Epidemiology and Time-Loss Shoulder Injuries in Professional South African Rugby Players: A Prospective Study That Focuses on Real-Time Collision Data during a Tackle

Background: In rugby, the shoulder contributes to attack/defence during collisions, tackling, falling, scrummaging, and mauling. We investigated the frequency, tissue, and pathology type of shoulder injuries per player position among professional South African rugby players, and compared injury severity in the context of momentum, intensity, and collision variables. Methods: A prospective study collecting shoulder injury data of 80 male Super Rugby players (>18 years) over 4 seasons (2018-2021). Players wore a Catapult Evo GPS unit during training and match-play, recording performance variables and collision forces during injury. We collected tissue and pathology types of injury from players' medical files, clinical examinations, and special investigations. Results: Shoulder injuries contributed to 17% of all injuries, ranging from 2 to 34% per year. Forwards (63%) sustained most shoulder injuries, specifically locks (30%). Acromioclavicular (AC) joint (47%) was mostly involved, and ligament/joint capsule (65%) was the most common tissue type injured. Injuries with the highest average momentum resulted in players suffering minimal to mild severity injuries (1-7 days time-loss). Backs (631.15 kg center dot m/s) required less momentum than forwards (816.00 kg center dot m/s) to suffer injuries resulting in >28 days time-loss (p = 0.008). Backs encountered higher match intensity (67.76 m/min, p = 0.031) and highest average collisions (0.28/min) without suffering more severe (>28 days time-loss) injuries. Match intensity of >60 m/min resulted in more than 55% of shoulder injuries. Conclusion: One in six injuries in this cohort was shoulder-related. Forwards, specifically locks, sustained most shoulder injuries. The AC joint was the tissue type that mainly contributed. Backline players were involved in higher velocity contact, game intensity, and collision frequency but suffered fewer injuries. However, they required less momentum to sustain more severe injuries.