Tackling sport-related concussion: effectiveness of lowering the maximum legal height of the tackle in amateur male rugby – a cross-sectional analytical study

Abstract

ObjectiveRugby union (‘rugby’) is popular globally, with most of its participants being amateur. Concern regarding sport-related concussion (SRC) sustained during rugby is increasing. SRC occurs most frequently in the tackle, yet few interventions have aimed to mitigate this risk factor. This study investigated the influence of a lowered legal tackle height on SRC incidence in amateur rugby.DesignCross-sectional analytical study: 2018 (control—standard tackle height) and 2019 (intervention—lowered legal tackle height) seasons.SettingSouth African collegiate student rugby competition.ParticipantsBetween 800 and 900 male amateur student players (age: 20±1.6 years) in each year.InterventionMaximum legal tackle height lowered from line of the shoulder on the ball carrier to the line of the armpit.Outcome measuresNumber of overall (medical attention) and time-loss (≥1 day lost) injuries, head injuries and SRCs in 2018 and 2019 (dependent variables); events associated with injury incidents (independent variables).ResultsThere was no statistically significant difference in incidences of time-loss injuries (IRR: 0.79; 95% CI: 0.6 to 1.1; p=0.13), head injuries (IRR: 0.83; 95% CI: 0.5 to 1.3; p=0.42) and SRC (IRR: 0.69; 95% CI: 0.4 to 1.2; p=0.20). In 2018 and 2019, most time-loss head injuries (57%, n=43) and SRCs (55%, n=26) occurred during the tackle.ConclusionsDespite a trend towards reducing injuries, head injuries and SRC, lowering maximum legal tackle height to armpit level did not change SRC incidence in this amateur male rugby cohort. Most time-loss head injuries and SRCs occurred during the tackle. Further tackle-related interventions to reduce SRC incidence require investigation.

Stakeholder perceptions of a tackle law variation to reduce concussion incidence in community rugby union: A qualitative study

“…14,21,22 Another measure aimed at reducing the risk of concussion during the tackle was implementing a lowered maximum legal tackle height law variation trial (lowering the maximum legal tackle height from the ball carrier's shoulder level to armpit level). 23,24 These two studies, which are to date the only lowered maximum legal tackle height trials reported in professional and amateur rugby union, did not reduce the incidence of concussion in the studied cohorts. Despite being based on sound empirical evidence, 18 this intervention has not yielded a clear effect on concussion incidence, highlighting that implementing such a law variation trial is complex and involves various stakeholders.…”

Innovation in sport medicine and science: a global social network analysis of stakeholder collaboration in rugby union

“…For example, to enhance player welfare standards, Word Rugby operates an internal research programme. Some research they have undertaken recently includes trialling the use of tackle-law changes to reduce concussion risk,45 understanding the collision demands at different levels of play46 and examining World Rugby’s Head Injury Assessment protocol to strengthen diagnostic accuracy 41 47. Partnerships with sports governing bodies are desirable because they have the resources to implement innovation nationally and globally, for example, New Zealand Rugby and the Accident Compensation Corporation partnered together to develop and deliver RugbySmart: a Nationwide Sports Injury Prevention Programme in New Zealand 48.…”

Sanctioned illegal high tackles significantly increase concussion risk to both tacklers and ball carriers in elite men’s Rugby Union

“…In contrast, a study in amateur level players found that lowering the legal tackle height to the armpit resulted in fewer upright tackles, suggesting player behaviour change, but a non-significant reduction in concussion incidence. 18 19 …”