Differences in injury and concussion rates in a cohort of Canadian female and male youth Rugby Union: A step towards targeted prevention strategies

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

doi:10.1136/bjsports-2023-106929

Differences in injury and concussion rates in a cohort of Canadian female and male youth Rugby Union: A step towards targeted prevention strategies

Isla J. Shill, Stephen W. West, Stacy Sick, Kathryn J. Schneider, J. Preston Wiley, Brent E. Hagel, Amanda M. Black, Carolyn A. Emery

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Abstract

Objective: To examine differences in match and training musculoskeletal injury and concussion rates and describe mechanisms of concussion while considering previous playing experience in female and male Canadian high school Rugby Union ('rugby') players. Methods: A 2-year prospective cohort study was completed in a high school league (n=361 females, 421 player-seasons; n=429 males, 481 player-seasons) in Calgary, Canada over the 2018 and 2019 rugby playing seasons. Baseline testing was completed at the start of each season and injury surveillance and individual player participation through session attendance was documented to quantify individual-level player exposure hours. Injury incidence rates (IRs) and incidence rate ratios (IRRs) were calculated using Poisson regression, offset by player exposure hours and clustered by team. Results: Overall match IR for females was 62% higher than males (overall IRR=1.62, 95% CI: 1.20 to 2.18) and the overall training IR was twice as high for females (overall IRR=2.15, 95% CI: 1.40 to 3.32). The female match concussion IR was 70% higher than the males (concussion IRR=1.70, 95% CI: 1.08 to 2.69). Females had a 75% greater tackle-related IR compared with males (IRR=1.75, 95% CI: 1.20 to 2.56). Additionally, female tacklers had a twofold greater rate of injury compared with male tacklers (IRR=2.17, 95% CI: 1.14 to 4.14). Previous playing experience was not associated with tackle-related injury or concussion IRs. Conclusion: The rate of injury and concussion was significantly higher in females within this Canadian high school cohort. These results emphasise the need for development, implementation and evaluation of female-specific injury and concussion prevention strategies to reduce injury and concussion in female youth rugby.

Original language	English
Pages (from-to)	34-41
Journal	British Journal of Sports Medicine
Volume	58
Issue number	1
Early online date	20 Nov 2023
DOIs	https://doi.org/10.1136/bjsports-2023-106929
Publication status	Published - 15 Dec 2023

Bibliographical note

This work was supported by funds available from a Canadian Institute for Health Research Foundation Research Grant [C Emery PI - grant 375089]. Isla Shill was funded through the Hotchkiss Brain Institute and Joan Snyder. Stephen West holds a Canadian Institute of Health Research Postdoctoral Fellowship. Carolyn Emery holds a Canada Research Chair (Tier 1) in Concussion. Stephen West was funded through the O’Brien institute for Public Health and a Candian Institutes of Health Research Postdoctoral Fewllowship. Since completion of this study, CAE, SWW, IJS have received funding from World Rugby.

We do not have a data sharing agreement.

Funding

The Sport Injury Prevention Research Centre is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee. We acknowledge the funding from Canadian Institutes of Health Research, Alberta Innovates, Hotchkiss Brain Institute, Alberta Children’s Hospital Foundation and Joan Snyder. We would like to acknowledge the research coordinators, research assistants, school districts and all of teachers, coaches and students involved for their time and support in completing this project. This work was supported by funds available from a Canadian Institute for Health Research Foundation Research Grant (C Emery PI: grant 375089). IJS was funded through the Hotchkiss Brain Institute and Joan Snyder. SWW holds a Canadian Institute of Health Research Postdoctoral Fellowship. CE holds a Canada Research Chair (Tier 1) in Concussion. SWW was funded through the O’Brien institute for Public Health and a Candian Institutes of Health Research Postdoctoral Fewllowship. Since completion of this study, CE, SWW and IJS have received funding from World Rugby.

Funders	Funder number
Canadian Institute for Health Research Foundation	375089
O’Brien institute for Public Health
Canadian Institute of Health Research
Alberta Children's Hospital Foundation
Alberta Innovates

Keywords

adolescent
rugby
sporting injuries

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Orthopedics and Sports Medicine

Access to Document

10.1136/bjsports-2023-106929

Shill et al Significant difference in injury and concussion rates in female and male youth rugby_March 7 2023 BJSM submitted
This article has been accepted for publication in British Journal of Sports Medicine, 2023 following peer review, and the Version of Record can be accessed online at [insert full DOI eg. http://dx.doi.org/10.1136/bjsports-2023-106929. © Authors (or their employer(s))
Accepted author manuscript, 318 KBLicence: CC BY-NC

Cite this

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title = "Differences in injury and concussion rates in a cohort of Canadian female and male youth Rugby Union: A step towards targeted prevention strategies",

abstract = "Objective: To examine differences in match and training musculoskeletal injury and concussion rates and describe mechanisms of concussion while considering previous playing experience in female and male Canadian high school Rugby Union ('rugby') players. Methods: A 2-year prospective cohort study was completed in a high school league (n=361 females, 421 player-seasons; n=429 males, 481 player-seasons) in Calgary, Canada over the 2018 and 2019 rugby playing seasons. Baseline testing was completed at the start of each season and injury surveillance and individual player participation through session attendance was documented to quantify individual-level player exposure hours. Injury incidence rates (IRs) and incidence rate ratios (IRRs) were calculated using Poisson regression, offset by player exposure hours and clustered by team. Results: Overall match IR for females was 62% higher than males (overall IRR=1.62, 95% CI: 1.20 to 2.18) and the overall training IR was twice as high for females (overall IRR=2.15, 95% CI: 1.40 to 3.32). The female match concussion IR was 70% higher than the males (concussion IRR=1.70, 95% CI: 1.08 to 2.69). Females had a 75% greater tackle-related IR compared with males (IRR=1.75, 95% CI: 1.20 to 2.56). Additionally, female tacklers had a twofold greater rate of injury compared with male tacklers (IRR=2.17, 95% CI: 1.14 to 4.14). Previous playing experience was not associated with tackle-related injury or concussion IRs. Conclusion: The rate of injury and concussion was significantly higher in females within this Canadian high school cohort. These results emphasise the need for development, implementation and evaluation of female-specific injury and concussion prevention strategies to reduce injury and concussion in female youth rugby.",

