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ObjectiveTo identify risk factors for head impact events (HIEs) during tackles in rugby league.DesignProspective cohort study.SettingTwo seasons (2017 – 2018) of the Australian National Rugby League (NRL).ParticipantsAll tackles causing HIEs (n = 716) were analyzed. A control group comprised 5,964 tackles that did not cause an HIE.Assessment of Risk FactorsThe role of the players involved in the tackle (tackler vs ball carrier), the speed of the defensive line, and each player’s body position were variables of interest.Outcome MeasuresThe propensity of each risk factor to cause an HIE was calculated as HIEs per 1,000 such occurrences. Incident Rate Ratios (IRR) compared the propensity of variables within a risk factor category.Main ResultsTacklers were significantly more likely to sustain HIEs than ball carriers (1.57 HIEs per 1000 tackles vs 0.93 HIEs per 1000 tackles, IRR 1.69 (95% CI 1.45 – 1.97). High defensive line speed was 1.41 times more likely to result in an HIE than low defensive line speed (2.87 HIEs per 1000 high line speed vs 2.03 HIEs per 1000 low line speed events). HIE propensity was greatest when tacklers were upright (IRR 3.11, 95% CI 2.60 to 3.73 for upright vs bent tacklers, respectively).ConclusionsReducing the defensive line speed and encouraging bent at the waist tacklers are two intervention strategies that may reduce the number of head impact events in Rugby League. These findings of this study are consistent with a similar study conducted in professional rugby union.

ObjectivesThe tackle is responsible for the majority of head injuries during rugby union. In order to address head injury risk, risk factors during the tackle must first be identified. This study analysed tackle characteristics in the professional game in order to inform potential interventions.Methods464 tackles resulting in a head injury assessment (HIA) were analysed in detail, with tackle type, direction, speed, acceleration, nature of head contact and player body position the characteristics of interest.ResultsPropensity to cause an HIA was significantly greater for active shoulder tackles, front-on tackles, high speeder tackles and an accelerating tackler. Head contact between a tackler’s head and ball carrier’s head or shoulder was significantly more likely to cause an HIA than contact below the level of the shoulder (incident rate ratio (IRR) 4.25, 95%–CI 3.38 to 5.35). The tackler experiences the majority (78%) of HIAs when head-to-head contact occurs. An upright tackler was 1.5 times more likely to experience an HIA than a bent at the waist tackler (IRR 1.44, 95% CI 1.18 to 1.76).ConclusionsThis study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers. To this end, World Rugby has implemented law change based on the present data.

Using an expert consensus-based approach, a rugby union Video Analysis Consensus (RUVAC) group was formed to develop a framework for video analysis research in rugby union. The aim of the framework is to improve the consistency of video analysis work in rugby union and help enhance the overall quality of future research in the sport. To reach consensus, a systematic review and Delphi method study design was used. After a systematic search of the literature, 17 articles were used to develop the final framework that described and defined key actions and events in rugby union (rugby). Thereafter, a group of researchers and practitioners with experience and expertise in rugby video analysis formed the RUVAC group. Each member of the group examined the framework of descriptors and definitions and rated their level of agreement on a 5-point agreement Likert scale (1: strongly disagree; 2: disagree; 3: neither agree or disagree; 4: agree; 5: strongly agree). The mean rating of agreement on the five-point scale (1: strongly disagree; 5: strongly agree) was 4.6 (4.3–4.9), 4.6 (4.4–4.9), 4.7 (4.5–4.9), 4.8 (4.6–5.0) and 4.8 (4.6–5.0) for the tackle, ruck, scrum, line-out and maul, respectively. The RUVAC group recommends using this consensus as the starting framework when conducting rugby video analysis research. Which variables to use (if not all) depends on the objectives of the study. Furthermore, the intention of this consensus is to help integrate video data with other data (eg, injury surveillance).

