Longitudinal study of five seasons of upper limb injuries in training and matches in elite female rugby union at club and national team level

Background Data on upper limb injuries in elite female rugby athletes are limited. This study aims to describe the incidence, severity and burden of upper limb injuries over five seasons in elite women's rugby at both the club and international levels in training and matches. Methods A longitudinal cohort study was conducted from the 2017/2018 to 2021/2022 seasons, involving female players from the English club top tier and international team. Data on upper limb injuries were reported by team medical staff, capturing injury type, location, severity and mechanism. Injury incidence was calculated per 1000 hours of match/training exposure, and burden was measured by multiplying incidence by severity. Results A total of 190 upper limb injuries were recorded, with shoulder injuries the most common, representing 43% of all injuries. Median severity (mid-range of injury severity within the data) in international settings was lower than in club settings (Club matches 38 days, IQR 65, international matches 15 days, IQR 55). Injury burden (which is derived from injury mean severity and injury incidence) was significantly higher at international level (club matches, 265 days/1000 hours, 95% CI 213 to 328; club training 6 days/1000 hours, 95% CI 6 to 8; international matches 2638 days/1000 hours, 95% CI 2000 to 3481; international training 51 days/1000 hours, 95% CI 30 to 88). Conclusions The current study data highlight a low injury severity at an international level. Although the international injury severity rate is higher than club injury incidence and burden. Hand injuries were more common within club training settings, and the shoulder was more prevalent in all other settings.