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407 The relationship between neck strength and concussion in male professional rugby players
  1. Theo Farley1,2,
  2. Ed Barry1,
  3. Richard Sylvester1,
  4. Akbar De Medici1,
  5. Mathew Wilson1
  1. 1The Institute of Sport Exercise and Health, London, UK
  2. 2The English Institute of Sports, London, UK


Background Sports related concussion has become one of the highest burden injuries within professional and amateur sports. There is currently limited evidence as to the existence of modifiable intrinsic risk factors to concussion however lab and field based studies indicate that muscle function may be a significant factor in reducing an external force and therefore the head accelerations thought to lead to a concussive injury. To date only one study supports the association of neck strength and concussion incidence with no unique range known to be significant.

Objective To investigate whether neck strength is significantly associated with concussion incidence in a group of male professional rugby players.

Design Prospective cohort study

Setting Conducted in a National Rugby base on 225 elite rugby union club players, during the 2018–2019 season.

Interventions Athletes were assessed for neck strength at three time points throughout the season using a method of self-resisted isometric contraction.

Main Outcome Measurements Associations with diagnosed concussion injuries are presented as Incidence Rate Ratios (IRR) with 95% confidence intervals. we present the IRR for a 10% increase in each variableand compared results against concussion using match minutes to allow for risk exposure.

Results A 10% increase in extension strength was associated with a 13% decrease in concussion risk.

A neck extension strength score of 41.2kg or below indicated athletes most at risk of sustaining a concussion with a true positive rate of 71.4% and a false positive rate of 46.1%

Conclusions To our knowledge this is the first study to demonstrate a unique strength range associated with concussion and to identify a minimum strength score associated with a quantifiable risk. Neck extension strength is a modifiable intrinsic risk factor to concussion in professional male rugby players and may be considered as part of a pre-season strength and conditioning regime.

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