Sports Performance and Injury Epidemiology in Portuguese XV Rugby Union’s 2023 World Cup Preparation in a High-Altitude Center: A Cross-Sectional Study
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
% MV | Percentage of personal maximum velocity |
CK | Creatine Kinase |
CRP | C-reactive protein |
GPS | Global Positioning System |
HI | Number of accelerations of high intensity |
HSRD | High-Speed Running Distance |
IL-6 | Interleukin-6 |
LDH | Lactate Dehydrogenase |
MRI | Magnetic Resonance Imaging |
MV | Maximum Velocity |
PTX-3 | Pentraxin-3 |
RD | Running Distance |
RWC | Rugby World Cup |
References
- Brazier, J.; Antrobus, M.; Stebbings, G.K.; Day, S.H.; Callus, P.; Erskine, R.M.; Bennett, M.A.; Kilduff, L.P.; Williams, A.G. Anthropometric and Physiological Characteristics of Elite Male Rugby Athletes. J. Strength Cond. Res. 2020, 34, 1790–1801. [Google Scholar] [CrossRef] [PubMed]
- Ball, S.; Halaki, M.; Orr, R. Training Volume and Soft Tissue Injury in Professional and Non-Professional Rugby Union Players: A Systematic Review. Br. J. Sports Med. 2017, 51, 1012–1020. [Google Scholar] [CrossRef]
- Bitchell, C.L.; Mathema, P.; Moore, I.S. Four-Year Match Injury Surveillance in Male Welsh Professional Rugby Union Teams. Phys. Ther. Sport 2020, 42, 26–32. [Google Scholar] [CrossRef]
- Sanz-Matesanz, M.; González-Fernández, F.T.; Blanco-Luengo, D.; Martínez-Aranda, L.M. Optimising Sprint Performance in Rugby: Insights from a Systematic Review of Training Methods. J. Funct. Morphol. Kinesiol. 2025, 10, 51. [Google Scholar] [CrossRef]
- Ren, X.; Henry, M.; Boisbluche, S.; Philippe, K.; Demy, M.; Ding, S.; Prioux, J. Optimization of Training for Professional Rugby Union Players: Investigating the Impact of Different Small-Sided Games Models on GPS-Derived Performance Metrics. Front. Physiol. 2024, 15, 1339137. [Google Scholar] [CrossRef]
- Starling, L.T.; Lambert, M.I. Monitoring Rugby Players for Fitness and Fatigue: What Do Coaches Want? Int. J. Sports Physiol. Perform. 2018, 13, 777–782. [Google Scholar] [CrossRef]
- Padulo, J.; Iuliano, E.; Brisola, G.; Iacono, A.D.; Zagatto, A.M.; Lupo, C.; Fuglsang, T.; Ardigò, L.P.; Cular, D. Validity and Reliability of a Standalone Low-End 50-Hz GNSS Receiver during Running. Biol. Sport 2019, 36, 75–80. [Google Scholar] [CrossRef]
- Garrett, J.; Akyildiz, Z.; Leduc, C.; Van Den Hoek, D.; Manuel Clemente, F.; Ardigò, L.P. Peak Running Speed Can Be Used to Monitor Neuromuscular Fatigue from a Standardized Running Test in Team Sport Athletes. Res. Sports Med. 2023, 31, 319–330. [Google Scholar] [CrossRef] [PubMed]
- Pino-Ortega, J.; Rojas-Valverde, D.; Gómez-Carmona, C.D.; Rico-González, M. Training Design, Performance Analysis, and Talent Identification—A Systematic Review about the Most Relevant Variables through the Principal Component Analysis in Soccer, Basketball, and Rugby. Int. J. Environ. Res. Public Health 2021, 18, 2642. [Google Scholar] [CrossRef] [PubMed]
