Background Understanding the mechanism of injury is necessary for the development of effective injury prevention strategies. Video analysis of injuries provides valuable information on the playing situation and athlete-movement patterns, which can be used to formulate these strategies. Therefore, we conducted a video analysis of the mechanism of concussion injury in junior-level rugby union and compared it with a representative and matched non-injury sample.
Methods Injury reports for 18 concussion events were collected from the 2011 to 2013 under-18 Craven Week tournaments. Also, video footage was recorded for all 3 years. On the basis of the injury events, a representative ‘control’ sample of matched non-injury events in the same players was identified. The video footage, which had been recorded at each tournament, was then retrospectively analysed and coded. 10 injury events (5 tackle, 4 ruck, 1 aerial collision) and 83 non-injury events were analysed.
Results All concussions were a result of contact with an opponent and 60% of players were unaware of the impending contact. For the measurement of head position on contact, 43% had a ‘down’ position, 29% the ‘up and forward’ and 29% the ‘away’ position (n=7). The speed of the injured tackler was observed as ‘slow’ in 60% of injurious tackles (n=5). In 3 of the 4 rucks in which injury occurred (75%), the concussed player was acting defensively either in the capacity of ‘support’ (n=2) or as the ‘jackal’ (n=1).
Conclusions Training interventions aimed at improving peripheral vision, strengthening of the cervical muscles, targeted conditioning programmes to reduce the effects of fatigue, and emphasising safe and effective playing techniques have the potential to reduce the risk of sustaining a concussion injury.
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Better understanding of concussion injury mechanisms in youth rugby union.
Injury prevention programmes may offer targeted training interventions to prevent concussion in youth rugby.
A video analysis method to describe and compare injury mechanisms of concussion to a representative non-injury sample.
A concussion is defined as “a complex pathophysiological process affecting the brain, induced by biomechanical forces”.1 On the basis of a meta-analysis of 29 papers, Gardner et al2 reported an overall incidence of match play concussion in men's rugby union of 4.7 concussions per 1000 player match hours (range 0.2–17.1). Considering the level of play, elite players have a rate of 0.40 concussions per 1000 player match hours (0.3–7.8), schoolboys 0.6 per 1000 player match hours (0.2–10.6), and community-level or subelite-level players 2.1 concussions per 1000 player match hours (1.2–6.9).2
Epidemiological studies serve to identify the extent of the problem and, in doing so, satisfy the first step in van Mechelen's ‘sequence of prevention’ model and the Translating Research into Injury Prevention Practice (TRIPP) model.3 ,4 In both injury prevention models, the second step is to establish the aetiology and the mechanisms of injury. A weakness of many sports injury studies is that the injury mechanisms have been insufficiently described to identify suitable injury prevention strategies.5 Furthermore, a multifactorial approach is required to account for all the factors involved, that is, the inciting event and also the global and local injury mechanisms.5 ,6
A systematic video analysis of injuries provides valuable information on the playing situation and athlete movement patterns, which can be used to formulate injury prevention strategies.7 Video analysis has been utilised in rugby union to study injury mechanisms in tackle contact situations