Rugby injuries: where they come from and which ones matter

Most rugby injuries come out of one event, and the surveillance data is unusually consistent about which one: the tackle. Across the English Premiership seasons from 2002/03 to 2018/19 the tackle accounted for 43 percent of all match injuries, and in English community rugby it caused 64 percent of head injuries and 74 percent of concussions, so rugby injuries gather around contact rather than around running. The professional and the club game are not the same sport for this purpose, and the gap is wide: head and face injuries ran at 11.3 per 1000 match hours in the Premiership, while time loss head injury at community levels 3 to 9 ran at 2.43 per 1000 player match hours on a stricter counting rule, which makes them two studies of two populations to be read side by side, not subtracted from each other. Four subjects get their own page in this hub, and the rest of the game routes to the condition programs. Read the first line in the warning list below, and the head injury lines under it, before anything else on this page, because they are the ones nobody has time to look up on a Saturday. Most of those lines are written to the injured player, so if you are reading this for somebody else, read you as him: you ask him the questions, you make the call, and you do not let him drive himself anywhere.

Warning signs, and when to get help

What the tackle, the scrum and the ruck ask of your body

Four parts of rugby union account for most of what a physio sees, and each one asks for something different. The tackle is a collision you choose, usually at speed, with your head and shoulder close to another player's hips and knees. The scrum is slow, heavy and sustained, with the front row's necks loaded in a line through eight bodies. The ruck and the maul are bodies arriving from angles you cannot always see, and the lineout adds a player lifted above head height who has to come down again.

The surveillance work says the tackle matters more than the rest put together. In the English Premiership from 2002/03 to 2018/19 the tackle was behind 43 percent of all match injuries and running was behind 12 percent (West and colleagues, 2021). In English community rugby the tackle caused 64 percent of head injuries and 74 percent of concussions (Roberts and colleagues, 2017). Those are two different levels of the game and two different injury classes, and the tackle leads in both.

The scrum shows why one number is never enough. It produces far fewer injuries than the tackle, and it carries a share of the most serious neck injuries that is out of all proportion to how much of a match it fills: in four studies of mixed elite and recreational rugby players, gathered in a systematic review of catastrophic injury across contact sports, 30 to 51 percent of catastrophic cervical spine injuries in rugby union came from the scrum against 29 to 39 percent from the tackle (Hutton and colleagues, 2016). More often is not the same as worse. The rugby neck injury page is where that difference is worked through, because it changes what a front row forward should do about a sore neck.

What are the most common rugby injuries?

In professional men's rugby union in England, concussion. From 2011 to 2019 it was the most commonly recorded injury in the Premiership, and its incidence, severity and burden all rose from the 2009 and 2010 season onward (West and colleagues, 2021). By body area in that same professional men's Premiership dataset, the head and face came top for how often injuries happened, at 11.3 per 1000 match hours, while the knee came top for burden, at 11.1 days lost per 1000 match hours in the same players.

Those two measures answer different questions and are easy to mix up. Incidence is how often something happens. Burden combines how often with how long it keeps a player out, so a knee that happens less often and costs 50 days can outrank a shoulder that happens more often and costs 10.

Drop the population and a true finding turns into a false one. The statement above belongs to professional men in one league over a defined window, and nobody has shown it holds for a girls' school team or a veterans' side.

The whole Premiership dataset gives a mean severity of 25 days per match injury, with a confidence interval of 22 to 28 (West and colleagues, 2021). That is an average across everything from a dead leg to a reconstruction, which is why this hub sends you to a page for the tissue instead of quoting an average at you.

How are rugby injuries counted, and why do two numbers never match?

Because rugby union agreed how to count them, and the agreement has definitions inside it that change the answer. The 2007 consensus statement set out what counts as an injury, what counts as a recurrence, what counts as non-fatal catastrophic injury, and how training and match exposure are measured, so that studies could be compared at all (Fuller and colleagues, 2007). The unit you will see most is injuries per 1000 player match hours.