- Uusitalo, A.L.T. Overtraining: Making a Difficult Diagnosis and Implementing Targeted Treatment. Phys. Sportsmed. 2001, 29, 35–50. [Google Scholar] [CrossRef]
- Chavarro-Nieto, C.; Beaven, M.; Gill, N.; Hébert-Losier, K. Hamstrings Injury Incidence, Risk Factors, and Prevention in Rugby Union Players: A Systematic Review. Phys. Sportsmed. 2023, 51, 1–19. [Google Scholar] [CrossRef]
- Williams, S.; Robertson, C.; Starling, L.; McKay, C.; West, S.; Brown, J.; Stokes, K. Injuries in Elite Men’s Rugby Union: An Updated (2012–2020) Meta-Analysis of 11,620 Match and Training Injuries. Sports Med. 2022, 52, 1127–1140. [Google Scholar] [CrossRef] [PubMed]
- George, T.M.; Olsen, P.D.; Kimber, N.E.; Shearman, J.P.; Hamilton, J.G.; Hamlin, M.J. The Effect of Altitude and Travel on Rugby Union Performance: Analysis of the 2012 Super Rugby Competition. J. Strength Cond. Res. 2015, 29, 3360–3366. [Google Scholar] [CrossRef]
- Tan, L.; Li, Y.; Chen, H.; Lanzi, G.; Hu, X. Sleep at High Altitude: A Bibliometric Study and Visualization Analysis from 1992 to 2022. Heliyon 2024, 10, e23041. [Google Scholar] [CrossRef] [PubMed]
- Mayo, B.; Miles, C.; Sims, S.; Driller, M. The Effect of Resistance Training in a Hypoxic Chamber on Physical Performance in Elite Rugby Athletes. High Alt. Med. Biol. 2018, 19, 28–34. [Google Scholar] [CrossRef]
- Sinex, J.A.; Chapman, R.F. Hypoxic Training Methods for Improving Endurance Exercise Performance. J. Sport Health Sci. 2015, 4, 325–332. [Google Scholar] [CrossRef]
- Smith, M.H.; Sharkey, B.J. Altitude Training: Who Benefits? Phys. Sportsmed. 1984, 12, 48–62. [Google Scholar] [CrossRef]
- Roberts, S.; Trewartha, G.; Stokes, K. A Comparison of Time–Motion Analysis Methods for Field-Based Sports. Int. J. Sports Physiol. Perform. 2006, 1, 388–399. [Google Scholar] [CrossRef]
- Harper, D.J.; Carling, C.; Kiely, J. High-Intensity Acceleration and Deceleration Demands in Elite Team Sports Competitive Match Play: A Systematic Review and Meta-Analysis of Observational Studies. Sports Med. 2019, 49, 1923–1947. [Google Scholar] [CrossRef]
- Akenhead, R.; Nassis, G.P. Training Load and Player Monitoring in High-Level Football: Current Practice and Perceptions. Int. J. Sports Physiol. Perform. 2016, 11, 587–593. [Google Scholar] [CrossRef]
- McHugh, C.; Hind, K.; O’Halloran, A.; Davey, D.; Farrell, G.; Wilson, F. Body Mass and Body Composition Changes over 7 Years in a MaleProfessional Rugby Union Team. Int. J. Sports Med. 2021, 42, 1191–1198. [Google Scholar] [CrossRef] [PubMed]
