Head impact prevention management plan announced for professional game

Written by Rugby Blindside

Player welfare is a buzz word in modern rugby. It’s something that had certainly been overlooked in the past. The ‘macho’ culture and image of rugby players has made way to a new culture that focuses heavily on safety and players’ health, during and after their career.

With this in mind, the Rugby Football Union (RFU), Premiership Rugby (PRL) and the Rugby Players’ Association (RPA) have announced an action plan aimed at reducing the exposure to head impacts and concussion risk within men’s and women’s elite rugby matches and training in England. The action plan sets out how science and technology is being used to evolve thinking to optimise player welfare and brain health for prospective, current and past players.

There has been extensive research looking at the correlation between head impacts and concussion risk. Regarding the research and plan Simon Kemp, RFU Medical Services Director said: “The RFU is fully committed to advancing our understanding of the short, medium and long-term consequences of head impacts and concussions so that we can ensure we can make continued improvements in player welfare.

“For many years we have been using science and technology to evolve our thinking to optimise player welfare for prospective, current and past players as demonstrated with the action plan we are setting out today. By refining our existing knowledge, for example around the head injury assessment and creating new knowledge, such as that from the saliva microRNA and BRAIN studies, we continue to enhance our understanding.”

As part of the investigation into head impact exposure a discovery research project was successfully conducted with Sports & Wellbeing Analytics (SWA) and Harlequins men’s and Bristol Bears women’s squads earlier this year. Players from both squads wore PROTECHT instrumented mouth guards with embedded accelerometers and gyroscopes, able to measure linear and rotational accelerations of the head, in matches and training.

This discovery study demonstrated the feasibility and value of instrumented mouth guards in describing the head impacts in matches and training and for the first time provided objective insights into the number and magnitude of head impacts associated with both match events and training activities in the elite English game.

A few of the findings were that male players experienced a higher volume of contacts in both training and competition than their female counterparts. The same was true of forwards who were exposed to greater volumes of contact than backs. Also, the ruck provided the biggest risk of head impact exposure in both training and competition and this is an area that will be the subject of further investigation and tackle height affected the intensity of the impact, with lower body tackles resulting in lower intensity impacts. 

The action plan also includes post-career brain health assessment and care for players. The Advanced BRAIN Health Clinic, due to start operations later in the year, will see the RFU and PRL partnering with independent clinical and academic experts Professor David Sharp and Dr Richard Sylvester. The specialist clinical service, which will run at the Institute of Sport, Exercise and Health (ISEH), it will provide the assessment and management of retired elite male and female rugby players between the ages of 30-55 who have concerns over their individual brain health.

This is a fantastic and much needed initiative especially as in recent years many retired international and professional rugby players have come forward with their diagnosis of long-term brain injuries. It should go without saying that the more that can be done to help prevent players developing long-term brain injuries after retiring the better. We must always remember that rugby is just a game, and although engrossing, it represents only a short period in a players lifetime.

Other initiatives will focus on the consistent application of the Head Contact Process by match officials, as well as the exploration of possible technical coaching interventions with the aim of seeing a change in player and coach behaviours.

A key outcome, which was evident in the 2020/21 Gallagher Premiership Rugby season, is that the focus by referees to issue red and yellow cards more accurately is contributing to what seems to be behavioural change by players. It’s reported that the data now suggests that dangerous tackle events are reducing.

Phil Winstanley, Rugby Director at Premiership Rugby, said “Premiership Rugby and all our clubs are united in our commitment to reduce exposure to head impacts and the risks of concussion. This is a game-wide issue and progress will be made through continued collaboration with stakeholders across rugby, both in England and the international game.

“Over the last decade, we have developed several initiatives to improve player welfare including having Hawkeye, head injury video reviewers in the stands and independent match day doctors at every game. Technology and understanding are at the centre of our initiatives and it’s important we continue to develop our understanding further allowing us to make player centred decisions, particularly linked to long term health.”

Whilst we can see that in-game punishments like yellow and red cards are working to reduce the amount of dangerous tackle events, post-game punishment is something that should be reviewed. This is a trial period for the game as a whole and it’s unfortunate for the current crop of players who will suffer and miss potentially life-changing and important games in their career in aid of changing behaviours. It could be seen as unfair for a player who has worked for years and years to get to the top of the game to then miss a final because of split-second decision that happened five weeks previously. Common sense needs to be used to ensure important moments in player’s careers aren’t missed for the sake of lessons learned.

Despite this, it’s great to see progress in player welfare and safety. The research being conducted is important and the results will help the game move forward in a safer manner. Of course there will be speed bumps along the road and initiatives will be needed to be tweaked and adapted but it seems like this is something that is heading in the right direction.