Objectives: To assess injury patterns and incidence in the Australian Wallabies rugby union players from 1994 to 2000. To compare these patterns and rates with those seen at other levels of play, and to see how they have changed since the beginning of the professional era.Methods: Prospective data were recorded from 1994 to 2000. All injuries to Australian Wallabies rugby union players were recorded by the team doctor. An injury was defined as one that forced a player to either leave the field or miss a subsequent game.Results: A total of 143 injuries were recorded from 91 matches. The overall injury rate was 69/1000 player hours of game play. The injury rates in the periods before (1994–1995) and after (1996–2000) the start of the professional era were 47/1000 player hours and 74/1000 player hours respectively. The lock was the most injured forward, and the number 10 the most injured back. Most injuries were soft tissue, closed injuries (55%), with the head being the most commonly injured region (25.1%). The phase of play responsible for most injuries was the tackle (58.7%). Injuries were more likely to occur in the second half of the game, specifically the third quarter (40%). The vast majority of injuries were acute (90%), with the remainder being either chronic or recurrent.Conclusions: Injury rate increases at higher levels of play in rugby union. Injury rates have increased in the professional era. Most injuries are now seen in the third quarter of the game, a finding that may reflect new substitution laws. There is a need for standardised collection of injury data in rugby union.

Padded headgear does not reduce the rate of head injury or concussion. The low compliance rates are a limitation. Although individuals may choose to wear padded headgear, the routine or mandatory use of protective headgear cannot be recommended.

Objectives: To study match injury patterns and incidence during the Rugby World Cup 2003 (RWC 2003); to compare these patterns and rates with comparative rugby injury data; and to assess differences between teams playing at different levels (eight finalists v 12 non-finalists). Methods: Data were collected prospectively during the tournament. All injuries were recorded by the 20 participating team physicians. These were submitted to the tournament medical officer. An injury was defined as an event which forced a player either to leave the field or to miss a subsequent game or both. Results: 189 injuries were recorded over 48 matches. This corresponds to 97.9 injuries per 1000 playerhours. Pool matches yielded a higher injury rate than non-pool matches. The 12 non-finalist teams sustained significantly higher injury rates than the eight finalist teams. The player positions open side flanker, inside centre, and number 8 were the most frequently injured positions. There was a low concussion rate, which may reflect under-reporting. The non-finalist teams had a higher rate of recurrent injury. Conclusions: The injury rate was higher than comparative data. Mismatches in the areas of skill, fitness, and the availability of resources for medical care of players may explain these differences.

Large rotator cuff tears are extremely uncommon in young people and when they occur they may be associated with shoulder instability. This paper reports on a series of six elite rugby union and rugby league footballers who presented with shoulder instability and large rotator cuff tears. They were treated with a two stage procedure: an open rotator cuff repair followed by an open shoulder stabilisation some 10 weeks later. All had successful outcomes. The paper also highlights the risk of tearing the rotator cuff when a patient continues to play contact sport with an untreated unstable shoulder.

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