- Smart, D.J.; Hopkins, W.G.; Gill, N.D. Differences and Changes in the Physical Characteristics of Professional and Amateur Rugby Union Players. J. Strength Cond. Res. 2013, 27, 3033–3044. [Google Scholar] [CrossRef]
- Sundaram, A.; Bokor, D.J.; Davidson, A.S. Rugby Union On-Field Position and Its Relationship to Shoulder Injury Leading to Anterior Reconstruction for Instability. J. Sci. Med. Sport 2011, 14, 111–114. [Google Scholar] [CrossRef]
- Williams, S.; Kay, E.; Bryan, R.; Lambert, M.; Cross, M.; West, S.W.; Kemp, S.; Stokes, K.A. The Influence of Match Exposure on Injury Risk in Elite Men’s Rugby Union. J. Sci. Med. Sport 2023, 26, 25–30. [Google Scholar] [CrossRef]
- Brooks, J.H.M.; Fuller, C.W.; Kemp, S.P.T.; Reddin, D.B. Epidemiology of Injuries in English Professional Rugby Union: Part 1 Match Injuries. Br. J. Sports Med. 2005, 39, 757–766. [Google Scholar] [CrossRef] [PubMed]
- Liu, H.; Garrett, W.E.; Moorman, C.T.; Yu, B. Injury Rate, Mechanism, and Risk Factors of Hamstring Strain Injuries in Sports: A Review of the Literature. J. Sport Health Sci. 2012, 1, 92–101. [Google Scholar] [CrossRef]
- West, S.W.; Williams, S.; Kemp, S.P.T.; Cross, M.J.; McKay, C.; Fuller, C.W.; Taylor, A.; Brooks, J.H.M.; Stokes, K.A. Patterns of Training Volume and Injury Risk in Elite Rugby Union: An Analysis of 1.5 Million Hours of Training Exposure over Eleven Seasons. J. Sports Sci. 2020, 38, 238–247. [Google Scholar] [CrossRef] [PubMed]
- Yu, B.; Liu, H.; Garrett, W.E. Mechanism of Hamstring Muscle Strain Injury in Sprinting. J. Sport Health Sci. 2017, 6, 130–132. [Google Scholar] [CrossRef]
- Stellingwerff, T.; Heikura, I.A.; Meeusen, R.; Bermon, S.; Seiler, S.; Mountjoy, M.L.; Burke, L.M. Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities. Sports Med. 2021, 51, 2251–2280. [Google Scholar] [CrossRef]
- Hendricks, S.; Till, K.; Brown, J.C.; Jones, B. Rugby Union Needs a Contact Skill-Training Programme. Br. J. Sports Med. 2017, 51, 829–830. [Google Scholar] [CrossRef]
- Leahy, T.M.; Kenny, I.C.; Campbell, M.J.; Warrington, G.D.; Purtill, H.; Cahalan, R.; Comyns, T.M.; Harrison, A.J.; Lyons, M.; Glynn, L.G.; et al. Injury Trends for School Rugby Union in Ireland: The Need for Position-Specific Injury-Prevention Programs. Sports Health Multidiscip. Approach 2023, 15, 131–141. [Google Scholar] [CrossRef] [PubMed]
- Hendricks, S.; Till, K.; Oliver, J.L.; Johnston, R.D.; Attwood, M.; Brown, J.; Drake, D.; MacLeod, S.; Mellalieu, S.D.; Treu, P.; et al. Technical Skill Training Framework and Skill Load Measurements for the Rugby Union Tackle. Strength Cond. J. 2018, 40, 44–59. [Google Scholar] [CrossRef]
- Hotfiel, T.; Freiwald, J.; Hoppe, M.; Lutter, C.; Forst, R.; Grim, C.; Bloch, W.; Hüttel, M.; Heiss, R. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz. Sportschaden 2018, 32, 243–250. [Google Scholar] [CrossRef] [PubMed]
