ment, we have seen a dra­matic re­duc­tion in in­juries in this study,” said one of its au­thors, Dr Si­mon Roberts from the Uni­ver­sity of Bath’s depart­ment for health. “This new pro­gramme is markedly dif­fer­ent from the kind of warm-up play­ers might typ­i­cally take part in dur­ing train­ing or pre­match, with a much greater fo­cus on move­ment con­trol.

“Com­bin­ing the im­pres­sive re­sults on in­jury re­duc­tion with the na­tional roll-out of this pro­gramme with Eng­land Rugby, we are par­tic­u­larly ex­cited by the po­ten­tial for this work in mak­ing a long-term im­pact on the game.”

Pro­fes­sor Keith Stokes, who led the study, said: “The in­jury that has re­ceived the great­est fo­cus in re­cent years has been con­cus­sion. At present we are not clear about the pre­cise mech­a­nisms by which the pro­gramme re­duces con­cus­sion in­ci­dence, but this is a par­tic­u­larly in­ter­est­ing find­ing.”

Con­cerns about se­ri­ous rugby in­juries are grow­ing and could tar­nish the sport’s im­age. Last month Pro­fes­sor Allyson Pol­lock, from New­cas­tle Uni­ver­sity, sug­gested that phys­i­cal con­tact should be re­moved from all school rugby matches, which alarmed those who run the game.

An in­creas­ing num­ber of pro­fes­sional play­ers are hav­ing to leave the sport pre­ma­turely due to se­ri­ous

in­jury. World Rugby has in­tro­duced heav­ier sanc­tions for high tack­les. But the ef­fi­cacy of this pol­icy has been ques­tioned. A re­cent study of Premier­ship rugby in Eng­land con­cluded that rates of con­cus­sion have gone from 6.7 per 1,000 player hours in 2012-13 to 15.8 in 2015-16 – or one brain in­jury ev­ery cou­ple of matches. Con­cus­sion now ac­counts for 25% of all in­juries.

The con­cerns may also be linked to the de­cline in the num­ber of adults now play­ing the am­a­teur game just as the sport’s ex­ec­u­tives want more peo­ple, es­pe­cially women, to play rugby. The Ac­ti­vate pro­gramme builds on a sim­i­lar ini­tia­tive ear­lier in the year that fo­cused on school­boy rugby. It is set to be a key el­e­ment of Eng­land Rugby’s “Rugby Safe” pro­gramme that pro­motes player wel­fare.

Steve Grainger, RFU rugby devel­op­ment di­rec­tor, said the ini­tia­tive was a chance to im­prove player safety and re­duce in­juries across the game. “Since launch­ing the Ac­ti­vate pro­gramme at the be­gin­ning of Septem­ber we’ve al­ready seen hun­dreds of coaches sign up to ac­cess the on­line re­sources and com­plete the face to face train­ing,” Grainger said. “Hav­ing this strong ev­i­dence be­hind the pro­gramme, we hope that coaches ap­pre­ci­ate the im­por­tance of it and in­te­grate the ex­er­cises into their train­ing and pre-match rou­tines to en­sure their play­ers are in the best po­si­tion pos­si­ble when tak­ing to the field.”

Con­cern over rugby in­juries has led to calls for the sport to be made non-con­tact in schools. Pho­to­graph: Cul­tura/REX/Shutterstock

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