The trap is the time loss threshold. The community study on this page counted head injuries only where the player was absent for 8 days or more, which is stricter than the 24 hour threshold the consensus definition uses (Roberts and colleagues, 2017). A stricter threshold finds fewer injuries. So when the Premiership head and face figure of 11.3 per 1000 hours sits next to a community head injury figure of 2.43 per 1000 hours, part of that gap is the level of rugby and part of it is the counting rule, and nobody can tell you how the gap divides.

Is club rugby as risky as the professional game?

Not on the evidence anyone has published, and the difference is large. English community rugby at Rugby Football Union levels 3 to 9, followed over six seasons and 175,940 hours of player match exposure, recorded time loss head injury at 2.43 per 1000 player match hours and concussion at 1.46 per 1000 player match hours (Roberts and colleagues, 2017). The professional figure for the head and face region is 11.3 per 1000 match hours (West and colleagues, 2021). Read them as two systems describing their own competitions with their own rules, not as one being four times the other.

One professional finding is worth knowing if you come off the bench. Across five professional men's unions, covering the English Premiership, the Welsh Pro14 and Australian, New Zealand and South African Super Rugby, injury incidence did not differ between starters and replacements overall, but mean injury burden was higher for replacements, with a rate ratio of 1.31 and a confidence interval of 1.17 to 1.46 (Roberts and colleagues, 2024). That is a professional men's finding and nobody has tested it in club rugby.

Can you lower the risk of a rugby injury?

Partly. There are two pieces of evidence and neither of them is a promise. The one randomized trial in this sport put a movement control program into 40 independent schools, with 118 teams and 3,188 players aged 14 to 18. The authors reported the effect on overall injury as unclear and the effect on concussion as a clear reduction, and in the teams that averaged three or more sessions a week both effects were clear and large (Hislop and colleagues, 2017). The numbers are in the question below, and the finding is the dose: a program that sits in a folder does nothing.

So if you want the program itself, take a published one instead of assembling a warm-up from a page like this. World Rugby puts one up free on its Passport site, called Activate, in separate versions for under 15s, under 16s, under 18s and adults, each in levels meant to be progressed through a season, with its own page of the research behind it. The age banding is the part a page of figures cannot do for you, and it is the part that matters most in a squad where two players of the same age can be a long way apart in physical maturity.

New Zealand took the same idea to a whole country. RugbySmart has been compulsory every year for coaches and referees since 2001, and its evaluation found a decrease in injury claims per 100,000 players in most of the areas it set out to change, with little movement where it was not aimed, backed by surveys showing safer behavior in the tackle, the scrum and the ruck (Gianotti, Quarrie and Hume, 2009). The paper reports a direction and an association, not a percentage, so there is no percentage here to quote.

Two prevention ideas get a page each here, because the evidence for them needs more room than a list allows. Eccentric hamstring work is on the rugby hamstring injury page, where two readable reviews of the same literature reach different conclusions. Neck strength training is on the rugby neck injury page, where the short answer is that it has been shown to build strength and has not been shown to prevent injury.

Where do I start if something already hurts?

Match the event to the page. One thing comes first for anybody who has had an operation on the injury: the protocol your surgeon gave you outranks every page linked below, and nothing here replaces the review appointments that go with it. The programs on this site are written for injuries managed without surgery, and where an operation changes the rules, the page says so and sends you back to the team who operated.

A shoulder that came out of its socket in a tackle, or one that has done it more than once, belongs with rugby shoulder dislocation for the sport specific part and with dislocated shoulder exercises and physiotherapy for the staged program. A fall straight onto the point of the shoulder, with a sore lump on top rather than a feeling of slipping, is usually AC joint sprain, and a shoulder that aches with lifting and overhead work rather than with contact is more often rotator cuff tendinopathy.

