It Takes Two to Tango: High Rates of Injury and Concussion in Ball Carriers and Tacklers in High School Boys' Rugby

Stephen W West; Isla J Shill; Stacy Sick; Kathryn J Schneider; James Preston WIley; Brent E Hagel; Carolyn A Emery; Amanda M Black

doi:10.1097/JSM.0000000000001118

It Takes Two to Tango: High Rates of Injury and Concussion in Ball Carriers and Tacklers in High School Boys' Rugby

Clin J Sport Med. 2023 Jan 12. doi: 10.1097/JSM.0000000000001118. Online ahead of print.

Authors

Stephen W West^{1

2}, Isla J Shill^{1

3}, Stacy Sick^{1

4}, Kathryn J Schneider^{1

3

4

5}, James Preston WIley^{1

4

6}, Brent E Hagel^{1

2

5

7

8}, Carolyn A Emery^{1

2

3

5

6

7

8}, Amanda M Black^{1

2

3

5}

Affiliations

¹ Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
² O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.
³ Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
⁴ Faculty of Kinesiology, University of Calgary Sport Medicine Centre, Calgary, Canada.
⁵ Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
⁶ McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
⁷ Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; and.
⁸ Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.

PMID: 36633403
DOI: 10.1097/JSM.0000000000001118

Abstract

Objective: To examine injury and concussion rates, mechanisms, locations, and types of injury in Canadian high school male rugby.

Design: Prospective cohort study.

Setting: High school male rugby.

Participants: A total of 429 high school players (2018: n = 225, 2019: n = 256) were recruited from 12 teams in 7 schools in Calgary, Canada.

Interventions: None.

Main outcome measures: Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, resulted in time loss and/or inability to complete a session. Concussion was defined as per the fifth Consensus on Concussion in Sport, and all players with a suspected concussion were referred to a study sport medicine physician.

Results: A total of 134 injuries were captured, leading to an injury incidence rate (IR) of 57.9/1000 hours [95% confidence intervals (CIs): 45.4-73.8]. Median time loss was 6 days (range: 0-90). Injuries to the head were the most common (40%), followed by shoulder (12%) and ankle (10%). The concussion IR was 22.0/1000 hours (95% CIs: 15.9-30.4), which was the most common injury type (38%), followed by sprain (20%) and strain (15%). Sixty-five percent of injuries occurred in the tackle (ball carrier 35%, tackler 30%) and 76% of concussions (ball carrier 41%, tackler 35%).

Conclusions: The rate of injury and concussion in Canadian youth high school male rugby is high, with tackle-related injuries and concussions the most common. Given this, there is a critical need for implementation of prevention strategies, in particular targeting concussion and the tackle event (eg, neuromuscular, tackle training, and law changes).