Uncovering the realities of contact training and head impact exposure in professional rugby union

Abstract

Professional rugby union, a sport with an inherently high risk of injury, especially concussion, has recently seen significant evolution in its efforts towards minimising head injury. While considerable attention has been devoted to recognising, managing, and preventing concussions over the last decade, recent years have witnessed an expanded focus to encompass all significant head impacts, not solely those that manifest clinically. Contact training holds dual significance in these efforts, as it poses the highest risk for training injuries and is also where the risk of head impacts is greatest. Against this backdrop, this thesis aimed to unravel the intricacies of how professional rugby clubs manage contact training, understand the perceptions and knowledge of club staff and players towards head impact exposure and shape practical innovations for management in this area.

The first experimental study in this thesis (Chapter 2) investigated the impact of an extended period of restricted training and congested fixture schedule on injury risk, in response to season structure changes due to the Coronavirus pandemic. The findings in this chapter provided support for the importance of managing training load for injury reduction. With limited objective data on contact training and head acceleration events available to guide training prescription, it is likely that the perceptions of coaching, medical, conditioning and player stakeholders would influence practise. Chapter 3 explored these perceptions and shed light on the multifaceted and highly individualised nature of contact training within professional rugby clubs. It also exposed a considerable knowledge gap among club staff and players on what constitutes head acceleration events and how best to identify, manage, and mitigate these events.

Building on this need to better manage and monitor contact loads, Chapter 4 sought to describe the implementation of the World Rugby and International Rugby Players ‘Contact Load Guidelines’, and identify areas where efforts are required to advance contact load management. In Chapters 3 and 4, the need for standardised definitions of contact training were raised by participants, subsequently resulting in the production of such definitions in Chapter 5.

The recurring narrative in the thesis about the complexities of defining and documenting contact training within the rugby landscape guided Chapter 6, which aimed to investigate and compare contact training exposure data recorded using various established data capture methods. This study provided further support for the notion that contact training in a team is highly individualised and, despite the development of standardised definitions, individual interpretation continues to influence reporting. Thus, constant collaboration with end-users is crucial when collecting and interpreting subjectively captured data.

Weaving throughout all chapters of the thesis was a resounding need for objective data to inform on contact training and head acceleration events, with instrumented mouthguards (iMGs) emerging as a promising tool. The thesis culminated in the establishment of minimum performance specifications for iMG use in rugby (Chapter7). These specifications not only lay the groundwork for uniformity and consistency in the rapidly evolving landscape of iMG technology but are being enforced as the benchmark standards for the use of iMGs in rugby union by World Rugby(World Rugby, 2023a). Extending beyond technical specifications, this chapter offers practical considerations and insights for the successful implementation and uptake of this cutting-edge technology within the dynamic context of professional rugby. It recognises the need for strategic implementation initiatives to foster an understanding of the benefits and implications of iMGs across diverse stakeholder groups.

By navigating the intricacies of contact training, this thesis highlights knowledge gaps across all stakeholder groups and emphasises the importance of adopting an integrated knowledge translation approach (iKT) for future initiatives. While the thesis advocates for objective data from iMGs to inform and monitor contact load and head acceleration events, the nascent state of the technology, relatively limited knowledge on head acceleration events, and uncertainties regarding the optimal use of data from iMGs stress the necessity of close collaboration amongst researchers, manufacturers, and end-users to ensure successful implementation. Concurrently, in instances where subjective measures are employed, collaboration with stakeholders becomes pivotal to address the influence of individual perception in these measurements and facilitate accurate and consistent data collection.

Date of Award	13 Nov 2024
Original language	English
Awarding Institution	University of Bath
Supervisor	Keith Stokes (Supervisor) & Carly McKay (Supervisor)