Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention

Mily Spiegelhalter; Sean Scantlebury; Omar Heyward; Cameron Owen; James Brown; Sharief Hendricks; Susan H. Backhouse; Marelise Badenhorst; Stuart Barrow; Lucy Jane Chesson; Laura Fairbank; Andrew J. Gardner; Robert Hicks; Richard Johnston; Peter Mackreth; Gemma Phillips; Dave Rotheram; Anna Stodter; Keith A. Stokes; Kevin Till; Dane Vishnubala; Ben Jones

doi:10.1136/bjsports-2024-109048

Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention

Mily Spiegelhalter, Sean Scantlebury, Omar Heyward, Cameron Owen, James Brown, Sharief Hendricks, Susan H. Backhouse, Marelise Badenhorst, Stuart Barrow, Lucy Jane Chesson, Laura Fairbank, Andrew J. Gardner, Robert Hicks, Richard Johnston, Peter Mackreth, Gemma Phillips, Dave Rotheram, Anna Stodter, Keith A. Stokes, Kevin TillDane Vishnubala, Ben Jones

Research output: Contribution to journal › Article › peer-review

Abstract

Objective Within women’s rugby league (n=12 teams), we (1) identified modifiers for head-to-head contacts informed by sport partners (eg, players, coaches, match officials); (2) compared head-to-head contact and concussion rates to the previous two seasons following a one-season tackle technique coaching intervention and (3) explored barriers and enablers of the intervention. Methods A multi-method design was used. Part 1: Mitigation strategies were identified by sport partners reviewing footage of head-to-head contacts, informing the development of a coach-targeted tackle technique intervention. Part 2 evaluated the intervention, comparing head-to-head contact and concussion incidence rates (IRs). Interviews with coaches and players (n=6) explored barriers and enablers to effective implementation and compliance with the intervention. Results Sport partners reported tacklers were more responsible for head-to-head contacts and lowering the tackle height was the most frequently suggested mitigation strategy preintervention and postintervention. Head-to-head contact rates were significantly lower during the intervention than preintervention (IR 59; 95% CI 56 to 62 vs IR 28; 95% CI 25 to 30/1000 tackle events); however, concussion rates showed no difference. Perceived barriers to the intervention included underdeveloped physical and technical foundations of players, lack of knowledge and understanding of the intervention and its purpose, and the environmental context and lack of resources in women’s rugby league. Beliefs about the consequences of the tackle and concussion were perceived as barriers and enablers. Conclusions Head-to-head contact rates were significantly lower; however, concussion rates did not decrease following a tackle technique coaching intervention. Reduced head-to-head contacts are potentially due to an increased focus on head injury reduction and increased player/coach awareness and support.

Original language	English
Journal	British Journal of Sports Medicine
Early online date	31 Jul 2025
DOIs	https://doi.org/10.1136/bjsports-2024-109048
Publication status	E-pub ahead of print - 31 Jul 2025

Data Availability Statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Acknowledgements

The research team would like to acknowledge coaches, match officials and players for participating in the study. The research team would also like to acknowledge Matt Halkier, Matt Kitchin and Scott Mitchell for supporting the video analysis.

Funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not- for- profit sectors.

Keywords

Brain Concussion
Head
Rugby
Sporting injuries
Women in sport

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Orthopedics and Sports Medicine

Access to Document

10.1136/bjsports-2024-109048Licence: CC BY-NC

Cite this

Spiegelhalter, M., Scantlebury, S., Heyward, O., Owen, C., Brown, J., Hendricks, S., Backhouse, S. H., Badenhorst, M., Barrow, S., Chesson, L. J., Fairbank, L., Gardner, A. J., Hicks, R., Johnston, R., Mackreth, P., Phillips, G., Rotheram, D., Stodter, A., Stokes, K. A., ... Jones, B. (2025). Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention. British Journal of Sports Medicine. Advance online publication. https://doi.org/10.1136/bjsports-2024-109048

Spiegelhalter, M, Scantlebury, S, Heyward, O, Owen, C, Brown, J, Hendricks, S, Backhouse, SH, Badenhorst, M, Barrow, S, Chesson, LJ, Fairbank, L, Gardner, AJ, Hicks, R, Johnston, R, Mackreth, P, Phillips, G, Rotheram, D, Stodter, A, Stokes, KA, Till, K, Vishnubala, D & Jones, B 2025, 'Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention', British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2024-109048

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title = "Reduced head-to-head contact rates in elite-level women{\textquoteright}s rugby league following a season-long tackle technique coaching intervention",

abstract = "Objective Within women{\textquoteright}s rugby league (n=12 teams), we (1) identified modifiers for head-to-head contacts informed by sport partners (eg, players, coaches, match officials); (2) compared head-to-head contact and concussion rates to the previous two seasons following a one-season tackle technique coaching intervention and (3) explored barriers and enablers of the intervention. Methods A multi-method design was used. Part 1: Mitigation strategies were identified by sport partners reviewing footage of head-to-head contacts, informing the development of a coach-targeted tackle technique intervention. Part 2 evaluated the intervention, comparing head-to-head contact and concussion incidence rates (IRs). Interviews with coaches and players (n=6) explored barriers and enablers to effective implementation and compliance with the intervention. Results Sport partners reported tacklers were more responsible for head-to-head contacts and lowering the tackle height was the most frequently suggested mitigation strategy preintervention and postintervention. Head-to-head contact rates were significantly lower during the intervention than preintervention (IR 59; 95\% CI 56 to 62 vs IR 28; 95\% CI 25 to 30/1000 tackle events); however, concussion rates showed no difference. Perceived barriers to the intervention included underdeveloped physical and technical foundations of players, lack of knowledge and understanding of the intervention and its purpose, and the environmental context and lack of resources in women{\textquoteright}s rugby league. Beliefs about the consequences of the tackle and concussion were perceived as barriers and enablers. Conclusions Head-to-head contact rates were significantly lower; however, concussion rates did not decrease following a tackle technique coaching intervention. Reduced head-to-head contacts are potentially due to an increased focus on head injury reduction and increased player/coach awareness and support.",

