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Supporting Player Health and Performance – IRFU Injury Surveillance & Research

Nicol van Dyk IRFU Injury Surveillance and Medical Research Officer

The Irish Rugby Football Union (IRFU) is constantly examining global best practice to support the performance and health of our elite players, and as such we have embarked on world leading long term research programmes that are clinically relevant, performance driven and will contribute to a culture of sustained success.

In line with the IRFU’s Strategic Plan 2018-2023, the High Performance Unit’s research strategy is focused on developing mental resilience and robustness to encourage high performance outcomes across the system. Our research strategy aims to enhance injury prevention through risk management, optimal rehabilitation programmes, and effective return to sport strategies. The long term physical and mental wellness of each player is at the heart of the research strategy.

Injury Surveillance and Medical Research

Injury and illness surveillance is a fundamental component of focused efforts to protect the health of the players. Carefully designed injury surveillance programmes, accurate data capture and careful analysis of data are building blocks for sports injury/illness prevention programmes.

It allows injury rates in a team be compared to other teams and provincial averages.  It also helps to identify potential factors within individuals, training and matches that may affect risk of injury or illness.

Important questions that sports injury and illness surveillance projects are designed to address include:

1) What is the risk of an individual athlete sustaining an injury?

2) What is the typical pattern and severity of injuries and illnesses? How do injury rates compare
     across the system?

3) Do specific characteristics and factors within competition and training affect risk and influence

The IRFU is working hard in addressing these questions and is currently engaged in more than 20 research projects related to promoting player wellness.

Technology is a key element in managing and interpreting the data being generated by the research programmes.  The establishment of The Sports Office as an integrated digital monitoring hub that houses coaching, athletic performance, medicine and science under one roof allows data from all four provinces to be collected and analysed centrally.

Informing Actions

The first step is understanding the magnitude of the injuries we manage.  What injuries are happening most often, what trends can we extrapolate from frequently occurring injuries, what are the mechanics or circumstance of the injury.  This allows us to develop strategies and programmes on how best can we prevent, limit or rehab these injuries.

In figure 1 we can follow the trends of common injuries across the system.  This information has been used to identify specific areas where we have invested in staff education as well as framing our prevention strategies and informing our work in building athlete robustness.  Injury trends  inform our research strategy to ensure all projects are directed by what is happening in the game.

Anterior cruciate ligament (ACL) injuries, a very serious injury for rugby players given the long rehab period, happen very seldom. Hamstring injuries, a common injury in rugby, have remained stable while calf/Achilles injuries are on the rise. And even though the 2019/20 season has been interrupted by the Covid-19 pandemic, the lower number of concussions are promising signs that IRFU efforts in this area are making a difference.

Figure 1 The most common injuries we observe in the past four seasons. The rise in injuries also demonstrates greater accuracy in reporting injuries.

To better understand what we need to do, we must also consider the burden of these injuries. Injuries are often reported in terms of their severity (how many days a player will be unavailable to play) and frequency (how often injuries happen). But when we combine these important metrics in figure 2, we understand the burden these injuries represent.

Players will miss the better part of a year with an ACL injury, but they are rare. We want to keep it that way. Calf/Achilles injuries are now almost as common as hamstring injuries. They don’t keep players out for long (2-3 weeks only), but considering the increased rates we observe, we can prioritize our effort around this type of injury.  Such insights allows us to develop strategies and programmes on how best can we prevent, limit or rehab these injuries.

Figure 2 Risk matrix illustrating the relationship between the severity (consequence) and incidence (likelihood) of the commonly reported injury types during 2019/20 season. For each injury type, severity is shown as the average number of days lost from training and competition (log scale), while incidence is shown as the number of injuries per 1000 hours of total exposure. The size of the bubble demonstrates the number of injuries. *ACL, anterior cruciate ligament

Irish Rugby Working Together

Across professional rugby in Ireland collaboration between the provinces, the IRFU’s medical and athletic development departments and different stakeholders allow for more accurate injury data collection and hence the ability to develop important strategies to support player performance.

During these uncertain times, concerted efforts are being made to support the department of health in their working promoting the health and safety of everyone during the Covid-19 pandemic. Importantly, we need to prepare for returning to normal training and competition after the Covid-19 restrictions are lifted. We need to be training smarter and harder when we come back to play.

Dr. Rod McLoughlin - Medical Director IRFU Spirit of Rugby Conference 2019

Dr. Rod McLoughlin – Medical Director IRFU Spirit of Rugby Conference 2019

The IRFU’s Athletic Performance and Medical Departments are working in tandem to provide guidelines that minimise the risk of injury or illness while allowing the appropriate training required to get the players ready to return to competition.

In elite sport, health and performance go hand in hand. When we play rugby, we want to see our top players step onto the pitch and perform at their best.   In order to achieve sustained success, we need to protect the performance of our players by managing the risk of injury or illness.

Nicol van Dyk

IRFU Injury Surveillance and Medical Research Officer

In December 2019, the IRFU appointed Dr. Nicol van Dyk, a physiotherapist and clinical researcher, as its Injury Surveillance and Medical Research Officer.  Nicol, who has fifteen years of clinical experience as a physiotherapist, will oversee and deliver best practice injury surveillance and medical research within the professional game.