Does ball carrier technique influence tackler head injury assessment risk in elite rugby union?

'Mind your head', tackle characteristics associated with concussions in rugby league: A case-control study

OBJECTIVES

Identify tackle characteristics associated with concussions in male professional rugby league.

DESIGN

Case-control study.

METHODS

Tackles resulting in 196 clinically diagnosed concussions and 6592 non-concussive tackles were analysed, from the men's rugby league Super League between 2018 and 2022. Eleven tackle characteristics were coded for each tackle, and Firth penalised logistic regression models were employed to identify influential variables through forward stepwise selection. Three multivariate models were produced; all (i.e., ball-carrier and tackler), tackler, and ball-carrier concussions.

RESULTS

Of the 196 concussions, 70 % occurred to the tackler and 30 % to the ball-carrier. Initial impact location on the ball-carrier was identified as a predictor in all models, specifically the shorts, upper- and lower-leg (OR 9.1-12.3, compared to shoulder) for tacklers and head/neck (OR 66.1, compared to shoulder) for ball-carriers. Tackler head placement in front of the ball-carrier (OR 8.5, compared to away from the body) and a ball-carrier leading arm in any position (OR 4.8-22.1, compared to no leading arm) provided the greatest odds of a tackler concussion. For player's body position the greatest risk of concussion for all players was observed when both players were falling/diving (OR 8.8, compared to both players upright). One (OR 4.9, compared to two) and four (OR 3.7, compared to two) defender tackles provide the greatest odds for all concussions.

CONCLUSIONS

Concussion prevention strategies should aim to reduce head impacts by deterring initial contact with the ball-carrier's head/neck. Tackle technique should prioritise making initial impact with the torso and avoid the head being in front of the ball-carrier and any leading arms.

A case-control study of tackle based head impact event (HIE) risk factors from the first three seasons of the National Rugby League Women's competition

Objective

The tackle is the most injurious event in rugby league and carries the greatest risk of concussion. This study aims to replicate previous research conducted in professional men's rugby league by examining the association between selected tackle characteristics and head impact events (HIEs) in women's professional rugby league.

Methods

We reviewed and coded 83 tackles resulting in an HIE and every tackle (6,318 tackles) that did not result in an HIE for three seasons (2018-2020) of the National Rugby League Women's (NRLW) competition. Tackle height, body position of the tackler and ball carrier, as well as the location of head contact with the other player's body were evaluated. Propensity of each situation that caused an HIE was calculated as HIEs per 1,000 tackles.

Results

The propensity for tacklers to sustain an HIE was 6.60 per 1,000 tackles (95% CI: 4.87-8.92), similar to that of the ball carrier (6.13 per 1,000 tackles, 95% CI: 4.48-8.38). The greatest risk of an HIE to either the tackler or ball carrier occurred when head proximity was above the sternum (21.66 per 1,000 tackles, 95% CI: 16.55-28.35). HIEs were most common following impacts between two heads (287.23 HIEs per 1,000 tackles, 95% CI: 196.98-418.84). The lowest propensity for both tackler (2.65 per 1,000 tackles, 95% CI: 0.85-8.20) and ball carrier HIEs (1.77 per 1,000 tackles, 95% CI: 0.44-7.06) occurred when the head was in proximity to the opponent's shoulder and arm. No body position (upright, bent or unbalanced/off feet) was associated with an increased propensity of HIE to either tackler or ball carrier.

Conclusions

In the NRLW competition, tacklers and ball carriers have a similar risk of sustaining an HIE during a tackle, differing from men's NRL players, where tacklers have a higher risk of HIEs. Further studies involving larger samples need to validate these findings. However, our results indicate that injury prevention initiatives in women's rugby league should focus on how the ball carrier engages in contact during the tackle as well as how the tackler executes the tackle.

A Case-Control Study of Tackle-Based Head Injury Assessment (HIA) Risk Factors in the National Rugby League

Background

The tackle is the in-game activity carrying the greatest risk for concussion in rugby. A recent evaluation of tackle characteristics in rugby union precipitated a rule modification to reduce head impact risk during tackles. This study aims to replicate the work conducted in rugby union by examining the association between tackle characteristics and head injury events in professional rugby league.