ObjectivesTo evaluate prevention strategies, their unintended consequences and modifiable risk factors for sport-related concussion (SRC) and/or head impact risk.DesignThis systematic review and meta-analysis was registered on PROSPERO (CRD42019152982) and conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesEight databases (MEDLINE, CINAHL, APA PsycINFO, Cochrane (Systematic Review and Controlled Trails Registry), SPORTDiscus, EMBASE, ERIC0 were searched in October 2019 and updated in March 2022, and references searched from any identified systematic review.Eligibility criteriaStudy inclusion criteria were as follows: (1) original data human research studies, (2) investigated SRC or head impacts, (3) evaluated an SRC prevention intervention, unintended consequence or modifiable risk factor, (4) participants competing in any sport, (5) analytic study design, (6) systematic reviews and meta-analyses were included to identify original data manuscripts in reference search and (7) peer-reviewed. Exclusion criteria were as follows: (1) review articles, pre-experimental, ecological, case series or case studies and (2) not written in English.ResultsIn total, 220 studies were eligible for inclusion and 192 studies were included in the results based on methodological criteria as assessed through the Scottish Intercollegiate Guidelines Network high (‘++’) or acceptable (‘+’) quality. Evidence was available examining protective gear (eg, helmets, headgear, mouthguards) (n=39), policy and rule changes (n=38), training strategies (n=34), SRC management strategies (n=12), unintended consequences (n=5) and modifiable risk factors (n=64). Meta-analyses demonstrated a protective effect of mouthguards in collision sports (incidence rate ratio, IRR 0.74; 95% CI 0.64 to 0.89). Policy disallowing bodychecking in child and adolescent ice hockey was associated with a 58% lower concussion rate compared with bodychecking leagues (IRR 0.42; 95% CI 0.33 to 0.53), and evidence supports no unintended injury consequences of policy disallowing bodychecking. In American football, strategies limiting contact in practices were associated with a 64% lower practice-related concussion rate (IRR 0.36; 95% CI 0.16 to 0.80). Some evidence also supports up to 60% lower concussion rates with implementation of a neuromuscular training warm-up programme in rugby. More research examining potentially modifiable risk factors (eg, neck strength, optimal tackle technique) are needed to inform concussion prevention strategies.ConclusionsPolicy and rule modifications, personal protective equipment, and neuromuscular training strategies may help to prevent SRC.PROSPERO registration numberCRD42019152982.

Background/aimConcussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion.Methods182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional rugby union competitions. A variable selection process was undertaken to identify the most important variables for interpretation. A multivariate generalised linear model was used to model the association between retained variables and concussion risk. Magnitude-based inferences provided an interpretation of the real-world relevance of the outcomes.ResultsThe four retained variables were: accelerating player, tackler speed, head contact type and tackle type. Overall, 70% of concussions occurred to the tackler and 30% to the ball carrier. There was a higher risk of concussion if the tackler accelerated into the tackle (OR: 2.49, 95% CI 1.70 to 3.64) or the tackler was moving at high speed (OR: 2.64, 95% CI 1.92 to 3.63). Head contact with the opposing player’s head (OR: 39.9, 95% CI 22.2 to 71.1) resulted in a substantially greater risk of concussion compared with all other head contact locations.ConclusionsInterventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.

ObjectivesConcussion is the most common match injury in professional Rugby Union, accounting for 25% of match injuries. The primary prevention of head injuries requires that the injury mechanism be known so that interventions can be targeted to specifically overall incidence by focusing on characteristics with the greatest propensity to cause a head injury.Methods611 head injury assessment (HIA) events in professional Rugby Union over a 3-year period were analysed, with specific reference to match events, position, time and nature of head contact.Results464 (76%) of HIA events occur during tackles, with the tackler experiencing a significantly greater propensity for an HIA than the ball carrier (1.40 HIAs/1000 tackles for the tackler vs 0.54 HIAs/1000 tackles for the ball carrier, incidence rate ratio (IRR) 2.59). Propensity was significantly greater for backline players than forwards (IRR 1.54, 95% CI 1.28 to 1.84), but did not increase over the course of the match. Head to head contact accounted for the most tackler HIAs, with the greatest propensity.ConclusionsBy virtue of its high propensity and frequency, the tackle should be the focus for interventions that may include law change and technique education. A specific investigation of the characteristics of the tackle is warranted to refine the approach to preventative strategies.

This study tested the hypothesis that the increase in rating of perceived exertion (RPE) predicts the duration of exercise to exhaustion during exercise in hot conditions. Seven subjects performed five cycling trials in an environmental chamber at temperatures of 15°C (C) and 35°C (H). The cool trials were performed at intensities of 65 and 70% and the hot trials at 55, 60 and 65%. RPE, rectal and skin temperature were measured during trials. Duration to fatigue was significantly shorter in H65 and C70 than H60, C65 and H55 ( P  < 0.05). RPE rose linearly throughout each trial and the rate of increase in RPE was significantly faster in H65 and C70 than H55 ( P  < 0.05). There was an inverse linear relationship between trial duration and rate of increase in RPE ( r  = 0.83). Rectal temperature increased linearly throughout the trial and correlated significantly with RPE ( r  = 0.92). This study shows that the rate of increase in RPE predicts the duration of exercise to exhaustion at a constant power output in different environmental conditions.

