Compared to high-contact sports like rugby union and rugby league, touch rugby has a lower overall injury risk. Professional rugby union players experience injury incidences ranging from 35 to 123 per 1,000 player hours, with the 2019 Rugby World Cup reporting 79.4 injuries per 1,000 player match hours (Fuller et al., 2020). The most common injuries in rugby union include concussions and soft tissue injuries, whereas, in touch rugby, the injury incidence rate is 103.5 per 1,000 player match hours, albeit with lower severity (Cropper et al., 2019). These findings reinforce the relative safety of touch rugby in terms of catastrophic injuries. However, the high prevalence of injuries, particularly among adolescent female athletes, demands further investigation. Targeted research and prevention programs are necessary to ensure young players' long-term safety and well-being.

Although several studies have explored injury patterns in youth sports and contact rugby, research on injury prevention strategies for adolescent female touch rugby players remains limited. This study aims to fill this gap by addressing three key shortcomings in previous investigations:

Previous research has predominantly focused on injury rates in contact sports like rugby union and soccer, with male athletes being the primary subjects. Studies such as Palmer-Green et al. (2013) examined youth rugby injuries. However, they did not differentiate between contact and non-contact variations, making extracting sport-specific injury risks for touch rugby challenging. Similarly, Fuller et al. (2020) analyzed injuries in professional rugby tournaments but failed to include adolescent or female athletes, leading to a knowledge gap in gender-specific injury prevention strategies.

Most existing research categorizes touch rugby as a low-risk sport, leading to a lack of investigation into its specific injury mechanisms. However, studies on non-contact sports like basketball and volleyball reveal that sudden directional changes, sprinting, and repetitive movements contribute to muscular strains and ligament injuries (Balachandar et al., 2017). Gabriel et al. (2019) discussed the benefits of neuromuscular training for reducing injuries but did not apply their findings specifically to touch rugby. This study expands on such work by examining how movement patterns in touch rugby differ from other non-contact sports, thereby informing more precise injury prevention strategies.

Another critical research gap is the lack of data on surface-related injuries and overuse conditions in youth touch rugby. Research by Meyers (2017) highlights how artificial turf increases frictional forces, leading to higher lower limb injury rates.

While this has been examined in professional and amateur rugby settings, few studies have assessed how different playing surfaces impact adolescent female athletes in touch rugby. Furthermore, previous studies rarely account for cumulative fatigue and overuse injuries, which increase the risk of soft tissue damage and ligament strains in youth players (Ramachandran et al., 2024). By focusing specifically on adolescent female touch rugby players, this study bridges the gaps in gender-specific research, assesses injury risks beyond contact-related trauma, and evaluates how playing surfaces contribute to injury trends. This evidence will help develop sport-specific training interventions and policy recommendations, ensuring female athletes receive targeted injury prevention strategies based on their unique physiological and biomechanical needs.

Adolescence is a critical period of athletic development, during which rapid skeletal and muscular growth often leads to imbalances in strength and joint stability. These imbalances increase the risk of overuse injuries, ligament sprains, and muscle strains.

The findings of this study revealed that soft tissue injuries were the most common among adolescent female touch rugby players, aligning with prior research linking musculoskeletal imbalances to higher injury risks (Mancino et al., 2024). Since ligament structures remain relatively weak during growth spurts, adolescent athletes require targeted neuromuscular training programs to reduce injury risk and enhance joint stability. Beyond general growth-related factors, female athletes have unique biomechanical characteristics contributing to injury risk. These factors lead to a higher prevalence of knee injuries, ligament sprains, and joint instability, particularly in high-movement, non-contact sports such as touch rugby (Stevenson et al., 2015).

Early biomechanical training and movement correction can minimize injury risks and enhance long-term athletic performance. Coaches play a pivotal role in minimizing injuries by integrating structured warm-up routines, neuromuscular training, and progressive conditioning into training regimens. Evidence-based training methods, such as the FIFA 11+ Injury Prevention Program, have significantly reduced lower limb injuries in youth athletes (Hilska et al., 2021). Adapting such programs to touch rugby can help improve proprioception, agility, and movement efficiency, reducing the likelihood of non-contact injuries. Recommended training adaptations for coaches include Neuromuscular Training Warm-Ups, Strength and Stability Development, and Load Management and Recovery. Medical teams must establish efficient on-field injury response protocols and post-injury rehabilitation strategies to ensure safe return-to-play procedures. While these methods aid in acute injury management, a more comprehensive rehabilitation approach is necessary to prevent recurring injuries (Hansrani et al., 2015).

Governing bodies must enforce regulations prioritizing player safety, including standardized playing surfaces, coach education programs, and mandatory injury prevention training. The AGTR 2024 findings suggest that synthetic turf contributed to increased friction-related injuries, emphasizing the need for surface regulation policies. Policy Recommendations for Sports Organizations:

Conduct routine inspections of synthetic and natural turf fields to ensure they meet safety standards. Provide footwear guidelines to reduce friction-related injuries on artificial surfaces (Meyers, 2017).

