High Concussion Rate in Student Community Rugby Union Players During the 2018 Season: Implications for Future Research Directions

Abstract

Collision sports, such as Rugby Union (“Rugby”) have a particularly high risk of injury. Of all injuries common to collision sports, concussions have received the most attention due to the potentially negative cognitive effects in the short- and long-term. Despite non-professional Rugby players comprising the majority of the world’s playing population, there is relatively little research in this population. Stellenbosch Rugby Football Club (“Maties”), the official rugby club of Stellenbosch University, represents one of the world’s largest non-professional Rugby clubs, making this an ideal cohort for community-level injury surveillance. The aim of this study was to describe the incidence and events associated with concussion in this cohort. Baseline demographics were obtained on the 807 male student Rugby non-professional players who registered for the 10-week long 2018 season, which comprised 101 matches and 2,915 of exposure hours. All match-related injuries were captured by the medical staff of Stellenbosch Campus Health Service on an electronic form developed from the consensus statement for injury recording in Rugby. The mean age, height and weight of this cohort were 20 ± 2 years, 182 ± 7 cm and 88 ± 14 kg, respectively. Overall, there were 89 time-loss injuries, which equated to an injury rate of 30.6 per 1,000 match hours [95% confidence intervals (CIs): 24.2–36.9], or about one injury per match. The most common injury diagnosis was “concussion” (n = 27 out of 90 injuries, 30%), at a rate of 9.3 per 1,000 match hours (95% CIs: 5.8–12.8). The three most common mechanisms of concussion in the present study were performing a tackle (33%), accidental collision (30%) and being tackled (11%). Concussion was the most common injury in this population, at a rate that was six times higher than the most comparable study from the UK, which had far more exposure time over six seasons and wider range of player ability, from recreational to semi-professional. This might be explained by the training and vigilance of the club’s first aiders observing all matches for concussion. Future studies should try to explain this high rate and subsequently reduce these concussions. The addition of video surveillance data would assist in identifying the etiology of these concussions injuries in order to develop specific targeted interventions.

Cumulative Sport-Related Injuries and Longer Term Impact in Retired Male Elite- and Amateur-Level Rugby Code Athletes and Non-contact Athletes: A Retrospective Study

“…The most frequently reported injury (total number of a given injury) was also concussion, followed by thumb sprain, and thigh contusion. This reflects recent injury surveillance data [7,20,21], and suggests that approximately 80% of rugby code players will experience at least one concussion at some point during their playing career, which, in the current study, spanned an average of 24-25 years. This is notably high in comparison to the data from earlier (pre-2005) injury surveillance studies [19,22].…”

“…Rugby code injury rates have been studied prospectively across different countries and levels [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In elite men's rugby union, pooled injury incidence has been reported at 81 injuries/1000 player match-hours [3], and at amateur level, 47 injuries/1000 player match-hours [6].…”

United States Under-19 Rugby-7s: Incidence and Nature of Match Injuries During a 5-year Epidemiological Study

“…These were also higher than a comparativeaged U.S. High School Rugby-15s (combined 15.8%; males 16.1%; females 14.3%) [17], international U18 Rugby-15s (9.3%) [29], and U20 Rugby-15s (4.7-12.5%) players [27,28]. These trends are a concern and need to be further evaluated with the literature documented high rates noted among student community rugby [26]. To note, Olympians in Rugby-7s encountering a concussion (7.1-12.5%) [6] were found at lower rates than U.S. Rugby-7s [2] and elite Rugby-7s (10.3-21.4%) [6].…”

“…The two popular formats of Rugby Union in the USA include Rugby-15s and Rugby-7s. Comparatively, there is more injury data on Rugby-15s among youths [17,18,20,26]. There is currently no injury information on Rugby-7s and the U19 population.…”

“…Recognition of concussions in U19 players, due to potential negative long-term effects, is a healthcare concern in adolescent rugby [26,38]. Therefore, the fluctuating duration of time to return to sport among participation levels is possibly due to variability in suggested rest periods for ages and return to sport, post a mild traumatic brain injury.…”