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note = "This work was supported by funds available from a Canadian Institute for Health Research Foundation Research Grant [C Emery PI - grant 375089]. Isla Shill was funded through the Hotchkiss Brain Institute and Joan Snyder. Stephen West holds a Canadian Institute of Health Research Postdoctoral Fellowship. Carolyn Emery holds a Canada Research Chair (Tier 1) in Concussion. Stephen West was funded through the O{\textquoteright}Brien institute for Public Health and a Candian Institutes of Health Research Postdoctoral Fewllowship. Since completion of this study, CAE, SWW, IJS have received funding from World Rugby. We do not have a data sharing agreement. ",

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AU - Shill, Isla J.

AU - West, Stephen W.

AU - Sick, Stacy

AU - Schneider, Kathryn J.

AU - Wiley, J. Preston

AU - Hagel, Brent E.

AU - Black, Amanda M.

AU - Emery, Carolyn A.

N1 - This work was supported by funds available from a Canadian Institute for Health Research Foundation Research Grant [C Emery PI - grant 375089]. Isla Shill was funded through the Hotchkiss Brain Institute and Joan Snyder. Stephen West holds a Canadian Institute of Health Research Postdoctoral Fellowship. Carolyn Emery holds a Canada Research Chair (Tier 1) in Concussion. Stephen West was funded through the O’Brien institute for Public Health and a Candian Institutes of Health Research Postdoctoral Fewllowship. Since completion of this study, CAE, SWW, IJS have received funding from World Rugby. We do not have a data sharing agreement.

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N2 - Objective: To examine differences in match and training musculoskeletal injury and concussion rates and describe mechanisms of concussion while considering previous playing experience in female and male Canadian high school Rugby Union ('rugby') players. Methods: A 2-year prospective cohort study was completed in a high school league (n=361 females, 421 player-seasons; n=429 males, 481 player-seasons) in Calgary, Canada over the 2018 and 2019 rugby playing seasons. Baseline testing was completed at the start of each season and injury surveillance and individual player participation through session attendance was documented to quantify individual-level player exposure hours. Injury incidence rates (IRs) and incidence rate ratios (IRRs) were calculated using Poisson regression, offset by player exposure hours and clustered by team. Results: Overall match IR for females was 62% higher than males (overall IRR=1.62, 95% CI: 1.20 to 2.18) and the overall training IR was twice as high for females (overall IRR=2.15, 95% CI: 1.40 to 3.32). The female match concussion IR was 70% higher than the males (concussion IRR=1.70, 95% CI: 1.08 to 2.69). Females had a 75% greater tackle-related IR compared with males (IRR=1.75, 95% CI: 1.20 to 2.56). Additionally, female tacklers had a twofold greater rate of injury compared with male tacklers (IRR=2.17, 95% CI: 1.14 to 4.14). Previous playing experience was not associated with tackle-related injury or concussion IRs. Conclusion: The rate of injury and concussion was significantly higher in females within this Canadian high school cohort. These results emphasise the need for development, implementation and evaluation of female-specific injury and concussion prevention strategies to reduce injury and concussion in female youth rugby.

AB - Objective: To examine differences in match and training musculoskeletal injury and concussion rates and describe mechanisms of concussion while considering previous playing experience in female and male Canadian high school Rugby Union ('rugby') players. Methods: A 2-year prospective cohort study was completed in a high school league (n=361 females, 421 player-seasons; n=429 males, 481 player-seasons) in Calgary, Canada over the 2018 and 2019 rugby playing seasons. Baseline testing was completed at the start of each season and injury surveillance and individual player participation through session attendance was documented to quantify individual-level player exposure hours. Injury incidence rates (IRs) and incidence rate ratios (IRRs) were calculated using Poisson regression, offset by player exposure hours and clustered by team. Results: Overall match IR for females was 62% higher than males (overall IRR=1.62, 95% CI: 1.20 to 2.18) and the overall training IR was twice as high for females (overall IRR=2.15, 95% CI: 1.40 to 3.32). The female match concussion IR was 70% higher than the males (concussion IRR=1.70, 95% CI: 1.08 to 2.69). Females had a 75% greater tackle-related IR compared with males (IRR=1.75, 95% CI: 1.20 to 2.56). Additionally, female tacklers had a twofold greater rate of injury compared with male tacklers (IRR=2.17, 95% CI: 1.14 to 4.14). Previous playing experience was not associated with tackle-related injury or concussion IRs. Conclusion: The rate of injury and concussion was significantly higher in females within this Canadian high school cohort. These results emphasise the need for development, implementation and evaluation of female-specific injury and concussion prevention strategies to reduce injury and concussion in female youth rugby.

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Differences in injury and concussion rates in a cohort of Canadian female and male youth Rugby Union: A step towards targeted prevention strategies

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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