title: Incidence and Nature of Medical Attendance Injuries in English Community Rugby Union.
abstract: BACKGROUND
  Previous research has identified injury patterns during community-level rugby union match play, but none have investigated the frequency and reasons for on-field injury management.
  
  
  OBJECTIVE
  To establish the frequency, reasons, and patterns of on-field injury management in English community rugby, including differences between different levels of play.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  Over 3 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), and 76 (2011-2012) English community clubs (Rugby Football Union [RFU] levels 3-9). Club injury management staff reported information for all medical attendances during match play, including details on the injury site and type, playing position (seasons 2010-2011 and 2011-2012 only), and whether the player was removed from play. Clubs were subdivided into groups A (RFU levels 3 and 4 [mainly semiprofessional]; n = 39), B (RFU levels 5 and 6 [mainly amateur]; n = 71), and C (RFU levels 7-9 [social and recreational]; n = 79) to differentiate playing levels.
  
  
  RESULTS
  The overall medical attendance incidence was 229 per 1000 player-match hours (95% CI, 226-232), with 45 players removed per 1000 player-match hours (95% CI, 44-46). Attendance incidence for group A (294 per 1000 player-match hours; 95% CI, 287-301) was higher compared with group B (213; 95% CI, 208-218; P < .001) and C (204; 95% CI, 200-209; P < .001). There was a higher incidence of attendances to forwards (254; 95% CI, 249-259) compared with backs (191; 95% CI, 187-196; P < .001). The head was the most common specific site of injury (55 per 1000 player-match hours; 95% CI, 53-57) but the lower limb region overall accounted for most attendances (87; 95% CI, 85-89) and the greatest chance of removal from the pitch (22; 95% CI, 21-23).
  
  
  CONCLUSIONS
  With the likelihood of 1 injury for each team per match severe enough for the player to leave the pitch and with at least 1 attendance for a head injury per match, there is clear evidence that pitch side staff should be trained to recognize potentially serious injuries.
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Roberts
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Grant
authors.initials: G
authors.lastname: Trewartha
authors.affiliation: Rugby Football Union, Twickenham, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: England
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Stokes
keywords: epidemiology; injury surveillance; sports medicine