2017 ISAKOS Biennial Congress ePoster #2406


The American Experience with a Growing Amateur Collision Sport

Victor Lopez Jr., DO, New York, NY UNITED STATES
Richard Ma, MD, Columbia, MO UNITED STATES
Patria A. Hume, PhD, Auckland NEW ZEALAND
Robert C. Cantu, MD, PhD, Boston, MA UNITED STATES
Meryle G. Weinstein, PhD, New York, NY UNITED STATES
Christian Victoria, MPH, Astoria, NY UNITED STATES
Erica Marcano, MS, ATC, New York, NY UNITED STATES
Arun T Gupta, MD, Calgary, Alberta CANADA
James L. Chen, MD, MPH, San Francisco, CA UNITED STATES
Answorth A. Allen, MD, New York, NY UNITED STATES

Rugby Research and Injury Prevention Group, Hospital for Special Surgery, New York, NY, UNITED STATES

FDA Status Not Applicable


USA amateur Rugby-7 players sustained frequent match injuries and were more likely to have head/ neck and upper extremity injuries than international rugby-7 players.



Rugby-7s is an emerging amateur collision sport in the United States (USA), which debuted in the 2016 Olympics. Rugby-7s is played internationally with a high incidence of match injuries. There is limited injury epidemiology data on Rugby-7s in developing countries including the United States, which is important to promote safe growth of the sport and player welfare.


To obtain incidence and causes for match injuries in amateur USA Rugby-7s. We hypothesized that match injuries would be frequent and the patterns of injuries would be similar between the USA population and international cohorts.

Design: Prospective descriptive epidemiology study.

Setting: The study encompassed different competitive levels of amateur play (Under-19, College, Social/Adult Club, Sub-elite, and Elite) in USA Rugby and USA Sevens LLC Tournaments.

Participants: A total of 13,644 USA players (Men=9,768; Women=3,876; age: 13-49 years) were included over 28 tournaments (37 days) and 2,688 matches (Men=1,886; Women=802) in 1,137 sides/teams (Men=814; Women=323).

Main Measurement Outcome: Incidence (per 1000 player-hour (ph)) and biomechanism of injuries were captured (Rugby Injury Survey & Evaluation, RISE, Report). An injury was defined as any physical complaint caused by transfer of energy that exceeded the body’s ability to maintain its structural and/or functional integrity, sustained by a player during a rugby match. A “time-loss injury” was defined as an injury that resulted in a player being unable to take part of a full rugby match. All injuries were then followed up (1, 3 and 6 month intervals) to obtain severity (days’ absence from matches or training). The injury definitions and methodology conformed to accepted international standards on rugby injury research.1


Overall incidence of time-loss injuries was 50.6/1000 ph. Time-loss injuries were highest among Sub-elite level players (69.5/1000ph) (P<0.001). The most injured age group was the 20-25 year olds (50% of all injuries). The average severity (days absent) before return to training/competition was 44 days (CI 37.7-49.4). Most match injuries were new acute injuries (95%) and occurred during tackling (68%). The main types of injuries were ligament sprains (35%). The most common injured body region was the lower extremity (52%). Compared to international cohorts, the American population had higher proportion of head/neck (men – 23.1%, women – 17.7%) and upper extremity injuries (men – 25.8%, women – 26.1%).


Compared to international elite cohorts (head/neck – 4.9%, upper extremity – 17.5%),2 the American amateur population had lower overall injury incidence. However, the American cohort had higher frequency of upper extremity and head/face injuries. Injury prevention protocols in USA will want to focus on tackling techniques, which may reduce rate of upper extremity and head/face injuries.

1. Fuller CW, Molloy MG, Bagate C et al. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. Br J Sports Med. 2007;41(5):328-31.
2. Fuller CW, Taylor A, Molloy MG. Epidemiological study of injuries in international Rugby Sevens. Clin J Sport Med. 2010;20(3):179-84.