Collapsed scrums and
collision tackles: what is the injury risk?

Roberts
SP., Trewartha G., England M., Stokes KA. British Journal of Sports Medicine.
2014;0:1-6.

Take Home Message: Illegal
collision tackles cause the most injuries per contact and weeks missed due to
injury. Six percent of scrums, a relatively controllable event, collapse;
however, the propensity for injury is 4 times higher and the severity is 6
times greater than non-collapsed scrums.

Medical
personnel rely on injury surveillance data to better understand the frequency
and causes of injuries in rugby. However, prior studies are limited to
professional levels, which may not be applicable to community rugby games.
Therefore, the authors investigated the propensity of specific contact events
to cause injury in community-level rugby. Community rugby player’s that
participated in the Rugby Football Union levels 3 through 9 were included in
this 3 year study (46 clubs in 2009/2010, 67 clubs in 2010/2011, and 76 clubs
in 2011/2012). The authors classified clubs as semi-professional (levels 3-4), amateur
(levels 5-6), or recreation/social levels (levels 7-9). Ten matches per group
were filmed to identify and record contact events (i.e., collision tackles,
tackles, rucks, mauls, lineouts, and scrums). Medical staff completed and
returned injury forms, which recorded injury event, severity, location, and
time loss due to injury. Semi-professional players had the greatest incidence
of injuries (17 injuries/1000 hours) compared with amateur level (13 injuries/1000
hours) and recreation/social level (11 injuries/1000 hours). Among the three
groups, semi-professional players also had the greatest number of contact
events with the exception of scrums and lineouts, which were similar between
groups. For all groups the propensity for injury was greatest for illegal collision
tackles. Semi-professional level suffered more injuries per contact (1.5
injuries/1000 contact events) compared with amateur level (1.1 injuries/1000 contact
events) and recreation/social level (1.2 injuries/1000 contact events);
however, there were fewer injuries due to illegal collision tackles among semi-professional
players (7 injuries/1000 contact events) compared with amateur (35
injuries/1000 contact events) and recreation/social players (26 injuries/1000 contact
events). More weeks were missed due to collision tackles (109 weeks/1000
events) and tackles (19 weeks/1000 events) compared to any other contact event.
In both tackle and collision tackles the ball carrier missed more weeks due to
injury compared to the tackler. One last interesting finding was that collapsed
scrums were 4 times more likely to result in an injury that resulted in 6 times
the number of weeks missed compared with non-collapsed scrums. The percentages
of collapsed scrums were similar between semi-professional (6%), amateur (6%),
and recreation/social level (5%).

Illegal
collision tackles poses the greatest injury risk in community tackles.
Collision tackles caused 5 times more weeks out than the second leading cause
of injuries, legal tackles. This insinuates that the collision tackles are frequent
and the rules need to be better enforced. Additionally, whether the tackle was
legal or not the ball handler had more weeks out due to injury compared with the
tackler. This is similar to other sports such as football, where the ball
carrier may not be ready for the hit. Another concerning point was that while scrums
had similar incidence of injury compared with mauls, lineouts, and rucks,
collapsed scrums had a higher propensity of injury and severity per event
compared to non-collapsed scrums. Given that the scrum is a controllable contact
event there should be continued focus on reducing scrum collapses to decrease the
risk of injury. It was interesting to note that semi-professional level had
more injuries, and more weeks lost due to injury; however, they had the lowest
amount of collision tackles. This could be due to a number of reasons. For
example, semi-professional players compete at a higher level and are more
skilled, referees working the higher level games may have more control over the
game, or lower level players do not have quality tackling skills. Medical
personal should use this information to better understand the extent of the
injury problems and educate players, coaches, and referees on how to reduce the
risk of injury.

Questions for Discussion:
Do you think those playing at higher levels have better tackling techniques?
What aspects of the legal tackle do you think causes the injury? Do you think
the results from England apply to college and community teams in the United
States?

Written
by: Jane McDevitt, PhD
Reviewed
by: Jeffrey Driban

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Roberts SP, Trewartha G, England M, & Stokes KA (2014). Collapsed scrums and collision tackles: what is the injury risk? British Journal of Sports Medicine PMID: 24516009