Mandatory Neuromuscular Training for Coaches and Athletes:

Implement a nationwide requirement for structured warm-up programs (e.g., FIFA 11+ adapted for touch rugby). Offer certification courses for coaches on injury prevention techniques (Richmond et al., 2020).

Implementation of Gender-Specific Training Considerations:

Introduce ACL prevention programs focusing on knee stabilization and hamstring activation (Mancino et al., 2024). Develop youth-specific training programs that address neuromuscular differences between male and female athletes.

Injury Reporting and Surveillance Systems:

Establish a nationwide injury reporting platform to monitor touch rugby injuries across different tournaments. Utilize data from the AGTR 2024 to refine prevention strategies and adjust training methodologies.

By integrating policy-driven safety measures, sports organizations can foster a safer playing environment while ensuring sustainable participation in touch rugby. The research questions guiding this study are:

What are the most common injuries sustained during the All-Girls Touch Rugby Championship (AGTR) 2024?

How effective are the on-field medical treatments in managing injuries during the tournament?

What preventive strategies can be proposed to reduce injury occurrences in future touch rugby events?

This study employed a retrospective observational design to examine injury patterns among adolescent female athletes during the All-Girls Touch Rugby Championship 2024 (AGTR 2024). The primary objective was to analyze the types, frequencies, and management strategies of injuries sustained throughout the tournament, offering insights into evidence-based prevention strategies. Retrospective observational studies are widely recognized in sports injury research as they systematically identify risk factors and injury trends in competitive environments (Emery & Pasanen, 2019). The AGTR 2024 study focused on female athletes aged 9 to 18, with 484 players competing over a two-day tournament in the Universiti Putra Malaysia rugby field. Medical personnel systematically recorded injury occurrences and treatment interventions, ensuring accuracy and consistency in data collection. This age range was deliberately chosen due to the unique physiological, neuromuscular, and developmental changes occurring during adolescence. This period is marked by rapid growth, evolving motor skills, and increased injury susceptibility, making it a crucial stage for understanding injury risk and implementing early prevention measures.

Only medical records from certified on-site healthcare professionals were utilized to ensure data accuracy and reliability. This methodological approach aligns with best practices in sports injury surveillance research, emphasizing systematic data collection, standardized injury classification, and rigorous analysis to ensure valid and reliable findings (Fuller et al., 2006; Kerr et al., 2018; McGuine et al., 2017). Ethical considerations were strictly adhered to, with all personal identifiers removed to maintain confidentiality and compliance with research ethics standards (Harmon et al., 2019).

The researcher used a semi-structured interview guide to collect data. To generate the a priori codes, the interview guide was developed using the notion layers of human experience. Before the in-person or face-to-face one-on-one interview took place, the interview questions were given to the ethics board for approval after being presented to the reading committee members. After collecting all the responses, the coding method was used to analyze the results.

Medical personnel systematically recorded injury occurrences and treatment interventions throughout the two-day tournament to ensure a comprehensive and accurate dataset. The retrospective observational approach allowed for detailed extraction of medical data, including:

To facilitate comparative analysis with previous studies on youth sports injuries, injuries were classified into three main categories (Emery & Pasanen, 2019; Vijam et al., 2015):

Superficial skin injuries caused by falls or contact with synthetic turf. It is common in sports played on artificial surfaces due to friction and impact (Meyers, 2017).

Includes muscle strains, contusions, and ligament micro-tears. It often results from rapid decelerations and sudden directional changes. Studies indicate that poor neuromuscular control and fatigue increase the likelihood of these injuries in adolescent athletes (Sañudo et al., 2019; Ramachandran et al., 2024).

Primarily affecting the ankle and knee, often due to improper landing mechanics and sharp pivoting movements. Research highlights that knee and ankle sprains are among the most common injuries in youth sports, particularly those requiring quick directional shifts (John et al., 2025; Davis et al., 2021).

By classifying injuries in this manner, the study provides a clearer understanding of injury patterns specific to touch rugby and identifies the most common mechanisms of injury. These findings form the basis for developing targeted prevention strategies to enhance safety and performance among adolescent female touch rugby players.

Descriptive statistical methods were applied to determine the frequency and distribution of injuries based on:

Age groups (10–14 years, 15–18 years).

Injury types (abrasions, soft tissue injuries, sprains).

Treatment modalities (ice therapy, bandaging, referrals for further care).

Statistical analysis focused on identifying age-related susceptibility to specific injuries and evaluating the effectiveness of on-field medical interventions. This approach is consistent with youth sports epidemiology research methodologies, emphasizing statistical modeling to detect injury trends and improve player safety (Bonato et al., 2018).

Across both days, a total of 24 injuries were reported. The breakdown of injuries by type is summarized in Table 2. Soft tissue injuries (STI) were the most frequent (50%), with a relatively even spread across both days. Abrasions and lacerations accounted for 16.7% of injuries, primarily occurring due to falls and surface contact. Sprains (12.5%) increased on Day 2, reflecting the higher match intensity and cumulative fatigue. Severe injuries (joint dislocations, cartilage damage) were only reported on Day 2, aligning with increased match demands.

