Globally, over three million women participate in rugby union, yet injury prevention and training strategies are predominantly based on androcentric data. These strategies may have limited generalisability to females, given the cervical spine is more susceptible to whiplash and less adept at resisting inertial loading. A total of 53 university rugby union players (25 female, 28 male, 20.7±1.8 years) had their isometric neck strength measured. Bespoke instrumented mouthguards were used to record the magnitude of head impact events in six female and seven male competitive matches. Mean female maximal isometric neck strength was 47% lower than male. Independent samples Mann-Whitney U tests showed no significant differences for peak linear head acceleration (female: median 11.7 g, IQR 7.9 g; male: median 12.5 g, IQR 7.0 g p=0.23) or peak rotational head acceleration (female: median 800.2 rad•s -2 , IQR 677.7 rad•s -2 ; male: median 849.4 rad•s -2 , IQR 479.8 rad•s -2 ; p=0.76), despite the mean male body mass being 24% greater than female. Coded video analysis revealed substantial differences in head-impact mechanisms; uncontrolled whiplash dominated >50% of all recorded female impact events and <0.5% in males. Direct head-to-ground impacts comprised 26.1% of female and 9.7% of male impacts, with whiplash occurring in 78.0% and 0.5%, respectively. Overall, the data provided in this study do not support the generalisation of male-derived training and injury-prevention data to female rugby athletes. These results suggest a considerable research effort is required to identify specific weakness of female rugby players and derive appropriate training, injury prevention and return to play protocols.

The purpose of this study was to determine and compare the efficacy of head impact measurements via an electronic sensor framework, embedded within a mouthguard, against an anthropometric testing device. Development of the former is in response to the growing issue of head impacts and concussion in rugby union. Testing was conducted in a vehicle safety laboratory using a standard impact protocol utilising the headforms of anthropometric testing devices. The headforms were subjected to controlled front and side impacts. For each impact, the linear acceleration and rotational velocity was measured over a 104-ms interval at a frequency of 1 kHz. The magnitude of peak linear acceleration and peak rotational velocity was determined from the measured time-series traces and statistically compared. The peak linear acceleration and rotational velocity had intraclass correlation coefficients of 0.95 and 0.99, respectively. The root-mean-square error between the measurement systems was 4.3 g with a standard deviation of 3.5 g for peak linear acceleration and 0.7 rad/s with a standard deviation of 0.4 rad/s for rotational velocity. Bland and Altman analysis indicated a systematic bias of 2.5 g and − 0.5 rad/s and limits of agreement (1.96 × standard deviation) of ± 13.1 g and ± 1.25 rad/s for the instrumented mouthguard. These results provide the basis on which the instrumented mouthguard can be further developed for deployment and application within professional rugby, with a view to accurately and reliably quantify head collision dynamics.

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