Injury Severity | Cycle 1 | Cycle 2 | Delta | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | Total | Forwards | Backs | Total | Forwards | Backs | Total | ||||||||||
n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | |
Without Injury | 89 | 93.7 | 66 | 94.3 | 155 | 93.9 | 82 | 87.2 | 50 | 71.4 | 132 | 80.5 | −0.08 | −0.07 | −0.24 | −0.24 | −0.15 | −0.14 |
Minor injury | 1 | 1.1 | 4 | 5.7 | 5 | 3 | 6 | 6.4 | 18 | 25.7 | 24 | 14.6 | +5.00 | +4.82 | +3.50 | +3.51 | +3.80 | +3.87 |
Major Injury | 5 | 5.3 | 0 | 0 | 5 | 3 | 6 | 6.4 | 2 | 2.9 | 8 | 4.9 | +0.20 | +0.21 | - | - | +0.60 | +0.63 |
Total | 95 | 100 | 70 | 100 | 165 | 100 | 94 | 100 | 70 | 100 | 164 | 100 | −0.01 | 0 | 0 | 0 | −0.01 | 0 |
Injury Location | Cycle 1 | Cycle 2 | Delta | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | Total | Forwards | Backs | Total | Forwards | Backs | Total | ||||||||||
n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | |
Head/Face | 1 | 1.1 | 0 | 0 | 1 | 0.6 | - | - | - | - | - | - | - | - | - | - | - | - |
Hip/Groin | - | - | - | - | - | - | 4 | 4.3 | 0 | 0 | 4 | 2.4 | - | - | - | - | - | - |
Anterior Thigh | 0 | 0 | 2 | 2.9 | 2 | 1.2 | 0 | 0 | 5 | 7.1 | 5 | 3 | - | - | +1.5 | +1.4 | +1.5 | +1.5 |
Posterior Thigh | 0 | 0 | 2 | 2.9 | 2 | 1.2 | 0 | 0 | 7 | 10 | 7 | 4.3 | - | - | +2.5 | +2.4 | +2.5 | +2.6 |
Feet/Toes | 5 | 5.3 | 0 | 0 | 5 | 3 | 4 | 4.3 | 4 | 5.7 | 8 | 4.9 | −0.2 | −0.19 | - | - | +0.6 | +0.6 |
Leg | - | - | - | - | - | - | 4 | 4.3 | 0 | 0 | 4 | 2.4 | - | - | - | - | - | - |
Shoulder | - | - | - | - | - | - | 0 | 0 | 2 | 2.9 | 2 | 1.2 | - | - | - | - | - | - |
Infectious Disease | - | - | - | - | - | - | 0 | 0 | 2 | 2.9 | 2 | 1.2 | - | - | - | - | - | - |
Total | 95 | 100 | 70 | 100 | 165 | 100 | 94 | 100 | 70 | 100 | 164 | 100 | −0.01 | 0 | 0 | 0 | −0.01 | 0 |
Injury Type | Cycle 1 | Cycle 2 | Delta | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | Total | Forwards | Backs | Total | Forwards | Backs | Total | ||||||||||
n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | |
Soreness | 1 | 1.1 | 0 | 0 | 1 | 0.6 | 4 | 4.3 | 2 | 2.9 | 6 | 3.7 | +3.00 | +2.91 | - | - | +5.00 | +5.17 |
Muscle Tear/Muscle Strain | 0 | 0 | 4 | 5.7 | 4 | 2.4 | 0 | 0 | 12 | 17.1 | 12 | 7.3 | - | - | +2.00 | +2.00 | +2.00 | +2.04 |
Tendinopathy | 5 | 5.3 | 0 | 0 | 5 | 3 | 8 | 8.5 | 4 | 5.7 | 12 | 7.3 | +0.60 | +0.60 | - | - | +1.4 | +1.43 |
Infectious Disease | - | - | - | - | - | - | 0 | 0 | 2 | 2.9 | 2 | 1.2 | - | - | - | - | - | - |
Total | 95 | 100 | 70 | 100 | 165 | 100 | 94 | 100 | 70 | 100 | 164 | 100 | −0.01 | 0 | 0 | 0 | −0.01 | 0 |
GPS Indicators | Cycle 1 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | |||||||||
Mean | ±SD | Median | Min | Max | Mean | ±SD | Median | Min | Max | |
RD (m) | 1975.0 | 972.1 | 2047.9 | 348.6 | 3910.7 | 2573.9 | 971.4 | 2789.5 | 952.7 | 4144.8 |