Methods

There were 446 tackles resulting in a head injury assessment (HIA) and 5,694 tackles that did not result in a head injury from two National Rugby League (NRL) seasons that were reviewed and coded. Tackle height, body position of players, and contact area on an opponent’s body were evaluated, with the propensity of each situation to cause an HIA calculated as HIAs per 1000 events.

Results

The propensity for tacklers to sustain a head injury was 0.99 HIAs per 1000 tackles, 1.74-fold greater than for the ball carrier (0.57 HIAs per 1000 tackles). There was a 3.2-fold higher risk for an HIA when the tackler was upright compared to bent-at-the-waist. The greatest risk of a tackler HIA occurred when head contact was very low (knee, boot) or high (head and elbow). HIAs were most common following head-to-head impacts. The lowest propensity for tackler HIA was found when the tackler’s head was in proximity with the ball carrier’s torso.

Conclusions

The result of this study replicated the findings in professional rugby union. This has implications for the injury prevention initiatives implemented to reduce HIA risk because the majority of injuries are sustained by the tackler.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-021-00377-9.

Tackler and ball-carrier technique during moderate and severe injuries (≥8 days lost) compared with player-matched and team-matched injury-free controls in Elite Rugby Union

OBJECTIVE

To analyse tackler and ball-carrier technical proficiency during moderate and severe contact injuries (≥8 days lost) in professional rugby union, and compare it with injury-free event-matched controls from the same player and from the same team.

METHODS

Technical proficiency for 74 (n=74) (moderate and severe; ≥8 days lost) tackler and ball-carrier injuries during The Currie Cup (2014-2018) and 623 matched non-injury events (253 own controls, 370 team controls) were examined through video analysis using a standardised list of technical criteria.

RESULTS

Mean technical proficiency score for injured tacklers during front-on tackles was 6.19/16 (arbitrary units (AU) 95% CI 4.89 to 7.48), which was significantly different to their own controls (8.90/16 AU, 95% CI 8.37 to 9.43, p<0.001, effect size (ES)=1.21, large) and team controls (9.93/16 AU, 95% CI 9.50 to 10.40, p<0.001, ES=1.71, large). Mean technical proficiency score for injured ball-carriers during front-on tackles was 5.60/14 AU (95% CI 4.65 to 6.55), which was significantly different to their own controls (8.08/14 AU, 95% CI 7.56 to 8.60, p<0.001, ES=1.16, moderate) and team controls (8.16/14 AU, 95% CI 7.75 to 8.57, p<0.001, ES=1.25, large).

CONCLUSION

For the tackler and ball-carrier, for both front-on and side-on/behind tackles, overall technical proficiency scores were significantly lower for the injury-causing event, when compared with the player's own injury-free tackles and the team's injury-free tackles. Through analysing player and team controls, player technique deficiencies for the injured player and player technique deficiencies that expose all players to injury were highlighted, which may inform injury prevention strategies and policies, and assist coaches in optimising training to reduce tackle injury risk.

How does the situation before a tackle influence a tackler's head placement in rugby union?: application of the decision tree analysis

Objectives

Tacklers need to decide where to place their head based on the evasive manoeuvres of the ball-carrier and positional relationship with the ball-carrier before tackle. Therefore, it is difficult for tacklers to improve incorrect head placement at the moment of contact. Moreover, the characteristics prior to tackle have a relationship with the tackler's head placement. However, how situations lead to incorrect head placement remains unknown. The aim of this study was to identify pre-contact situations that lead to incorrect head placement by using decision tree analysis.

Methods

Tackles leading to concussions were used to identify events that provoked injury using the video recordings of matches. Injury-free tackle was used as a control. All tackles were classified according to head placements and coded from seven pre-contact factors configured aspect of both tacklers and ball-carriers.

Results

Three situations that led to incorrect head placement were identified. Evasive manoeuvres implemented by the ball-carrier significantly contributed to the head placement at the time of contact.

