Liam Colbert

OBJECTIVES: To investigate whether lowering the legal tackle height from below the armpit to below the sternum influenced tackle behaviour, match events, suspected injury and concussion rates, and concussion-related tackle characteristics in adolescent female rugby union. DESIGN: Case-control video analysis of 49 matches across two seasons, before and after the law change. METHODS: Tackle behaviour, match events, and suspected concussion characteristics were compared between seasons. Associations between tackle characteristics and suspected concussion were assessed using 37 cases and 222 control tackles. RESULTS: Head-high tackles were 83% lower (incidence rate ratio 0.17, 95% confidence interval 0.09-0.34) and shoulder-to-armpit tackles 46% lower (incidence rate ratio 0.54, 95% confidence interval 0.40-0.72) after the law change. Offloads, penalties, and open-play kicks increased. Suspected injury rates were 27% lower (rate ratio 0.73, 95% confidence interval 0.53-0.90; p = 0.05). Tackle-related suspected concussion rates were unchanged (incidence rate ratio 0.94, 95% confidence interval 0.49-1.79; p = 0.85). Ruck-related suspected concussions were higher but based on small numbers (incidence rate ratio 9.83, 95% confidence interval 1.26-76.77; p = 0.03). High-intensity head contacts were strongly associated with suspected concussion (odds ratio 52.6, 95% confidence interval 9.2-301.3; p < 0.001), as was lower-leg versus torso or hip head contact (odds ratio 17.22, 95% confidence interval 2.85-103.97; p < 0.001). CONCLUSIONS: Lowering the legal tackle height changed tackle behaviour and was associated with lower overall suspected injury rates, but tackle-related suspected concussion rates and concussion-related tackle characteristics did not differ. Additional head-safe contact strategies may be required.

Background and aims Within adolescent female rugby union, various effective injury prevention strategies are available to players to mitigate injury. However, little is known regarding the players’ attitudes, beliefs and behaviours towards those strategies, as well as injuries. The primary aim of the study was to investigate the attitudes, beliefs, behaviours and injury-reporting behaviours of adolescent female rugby players regarding injury and injury prevention strategies. The secondary aim was to examine associations between individual factors (eg, player demographics) and injury-reporting behaviours. Methods Participants completed an online cross-sectional survey and were recruited from under-16 and under-18 rugby teams in schools/colleges, clubs and developing player pathway programmes in England. Results 1062 players were contacted to participate, 424 responded and 422 met the eligibility criteria; 79 participants had incomplete responses. 14% of players had not previously reported a suspected concussion to a coach/medical staff member, and 37% of players had previously not reported sustaining one or more musculoskeletal (MSK) injuries to a coach/medical staff member. Factors cited for non-disclosure of concussion and MSK injuries included not wanting to miss rugby sessions (43% and 39%) and not knowing that symptom(s) were related to an injury (11% and 17%). Players held positive attitudes, beliefs and behaviours towards injury and injury prevention, but their understanding of the effectiveness of protective equipment varied. Conclusion This study provides a greater understanding of adolescent female rugby players’ attitudes, beliefs and behaviours towards injury and injury prevention and aids in the development of effective injury prevention initiatives.