Differences in injury and concussion rates in a cohort of Canadian female and male youth Rugby Union: a step towards targeted prevention strategies

Assessing Head Acceleration Events in Female Community Rugby Union Players: A Cohort Study Using Instrumented Mouthguards

BACKGROUND

The rapid growth of women's rugby union has underscored the need for female-specific player welfare protocols, particularly regarding the risk of head injuries. Instrumented mouthguards (iMGs) play a vital role in gathering comprehensive data on head acceleration events (HAEs), including their frequency, magnitude, and spatial distribution during games and training. By doing so, iMGs offer valuable context for circumstances in women's matches that may increase player risk.

OBJECTIVES

The study aimed to contextualize HAEs in female community rugby players using instrumented mouthguards and video review.

METHODS

This prospective, observational cohort study involved 332 female rugby players across 38 matches and 80 training sessions during the 2021/2022 seasons. Players were representative of four playing grades: U13 (N = 9), U15 (N = 111), U19 (N = 95) and Premier women (N = 115). HAEs were recorded using boil-and-bite iMGs, with a single-axis recording threshold of 5 g. The incidence and prevalence of HAEs was expressed by grade, years of experience, playing positions, and session types (match or training). The effect of playing grade and previous playing experience on HAE propensity during tackles and rucks was also examined.

RESULTS

Throughout the study, 9151 iMG events over 5 g were recorded, with 80% verified for analysis. Overall, the incidence rate (IR) was highest for HAEs between 10 and 29 g, 12-18 times higher than the IR for > 30-g events. Premier grade players had the highest weekly HAE load (26.2 per player per week) and the highest prevalence of players (49%) exposed to events over 30 g. An inverse relationship was found between years of rugby experience and peak angular acceleration (PAA) in U13-U19 players (p = 0.002, 95% CI [47,177 rads/s2]), showing that more experienced school-age players had lower rotational acceleration during HAEs. However, propensity for HAEs in tackle events was highest in Premier players with > 9 years of experience compared with U13-U19 grade players with similar years of experience (RR = 1.21, 95% CI 1.06-1.37; p = 0.004). Ball carries consistently resulted in the highest propensity of events over 30 g, regardless of playing grade or experience.

CONCLUSIONS

This research presents unique information regarding head accelerations that occur during women's community rugby matches and practices. The results have significant implications for recognising populations that are at the highest risk of experiencing high cumulative and acute head accelerations. The findings may assist in managing training loads and instructing skill execution in high-risk activities, particularly for younger players who are new to the sport. Consideration of playing grade, experience, and contact phases is crucial for understanding head acceleration exposure and injury risk in female rugby players. These insights can inform injury prevention strategies.

An examination of social relations and concussion management via the blue card

Introduction

Initially developed by New Zealand Rugby in 2014, the Blue Card initiative in rugby enables match officials to remove athletes from play if they are suspected to have sustained a concussion. Considerable attention has been paid by sport and health advocates to the possibilities and limitations of this initiative in safeguarding athlete health. However, little if any attention has been paid to the well-being of those responsible for administering the Blue Card (i.e., match officials). The aim of this paper was to examine match officials' experiences with and perspectives on implementing the Blue Card initiative in Ontario, Canada, with focused attention on the tensions around their ability to manage games and participants (e.g., athletes, coaches) while attempting to safeguard athlete well-being.

Methods

Using Relational Coordination Theory (RCT) as a guiding framework and qualitative research method, we highlight the rich accounts of 19 match officials' perspectives and experiences regarding sport-related concussion (SRC) management and the Blue Card protocol.

Results

Four themes were derived from the data, reflecting latent assumptions embedded within the concussion management process, which include: assumptions of trust, respect, and cooperation; assumptions of shared responsibility; assumptions of shared understanding; and assumptions of harassment-free sport.

Discussion

Our findings emphasize the need to attend to social relations in concussion management and provide insight into match officials' fraught experiences on the frontlines of concussion management. We identify factors affecting match official well-being and provide considerations for concussion management initiatives designed to improve athlete safety, such as the Blue Card.