A hamstring that let go in a sprint or a kick goes to rugby hamstring injury and then to the program on hamstring strain. Pain high at the back of the thigh that built up over weeks rather than tearing in one stride is more likely hamstring tendinopathy, and a groin that complained after a long session belongs with groin strain.

The neck has its own page here for a reason, and so does getting back. Any suspected neck injury on a pitch is handled on rugby neck injury, the ordinary non specific stiff neck is on neck pain, and a neck hurt in a car crash or a fall is on whiplash. The rules on when you are allowed back into contact, and who signs that off, are on rugby return to play, while the full staged protocol and the day counts after a head injury live on concussion recovery and return to play.

For the rest of the body, a rolled ankle goes to ankle sprain, a knee twisted or taken from the side to MCL sprain or meniscus tear, and the tests clinicians use before clearing anybody for sport are set out in the return to sport test battery.

When to see a physio

Two weeks of the same complaint is the usual trigger, and in a contact sport there are faster ones. A shoulder that has felt as though it might slip, a knee that has given way, a hamstring that grabs at the top of a sprint, or an arm that went numb or dead in a tackle should all move the appointment forward instead of waiting for the fortnight to pass.

A few situations do not follow that rule at all. A knock to the head is assessed on the day and does not go back on in the same match, whatever the player says. A suspected neck injury is an emergency and nobody moves the player. And an arm or leg that is weak, numb or tingling after contact is seen the same day once the feeling has come back, because a nerve that has been stretched is a different problem from a bruised muscle. While the symptoms are still there, the player is treated as a possible neck injury at the ground rather than sent home with an appointment, which is set out on rugby neck injury. So is the first time it happens to a player, even if the arm clears in seconds, because World Rugby's own course material treats a first dead arm as a possible spinal injury until somebody trained says otherwise.

Expect a first appointment to be mostly watching you move, and take the detail with you: your position, what happened in the contact, how many sessions a week you were doing before it, and whether this has happened before. Previous injury is one of the risk factors the sport's own hamstring review was able to identify, alongside playing position, fatigue, a strength difference between the legs, running actions and a lack of readiness on returning (Chavarro-Nieto and colleagues, 2023), and it is the one on that list a physio cannot find out by looking. The warning list below sets its own speed, line by line.

In this topic

Rugby hamstring injury: why it happens and why it comes back
What the sport's own research says about a rugby hamstring injury: the running and kicking mechanisms, position risk, and what eccentric work does.
Rugby neck injury: the scrum, the tackle and what to do on the pitch
A rugby neck injury at the side of a pitch: what World Rugby tells first aiders to do and not do, what a stinger is, and how the scrum differs.
Rugby return to play: the rule where you play, and who signs you off
Who sets the rugby return to play rule where you play: World Rugby Regulation 10, the RFU, Rugby Australia and New Zealand Rugby, and who signs you off.
Rugby shoulder dislocation: will it happen again, and do I need surgery
What a collision sport does to the odds of a rugby shoulder dislocation happening again, what each operation trades, and why two surgeons differ.

