Concussion in schools rugby: are we winning the battle?

Rugby union has been played since the early eighteen hundreds. Being a high contact sport, it has some of the highest announced rates of concussion. The term “concussion” refers to a common form of traumatic brain injury, which typically occurs after a blow or injury to the head. It has been described as a “complex pathophysiological process affecting the brain, induced by biomechanical factors”. Shear forces induced by rotational acceleration are believed to be the primary mechanism of injury in concussion. The incidence of concussion in the UK has been shown to be up to 6.9 (youth) and 4.9 (adult) concussions within rugby union. The tackle is the most injurious match event in Rugby Union, accounting for between 40% and 60% of all match injuries. Concussion is now seen as a public health epidemic, with clinicians seeing more occurrences, which is likely due to better symptom recognition rather than greater incidence. It has also been related to mental health difficulties and future development of neurological disorders and dementia. To establish both short- and long term effects of concussion within rugby, more focus must be placed on the development of multiple component assessments that cover a range of symptoms that may be present, following a concussion. A group of academics are urging the UK chief medical officers to ban tackling in school age rugby union amid growing worries about brain injuries in the sport. England former head coach Eddie Jones has proposed a ban on tackling above the waist for primary school children.

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