Surveillance of injuries among Kenya Rugby Union (KRU) players — Season 2010
Authors: Muma N1 MBChB, MMed, Saidi H2 MBChB, MMed, FACS, Githaiga3 JW MBChB, MMed
Affiliation: 1- Kijabe Hospital, Kenya 2- Department Human Anatomy, University of Nairobi 3- Department of Surgery, University of
Nairobi. Correspondence: Dr. Muma Nyagetuba; Kijabe Hospital, Kenya Email
Objective: To determine the incidence and characteristics of injury amongst Kenya rugby union players and associated factors.
Design: A whole population prospective cohort study.
Methods: 364 registered Kenya rugby union (KRU) players were stud-ied throughout the 2010 season. Data on their demographics, injury incidence, pattern and severity were gathered. The study tool used was the Rugby International Consensus Group (RICG) Statement.
Results: There were 173 backs and 191 forwards. One hundred and two 1 injuries for 60 league games (2400match player hours) were recorded. The incidence of injuries was 42.5/1000 match player hours (mph), (44.2 for forwards and 40.8 for backs). Lower limb injuries were the most common (41.2%) . Players were most prone to injuries in the in tackle scenario (63.7%), at the beginning of the season (47.1%), and in the last quarter (50%) of a game.
Conclusion: The injury incidence recorded contrast the earlier Kenyan data but is comparable to international amateur level incidence, uniqueness of the Kenyan environment notwithstanding. The higher rates associated with the tackle/tackled scenario, earlier part of the season and later part of the game, suggest interventions can target player conditioning, and use of protective gear.
Rugby is a high velocity and collision sport attended by one of the highest rates of injuries in team sports (1-3). As is the trend in the global scene, rugby is increasingly a popular sport in Kenya. Competition is higher, the game faster and the players stronger. The combination of fac-tors is fodder for rising rates of injury (1-7) with signifi-cant impact on player and team performance. 'prevention is better than cure’ approach to rugby in-jury is made possible by understanding the characteris-tics and magnitude of the problem. An earlier Kenyan study suggested comparatively higher rates of rugby re-lated injuries but did not establish models of relation-ships with risk factors (8). Internal and external factors shown to influence the outcome of injury include player fitness, part of the season, phase of play, player position, state of the pitch and player physique (9-14). Accord-ing to Brooks for example, injuries that cause the most significant absence from the field of play for forwards and backs are anterior cruciate ligament and hamstring injury respectively (6).
This paper explores the injury experience and the asso-ciated risk profile during the Kenya 2010 15-side rugby season.
The prospective whole population cohort study of 364 players was conducted in the 2010 15-aside season. It comprised of the Kenya cup (KC) division one and Eric Shirley shield (ESS) division two leagues. All players were KRU registered and had to be above 18years of age. The clinical officers in charge of data collection were trained for two weeks to use the instrument of data col-lection followed by a proficiency exam using preseason matches.
Blood bin injuries defined by Law 3.11(a) of International Rugby Board ( IRB) were excluded unless a training session or match was subsequently missed because of the said injury. Age, height, weight, injury status at that time and posi-tion played were documented preseason. The players were clustered into forwards (positions 1 to 8) and backs (positions 9 to 15).
Data analysis was performed using SPSS version 17 soft-ware. Incidence was calculated as injuries per 1000 match player hours (mph) (95% CI). Student t-test was used to compare the means between injured and non-injured for continuous vari- ables i.e. age, weight, height, BMI. Match exposure was calculated on the basis of 15 players (8 forwards, 7 backs) per team exposed for 80 minutes (first half 0-20, 20-40, second half 40-60, 60-80minutes). Approval for study was obtained from the Kenyat-ta National Hospital Ethics and Research Committee and the KRU board.
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Players enrolled in the study were 169 (76 backs and 93 forwards) for KC and 195 (97 backs 98 forwards) for ESS. The 30 KC and 30 ESS games played constituted a total 2400 mph. The season lasted 4 months during which 102 injuries were recorded. The incidence of injuries was 42.50/1000mph (Forwards 44.17; Backs 40.83). The ages of the players ranged from 18 to 40 years with a mean of 22.80 years (SD 3.724). The mean weight was 81.83kg (SD12.57) with a mean height of 1.75metres (SD 0.70) and a mean BMI of 26.59(SD 3.73). KC accounted for 64.6% of injuries which translated to an incidence of 55 injuries/1000mph and 30 injuries /1000mph for the ESS (p<0.0001). There was no career ending injury.
Anthropometry in relation to level of play
The Kenyan player’s mean age was 22.80 years (SD 3.724) with a mean weight of 81.83kg (SD12.57) and mean height of 1.75(SD 0.70).
The KC player was older (p <0.001), heavier (p <0.001) and taller (p0.002) (Table 1).
Anthropometry between injured and non-injured
The 102 injuries occurred amongst 92 players. The in-jured player was older (p 0.046), heavier (p 0.014), taller (p 0.004), and with a larger BMI (p 0.271), (Table 2).
Distribution of injury based on location of body
The forwards had an injury incidence of 44.17injuries per 1000mph compared to 40.83 injuries per 1000mph for the backs (p 0.52). The most common regions injured were the lower limb (41.2%), upper limb (24.6%) and head and neck (26.4%). The most common types of injuries were ligamentous (38.2%) and concussion (8.9%) (table4). The types of injuries were generally of similar amongst the forwards and backs. (Table 3)being linked with dangerous play.A player in KC had higher overall risk to injury as compared ESS, odds ratio 2.18 (p 0.006).
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Distribution of injuries bas