Conclusion

Our findings suggest that tacklers should keep their heads up to identify the movements of the ball-carrier, which might lead to tackling the head on the correct side at the moment of tackling and decrease the risk of tackler-related concussions.

Trends in player body mass at men's and women's Rugby World Cups: a plateau in body mass and differences in emerging rugby nations

Objectives

This study assessed the mass of international rugby players in the men's and women's Rugby World Cups between 1991 and 2019. The objective was to quantify changes in mass of players by position, and to compare changes between men and women, and between established (Tier 1 (T1)) and emerging (Tier 2 (T2)) rugby nations.

Setting

Rugby World Cups from 1991 to 2019 for men's players and 2010 to 2017 for women's players.

Participants

4447 elite male and 958 elite female players.

Primary and secondary outcome measures

Player body mass, grouped as men and women, T1 and T2 nations, and by playing position, assessed over time.

Results

Men's player mass increased significantly between 1991 and 2019 (T1 overall 9.7% increase), but this increase occurred almost entirely up to 2011. Women's forwards mass increased by 4.8% in T1, with no changes in T2 or backs from either tier. Significant differences in mass were found between T1 and T2 forwards and backs for both men and women.

Conclusions

The body mass of men's players has stabilised after initial increases following professionalisation. Player body mass may be approaching a plateau, beyond which no further performance advantages occur. Changes to laws and tactical approaches by coaches may have contributed to this, by changing match demands on players, necessitating endurance, agility and speed. Trends in the evolution of T2 players suggest a barrier to identifying and developing heavy athletic players, and may require intervention to ensure competitive parity.

Lay of the land: narrative synthesis of tackle research in rugby union and rugby sevens

Objectives

The purpose of this review was to synthesise both injury prevention and performance tackle-related research to provide rugby stakeholders with information on tackle injury epidemiology, including tackle injury risk factors and performance determinants, and to discuss potential preventative measures.

Design

Systematic review and narrative synthesis.

Data sources

PubMed, Scopus and Web of Science.

Eligibility criteria

Limited to peer-reviewed English-only publications between January 1995 and October 2018.

Results

A total of 317 studies were identified, with 177 in rugby union and 13 were in rugby sevens. The tackle accounted for more than 50% of all injuries in rugby union and rugby sevens, both at the professional level and at the lower levels, with the rate of tackle injuries higher at the professional level (mean 32/1000 player-hours) compared with the lower levels (mean 17/1000 player-hours). A player’s tackle actions and technical ability were identified as major risk factors for injury and a key determinant of performance.

Summary/conclusion

Evidence-based education, progressive tackle technique training with a high potential to transfer and law changes have been proposed as key modifiers of player tackle actions and technical ability. Conceivably, all three modifiers working in unison (as opposed to separately) will have a higher potential at reducing tackle injury risk while enhancing performance. With the guidance of tackle injury and performance studies, as well as stakeholder engagement, experiential and explorative tackle research has the potential to inspire innovative injury prevention and performance strategies.

Predictive Capacity of the MADYMO Multibody Human Body Model Applied to Head Kinematics During Rugby Union Tackles

Multibody models have not yet been evaluated for reconstructing head kinematics during sports impacts. Accordingly, the goal of this study was to utilise whole-body motion data from twenty upper and mid/lower trunk rugby shoulder tackles recorded in a marker-based 3D motion analysis laboratory to assess the MADYMO human body passive ellipsoid model for head kinematic reconstruction. Head linear and angular velocity during the tackle for the multibody model predictions and 3D motion laboratory measures were recorded for the ball carrier. Examined were the linear and angular velocity, as well as the absolute and percentage differences. For upper trunk tackles, the median percentage error (with quartiles) for the MADYMO predictions were 10% (6% to 45%) and 23% (16% to 39%) for change in head linear and angular velocity, respectively. For mid/lower trunk tackles, the median percentage error (with quartiles) for the MADYMO predictions were 46% (33% to 63%) and 60% (53% to 123%) for change in head linear and angular velocity, respectively. In conclusion, the model is currently unsuitable for reconstruction of head kinematics during individual rugby union tackle cases.