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161 High concussion rate amongst South African university rugby student tournament
  1. James Craig Brown1,2,
  2. Lindsay Starling1,2,
  3. Keith Stokes3,4,
  4. Pierre Viviers1,2,
  5. Sean Surmon1,2,7,
  6. Keith Derman1,2
  1. 1Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa
  2. 2IOC Research Centre, South Africa, Cape Town, South Africa
  3. 3Department for Health, University of Bath, Bath, UK
  4. 4Rugby Football Union, London, UK
  5. 7Maties Sport, Stellenbosch University, Stellenbosch, South Africa


Background Of all injuries common to collision sports, concussions have received the most attention due to the potentially negative cognitive effects in the short- and long- term. Stellenbosch Rugby Football Club (‘Maties’), the official rugby club of Stellenbosch University, represents one of the world’s largest non-professional Rugby clubs, making this an ideal cohort for community level injury surveillance.

Objective To describe the incidence and events associated with concussion in this large non-professional homogenous cohort.

Design A one-season prospective cohort injury surveillance study.

Setting Students (young adults) athletes competing in the internal (‘Koshuis’) tournament of the Maties Rugby Club in 2018

Patients (or Participants) All 807 male players registered for the Koshuis tournament in 2018, which was comprised of 101 matches and 2,915 of exposure hours. The average age, height and weight of this cohort was 20±2 years, 182±7 cm and 88±14 kg, respectively.

Interventions (or Assessment of Risk Factors) Recording of all injuries, and factors associated with injury, according to the consensus statement for injury recording in rugby.

Main Outcome Measurements Overall, there were 89 time-loss injuries, which equated to an injury rate of 31 per 1000 match hours (95% confidence intervals [CIs]: 24–37), or about one injury per match. The most common injury diagnosis was ‘concussion’ (n=27 out of 90 injuries, 30%), at a rate of 9 per 1000 match hours (95% CIs: 6–12).

Results The three most common mechanisms of concussion in the present study were performing a tackle (33%), accidental collision (30%) and being tackled (11%).

Conclusions Concussion was the most common injury in this population, at a rate that was six times higher than a comparable cohort in the UK. Future studies should try to explain this higher rate and subsequently reduce these concussions.

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