HSRD (m) | 325.2 | 331.3 | 220.1 | 0.0 | 1340.0 | 667.1 | 438.3 | 548.68 | 8.5 | 1545.8 |
No. accels HI | 24.1 | 14.0 | 23.0 | 1.0 | 60.0 | 35.6 | 18.01 | 34 | 3.0 | 71.0 |
MV (km/h) | 23.3 | 3.0 | 23.8 | 16.3 | 29.8 | 26.8 | 2.042 | 26.833 | 18.7 | 31.5 |
% MV | 83.9 | 8.3 | 84.9 | 63.0 | 99.9 | 82.4 | 6.792 | 83.031 | 58.0 | 96.3 |
GPS Indicators | Cycle 2 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | |||||||||
Mean | ±SD | Median | Min | Max | Mean | ±SD | Median | Min | Max | |
RD (m) | 2419.0 | 1385.1 | 2350.4 | 0.0 | 5001.2 | 2998.4 | 3242.8 | 1589.0 | 0.0 | 5655.0 |
HSRD (m) | 360.3 | 366.6 | 203.7 | 0.0 | 1342.8 | 768.6 | 780.2 | 558.7 | 0.0 | 1871.2 |
No. accels HI | 31.6 | 21.2 | 28.0 | 0.0 | 92.0 | 46.0 | 52.0 | 32.0 | 0.0 | 104.0 |
MV (km/h) | 22.9 | 4.5 | 23.0 | 0.1 | 29.8 | 25.8 | 26.1 | 4.2 | 0.4 | 31.6 |
% MV | 81.9 | 15.2 | 84.3 | 0.4 | 100.2 | 79.2 | 81.4 | 13.4 | 1.2 | 95.1 |
GPS Indicators | Delta | ||||||||
---|---|---|---|---|---|---|---|---|---|
Forwards | Backs | ||||||||
Mean | Median | Min | Max | Mean | Median | Min | Max | p | |
RD (m) | +0.23 | +0.15 | −1.00 | +0.28 | +0.16 | −0.43 | −1.00 | +0.36 | 0.240 |
HSRD (m) | +0.11 | −0.07 | - | 0 | +0.15 | +0.02 | −1.00 | +0.21 | 0.815 |
No. accels HI | +0.31 | +0.21 | −1.00 | +0.53 | +0.29 | −0.06 | −1.00 | +0.47 | 0.142 |
MV (km/h) | −0.02 | −0.03 | −0.99 | 0 | −0.04 | −0.84 | −0.98 | 0 | 0.174 |
% MV | −0.02 | +0.01 | −0.99 | 0 | −0.04 | −0.84 | −0.98 | −0.01 | 0.679 |
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Braga, C.; Cruz-Ferreira, A.; Santiago, L.M. Sports Performance and Injury Epidemiology in Portuguese XV Rugby Union’s 2023 World Cup Preparation in a High-Altitude Center: A Cross-Sectional Study. J. Funct. Morphol. Kinesiol. 2025, 10, 332. https://doi.org/10.3390/jfmk10030332
Braga C, Cruz-Ferreira A, Santiago LM. Sports Performance and Injury Epidemiology in Portuguese XV Rugby Union’s 2023 World Cup Preparation in a High-Altitude Center: A Cross-Sectional Study. Journal of Functional Morphology and Kinesiology. 2025; 10(3):332. https://doi.org/10.3390/jfmk10030332
Chicago/Turabian StyleBraga, Carlos, António Cruz-Ferreira, and Luiz Miguel Santiago. 2025. "Sports Performance and Injury Epidemiology in Portuguese XV Rugby Union’s 2023 World Cup Preparation in a High-Altitude Center: A Cross-Sectional Study" Journal of Functional Morphology and Kinesiology 10, no. 3: 332. https://doi.org/10.3390/jfmk10030332
APA StyleBraga, C., Cruz-Ferreira, A., & Santiago, L. M. (2025). Sports Performance and Injury Epidemiology in Portuguese XV Rugby Union’s 2023 World Cup Preparation in a High-Altitude Center: A Cross-Sectional Study. Journal of Functional Morphology and Kinesiology, 10(3), 332. https://doi.org/10.3390/jfmk10030332