Objective To examine differences in match and training musculoskeletal injury and concussion rates and describe mechanisms of concussion while considering previous playing experience in female and male Canadian high school Rugby Union (‘rugby’) players.
Methods A 2-year prospective cohort study was completed in a high school league (n=361 females, 421 player-seasons; n=429 males, 481 player-seasons) in Calgary, Canada over the 2018 and 2019 rugby playing seasons. Baseline testing was completed at the start of each season and injury surveillance and individual player participation through session attendance was documented to quantify individual-level player exposure hours. Injury incidence rates (IRs) and incidence rate ratios (IRRs) were calculated using Poisson regression, offset by player exposure hours and clustered by team.
Results Overall match IR for females was 62% higher than males (overall IRR=1.62, 95% CI: 1.20 to 2.18) and the overall training IR was twice as high for females (overall IRR=2.15, 95% CI: 1.40 to 3.32). The female match concussion IR was 70% higher than the males (concussion IRR=1.70, 95% CI: 1.08 to 2.69). Females had a 75% greater tackle-related IR compared with males (IRR=1.75, 95% CI: 1.20 to 2.56). Additionally, female tacklers had a twofold greater rate of injury compared with male tacklers (IRR=2.17, 95% CI: 1.14 to 4.14). Previous playing experience was not associated with tackle-related injury or concussion IRs.
Conclusion The rate of injury and concussion was significantly higher in females within this Canadian high school cohort. These results emphasise the need for development, implementation and evaluation of female-specific injury and concussion prevention strategies to reduce injury and concussion in female youth rugby.
- sporting injuries
Data availability statement
No data are available.
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Contributors KJS, BEH, PW, CE and AMB contributed to study proposal development. AMB led all components of data collection, cleaning and management. IJS, SWW, SS, KJS, PW and AMB contributed to data collection, entry and cleaning. IJS, SWW, BEH, CE and AMB contributed to data analysis and interpretation of study results. CE led acquisition of funding and study design and is the guarantor for this study. All authors critically reviewed the manuscript for submission.
Funding This work was supported by funds available from a Canadian Institute for Health Research Foundation Research Grant (C Emery PI: grant 375089). IJS was funded through the Hotchkiss Brain Institute and Joan Snyder. SWW holds a Canadian Institute of Health Research Postdoctoral Fellowship. CE holds a Canada Research Chair (Tier 1) in Concussion. SWW was funded through the O’Brien institute for Public Health and a Candian Institutes of Health Research Postdoctoral Fewllowship. Since completion of this study, CE, SWW and IJS have received funding from World Rugby.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.