2017 ISAKOS Biennial Congress ePoster #2407


American Youth Rugby-7s: An Emerging Adolescent Collision Sport and Its Injuries

Richard Ma, MD, Columbia, MO UNITED STATES
Victor Lopez Jr., DO, New York, NY UNITED STATES
Meryle G. Weinstein, PhD, New York, NY UNITED STATES
Patria A. Hume, PhD, Auckland NEW ZEALAND
Robert C. Cantu, MD, PhD, Boston, MA UNITED STATES
Christian Victoria, MPH, Astoria, NY UNITED STATES
Sophie Queler, BS, New York, NY 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


American youths playing Rugby-7s sustained frequent match injuries and had high rates of injuries to their head and neck as well as upper extremities from tackling.



Rugby-7s is a popular world-wide collision sport and played with a high injury incidence. Rugby-7’s growth in the United States (USA) has been in the amateur population, including youth rugby. An understanding of playing injuries and how they occur will help develop prevention programs and promote safe growth of Rugby-7s in the USA.


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

Design: Prospective descriptive epidemiology study.

Setting: The study encompassed youth (Under-19) amateur competitions in USA Rugby and USA Sevens LLC Tournaments (2010-2014).

Participants: A total of 3,804 adolescent Rugby-7s players (aged 13-19 years old) on 317 teams (61 women, 256 men) in 643 youth-division matches (515 male; 140 female; 12 forfeits) over 24 USA tournaments (21 one-day tournaments and 3 three-day tournaments) were included between 2010-2014.

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. An injury that resulted in a player receiving medical attention was defined as a “medical-attention” injury, and an injury that resulted in a player being unable to take full part in future rugby match play as a “time-loss” injury. 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.


Overall injuries (medical attention and time-loss) were found at 81.9/1000ph (n=172), with time-loss injuries at 33.3/1000ph (n=70; 95% CI: 25.9-42.1) and medical attention injuries at 48.6/1000ph (n=102, 95% CI: 39.6-58.9) (P=0.013). Males experienced higher rates of injuries (backs 81.8/1000ph, n=77; forwards 56.7/1000ph, n=40; RR: 1.16, P=0.053) than females (backs 65.6/1000ph, n=17; forwards 77.1/1000ph, n=15; RR: 0.93, P=0.642) (RR: 0.96, P=0.332). Time-loss injuries resulted in a mean severity of 35.4 days (females, 29.6 days; males, 37.6 days; P=0.494). Most injuries were acute (93%; RR: 2.3, P<0.001) and result of tackling (80.3%; RR: 1.6, P<0.001). Injuries most commonly involved the joints or ligaments (40%) and the lower extremities (39%). High incidences of head and neck injuries including concussions (overall 26%) and upper extremity injuries (29%) were seen among the youth population.


USA adolescents playing Rugby-7s tournaments had lower rates of injury (33.3/1000ph) than USA amateur adult Rugby-7s (49.2-55.4/1000ph) and international adolescent boys’ Rugby-15s (35-.57.2/1000ph). A majority of injuries occurred during tackling (80.3%), and rates of injury to the head, neck, and upper extremity were elevated, which emphasizes the need for proper safe tackling techniques in USA youth. This study establishes the need for continued epidemiological research to document age-based injury rates and patterns that will help develop evidence-based sport-specific injury prevention initiatives.

Summary: USA youth Rugby-7 players sustained frequent match injuries and had high rates of injuries to their head and neck as well as upper extremities from tackling.