Related exercise programs

Warning signs

Get emergency help now

Emergency: a player who has gone down in contact has pain down the middle of the neck or back, numbness, tingling, burning or weakness in the arms or legs, limbs that feel heavy, a neck or back that looks out of shape, or trouble breathing. Treat it as a neck injury in the same way if the player has been knocked out, or has any injury above the collarbone, because somebody who is not fully awake cannot tell you their neck hurts. Do not move the player, and do not let anybody roll them onto their side. Call emergency services, keep the head and neck as still as possible, and wait for emergency healthcare professionals with spinal care training to move them, which is what World Rugby's own immediate care and first aid course material instructs. If you are not sure whether the neck is injured, treat it as though it is. If the player is not breathing, cannot keep their airway clear, for example because there is blood or vomit in their mouth, or you cannot be sure whether the airway is open and they are breathing, that comes first, and the emergency call handler will tell you what to do.
Emergency: after a knock to the head, being very drowsy or finding it hard to keep your eyes open, confusion, a fit (seizure), new weakness or numbness anywhere in your body, new trouble understanding, speaking, walking or keeping your balance, new problems seeing or hearing, clear fluid coming from your ears or nose, bleeding from your ears or bruising behind them, a black eye when your eye was not hit, a dent in your head or a wound with something stuck in it, or a change in behavior. Call emergency services straight away. These can be signs of an injury to the brain.
Emergency: after a knock to the head, you were knocked out, even for a moment, you cannot remember what happened just before or after, you have had a headache ever since, or you are being sick (vomiting). The same applies, even if you feel fine, if you take medicine that thins your blood, other than aspirin on its own, have a bleeding or clotting condition, have had brain surgery in the past, or had been drinking alcohol or taking drugs when it happened. Go to an emergency department straight away, and do not drive yourself.
Emergency: severe neck pain after a knock to the head, whatever the fall or the knock was like. Keep still and call emergency services, and do not let anyone move you until someone trained has checked your neck. If the neck pain only starts later and nobody has checked your neck since, go to an emergency department straight away, and do not drive yourself.
Emergency: after a knock to the head, swelling, a deep cut or severe pain at the exact spot that was hit. Call emergency services or go to an emergency department straight away, and do not drive yourself. These can be signs of a broken skull.
Emergency: new problems walking, for example your legs feel stiff, heavy or weak or you have become unsteady on your feet, new trouble controlling your bladder or bowels, or hands that suddenly become clumsy, for example you can no longer do up buttons. Call emergency services straight away. These can be signs of pressure on the spinal cord in the neck.
Emergency: after a ball, a boot, a hand or elbow, a collision or a fall to the face, any change to your sight, severe pain in the eye, a headache or finding light hard to bear, feeling sick or being sick, an eye you cannot move or keep open, or blood or pus coming from the eye. The same applies if something has pierced the eye or hit it at high speed, or if a strong chemical has gone into it. Go to an emergency department or call emergency services straight away, and do not drive yourself.
Emergency: after a heavy blow to the stomach, the side or the lower ribs, for example a knee, a shoulder or a boot, stomach pain that came on suddenly and is severe, stomach pain that is getting worse, pain at the tip of your shoulder along with it, feeling faint, dizzy or light-headed, passing out, or struggling to breathe. Call emergency services or go to an emergency department straight away, and do not drive yourself: ask someone else to drive you, or call an ambulance (NHS). That kind of force can tear the spleen or the liver, and the bleeding is inside you, so how it looks from the outside tells you nothing.
Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
Emergency: if you faint while exercising, call emergency services, even if you feel fine again quickly.
Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
Emergency: the shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or the pain is severe after a fall or an injury. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.
Emergency: your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
Emergency: the knee became very swollen very quickly, within a few hours of a twist, fall or blow, or you felt a pop or snap. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance. A knee that fills up that fast has usually bled inside the joint, which can come from a torn ligament, a kneecap that slipped out or a break, so it needs checking before you play again.
Emergency: the ankle or foot looks deformed or out of place, you heard a crack when you were injured, or the foot is numb, tingling, cold, pale or blue. Go to an emergency department straight away, and do not drive yourself.
Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away, and do not drive yourself. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
Emergency: sciatica in both legs, or pain, tingling, numbness or weakness in both legs. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away, and do not drive yourself.