Rugby‐style tackle techniques have been evaluated for a number of years and have traditionally focused on injury prevention and performance outcomes. Recent tackle technique research has increasingly been directed towards reduced head contact and reducing the risk for concussion. This video analysis study examined the association between the ball carrier's evasion technique and the tackler's head position and the risk for a Head Injury Assessment (HIA) in professional male rugby league players. Retrospective video analysis cohort study. Three seasons of National Rugby League (NRL) head injury assessment (HIA) events (n = 446) were retrospectively video coded. For comparison and the calculation of propensity, 5694 tackles that did not result in a head injury were also coded. In this study, the two variables of interest were the ball carrier's evasion technique and the tackler's head position. Propensity was calculated as HIAs per 1000 tackles. The results of this study demonstrate the highest proportion of HIAs occurred when ball carriers did not utilise an evasion strategy and when the tacklers positioned their head in front of the ball carrier, especially when combined with high‐risk evasion strategies such as jumping or shoulder charging. HIA prevention initiatives should consider tackle techniques that encourage tacklers to place their head beside the ball carrier and ball carrying strategies that utilise an evasion technique, such as twisting or bending the torso. Further tackle‐based research is required in female and youth players to evaluate whether the findings in elite male players generalise to other rugby league players. Highlights Ball carrier tackle evasion techniques appear to reduce risk of a Head Injury Assessment in professional male rugby league. Tackler head positioning to the side of the ball carrier reduces the risk of a Head Injury Assessment in professional male rugby league. A safer and more effective tackle is likely to be achieved with a ball carrier using an evasion technique and the tackler positioning their head outside of the ball carrier's body.

ObjectivesThis study analysed the overall sentiment of attitudes, opinions, views and emotions expressed in posts on X related to red-carded and yellow-carded tackles during the 2019 Rugby World Cup (RWC).MethodsSentiment analysis was conducted on posts on X about red or yellow cards issued at the 2019 RWC. Posts were classified as ‘agree’, ‘disagree’ and ‘neutral’. The frequency of posts, red cards, yellow cards, all injuries, tackle injuries and total number of tackles per match were also synced to the 45-match playing schedule.ResultsFive tackle-related red cards were issued during the 2019 RWC, and 15 tackle-related yellow cards, with 337 and 302 posts identified for each card decision, respectively. For red cards, 42% of posts (n=158/377) agreed with the referee’s decision, 19% (n=71/377) disagreed and 40% were neutral. For yellow cards, 24% (n=73/302) agreed with the referee’s decision, 33% (n=99/302) disagreed and 43% were neutral.ConclusionsFor red cards, posts were 2.2 times more likely to agree with the referee’s decision than disagree. Posts that agreed with a red card decision were also more likely to be shared (reposted) than posts that disagreed with a red card decision. In contrast, sentiments expressed for yellow card decisions were mixed. This may be related to interpreting the degree of danger and whether mitigation is applied. Within the ecosystem of rugby, sharing sentiments on social media plays a powerful role in creating a positive player welfare narrative.

ObjectivesTo examine the propensity of tackle height and the number of tacklers that result in head acceleration events (HAEs) in elite-level male and female rugby tackles.MethodsInstrumented mouthguard data were collected from women (n=67) and men (n=72) elite-level rugby players from five elite and three international teams. Peak linear acceleration and peak angular acceleration were extracted from HAEs. Propensities for HAEs at a range of thresholds were calculated as the proportion of tackles/carries that resulted in an HAE exceeding a given magnitude for coded tackle height (low, medium, high) and number of tacklers. Propensity ratios with 95% CIs were calculated for tackle heights and number of tacklers.ResultsHigh tackles had a 32.7 (95% CI=6.89 to 155.02) and 41.2 (95% CI=9.22 to 184.58) propensity ratio to cause ball carrier HAEs>30 g compared with medium tackles for men and women, respectively. Low tackles had a 2.6 (95% CI=1.91 to 3.42) and 5.3 (95% CI=3.28 to 8.53) propensity ratio to cause tackler HAEs>30 g compared with medium tackles for men and women, respectively. In men, multiple tacklers had a higher propensity ratio (6.1; 95% CI=3.71 to 9.93) than singular tacklers to cause ball carrier HAEs>30 g but a lower propensity ratio (0.4; 95% CI=0.29 to 0.56) to cause tackler HAEs>30 g. No significant differences were observed in female tacklers or carriers for singular or multiple tacklers.ConclusionTo limit HAE exposure, rule changes and coaching interventions that promote tacklers aiming for the torso (medium tackle) could be explored, along with changes to multiple tackler events in the male game.