title: A meta-analysis of injuries in senior men's professional Rugby Union.
abstract: BACKGROUND
  Rugby Union has one of the highest reported incidences of match injuries amongst all professional team sports. The majority of research within this field has focused on elite male cohorts; in this study we present the first meta-analytic review of these data.
  
  
  OBJECTIVE
  The aim of this study was to summarise the incidence and severity of injuries in senior men's professional Rugby Union, and determine the overall effects of level of play, new versus recurrent injuries, playing position, type of injuries, location of injuries, severity of injuries, period of match, and injury incident.
  
  
  METHODS
  Electronic databases were searched using keywords 'Rugby Union' and 'inj*'. Fifteen papers addressing injuries in senior men's professional Rugby Union (from 1995 through September 2012) were included in the review. A maximum of ten of these papers provided incidence data that could be modelled via a Poisson mixed-effects generalised linear model, while up to nine studies provided severity data that could be modelled via a general linear mixed model. Magnitude based inferences were used to assess differences between factors. A descriptive analysis was provided for studies that could not be included in the pooled analysis due to incongruent injury definitions.
  
  
  RESULTS
  The overall incidence of injuries in senior men's professional Rugby Union matches was 81 per 1,000 player hours (95 % CI 63-105), and 3 per 1,000 player hours (95 % CI 2-4) during training. Estimated mean severity for match injuries was 20 days (95 % CI 14-27), and 22 days (95 % CI 19-24) for training injuries. A higher level of play was associated with a greater incidence of injuries in matches, with no clear difference in severity. New injuries occurred substantially more often than recurrent injuries, while the severity of recurrent injuries was, on average, 10 days (95 % CI 4-17) greater than new injuries. Trivial differences were found in injury incidence and severity between forwards and backs. Muscle/tendon and joint (non-bone)/ligament injuries were the two most prevalent injury groups, whereas fractures and bone stress injuries had the highest average severity. The lower limb was the body region with the highest injury incidence, while upper limb injuries were most severe. The third quarter (40-60 min) of matches had the highest injury rate, and injuries most commonly occurred as a result of being tackled.
  
  
  CONCLUSIONS
  This meta-analysis confirms match injury incidence rates in professional Rugby Union can be considered high in comparison with other team sports, but similar to other collision sports. In order to markedly reduce overall injury burden, efforts should target lower-limb injury prevention strategies and technique during contact, as these may render the largest effect.
authors.affiliation: Applied Biomechanics Suite 1.308, Sport and Exercise Science Research Group, Department for Health, University of Bath, Bath, BA2 7AY, UK, S.Williams@bath.ac.uk.
authors.forename: Sean
authors.initials: S
authors.lastname: Williams
authors.forename: Grant
authors.initials: G
authors.lastname: Trewartha
authors.forename: Simon
authors.initials: S
authors.lastname: Kemp
authors.forename: Keith
authors.initials: K
authors.lastname: Stokes
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control*; D005538:Football / Q000293:injuries*; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male