Get help today

Same day: you have had a knock to the head and you take aspirin on its own, without any of the emergency signs above. Get medical advice the same day. Aspirin on its own is the only blood thinning medicine left out of the emergency line above, and the NHS still asks anybody taking a medicine that thins the blood to get urgent advice after a head injury.
Same day: pain in your chest, your ribs or your breastbone that started with a blow in contact, a fall, a crush under bodies or a boot, rather than coming on by itself. Get medical advice the same day, and do not go back into training or contact until your chest has been checked, because the same knock can crack a rib or the breastbone and the sore spot sits right where an ordinary strain would be. Call emergency services or go to an emergency department straight away if the injury was a serious accident, your breathlessness is getting worse, your chest pain is getting worse, you have pain in your tummy or your shoulder, or you cough up blood, as a broken rib can damage something else such as a lung, the liver or the spleen. Do not drive yourself to hospital: ask someone else to drive you, or call an ambulance (NHS).
Same day: a sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
Same day: you cannot walk or put weight on the leg, whether or not there was a fall or injury, or you have very bad knee pain after a fall or injury, or very bad knee pain that came on suddenly with no injury at all. Get medical advice the same day.
Same day: you felt or heard a pop or snap high at the back of your thigh, near the buttock or the bone you sit on, and now have large bruising spreading down the back of the thigh, a gap or dip you can feel, a stiff-legged walk, or clear weakness when you bend the knee. Get assessed the same day at urgent care or an emergency department, and ask whether you need a scan and a surgeon's opinion. The tendon may have pulled away from the bone (proximal hamstring avulsion). When surgery is needed, repair within the first 4 weeks is favored over later repair, so do not wait to see if it settles. If it already happened longer ago than that, do not decide you have missed your chance, because later repair is still done and still works: it takes longer to get back to sport and carries more nerve trouble, which is a reason to go now and not a reason to stay home.
Same day: a player who is still growing, which in rugby mostly means the early to middle teens, felt a sudden sharp pain right on the bone they sit on while sprinting or kicking, and afterwards cannot run, cannot sit down on that side, or walks with a stiff leg. Get assessed the same day and ask for an X-ray. At that age the hamstring can pull the growth area off the bone (ischial apophyseal avulsion), and the large bruising and the gap you can feel in an adult injury are often missing, so this one gets missed as a pulled hamstring.
Same day: pins and needles in an arm together with neck or arm pain, or an arm that feels heavy or weak, and nobody has checked it yet. Get medical advice the same day. If it came on in contact and the symptoms are still there, or this is the first time it has happened, follow the first line in this list instead and get help at the ground, because World Rugby's own course material treats that player as a possible neck injury.
Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
Same day: the pain is there at night or at rest and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Book an appointment

Within a day or two: the pain is there at night or at rest and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
Within a few days: the pain is there at night or at rest and keeps getting worse. See your doctor within a few days.

Common questions

How often do rugby players get hurt?

It depends entirely on which rugby you play, and the two readable answers are a long way apart. In the English Premiership from 2002/03 to 2018/19, 10,851 match injuries were recorded in 124,952 hours of match play, a mean of 87 injuries per 1000 match hours with a confidence interval of 82 to 92, and a mean severity of 25 days with a confidence interval of 22 to 28 (West and colleagues, 2021). That is professional men's rugby union in one country. In English community rugby at Rugby Football Union levels 3 to 9, six seasons and 175,940 hours of player match exposure gave time loss head injury at 2.43 per 1000 player match hours and concussion at 1.46 per 1000 player match hours, counting only injuries that kept a player out for 8 days or more (Roberts and colleagues, 2017). Neither figure is a measure of your own risk, and no study anywhere gives a player their personal odds for next Saturday.

Is the tackle the most dangerous part of rugby?

It produces the most injuries, and the scrum produces some of the worst ones, which is a distinction worth holding on to. The tackle was behind 43 percent of all match injuries in the Premiership, with running next at 12 percent (West and colleagues, 2021), and in the community game it caused 64 percent of head injuries and 74 percent of concussions (Roberts and colleagues, 2017). For catastrophic cervical spine injury the picture changes: in four studies of mixed elite and recreational rugby players, gathered in a systematic review of 14 studies of catastrophic injury across contact sports, the scrum accounted for 30 to 51 percent of them in rugby union and the tackle for 29 to 39 percent (Hutton and colleagues, 2016). So one event dominates the ordinary injury list, and a rarer one carries a share of the serious neck injuries out of proportion to how much of a match it occupies. The rugby neck injury page sets that out with the mechanism studies behind it.

