Concussion in school rugby: new study evaluates risks

A new study by researchers from the South African Rugby Union and the University of Cape Town shows that while South African school rugby players suffer concussions more often than their professional counterparts, the rate of incidence of such sports injuries is similar to that observed in other countries.

First systematic study of its kind

The findings were published in the peer-reviewed Clinical Journal of Sports Medicine and should aid coaches in teaching young players how to reduce the impact of concussion-prone activities during matches.

Read: Rugby takes a huge toll on the spine

With its high intensity and frequency of physical contact, concussion injuries are common in rugby. School children engaged in the sport are believed to be particularly vulnerable to this risk because they have yet to develop the skills, cognitive abilities, mobility, co-ordination, strong neck muscles, skull thickness and head-to-body ratio which tend to offer grown-up players a greater degree of protection.

By evaluating the concussion injuries sustained by young rugby players who competed in the four annual South African Rugby Union Youth Week tournaments from 2011 to 2014, the scientists involved in the research conducted the first systematic study of its kind in South African youth rugby.

Here are the most important results:

  • Concussion accounted for 108 of the 875 injuries contracted by 837 players during the four tournaments which involved a grand total of 7,216 players and 531 matches. The researchers calculated an incidence rate of 6.8 concussions for every 1,000 player-match-hours across all age groups represented. This rate is higher than that reported for professional senior rugby players, but falls well within the range observed for youth rugby in other countries, including England and Australia, which extends from 1.8 to 10.5 incidents of concussion per 1,000 player-exposure-hours.

Read: New rugby scrum technique may be safer

  • Predictably, 62% of all concussions happened as a result of tackle situations, the most common contact events in rugby. Tacklers experienced concussions four times more often than the ball carriers who were being tackled.
  • Rucks had the second highest incidence of concussions (24%), involving players who were already in a ruck two-thirds of the time when compared to those entering a ruck.
  • Concussions were more common in the under-16 and under-13 age groups than they were in the under-18s, perhaps because younger kids are typically less skilled in the techniques involved in tackling an opponent.

Read: Preventing injuries on the rugby field

  • As may be expected, concussions tended to become more frequent as games progressed and as the tackle-counts of players rose while they were becoming increasingly fatigued. The study indicates that the incidence of concussion is significantly higher in the third and fourth quarters of youth rugby matches compared to the first quarter. Some 60% of all concussions occurred in the second half of matches.
  • As far as player positions are concerned, forwards were more concussion prone than backline players. Hookers, loose forwards and centres suffered from higher concussion incident rates than players in other positions, with scrumhalves experiencing the lowest rate at 1.9 concussions per 1,000 player-match-hours.
  • Concussions were more frequent in the 2014 tournament than in each of the previous three events, but the authors of the study suggest that this may reflect an increased awareness about concussion risks and better reporting of concussion injuries during matches. 

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