Upper Limb Injuries In Irish Schoolboy Rugby Union

School Rugby in many countries is representative of a highly competitive, elite game yet, there is limited rigorous research into the potential risk of injury to the upper limb. The nature of the Rugby tackle coupled with the physical and skeletal immaturity of school age players may predispose this cohort to an increased risk of severe injury to the upper limb. PURPOSE: To characterize the incidence, mechanism and severity of upper limb injuries in Irish Schoolboy Rugby Union players. METHODS: Twenty three school Rugby teams were recruited across two seasons 2018-2020, representing a total of 665 players aged 17-19 yrs. Nature, location, mechanism, occurrence, severity of injury and playing position were recorded by a nominated ‘injury recorder’ onto a web-based injury recording system (IRISWeb). Final injury diagnoses were verified at return to play. A 24 hr time loss injury definition was utilised (per World Rugby consensus) for injury incidence calculations. RESULTS: Seventy-five match injuries and seven training injuries involved the upper limb, representing 36% of total injuries. The match injury incidence of upper limb injuries was 19.4 per 1,000 player hours (h). The most commonly reported upper limb injury was shoulder dislocations (4.4/1,000 h), also accounting for the most burdensome (296 days absence/1,000 h). The tackle event was responsible for 76% of all match upper limb injuries, while 51% of match upper limb injuries were severe quantified by days absent from play (>28 days). Forwards (13/1000 h) suffered twice as many upper limb injuries as backs (6.5/1000 h), while the largest percentage (41%) of upper limb injuries were sustained in the 3rd quarter. CONCLUSIONS: This study reports a notably higher upper limb injury incidence in school Rugby compared to the adult amateur and professional game. Forwards were at a higher risk of sustaining an upper limb injury which may be attributed to the greater physical forces typically experienced by forwards compared to backs. The incidence of severe injuries so early in a playing career is of particular concern. Thus, future research into potential risk factors and mechanisms of upper limb injuries in School Rugby is warranted, particularly to inform the development of appropriate education and injury risk reduction programmes.