Do these numbers cover rugby league?

No. Everything on this page is rugby union, and league is a different sport with a different governing body and different numbers. The clearest illustration is the one above: in the same four studies of mixed elite and recreational players, the scrum accounted for 30 to 51 percent of catastrophic cervical spine injuries in union and 0 to 4 percent in league, while the tackle accounted for 29 to 39 percent in union and 78 to 100 percent in league (Hutton and colleagues, 2016). Nothing here is written for league, and a page that says rugby and means union should say union, which is what this one is doing.

Can you make rugby safer for a teenage player?

One randomized trial has tried in this sport, and it needs reading closely before anybody quotes it. Forty independent schools, 118 teams and 3,188 players aged 14 to 18 were randomized to a movement control exercise program or to a reference program, and 441 time loss match injuries were recorded across 15,938 match exposure hours. On the main analysis the authors called the effect on overall injury unclear, a rate ratio of 0.85 with 90 percent confidence limits of 0.61 to 1.17, and called the concussion result a clear reduction, at 0.71, 0.48 to 1.05. In the teams that actually averaged three or more sessions a week, both results were clear: 0.28, 0.14 to 0.51 for overall injury and 0.41, 0.17 to 0.99 for concussion (Hislop and colleagues, 2017). The authors read that as a dose effect rather than as proof that the program works whatever you do with it, and so should anybody quoting the lower numbers. New Zealand's RugbySmart program, compulsory every year for coaches and referees since 2001, was associated with a fall in injury claims per 100,000 players in most of the areas it targeted and little change where it did not target, alongside survey evidence of safer tackle, scrum and ruck behavior (Gianotti, Quarrie and Hume, 2009); that study reports a direction and an association rather than a percentage, so no percentage is given here.

