Musculoskeletal Health of Retired Rugby Players

Abstract

Currently active rugby players demonstrate greater bone density, lean mass and strength compared to other athletes. However, the longevity of these characteristics and the long term health of retired rugby players is not well understood. There exists a high injury toll in rugby, including concussion and the impact of these injuries in retirement is less well known.
In later life, as part of the ageing process, there is a loss of bone density, lean mass and muscle strength. It is not known if the benefits of sports participation, specifically rugby, are preserved in later life and whether the superiority in bone density and strength is present in retirement, following cessation of sports participation.
This research was performed as a cross-sectional study of 138 male participants. Retired rugby players (n=87; 46.1 ±10.5 y; 100 ±15.1 kg; 1.80 ±0.08 m) were from amateur and elite rugby union and rugby league codes. The non-rugby group (n=51; 49.7 ±14.4 y; 86.7 ±14.5 kg; 1.77 ±0.06 m) consisted of retired non-contact athletes (n=30) or those that had never taken part in organised sport (n=21). Participants completed a validated general health questionnaire and were subsequently invited to clinical testing. Basic anthropometry was performed followed by DXA scans of the whole body, both hips and lumbar spine. Balance was assessed using a force plate. A handgrip dynamometer was used to assess grip strength. All participants completed a bone-specific physical activity questionnaire to record past and current levels of physical activity.
Former elite rugby players demonstrated higher bone density (hip neck) than amateur rugby players (1.150 kgcm-2 vs. 1.060 kgcm-2, p = 0.03) and non-contact athletes (1.150 kgcm-2 vs. 1.032 kgcm-2p = 0.01). The elite group also had greater lean mass (71.6 kg vs. 65.2 kg, p=0.002) and strength (54.3 kg vs. 48.8 kg, p=0.038) compared to the amateur group and non-contact group. However, following adjustment of bone density scores for weight and age, there were no differences between groups. Furthermore, muscle quality was similar across all groups. No difference in balance performance were seen between groups.
The greater bone density, lean mass and strength of retired elite rugby players may represent a genetic influence providing an inherent advantage for rugby participation or the result of previous participation in a physical, contact sport such as rugby. However, the absence of a relationship between past physical activity and bone density suggests that current physical activity exerts more influence on current musculoskeletal health status. This highlights the importance of continued physical activity in retirement in order to offset the age-related decline in bone density, lean mass and strength.