Incidence of Stingers in Young Rugby Players.
BACKGROUND
A stinger is a type of neurapraxia of the cervical roots or brachial plexus and represents a reversible peripheral nerve injury. The incidence of and major risk factors for stingers among young rugby players remain uninvestigated.


OBJECTIVE
To investigate the incidence, symptoms, and intrinsic risk factors for stingers in elite rugby union teams of young players.


METHODS
Descriptive epidemiology study.


METHODS
A total of 569 male rugby players, including 358 players from 7 high school teams and 211 players from 2 university teams, were investigated using self-administered preseason and postseason questionnaires.


RESULTS
The prevalence of a history of stingers was 33.9% (95% CI, 30.3-37.9), and 20.9% (119/569) of players experienced at least 1 episode of a stinger during the season (34.2 [95% CI, 26.2-42.1] events per 1000 player-hours of match exposure). The reinjury rate for stingers per season was 37.3% (95% CI, 30.4-44.2). Using the multivariate Poisson regression method, a history of stingers in the previous season and the grade and position of the player were found to be risk factors for stingers during the current season. The mean severity of injury was 2.9 days, with 79.3% (191/241) of the players not losing any time from playing after sustaining a stinger injury and 5.8% (14/241) of the players recovering within more than 14 days. The most frequent symptom was numbness in the unilateral upper extremity, and the most severe symptom was weakness of grasping (mean severity, 6 days). A logistic regression analysis indicated that a history of stingers in the previous season and an injury with more than 3 symptoms, especially motor weakness, were correlated with the severity of injury.


CONCLUSIONS
Young rugby players with a history of stingers have a significantly high rate of repeat injuries. Although nearly 80% of the players experienced only minimal (0-1 day) time loss injuries, neurological deficits sometimes last beyond 1 month. A history of stingers was identified to be the strongest risk factor for injuries and for lasting symptoms. This information may be useful for planning the proper treatment for stingers in young rugby players.
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan k-saki@luck.ocn.ne.jp.
Takayuki
T
Kawasaki
Rugby Football Club, Keio University, Yokohama, Japan.
Chihiro
C
Ota
Rugby Football Club, Keio University, Yokohama, Japan.
Takeshi
T
Yoneda
Mejiro Orthopaedic and Internal Medicine Clinic, Tokyo, Japan.
Nobukazu
N
Maki
Department of Sports Medicine, International Budo University, Katsuura, Japan.
Shingo
S
Urayama
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Masashi
M
Nagao
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Masataka
M
Nagayama
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Takefumi
T
Kaketa
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Yuji
Y
Takazawa
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Kazuo
K
Kaneko
D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology*; D001917:Brachial Plexus / Q000293:injuries; D015331:Cohort Studies; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D059348:Peripheral Nerve Injuries / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012574:Schools; D014495:Universities; D034941:Upper Extremity / Q000293:injuries; D055815:Young Adult
burner; epidemiology; rugby; stinger; young athlete