This finding aligns with Faude et al. (2017), who identified soft tissue injuries as predominant in non-contact sports where players engage in frequent acceleration, deceleration, and pivoting. The high physical demands of touch rugby significantly strain muscles and joints, making athletes particularly susceptible to overuse injuries (Meyers, 2017). Repetitive muscle contractions and high-impact movements increase the likelihood of muscle fatigue, reducing joint stability and heightening the risk of strains and contusions. These results emphasize the need for structured strength training and flexibility programs to improve muscular resilience and prevent soft tissue damage.

Given these risks, surface safety regulations, improved footwear recommendations, and fall training techniques should be incorporated into injury prevention strategies. Sprains were exclusive to older players (15–18 years), increasing from Day 1 to Day 2. No 10–14-year-olds reported sprains, possibly because younger athletes generate less force and experience lower ligament strain. The findings are consistent with Franco et al. (2024), who reported that sports requiring frequent pivoting and abrupt stopping place significant strain on ligaments, leading to a high incidence of ankle and knee sprains. More severe injuries (joint dislocations, cartilage injuries) appeared only on Day 2 in 15–18-year-olds. These injuries were likely caused by repeated physical exertion and accumulated joint stress. Cramps and blisters only occurred on Day 2, suggesting hydration and muscle fatigue management should be improved as tournaments progress.

The age distribution of injuries revealed significant differences in vulnerability between younger (10–14 years) and older (15–18 years) athletes.

Younger athletes (10–14 years) sustained more injuries on Day 1 (55.6%) but fewer on Day 2 (40.0%) (Table 4), suggesting that early-match play and adapting to competitive intensity influenced their injury risk. Older athletes (15–18 years) saw a significant injury increase on Day 2 (125% rise), likely due to accumulated fatigue, higher physical demands, and more aggressive play. Younger players were more prone to abrasions, while older players had higher rates of soft tissue injuries, sprains, and joint injuries. As adolescent athletes mature, their training loads and physical demands increase, predisposing them to muscle strains, ligament sprains, and overuse injuries (Emery & Pasanen, 2019).

The high frequency of abrasions in 10–14-year-old players can be attributed to their developing motor coordination, balance, and body control. Research in youth sports suggests that children in this age group are still refining fundamental movement skills, which increases their risk of falling and suffering minor injuries (Emery & Pasanen, 2019). These findings also align with the work of Faude et al. (2017), who noted that younger athletes often lack refined movement patterns, increasing their susceptibility to surface-related injuries. Given these vulnerabilities, ensuring safe playing conditions and implementing skill-based training programs could significantly reduce the risk of abrasions in younger players.

Referring to Table 6, ice therapy remained the most common treatment (45.8%) across both age groups. Younger players had more ice therapy applications (60% on Day 1, 50% on Day 2), likely for abrasions and minor muscle strains. Among older players, ice therapy was used more for muscle fatigue and sprains but declined on Day 2 as other treatments (stretching, bandaging) were prioritized. These findings align with Crunkhorn et al. (2024), who emphasized the critical role of immediate cryotherapy in sports injury management. By constricting blood vessels and decreasing metabolic activity, ice therapy helps control swelling and prevent further damage, making it a cornerstone of early intervention in athletic injuries.

Bandaging increased in use on Day 2 across both age groups. This coincides with the rise in sprains and joint injuries among 15–18-year-olds, who needed joint stabilization and ligament support. Research by Hansrani et al. (2015) supports the effectiveness of compression techniques in sports medicine, noting that they help limit internal bleeding, reduce swelling, and provide structural support to weakened tissues. Given the agility-based demands of touch rugby, where rapid accelerations and sudden stops place significant stress on joints, applying bandaging as an immediate stabilization measure can be instrumental in preventing secondary injuries. However, while bandaging offers temporary support, injured athletes must undergo proper evaluation and follow structured rehabilitation programs to ensure complete recovery and avoid reinjury.

Dressing (wound care) was more common in younger players due to abrasions. No younger players required outpatient referrals, indicating their injuries were minor and surface-related. On-field stretching and oral rehydration solutions (ORS) were only introduced on Day 2 for older players. This correlates with increased cramps and muscle fatigue, reinforcing the need for hydration and endurance-based recovery methods in multi-day tournaments. Ngatuvai et al. (2021) emphasize that immediate professional intervention significantly reduces long-term recovery times, as early medical assessment can prevent the worsening of injuries and facilitate more effective rehabilitation planning. Given the growing participation of young female athletes in touch rugby, ensuring access to experienced sports medical personnel during tournaments is critical for injury risk mitigation and player safety. Outpatient referrals (8.3%) were necessary for severe cases, emphasizing the importance of having specialized medical personnel available during tournaments.

While this study provides valuable insights into injury prevalence and prevention strategies in adolescent touch rugby, several limitations should be acknowledged. One key limitation is the potential underreporting of minor injuries, as some players may not have sought medical attention for less severe conditions (Pennock et al., 2023). Additionally, this study was limited to short-term injury tracking, as it did not include follow-up data on recovery duration or long-term effects (McGuine et al., 2017). Environmental variability, such as differences in playing surface conditions and weather factors, may have also influenced injury occurrences, highlighting the need for further research into external factors affecting injury risk (Meyers, 2017).