Tackling concussion in professional rugby union: a case-control study of tackle-based risk factors and recommendations for primary prevention

Br J Sports Med. 2019 Aug;53(16):1021-1025. doi: 10.1136/bjsports-2017-097912. Epub 2017 Oct 11.


Background/aim: Concussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion.

Methods: 182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional rugby union competitions. A variable selection process was undertaken to identify the most important variables for interpretation. A multivariate generalised linear model was used to model the association between retained variables and concussion risk. Magnitude-based inferences provided an interpretation of the real-world relevance of the outcomes.

Results: The four retained variables were: accelerating player, tackler speed, head contact type and tackle type. Overall, 70% of concussions occurred to the tackler and 30% to the ball carrier. There was a higher risk of concussion if the tackler accelerated into the tackle (OR: 2.49, 95% CI 1.70 to 3.64) or the tackler was moving at high speed (OR: 2.64, 95% CI 1.92 to 3.63). Head contact with the opposing player's head (OR: 39.9, 95% CI 22.2 to 71.1) resulted in a substantially greater risk of concussion compared with all other head contact locations.

Conclusions: Interventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.

Keywords: concussion; prevention; risk factor; sporting injuries.

MeSH terms

  • Acceleration
  • Brain Concussion / physiopathology
  • Brain Concussion / prevention & control*
  • Case-Control Studies
  • Competitive Behavior / physiology
  • Football / injuries*
  • Head / physiology
  • Humans
  • Male
  • Primary Prevention*
  • Risk Factors
  • Task Performance and Analysis