keywords = "Brain Concussion, Head, Rugby, Sporting injuries, Women in sport",

author = "Mily Spiegelhalter and Sean Scantlebury and Omar Heyward and Cameron Owen and James Brown and Sharief Hendricks and Backhouse, \{Susan H.\} and Marelise Badenhorst and Stuart Barrow and Chesson, \{Lucy Jane\} and Laura Fairbank and Gardner, \{Andrew J.\} and Robert Hicks and Richard Johnston and Peter Mackreth and Gemma Phillips and Dave Rotheram and Anna Stodter and Stokes, \{Keith A.\} and Kevin Till and Dane Vishnubala and Ben Jones",

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T1 - Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention

AU - Spiegelhalter, Mily

AU - Scantlebury, Sean

AU - Heyward, Omar

AU - Owen, Cameron

AU - Brown, James

AU - Hendricks, Sharief

AU - Backhouse, Susan H.

AU - Badenhorst, Marelise

AU - Barrow, Stuart

AU - Chesson, Lucy Jane

AU - Fairbank, Laura

AU - Gardner, Andrew J.

AU - Hicks, Robert

AU - Johnston, Richard

AU - Mackreth, Peter

AU - Phillips, Gemma

AU - Rotheram, Dave

AU - Stodter, Anna

AU - Stokes, Keith A.

AU - Till, Kevin

AU - Vishnubala, Dane

AU - Jones, Ben

PY - 2025/7/31

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N2 - Objective Within women’s rugby league (n=12 teams), we (1) identified modifiers for head-to-head contacts informed by sport partners (eg, players, coaches, match officials); (2) compared head-to-head contact and concussion rates to the previous two seasons following a one-season tackle technique coaching intervention and (3) explored barriers and enablers of the intervention. Methods A multi-method design was used. Part 1: Mitigation strategies were identified by sport partners reviewing footage of head-to-head contacts, informing the development of a coach-targeted tackle technique intervention. Part 2 evaluated the intervention, comparing head-to-head contact and concussion incidence rates (IRs). Interviews with coaches and players (n=6) explored barriers and enablers to effective implementation and compliance with the intervention. Results Sport partners reported tacklers were more responsible for head-to-head contacts and lowering the tackle height was the most frequently suggested mitigation strategy preintervention and postintervention. Head-to-head contact rates were significantly lower during the intervention than preintervention (IR 59; 95% CI 56 to 62 vs IR 28; 95% CI 25 to 30/1000 tackle events); however, concussion rates showed no difference. Perceived barriers to the intervention included underdeveloped physical and technical foundations of players, lack of knowledge and understanding of the intervention and its purpose, and the environmental context and lack of resources in women’s rugby league. Beliefs about the consequences of the tackle and concussion were perceived as barriers and enablers. Conclusions Head-to-head contact rates were significantly lower; however, concussion rates did not decrease following a tackle technique coaching intervention. Reduced head-to-head contacts are potentially due to an increased focus on head injury reduction and increased player/coach awareness and support.

AB - Objective Within women’s rugby league (n=12 teams), we (1) identified modifiers for head-to-head contacts informed by sport partners (eg, players, coaches, match officials); (2) compared head-to-head contact and concussion rates to the previous two seasons following a one-season tackle technique coaching intervention and (3) explored barriers and enablers of the intervention. Methods A multi-method design was used. Part 1: Mitigation strategies were identified by sport partners reviewing footage of head-to-head contacts, informing the development of a coach-targeted tackle technique intervention. Part 2 evaluated the intervention, comparing head-to-head contact and concussion incidence rates (IRs). Interviews with coaches and players (n=6) explored barriers and enablers to effective implementation and compliance with the intervention. Results Sport partners reported tacklers were more responsible for head-to-head contacts and lowering the tackle height was the most frequently suggested mitigation strategy preintervention and postintervention. Head-to-head contact rates were significantly lower during the intervention than preintervention (IR 59; 95% CI 56 to 62 vs IR 28; 95% CI 25 to 30/1000 tackle events); however, concussion rates showed no difference. Perceived barriers to the intervention included underdeveloped physical and technical foundations of players, lack of knowledge and understanding of the intervention and its purpose, and the environmental context and lack of resources in women’s rugby league. Beliefs about the consequences of the tackle and concussion were perceived as barriers and enablers. Conclusions Head-to-head contact rates were significantly lower; however, concussion rates did not decrease following a tackle technique coaching intervention. Reduced head-to-head contacts are potentially due to an increased focus on head injury reduction and increased player/coach awareness and support.

KW - Brain Concussion

KW - Head

KW - Rugby

KW - Sporting injuries

KW - Women in sport

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ER -

Reduced head-to-head contact rates in elite-level women’s rugby league following a season-long tackle technique coaching intervention

Abstract

Data Availability Statement

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

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