References

Fuller CW, Molloy MG, Bagate C, Bahr R, Brooks JH, Donson H, Kemp SP, McCrory P, McIntosh AS, Meeuwisse WH, Quarrie KL, Raftery M, Wiley P. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. British Journal of Sports Medicine. 2007;41(5):328-331. https://doi.org/10.1136/bjsm.2006.033282
West SW, Starling L, Kemp S, Williams S, Cross M, Taylor A, Brooks JHM, Stokes KA. Trends in match injury risk in professional male rugby union: a 16-season review of 10 851 match injuries in the English Premiership (2002-2019): the Professional Rugby Injury Surveillance Project. British Journal of Sports Medicine. 2021;55(12):676-682. https://doi.org/10.1136/bjsports-2020-102529
Roberts SP, Trewartha G, England M, Goodison W, Stokes KA. Concussions and Head Injuries in English Community Rugby Union Match Play. American Journal of Sports Medicine. 2017;45(2):480-487. https://doi.org/10.1177/0363546516668296
Roberts SP, Stokes KA, Williams S, West SW, Kemp S, Cross M, Moore IS, Bitchell CL, Mathema P, Quarrie K, McDonald W, Fortington L, Rubio Del Castillo E, Readhead C, Sewry N, Falvey E, Tucker R. Injury in Starting and Replacement Players from Five Professional Men's Rugby Unions. Sports Medicine. 2024;54(8):2157-2167. https://doi.org/10.1007/s40279-024-02014-3
Hislop MD, Stokes KA, Williams S, McKay CD, England ME, Kemp SPT, Trewartha G. Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial. British Journal of Sports Medicine. 2017;51(15):1140-1146. https://doi.org/10.1136/bjsports-2016-097434
Gianotti SM, Quarrie KL, Hume PA. Evaluation of RugbySmart: a rugby union community injury prevention programme. Journal of Science and Medicine in Sport. 2009;12(3):371-375. https://doi.org/10.1016/j.jsams.2008.01.002
Chavarro-Nieto C, Beaven M, Gill N, Hebert-Losier K. Hamstrings injury incidence, risk factors, and prevention in Rugby Union players: a systematic review. The Physician and Sportsmedicine. 2023;51(1):1-19. https://doi.org/10.1080/00913847.2021.1992601
Degen RM. Proximal hamstring injuries: management of tendinopathy and avulsion injuries. Current Reviews in Musculoskeletal Medicine. 2019;12(2):138-146. https://doi.org/10.1007/s12178-019-09541-x
Ferraro SL, Batty M, Heyworth BE, Cook DL, Miller PE, Novais EN. Acute Pelvic and Hip Apophyseal Avulsion Fractures in Adolescents: A Summary of 719 Cases. Journal of Pediatric Orthopaedics. 2023;43(4):204-210. https://doi.org/10.1097/BPO.0000000000002355
Hutton MJ, McGuire RA, Dunn R, Williams R, Robertson P, Twaddle B, Kiely P, Clarke A, Mazda K, Davies P, Pagarigan KT, Dettori JR. Catastrophic Cervical Spine Injuries in Contact Sports. Global Spine Journal. 2016;6(7):721-734. https://doi.org/10.1055/s-0036-1586744
MacLean JG, Hutchison JD. Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland. British Journal of Sports Medicine. 2012;46(8):591-594. https://doi.org/10.1136/bjsports-2011-090183
World Rugby. Concussion Guidance, August 2024. https://resources.worldrugby-rims.pulselive.com/worldrugby/document/2024/08/26/ab286493-d1b4-4213-b476-ee6309a3f9c9/Concussion-Guidance-August-2024.pdf
World Rugby Passport. Activate, Injury Prevention and Risk Management. https://passport.world.rugby/injury-prevention-and-risk-management/activate/
World Rugby Passport. First Aid in Rugby, Chapter 5: Neck and spinal injuries in Rugby Union. https://passport.world.rugby/player-welfare-medical/first-aid-in-rugby/chapter-5-neck-and-spinal-injuries-in-rugby-union/
World Rugby Passport. Immediate Care in Rugby, Spinal Injuries: recognition, assessment and management. https://passport.world.rugby/player-welfare-medical/immediate-care-in-rugby/spinal-injuries/recognition/
World Rugby Passport. Immediate Care in Rugby, Spinal Injuries: stingers. https://passport.world.rugby/player-welfare-medical/immediate-care-in-rugby/spinal-injuries/stingers/
NHS. Chest pain. Page last reviewed 8 August 2023. https://www.nhs.uk/symptoms/chest-pain/
NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/
NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
National Institute for Health and Care Excellence (NICE). Head injury: assessment and early management. NICE guideline NG232. 2023. https://www.nice.org.uk/guidance/ng232
NHS. Eye injuries. Page last reviewed 12 March 2026. https://www.nhs.uk/conditions/eye-injuries/
NHS. Broken or bruised ribs. Page last reviewed 10 January 2024. https://www.nhs.uk/conditions/broken-or-bruised-ribs/
NHS. Stomach ache. Page last reviewed 20 October 2026. https://www.nhs.uk/symptoms/stomach-ache/
NHS. Dislocated shoulder. Page last reviewed 16 September 2026. https://www.nhs.uk/conditions/dislocated-shoulder/
NHS. Knee pain. Page last reviewed 21 December 2023. https://www.nhs.uk/symptoms/knee-pain/
NHS. Sprains and strains. Page last reviewed 23 April 2024. https://www.nhs.uk/conditions/sprains-and-strains/
NHS. Back pain. Page last reviewed 5 March 2026. https://www.nhs.uk/conditions/back-pain/
NHS. Sciatica. Page last reviewed 3 December 2024. https://www.nhs.uk/conditions/sciatica/
NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/

Written and checked by the PocketPhysio editorial team. Last updated 2026-11-06.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.