The epidemiology of kicking injuries in professional Rugby Union: a 15-season prospective study

Purpose
While kicking in Rugby Union can be influential to match outcome, the epidemiology of kicking injuries remains unknown. This study therefore aimed to investigate the epidemiology of injuries attributed to kicking in professional rugby, including playing position‐specific effects and differences in kicking volumes and kick types.

Methods
Fifteen seasons of injury surveillance data and two seasons of match kicking characteristics from professional rugby players were analyzed. Incidence, propensity, and severity of kicking‐related injuries were calculated together with the locations and types of these injuries. Position‐related differences in match kicking types and volumes were also established.

Results
Seventy‐seven match and 55 training acute‐onset kicking injuries were identified. The match kicking injury incidence for backs was 1.4/1000 player‐match‐hours. Across all playing positions, the propensity for match kicking injury was 0.57 injuries/1000 kicks. Fly‐halves sustained the greatest proportion of match kicking injuries (47%) and performed the greatest proportion of match kicks (46%); an average propensity for match kicking injury (0.58/1000 kicks). Scrum‐halves executed 27% of match‐related kicks but had a very low propensity for match kicking injury (0.17/1000 kicks). All other positional groups executed a small proportion of match‐related kicks but a high propensity for match kicking injury. Ninety‐two percent of match kicking injuries occurred in the pelvis or lower limb, with the majority sustained by the kicking limb. 21% of all match kicking injuries were associated with the rectus femoris muscle.

Conclusion
Match kicking profiles and kicking injuries sustained are position‐dependent, which provides valuable insight for developing player‐specific conditioning and rehabilitation protocols.