title: Time loss injuries compromise team success in Elite Rugby Union: a 7-year prospective study.
abstract: BACKGROUND
  A negative association between injuries and team success has been demonstrated in professional football, but the nature of this association in elite Rugby Union teams is currently unclear.
  
  
  OBJECTIVE
  To assess the association between injury burden measures and team success outcomes within professional Rugby Union teams.
  
  
  METHODS
  A seven-season prospective cohort design was used to record all time-loss injuries incurred by English Premiership players. Associations between team success measures (league points tally and Eurorugby Club Ranking (ECR)) and injury measures (injury burden and injury days per team-match) were modelled, both within (changes from season to season) and between (differences averaged over all seasons) teams. Thresholds for the smallest worthwhile change in league points tally and ECR were 3 points and 2.6%, respectively.
  
  
  RESULTS
  Data from a total of 1462 players within 15 Premiership teams were included in the analysis. We found clear negative associations between injury measures and team success (70-100% likelihood), with the exception of between-team differences for injury days per team-match and ECR, which was unclear. A reduction in injury burden of 42 days (90% CI 30 to 70) per 1000 player hours (22% of mean injury burden) was associated with the smallest worthwhile change in league points tally.
  
  
  CONCLUSIONS
  Clear negative associations were found between injury measures and team success, and moderate reductions in injury burden may have worthwhile effects on competition outcomes for professional Rugby Union teams. These findings may be useful when communicating the value of injury prevention initiatives within this elite sport setting.
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Sean
authors.identifier: http://orcid.org/0000-0003-1460-0085
authors.initials: S
authors.lastname: Williams
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Grant
authors.initials: G
authors.lastname: Trewartha
authors.affiliation: Department of Sports Medicine, Rugby Football Union, Twickenham, UK.
authors.forename: Simon P T
authors.initials: SP
authors.lastname: Kemp
authors.affiliation: Imperial College Healthcare NHS Trust, London, UK.
authors.forename: John H M
authors.initials: JH
authors.lastname: Brooks
authors.affiliation: Colin Fuller Consultancy, Sutton Bonington, UK.
authors.forename: Colin W
authors.initials: CW
authors.lastname: Fuller
authors.affiliation: Karabati Limited, Nottingham, UK.
authors.forename: Aileen E
authors.initials: AE
authors.lastname: Taylor
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Cross
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Stokes
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology*; D054874:Athletic Performance; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D011446:Prospective Studies
keywords: Epidemiology; Injury; Rugby